Impact of diagnostic stewardship on catheter-associated urinary tract infections and patient outcomes.

Background: Diagnostic stewardship of urine cultures from patients with indwelling urinary catheters may improve diagnostic specificity and clinical relevance of the test, but risk of patient harm is uncertain.

Methods: We retrospectively evaluated the impact of a computerized clinical decision support tool to promote institutional appropriateness criteria (neutropenia, kidney transplant, recent urologic surgery, or radiologic evidence of urinary tract obstruction) for urine cultures from patients with an indwelling urinary catheter. The primary outcome was a change in catheter-associated urinary tract infection (CAUTI) rate from baseline (34 mo) to intervention period (30 mo, including a 2-mo wash-in period).

First results from a multimodal psychosomatic post-COVID treatment approach - a prospective longitudinal study.

Background: Clinical experiences using a psychosomatic-oriented multimodal treatment approach in patients with post-COVID are promising. We established a half-day multimodal treatment program for post-COVID patients at the Department of Psychosomatic Medicine at General Hospital Nuremberg, Paracelsus Medical University, Germany.

Methods: This observational study between January 2022 and March 2023 comprised baseline documentation of Patient Health Questionnaire (PHQD), ICD-10 Symptom Rating (ISR), Fatigue Scale (FS) and Health Status Questionnaire (SF-12) at admission and discharge of 65 patients suffering from post-COVID.

Examining the Impact of Eliminating the X Waiver on Buprenorphine Dispensation in 63 Counties in Pennsylvania.

Background: Opioid overdose rates continue to rise in the United States while access to treatment options remains limited. The X waiver, which allowed clinicians to prescribe buprenorphine, a medication for opioid use disorder (MOUD), in an outpatient setting, was eliminated in December 2022 with hopes of increasing buprenorphine access. We used a quasi-experimental approach to evaluate how eliminating the X waiver affected buprenorphine prescribing in Pennsylvania.

Buprenorphine prescribing practices for older adults in 2019 and 2020.

Background: Opioid use disorder (OUD) prevalence has increased threefold among Medicare beneficiaries 65 years and older (hereafter "older adults") since 2013, with a prevalence of 15.7 per 1000 Medicare beneficiaries in 2018. Yet, access to treatment that addresses the needs of older adults with OUD is limited, including patterns of buprenorphine prescribing to older adults.

A genuine need or nice to have? Understanding HTA representatives' perspectives on the use of patient preference data.

Objectives: The roles and potential value of patient preference (PP) data in health technology assessment (HTA) remain to be fully realized despite an expanding literature and various efforts to establish their utility. This article reports lessons learned through a series of collaborative workshops with HTA representatives, organized by the Health Technology Assessment International's Patient Preferences Project Subcommittee.

Methods: Five online workshops were conducted between June 2022 and June 2023, seeking to facilitate collaborative learning and reflection on ways that PP data can be integrated into HTA.

Associations Between State Policies Facilitating Telehealth and Buprenorphine Episode Initiation and Duration Early in the COVID Pandemic : State Telehealth Policies and Buprenorphine.

Importance: State policies facilitating telehealth implemented early in COVID may support buprenorphine treatment of opioid use disorder. However, little empirical information is available about those policies' effects.

Objective: Examine association between state policies that may facilitate telehealth use and buprenorphine treatment.

Tail-specific protease is an essential virulence factor that mediates the differentiation of elementary bodies into reticulate bodies.

Tail-specific proteases (Tsp) are members of a widely distributed family of serine proteases that commonly target and process periplasmic proteins in Gram-negative bacteria. The obligately intracellular, Gram-negative encode a highly conserved Tsp homolog whose target and function are unclear. We identified a mutant with a nonsense mutation in .

Implementation Of New Mexico's 'No Behavioral Health Cost Sharing' Law: A Qualitative Study.

