Relativity, Rank, and the US News Health's Cardiology, Heart, and Vascular Surgery Best Hospitals.

Objective: Virtually anything can be ranked; the (USNWR or US News) ranks the top 50 hospitals specializing in cardiology, heart, and vascular surgery. Here the authors propose validating the effectiveness of rankings by comparing differences among the USNWR metrics across the top 50 hospitals.

Methods: The ranking system for the top 50 hospitals specializing in cardiology, heart, and vascular surgery was derived from 16 variant scores.

Functional Impairments, Phenotypic Frailty, and Sector-Specific Incremental Healthcare Costs in Older Adults.

Background: This study quantifies incremental healthcare expenditures of functional impairments and phenotypic frailty in specific healthcare sectors.

Methods: Pooled 2023 analysis of 4 prospective cohort studies linked with Medicare claims including 4 318 women and 3 847 men attending an index examination (2002-2011). Annualized inpatient, skilled nursing facility (SNF), home healthcare (HHC), and outpatient costs (2023 dollars) ascertained for 36 months following index examination.

Life-space mobility and cognition in community-dwelling late-life women: A cross-sectional analysis.

Background: Life-space mobility captures the daily, enacted mobility of older adults. We determined cross-sectional associations between life-space mobility and cognitive impairment (CI) among community-dwelling women in the 9th and 10th decades of life.

Methods: A total of 1375 (mean age 88 years; 88% White) community-dwelling women enrolled in a prospective cohort of older women.

Neighborhood Socioeconomic Deprivation and Health Care Costs in Older Community-Dwelling Adults: Importance of Functional Impairment and Frailty.

Background: Low neighborhood socioeconomic status is associated with adverse health outcomes, but its association with health care costs in older adults is uncertain.

Objectives: To estimate the association of neighborhood Area Deprivation Index (ADI) with total, inpatient, outpatient, skilled nursing facility (SNF), and home health care (HHC) costs among older community-dwelling Medicare beneficiaries, and determine whether these associations are explained by multimorbidity, phenotypic frailty, or functional impairments.

Design: Four prospective cohort studies linked with each other and with Medicare claims.

Incremental Health Care Costs of Self-Reported Functional Impairments and Phenotypic Frailty in Community-Dwelling Older Adults : A Prospective Cohort Study.

Background: Health care systems need better strategies to identify older adults at risk for costly care to select target populations for interventions to reduce health care burden.

Objective: To determine whether self-reported functional impairments and phenotypic frailty are associated with incremental health care costs after accounting for claims-based predictors.

Design: Prospective cohort study.

Design, methods, and recruitment outcomes of the Veterans' Pain Care Organizational Improvement Comparative Effectiveness (VOICE) study.

The Veterans' Pain Care Organizational Improvement Comparative Effectiveness (VOICE) study is a 12-month pragmatic randomized comparative effectiveness trial conducted at ten United States Veterans Affairs (VA) health care sites. The overall goal was to test interventions to improve pain while reducing opioid use among VA patients with moderate-severe chronic pain despite treatment with long-term opioid therapy (LTOT). Aims were 1) to compare lower-intensity telecare collaborative pain management (TCM) versus higher-intensity integrated pain team management (IPT), and 2) to test the option of switching to buprenorphine (versus no option) in a high-dose subgroup.

Characteristics Associated With 5-Year Fracture Risk Versus 5-Year Mortality Risk Among Late-Life Men.

Background: Identifying late-life men who might benefit from treatment to prevent fracture is challenging given high mortality. Our objective was to evaluate risks of clinical fracture, hip fracture, and mortality prior to fracture among men aged at least 80 years.

Methods: Study participants included 3 145 community-dwelling men (mean [standard deviation] age 83 [2.

Pleckstrin Levels Are Increased in Patients with Chronic Periodontitis and Regulated the MAP Kinase-p38α Signaling Pathway in Gingival Fibroblasts.

Chronic periodontitis (CP) is a bacteria-driven inflammatory disease characterized by the breakdown of gingival tissue, the periodontal ligament, and alveolar bone, leading ultimately to tooth loss. We previously reported the pleckstrin gene () to be highly upregulated in gingival tissue of patients with CP and the only gene concurrently upregulated in other inflammatory diseases including rheumatoid arthritis and cardiovascular diseases. Using saliva from 169 individuals diagnosed with CP and healthy controls, we investigated whether pleckstrin could serve as a novel biomarker of periodontitis.

Ehrlichia-induced hemophagocytic lymphohistiocytosis in a pediatric kidney transplant recipient.

Background: Kidney transplant patients are susceptible to a variety of infections in the post-transplant period due to the use of immunosuppressant medications. Ehrlichiosis is a rare infection in solid organ transplant recipients with signs and symptoms that mimic rejection and other viral infections. Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal hyperinflammatory syndrome that can be triggered by infections.

