Performance-based and patient-reported outcome measures for custom ankle-foot orthosis users: reliability, validity, and sensitivity evidence.

Purpose: To evaluate the psychometric properties of performance and patient-reported outcome measures (PROMs) for custom ankle-foot orthosis (AFOs) users.

Materials And Methods: Current AFO users completed two assessments one week apart; new AFO users completed an assessment before device delivery and at one- and two-months post-delivery.

Results: Seventy current and 31 new users consented and provided data.

Participatory Modeling for High Complexity, Multi-System Issues: Challenges and Recommendations for Balancing Qualitative Understanding and Quantitative Questions.

Community stakeholder participation can be incredibly valuable for the qualitative model development process. However, modelers often encounter challenges for participatory modeling projects focusing on high-complexity, synergistic interactions between multiple issues, systems, and granularity. The diverse stakeholder perspectives and volumes of information necessary for developing such models can yield qualitative models that are difficult to translate into quantitative simulation or clear insight for informed decision-making.

Nonresponse Bias on Inpatient Rehabilitation Hospitals' Experience of Care Quality Measure Scores.

Objective: To describe the magnitude of nonresponse bias on inpatient rehabilitation facility (IRF) experience of care survey data in patients with neurologic disorders.

Design: Cohort study of patients at 2 IRFs. Patients reported experience of care via an IRF-administered survey as part of routine operations approximately 2 weeks after discharge.

Palliative Care Initiated in the Emergency Department: A Cluster Randomized Clinical Trial.

Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.

Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.

Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.

A descriptive examination of rurality in the Environmental influences on Child Health Outcomes Cohort: Implications, illustrations, and future directions.

Purpose: The Environmental influences on Child Health Outcomes (ECHO) Cohort has enrolled over 60,000 children to examine how early environmental factors (broadly defined) are associated with key child health outcomes. The ECHO Cohort may be well-positioned to contribute to our understanding of rural environments and contexts, which has implications for rural health disparities research. The present study examined the outcome of child obesity to not only illustrate the suitability of ECHO Cohort data for these purposes but also determine how various definitions of rural and urban populations impact the presentation of findings and their interpretation.

Low vs. conventional intra-abdominal pressure in laparoscopic colorectal surgery: a prospective cohort study.

Purpose: Low intraabdominal pressure (IAP) during laparoscopy is associated with improved post-operative outcomes across a variety of surgical specialties. A prospective cohort study was undertaken to assess post-operative outcomes in patients undergoing laparoscopic colorectal surgery (LCRS) with low (8mmHg) versus conventional (15mmHg) IAP.

Methods: A prospective real-world observational study of patients undergoing LCRS in a single-centre, between June 2020 and June 2023 was performed.

Development and Deployment of an Emergency Department Radiology Dashboard to Improve Communication and Transparency of Radiologic Imaging and Report Status.

Purpose: The status of radiology examinations affects the flow of patients through the emergency department (ED). Yet this information is not readily available to ED physicians, nurses, and staff members (collectively referred to as ED staff members) or patients. The aim of this study was to improve ED workflow by providing real-time information about the status of radiology reports to ED staff members.

Substance use during the COVID-19 pandemic among persons with traumatic spinal cord injury: A cross-sectional perspective.

Study Design: Analysis of data from two cohorts of Spinal Cord Injury Model Systems Database (SCIMS) participants, pre-pandemic (2017-2019,  = 6368) and during pandemic (2020,  = 1889).

Objectives: To examine differences in substance use during the pandemic compared to the years prior to the pandemic.

Setting: 19 SCIMS Centers.

Identification of Immune Checkpoint Inhibitor-Induced Diabetes.

Importance: Immune checkpoint inhibitors (ICIs) have revolutionized cancer care; however, accompanying immune-related adverse events (irAEs) confer substantial morbidity and occasional mortality. Life-threatening irAEs may require permanent cessation of ICI, even in patients with positive tumor response. Therefore, it is imperative to comprehensively define the spectrum of irAEs to aid individualized decision-making around the initiation of ICI therapy.

ATLAS: A positive, high-yield review of patient symptoms most significantly associated with melanoma recurrence.

Background: No standardized, evidence-based surveillance practices exist to guide and optimize recurrence detection in patients with cutaneous melanoma.

Objective: To determine the most high-yield positive review of systems for signaling recurrence in patients with cutaneous melanoma.

Methods: This retrospective cohort study assessed patients with a history of cutaneous melanoma and compared demographic and clinical characteristics, including a comprehensive review of systems, among those who experienced recurrence and those who did not.

Methods for Estimating Costs for Stays at Inpatient Rehabilitation Facilities and Long-Term Care Hospitals.

