Predicting right ventricular failure after left ventricular assist device implant: A novel approach.

Aims: Right ventricular (RV) failure (RVF) after left ventricular assist device (LVAD) implant is an important cause of morbidity and mortality. Modern, data-driven approaches for defining and predicting RVF have been under-utilized.

Methods: Two hundred thirty-two patients were identified with a mean age of 55 years; 40 (17%) were women, 132 were (59%) Caucasian and 74 (32%) were Black.

Screening for Health-Related Social Needs: American College of Preventive Medicine's Practice Statement.

Interest is rapidly growing around screening for health-related social needs (HRSN) in direct patient care settings. The screening and provision of HRSN is often done in the context of trying to address social determinants of health (SDOH). While there is emerging evidence that screening and referral for HRSN can improve health outcomes, there are educational, operational, and systemic gaps that need to be filled in order for HRSN screening and referral to be implemented system-wide and result in meaningful improvement in population health outcomes.

Retinitis Pigmentosa and Therapeutic Candidates.

Retinitis pigmentosa (RP) is a class of inherited retinal dystrophies (IRDs) that involves the degeneration of retinal photoreceptor cells and results in progressive vision loss. It was identified and named in 1857. For over 100 years, treatment of RP was generally limited to modifications in diet, management of cystoid macular edema, and supportive care for low vision.

Chronic Opioid Use After Implementation of Oregon's Medicaid Back Pain Policy.

Introduction: In 2016, Oregon developed an innovative policy to improve care for Medicaid patients with back pain. The objective of this study was to identify the factors associated with dose reduction and discontinuation among Medicaid patients using chronic opioid therapy after implementation of this policy.

Methods: Using Medicaid administrative claims data, this was a retrospective cohort of patients on chronic stable opioid therapy between July and December 2016.

Emergency physicians perspectives of state continuing medical education requirements for medical licensure.

Objectives: This study aims to better understand the perspectives of emergency medicine physicians' on the role that state-mandated, topic-specific continuing medical education (CME) plays in addressing knowledge gaps, its relevance to current emergency practice, its reported burden and costs of CME activities to emergency physicians, and its perceived improvement in patient care.

Methods: A cross-sectional survey was designed by the Coalition of Board-Certified Emergency Physicians (COBCEP) and distributed in February 2023 to all American Board of Emergency Medicine (ABEM)-certified physicians. Statistical tests of significance (Pearson's chi-square and Fisher's exact test) assessed the cost and time spent on CME as well as the perceived value placed on CME by ABEM-certified physicians to improve patient care.

The Ineffectiveness of Osimertinib in Epidermal Growth Factor Receptor (EGFR)-Mutated Stage IV Lung Adenocarcinoma With Bone Metastasis: A Case Report.

This case report examines the effectiveness of osimertinib in a 64-year-old non-smoking female diagnosed with stage IV lung adenocarcinoma and an epidermal growth factor receptor (EGFR) exon 19 mutation, focusing on the treatment's impact on bone metastasis. Despite initial responsiveness to osimertinib, the patient's bone lesions remained largely unresponsive, prompting a comprehensive exploration of alternative treatments and clinical trials. This report highlights the patient's clinical journey, from diagnosis through various treatment phases, culminating in palliative care, and underscores the need for further research into targeted treatments for bone metastasis in lung cancer.

Adaptive Approaches to Physical Pain Treatment Modalities During the COVID-19 Pandemic: A Qualitative Analysis.

Despite the lack of proven efficacy, opioids historically have been used for the treatment of noncancer back pain. A variety of other effective therapeutic options for pain management are becoming more available over time. In 2016, Oregon implemented a unique and novel policy to improve evidence-based back pain care and promote safer and more effective opioid prescribing through the state's Medicaid program, the Oregon Health Plan.

"It Has Improved My Practice to Be Able to Offer Alternative Treatments": A Longitudinal Qualitative Study of Oregon Medicaid Back Pain Providers.

This study aimed to understand health care providers' experiences implementing the Oregon Back Pain Policy (OBPP) over time. The Medicaid OBPP expanded coverage of evidence-based nonpharmacological therapy (NPT) for back pain and restricted access to opioid therapy and interventional approaches. The study included six online, asynchronous focus groups with providers in February 2020 (Time 1) and August 2022 (Time 2).

Systematic Review of Differential Reinforcement in Skill Acquisition.

The purpose of this article was to review and summarize the literature investigating the impact of differential reinforcement on skill acquisition. Researchers synthesized data from 10 articles across the following categories: (1) participant characteristics; (2) setting; (3) reinforcement procedures; (4) within-subject replication; (5) results; and (6) secondary measures (e.g.

How Should Harm Reduction Be Included in Care Continua for Patients With Opioid Use Disorder?

Practices and interventions that aim to slow progression or reduce negative consequences of substance use are harm reduction strategies. Often described as a form of tertiary prevention, harm reduction is key to caring well for people who use drugs. Evidence-based harm reduction interventions include naloxone and syringe service programs.

Outcomes After a Statewide Policy to Improve Evidence-Based Treatment of Back Pain Among Medicaid Enrollees in Oregon.

