Disparities in Access to, Use of, and Quality of Rehabilitation After Stroke in the United States: A Scoping Review.

Objectives: To summarize current reports in the literature on disparities in rehabilitation after stroke; identify gaps in our understanding of rehabilitation disparities; and make recommendations for future research.

Data Sources: A health sciences librarian developed a search string based on an a priori protocol and searched Medline (Ovid) Embase (Elsevier), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL and EBSCO).

Study Selection: A 2-step screening process of titles and abstracts followed by full-text review was conducted.

Long-term, Dynamic Remodelling of the Corticotroph Transcriptome and Excitability After a Period of Chronic Stress.

Chronic stress results in long-term dynamic changes at multiple levels of the hypothalamic-pituitary-adrenal (HPA) axis resulting in stress axis dysregulation with long-term impacts on human and animal health. However, the underlying mechanisms and dynamics of altered of HPA axis function, in particular at the level of pituitary corticotrophs, during a period of chronic stress and in the weeks after its cessation (defined as "recovery") are very poorly understood. Here, we address the fundamental question of how a period of chronic stress results in altered anterior pituitary corticotroph function and whether this persists in recovery, as well as the transcriptomic changes underlying this.

Developing optimized physical activity interventions for drug-resistant epilepsy: Challenges and lessons learned from a remote exercise intervention pilot trial.

People with epilepsy (PWE) stand to benefit significantly from increasing their physical activity, but promotion of physical activity is difficult in any population; a challenge compounded by the unique barriers encountered by PWE, especially those with drug-resistant epilepsy (DRE). This study explores the feasibility of a remotely delivered, 12-week aerobic exercise program based on social cognitive theory principles in adults with DRE. This line of research is nested within the Multiphase Optimization Strategy (MOST), a framework that emphasizes iterative early pilot work (preparation phase research), followed by iterative optimization phase research.

Detection of gluten peptides in human duodenal fluids with immuno-liquid chromatography-mass spectrometry.

Gluten proteins are storage proteins in wheat that exhibit a certain resistance to gastrointestinal digestion. To explore solutions to cope with accidental ingestion of gluten in individuals suffering from gluten-related disorders, it is essential to monitor the fate of gluten peptides in biological samples, , gastrointestinal juices, blood plasma or urine. In this work, we aimed at developing a mass spectrometry (MS)-based method for measuring gluten peptides in human duodenal fluids.

Not all healthcare inequities in diabetes are equal: a comparison of two medically underserved cohorts.

Introduction: Diabetes disparities exist based on socioeconomic status, race, and ethnicity. The aim of this study is to compare two cohorts with diabetes from California and Florida to better elucidate how health outcomes are stratified within underserved communities according to state location, race, and ethnicity.

Research Design And Methods: Two cohorts were recruited for comparison from 20 Federally Qualified Health Centers as part of a larger ECHO Diabetes program.

carriage by geckos detected within households in Malawi.

was isolated from 23/79 (29.1%) pooled gecko stool samples from households in southern Malawi. Whole genome sequencing of 47 individual isolates within this collection revealed 27 serovars spanning two subspecies.

Patient safety in actioning and communicating blood test results in primary care: a UK wide audit using the Primary care Academic CollaboraTive (PACT).

Background: Errors associated with failures in filing, actioning and communicating blood test results can lead to delayed and missed diagnoses and patient harm. This study aimed to audit how blood tests in primary care are filed, actioned and communicated in primary care, to identify areas for patient safety improvements.

Methods: UK primary care clinicians were recruited through the Primary Care Academic CollaboraTive (PACT).

Prevalence and Detection of Obstructive Sleep Apnea Early after Stroke.

Background: Obstructive sleep apnea (OSA) negatively impacts post-stroke recovery. This study's purpose: examine the prevalence of undiagnosed OSA and describe a simple tool to identify those at-risk for OSA in the early phase of stroke recovery.

Methods: This was a cross-sectional descriptive study of people ∼15 days post-stroke.

Quality of life during usual epilepsy care for anxiety or depression symptoms: Secondary patient-reported outcomes in a randomized trial of remote assessment methods.

Background And Objectives: Anxiety and depression are highly prevalent and impactful in epilepsy. American Academy of Neurology quality measures emphasize anxiety and depression screening and quality of life (QOL) measurement, yet usual epilepsy care QOL and anxiety/depression outcomes are poorly characterized. The main objective was to assess 6-month QOL, anxiety and depression during routine care among adults with epilepsy and baseline anxiety or depression symptoms; these were prespecified secondary outcomes within a pragmatic randomized trial of remote assessment methods.

Anomalous systemic arterial supply to the basal segment of the lung presenting with haemoptysis in the third trimester of pregnancy.

Anomalous systemic arterial supply to the basal segment of the lung (ABLL) is a rare cause of haemoptysis. ABLL may be complicated by massive haemoptysis, heart failure due to left-to-right shunt and infection. We describe a case of this condition presenting in the third trimester of pregnancy.

Further development and validation of the Multimorbidity Treatment Burden Questionnaire (MTBQ).

Objectives: To undertake further psychometric testing of the Multimorbidity Treatment Burden Questionnaire (MTBQ) and examine whether reversing the scale reduced floor effects.

Design: Survey.

Setting: UK primary care.

Association of Continuity of Care With Health Care Utilization and Expenditures Among Patients Discharged Home After Stroke or Transient Ischemic Attack.

Objectives: To examine the association of prestroke continuity of care (COC) with postdischarge health care utilization and expenditures.

Study Population: The study population included 2233 patients with a diagnosis of stroke or a transient ischemic attack hospitalized in one of 41 hospitals in North Carolina between March 2016 and July 2019 and discharged directly home from acute care.

