The feasibility of implementing a digital pregnancy and postpartum support program in the Midwestern United States and the association with maternal and infant health.

Objective: The benefits of mobile applications in the prenatal period remain understudied. This study assessed associations between the Pregnancy Postpartum Support Program (PPSP), a digital wraparound service, and maternal and infant outcomes in a Medicaid population.

Methods: A retrospective analysis was conducted on pregnant patients with Medicaid insurance who received care and delivered in a Midwestern United States healthcare system between 8/1/2022-8/15/2023, comparing outcomes among those who did versus did not opt for PPSP enrollment.

Advanced Practice Nurse-Led Research: Challenges and Approaches to Digital Health Programs' Evaluation Using Big Data.

Advanced practice nurse leaders are in key positions within health systems to provide time and resources for implementation and evaluation of digital health services. As virtual monitoring programs become more embedded within nursing, nurse leaders and educators need to ensure that nurses are prepared to work within interprofessional teams to administer and evaluate them. This article discusses challenges and implementation strategy considerations for data curation and analysis using large datasets from the Medicaid population for research.

Can a 5-to-90-day Mortality Predictor Perform Consistently Across Time and Equitably Across Populations?

Advance care planning (ACP) facilitates end-of-life care, yet many die without it. Timely and accurate mortality prediction may encourage ACP. However, performance of predictors typically differs among sub-populations (e.

Derivation of a Unique, Algorithm-Based Approach to Cancer Patient Navigator Workload Management.

Purpose: Cancer patient navigators (CPNs) can decrease the time from diagnosis to treatment, but workloads vary widely, which may lead to burnout and less optimal navigation. Current practice for patient distribution among CPNs at our institution approximates random distribution. A literature search did not uncover previous reports of an automated algorithm to distribute patients to CPNs.

Novel Techniques to Assess Predictive Systems and Reduce Their Alarm Burden.

Machine prediction algorithms (e.g., binary classifiers) often are adopted on the basis of claimed performance using classic metrics such as precision and recall.

Closing the Gap: A Comparison of Engagement Interventions to Achieve Equitable Breast Cancer Screening in Rural Illinois.

Mammography screening rates are typically lower in those with less economic advantage (EA). This study, conducted at an integrated health care system covering a mixed rurality population, assessed the ability of interventions (text messages linking to a Web microsite, digital health care workers, and a community health fair) to affect mammography screening rates and disparity in those rates among different EA populations. Payor type served as a proxy for greater (commercially insured) versus lower (Medicaid insured) EA.

Laboratory monitoring to reduce adverse drug-related events: a mixed methods study.

Therapy with angiotensinconverting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) requires laboratory monitoring to avoid hyperkalemia and acute kidney failure. To assess the frequency of recommended annual serum potassium and creatinine monitoring and determine potential factors associated with care gaps among adults dispensed an ACEI or ARB. This mixed-methods study integrated findings from a retrospective cohort study and individual patient interviews.

Adult Granulosa Cell Tumor With Sarcomatous Transformation: A Case Study With Emphasis on Molecular Alterations.

Adult granulosa cells tumors (AGCTs) are typically low-grade indolent tumors. On rare occasions, they undergo high-grade/sarcomatous transformation and behave aggressively. This transformation is postulated to occur as the result of acquired genetic alterations, some of which may be eligible for targeted therapy.

Discovery of a first-in-class reversible DNMT1-selective inhibitor with improved tolerability and efficacy in acute myeloid leukemia.

DNA methylation, a key epigenetic driver of transcriptional silencing, is universally dysregulated in cancer. Reversal of DNA methylation by hypomethylating agents, such as the cytidine analogs decitabine or azacytidine, has demonstrated clinical benefit in hematologic malignancies. These nucleoside analogs are incorporated into replicating DNA where they inhibit DNA cytosine methyltransferases DNMT1, DNMT3A and DNMT3B through irreversible covalent interactions.

