Percutaneous decannulation of extracorporeal membrane oxygenation using MANTA device: A real-world single-center experience.

Background: The MANTA vascular closure device (VCD) represents a novel approach to achieving hemostasis after large-bore femoral access procedures. Numerous clinical studies have evaluated the efficacy of the MANTA device across a range of patient populations undergoing different procedures. However, there is still a paucity of data available concerning the use of MANTA devices in aiding the decannulation of venoarterial extracorporeal membrane oxygenation (VA-ECMO).

"Veteran to Veteran, There's Automatically a Trust": A Qualitative Study of Veterans' Experiences in a Peer Health-Coaching Program for Hypertension.

Introduction: Veteran peer Coaches Optimizing and Advancing Cardiac Health was an randomized controlled trial (RCT) to test the effectiveness of a peer support intervention to reduce blood pressure among veterans with hypertension and 1 or more cardiovascular risks. The authors studied participant perceptions of the intervention, including barriers and facilitators to participation, factors promoting behavior change, and disease self-management practices.

Methods: The authors enrolled participants at their exit visit for the Veteran peer Coaches Optimizing and Advancing Cardiac Health study.

Women's Health Care Delivery and Coordination After Transitioning From One Electronic Health Record to Another: Perspectives From Staff in the Veterans Health Administration.

Objectives: The Veterans Health Administration (VA) is transitioning its 1,300 health care facilities from one electronic health record (EHR) to another. The transition aims to improve care delivery and interoperability; however, specific effects on women veterans, who comprise only 7.5% of the patient population, may be obscured without focused evaluation.

Unleashing surgical skills: Ultra-high fidelity trauma thoracotomy training on knowledge donor platform.

Background: Resuscitative thoracotomies are a time-sensitive emergency surgical procedure with an immediate risk of mortality. We hypothesize that a high-fidelity whole-body donor simulation model, referred to as a Knowledge Donor (KD), with mechanical lung ventilation and expired human blood perfusion could increase learner confidence in performing this critical procedure.

Methods: General surgery residents and faculty were invited to participate in KD training.

Outcomes from Partner2Lose: a randomized controlled trial to evaluate 24-month weight loss in a partner-assisted intervention.

Background: Partner support is associated with better weight loss outcomes in observational studies, but randomized trials show mixed results for including partners. Unclear is whether teaching communication skills to couples will improve weight loss in a person attempting weight loss (index participant).

Purpose: To compare the efficacy of a partner-assisted intervention versus participant-only weight management program on 24-month weight loss.

"You want people to listen to you": Patient experiences of women's healthcare within the Veterans Health Administration.

Objective: To identify constructs that are critical in shaping Veterans' experiences with Veterans Health Administration (VA) women's healthcare, including any which have been underexplored or are not included in current VA surveys of patient experience.

Data Sources And Study Setting: From June 2022 to January 2023, we conducted 28 semi-structured interviews with a diverse, national sample of Veterans who use VA women's healthcare.

Study Design: Using VA data, we divided Veteran VA-users identified as female into four groups stratified by age (dichotomized at age 45) and race/ethnicity (non-Hispanic White vs.

Extracorporeal cardiopulmonary resuscitation outcomes for children with out-of-hospital and emergency department cardiac arrest.

Objective: Data suggest extracorporeal cardiopulmonary resuscitation (ECPR) improves survival in adult patients with refractory cardiac arrest; however, ECPR outcomes in pediatric patients with out-of-hospital cardiac arrest (OHCA) is lacking. The primary aim of this study was to characterize pediatric patients who experience OHCA or cardiac arrest in the ED (EDCA). The secondary aim was to examine associations of cardiac arrest and location of ECPR cannulation with mortality.

Factors Associated With Use of the Preventive Health Inventory in US Veterans.

