Clinical Research Network: JHCRN Infrastructure and Lessons Learned.

Clinical research studies are becoming increasingly complex resulting in compounded work burden and longer study cycle times, each fueling runaway costs. The impact of protocol complexity often results in inadequate recruitment and insufficient sample sizes, which challenges validity and generalizability. Understanding the need to provide an alternative model to engage researchers and sponsors and bringing clinical research opportunities to the broader community, clinical research networks (CRN) have been proposed and initiated in the United States and other parts of the world.

A Systematic Review of Single-Layer Versus Double-Layer Intestinal Anastomosis: Is One Better?

Introduction: To perform a systematic review of randomized controlled trials comparing outcomes from handsewn single-layer and double-layer intestinal anastomosis in adults.

Methods: A literature search was conducted using PubMed, SCOPUS, and Web of Science databases for studies published up to September 14, 2023 using the following keyword search query: ((one) OR (single)) AND ((two) OR (double)) AND (layer) AND ((anastomoses) OR (anastomosis)).

Results: In seven of the eight studies, there was no significant difference in anastomotic leakage rate.

African American patient and caregiver attitudes and perceptions of community health workers as lay patient navigators in palliative care.

Background: Concurrent palliative care for patients with advanced cancer has been shown to reduce physical and psychological symptoms, and improve the quality of life of patients with advanced cancer. Underutilization of palliative care services, especially among African American patients with advanced cancer, remains an important public health problem. To address this gap, we developed a community health worker (CHW) palliative care intervention for African American patients with advanced cancer, which is being formally assessed through an ongoing effectiveness-implementation trial (NCT05407844).

Bioabsorbable, subcutaneous naltrexone implants mitigate fentanyl-induced respiratory depression at 3 months-A pilot study in male canines.

The aim of this study is to determine if extended-release, bioabsorbable, subcutaneous naltrexone (NTX) implants can mitigate respiratory depression after an intravenous injection (IV) of fentanyl. Six different BIOabsorbable Polymeric Implant Naltrexone (BIOPIN) formulations, comprising combinations of Poly-d,l-Lactic Acid (PDLLA) and/or Polycaprolactone (PCL-1 or PCL-2), were used to create subcutaneous implants. Both placebo and naltrexone implants were implanted subcutaneously in male dogs.

Appendicitis in the Neutropenic Patient: A Systematic Review.

Neutropenia increases the complexity of surgical decision-making in cases of acute appendicitis. In this systematic review, we discuss medical vs surgical management and timing of appendectomy in the neutropenic adult patient. We queried databases utilizing the key words "neutropenia" and "appendicitis.

Patient perspectives on cancer care during COVID-19: A qualitative study.

Purpose: The COVID-19 pandemic posed unique challenges to cancer-related care as health systems balanced competing risks of timely delivery of care and minimizing exposure to infection in a high-risk, immunocompromised patient population. This study aimed to better understand how pandemic-related factors affected the patient experience of cancer care during this time.

Methods: We conducted fifteen semi-structured interviews with adults from rural counties in Maryland who were diagnosed with and/or actively treated for cancer at the TidalHealth healthcare network between January 2020 and October 2022.

Online communication skill training of patients with cancer: A test of the behavioral intention predictive framework for communication skills.

Objective: To assess the Behavioral Intention Predictive Framework's utility in explaining variation in cancer patients' strong behavioral intention (SBI) to use LEAPS (Listen, Educate, Assess, Partner, Support) communication skills after viewing training videos.

Methods: Ninety-eight patients were enrolled through anonymized online platforms to view LEAPS training videos, complete background and communication questionnaires and report their SBI to use LEAPS skills.

Results: On average, patients indicated SBI to use 6 of 13 skills and 46% of patients expressed SBI across individual skills.

Implementation Barriers and Recommendations for a Multisite Community Health Worker Intervention in Palliative Care for African American Oncology Patients: A Qualitative Study.

Palliative care remains underutilized by African American patients with advanced cancer. Community health workers (CHWs) may help improve palliative care outcomes among this patient population. To explore barriers to success of a proposed CHW intervention and synthesize design and implementation recommendations to both optimize our intervention and inform others working to alleviate palliative care disparities.

Dissemination and Implementation of a Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC): a study protocol for a hybrid type 1 randomized controlled trial.

