Decision Making for Older Adults With Multiple Chronic Conditions: Executive Summary for the American Geriatrics Society Guiding Principles on the Care of Older Adults With Multimorbidity.

Caring for older adults with multiple chronic conditions (MCCs) is challenging. The American Geriatrics Society (AGS) previously developed The AGS Guiding Principles for the Care of Older Adults With Multimorbidity using a systematic review of the literature and consensus. The objective of the current work was to translate these principles into a framework of Actions and accompanying Action Steps for decision making for clinicians who provide both primary and specialty care to older people with MCCs.

Breast-Specific Gamma Imaging Versus MRI: Comparing the Diagnostic Performance in Assessing Treatment Response After Neoadjuvant Chemotherapy in Patients With Breast Cancer.

Objective: The purpose of this retrospective study was to evaluate the diagnostic performance of breast-specific gamma imaging (BSGI) and breast MRI in assessing for residual tumor after neoadjuvant chemotherapy (NAC) in patients with breast cancer.

Materials And Methods: A total of 114 patients underwent BSGI and MRI for initial staging as well as after undergoing NAC. Of those, 112 underwent subsequent definitive breast surgery.

Managing Pain in Chronically Ill Homebound Patients Through Home-Based Primary and Palliative Care.

Background:: Many older adults are homebound due to chronic illness and suffer from significant symptoms, including pain. Home-based primary and palliative care (HBPC), which provides interdisciplinary medical and psychosocial care for this population, has been shown to significantly reduce symptom burden. However, little is known about how pain is managed in the homebound.

Rest and Activity Patterns of Army Aviators in Routine and Operational Training Environments.

Fatigue continues to be a leading cause of military aviation mishaps. Several factors, including reversed shift missions, can negatively affect sleep patterns and increase the risk of fatigue due to sleep restriction. Currently, there is a lack of objective data regarding the current rest and activity patterns of military aviators across multiple operational conditions.

Preventing Substance Use in American Indian Youth: The Case for Social Support and Community Connections.

Aims: This study explored the relationship between social support, community connections, self-esteem, and culture on misuse in American Indian youth.

Methods: The study team developed a culturally-responsive 16-question survey for American Indian youth ages 12-20 living in six American Indian communities in the Great Plains Region of the United States. The study was grounded in primary socialization theory and variables were explored using regression models.

Army Aviators' Perceptions of Advanced Cockpit Aircraft.

Perceptions of features of automation, such as its safety and effects on basic flying skills, can shape how someone uses automation and accepts newly developed technology. The purpose of the present study was to evaluate current U.S.

Analysis of post-translational modifications in Alzheimer's disease by mass spectrometry.

The roles of post-translational modifications (PTMs) in the onset and progression of disease have been extensively studied for decades. More specifically, various PTMs have been the focus of research in Alzheimer's disease (AD). The two most discussed hallmarks of the disease, senile plaques and tau tangles, are the result of PTMs of the amyloidβ protein precursor (AβPP) and the microtubule stabilizing protein: tau.

'Til Death Do Us Part: End-of-Life Experiences of Married Couples in a Nationally Representative Survey.

Objectives: To determine whether end-of-life (EOL) experiences in the first spouse in a marriage are associated with EOL experiences in the other spouse.

Design: Nationally representative, longitudinal survey.

Setting: Health and Retirement Study, Waves 1992-2012 linked to Medicare claims PARTICIPANTS: Community-dwelling older adults who died (N=4,558), representing 2,279 married heterosexual couples.

High Burden of Palliative Care Needs of Older Adults During Emergency Major Abdominal Surgery.

Objectives: To quantify preoperative illness burden in older adults undergoing emergency major abdominal surgery (EMAS), to examine the association between illness burden and postoperative outcomes, and to describe end-of-life care in the year after discharge.

Design: Retrospective study using data from Health and Retirement Study interviews linked to Medicare claims (2000-2012).

Setting: National population-based dataset.

Age of transfused red blood cells and health outcomes in two surgical cohorts.

Rationale: Red blood cells (RBC) undergo morphologic and biochemical changes during storage which may lead to adverse health risks upon transfusion. In prior studies, the effect of RBC age on health outcomes has been conflicting. We designed the study to assess the effects of RBC units' storage duration on health outcomes specifically for hospitalized patients undergoing hip fracture surgery or coronary artery bypass grafting (CABG) surgery.