Objective: To describe and compare 3 methods for estimating stay-level Medicare facility (Part A) costs using claims and cost report data for inpatient rehabilitation facilities (IRFs) and long-term care hospitals (LTCHs), the 2 hospital-based postacute care providers.

Design: We calculated stay-level facility costs using different methods. Method 1 used routine costs per day and ancillary cost-to-charge ratios.

Evolution of phenotypic plasticity leads to tumor heterogeneity with implications for therapy.

Cancer is a significant global health issue, with treatment challenges arising from intratumor heterogeneity. This heterogeneity stems mainly from somatic evolution, causing genetic diversity within the tumor, and phenotypic plasticity of tumor cells leading to reversible phenotypic changes. However, the interplay of both factors has not been rigorously investigated.

Cross-setting Comparison of Risk Factors for Pressure Injuries Acquired in Post-Acute Care.

General Purpose: To provide information on the association between risk factors and the development of new or worsened stage 2 to 4 pressure injuries (PIs) in patients in long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), and skilled nursing facilities (SNFs).

Target Audience: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

Learning Objectives/outcomes: After participating in this educational activity, the participant will:1.

Do Medicare Inpatient Rehabilitation Facility Patients' Self-care and Mobility Outcomes Vary by Dual Eligibility Status, Race and Ethnicity, Rural Residence, Socioeconomic Status, and Living Alone?

Objective: The aim of the study is to examine whether inpatient rehabilitation facility patients' risk-adjusted functional outcomes varied with the following five social drivers of health: Medicare-Medicaid dual eligibility status, race and ethnicity, rural residence, socioeconomic status, and living alone.

Design: This cohort study examined unadjusted and adjusted mobility and self-care change scores during inpatient rehabilitation facility stays for 428,710 Medicare patients with and without social drivers of health. Regression models isolated the mean marginal effect of each of the five social factors on mobility and self-care change scores after adjusting for covariates.

Differential Effects of Intra-Abdominal Hypertension and ARDS on Respiratory Mechanics in a Porcine Model.

: Intra-abdominal hypertension (IAH) and acute respiratory distress syndrome (ARDS) are common concerns in intensive care unit patients with acute respiratory failure (ARF). Although both conditions lead to impairment of global respiratory parameters, their underlying mechanisms differ substantially. Therefore, a separate assessment of the different respiratory compartments should reveal differences in respiratory mechanics.

Dysregulation of persistent inward and outward currents in spinal motoneurons of symptomatic SOD1-G93A mice.

Persistent inward currents (PICs) and persistent outward currents (POCs) regulate the excitability and firing behaviours of spinal motoneurons (MNs). Given their potential role in MN excitability dysfunction in amyotrophic lateral sclerosis (ALS), PICs have been previously studied in superoxide dismutase 1 (SOD1)-G93A mice (the standard animal model of ALS); however, conflicting results have been reported on how the net PIC changes during disease progression. Also, individual PICs and POCs have never been examined before in symptomatic ALS.

Near real-time patient experience feedback with data relay to providers: a systematic review of its effectiveness.

Near Real-Time Feedback (NRTF) on the patient's experience with care, coupled with data relay to providers, can inform quality-of-care improvements, including at the point of care. The objective is to systematically review contemporary literature on the impact of the use of NRTF and data relay to providers on standardized patient experience measures. Six scientific databases and five specialty journals were searched supplemented by snowballing search strategies, according to the registered study protocol.

Forecasting the Economic Burden of Cardiovascular Disease and Stroke in the United States Through 2050: A Presidential Advisory From the American Heart Association.

Background: Quantifying the economic burden of cardiovascular disease and stroke over the coming decades may inform policy, health system, and community-level interventions for prevention and treatment.

Methods: We used nationally representative health, economic, and demographic data to project health care costs attributable to key cardiovascular risk factors (hypertension, diabetes, hypercholesterolemia) and conditions (coronary heart disease, stroke, heart failure, atrial fibrillation) through 2050. The human capital approach was used to estimate productivity losses from morbidity and premature mortality due to cardiovascular conditions.

Self-Assembling Peptide-Based High-Relaxivity Targeted MRI Contrast Agents.

Concentration-dependent increases in relaxivity (r1) were found to be induced by self-assembly when Fmoc is adjacent to tryptophan in peptide-based MRI contrast agents featuring Gd-DOTA. A series of di- and tri-peptides were synthesized to test the effect of ionic strength, N-terminal substituent, peptide length, net charge, and relative location of Fmoc and tryptophan on r1 and critical aggregation concentration (CAC) at 1.0 Tesla.

Systematic review of contemporary interventions for improving discharge support and transitions of care from the patient experience perspective.

Aim: To synthesize the impact of improvement interventions related to care coordination, discharge support and care transitions on patient experience measures.

Method: Systematic review. Searches were completed in six scientific databases, five specialty journals, and through snowballing.