Changes in global mortality from aortic aneurysm.

Objective: Globally, there has been a marked increase in aortic aneurysm-related deaths between 1990 and 2019. We sought to understand the underlying etiologies for this mortality trend by examining secular changes in both demographics and the prevalence of risk factors, and how these changes may vary across sociodemographic index (SDI) regions.

Methods: We queried the Global Burden of Disease Study (GBD) for aortic aneurysm deaths from 1990 to 2019 overall and by age group.

The global burden of peripheral artery disease.

Background: Previous efforts to characterize the burden of peripheral artery disease (PAD) have focused on national populations. A need for a more detailed analysis of how PAD impacts the global population has been identified. Our objective was to study in greater detail the global burden of PAD, including its impact on mortality, over the past three decades.

MtING2 encodes an ING domain PHD finger protein which affects Medicago growth, flowering, global patterns of H3K4me3, and gene expression.

Flowering of the reference legume Medicago truncatula is promoted by winter cold (vernalization) followed by long-day photoperiods (VLD) similar to winter annual Arabidopsis. However, Medicago lacks FLC and CO, key regulators of Arabidopsis VLD flowering. Most plants have two INHIBITOR OF GROWTH (ING) genes (ING1 and ING2), encoding proteins with an ING domain with two anti-parallel alpha-helices and a plant homeodomain (PHD) finger, but their genetic role has not been previously described.

CRISPR-Cas9-mediated mutagenesis of kiwifruit BFT genes results in an evergrowing but not early flowering phenotype.

Phosphatidylethanolamine-binding protein (PEBP) genes regulate flowering and architecture in many plant species. Here, we study kiwifruit (Actinidia chinensis, Ac) PEBP genes with homology to BROTHER OF FT AND TFL1 (BFT). CRISPR-Cas9 was used to target AcBFT genes in wild-type and fast-flowering kiwifruit backgrounds.

Factors Associated With Patient Ratings of Timeliness of Primary Care Appointments.

As access is the lowest rated dimension in surveys of outpatient experience, we sought to identify patient, practice, and provider factors associated with positive ratings of timeliness of primary care appointments. A cross-sectional study with multivariable, multilevel logistic regression was performed using survey responses from 236 695 individuals receiving care in the Veterans Health Administration (VA). Top box ratings (response of "always") for whether the patient reported receiving an appointment as soon as they needed in primary care for routine care and for care needed right away were the main outcomes.

Results of a Regional Effort to Improve Warfarin Management.

Background: Improved anticoagulation control with warfarin reduces adverse events and represents a target for quality improvement. No previous study has described an effort to improve anticoagulation control across a health system.

Objective: To describe the results of an effort to improve anticoagulation control in the New England region of the Veterans Health Administration (VA).

Experience of the Veterans Health Administration in Massachusetts after state health care reform.

Starting in 2006, Massachusetts enacted a series of health insurance reforms that successfully led to 96.6% of its population being covered by 2011. As the rest of the nation undertakes similar reforms, it is unknown how the Veterans Health Administration (VHA), one of many important Federal health care programs, will be affected.

The effect of physician panel size on health care outcomes.

An inadequate supply of primary care providers is leading to a crisis in access. Pressures are being placed on primary care practices to increase panel sizes. The impact of these pressures on clinical processes, patient satisfaction and waiting times is largely unknown, although evidence from recent literature shows that longer waiting time results in higher mortality rates and other adverse outcomes.

Relationship of scheduling interval to missed and cancelled clinic appointments.

Background: The interval between when a clinical appointment is created and when it occurs may affect the rate of missed and cancelled appointments, affecting access and loss to follow-up, key component of quality.

Methods: We examined this relationship in various clinic types across Veterans Health Administration clinics nationwide.

Results: As the interval increased, the missed appointment rate increased from 12.

Factors associated with improved completion of computerized clinical reminders across a large healthcare system.

Objective: To analyze the relationship of completion rates for a standardized set of computerized clinical reminders across a large healthcare system to practice and provider characteristics.

Methods: The relationship between completion rate for 13 standardized reminders at 49 primary care practices in the VA New England Healthcare System for a 30-day period and practice characteristics, provider demographics and, via survey, provider attitudes was analyzed.

Results: There was no difference in clinical reminder completion rate between staff physicians versus nurse practitioners/physician assistants (87.

Adherence to computerized clinical reminders in a large healthcare delivery network.

