The Effect of Medicaid Expansion on Access to Anti-incontinence Surgery.

Importance: Medicaid expansion broadened access to care; however, limited data about the effect on access to anti-incontinence surgical procedures exist.

Objective: Since the Affordable Care Act (ACA) Medicaid expansion in 2014, some regions have had more states adopt expansion (NE-Northeast, W-West) than other regions (S-South, MW-Midwest). We aimed to determine if the proportion of Medicaid funded anti-incontinence procedures increased after Medicaid expansion and whether increases were different by U.

Survey of Medical Trainees Indicates a Need for Increased Access to Obstetrics and Gynecology Care.

Given the higher rates of infertility and complicated pregnancies among female physicians, we identified a need to assess access to obstetrics and gynecology (OBGYN) care for medical trainees. We hypothesized that medical students and residents are not up-to-date on routine OBGYN care.  Methods: We administered an optional, anonymous survey to all medical students and residents at Albany Medical College (Albany, NY, USA) who self-identified as having a uterus to assess their access to gynecologic care in November 2022.

Horse Owners' Knowledge of Fundamental Care and their Perceptions on the Implementation of a Mandatory Certificate of Knowledge.

The aims of this study were to first determine the extent of owners' fundamental knowledge of equine care, second, gain their opinions on the implementation of a mandatory certificate of knowledge and third, to investigate the association of certification on horse owner knowledge. An online survey comprising 23 questions (18 closed, 5 open) was distributed worldwide via snowball sampling, and completed by 1847 horse owners who were all ≥18 years old from 17 different countries. Almost all (96%,  = 1781) completed surveys were usable.

A Delphi Study to Determine International and National Equestrian Expert Opinions on Domains and Sub-Domains Essential to Managing Sporthorse Health and Welfare in the Olympic Disciplines.

The public is increasingly questioning equestrianism's social license to operate. While the focus historically centered on horseracing, increased scrutiny is now being placed on how dressage, showjumping, and eventing are addressing equine management and welfare concerns. Nominated equestrian federation and equestrian organization experts ( = 104) directly involved in international and/or national-level horse sports took part in a four-stage, iterative Delphi to obtain consensus on what factors should be considered essential to manage sporthorse health and welfare.

Visually Assessing Equine Quality of Movement: A Survey to Identify Key Movements and Patient-Specific Measures.

Outcome measures are essential for monitoring treatment efficacy. The lack of measures for quality of movement in equine physiotherapy and rehabilitation impairs evidence-based practice. To develop a new field-based outcome measure, it is necessary to determine movements most frequently observed during assessment of rehabilitation and performance management cases.

The Effect of Stabling Routines on Potential Behavioural Indicators of Affective State in Horses and Their Use in Assessing Quality of Life.

Increasing interest in equine welfare has emphasised the need for objective and reliable behavioural indicators of horses' affective state. However, research has yielded mixed results regarding behaviours suited for industry use largely because they are subject to anthropomorphic interpretation. Stabling is commonly used to manage domesticated horses despite research indicating that it can negatively impact horse welfare, but its effect on their affective state is yet to be quantified.

Habit Formation and the Effect of Repeated Stress Exposures on Cognitive Flexibility Learning in Horses.

Horse training exposes horses to an array of cognitive and ethological challenges. Horses are routinely required to perform behaviours that are not aligned to aspects of their ethology, which may delay learning. While horses readily form habits during training, not all of these responses are considered desirable, resulting in the horse being subject to retraining.

Colonoscopy screening and surveillance disparities during the COVID-19 pandemic.

Background: The COVID-19 pandemic has increased barriers to accessing preventive healthcare. This study identifies populations disproportionately underrepresented in screening and surveillance colonoscopies during the COVID-19 pandemic.

Methods: In this single-center cohort study, colonoscopy procedures were reviewed during 6-month intervals before the pandemic (July 1, 2019 - December 31, 2019) and during the pandemic (July 1, 2020 - December 31, 2020 and January 1, 2021 - June 30, 2021).

A Systematic Review of Clinical Signs Associated With Degenerative Conditions and Morphological Variations of the Equine Caudal Neck.

Conditions of the equine caudal neck (C5-C7) are thought to be associated with various clinical signs. However, little investigation has been undertaken to isolate clinical indicators associated with specific conditions of the equine caudal cervical spine. This systematic review aimed to evaluate associations of clinical signs with anatomical malformation of caudal cervical vertebrae, spinal cord compression of the caudal cervical spine, and arthropathy of the caudal cervical articular process joints (APJs).

The effect of stress and exercise on the learning performance of horses.

