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/Objectives Alcohol and smoking cessation are recommended in chronic pancreatitis. The aim of this study is to measure the rates of alcohol and smoking cessation counselling among providers and adherence to recommendations.

Retrospective cohort study of chronic pancreatitis patients at a tertiary hospital. Provider types were defined as primary care (PCP), gastroenterologist, or pancreas specialist. Pairwise comparisons and multivariable analysis were conducted to assess the relation between provider type and smoking/alcohol cessation.

Of 256 patients with chronic pancreatitis, 142 (55.5%) consumed alcohol and 130 (91.5%) were advised to stop. Alcohol cessation was advised to 88.9, 96.0 and 92.5% of patients followed by PCP, gastroenterologists and pancreas specialists, respectively. Sixty-one patients (46.9%) were compliant with the recommendation 31.3, 44.0 and 54.1% of patients followed by PCP, gastroenterologists and pancreas specialists, respectively (Pairwise comparisons PCP vs Pancreas p=0.03, ot to adhere to alcohol cessation recommendation.

A variety of substance use-related topics are discussed in the public discourse; however, it is unknown how public discussion of published substance-related findings relates to manuscript downloads and citations. This manuscript examines how traditional and social media coverage of published findings about substance use affects downloads and scientific citations.

Altmetric and bibliographic information was obtained for manuscripts published in Drug and Alcohol Dependence between 2018 and 2019 (n = 943). Associations were examined between news and social media coverage (i.e., Twitter, Facebook) in relation to number of manuscript downloads and number of citations. This was done in a bivariable manner and in a multivariable manner examining correlates of being in the top 10

percentile of downloads and citations.

73.3 % of articles were shared on Twitter, 23.6 % were shared on Facebook, and 13.9 % were covered in news sources (with 4.0 % receiving major media coverage). Epidemiology papers were among the most covered in the news, and e-cigarette review papers were among the most downloaded. News and social media coverage were positively associated with number of downloads and citations in bivariable models and with achieving the top 10 % of downloads and citations in multivariable models (ps < .001). Publishing a press release was associated with higher likelihood of receiving additional news coverage (aPR = 7.85, 95 % CI 5.15-11.97).

Traditional and social media coverage of manuscripts focusing on substance use are associated with more downloads and citations. Researchers should consider sharing findings not only to increase downloads and citations but also to educate the general public.

Traditional and social media coverage of manuscripts focusing on substance use are associated with more downloads and citations. Researchers should consider sharing findings not only to increase downloads and citations but also to educate the general public.

Parents of children with autism spectrum disorder (ASD) experience higher levels of stress and impaired life satisfaction as a result of their children's behavior. The well-acknowledged protective role of social support against stress has not been studied in detail with regard to parents of children with ASD in the Kingdom of Saudi Arabia (KSA). Therefore, the purpose of this study is to assess the impact of social support as a mediator and/or a moderator between parental stress and life satisfaction among parents of children with ASD in KSA.

A cross-sectional survey was conducted among centers that care for children with autism in KSA. The survey encompassed four dimensions demographic data, family stress and coping, parenting life satisfaction, and perceived social support. Multiple linear regression analyses were conducted to assess the moderating and/or mediating effect of social support.

The analysis of 131 parents indicated that perceived family and parental stress was associated with life satisfaction levels, and this relationship was approximately 0.19 points lower when mediated by social support (β=-0.19, 95% CI [-0.34, -0.05], p=.02). Social support moderated the relationship between family stress and life satisfaction, which was significant at low (p=.002) and average levels of stress (p=.017) but not at high levels of stress.

Social support is protective for parents of children with ASD.

Social support, including the use of social media groups, should be considered in supporting stressed parents of children with ASD. Therefore, the protective role of social support should be highlighted to healthcare professionals.

Social support, including the use of social media groups, should be considered in supporting stressed parents of children with ASD. Therefore, the protective role of social support should be highlighted to healthcare professionals.

Nivolumab, a programmed death 1 inhibitor, has been approved as second-line treatment for advanced renal cell carcinoma (RCC) in Europe since 2016. We investigated the toxicity and efficacy of nivolumab as well as potential predictive biomarkers in the Dutch population.

This was a retrospective, multicenter study of the Dutch national registry of nivolumab for the treatment of advanced RCC. The main outcome parameters included toxicity, objective response rate (ORR), overall survival (OS), progression-free survival (PFS), time to progression (TTP), and time to treatment failure (TTF). In addition, potential predictive and prognostic biomarkers for outcomes were evaluated.

Data on 264 patients were available, of whom 42% were International Metastatic RCC Database Consortium (IMDC) poor risk at start of nivolumab, 16% had≥ 3 lines of previous therapy, 7% had non-clear-cell RCC, 11% had brain metastases, and 20% were previously treated with everolimus. Grade 3/4 immune-related adverse events occurred in 15parable with the results in the pivotal phase III trial and other real-world data. On-treatment increase in eosinophil count is a potential biomarker for efficacy and warrants further investigation.