Methods: COC was assessed from linked Centers for Medicare and Medicaid Services Medicare claims using the Modified, Modified Continuity Index.

Vasoactive Intestinal Peptide Receptor, CRTH2, Antagonist Treatment Improves Eosinophil and Mast Cell-Mediated Esophageal Remodeling and Motility Dysfunction in Eosinophilic Esophagitis.

Background And Aims: Ultrasonography has shown that eosinophils accumulate in each segment of the esophageal mucosa in human EoE, ultimately promoting esophageal motility dysfunction; however, no mechanistic evidence explains how or why this accumulation occurs.

Methods: Quantitative PCR, ELISA, flow cytometry, immunostaining, and immunofluorescence analyses were performed using antibodies specific to the related antigens and receptors.

Results: In deep esophageal biopsies of EoE patients, eosinophils and mast cells accumulate adjacent to nerve cell-derived VIP in each esophageal segment.

INTERACTIVE EFFECTS OF INCREASED NESTBOX TEMPERATURE AND VITAMIN E ON NESTLING GROWTH ARE ATTENUATED BY PLASTICITY IN FEMALE INCUBATION EFFORT.

In recent years, temperatures have increased globally, and nestlings of many bird species are likely regularly exposed to increased temperatures both pre- and postnatally. Even small increases in nest temperature during incubation affect offspring growth and survival in a variety of species, one cause of which is thought to be increased production of prooxidants in embryos and nestlings. Defences marshalled in response to this oxidative stress could, in turn, result in trade-offs that lead to reduced survival or growth.

Development of an exercise therapy referral clinical support tool for patients with osteoporosis at risk for falls.

Background: The purpose of this study was to develop a clinical support tool for osteoporosis clinic providers to support risk assessment and referrals for evidence-based exercise therapy programs.

Methods: A sequential Delphi method was used with a multidisciplinary group of national falls experts, to provide consensus on referral to exercise therapy for patients at risk for falls. The Delphi study included a primary research team, expert panel, and clinical partners to answer the questions: (1) "What patient characteristics are needed to develop a clinical support tool?"; (2) "What are the recommended exercise referrals for patients with osteoporosis at risk for falls?" The consensus process consisted of two rounds with 8 weeks between meetings.

Translation, cross-cultural adaptation and validation of the Arabic multimorbidity treatment burden questionnaire (MTBQ-A): A study of adults with multimorbidity.

Background: Studies internationally have found that a high treatment burden is associated with several long-term conditions and poor quality of life.

Objectives: To translate, culturally adapt, and provide evidence of reliability, validity, and factor structure of the Multimorbidity Treatment Burden Questionnaire for use among Arabic-speaking adults with multimorbidity.

Methods: Standard guidelines for the cross-cultural adaptation of self-report measures were followed.

Communicating computational workflows in a regulatory environment.

The volume of nucleic acid sequence data has exploded recently, amplifying the challenge of transforming data into meaningful information. Processing data can require an increasingly complex ecosystem of customized tools, which increases difficulty in communicating analyses in an understandable way yet is of sufficient detail to enable informed decisions or repeats. This can be of particular interest to institutions and companies communicating computations in a regulatory environment.

Referral to Community-Based Rehabilitation Following Acute Stroke: Findings From the COMPASS Pragmatic Trial.

Background: Few studies on care transitions following acute stroke have evaluated whether referral to community-based rehabilitation occurred as part of discharge planning. Our objectives were to describe the extent to which patients discharged home were referred to community-based rehabilitation and identify the patient, hospital, and community-level predictors of referral.

Methods: We examined data from 40 North Carolina hospitals that participated in the COMPASS (Comprehensive Post-Acute Stroke Services) cluster-randomized trial.

Why Competency Frameworks Are Insufficiently Nuanced for Health Equity Teaching and Assessment.

This article suggests how competency-based medical education should robustly integrate health equity by focusing on physicians' responsibilities to (1) know why and how underlying structural mechanisms contribute to health equity and then (2) take action to achieve health equity in their practice. This article first canvasses currently available frameworks for helping trainees cultivate these 2 specific skills of discernment and action. This article then offers strategies for teaching and assessing these skills in specific learning activities.

Feasibility of Implementing Patient-Reported and Physical Performance Measures to Identify and Manage Fall Risk in Older Adults Within a Secondary Fracture Clinic.

The purpose of this study was to assess the feasibility of implementing both electronic and in-person assessments to assess falls risk in an older adult secondary fracture clinic. Electronic data capture feasibility was defined as the proportion of patients that completed the electronic questionnaires prior to their clinic visit. In-clinic feasibility was defined in two ways: (1) the proportion of patients that consented to participate at their clinic visit; (2) time to complete testing.

Validation of the Lithuanian multimorbidity treatment burden questionnaire (MTBQ) and its association with primary care patient characteristics.

Background: The increasing prevalence of multimorbidity among older people in Lithuania and other Central-Eastern European countries leads to a greater patient treatment burden and puts additional pressure on healthcare services.

Objectives: This study aimed to validate the Lithuanian version of the Multimorbidity Treatment Burden Questionnaire (MTBQ).

Methods: The Lithuanian version of the MTBQ was tested (2021-2022) with 789 patients from seven Lithuanian primary care centres who had two or more long-term conditions.

"A Look Under the Hood": Reflections on the Inaugural RIME Mentorship Program.

In 2021, Research in Medical Education (RIME) celebrated 60 years of advancing scholarship in health professions education (HPE). At that time, the nation's educational institutions faced a public reckoning on the long-standing pandemic of racism that sweltered in their practices and policies, laid bare by COVID-19 and the Black Lives Matters movement. RIME responded with a mentorship program for minoritized early career HPE faculty, which aims to amplify their voices in settings where their experiences and contributions are frequently dampened.