Improving colonoscopy quality in the national VA healthcare system.

Background: Colorectal cancer (CRC) prevention is a Veterans Affairs (VA) priority. Colonoscopy quality, especially adenoma detection rate (ADR), is critical for effective screening. Our research indicates considerable variation in ADR among VA providers.

A Crisis in Scope: Recruitment and Retention Challenges Reported by VA Gastroenterology Section Chiefs.

Background: Having a sufficient number of gastroenterologists is important for protecting the digestive health of veterans. However, gastroenterology is among the most difficult medical specialties for recruitment at the US Department of Veterans Affairs (VA).

Methods: We surveyed VA gastroenterology section chiefs to learn about current barriers to recruitment and retention and to identify opportunities for improvement.

Ultrasonic-Assisted Conversion of Micrometer-Sized BiI into BiOI Nanoflakes for Photocatalytic Applications.

This work describes a novel method for converting bismuth triiodide (BiI) microplates into bismuth oxyiodide (BiOI) nanoflakes under ultrasonic irradiation. To produce BiOI nanoflakes with a high yield and high purity, the conversion process was carefully adjusted. Rapid reaction kinetics and increased mass transfer are benefits of the ultrasonic-assisted approach that result in well-defined converted BiOI nanostructures with superior characteristics.

Neuronal Mechanisms of Reading Informational Texts in People with Different Levels of Mental Resilience.

The aim of this study was to verify whether the level of mental resilience would differentiate reading comprehension performance when using different information carriers. More than 150 people filled out a test regarding the level of resilience. They then participated in a survey using fNIRS.

Migration, Partner Selection, and Fertility in Germany: How Many Children are Born in Mixed Unions?

For the German context, we investigate whether the number of children ever born differs between mixed unions (exogamous unions between natives and migrants or migrant descendants) and endogamous unions (unions among co-ethnics). Our theoretical considerations are derived from assimilation theories, which view exogamous unions as indicators of assimilation processes, and the framework on migrant fertility. The migrant (or descendant) partner in an exogamous union may adapt to the majority group, both partners may adapt to each other, or both partners may constitute a selected group in their fertility preferences.

The Influence of Graphite Filler on the Self-Lubricating Properties of Epoxy Composites.

In this work, epoxy composites filled with flake graphite of various size (less than 10 μm and less than 45 μm) were produced. The aim of the research was to develop a self-lubricating material with favorable tribological properties, i.e.

Molecular relapse monitoring reveals the domination of impaired NK cell education over impaired inhibition in missing KIR-ligand recognition in patients after unrelated hematopoietic stem cell transplantation for malignant diseases.

Transplantation of HLA and/or KIR mismatched allogeneic hematopoietic stem cells can lead NK cells to different states of activation/inhibition or education/resetting and change anti-tumor immunosurveillance. In this study, we used molecular relapse monitoring to investigate a correlation between either missing ligand recognition or variation of the cognate iKIR-HLA pairs with clinical outcomes in patients with hematological malignancies requiring allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients (N = 418) with acute myeloid leukemia (AML), chronic myeloid leukemia (CML), acute lymphoblastic leukemia (ALL), myelodysplastic syndrome (MDS), or lymphoma receiving T-cell repleted graft from HLA-matched or partly mismatched unrelated donors between 2012 and 2020 in our center were included in this study.

Flexible Piezoresistive Polystyrene Composite Sensors Filled with Hollow 3D Graphitic Shells.

The objective of this research was to develop highly effective conductive polymer composite (CPC) materials for flexible piezoresistive sensors, utilizing hollow three-dimensional graphitic shells as a highly conductive particulate component. Polystyrene (PS), a cost-effective and robust polymer widely used in various applications such as household appliances, electronics, automotive parts, packaging, and thermal insulation materials, was chosen as the polymer matrix. The hollow spherical three-dimensional graphitic shells (GS) were synthesized through chemical vapor deposition (CVD) with magnesium oxide (MgO) nanoparticles serving as a support, which was removed post-synthesis and employed as the conductive filler.

Incidence of retained biopsy specimens after esophagogastroduodenoscopy and colonoscopy.

In gastrointestinal endoscopy, biopsies must transit through the accessory channel and cap, presenting an opportunity for loss of tissue. We sought to determine the incidence of specimen retention in the accessory channel or cap and identify procedure characteristics associated with specimen retention. After completion of standard endoscopic procedures in which biopsies were obtained, the biopsy cap and accessory channel were inspected, brushed, and irrigated for any retained biopsy specimens according to a standard protocol.

Multi-ancestry genome- and phenome-wide association studies of diverticular disease in electronic health records with natural language processing enriched phenotyping algorithm.

Objective: Diverticular disease (DD) is one of the most prevalent conditions encountered by gastroenterologists, affecting ~50% of Americans before the age of 60. Our aim was to identify genetic risk variants and clinical phenotypes associated with DD, leveraging multiple electronic health record (EHR) data sources of 91,166 multi-ancestry participants with a Natural Language Processing (NLP) technique.

