Lessons for a learning health system: Effectively communicating to patients about research with their health information and biospecimens.

Introduction: Sharing patient health information and biospecimens can improve health outcomes and accelerate breakthroughs in medical research. But patients generally lack understanding of how their clinical data and biospecimens are used or commercialized for research. In this mixed methods project, we assessed the impact of communication materials on patient understanding, attitudes, and perceptions.

Early Identification of Poorly Performing Implants in Michigan With the Example of the Vanguard XP.

Background: Arthroplasty registries play a critical role in improving the quality of care and performing post-market surveillance of medical devices. We report the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI) findings specific to the Biomet Vanguard XP bicruciate-retaining total knee implant.

Methods: Data were collected from MARCQI's 2019 report (February 15, 2012, through December 31, 2018).

An Acellular Platform to Drive Urinary Bladder Tissue Regeneration.

Impaired bladder compliance secondary to congenital or acquired bladder dysfunction can lead to irreversible kidney damage. This is managed with surgical augmentation utilizing intestinal tissue, which can cause stone formation, infections, and malignant transformation. Co-seeded bone marrow mesenchymal stem cell (MSC)/CD34+ hematopoietic stem cell (HSPC) scaffolds (PRS) have been successful in regenerating bladder tissue.

Clinical Confidence, Certification, and Connectedness: Impact of a Journal Club for Inpatient Psychiatry Faculty.

Introduction: Inpatient psychiatry faculty manage complex clinical, administrative, and legal issues amid increasing mental health service utilization rates, limiting time for (1) focusing on lifelong learning and (2) connecting. We examined the impact of a monthly journal club on inpatient psychiatry faculty's (1) confidence that their practice is evidence informed, (2) stress related to board recertification, and (3) sense of connectedness with peers.

Methods: We employed a primarily qualitative approach using semi-structured interviews and brief survey questions to elicit input from inpatient psychiatry faculty at an academic medical center on their experience participating in a monthly journal club, including perceived changes in one's practice of evidence-based medicine, recertification stress, and connectedness with peers.

Brain-inspired wiring economics for artificial neural networks.

Wiring patterns of brain networks embody a trade-off between information transmission, geometric constraints, and metabolic cost, all of which must be balanced to meet functional needs. Geometry and wiring economy are crucial in the development of brains, but their impact on artificial neural networks (ANNs) remains little understood. Here, we adopt a wiring cost-controlled training framework that simultaneously optimizes wiring efficiency and task performance during structural evolution of sparse ANNs whose nodes are located at arbitrary but fixed positions.

Older US adults' experiences with and views about cognitive screening and blood biomarker testing for Alzheimer's disease.

Introduction: Dementia is underdiagnosed in the United States. Understanding of older adults' experiences with screening is needed to optimize diagnosis.

Methods: US adults ages 65 to 80 ( = 1298) were surveyed on experiences with cognitive screening and blood biomarker (BBM) testing.

Coding intensity variation in Medicare Advantage.

Enrollment in Medicare Advantage (MA) plans rose to over 50% of eligible Medicare patients in 2023. Payments to MA plans incorporate risk scores that are largely based on patient diagnoses from the prior year, which incentivizes MA plans to code diagnoses more intensively. We estimated coding inflation rates for individual MA contracts using a method that allows for differential selection into contracts based on patient health.

Weightbearing in Select Geriatric Ankle Fractures Following Open Reduction Internal Fixation: Short Scientific Report.

Background: Geriatric ankle fractures are increasingly common. Previous work has suggested that early weightbearing following ankle fracture fixation is safe in nongeriatric patients. However, limited data is available regarding the safety of immediate weightbearing following fixation of geriatric ankle fractures using standard open reduction internal fixation techniques.

Development of a Perioperative Risk Mortality Calculator for Humanitarian Surgical Care.

Background: Risk models to predict perioperative mortality rates (POMR) are critical to surgical quality improvement yet are not widely adapted for use in humanitarian and low-resource settings (LRS). We developed a POMR and corresponding nomogram and calculator for use in humanitarian surgical care.