Scalable 3D printing of aperiodic cellular structures by rotational stacking of integral image formation.

The limitation of projection microstereolithography in additive manufacturing methods is that they typically use a single-aperture imaging configuration, which restricts their ability to produce microstructures in large volumes owing to the trade-off between image resolution and image field area. Here, we propose an integral lithography based on integral image reconstruction coupled with a planar lens array. The individual microlenses maintain a high numerical aperture and are used to create digital light patterns that can expand the printable area by the number of microlenses (10 to 10), thereby allowing for the scalable stereolithographic fabrication of 3D features that surpass the resolution-to-area scaling limit.

Patient-reported outcome after oncoplastic breast surgery compared with conventional breast-conserving surgery in breast cancer.

Introduction: Oncoplastic breast surgery (OBS) has developed as an extension of breast-conserving surgery (BCS) in an effort to improve esthetic and functional outcome following surgery for breast cancer. The aim of the present study was to evaluate the possible benefits of OBS, as compared with BCS, with regard to health-related quality of life (HRQoL), using patient-reported outcome measures (PROMs).

Patients And Methods: Patients treated with OBS (n = 200) and BCS (n = 1304) in the period 1 January 2008 to 31 December 2013 were identified in a research database and in the Danish Breast Cancer Cooperative Group (DBCG) registry.

Effects of Different Freezing Protocols on Motility, Viability, Mitochondrial Membrane Potential, Intracellular Calcium Level, and DNA Integrity of Cryopreserved Equine Epididymal Sperm.

The aim of the present study was to evaluate the effect of different freezing procedures on sperm motion, viability, the acrosome status, mitochondrial membrane potential (MMP), intracellular calcium content, and DNA integrity on epididymal stallion sperm. Therefore, the sperm of 10 healthy stallions was harvested by retrograde flushing after testectomy, diluted with a semen extender containing defined milk proteins and a freezing extender containing egg yolk and glycerol and frozen according to 4 different protocols, using a programmable freezer and a floating rack performing a slow (processes 1 and 2) or a fast cooling rate (processes 3 and 4, respectively). Post-thaw total motility and slow sperm values were lower when using process 4 compared with processes 1 and 2 (P < .

[Birth of a foal following insemination with frozen-thawed epididymal sperm and simultaneous intrauterine delivery of homologous seminal plasma].

Cryopreservation of epididymal sperm allows final preservation of the gene reserve from valuable sires in case of unexpected injury terminating the breeding career. This case report describes the birth of a healthy foal following insemination with frozen-thawed epididymal sperm. The testes and epididymides were removed under general anaesthesia and sent cooled to the laboratory overnight.

Comparison of the Effects of Five Semen Extenders on the Quality of Frozen-Thawed Equine Epididymal Sperm.

Cryopreservation of epididymal sperm allows the saving of genetic material in case of unexpected death or emergency castration. The aim of the present study was the comparison of five different combinations of extenders commercially available for equine frozen semen processing for cryopreservation of epididymal sperm. Epididymal sperm were harvested from gonads of 10 healthy stallions after routine castration by retrograde flush technique.

Oncoplastic Breast Surgery Compared to Conventional Breast-Conserving Surgery With Regard to Oncologic Outcome.

Introduction: Oncoplastic breast surgery (OBS) has been implemented with increasing frequency in the treatment of breast cancer. The aim of this study was to compare the oncologic outcome after OBS to the outcome after conventional breast-conserving surgery (BCS) in patients with invasive breast cancer.

Patients And Methods: In all, 197 patients treated with OBS were compared to 1399 patients treated with conventional BCS from 2008 to 2013.

Fertility and 63,X Mosaicism in a Haflinger Sibship.

Chromosomal abnormalities are notable causes of infertility in horses. Mares show various degrees of estrous behavior, and ultrasound examination often reveals an underdeveloped genital tract. This article reports investigations on fertility in a Haflinger sibship with a healthy, normally developed, fertile mare with at least three healthy offspring.

