Diabetes-Related Extremity Amputation Depression and Distress (DREADD): A Multimethod Study.

Of the roughly 38 million people diagnosed with type 2 diabetes mellitus in the United States, up to 34% will develop a diabetic foot ulcer at some point, up to 75% of those who develop an ulcer will experience recurrent ulcers, and approximately 18% of patients with a diabetic foot ulcer will undergo lower-limb amputation. The aim of this study was to determine whether depressive symptoms change after a minor, nontraumatic amputation. We conducted a multimethod study consisting of semi-structured interviews (n = 12) and a retrospective cohort (n = 20) of patients with type 2 diabetes mellitus who underwent a nontraumatic, minor amputation of a single toe (partial or total) or partial ray resection.

Robot-assisted renal autotransplant for nutcracker syndrome following unsuccessful renocaval bypass.

The nutcracker phenomenon results from a rare anatomic abnormality where the left renal vein (LRV) is compressed by the aorta and superior mesenteric artery. Nutcracker syndrome (NCS) is defined by the constellation of symptoms that may develop, which includes haematuria, pelvic pain and venous congestion. We present a case of an otherwise healthy woman in her early 40s with NCS with a failed initial attempt at LRV to inferior vena cava bypass grafting, with subsequent successful treatment via robot-assisted left renal autotransplantation.

Effects of the COVID-19 Pandemic on New Physician Job Market Outcomes.

Objective: To evaluate the pandemic's impacts on new physician job market outcomes.

Design: We conducted a retrospective, repeated cross-sectional analysis using an interrupted time series approach on graduating residents and fellows from New York. We estimated linear probability models to examine binary outcomes and a generalized estimating equations model to analyze the base salary (measured in 2022 dollars).

How many doctors does a health system need? Histories of workforce planning in the NHS.

Health systems across the world are currently facing profound workforce shortages. This is, however, not a new phenomenon. Drawing on the case study of the British National Health Service (NHS), we explore how it has struggled to answer the fundamental question of how many doctors it needs with any accuracy or certainty.

Retrospective analysis of the effect of vaporous hyperoxia therapy as an adjunct to standard wound care in chronic wounds.

Background: Considering the rising incidence and cost associated with chronic wounds, further investigation of safe and effective treatments is needed.

Objective: To conduct a retrospective analysis of patients with chronic wounds in order to evaluate the healing effect of vaporous hyperoxia therapy (VHT) used adjunctively with standard wound care.

Materials And Methods: The data of patients with chronic wounds (≥4 weeks' duration) who received commercial treatment with VHT between February 28, 2020, and August 30, 2022, were reviewed.

Getting fit for hip and knee replacement: The Fit-Joints multimodal intervention for frail patients with osteoarthritis - a pilot randomized controlled trial.

Background: Older adults with frailty have high risk for poor postoperative outcomes.

Objective: To evaluate the feasibility of a multimodal prehabilitation program in older adults with frailty awaiting hip or knee replacement.

Design: Parallel two-arm randomized controlled pilot trial.

Current and Projected Future Supply and Demand for Physical Therapists From 2022 to 2037: A New Approach Using Microsimulation.

Importance: Projections of physical therapist supply and demand provide critical insights into workforce trends, including factors that may influence possible shortages.

Objective: This study evaluates the current and forecasted adequacy of the physical therapist workforce in the United States to meet the evolving health care needs of the population.

Design: This is a cross-sectional study that combines survey data, analysis of administrative databases, and microsimulation modeling.

Selectivity modulation and its prediction in cyclofructan-6 phase for chaotropic ions.

Background: Modifying additives to alter the selectivity of a single stationary phase and solvent system is appealing in mixed-mode separations. Silica-bonded cyclofructan-6 uniquely binds with cations strongly in the presence of organic solvents and is hydrolytically stable. Perchlorate with inorganic and organic quaternary ammonium cations could adjust retention for molecules with carboxylic acids, sulfonic acids, and nitrogen-containing functional groups, which are common in pharmaceutically relevant molecules.

Germline-Somatic Interactions in BRCA-Associated Cancers: Unique Molecular Profiles and Clinical Outcomes Linking ATM to TP53 Synthetic Essentiality.

Background: Germline alterations in homologous recombination repair (gHRR) genes impact the pathogenesis, treatment options, and survival of cancer patients. However, distinct gHRR gene alterations may differentially impact treatment response and oncogenic signaling. Here we interrogated genomic and transcriptomic data and assessed clinical outcomes of patients with gHRR mutations across four BRCA-associated cancers (breast, ovarian, pancreatic, and prostate cancers) to identify therapeutic vulnerabilities.

Actions and Interactions of Mirror-Image Cyclodextrins.

Cyclodextrins (CDs) were the first identified molecules and arguably the most consequential molecules in the areas of macrocyclic science and technology. As carbohydrates, their intrinsic architecture and chirality have played a fundamental role in their response to and effect on guest molecules. Indeed, the nature of inclusion complexation was formalized with CD-based hosts.

Cancer Susceptibility Gene Testing in Patients With Pancreatic Ductal Adenocarcinoma: Implementation in a Cancer Center Oncology Clinic.

Purpose: Current guidelines recommend offering genetic susceptibility testing to individuals with pancreatic cancer regardless of family history, but previous studies have reported only moderate test uptake, highlighting the need for efficient and accessible clinical pathways for delivering pretest genetic education and testing. We evaluated gene testing uptake offered at the point-of-oncology care by a nongenetics provider in an outpatient setting.

Methods: A retrospective chart review was performed of patients with pancreatic cancer treated at the Johns Hopkins Hospital between January 2021 and December 2023.