Methods: Electronic health record data from a high-income academic medical center from 2015 to 2019 were retrospectively extracted, selecting variables and operations specific to LRS.

Emergency department utilization by youth before and after firearm injury.

Background: Emergency department (ED) visits may serve as opportunities for firearm injury prevention and intervention efforts. Our objective was to determine ED utilization by youth before and after firearm injury.

Methods: We performed a retrospective cohort study of ED encounters by youth (0-18 years old) with firearm injury from eight states using the 2019 State ED and Inpatient Databases.

New Index Demonstrates Association between Social Vulnerability, Environmental Burden, and Kidney Failure Risk among Individuals with Glomerular Disease.

Background: The Centers for Disease Control and Prevention (CDC) Environmental Justice Index Social-Environmental Ranking (EJI-SER) combines a Social Vulnerability Module (SV) with an Environmental Burden Module (EB) to characterize cumulative environmental and social burden at the census tract level. This analysis evaluates the association between EJI-SER and kidney outcomes in glomerular disease (GD) patients.

Methods: Cure Glomerulopathy (CureGN) is an observational cohort study of adults and children with biopsy-proven GD.

Changes in the effective optical zone following hyperopic keratorefractive lenticule extraction.

Objective: To evaluate the longitudinal changes in the effective optical zone (EOZ) following hyperopic keratorefractive lenticule extraction (KLEx) and investigate factors influencing the EOZ.

Patients And Methods: This retrospective study included 27 patients who underwent hyperopic KLEx. According to the transition zone (TZ) sizes, they were divided into two groups: group A (21 eyes) with a 2.

Optimal doses of intranasal esketamine plus dexmedetomidine for sedating toddlers during transthoracic echocardiography: a prospective, double-blind, randomized trial.

Introduction: Esketamine has unique advantages in combination with dexmedetomidine for sedation in young children, owing to its sympathetic activity and mild respiratory depression. However, the optimal dose is yet to be determined. In this study, we compared the different doses of intranasal esketamine combined with dexmedetomidine for sedation during transthoracic echocardiography in toddlers.

A Clinicopathologic and Molecular Reappraisal of Myxoinflammatory Fibroblastic Sarcoma-A Controversial and Pathologically Challenging Low-Grade Sarcoma.

Purpose: Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare, low-grade sarcoma affecting with predilection the acral soft tissues of middle-aged adults. Clinically, MIFS is associated with a high rate of local recurrence but infrequent distant metastases. The diagnosis remains challenging due to their wide histologic spectrum and overlap with reactive, benign, and low-grade malignant lesions.

Clinical Relevance of 'Cap' and 'Track' Development after Recent Small Subcortical Infarct.

Objective: After a recent small subcortical infarct (RSSI), some patients develop perilesional or remote hyperintensities ('caps/tracks') to the index infarct on T2/FLAIR MRI. However, their clinical relevance remains unclear. We investigated the clinicoradiological correlates of 'caps/tracks', and their impact on long-term outcomes following RSSI.

Renin-angiotensin-aldosterone system activation in plasma as marker for prognosis in critically ill patients with COVID-19: a prospective exploratory study.

Background: Acute respiratory distress syndrome (ARDS) associated with coronavirus infectious disease (COVID)-19 has been a challenge in intensive care medicine for the past three years. Dysregulation of the renin-angiotensin system (RAS) is linked to COVID-19, but also to non-COVID-19 ARDS. It is still unclear whether changes in the RAS are associated with prognosis of severe COVID-19.

Nutrition and Huntington's Disease- A Review of Current Practice and Theory.

Purpose Of Review: Nutition has long been of importance in the care of Huntington's disease (HD). The purpose of this review is to summarize recent research relevant to HD nutrition, and to describe some emerging theoretical approaches to research in this area.

Recent Findings: Clinical studies have identified swallowing problems and fear of choking as major impediments to maintaining nutritional status with HD.