Importance: The COVID-19 pandemic caused significant declines in the quality of preventive and chronic disease care. The Veterans Health Administration (VHA) used the Preventive Health Inventory (PHI), a multicomponent care management intervention, to catch up on care disrupted by the pandemic.

Objective: To identify key factors associated with PHI use.

Effect of a Peer Health Coaching Intervention on Clinical Outcomes Among US Veterans With Cardiovascular Risks: The Vet-COACH Randomized Clinical Trial.

Importance: Although cardiovascular disease (CVD) is the leading cause of death in the US, CVD risk factors remain suboptimally controlled.

Objective: To test the effectiveness of a home-visit, peer health coaching intervention to improve health outcomes for veterans with multiple CVD risks.

Design, Setting, And Participants: This 2-group, unblinded randomized clinical trial, called Vet-COACH (Veteran Peer Coaches Optimizing and Advancing Cardiac Health), used a novel geographic-based method to recruit a racially diverse population of veterans with low income.

Racial Disparities in Uterine Fibroid Treatment Among Veterans Using VA Health Care.

Introduction: Uterine fibroids are common, nonmalignant tumors that disproportionately impact Black patients. We aimed to examine Black and White differences in receipt of any treatment and type of first treatment in the Department of Veterans Affairs, including effect modification by severity as approximated by anemia.

Methods: We used Department of Veterans Affairs administrative data to identify 5,041 Black and 3,206 White veterans with symptomatic uterine fibroids, identified by International Classification of Diseases, 9th edition, Clinical Modification, codes, between fiscal year 2010 and fiscal year 2012 and followed in the administrative data through fiscal year 2018 for outcomes.

Changes in Primary Care Quality Associated With Implementation of the Veterans Health Administration Preventive Health Inventory.

Importance: The COVID-19 pandemic caused significant disruptions in primary care delivery. The Veterans Health Administration (VHA) launched the Preventive Health Inventory (PHI) program-a multicomponent care management intervention, including a clinical dashboard and templated electronic health record note-to support primary care in delivering chronic disease care and preventive care that had been delayed by the pandemic.

Objectives: To describe patient, clinician, and clinic correlates of PHI use in primary care clinics and to examine associations between PHI adoption and clinical quality measures.

Complete Genome Sequences of Chop, DelRio, and GrandSlam, Three Phages Isolated from Soil in Central Arkansas.

Chop, DelRio, and GrandSlam are phage with a morphotype isolated from soil in Arkansas using the host Gordonia terrae 3612. All three are temperate, and their genomes share at least 96% nucleotide identity. These phage are assigned to cluster DI based on gene content similarity to other sequenced actinobacteriophage.

Uterine Weight as a Modifier of Black/White Racial Disparities in Minimally Invasive Hysterectomy Among Veterans with Fibroids in the Veterans Health Administration.

Introduction: Uterine fibroids are the most common indication for hysterectomy. Minimally invasive hysterectomy (MIH) confers lower risk of complications and shorter recovery than open surgical procedures; however, it is more challenging to perform with larger fibroids. There are racialized differences in fibroid size and MIH rates.

"We Are Working Harder, Not Smarter": A Qualitative Inquiry into Care Coordination for Department of Veterans Affairs Mammograms Referred to the Community.

Introduction: The Department of Veterans Affairs (VA) relies on facilities outside of VA to provide mammograms for most VA patients. Prior work suggests challenges to coordinating some sex-specific services between VA and other health care systems (e.g.

Gender differences in social support for diabetes self-management: A qualitative study among veterans.

Objective: Describe the role of social support in veterans' diabetes self-management and examine gender differences.

Methods: We conducted semi-structured interviews among veterans with diabetes from one Veterans Health Administration Health Care System. Participants described how support persons influenced their diabetes self-management and perspectives on a proposed self-management program incorporating a support person.

A Method to Deliver Automated and Tailored Intervention Content: 24-month Clinical Trial.