Background: There are persistent racial and ethnic health disparities in end-of-life health outcomes in the United States. African American patients are less likely than White patients to access palliative care, enroll in hospice care, have documented goals of care discussions with their healthcare providers, receive adequate symptom control, or die at home. We developed Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC) to address these disparities.

A wearable multi-modal acoustic system for breathing analysis.

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide with over 3 × 10 deaths in 2019. Such an alarming figure becomes frightening when combined with the number of lost lives resulting from COVID-caused respiratory failure. Because COPD exacerbations identified early can commonly be treated at home, early symptom detections may enable a major reduction of COPD patient readmission and associated healthcare costs; this is particularly important during pandemics such as COVID-19 in which healthcare facilities are overwhelmed.

Simplifying Survivorship Care Planning: A Randomized Controlled Trial Comparing 3 Care Plan Delivery Approaches.

Background: Survivorship care plans seek to improve the transition to survivorship, but the required resources present implementation barriers. This randomized controlled trial aimed to identify the simplest, most effective approach for survivorship care planning.

Methods: Stage 1-3 breast, colorectal, and prostate cancer patients aged 21 years or older completing treatment were recruited from an urban-academic and rural-community cancer center.

Death of an infant: Accessing the voices of bereaved mothers to create healing. A qualitative study.

Aims And Objectives: To describe the health challenge for mothers whose infants have died and approaches and resources they used to manage the loss.

Background: The death of an infant is a devastating experience for families. Bereaved mothers have higher rates of mental distress, loneliness and isolation.

Intraocular pressure following four different intravenous sedation protocols in normal horses.

Background: Intravenous sedation is frequently necessary for ophthalmic examination in horses. Common sedation protocols have not been directly compared in terms of relative intraocular pressure (IOP) reduction, duration of IOP reduction and time to maximum IOP reduction.

Objectives: To compare the effects of standing sedation protocols on IOP.

The Prevalence of Dyslexia: A New Approach to Its Estimation.

How prevalent is dyslexia? A definitive answer to this question has been elusive because of the continuous distribution of reading performance and predictors of dyslexia and because of the heterogeneous nature of samples of poor readers. Samples of poor readers are a mixture of individuals whose reading is consistent with or expected based on their performance in other academic areas and in language, and individuals with dyslexia whose reading is not consistent with or expected based on their other performances. In the present article, we replicate and extend a new approach for determining the prevalence of dyslexia.

Co-occurrence of Reading Disabilities and Math Disabilities: A Meta-Analysis.

Despite the importance of identifying individuals with reading disabilities, existing operational definitions of reading disability do not result in reliable identification. A large part of the problem arises from measurement error when a cut-point is imposed on a continuous distribution, especially for low base-rate conditions. One way to reduce measurement error is to include additional predictors in reading disability models.

Adequacy of the Provider Workforce for Persons With Cardiopulmonary Disease.

Background: Access and quality of health care for cardiopulmonary disease in the United States ranks poorly compared with economically similar nations. No recent comprehensive assessment of the cardiopulmonary workforce is available. This systematic review was conducted to evaluate current published evidence about the workforce caring for persons with cardiopulmonary disease.

Combining Old and New for Better Understanding and Predicting Dyslexia.

Despite decades of research, it has been difficult to achieve consensus on a definition of common learning disabilities such as dyslexia. This lack of consensus represents a fundamental problem for the field. Our approach to addressing this issue is to use model-based meta-analyses and Bayesian models with informative priors to combine the results of a large number of studies for the purpose of yielding a more stable and well-supported conceptualization of reading disability.

The Eastern Shore Collaborative for Interprofessional Education's Implementation and Impact over Five Years.

Health care professionals working collaboratively on interprofessional teams are essential to optimize patient-centered care. Collaboration and teamwork can be best achieved if interprofessional education (IPE) starts early for health professions students. This commentary describes the formation, implementation, impact, and lessons learned from students' curricular and co-curricular activities and faculty collaboration over a five-year trajectory of the Eastern Shore Collaborative for Interprofessional Education (ESCIPE).

A glucose-starvation response regulates the diffusion of macromolecules.

The organization and biophysical properties of the cytosol implicitly govern molecular interactions within cells. However, little is known about mechanisms by which cells regulate cytosolic properties and intracellular diffusion rates. Here, we demonstrate that the intracellular environment of budding yeast undertakes a startling transition upon glucose starvation in which macromolecular mobility is dramatically restricted, reducing the movement of both chromatin in the nucleus and mRNPs in the cytoplasm.