Out-of-pocket spending is a long-standing challenge for privately insured people. New Mexico passed the first US law prohibiting private insurers from applying cost sharing to behavioral health treatment, effective January 1, 2022. We examined the perceptions of key informants, including clinicians, insurers, and state officials, about implementing the No Behavioral Health Cost Sharing law to explore how it might affect downstream outcomes such as spending and access.

The interplay of personality pathology and treatment outcome in psychosomatic psychotherapy: A longitudinal analysis using latent change score modelling.

Introduction: While ample data demonstrate the effectiveness of inpatient psychosomatic treatment, clinical observation and empirical evidence demonstrate that not all patients benefit equally from established therapeutic methods. Especially patients with a comorbid personality disorder often show reduced therapeutic success compared to other patient groups. Due to the heterogeneous and categorical personality assessment, previous studies indicated no uniform direction of this influence.

Association of Daily Doses of Buprenorphine With Urgent Health Care Utilization.

Importance: Higher buprenorphine doses may benefit the increasing number of individuals using fentanyl and other synthetic opioids, but there is little empirical evidence on the efficacy of such higher doses.

Objective: To examine the association between higher buprenorphine doses (above 16 mg and 24 mg) and subsequent emergency department (ED) or inpatient service use among patients diagnosed with opioid use disorder.

Design, Setting, And Participants: This cross-sectional study was a retrospective analysis of health data from Optum's deidentified Clinformatics Data Mart Database from 2016 to 2021 for commercially insured individuals aged 18 years or older diagnosed with opioid use disorder (OUD).

Exploring How Values of Colorectal Cancer Patients and their Caregivers Influence Treatment Decision-Making.

Background: As we adopt value models to inform drug reimbursement, coverage, clinical trials, and treatment choices, aligning these models to reflect patient values and preferences becomes increasingly relevant. In this study, we focus on colorectal cancer (CRC), which is highly prevalent and a leading cause of death in Canada, and new drug treatment options are costly.

Objective: The aim of this study was to understand how the values and experiences of people with CRC and their caregivers inform their perspectives about new and emerging colorectal cancer drug treatments.

Stress, resilience, and emotional well-being in children and adolescents with specific learning disabilities.

This article reviews the prevalence of stress and explores resilience factors in children and adolescents with specific learning disabilities (SLDs). We show that the increased stress and emotional challenges faced by this group are likely due to societal pressures and stigma. Recent findings on neuroendocrine changes in this population are discussed, suggesting a predisposition to psychiatric disorders.

PuCl{CoCp[OP(OEt)]}: transuranic elements entering the field of heterometallic molecular chemistry.

Recent advances enabled the discovery of heterometallic molecules for many metals: main group, d-block, lanthanides, and some actinides (U, Th). These complexes have at least two different metals joined by bridging ligands or by direct metal-metal bonding interactions. They are attractive because they can enable chemical cooperativity between metals from different parts of the periodic table.

High-Dose Opioid Prescribing in Individuals with Acute Pain: Assessing the Effects of US State Opioid Policies.

Background: How state opioid policy environments with multiple concurrent policies affect opioid prescribing to individuals with acute pain is unknown.

Objective: To examine how prescription drug monitoring programs (PDMPs), pain management clinic regulations, initial prescription duration limits, and mandatory continued medical education affected total and high-dose prescribing.

Design: A county-level multiple-policy difference-in-difference event study framework.

A Longitudinal Multivariable Analysis: State Policies and Opioid Dispensing in Medicare Beneficiaries Undergoing Surgery.

Background: States have implemented policies to decrease clinically unnecessary opioid prescribing, but few studies have examined how state policies affect opioid dispensing rate trends for surgical patients.

Objective: To examine trends in the perioperative opioid dispensing rates for fee-for-service Medicare beneficiaries and the effects of select state policies.

Design And Participants: A retrospective cohort study using 2006 to 2018 Medicare claims data for individuals undergoing surgical procedures for which opioid analgesic treatment is common.

Integration of the PD-L1 inhibitor atezolizumab and WT1/DC vaccination into standard-of-care first-line treatment for patients with epithelioid malignant pleural mesothelioma-Protocol of the Immuno-MESODEC study.