Bladder exstrophy patients have a high prevalence of inguinal hernia that often become clinically evident following bladder closure. Understanding when the bladder exstrophy patient is under greatest risk of developing an inguinal hernia following bladder closure is important, since incarceration resulting in strangulation of intra-abdominal contents can lead to significant morbidity if not addressed in a timely fashion. Although the incidence and risk factors of inguinal hernia have been reported, the timing of occurrence is not well understood.

The primary objective of this study was to assess the timing of inguinal hernia following complete primary repair of bladder exstrophy (CPRE). In addition, we aimed to evaluate possible risk factors associated with inguinal hernia, including sex, age at bladder closure and iliac osteotomy status.

A multi-institutional retrospective review identified patients with bladder exstrophy repaired by CPRE under 6 months of age while excluding those who underwent inguinhernia is within the first six months following bladder closure. The decreased risk of inguinal hernia after one year of follow-up may reflect anatomic stability that is reached following major reconstruction of the pelvis. While male bladder exstrophy patients are significantly more susceptible to inguinal hernias following CPRE, osteotomy and delayed bladder closure do not appear to be protective factors for inguinal hernia development following initial bladder closure.

There is a heightened risk of inguinal hernia in the first six months following closure. The rate of recurrence following inguinal hernia repair is significantly elevated compared to the general pediatric population.

There is a heightened risk of inguinal hernia in the first six months following closure. The rate of recurrence following inguinal hernia repair is significantly elevated compared to the general pediatric population.

For the Y-subtype of urethral duplications expression and nomenclature vary, as treatment recommendations do.

To raise awareness of the variety and variable terminology of Y-type duplication of the urethra, and to discuss the diagnostic work-up in light of options for or against surgical reconstruction.

Five patients with congenital Y-urethra were treated in four institutions within 15 years (2004-2019). While patients were managed in our respective institution with some exchange of experience, all available data were shared and evaluated for this review.

The age at initial presentation was 1 day-6 months. In three patients the Y-urethra was found together with an anorectal malformation (ARM). With the focus on reconstruction rather than suprapubic diversion the orthotopic urethra was restored in the majority of patients using either single-step or staged approaches while the accessory urethral limb was incorporated. This was successful despite additional procedures aiming at ARM reconstruction. The p are lacking.

Acute scrotal pain is a common problem in children. Amongst the various causes, only testicular torsion (TT) needs urgent, and arguably any, surgical intervention. However TT accounts for only approximately 25% of cases. The diagnosis of TT is currently based mainly on history and clinical examination in the UK.

We sought to find the incidence of finding TT during emergency scrotal exploration in four paediatric surgical centres in the UK. We also assessed the preoperative utilisation of clinical risk scores and Doppler ultrasound (DUS) to aid in the diagnosis.

A retrospective review of 50 consecutive scrotal explorations done for acute scrotal pain at four tertiary pediatric surgical centres in 2019, including the preoperative utilisation of DUS, was analysed. Additionally an online survey was also sent out to consultant members of the British Association of Paediatric Urology to gauge their threshold for exploration, use of preoperative investigations and incidence of finding TT in their practice.

I preoperative utilisation of clinical risk scores and Doppler ultrasound, which if utilised, could improve diagnostic accuracy.Growth differentiation factor-15 (GDF-15) is cytokine involved in the regulation of multiple systems. Because it has regularly been shown to be increased in cardiovascular disease (CVD) and diabetes, it has been suggested that GDF-15 could be used as a biomarker for these diseases and their severity. However, several studies have demonstrated that GDF-15 has a protective role in regulation of inflammation, endothelial cell function, insulin sensitivity, weight gain, and is cardioprotective in myocardial infarction (MI). While GDF-15 has been implicated in the pathophysiology of many conditions including cancer, this review focuses on the potential functions of GDF-15 and signaling pathways implicated in its role regulating metabolism, insulin sensitivity, and the cardiovascular system.

There is a need for the development of brief tools to screen for cognitive impairments in epilepsy patients in order to prioritize and direct formal comprehensive cognitive testing. Yet, shorter cognitive screening tools are limited in their breadth of cognitive domains or have not been intensively studied on an epilepsy population. This study used a brief cognitive screening tool in order to compare cognitive profiles between patients with epilepsy and those with nonepileptic seizures.

Patients admitted to the Royal Melbourne Hospital video-EEG monitoring unit between 2005 and 2017 were included. Patients were categorized according to seizure etiology (epileptic, psychogenic or other nonepileptic seizures), epilepsy syndrome (focal or generalized; temporal lobe (TLE) or extra-temporal lobe epilepsy (ETLE)), seizure frequency, and anti-seizure medications (ASMs). Attention, visuoconstructional, memory, executive, and language functioning were assessed with the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG).