How is Telehealth Used to Increase Access to Specialty Palliative Care? A Systematic Review.

Context: Specialty palliative care remains inaccessible for many with serious illness, especially in rural areas. Telehealth may be one solution.

Objectives: To describe how telehealth increases access to specialty palliative care, describe facilitators and barriers to its use, and summarize evidence of patient benefits.

Avian circoviruses and hepadnaviruses identified in tissue samples of various waterfowl.

North America is home to over 40 species of migratory waterfowl. Utilizing tissue and cloacal-swab sampling from hunter-harvested carcasses in 2021-2023, we identified circular DNA viruses associated with 116 waterfowl samples from nine species (American wigeons, Mexican ducks, northern shovelers, northern pintails, canvasbacks, mallards, American black ducks, gadwalls, and green-winged teals). We determined the genome sequences of viruses in the families Circoviridae (n = 18) and Hepadnaviridae (n = 2) from the 13 virus-infected birds.

Skin immune-mesenchymal interplay within tertiarylymphoid structures promotes autoimmunepathogenesis in hidradenitis suppurativa.

Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory skin disease characterized by keratinized epithelial tunnels that grow deeply into the dermis. Here, we examined the immune microenvironment within human HS lesions. Multi-omics profiling and multiplexed imaging identified tertiary lymphoid structures (TLSs) near HS tunnels.

Utilization Fraction of Ambulatory Hand Procedures: Cost-Reduction Through Surgical Instrument Tray Optimization.

Background: Our objective is to evaluate the utilization fraction (UF) of surgical instruments during a commonly performed ambulatory hand surgery case as an avenue for cost reduction, increased operating room efficiency, and systems quality improvement.

Methods: The total number of instruments opened at the start of the case was recorded followed by instruments being divided into those used and not used during the procedure. Total sterile processing costs were estimated at $1.