Personalized neuron-specific enolase level based on EEG pattern for prediction of poor outcome after cardiac arrest.

Background: After cardiac arrest (CA), the European recommendations suggest to use a neuron-specific enolase (NSE) level > 60 µg/L at 48-72 h to predict poor outcome. However, the prognostic performance of NSE can vary depending on electroencephalogram (EEG). The objective was to determine whether the NSE threshold which predicts poor outcome varies according to EEG patterns and the effect of electrographic seizures on NSE level.

Association of Alzheimer's Disease Polygenic Risk Score with Concussion Severity and Recovery Metrics.

Background: Identification of genetic alleles associated with both Alzheimer's disease (AD) and concussion severity/recovery could help explain the association between concussion and elevated dementia risk. However, there has been little investigation into whether AD risk genes associate with concussion severity/recovery, and the limited findings are mixed.

Objective: We used AD polygenic risk scores (PRS) and APOE genotypes to investigate any such associations in the NCAA-DoD Grand Alliance CARE Consortium (CARE) dataset.

Psychosocial Support Needs and Preferences Among Family Caregivers of ICU Patients with Severe Acute Brain Injury: A Qualitative Thematic Analysis.

Background: Family caregivers of patients with severe acute brain injury (SABI) are at risk for clinically significant chronic emotional distress, including depression, anxiety, and posttraumatic stress. Existing psychosocial interventions for caregivers of intensive care unit (ICU) patients are not tailored to the unique needs of caregivers of patients with SABI, do not demonstrate long-term efficacy, and may increase caregiver burden. In this study, we explored the needs and preferences for psychosocial services among SABI caregivers to inform the development and adaptation of interventions to reduce their emotional distress during and after their relative's ICU admission.

Biomarkers of sepsis-induced coagulopathy: diagnostic insights and potential therapeutic implications.

Diagnosing coagulopathy in septic patients remains challenging in intensive care. Disseminated intravascular coagulation (DIC) indeed presents with complex pathophysiology, complicating timely diagnosis. Epidemiological data indicate a significant prevalence of DIC in septic patients, with mortality rates up to 60%.

A Novel Method for Hemorrhage Control During Laparoscopic Distal Pancreatectomy with Splenic Vessel Preservation: Triple Occlusion.

Introduction: Laparoscopic distal pancreatectomy (LDP) has the advantages of reduced blood loss, shorter hospital stays, and a better postoperative quality of life compared with open distal pancreatectomy (ODP). Meanwhile, spleen-preserving laparoscopic distal pancreatectomy is the preferred technique for low-grade malignant and benign tumors located in pancreatic body and tail, since it preserves the immune function of the spleen. The splenic-vessel-preserving (SVP) Kimura technique and splenic vessel resection Warshaw technique are the two primary procedures.

Total Pancreatectomy for Locally Advanced Pancreatic Adenocarcinoma with Coeliac Trunk Resection and Retrograde Gastric Revascularization Through Aorto-Hepato-Spleno Allograft.

Background: Locally advanced pancreatic adenocarcinomas (LA-PDAC) are more frequently operated now than in the past because of new regimen chemotherapy and improvement in surgical technique. Resection of the coeliac trunk (CT) during pancreatoduodenectomy (PD) or total pancreatectomy (TP) is not routinely done owing to the risk of liver and gastric ischaemia. In this video, a patient with LA-PDAC underwent TP with CT resection and retrograde gastric revascularization through the distal splenic artery.

Associations of KRAS Point Mutations with Survival of Patients Who Underwent Curative-Intent Resection of Colorectal Liver Metastases.

Background: The oncologic significance of specific KRAS point mutations for patients with colorectal liver metastases (CLM) is uncertain. This study aimed to assess the prognostic impact of KRAS point mutations on patients who underwent surgery for CLM.

Methods: Patients who underwent curative-intent surgery for CLM from 2001 to 2020 were selected for the study.