Malignant pleural mesothelioma (MPM) is an aggressive cancer with a very poor prognosis. Recently, immune checkpoint inhibition (ICI) has taken center stage in the currently ongoing revolution that is changing standard-of-care treatment for several malignancies, including MPM. As multiple arguments and accumulating lines of evidence are in support of the existence of a therapeutic synergism between chemotherapy and immunotherapy, as well as between different classes of immunotherapeutics, we designed a multicenter, single-arm, phase I/II trial in which both programmed-death-ligand 1 (PD-L1) inhibition and dendritic cell (DC) vaccination are integrated in the first-line conventional platinum/pemetrexed-based treatment scheme for epithelioid MPM patients (Immuno-MESODEC, ClinicalTrials.

Infection of Alfalfa Cotyledons by an Incompatible but Not a Compatible Species of Induces Formation of Paramural Bodies and Secretion of EVs.

Hemibiotrophic fungi in the genus employ a biotrophic phase to invade host epidermal cells followed by a necrotrophic phase to spread through neighboring mesophyll and epidermal cells. We used serial block face-scanning electron microscopy (SBF-SEM) to compare subcellular changes that occur in (alfalfa) cotyledons during infection by (compatible on ) and (incompatible on ). Three-dimensional reconstruction of serial images revealed that alfalfa epidermal cells infected with undergo massive cytological changes during the first 60 h following inoculation to accommodate extensive intracellular hyphal growth.

A Survey Detailing Early Onset Colorectal Cancer Patient and Caregiver Experiences in Canada.

The incidence of early onset colorectal cancer (EOCRC) in Canada has increased. To address the growing incidence of EOCRC, Colorectal Cancer Canada (CCC) developed the Never Too Young (N2Y) program to identify gaps in care and evaluate patient and caregiver experiences with CRC. The survey was available online using SurveyMonkey across Canada between 12 December 2022 and 1 May 2023.

Understanding Colorectal Cancer Patient Experiences with Family Practitioners in Canada.

Despite ongoing screening efforts, colorectal cancer (CRC) remains a leading cause of death in Canada. The aim of this study was to better understand the experiences of Canadian CRC patients with their family practitioners (FPs) during and after their CRC diagnosis. Patient-reported data were collected through an online questionnaire to understand their CRC diagnosis experiences and identify potential gaps in care.

Availability of Medications for Opioid Use Disorder in Community Mental Health Facilities.

Importance: Medications for opioid use disorder (MOUD) are an effective but underutilized treatment. Opioid use disorder prevalence is high among people receiving treatment in community outpatient mental health treatment facilities (MHTFs), but MHTFs are understudied as an MOUD access point.

Objective: To quantify availability of MOUD at community outpatient MHTFs in high-burden states as well as characteristics associated with offering MOUD.

Extreme Ultraviolet Reflection Spectroscopy of Lanthanides and Actinides Using a High Harmonic Generation Light Source.

Absorption spectroscopy probing transitions from shallow-core d and f orbitals in lanthanides and actinides reveals information about bonding and the electronic structure in compounds containing these elements. However, spectroscopy in this photon energy range is challenging because of the limited availability of light sources and extremely short penetration depths. In this work, we address these challenges using a tabletop extreme ultraviolet (XUV), ultrafast, laser-driven, high harmonic generation light source, which generates femtosecond pulses in the 40-140 eV range.

The brain can develop conflicting multisensory principles to guide behavior.

Midbrain multisensory neurons undergo a significant postnatal transition in how they process cross-modal (e.g. visual-auditory) signals.

Hospital Quality Indicators for Opioid-Exposed Infants: Results From an Expert Consensus Panel.

Objective: To elicit expert consensus on quality indicators for the hospital-based care of opioid-exposed infants.

Methods: We used the ExpertLens online platform to conduct a 3-round modified Delphi panel. Expert panelists included health care providers, parents in recovery, quality experts, and public health experts.