Improving apgar scores and reducing perineal injuries through midwife-led quality improvements: an observational study in Uganda.

Background: Globally, the quality of maternal and newborn care remains inadequate, as seen through indicators like perineal injuries and low Apgar scores. While midwifery practices have the potential to improve care quality and health outcomes, there is a lack of evidence on how midwife-led initiatives, particularly those aimed at improving the use of dynamic birth positions, intrapartum support, and perineal protection, affect these outcomes.

Objective: To explore how the use of dynamic birth positions, intrapartum support, and perineal protection impact the incidence of perineal injuries and the 5-min Apgar score within the context of a midwife-led quality improvement intervention.

Evaluation of the use of intraosseous access on adult patients presenting to the emergency department in urban South Africa.

Background: Timely vascular access forms a necessary part of patient management in the Emergency Department (ED). Factors such as hypotension, intravenous drug use, obesity, dark skin, patients at extremes of age, and patients with multiple injuries may make peripheral intravenous cannulation difficult. The intraosseous route remains a suitable alternative for emergency circulatory access.

Examining individual- versus population-level social determinants of health in a cluster randomized trial of health coaches for patients with multiple chronic conditions.

Introduction: Social determinants of health (SDOH) are an important contributor to health status and health outcomes. In this analysis, we compare SDOH measured both at the individual and population levels in patients with high comorbidity who receive primary care at Federally Qualified Health Centers in New York and Chicago and enrolled in the Tipping Points trial.

Methods: We analyzed individual- and population-level measures of SDOH in 1,488 patients with high comorbidity (Charlson Comorbidity Index ≥ 4) enrolled in Tipping Points.

The effect of incline walking on lower extremity and trunk mechanics in older adults.

Older adults are at an increased risk of developing knee osteoarthritis. High internal knee abduction moment during daily activities may elevate the risk of knee osteoarthritis. Incline walking exercise has been found to decrease knee abduction moment in healthy young adults.

Patient and Caregiver Experience of Diagnosis, Treatment, and Living With Recurrent Oropharyngeal Cancer.

Importance: The management of recurrent oropharyngeal cancer (rOPC) is complex. Curative options carry considerable risk of morbidity with overall poor prognosis. Little data exist on function and quality of life (QoL) outcomes for noncurative treatments.

Fate of biosolids-bound PFAS through pyrolysis coupled with thermal oxidation for air emissions control.

Pyrolysis has been identified as a possible thermal treatment process for reducing perfluoroalkyl and polyfluoroalkyl substances (PFAS) from wastewater solids, though off-gas from the pyrolysis unit can still be a source of PFAS emissions. In this work, the fate of PFAS through a laboratory-scale pyrolysis unit coupled with a thermal oxidizer for treatment of off-gasses is documented. Between 91.

The understanding of dynamic birth positions for women in labor and childbirth - A hybrid concept analysis.

Problem And Background: The assessment of advantages and drawbacks associated with varying birthing positions has predominantly centered around medical or technical considerations and few studies have accounted for a woman's ability to attune to her bodily instincts during labor and birth. The objective of this study was to define the concept of dynamic birth positions and its significance within the birthing process.

Methods: This hybrid concept analysis consisted of three phases: theoretical, fieldwork, and analytical.

"Oh when's your treatment ending?" "Never!" The unmet needs of cancer patients treated with immunological, biological and precision therapies: A qualitative interview study.

Purpose: To explore the unmet supportive care needs of patients with advanced cancer receiving immuno-, biological and precision (IBP) therapies.

Methods: We conducted semi-structured interviews with: (1) adults diagnosed with advanced cancer (lung, colorectal, ovary, breast, renal, melanoma) treated with an IBP therapy (e.g.

Intramedullary nail fixation versus open reduction and internal fixation for treatment of adult diaphyseal forearm fractures: a systematic review and meta-analysis.

Background: Diaphyseal radius and ulna fractures require surgical fixation in adults. Open reduction and internal fixation (ORIF) have been considered the gold standard of treatment. The recent development of an interlocking intramedullary nail (IMN) has provided an alternative treatment method for these fractures.

Psychometric Properties of the Generalized Anxiety Disorder Scale (GAD-7) in Older Adults With Advanced Cancer.

Objectives: Over half of new cancer diagnoses occur in patients aged 65 or older, with up to 40% experiencing anxiety. The American Society of Clinical Oncology recommends using the Generalized Anxiety Disorder Scale (GAD-7) for anxiety screening, but the GAD-7 psychometric properties in this population are unknown. This study examined the GAD-7's reliability, validity, and item parameters, comparing its utility with the GAD-2 in older adults with cancer.

Effect of a pre-calving injectable trace mineral supplement on white blood cell function in seasonally calving pastoral dairy cows.