Postthaw Addition of Autologous Seminal Plasma Improves Sperm Motion Characteristics in Fair and Poor Freezer Stallions.

During semen processing for cryopreservation, most seminal plasma is usually removed, and components with protective effects on sperm may be missing after thawing and within the female reproductive tract. The present study evaluated the effect of postthaw addition of autologous seminal plasma on motion characteristics of stallion sperm with fair (n = 4) or poor (n = 3) freezability. Therefore, pure seminal plasma (group SP1), seminal plasma combined with fresh semen extender (group SP2), or seminal plasma mixed with freezing extender (group SP3) were used to fill 0.

Nocturia as an Unrecognized Symptom of Uncontrolled Hypertension in Black Men Aged 35 to 49 Years.

Background Hypertension is assumed to be asymptomatic. Yet, clinically significant nocturia (≥2 nightly voids) constitutes a putative symptom of uncontrolled hypertension. Black men with hypertension may be prone to nocturia because of blunted nocturnal blood pressure ( BP ) dipping, diuretic drug use for hypertension, and comorbidity that predisposes to nocturia.

Sustainability of Blood Pressure Reduction in Black Barbershops.

Background: We developed a new model of hypertension care for non-Hispanic black men that links health promotion by barbers to medication management by American Society of Hypertension-certified pharmacists and demonstrated efficacy in a 6-month cluster-randomized trial. The marked reduction in systolic blood pressure (BP) seen at 6 months warranted continuing the trial through 12 months to test sustainability, a necessary precondition for implementation research.

Methods: We enrolled a cohort of 319 black male patrons with systolic BP ≥140 mm Hg at baseline.

Low Systolic Blood Pressure From Treatment and Association With Serious Falls/Syncope.

Introduction: With the growing emphasis on intensive blood pressure control, the potential for overtreatment and treatment-related adverse outcomes has become an area of interest. A large representative population within a real-world clinical environment with successful hypertension control rates was used to evaluate serious falls and syncope in people with low-treated systolic blood pressure (SBP).

Methods: A cross-sectional study among medically treated hypertensive individuals within the Kaiser Permanente Southern California health system (2014-2015) was performed.

Influence of cycle stage, age and endometrial biopsy score on oxytocin receptor distribution and gene expression in the cervix and uterus of non-pregnant mares.

Persistent breeding-induced endometritis (PBIE) or delayed uterine clearance (DUC) are major causes of mare subfertility. Oxytocin and its receptor are thought to play significant roles in the pathogenesis of DUC but the specific roles of oxytocin receptor (OR) distribution and gene expression remain undefined. In this study both OR distribution and gene expression in the endometrium, myometrium and cervix during both luteal and non-luteal phases in non-pregnant mares (n = 27) of differing age (young: 2-9 years, n = 17; old: > 10 years, n = 10) and endometrial biopsy score were described using immunohistochemistry (IHC) and quantitative reverse-transcription polymerase chain reaction (RT-qPCR), respectively.

Disorder of Sexual Development in a Mare with an Unusual Tentative Mosaic Karyotype: 63,X/64,Xdel(Y).

The present report describes a 4-year-old Trakehner mare which was referred to the clinic for a breeding soundness evaluation. Clinical, histological, and postmortem examination revealed an underdeveloped genital tract, the absence of a cervix uteri, and small inactive ovaries without male gonadal tissue. Blood lymphocyte analysis revealed an unusual mosaic karyotype consisting of 2 cell lines.

[Clinical signs in late pregnant mares].

Objective: During the peripartal period, interpretation of basic clinical signs may be challenging. In the present study, heart rate (HR), respiratory rate (RR) and body temperature (BT) were evaluated in healthy mares of different breed types and compared to reference values for adult horses from the literature.

Material And Methods: During daily physical exams of periparturient mares, the HR, RR and BT were evaluated.