Objective: To evaluate clinicians' adherence with clinical reminders (CRs) across multiple ambulatory practice settings in an integrated health care network.

Materials And Methods: Adherence rate to 15 CRs, integrated into a computerized patient record system, was evaluated for 451 clinicians in 49 clinics from eight Veterans Affairs (VA) medical centers.

Results: Overall, mean rate of adherence to CRs for all clinics was 86.

Management of alcohol withdrawal delirium. An evidence-based practice guideline.

Background: Alcohol withdrawal delirium is the most serious manifestation of alcohol withdrawal. Evidence suggests that appropriate care improves mortality, but systematic reviews are unavailable.

Methods: Articles with original data on management of alcohol withdrawal delirium underwent structured review and meta-analysis.

Double-blind placebo-controlled trial of static magnets for the treatment of osteoarthritis of the knee: results of a pilot study.

Context: Outpatient clinical studies of magnet therapy, a complementary therapy commonly used to treat osteoarthritis (OA), have been limited by the absence of a credible placebo control.

Objective: Our objective was to assess the feasibility and promise of studying static magnetic therapy for knee OA and determine the ability of a new placebo-magnet device to provide concealment of group assignment.

Design: Randomized, double-blind, placebo-controlled clinical trial.

Independent clinical correlates of severe alcohol withdrawal.

This retrospective cohort study sought to identify clinical variables that independently correlate with severe alcohol withdrawal and to quantify risk in a clinically useful manner. The records of 284 inpatients admitted to an acute detoxification unit at a Veterans Affairs teaching hospital were reviewed. Clinical data were recorded on standardized forms at the time of admission and abstracted by a physician reviewer.

Are guidelines following guidelines? The methodological quality of clinical practice guidelines in the peer-reviewed medical literature.

Context: Practice guidelines play an important role in medicine. Methodological principles have been formulated to guide their development.

Objective: To determine whether practice guidelines in peer-reviewed medical literature adhered to established methodological standards for practice guidelines.

Impact of age on the severity, course, and complications of alcohol withdrawal.

Background: Early identification of alcohol-dependent patients at increased risk for severe or complicated alcohol withdrawal would improve triage and treatment. However, the role of age in predicting alcohol withdrawal outcomes has not been well studied.

Objective: To assess the impact of age on the severity, course, and complications of alcohol withdrawal.

Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. American Society of Addiction Medicine Working Group on Pharmacological Management of Alcohol Withdrawal.

Objective: To provide an evidence-based practice guideline on the pharmacological management of alcohol withdrawal.

Data Sources: English-language articles published before July 1, 1995, identified through MEDLINE search on "substance withdrawal--ethyl alcohol" and review of references from identified articles.

Study Selection: Articles with original data on human subjects.

Thermal epiglottitis in adults: a new complication of illicit drug use.

Four cases of acute epiglottitis due to thermal injury were identified in a larger study of 407 cases of epiglottitis in Rhode Island from 1975 through 1992. All occurred in young adults (aged 22-33 yr) and were caused by the inhalation of heated objects when smoking illicit drugs (a tip of a marijuana cigarette in 1 case and metal pieces from crack cocaine pipes in 3 cases). Symptoms, signs, and X-ray and laryngoscopic findings were similar to infectious epiglottitis.

Differences in generalists' and cardiologists' perceptions of cardiovascular risk and the outcomes of preventive therapy in cardiovascular disease.

Objective: To compare generalists' and cardiologists' estimates of baseline cardiovascular risk and the outcomes of preventive therapy.

Design: Cross-sectional mail survey using written case simulations of typical patients from primary prevention trials for hypercholesterolemia and isolated systolic hypertension, and tertiary prevention studies of coronary artery bypass surgery for chronic stable angina with left main coronary stenosis.

Participants: Nationally representative sample of 599 practicing family physicians, general internists, and cardiologists selected from the American Medical Association masterfile.

Acute epiglottitis. An 18-year experience in Rhode Island.

Objective: To assess the incidence, clinical characteristics, management, and outcome of epiglottitis in a defined population over an 18-year period.

Design: Case series.

Setting: The state of Rhode Island, 1975 through 1992.

Alcohol withdrawal: a nationwide survey of inpatient treatment practices.

Objective: To describe current practices employed in the inpatient treatment for alcohol withdrawal.

Design: Survey.

Setting: Inpatient alcoholism treatment programs in the United States.