Lung cancer recovery focus post pandemic: an income-deprived area paradigm.

'Stage shift' has been proposed as a marker of impact of Coronavirus 2019 (COVID-19) in lung cancer services; however, there are no data available specifically from income-deprived areas. Thus, this study evaluated the impact of the COVID-19 pandemic on lung cancer care in our area (Corby; among the most income deprived in England) and identified focus recovery areas. The study was a retrospective observational study of 668 consecutive patients with lung cancer at a district general hospital, pre-, during and after the COVID peak. Outcomes were the overall number of cases, presenting staging and treatment pathway. Overall, 32 fewer patients were diagnosed during the pandemic, with more inpatient diagnoses (p=0.01) and fewer primary care referrals (p<0.0001). There were no differences observed in treatment intent or 'stage shift'. Our results suggest that COVID-19 negatively affected the whole lung cancer pathway in our area. However, 'stage shift' might not be ideal to assess the impact of COVID-19 in income-deprived areas. Further studies will help the strategic rollout of a screening programme to identify patients with lung cancer earlier on in such areas.

Determinants of Transgender Individuals' Well-Being, Mental Health, and Suicidality in a Rural State.

This project utilized a Community-Based Participatory Research (CBPR) approach to conduct qualitative interviews with 30 transgender adults living in a rural state. Participants' identities spanned from trans women and men to non-binary and Two-Spirit. The aim of this study was to better understand the experiences, needs, and priorities of the participants as well as to examine possible determinants of mental health, well-being, and suicidality for transgender individuals in Montana. These factors were investigated at individual, interpersonal, community, and societal levels using an ecological framework. Qualitative results indicate that participants experienced discrimination at all levels. Participants noted that discrimination contributed to mental health challenges and limited access to adequate general and transgender-specific healthcare services, both of which impacted overall well-being. This is reflected most notably in the elevated rate of past suicidal ideation attempts among the sample. Participants reported that the ability to transition, as well as other protective factors, played a role in reducing suicidality and improving mental and physical health. Our findings highlight the need to address transgender mental health through implementing changes at multiple ecological levels.

Successful treatment of infertility in a female Sumatran orangutan Pongo abelii.

In 2011, a female Sumatran orangutan housed at Durrell Wildlife Conservation Trust became infertile following a massive antepartum hemorrhage in labor and the delivery of a stillborn infant. The placenta was infected with Pantoea sp. Hysterosalpingography (HSG) revealed blocked fallopian tubes, and pressurized fallopian tube perfusion was used to reverse the tubal occlusion. She subsequently conceived and following an intensive training program, we were able to measure umbilical artery waveform analysis for fetal well-being and placental localization to exclude placenta previa, which could complicate pregnancy and lead to catastrophic hemorrhage. The female went on to deliver a healthy offspring. We suggest that these techniques should be considered for other infertile females in the global captive population.