Domestic horses are widely used for physically demanding activities but the effect of exercise on their learning abilities has not been explored. Horses are also frequently exposed to stressors that may affect their learning. Stress and exercise result in the release of glucocorticoids, noradrenaline and other neurotransmitters that can influence learning.

Investigating Equestrians' Perceptions of Horse Happiness: An Exploratory Study.

Happiness is a subjective feeling and associated with positive affective states that can indicate good welfare. It is becoming increasingly agreed that equestrians' ability to recognize indicators of positive emotions has the potential to enhance overall horse wellbeing, but research in this area is limited. Therefore, this study investigated equestrians' perceptions of horse happiness.

COVID-19: Impact on United Kingdom Horse Owners.

COVID-19 was declared a global pandemic on 11 March 2020; the United Kingdom (UK) implemented quarantine measures shortly afterward, resulting in rapid changes in how owners managed and interacted with their horses. This study provides a rapid analysis of the initial impact of the COVID-19 outbreak on the management of UK leisure and competition horses. A 17 question online survey was distributed via equestrian social media sites to ascertain the impact of COVID-19 on horse and yard management and on human-horse interactions.

Evaluation of the use of non-formulary oncology medications restricted to outpatient use in hospitalized patients after implementation of a criteria-for-use algorithm.

Objective: To decrease the number of orders and total hospital spend for inpatient use of antineoplastic drugs of interest, while evaluating each case for urgent or emergent need for administration.

Methodology: This study is a multicenter, retrospective, cost-evaluation, cohort study performed in five Ascension Seton hospitals in the Austin, Texas area between 1 January 2013 and 31 December 2018. Patients were identified via a dispense analysis report for the antineoplastic drugs of interest.

Inadequate DNA Damage Repair Promotes Mammary Transdifferentiation, Leading to BRCA1 Breast Cancer.

Loss of BRCA1 p220 function often results in basal-like breast cancer (BLBC), but the underlying disease mechanism is largely opaque. In mammary epithelial cells (MECs), BRCA1 interacts with multiple proteins, including NUMB and HES1, to form complexes that participate in interstrand crosslink (ICL) DNA repair and MEC differentiation control. Unrepaired ICL damage results in aberrant transdifferentiation to a mesenchymal state of cultured, human basal-like MECs and to a basal/mesenchymal state in primary mouse luminal MECs.

Modeling of octave-spanning Kerr frequency combs using a generalized mean-field Lugiato-Lefever model.

A generalized Lugiato-Lefever equation is numerically solved with a Newton-Raphson method to model Kerr frequency combs. We obtain excellent agreement with past experiments, even for an octave-spanning comb. Simulations are much faster than with any other technique despite including more modes than ever before.

Is there evidence of learned helplessness in horses?

Learned helplessness is a psychological condition whereby individuals learn that they have no control over unpleasant or harmful conditions, that their actions are futile, and that they are helpless. In a series of experiments in which dogs were exposed to inescapable shocks, this lack of control subsequently interfered with the ability to learn an avoidance task. There is evidence that both neural adaptations and behavioral despair occur in response to uncontrollable aversive experiences in rodents, although this has yet to be demonstrated in other species such as horses.

Ergonomics in office-based surgery: a survey-guided observational study.

Background: The practice of office-based surgery is increasing in many specialties.

Objective: Using Mohs surgery as a model, we investigated the role of ergonomics in office-based surgery to limit work-related musculoskeletal disorders.

Methods: All Mayo Clinic surgeons currently performing Mohs surgery and Mohs surgeons trained at Mayo Clinic between 1990 and 2004 received a questionnaire survey between May 2003 and September 2004.

Eruptive epidermoid cysts resulting from treatment with imiquimod.

Background: Because of its unique mechanism of action and safety profile, imiquimod, a topical immune response modifier, is used for many benign and malignant dermatologic conditions. Adverse effects are typically limited to treatment site erythema and erosion.

Objective: To describe a newly recognized adverse effect of imiquimod.

The historical link between solid-organ transplantation, immunosuppression, and skin cancer.

Background: Skin cancers are more common in organ transplant recipients than in the general population.

Objective: The objective of this study was establish the historical link between organ transplantation, immunosuppression, and the development of skin cancer.

Methods: The pertinent literature in cutaneous oncology and transplantation is reviewed.

Skin cancer in an atomic veteran: cause or coincidence?

Background: Some military personnel who were exposed to ionizing radiation during atomic weapons tests subsequently developed skin cancer, but the cause-effect relationship is unclear.

Objective: To explore the possible relationship between exposure to atomic tests and the development of skin cancer.

Methods: We reviewed available literature regarding the effects of radiation on the skin and the case history of a patient in whom more than 300 basal cell carcinomas developed over a 30-year period after exposure to radiation during atomic testing.