Patterns of initial treatment and subsequent care escalation among medicare beneficiaries with neck pain: a retrospective cohort study.

Purpose: To compare long-term care escalation encounters among three care patterns for new episodes of neck pain among Medicare beneficiaries.

Methods: We examined Medicare claims spanning a four-year period for beneficiaries with new episodes of neck pain beginning in 2019. All patients were continuously enrolled under Medicare parts A, B, and D and aged 65-99 years.

Reliably measuring learning-dependent distractor suppression with eye tracking.

In the field of psychological science, behavioral performance in computer-based cognitive tasks often exhibits poor reliability. The absence of reliable measures of cognitive processes contributes to non-reproducibility in the field and impedes the investigation of individual differences. Specifically in visual search paradigms, response time-based measures have shown poor test-retest reliability and internal consistency across attention capture and distractor suppression, but one study has demonstrated the potential for oculomotor measures to exhibit superior reliability.

Accelerating evidence generation: Addressing critical challenges and charting a path forward.

Efficient evidence generation to assess the clinical and economic impact of medical therapies is critical amid rising healthcare costs and aging populations. However, drug development and clinical trials remain far too expensive and inefficient for all stakeholders. On October 25-26, 2023, the Duke Clinical Research Institute brought together leaders from academia, industry, government agencies, patient advocacy, and nonprofit organizations to explore how different entities and influencers in drug development and healthcare can realign incentive structures to efficiently accelerate evidence generation that addresses the highest public health needs.

Remotely extinguishing flames through transient acoustic streaming using time reversal focusing of sound.

Acoustic waves are a possible reusable method to extinguish flames. Previous studies have placed the sound source near the flame or have used standing waves to reach large enough acoustic amplitudes to extinguish it. In this study, a new method is explored: using time reversal in a room to focus transient acoustic waves to the flame to extinguish it.

Implementation of the California End of Life Option Act at UCSF: Examining the Utility of the Mandatory Mental Health Assessment in Medical Aid in Dying.

Background: The End of Life Option Act (EOLOA) legalized medical aid in dying (MAID) in California in 2015. University of California, San Francisco Health initially implemented a policy requiring a mandatory mental health assessment of all patients seeking MAID, though this was not required by the EOLOA. State-level statistics on EOLOA are available, but less is known about outcomes at individual institutions and how institutional policy affects outcomes for patients seeking MAID.

Rapid in vivo EPID image prediction using a combination of analytically calculated attenuation and AI predicted scatter.

Background: The electronic portal imaging device (EPID) can be used in vivo, to detect on-treatment errors by evaluating radiation exiting a patient. To detect deviations from the planning intent, image predictions need to be modeled based on the patient's anatomy and plan information. To date in vivo transit images have been predicted using Monte Carlo (MC) algorithms.

Statistically learned associations among objects bias attention.

A growing body of research suggests that semantic relationships among objects can influence the control of attention. There is also some evidence that learned associations among objects can bias attention. However, it is unclear whether these findings are due to statistical learning or existing semantic relationships.

Relating distractor suppression to problematic drinking behavior.

Background: Impaired cognitive control has been linked to weakened self-regulatory processes underlying compulsive substance intake. Previous research has provided evidence for impaired task performance in substance-abusing groups during Stroop and Go/No-Go tasks. Mechanisms of distractor suppression in visual search might also involve overlapping regulatory components that support goal-directed behavior by resolving the attentional competition between distractors and the target of search.

Protocol to evaluate the effectiveness of a virtual-reality-based behavioral intervention in enhancing sensory responses to real-world warning.

Habituation to signals that warn of a potential danger in high-risk work environments is a critical causal factor of workplace accidents. Such habituation is hard to measure in a real-world setting, and no existing intervention can effectively curb it. Here, we present a protocol to enhance workers' sensory responses to frequently encountered warnings at workplaces using a virtual-reality-based behavioral intervention.

Psilocybin-assisted therapy and HIV-related shame.

As a proposed mediator between stigma-related stressors and negative mental health outcomes, HIV-related shame has been predictive of increased rates of substance use and difficulties adhering to antiretroviral treatment among people with HIV. These downstream manifestations have ultimately impeded progress toward national goals to End the HIV Epidemic, in part due to limited success of conventional psychotherapies in addressing HIV-related shame. In a pilot clinical trial (N = 12), receipt of psilocybin-assisted group therapy was associated with a large pre-post decrease in HIV-related shame as measured by the HIV and Abuse Related Shame Inventory, with a median (IQR) change of - 5.

Absorption pharmacokinetics and feasibility of intranasal dexmedetomidine in patients under general anaesthesia.

Background: The use of intranasal dexmedetomidine is hampered by a limited understanding of its absorption pharmacokinetics.

Methods: We examined the pharmacokinetics and feasibility of intranasal dexmedetomidine administered in the supine position to adult patients undergoing general anaesthesia. Twenty-eight patients between 35 and 80 years of age, ASA 1-3 and weight between 50 and 100 kg, who underwent elective unilateral total hip or knee arthroplasty under general anaesthesia were recruited.

An examination of the motivation to manage distraction.

Individuals exhibit limited awareness of when their attention is captured by salient but irrelevant stimuli, and it has long been argued that involuntary attentional capture by such stimuli is minimally disruptive to information processing. Yet, robust mechanisms of distractor suppression are hypothesized to support the control of attention, which presumably serve in the interest of managing distraction. In the present study, I examine whether participants are aware of the cost of distraction with respect to task performance, and whether they are motivated to manage this cost even when it is effortful to do so.

A pharmacokinetic framework describing antibiotic adsorption to cardiopulmonary bypass devices.

Cardiopulmonary bypass (CPB) can alter pharmacokinetic (PK) parameters and the drug may adsorb to the CPB device, altering exposure. Cefazolin is a beta-lactam antibiotic used for antimicrobial prophylaxis during cardiac surgery supported by CPB. Adsorption of cefazolin could result in therapeutic failure.

Framework of the strengths and challenges of clinically integrated trials: An expert panel report.

The limitations of the explanatory clinical trial framework include the high expense of implementing explanatory trials, restrictive entry criteria for participants, and redundant logistical processes. These limitations can result in slow evidence generation that is not responsive to population health needs, yielding evidence that is not generalizable. Clinically integrated trials, which integrate clinical research into routine care, represent a potential solution to this challenge and an opportunity to support learning health systems.

Restricting angles of incidence to improve super resolution in time reversal focusing that uses metamaterial properties of a resonator array.

Focusing waves with a spatial extent smaller than a half wavelength (i.e., super resolution or sub diffraction limit) is possible using resonators placed in the near field of time reversal (TR) focusing.

Perceptions on and roadblocks to implementation of standardized nomenclature in radiation oncology: A survey from TG-263U1.

Purpose: AAPM Task Group No. 263U1 (Update to Report No. 263 - Standardizing Nomenclatures in Radiation Oncology) disseminated a survey to receive feedback on utilization, gaps, and means to facilitate further adoption.

Pediatric anesthesia in Australia and New Zealand and health inequity among First Nations and Māori children.

Australia and New Zealand are two countries in the Southern Pacific region. They share many pediatric anesthesia similarities in terms of medical organizational systems, education, training, and research, however there are important differences between the two nations in relation to geography, the First Nations populations and the history of colonization. While the standards for pediatric anesthesia and the specialty training requirements are set by the Australian and New Zealand College of Anesthetists and the Society for Pediatric Anesthesia in New Zealand and Australia, colonization has created distinct challenges that each nation now faces in order to improve the anesthetic care of its pediatric population.