Outliers of Total Shoulder Arthroplasty in the Bundled Payment Era.

Background: The Centers for Medicare & Medicaid Services (CMS) implemented the Bundled Payments for Care Improvement Advanced (BPCIA) Model that covers 90-day care episodes after select orthopedic procedures including anatomic or reverse ball-and-socket total shoulder arthroplasty (TSA/rTSA). This study investigated whether patients undergoing TSA/rTSA for non-degenerative processes incur higher costs than patients undergoing arthroplasty for degenerative processes.

Methods: A retrospective review was conducted of all patients at a single academic medical center enrolled in the BPCIA model for TSA/rTSA from October 1, 2018, through December 31, 2022.

Billing for Exercise Is Medicine: An Analysis of Reimbursement Trends for Physical Activity-Related Billing Codes.

Background: Physical inactivity is a significant health risk factor linked to chronic diseases and premature death. To address this, initiatives like Exercise is Medicine® aim to promote physical activity in health care systems. However, integrating physical activity counseling into clinical practice faces barriers such as limited reimbursement.

Weight loss with atogepant during the preventive treatment of migraine: A pooled analysis.

Background: Migraine is associated with obesity. These analyses evaluated weight change with atogepant used as a preventive migraine treatment.

Methods: Five atogepant clinical trials in adults with migraine (one phase 2b/3; four phase 3) were included: Three 12-week, randomized, placebo-controlled trials (episodic migraine: two; chronic migraine: one); one 40-week, open-label extension trial and one 52-week, standard care, randomized, long-term safety trial in episodic migraine.

Atherosclerotic cardiovascular disease risk based on SCORE algorithms and reclassification based on preclinical atherosclerotic plaques.

Background: The aim of this study was to determine the efficacy of the number of carotid and common femoral bifurcations with plaque (NBP) detected by ultrasound in reclassifying atherosclerotic cardiovascular disease (ASCVD) risk obtained from SCORE algorithms. Data from the cohort of 1000 individuals free from ASCVD in the Cyprus Epidemiological Study on Atherosclerosis was used.

Methods: In each predicted ASCVD risk class (low, moderate, high) based on SCORE algorithms and baseline data, the observed 10-year risk of subgroups according to the NBP was used to reclassify participants.

IVC filter use in patients with a history of venous thromboembolism undergoing bariatric surgery: a MBSAQIP study.

Background: Research on the use of prophylactic inferior vena cave filter (IVCF) placement prior to metabolic and bariatric surgery (MBS) in high risk patients has yielded conflicting results. We evaluated thrombotic events and mortality in patients with a history of venous thromboembolism (VTE) who underwent IVCF placement in anticipation of MBS.

Methods: We queried the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database for all patients undergoing primary sleeve gastrectomy or Roux-en-Y gastric bypass from 2015 to 2019 with a history of VTE.

Early changes in the gut microbiota are associated with weight outcomes over 2 years following metabolic and bariatric surgery.

Objective: Metabolic and bariatric surgery (MBS) is associated with substantial, but variable, weight outcomes. The gut microbiome may be a factor in determining weight trajectory, but examination has been limited by a lack of longitudinal studies with robust microbiome sequencing. This study aimed to describe changes in the microbiome and associations with weight outcomes more than 2 years post surgery.

Associations of weather and air pollution with objective physical activity and sedentary time before and after bariatric surgery: a secondary analysis of a prospective cohort study.

Purpose: Identifying factors that influence moderate-to-vigorous intensity physical activity (MVPA) and sedentary time in metabolic and bariatric surgery (MBS) patients is necessary to inform the development of interventions. Weather/environmental factors may be especially important considering rapid climate change and the vulnerability of people with obesity to heat and pollution. Our study aimed to examine the associations of weather (maximal, average and Wet Bulb Globe Temperatures), and air pollution indices (air quality index [AQI]) with daily physical activity (PA) of both light (LPA) and MVPA and sedentary time before and after MBS.

Association of preoperative frailty with suboptimal weight loss response among patients undergoing metabolic and bariatric surgery.

Background: Preoperative patient frailty (i.e., aging-related functional decline across multiple physiological systems) has been linked to greater perioperative complications following metabolic bariatric surgery (MBS).

Mega El Niño instigated the end-Permian mass extinction.

The ultimate driver of the end-Permian mass extinction is a topic of much debate. Here, we used a multiproxy and paleoclimate modeling approach to establish a unifying theory elucidating the heightened susceptibility of the Pangean world to the prolonged and intensified El Niño events leading to an extinction state. As atmospheric partial pressure of carbon dioxide doubled from about 410 to about 860 ppm (parts per million) in the latest Permian, the meridional overturning circulation collapsed, the Hadley cell contracted, and El Niños intensified.

Risk factors and recurrence of hyperemesis gravidarum: A population-based record linkage cohort study.

Introduction: There are limited contemporary population-based studies on the risk factors for hyperemesis gravidarum (HG), a severe type of nausea and vomiting in pregnancy. This study aimed to determine the prevalence and trend of HG over time, identify risk factors for any and multiple HG health service visits during pregnancy, and investigate HG recurrence across pregnancies.

Material And Methods: This population-based record linkage cohort study featured births in New South Wales, Australia from 2010 to 2019.

Examining the bidirectional longitudinal associations between body mass index and episodic memory following bariatric surgery.

Background: The relationship between obesity and episodic memory (i.e., conscious memory for specific events) is hypothesized to be bidirectional.

Disordered eating behavior and dietary intake prior to metabolic and bariatric surgery.

