One poison center's experience with "snake" firework ingestions.

Introduction: "Snake" fireworks are a type of pyrotechnic device that, when ignited, burn and transform into a friable, snake-like structure. The inclusion of barium salts produces a green flame. Ingestion of these fireworks poses a risk of barium toxicity, which may result in hypokalemia, weakness, dysrhythmias, and respiratory distress.

Parent-identified intrinsic and extrinsic factors that influence performance across developmental domains and participation in their communities.

Children with neurodevelopmental disabilities living in rural and low-resourced regions within the United States, such as Appalachia, face gaps and barriers to accessing healthcare services due to a shortage of providers, specialists, hospitals, and clinics. Without access to specialized medical and rehabilitation services, their performance across developmental domains and participation within their communities is likely suboptimal. The purpose of this study was to identify both intrinsic and extrinsic factors using a mixed-methods approach to better understand factors that may impact performance across developmental domains and participation for children with disabilities living in Appalachia.

Use of large language models as clinical decision support tools for management pancreatic adenocarcinoma using National Comprehensive Cancer Network guidelines.

Background: Large language models may form the basis of clinical decision support tools to improve rates of guideline concordant care for pancreatic ductal adenocarcinoma. The objectives of this study were to 1) define the first-pass accuracy of 2 publicly available large language models in responding to prompts on the basis of National Comprehensive Cancer Network guidelines for pancreatic ductal adenocarcinoma, 2) describe consistency of responses within each large language models, and 3) explore differences between the 2 large language models in their accuracy and verbosity.

Methods: Clinical scenarios were developed on the basis of current National Comprehensive Cancer Network guidelines.

Impact of Primary Care Team Configuration on Access and Quality of Care.

Background: Team-based primary care has become the norm within many large healthcare systems; however, limited guidance exists on how to optimally staff primary care teams in relationship to healthcare.

Objective: This paper examines the associations between variations in team staffing configurations on primary care access and clinical quality.

Design: Observational study linking national Veterans Health Administration (VHA) data from February 2020 on primary care team staffing configurations to data on access to and quality of care the teams delivered.