Materials And Methods: We developed a NLP-enriched phenotyping algorithm that incorporated colonoscopy or abdominal imaging reports to identify patients with diverticulosis and diverticulitis from multicenter EHRs.

Leveraging Natural Language Processing to Extract Features of Colorectal Polyps From Pathology Reports for Epidemiologic Study.

Purpose: Histopathologic features are critical for studying risk factors of colorectal polyps, but remain deeply embedded within unstructured pathology reports, requiring costly and time-consuming manual abstraction for research. In this study, we developed and evaluated a natural language processing (NLP) pipeline to automatically extract histopathologic features of colorectal polyps from pathology reports, with an emphasis on individual polyp size. These data were then linked with structured electronic health record (EHR) data, creating an analysis-ready epidemiologic data set.

Adenoma Detection Rate and Clinical Characteristics Influence Advanced Neoplasia Risk After Colorectal Polypectomy.

Background And Aims: Postpolypectomy risk stratification for subsequent metachronous advanced neoplasia (MAN) is imprecise and does not account for colonoscopist adenoma detection rate (ADR). Our aim was to assess association of ADR with MAN and create a prediction model for postpolypectomy risk stratification incorporating ADR and other factors.

Methods: We conducted a retrospective cohort study of individuals with baseline polypectomy and subsequent surveillance colonoscopy from 2004 to 2016 within the U.

Baseline Characteristics and Longitudinal Outcomes of Traditional Serrated Adenomas: A Cohort Study.

Background And Aims: Traditional serrated adenomas (TSAs) may confer increased risk for colorectal cancer (CRC). Our objective with this study was to examine clinical characteristics and long-term outcomes associated with TSA diagnosis.

Methods: We conducted a retrospective cohort study of U.

COVID-19 Pandemic Had Minimal Impact on Colonoscopy Completion After Colorectal Cancer Red Flag Sign or Symptoms in US Veterans.

Background: Delays in colonoscopy work-up for red flag signs or symptoms of colorectal cancer (CRC) during the COVID-19 pandemic are not well characterized.

Aims: To examine colonoscopy uptake and time to colonoscopy after red flag diagnosis, before and during the COVID-19 pandemic.

Methods: Cohort study of adults ages 50-75 with iron deficiency anemia (IDA), hematochezia, or abnormal stool blood test receiving Veterans Health Administration (VHA) care from April 2019 to December 2020.

Index diagnoses of gastric intestinal metaplasia in the United States: patient characteristics, endoscopic findings, and clinical practice patterns at a large tertiary care center.

Background: Gastric intestinal metaplasia (GIM) is a premalignant gastric mucosal change that is often incidentally detected during esophagogastroduodenoscopy (EGD). Despite the established higher risk of gastric cancer associated with GIM, the incidence, prevalence, and outcomes data for GIM are limited in the United States (US), and practice patterns are highly variable.

Objectives: Our primary objectives were to accurately identify incident histology-confirmed GIM cases and determine patient characteristics, endoscopy findings, (HP) detection, and eradication treatment outcomes, as well as surveillance and follow-up recommendations.

Clinical role of ambulatory reflux monitoring in PPI non-responders: recommendation statements.

Background: Optimal ambulatory reflux monitoring methodology in symptomatic reflux patients continues to be debated.

Aims: To utilise published literature and expert opinion to develop recommendation statements addressing use of ambulatory reflux monitoring in clinical practice METHODS: The RAND Appropriateness Method (RAM) was utilised among 17 experts with discussion, revision and two rounds of ranking of recommendation statements. Ambulatory reflux monitoring protocol, methodology and thresholds ranked as appropriate by ≥80% of panellists met the criteria for appropriateness.

Stress-Inducing Factors vs. the Risk of Occupational Burnout in the Work of Nurses and Paramedics.

Introduction: Contemporary healthcare faces new challenges and expectations from society. The profession of a nurse, as well as a paramedic, is essential for the efficient functioning of healthcare. It has its importance not only in promoting and preserving health but also in prevention.

Pre-endoscopy coronavirus disease 2019 screening and severe acute respiratory syndrome coronavirus-2 nucleic acid amplification testing in the Veterans Affairs healthcare system: clinical practice patterns, outcomes, and relationship to procedure volume.

Background And Aims: The coronavirus disease 2019 (COVID-19) pandemic has had profound impacts worldwide, including on the performance of GI endoscopy. We aimed to describe the performance and outcomes of pre-endoscopy COVID-19 symptom and exposure screening and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) nucleic acid amplification testing (NAAT) across the national Veterans Affairs healthcare system and describe the relationship of SARS-CoV-2 NAAT use and resumption of endoscopy services.

Methods: COVID-19 screening and NAAT results from March 2020 to April 2021 were analyzed to determine use, performance characteristics of screening, and association between testing and endoscopic volume trends.

Higher Quality Colonoscopy: Worth the Wait?

To meet the high demand for colonoscopy, the Veterans Health Administration often refers veterans to community practices. Petros et al. compared colonoscopy quality at a Veterans Affairs Medical Center with that of local community practices.