Background: Disordered eating is a concern for patients seeking metabolic and bariatric surgery (MBS), but little is known about how these behaviors are reflected in typical dietary intake prior to surgery.

Objectives: This study examined the relationships between disordered eating behavior and the content and context of typical dietary intake among patients seeking MBS using an innovative combination of rigorous self-report and interview assessments.

Setting: Participants were recruited from two academic medical centers in the United States.

Coat colour in marsupials: genetic variants at the locus determine grey and black fur of the brushtail possum.

The possession of fur or hair is a defining characteristic of mammals and can occur in a variety of colours and patterns. While genetic determinants of coat colour are well described in eutherian 'placental' mammals, the other major mammalian infraclass, marsupials, is grossly understudied. The fur of the common brushtail possum (), an iconic native mammal found throughout Australia and introduced into Aotearoa New Zealand, possesses two main colour morphs: grey and black.

A novel technology for harmonizing and analyzing cancer data. Observations from integrating health connect in Newfoundland and Labrador, Canada.

This article aims to describe the implementation of a new health information technology system called Health Connect that is harmonizing cancer data in the Canadian province of Newfoundland and Labrador; explain high-level technical details of this technology; provide concrete examples of how this technology is helping to improve cancer care in the province, and to discuss its future expansion and implications. We give a technical description of the Health Connect architecture, how it integrated numerous data sources into a single, scalable health information system for cancer data and highlight its artificial intelligence and analytics capacity. We illustrated two practical achievements of Health Connect.

Isolation and genomic analysis of " MK1, a Gram-positive, Fe(III)-reducing bacterium from the Soudan Underground Mine, an iron-rich Martian analog site.

The Soudan Underground Mine State Park, found in the Vermilion Iron Range in northern Minnesota, provides access to a ~ 2.7 billion-year-old banded iron formation. Exploratory boreholes drilled between 1958 and 1962 on the 27th level (713 m underground) of the mine intersect calcium and iron-rich brines that have recently been subject to metagenomic analysis and microbial enrichments.

Characterization of early non-responders within behavioral weight loss treatment.

Objective: Given that low early (4 weeks) weight loss (WL) predicts longer-term WL, the purpose of this study was to identify factors associated with poor early WL.

Methods: 438 adults with overweight/obesity participating in an Internet-delivered behavioral WL program provided weights at baseline and 4 weeks. Participants were stratified by percent WL at 4 weeks: LOW: <2% WL, MEDIUM: 2 to <4% WL, HIGH: ≥4% WL and groups were compared on baseline variables (demographics, physical activity, and psychosocial measures) and 4-week intervention adherence.

An Adaptive Telephone Coaching Intervention for Patients in an Online Weight Loss Program: A Randomized Clinical Trial.

Importance: Weight loss (WL) during the first month of a behavioral program is associated with longer-term WL. Testing of translatable and adaptive obesity programs is needed.

Objective: To compare brief, extended, and no telephone coaching for individuals with suboptimal response (ie, 1-month WL <4%) within an online WL program.

Prognostic relevance of circulating lymphoma cells at diagnosis in newly diagnosed follicular lymphoma patients.

Follicular lymphoma (FL) is the most common indolent B-cell non-Hodgkin lymphoma. Circulating lymphoma (CL) cells can be seen at diagnosis in some FL patients, however, previous studies evaluating this have shown mixed results. Therefore, we sought to evaluate the impact of CL at diagnosis on outcomes in patients with newly diagnosed FL using data from a single center.

Brentuximab Vedotin Plus Ibrutinib in Relapsed and Refractory Hodgkin Lymphoma.

Introduction: Brentuximab vedotin (BV) is an antibody-drug conjugate that delivers monomethyl auristatin E (MMAE) to CD30+ cells and is safe and effective in relapsed/refractory (r/r) Hodgkin lymphoma (HL). Although most patients respond to BV, only a minority will obtain a complete response (CR), and almost all patients eventually progress. Ibrutinib is a Bruton's tyrosine kinase (BTK) inhibitor highly active in multiple subtypes of non-Hodgkin lymphoma; limited data exist regarding its use in HL.

Multimodal approach utilising a weight management programme prior to bariatric surgery in patients with BMI ≥50 kg/m: A propensity score matching retrospective cohort study.

We evaluated preoperative weight loss and days from initial consult to surgery in patients with BMI ≥50 kg/m who were and were not enrolled in medical weight management (MWM) prior to laparoscopic sleeve gastrectomy. We retrospectively identified patients with BMI ≥50 kg/m who had primary sleeve gastrectomy between 2014 and 2019 at two bariatric surgery centres in our healthcare system. Patients presenting after 2017 that received preoperative MWM (n = 28) were compared to a historical cohort of non-MWM patients (n = 118) presenting prior to programme initiation in 2017 on preoperative percent total body weight loss (%TBWL) and days from initial consult to surgery.

Combining 5-azacitidine with the E-selectin antagonist uproleselan is an effective strategy to augment responses in myelodysplasia and acute myeloid leukaemia.

The interaction of acute myeloid leukaemic (AML) blasts with the bone marrow (BM) microenvironment is a major determinant governing disease progression and resistance to treatment. The constitutive expression of E-selectin in the vascular compartment of BM, a key endothelial cell factor, directly mediates chemoresistance via E-selectin ligand/receptors. Despite the success of hypomethylating agent (HMA)-containing regimens to induce remissions in older AML patients, the development of primary or secondary resistance is common.