Evaluating Provider Perceptions of Telehealth Utility in Outpatient Rheumatology Telehealth Encounters.

Objective: This study aims to explore the factors associated with rheumatology providers' perceptions of telehealth utility in real-world telehealth encounters.

Methods: From September 14, 2020 to January 31, 2021, 6 providers at an academic medical center rated their telehealth visits according to perceived utility in making treatment decisions using the following Telehealth Utility Score (TUS) (1 = very low utility to 5 = very high utility). Modified Poisson regression models were used to assess the association between TUS scores and encounter diagnoses, disease activity measures, and immunomodulatory therapy changes during the encounter.

Encounter Appropriateness Score for You Model: Development and Pilot Implementation of a Predictive Model to Identify Visits Appropriate for Telehealth in Rheumatology.

Objective: We aimed to develop a decision-making tool to predict telehealth appropriateness for future rheumatology visits and expand telehealth care access.

Methods: The model was developed using the Encounter Appropriateness Score for You (EASY) and electronic health record data at a single academic rheumatology practice from January 1, 2021, to December 31, 2021. The EASY model is a logistic regression model that includes encounter characteristics, patient sociodemographic and clinical characteristics, and provider characteristics.

Serum Metabolites Are Associated With HFpEF in Biopsy-Proven Nonalcoholic Fatty Liver Disease.

Background Nonalcoholic fatty liver disease (NAFLD) and heart failure with preserved ejection fraction (HFpEF) share common risk factors, including obesity and diabetes. They are also thought to be mechanistically linked. The aim of this study was to define serum metabolites associated with HFpEF in a cohort of patients with biopsy-proven NAFLD to identify common mechanisms.

Telehealth Made EASY: Understanding Provider Perceptions of Telehealth Appropriateness in Outpatient Rheumatology Encounters.

Objective: The purpose of this study was to evaluate a novel scoring system, the Encounter Appropriateness Score for You (EASY), to assess provider perceptions of telehealth appropriateness in rheumatology encounters.

Methods: The EASY scoring system prompts providers to rate their own encounters as follows: in-person or telehealth acceptable, EASY = 1; in-person preferred, EASY = 2; or telehealth preferred, EASY = 3. Assessment of the EASY scoring system occurred at a single academic institution from January 1, 2021, to August 31, 2021.

Rate of and Factors Associated with Palliative Care Referral among Patients Declined for Liver Transplantation.

End-stage liver disease (ESLD) is associated with high morbidity and mortality, with liver transplantation as the only existing cure. Despite reduced quality of life and limited life expectancy, referral to palliative care (PC) rarely occurs. Moreover, there is scarcity of data on the appropriate timing and type of PC intervention needed.

Association of Health Literacy and Numeracy With Lupus Knowledge and the Creation of the Lupus Knowledge Assessment Test.

Objective: Limited health literacy and numeracy are associated with worse patient-reported outcomes and higher disease activity in systemic lupus erythematosus (SLE), but which factors may mediate this association is unknown. We sought to determine the association of health literacy and numeracy with SLE knowledge.

Methods: Patients with SLE were recruited from an academic center clinic.

Serum Bile Acid, Vitamin E, and Serotonin Metabolites Are Associated With Future Liver-Related Events in Nonalcoholic Fatty Liver Disease.

Identifying patients at higher risk for poor outcomes from nonalcoholic fatty liver disease (NAFLD) remains challenging. Metabolomics, the comprehensive measurement of small molecules in biological samples, has the potential to reveal novel noninvasive biomarkers. The aim of this study was to determine if serum metabolite profiles in patients with NAFLD associate with future liver-related events.

Idiopathic Myointimal Hyperplasia of the Mesenteric Veins: A Rare Imitator of Inflammatory Bowel Disease.

Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare cause of chronic colonic ischemia characterized by intimal smooth muscle proliferation and luminal narrowing of the small to medium sized mesenteric veins. It predominantly affects the rectosigmoid colon in otherwise healthy, middle-aged males. Definitive diagnosis and treatment are surgical; however, patients are frequently misdiagnosed, which often results in a protracted clinical course.

The association between anti-Müllerian hormone and vitamin 25(OH)D serum levels and polycystic ovarian syndrome in adolescent females.

Background: High anti-Müllerian hormone (AMH) levels and 25-hydroxyvitamin D [25(OH)D] deficiency have been associated with polycystic ovarian syndrome (PCOS) in adult women, and implicated in its pathogenesis. Herein we determined if the level of both AMH and 25(OH)D are altered in adolescent females with clinical features of PCOS.

Methods: This is a cross-sectional study utilizing a retrospective chart review of 128 patients aged 12-20 referred to an academic adolescent gynecology and endocrinology clinic for an evaluation of suspected PCOS.

Maintaining "mianzi" and "lizi": Understanding the reasons for formality marriages between gay men and lesbians in China.

As a result of societal expectations and to avoid societal homophobia, many lesbians and gay men in China marry heterosexual partners and do not disclose their own sexual orientation. This study used qualitative methods to explore why gay men enter into such marriages of convenience. A total of 17 in-depth interviews were conducted with lesbians and gay men who had entered "formality marriages.