Is culturally based prevention effective? Results from a 3-year tribal substance use prevention program.

American Indian youth substance use is a major public health concern. To date, there has been limited evaluation of American Indian youth substance use prevention programs. Evaluation of prevention programs is necessary to understand the aspects of programming that are effective or not effective.

Spontaneous reactivation of latent HIV-1 promoters is linked to the cell cycle as revealed by a genetic-insulators-containing dual-fluorescence HIV-1-based vector.

Long-lived latently HIV-1-infected cells represent a barrier to cure. We developed a dual-fluorescence HIV-1-based vector containing a pair of genetic insulators flanking a constitutive fluorescent reporter gene to study HIV-1 latency. The protective effects of these genetic insulators are demonstrated through long-term (up to 394 days) stable fluorescence profiles in transduced SUP-T1 cells.

Clinical Diagnoses Leading to Suspension in Army Aircrew: An Epidemiological Study.

Introduction: There have been few large-scale epidemiological examinations of military aircrew populations reported in recent literature. This study examined 10 yr of medical records contained in the U.S.

A Survey of Fatigue in Army Aviators.

Introduction: Fatigue plays a critical role in mission success due to its effect on a number of performance variables. The purpose of this study was to gauge the extent to which U.S.

Postoperative Harlequin Syndrome: Case Report of a Rare but Clinically Striking Condition.

We present a case of a 2-year-old boy who underwent thoracoscopic resection of a left paraspinal mediastinal mass and developed Harlequin syndrome postoperatively. Harlequin syndrome is a rare neurological condition characterized by unilateral hyperhidrosis and erythema of the head and neck. Our discussion highlights this condition and other differential diagnoses that may present similarly in the postoperative period.

Barriers to Advance Care Planning in End-Stage Renal Disease: Who is to Blame, and What Can be Done?

Patients with end-stage renal disease experience significant mortality and morbidity, including cognitive decline. Advance care planning has been emphasized as a responsibility and priority of physicians caring for patients with chronic kidney disease in order to align with patient values before decision-making capacity is lost and to avoid suffering. This emphasis has proven ineffective, as illustrated in the case of a patient treated in our hospital.

Impact of In-Hospital Death on Spending for Bereaved Spouses.

Objective: To examine how patients' location of death relates to health care utilization and spending for surviving spouses.

Data Sources/study Setting: Health and Retirement Study (HRS) 2000-2012 linked to the Dartmouth Atlas and Medicare claims data.

Study Design: This was an observational study.

Characterization of Proteins Present in Isolated Senile Plaques from Alzheimer's Diseased Brains by MALDI-TOF MS with MS/MS.

The increase of insoluble senile plaques in the brain is a primary hallmark of Alzheimer's disease. The usefulness of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) with tandem MS for the characterization of senile plaques from AD brains and the relevance of the components identified to furthering AD research using MS is discussed. Thirty-three components were reproducibly observed within tryptic aliquots of senile plaques from two different AD brains after sample preparation optimization.

Resonance Raman excitation profiles of CdS in pure CdS and CdSe/CdS core/shell quantum dots: CdS-localized excitons.

Resonance Raman excitation profiles have been measured for the longitudinal optical phonon in two sizes of CdS quantum dots and in CdSe/CdS core/shell quantum dots. In pure CdS, the resonance Raman cross section for the fundamental transition is sharply peaked around the lowest-energy excitonic transition and becomes weaker with higher-energy excitation even though the absorbance continues to increase to higher energies. This effect, also observed in earlier studies of CdSe quantum dots, is attributed largely to interferences among multiple excitonic transitions contributing to the resonance Raman polarizability.

Accountability for Community-Based Programs for the Seriously Ill.

Innovation is needed to improve care of the seriously ill, and there are important opportunities as we transition from a volume- to value-based payment system. Not all seriously ill are dying; some recover, while others are persistently functionally impaired. While we innovate in service delivery and payment models for the seriously ill, it is important that we concurrently develop accountability that ensures a focus on high-quality care rather than narrowly focusing on cost containment.