Clinical outcomes of long-term transmural drainage with double pigtail stents in disconnected pancreatic duct syndrome.

Background: Disconnected pancreatic duct syndrome (DPDS) is a common cause of recurrent pancreatic fluid collections (PFCs), often requiring repeat drainage. Following initial drainage with lumen apposing metal stents (LAMS), replacement with transmural double pigtail stents (DPS) has been shown to be a viable drainage modality mitigating the risk of recurrence. The sparsity of literature on the consequences of this strategy requires further investigation.

EUS-guided hepaticogastrostomy versus percutaneous transhepatic biliary drainage after failed ERCP: A propensity score-matched analysis.

Percutaneous transhepatic biliary drainage (PTBD) is the traditional second-line option after unsuccessful endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HG) is a viable alternative to PTBD. Our study aimed to compare outcomes of EUS-HG and PTBD for benign and malignant biliary diseases following failed ERCP.

Driving among individuals with chronic conditions: A systematic review of applied research using kinematic driving sensors.

Background: Kinematic driving data studies are a novel methodology relevant to health care, but prior studies have considerable variance in their methods, populations, and findings suggesting a need for critical analysis and appraisal for feasibility and methodological guidelines.

Methods: We assessed kinematic driving studies of adults with chronic conditions for study feasibility, characteristics, and key findings, to generate recommendations for future study designs, and to identify promising directions for applications of kinematic driving data. PRISMA was used to guide the review and searches included PubMed, CINAHL, and Compendex.

Editing the 19 kDa alpha-zein gene family generates non-opaque2-based quality protein maize.

Maize grain is deficient in lysine. While the opaque2 mutation increases grain lysine, o2 is a transcription factor that regulates a wide network of genes beyond zeins, which leads to pleiotropic and often negative effects. Additionally, the drastic reduction in 19 kDa and 22 kDa alpha-zeins causes a floury kernel, unsuitable for agricultural use.

The Stanford Medicine data science ecosystem for clinical and translational research.

Objective: To describe the infrastructure, tools, and services developed at Stanford Medicine to maintain its data science ecosystem and research patient data repository for clinical and translational research.

Materials And Methods: The data science ecosystem, dubbed the Stanford Data Science Resources (SDSR), includes infrastructure and tools to create, search, retrieve, and analyze patient data, as well as services for data deidentification, linkage, and processing to extract high-value information from healthcare IT systems. Data are made available via self-service and concierge access, on HIPAA compliant secure computing infrastructure supported by in-depth user training.

A rapid, simple, high-performance liquid chromatography method for the clinical measurement of beta-lactam antibiotics in serum and interstitial fluid.

: enhanced methods of therapeutic drug monitoring are required to support the individualisation of antibiotic dosing based on pharmacokinetics (PK) parameters. PK studies can be hampered by limited total serum volume, especially in neonates, or by sensitivity in the case of critically ill patients. We aimed to develop a liquid chromatography-mass spectrometry (LC/MS) analysis of benzylpenicillin, phenoxymethylpenicillin and amoxicillin in single low volumes of human serum and interstitial fluid (ISF) samples, with an improved limit of detection (LOD) and limit of quantification (LOQ), compared with previously published assays.

The development of a mobile app-focused deduplication strategy for the Apple Heart Study that informs recommendations for future digital trials.

An app-based clinical trial enrolment process can contribute to duplicated records, carrying data management implications. Our objective was to identify duplicated records in real time in the Apple Heart Study (AHS). We leveraged personal identifiable information (PII) to develop a dissimilarity score (DS) using the Damerau-Levenshtein distance.

Understanding downstream service profitability generated by dermatology faculty in an academic medical center: a key driver to promotion of access-to-care.

Hiring new dermatology faculty at academic medical centers (AMCs) can be a difficult process. Academic dermatology departments, however, must have the financial freedom to nimbly respond to the needs of their community. To determine the downstream revenue and profitability produced by dermatology faculty, a retrospective review of charges and expenses downstream of professional services was performed to assess dermatology faculty and nurse practitioners from January 2019 to December 2020 at a single AMC in the southern United States.

Lessons learned in the Apple Heart Study and implications for the data management of future digital clinical trials.

The digital clinical trial is fast emerging as a pragmatic trial that can improve a trial's design including recruitment and retention, data collection and analytics. To that end, digital platforms such as electronic health records or wearable technologies that enable passive data collection can be leveraged, alleviating burden from the participant and study coordinator. However, there are challenges.

Potential impact of hospital at home on postoperative readmissions.

Objectives: Hospital at home (HAH) is a health care delivery model that substitutes hospital-level services in the home for inpatient hospitalizations. HAH has been shown to be safe and effective for medical patients but has not been investigated in surgical readmissions. We estimated the potential impact of an HAH program for patients readmitted within 60 days postoperatively and described the characteristics of eligible patients to aid in the design of future programs.

Narrowing feedstock exemptions under the Montreal Protocol has multiple environmental benefits.

The Montreal Protocol on Substances that Deplete the Ozone Layer (Montreal Protocol) can be further strengthened to control ozone-depleting substances and hydrofluorocarbons used as feedstocks to provide additional protection of the stratospheric ozone layer and the climate system while also mitigating plastics pollution. The feedstock exemptions were premised on the assumption that feedstocks presented an insignificant threat to the environment; experience has shown that this is incorrect. Through its adjustment procedures, the Montreal Protocol can narrow the scope of feedstock exemptions to reduce inadvertent and unauthorized emissions while continuing to exempt production of feedstocks for time-limited, essential uses.

Expansion of Insurance Under the Affordable Care Act and Invasive Management of Acute Myocardial Infarction.

Background: The Affordable Care Act of 2010 extended health insurance through expansion of Medicaid and subsidies for commercial insurance. Prior work has produced differing results in associating expanded insurance with improvements in health care processes and outcomes. Evaluating specific mechanisms of care processes and their association with insurance expansion may help reconcile those results.

Arrhythmias Other Than Atrial Fibrillation in Those With an Irregular Pulse Detected With a Smartwatch: Findings From the Apple Heart Study.

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Skin cancer knowledge, attitudes, and practices among non-medical skin care professionals: A narrative review of cross-sectional and interventional studies.

Background: Skin cancers are the most common malignancies in the United States. Total body skin examination by a physician, especially a dermatologist, is the gold standard for detecting suspicious lesions that may require further evaluation. Non-medical professionals (NMPs) including massage therapists, estheticians, hairdressers, and cosmetologists have the unique opportunity to frequently examine their client's skin outside of a clinical setting.

Use of radioiodine in nuclear medicine-A brief overview.

Radioiodines have a long history in nuclear medicine. Herein, we discuss the production, properties and applications of these versatile iodine-based imaging and theragnostic agents. There are 38 isotopes of iodine (I) including one stable form ( I).

Effects of health beliefs, social support, and self-efficacy on sun protection behaviors among medical students: testing of an extended health belief model.

Sun protection behaviors (SPB) are important modifiable risk factors for skin cancer. As the most common malignancies in the world, skin cancers account for significant morbidity, mortality, and economic burden. Physicians play a key role in educating patients about proper SPB.

Association of an Acute Myocardial Infarction Readmission-Reduction Program With Mortality and Readmission.

Background: Reducing hospital readmission after acute myocardial infarction (AMI) has the potential to both improve quality and reduce costs. As such, readmission after AMI has been a target of financial penalties through Medicare. However, substantial concern exists about potential adverse effects and efficacious readmission-reduction strategies are not well validated.