Background: A novel Oregon Medicaid policy guiding back pain management combined opioid restrictions with emphasis on non-opioid and non-pharmacologic therapies.

Objective: To examine the effect of the policy on prescribing, health outcomes, and health service utilization.

Design: Using Medicaid enrollment, medical and prescription claims, prescription drug monitoring program, and vital statistics files, we analyzed the policy's association with selected outcomes using interrupted time series models.

Volatile anesthetic and outcome in acute trauma care: planned secondary analysis of the PROPPR study.

Background: This retrospective analysis of prospectively collected data from the PROPPR study describes volatile anesthetic use in severely injured trauma patients undergoing anesthesia.

Methods: After exclusions, 402 subjects were reviewed of the original 680, and 292 had complete data available for analysis. Anesthesia was not protocolized, so analysis was of contemporary practice.

Automated Spot Counting in Microbiology.

Biological samples are routinely analyzed for microbe concentration. The samples are diluted, loaded onto established host cell cultures, and incubated. If infectious agents are present in the samples, they form circular spots that do not contain the host cells.

An RNA-based system to study hepatitis B virus replication and evaluate antivirals.

Hepatitis B virus (HBV) chronically infects an estimated 300 million people, and standard treatments are rarely curative. Infection increases the risk of liver cirrhosis and hepatocellular carcinoma, and consequently, nearly 1 million people die each year from chronic hepatitis B. Tools and approaches that bring insights into HBV biology and facilitate the discovery and evaluation of antiviral drugs are in demand.

Biomechanical Impact of Pathogenic MYBPC3 Truncation Variant Revealed by Dynamically Tuning In Vitro Afterload.

Engineered cardiac microtissues were fabricated using pluripotent stem cells with a hypertrophic cardiomyopathy associated c. 2827 C>T; p.R943x truncation variant in myosin binding protein C (MYBPC3).

A Review of Levodopa Formulations for the Treatment of Parkinson's Disease Available in the United States.

: The safety and efficacy of levodopa formulations are evaluated to inform clinical decision making for the treatment of Parkinson's disease. : Levodopa is a cornerstone of treatment for Parkinson's disease due to its proven efficacy. Although many patients can initially be managed using immediate release tablets, as their disease progresses they often require escalating doses as well as more frequent dosing to prevent wearing off effects.

A cross-sectional survey exploring clinician perceptions of a novel Medicaid back pain policy.

Objectives: Oregon Medicaid (Oregon Health Plan, or OHP) implemented an innovative policy in 2016 that increased coverage of evidence-based non-pharmacologic therapies (NPT, including physical therapy, massage, chiropractic, and acupuncture) while restricting opioids, epidural steroid injections, and surgeries. The objective of this study was to compare the perspectives of clinicians who see back pain patients and can prescribe pharmacologic therapies and/or refer to NPTs and clinicians who directly provide NPT therapies affected by the policy.

Methods: A cross-sectional online survey was administered to Oregon prescribing clinicians and NPT clinicians between December 2019 and February 2020.

Factors Impacting Vaccine Uptake during Pregnancy: A Retrospective Analysis.

Background And Objective: Vaccine uptake rates during pregnancy remain below target goals due to a convergence of factors. In particular, women of lower socioeconomic means and racial minorities typically have reduced rates of vaccine acceptance. This study aims to identify additional factors contributing to vaccine acceptance within a sample population of women receiving prenatal care in Houston, Texas, United States of America.

Clinician Perspectives on Referring Medicaid Back Pain Patients to Integrative and Complementary Medicine: A Qualitative Study.

To increase understanding of referral processes from primary care to integrative and complementary medicine (ICM) under an Oregon Medicaid policy that restricted opioids and expanded access to ICM for back pain patients. Four asynchronous online focus groups with 48 medical clinicians were conducted. Themes were constructed using thematic analysis.

Extracellular stiffness induces contractile dysfunction in adult cardiomyocytes via cell-autonomous and microtubule-dependent mechanisms.

The mechanical environment of the myocardium has a potent effect on cardiomyocyte form and function, yet an understanding of the cardiomyocyte responses to extracellular stiffening remains incomplete. We therefore employed a cell culture substrate with tunable stiffness to define the cardiomyocyte responses to clinically relevant stiffness increments in the absence of cell-cell interactions. When cultured on substrates magnetically actuated to mimic the stiffness of diseased myocardium, isolated rat adult cardiomyocytes exhibited a time-dependent reduction of sarcomere shortening, characterized by slowed contraction and relaxation velocity, and alterations of the calcium transient.

American College of Preventive Medicine: Addressing the Opioid Epidemic Through a Prevention Framework.

The opioid epidemic has resulted in significant morbidity and mortality in the U.S. Health systems, policymakers, payers, and public health have enacted numerous strategies to reduce the harms of opioids, including opioid use disorder (OUD).

How to Apply Translational Models to Probe Mechanisms of Cardiotoxicity.

• Treatment-related cardiovascular disease is a leading cause of morbidity and mortality in cancer survivors. • For investigators, it is crucial that in vitro models are well-matched to the toxicity studied. • From simple to complex, we describe how in vitro models are used to model cardiotoxicity.