Psychiatric and psychological perspectives on chronic pain.

Chronic pain patients often have psychiatric disorders that negatively influence their responses to treatment. Also, many of them have dysfunctional beliefs and coping strategies, even if they do not meet DSM-5 criteria for a psychiatric disorder. Physiatrists should have a low threshold for referring both groups of patients for mental health services.

The missing 'P' in pain management: how the current opioid epidemic highlights the need for psychiatric services in chronic pain care.

Objective: The prevalence of opioid therapy for chronic noncancer pain has increased dramatically in recent years, with a parallel increase in opioid abuse, misuse and deaths from accidental overdose. We review epidemiological and clinical data that point to the important roles psychiatric disorders have in the use and abuse of opioids in patients with chronic pain.

Method: We conducted literature searches on the PubMed with the key phrases "chronic pain" and "opioid therapy" and selected those articles on the epidemiology of comorbidity between chronic pain and psychiatric disorders, the trends in long-term opioid therapy and the clinical trials that involved using opioid therapy for chronic pain or for mental health disorders.

Opioid therapy for chronic pain in the United States: promises and perils.

Opioid therapy offers the promise of reducing the burden of chronic pain in not just individual patients, but among the broad population of patients with chronic pain. Randomized trials have demonstrated that opioid therapy for up to 12-16weeks is superior to placebo, but have not addressed longer-term use. In the United States, opioid sales have quadrupled during 2000-2010, with parallel increases in opioid accidental overdose deaths and substance abuse admissions.

Depression and ambivalence toward chronic opioid therapy for chronic noncancer pain.

Objectives: Chronic opioid therapy (COT) for chronic noncancer pain (CNCP) is characterized by both high rates of patient-initiated discontinuation and by perceived helpfulness among those who sustain opioid use. This study examines predictors of the desire to cut down or stop opioid therapy among patients receiving COT who report that opioids are helpful for relieving pain.

Methods: We conducted a cross-sectional survey of 1737 selected patients receiving COT for CNCP who perceived opioids to be helpful in relieving their pain.

Comparison of Bayesian and empirical ranking approaches to visual perception.

Much current vision research is predicated on the idea--and a rapidly growing body of evidence--that visual percepts are generated according to the empirical significance of light stimuli rather than their physical characteristics. As a result, an increasing number of investigators have asked how visual perception can be rationalized in these terms. Here, we compare two different theoretical frameworks for predicting what observers actually see in response to visual stimuli: Bayesian decision theory and empirical ranking theory.

The Poggendorff illusion explained by natural scene geometry.

One of the most intriguing of the many discrepancies between perceived spatial relationships and the physical structure of visual stimuli is the Poggendorff illusion, when an obliquely oriented line that is interrupted no longer appears collinear. Although many different theories have been proposed to explain this effect, there has been no consensus about its cause. Here, we use a database of range images (i.

Natural-scene geometry predicts the perception of angles and line orientation.

Visual stimuli that entail the intersection of two or more straight lines elicit a variety of well known perceptual anomalies. Preeminent among these anomalies are the systematic overestimation of acute angles, the underestimation of obtuse angles, and the misperceptions of line orientation exemplified in the classical tilt, Zollner, and Hering illusions. Here we show that the probability distributions of the possible real-world sources of projected lines and angles derived from a range-image database of natural scenes accurately predict each of these perceptual peculiarities.

The Müller-Lyer illusion explained by the statistics of image-source relationships.

The Müller-Lyer effect, the apparent difference in the length of a line as the result of its adornment with arrowheads or arrow tails, is the best known and most controversial of the classical geometrical illusions. By sampling a range-image database of natural scenes, we show that the perceptual effects elicited by the Müller-Lyer stimulus and its major variants are correctly predicted by the probability distributions of the possible physical sources underlying the relevant retinal images. These results support the conclusion that the Müller-Lyer illusion is a manifestation of the probabilistic strategy of visual processing that has evolved to contend with the uncertain provenance of retinal stimuli.

Size contrast and assimilation explained by the statistics of natural scene geometry.

The term "size contrast and assimilation" refers to a large class of geometrical illusions in which the apparent sizes of identical visual targets in various contexts are different. Here we have examined whether these intriguing discrepancies between physical and perceived size can be explained by a visual process in which percepts are determined by the probability distribution of the possible real-world sources of retinal stimuli. To test this idea, we acquired a range image database of natural scenes that specified the location of every image point in 3-D space.

The statistical structure of human speech sounds predicts musical universals.

The similarity of musical scales and consonance judgments across human populations has no generally accepted explanation. Here we present evidence that these aspects of auditory perception arise from the statistical structure of naturally occurring periodic sound stimuli. An analysis of speech sounds, the principal source of periodic sound stimuli in the human acoustical environment, shows that the probability distribution of amplitude-frequency combinations in human utterances predicts both the structure of the chromatic scale and consonance ordering.

Range image statistics can explain the anomalous perception of length.

A long-standing puzzle in visual perception is that the apparent extent of a spatial interval (e.g., the distance between two points or the length of a line) does not simply accord with the length of the stimulus but varies as a function of orientation in the retinal image.