MAGE-A4 induces non-small cell lung cancer and tumor-promoting plasma cell accumulation.

Adaptive immunity is critical in eliminating tumors, but cancer-intrinsic factors can subvert this function. Melanoma antigen-A4 (MAGE-A4), a cancer-testis antigen, is expressed in solid tumors and correlates with poor survival, but its role in tumorigenesis and antitumor immunity remains unclear. We found that expression of MAGE-A4 was highly associated with the loss of , a tumor suppressor, in human non-small cell lung cancers (NSCLC).

The impact of cardiovascular risk factors on cancer progression: a prospective study in female breast cancer survivors.

Purpose: To examine the effect of selected cardiovascular disease (CVD) risk factors over time on early cancer outcomes in breast cancer (BC) survivors.

Methods: A prospective study was conducted among women aged 20-65 years with an incident invasive BC enrolled in the Breast and Ovarian Surveillance Service (BOSS) Cohort between 2005 and 2013. CVD risk based on selected risk factors was assessed at baseline and two follow-ups.

Update on safety and feasibility of the combination of pembrolizumab and pelvic chemoradiation in locally advanced cervical cancer.

Background: The addition of immune checkpoint inhibitors to standard-of-care chemoradiation (CRT) is established as the new standard of care in high-risk, locally advanced cervical cancer. However, the optimal sequencing of therapies is unknown. Defining safety and feasibility of the combination was a primary objective of this study examining concurrent versus sequential schedules.

Sustainable practice in gastroenterology: travel-related CO emissions for gastroenterology clinic appointments in Canada.

Background: Telemedicine is increasingly common in gastroenterology and may represent an opportunity for improving sustainability in medical care. The purpose of this study was to determine the carbon emissions related to travel for in-person gastroenterology clinic appointments.

Methods: We conducted a cross-sectional analysis evaluating carbon emissions associated with travel to gastroenterology appointments over a 2-week period.

Maternal diet quality and circulating extracellular vesicle and particle miRNA during pregnancy.

Purpose: During pregnancy, extracellular vesicle and particle microRNAs (EVP miRNA) in maternal circulation have the capacity to cross the placenta and facilitate maternal-fetal communication. Both dysregulation of circulating EVP miRNA during pregnancy and maternal diet quality have been previously associated with pregnancy complications and adverse birth outcomes. However, little is known about how maternal diet influences circulating EVP miRNA during pregnancy.

Comparing the Efficacy of a Unique Advanced Bioengineered Type-I Collagen-Based Skin Substitute Versus an Amnion Graft With Standard of Care in the Treatment of Non-healing Diabetic Foot Ulcers: A Randomized Clinical Trial.

The increased cost and morbidity associated with diabetic foot ulcers (DFUs) place a substantial strain on the entire global healthcare system. In this trial, 24 subjects with a chronic DFU, Wagner grade 1 (University of Texas grade 1A), were treated with Standard of Care (SOC) therapy and randomized, one-half to receive advanced high-purity Type-I collagen-based skin substitute (HPTC; manufactured by Encoll Corp., Fremont, CA, USA), and the other half to receive a dehydrated human amnion/chorion membrane (dHACM) or viable cryopreserved human placental membrane (vCHPM).

Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: ASCO Guideline Update.

Purpose: To provide updated guidance regarding neoadjuvant chemotherapy (NACT) and primary cytoreductive surgery (PCS) among patients with stage III-IV epithelial ovarian, fallopian tube, or primary peritoneal cancer (epithelial ovarian cancer [EOC]).

Methods: A multidisciplinary Expert Panel convened and updated the systematic review.

Results: Sixty-one studies form the evidence base.

Sialidase fusion protein protects against influenza infection in a cigarette smoke-induced model of COPD.

First- and secondhand smokers are at an increased risk for influenza virus (IFV)-related respiratory failure and death. Despite approved influenza antiviral treatments, there is an unmet need for treatments that can improve outcomes in populations at risk for respiratory failure, including tobacco users with Chronic Obstructive Pulmonary Disease (COPD). Here we show that the sialidase fusion protein, DAS181, reduced viral burden, mitigated inflammation, and attenuated lung function loss, consistent with broad-spectrum anti-influenza responses in a mouse model of COPD and IFV-A infection.

Health workforce issues and challenges in the post-pandemic era.

The health workforce is an essential component of our health care delivery system. A well-trained, sufficiently sized, and diverse workforce is critical to meet the health care needs of the population. However, in this postpandemic era, many challenges persist.

PET/CT guided tuberculosis treatment shortening: a randomized trial.

Six months of chemotherapy using current agents is standard of care for pulmonary, drug-sensitive tuberculosis (TB), even though some are believed to be cured more rapidly and others require longer therapy. Understanding what factors determine the length of treatment required for durable cure in individual patients would allow individualization of treatment durations, provide better clinical tools to determine the of appropriate duration of new regimens, as well as reduce the cost of large Phase III studies to determine the optimal combinations to use in TB control programs. We conducted a randomized clinical trial in South Africa and China that recruited 704 participants with newly diagnosed, drug-sensitive pulmonary tuberculosis and stratified them based on radiographic disease characteristics as assessed by FDG PET/CT scan readers.

Improved Diabetic Foot Ulcer Outcomes in Medicaid Beneficiaries with Podiatric Care Access.

Objectives: This study aims to examine the association between state Medicaid coverage of podiatry services and the outcomes of beneficiaries with new diabetic foot ulcers (DFUs).

Methods: Medicaid beneficiaries who developed a DFU between 2010 and 2015 were identified using the PearlDiver claims database. The states were categorized into covered states (CS) and non-covered states (NCS) based on podiatric coverage during the study period.