Patient-reported factors associated with avoidance of in-person care during the COVID-19 pandemic: Results from a national survey.

Background: There has been a substantial decline in in-person care in inpatient and outpatient settings during the ongoing COVID-19 pandemic. Avoidance of needed in-person care may contribute to an avoidable decline in patient health and an increase in mortality. While several systems and behavioral theories have been put forward to explain the decline, there is a lack of studies informed by patients' own experiences.

Accuracy and Implications of Hemorrhagic Stroke Recognition by Emergency Medical Services.

Hemorrhagic stroke is a medical emergency that requires rapid identification and treatment. Despite playing a critical role in the emergency response to hemorrhagic stroke patients, a minimal amount is known about the quality of emergency medical services (EMS) care for this condition. The objectives of this study were to quantify EMS hemorrhagic stroke recognition, identify predictors of accurate EMS recognition, and examine associations between EMS recognition, quality of prehospital care, and patient outcomes.

Educating Paramedics on the Finger-to-Nose Test Improves Recognition of Posterior Stroke.

Background and Purpose- Emergency medical services (EMS) stroke recognition facilitates rapid care, however, prehospital stroke screening tools rely on signs that are often absent in posterior circulation strokes. We hypothesized that addition of the finger-to-nose (FTN) test to the Cincinnati Prehospital Stroke Scale would improve EMS posterior stroke recognition. Methods- In this controlled before and after study of consecutive EMS transported posterior ischemic strokes, paramedics in a single EMS agency received in-person training in the use of the FTN test.

Brief Educational Intervention Improves Emergency Medical Services Stroke Recognition.

Background and Purpose- Recognition of stroke symptoms and hospital prenotification by emergency medical services (EMS) facilitate rapid stroke treatment; however, one-third of patients with stroke are unrecognized by EMS. To promote stroke recognition and quality measure compliant prehospital stroke care, we deployed a 30-minute online EMS educational module coupled with a performance feedback system in a single Michigan county. Methods- During a 24-month study period, a registry of consecutive EMS-transported suspected or unrecognized stroke cases was utilized to perform an interrupted time series analysis of the impact of the EMS education and feedback intervention.

Randomized trial finds that prostate cancer genetic risk score feedback targets prostate-specific antigen screening among at-risk men.

Background: Prostate-specific antigen (PSA) screening may reduce death due to prostate cancer but leads to the overdiagnosis of many cases of indolent cancer. Targeted use of PSA screening may reduce overdiagnosis. Multimarker genomic testing shows promise for risk assessment and could be used to target PSA screening.

Investigation of forces involved in closure of the renal remnant after simulated partial nephrectomy.

Objective: To investigate the potential biomechanical causes of the complications of partial nephrectomy (PN) in a preclinical model of sliding-clip renorrhaphy. PN is a reference standard for amenable small renal masses. One disadvantage of PN, however, is the risk of postoperative bleeding and/or urinary leak.

Stuart London's standard of living: re-examining the Settlement of Tithes of 1638 for rents, income, and poverty.

The Settlement of Tithes of 1638 can be tested for biases in its London rents. Even so, it proves to be a relatively good source for seventeenth-century London, and for calculating associated median and mean rents, as well as a Gini coefficient of inequality for the distribution of resources. Through other evidence in the Settlement, rent/income ratios for London can be approximated, and from them estimates made of London's median income.

The classic: The treatment of chronic osteomyelitis with the maggot (larva of the blow fly). 1931.

This Classic article is a reprint of the original work by William S. Baer, MD, The Treatment of Chronic Osteomyelitis With the Maggot (Larva of the Blow Fly). An accompanying biographical sketch on William Baer, is available at DOI 10.

Renal biomarker qualification submission: a dialog between the FDA-EMEA and Predictive Safety Testing Consortium.

The first formal qualification of safety biomarkers for regulatory decision making marks a milestone in the application of biomarkers to drug development. Following submission of drug toxicity studies and analyses of biomarker performance to the Food and Drug Administration (FDA) and European Medicines Agency (EMEA) by the Predictive Safety Testing Consortium's (PSTC) Nephrotoxicity Working Group, seven renal safety biomarkers have been qualified for limited use in nonclinical and clinical drug development to help guide safety assessments. This was a pilot process, and the experience gained will both facilitate better understanding of how the qualification process will probably evolve and clarify the minimal requirements necessary to evaluate the performance of biomarkers of organ injury within specific contexts.

Towards consensus practices to qualify safety biomarkers for use in early drug development.

Application of any new biomarker to support safety-related decisions during regulated phases of drug development requires provision of a substantial data set that critically assesses analytical and biological performance of that biomarker. Such an approach enables stakeholders from industry and regulatory bodies to objectively evaluate whether superior standards of performance have been met and whether specific claims of fit-for-purpose use are supported. It is therefore important during the biomarker evaluation process that stakeholders seek agreement on which critical experiments are needed to test that a biomarker meets specific performance claims, how new biomarker and traditional comparators will be measured and how the resulting data will be merged, analyzed and interpreted.