Life-space mobility and healthcare costs and utilization in older men.

Objectives: To determine the association of life-space score with subsequent healthcare costs and utilization.

Design: Prospective cohort study (Osteoporotic Fracture in Men [MrOS]).

Setting: Six U.

Motor and sensory features successfully decode autism spectrum disorder and combine with the original RDoC framework to boost diagnostic classification.

Sensory processing and motor coordination atypicalities are not commonly identified as primary characteristics of autism spectrum disorder (ASD), nor are they well captured in the NIMH's original Research Domain Criteria (RDoC) framework. Here, motor and sensory features performed similarly to RDoC features in support vector classification of 30 ASD youth against 33 typically developing controls. Combining sensory with RDoC features boosted classification performance, achieving a Matthews Correlation Coefficient (MCC) of 0.

Joint Associations of Prevalent Radiographic Vertebral Fracture and Abdominal Aortic Calcification With Incident Hip, Major Osteoporotic, and Clinical Vertebral Fractures.

Prevalent vertebral fractures (PVFx) and abdominal aortic calcification (AAC) are both associated with incident fractures and can be ascertained on the same lateral spine images, but their joint association with incident fractures is unclear. Our objective was to estimate the individual and joint associations of PVFx and AAC with incident major osteoporotic, hip, and clinical vertebral fractures in 5365 older men enrolled in the Osteoporotic Fractures in Men (MrOS) Study, using Cox proportional hazards and Fine and Gray subdistribution hazards models to account for competing mortality. PVFx (Genant SQ grade 2 or 3) and 24-point AAC score were ascertained on baseline lateral spine radiographs.

Height Loss in Old Age and Fracture Risk Among Men in Late Life: A Prospective Cohort Study.

To assess the association of height loss in old age with subsequent risk of hip and any clinical fracture in men late in life while accounting for the competing risk of mortality, we used data from 3491 community-dwelling men (mean age 79.2 years). Height loss between baseline and follow-up (mean 7.

Complications of Cryptosporidium infection after pediatric liver transplantation: Diarrhea, rejection, and biliary disease.

Background: Cryptosporidium enteritis can be devastating in the immunocompromised host. In pediatric liver transplant recipients, infection may be complicated by prolonged carriage of the parasite, rejection, and biliary tree damage and fibrosis. Herein, we report on six patients and their long-term outcomes following cryptosporidiosis.

Characterizing the frequency of modifiable histological changes observed on surveillance biopsies in pediatric kidney allograft recipients.

Background: Rejection is responsible for just under 50% of graft loss in the pediatric kidney transplant population. Early identification and treatment of allograft injury, specifically modifiable pathologies such as subclinical rejection (SCR), calcineurin inhibitor toxicity, and BK virus nephropathy, may improve allograft survival. Protocol surveillance biopsy (SB) currently offers the earliest opportunity for targeted interventions.

Frailty Phenotype and Healthcare Costs and Utilization in Older Men.

Objectives: To determine the association of the frailty phenotype with subsequent healthcare costs and utilization.

Design: Prospective cohort study (Osteoporotic Fracture in Men [MrOS]).

Setting: Six US sites.

Self-reported poor sleep on multiple dimensions is associated with higher total health care costs in older men.

Study Objectives: To estimate the association of self-reported poor sleep in multiple dimensions with health care costs in older men.

Methods: Participants were 1,413 men (mean [SD] age 76.5 [5.

Abdominal aortic calcification (AAC) and ankle-brachial index (ABI) predict health care costs and utilization in older men, independent of prevalent clinical cardiovascular disease and each other.

Background And Aims: Abdominal aortic calcification (AAC) and low ankle-brachial index (ABI) are markers of multisite atherosclerosis. We sought to estimate their associations in older men with health care costs and utilization adjusted for each other, and after accounting for CVD risk factors and prevalent CVD diagnoses.

Methods: This was an observational cohort study of 2393 community-dwelling men (mean age 73.

Human tau pathology transmits glial tau aggregates in the absence of neuronal tau.

Tauopathies are characterized by abnormal accumulation of tau protein in neurons and glia. In Alzheimer's disease (AD), tau aggregates in neurons, while in corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP), tau also aggregates in astrocytes and oligodendrocytes. We previously demonstrated that human CBD and PSP tauopathy lysates (CBD-tau and PSP-tau) contain distinct tau strains that propagate neuronal and glial tau aggregates in nontransgenic (nonTg) mouse brain.

Multidimensional sleep health and subsequent health-care costs and utilization in older women.

Study Objectives: Determine the association of poor multidimensional sleep health with health-care costs and utilization.

Methods: We linked 1,459 community-dwelling women (mean age 83.6 years) participating in the Study of Osteoporotic Fractures Year 16 visit (2002-2004) with their Medicare claims.