The Surgical Pause: The Importance of Measuring Frailty and Taking Action to Address Identified Frailty.

Conceptual Framework: The Surgical Pause is a rapid, scalable strategy for health care systems to optimize perioperative outcomes for high-risk, frail patients considering elective surgery. The first and most important step is to screen for frailty, thereby identifying the 5% to 10% of patients at most risk for postoperative complications, loss of independence, institutionalization, and mortality. The second step is to take action to improve outcomes.

Examining Truth Regimes Reveals How Local Communities View Flooding and River Management in the Lower Missouri River Basin, USA.

Riverine flooding is increasing in frequency and intensity, requiring river management agencies to consider new approaches to working with communities on flood mitigation planning. Communication and information sharing between agencies and communities is complex, and mistrust and misinformation arise quickly when communities perceive that they are excluded from planning. Subsequently, riverfront community members create narratives that can be examined as truth regimes-truths created and repeated that indicate how flooding and its causes are understood, represented, and discussed within their communities-to explain why flooding occurs in their area.

How In Vivo Alteration of Hip Replacement Wear Mode Can Cause a Voluminous Inflammatory Reaction and an Excessive Titanium Exposure.

Wear particle reaction is present in every arthroplasty. Sometimes, this reaction may lead to formation of large pseudotumors. As illustrated in this case, the volume of the reaction may be out of proportion to the volume of the wear scar.

Predictive Methods and Probabilistic Mapping of Subcortical Brain Components in Fossil Carnivora.

Paleoneurology reconstructs the evolutionary history of nervous systems through direct observations from the fossil record and comparative data from extant species. Although this approach can provide direct evidence of phylogenetic links among species, it is constrained by the availability and quality of data that can be gleaned from the fossil record. Here, we sought to translate brain component relationships in a sample of extant Carnivora to make inferences about brain structure in fossil species.

Private-Sector Readmissions for Inpatient Surgery in Veterans Health Administration Hospitals.

Importance: The Veterans Health Administration (VHA) reports multiple indicators of hospital surgical performance, including hospital risk-standardized 30-day readmission rates (RSRRs). Currently, most routinely reported measures do not include readmissions that occur outside VHA hospitals. The impact of readmissions outside the VHA on hospital RSRR is not known.