Aims: To investigate the effect of injection of trace mineral supplement (TMS) 14-28 days before calving on white blood cell count (WBCC) and function, serum antioxidant capacity (SAC) and reactive oxygen species (ROS) in pasture-fed cattle after calving.

Methods: On each of two South Island, seasonally calving, pastoral dairy farms,1 month before dry-off, a random sample of 150 multiparous cows predicted to calve within 7 days of the herd's planned start of calving (PSC) were stratified on individual somatic cell count, age, breed and expected calving date. On each farm, 14-24 days before PSC, 60 selected cows were randomly assigned for TMS (Zn, Mn, Se, Cu) injection, and 60 were controls.

At-home wearable-based monitoring predicts clinical measures and biological biomarkers of disease severity in Friedreich's Ataxia.

Background: Friedreich ataxia (FRDA) results in progressive impairment in gait, upper extremity coordination, and speech. Currently, these symptoms are assessed through expert examination at clinical visits. Such in-clinic assessments are time-consuming, subjective, of limited sensitivity, and provide only a limited perspective of the daily disability of patients.

Ewing Sarcoma in the Pediatric Population: Predictors of Survival Within the United States.

Introduction: Bone and joint tumors are the third most common cause of pediatric cancer-related deaths in the United States. Although there have been improvements in survival rates among pediatric cancer patients over the past few decades, bone and joint cancers remain the exception. Considering current clinical trials involving novel targeted therapies, the establishment of updated mortality rates and predictors of survival for this cancer would be prudent.

Telehealth regulating together pilot trial: emotion regulation intervention for autistic children and adolescents.

Introduction: Autistic children and adolescents frequently experience emotion dysregulation, or difficulties with appropriately modifying their emotional reactions. Caregivers of autistic teens frequently seek psychotherapy support for navigating challenges associated with emotion dysregulation. During the COVID-19 pandemic, access to clinical services became limited, with interventions halted or transitioned into a telehealth format.

The effectiveness of delivery modalities of non-pharmacological diabetes prevention programs: A systematic review and component network meta-analysis.

Background And Aims: Type 2 diabetes prevention programs are effective but costly and intensive, making translation into routine primary care and community settings challenging. Identifying drivers of intervention effectiveness can inform pragmatic future implementation whilst maintaining effectiveness. Translational studies have demonstrated that delivery modalities impact their effectiveness.

High-Sensitivity Analysis of Native Bacterial Biofilms Using Dynamic Nuclear Polarization-Enhanced Solid-State NMR.

Bacterial biofilms cause persistent infections that are difficult to treat and contribute greatly to antimicrobial resistance. However, high-resolution structural information on native bacterial biofilms remain very limited. This limitation is primarily due to methodological constraints associated with analyzing complex native samples.

Total body weight estimation by 3D camera systems: Potential high-tech solutions for emergency medicine applications? A scoping review.

Background: Weight estimation is required in adult patients when weight-based medication must be administered during emergency care, as measuring weight is often not possible. Inaccurate estimations may lead to inaccurate drug dosing, which may cause patient harm. High-tech 3D camera systems driven by artificial intelligence might be the solution to this problem.

Workplace violence in trauma centers: an American Trauma Society Position Statement.

In 1966, the National Academy of Sciences and National Research Council published 'Accidental Death and Disability: the Neglected Disease of Modern Society' which served as a national call to action to address the apparent public apathy towards the devastating and unnecessary toll that injury was taking on America. This white paper recommended the establishment of a National Trauma Association to drive public demand for injury prevention and mitigation. The American Association for the Surgery of Trauma heeding that call, founded the American Trauma Society (ATS) in 1968.

United States Provider Experiences With Telemedicine for Hepatitis C Treatment: A Nationwide Survey.

Hepatitis C virus (HCV) elimination requires treatment access expansion, especially for underserved populations. Telehealth has the potential to improve HCV treatment access, although data are limited on its incorporation into standard clinical practice. We conducted a cross-sectional, email survey of 598 US HCV treatment providers who had valid email addresses and (1) were located in urban areas and had written ≥ 20 prescriptions for HCV treatment to US Medicare beneficiaries in 2019-2020 or (2) were located in non-urban areas and wrote any HCV prescriptions in 2019-2020.

Deletion of miR-33, a regulator of the ABCA1-APOE pathway, ameliorates neuropathological phenotypes in APP/PS1 mice.

Introduction: Rare variants in ABCA1 increase the risk of developing Alzheimer's disease (AD). ABCA1 facilitates the lipidation of apolipoprotein E (apoE). This study investigated whether microRNA-33 (miR-33)-mediated regulation of this ABCA1-APOE pathway affects phenotypes of an amyloid mouse model.