Background: The use of digital technologies and software allows for new opportunities to communicate and engage with research participants over time. When software is coupled with automation, we can engage with research participants in a reliable and affordable manner. Research Electronic Data Capture (REDCap), a browser-based software, has the capability to send automated text messages.

Surgical Repair vs Stent for Esophageal Perforation: A Multi-institutional Database Analysis.

Background: Endoscopic esophageal stenting is used as an alternative to surgical repair for esophageal perforation. Multi-institutional studies supporting stenting are lacking. The purpose of this study was to compare the outcomes of surgical repair and esophageal stenting in patients with esophageal perforation using a nationally representative database.

National Veterans Health Administration MOVE! Weight Management Program Participation During the COVID-19 Pandemic.

Introduction: In response to COVID-19, the Veterans Health Administration (VHA) converted appropriate outpatient visits to virtual care, including MOVE! Weight Management Program for Veterans (MOVE!) visits. Before the pandemic, most veterans participated in MOVE! in person, with several telehealth modalities available. We sought to describe national trends in MOVE! participation during the pandemic (March 2020-January 2021) overall and by modality and to compare participation to prepandemic levels.

Home Telehealth in the Veterans Health Administration: Trends and Correlates of Length of Enrollment from 2010 to 2017.

Background: Home telehealth (HT) programs enable communication and remote monitoring of patient health data between clinician visits, with the goal of improving chronic disease self-management and outcomes. The Veterans Health Administration (VHA) established one of the earliest HT programs in the country in 2003; however, little is known about how these services have been utilized and expanded over the last decade.

Objective: To describe trends in use of VHA's HT program from 2010 through 2017 and correlates of length of enrollment in HT services.

Early pregnancy loss in the emergency department, 2006-2016.

Objectives: Women experiencing early pregnancy loss (EPL) frequently present to the emergency department (ED), but little is known about who receives EPL care in these settings. We aimed to estimate the proportion of ED visits for EPL-related care and determine characteristics associated with seeking care for EPL in the ED in a national sample.

Methods: We conducted a secondary analysis of the 2006-2016 National Hospital Ambulatory Medical Care Survey (NHAMCS), a nationally representative survey of US ED visits.

Improvements in physical activity and some dietary behaviors in a community health worker-led diabetes self-management intervention for adults with low incomes: results from a randomized controlled trial.

People with low incomes have a disproportionate prevalence of diabetes and its complications and experience many barriers to self-management, which community health workers (CHWs) may help address. We sought to examine the effects of an in-home CHW-led intervention for adults with diabetes and incomes <250% of the federal poverty line on self-management behaviors and test mediators and moderators. From 2010 to 2013, we randomized participants from three Washington State health systems with type 2 diabetes and hemoglobin A1c (HbA1c) ≥ 8% to the CHW intervention (N = 145) or usual care control (N = 142) arms.

Robotic Approach Has Improved Outcomes for Minimally Invasive Resection of Mediastinal Tumors.

Background: The optimal minimally invasive surgical approach to mediastinal tumors is unknown. There are limited reports comparing the outcomes of resection with robotic-assisted thoracoscopic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) surgery. We hypothesized that patients who underwent RATS would have improved outcomes.

Wedge Resection Offers Similar Survival to Segmentectomy for Typical Carcinoid Tumors.

Current guidelines recommend anatomic lung resection of typical bronchopulmonary carcinoids. Typical carcinoid tumors have excellent prognosis and sublobar resection has been associated with noninferior long-term survival. It's unclear whether wedge resection is acceptable for small typical carcinoid tumors.

Does Timing of Robotic Esophagectomy Adoption Impact Short-Term Postoperative Outcomes?

Background: Robotic esophagectomies are increasingly common and are reported to have superior outcomes compared with an open approach; however, it is unclear if all institutions can achieve such outcomes. We hypothesize that early adopters of robotic technique would have improved short-term outcomes.

Methods: The National Cancer Database (2010-2016) was used to identify robotic esophagectomies.