Mindfulness Meditation Effects on Poststroke Spasticity: A Feasibility Study.

This study examined the feasibility of an adapted 2-week mindfulness meditation protocol for chronic stroke survivors. In addition, preliminary effects of this adapted intervention on spasticity and quality of life in individuals after stroke were explored. Ten chronic stroke survivors with spasticity listened to 2 weeks of short mindfulness meditation recordings, adapted from Jon Kabat-Zinn's Mindfulness-Based Stress Reduction course, in a pre/post repeated measures design.

Successful Implementation of Extracorporeal Membrane Oxygenation Support as a Bridge to Heart-Lung Transplantation in an Eisenmenger's Syndrome Patient With Paradoxical Coronary Embolism.

We report a case of a 23-year-old female with a history of unrepaired ventricular septal defect and pulmonary arterial hypertension with Eisenmenger's syndrome (ES) presenting with chest pain. Electrocardiography demonstrated new anterior Q waves and anterolateral ST elevations, and coronary angiography revealed a large organized thrombus in the mid-left anterior descending artery consistent with paradoxical coronary embolism. Patient was treated with percutaneous coronary intervention and aggressive anticoagulation management.

Pilot Evaluation of a Conservation Corps Program for Young Adults.

Education and employment programs may be effective at reducing problem behaviors among at-risk young adults. This pilot study evaluated whether participants in a Conservation Corps program ( = 100) showed changes in antisocial behavior, gang membership, and substance use during the program. Participants were young adults between 18 and 24 years who were predominantly male (60%) and ethnic minority (62% Latino; 31% African American).

Clear Cell Variant of Solid Pseudopapillary Neoplasm of the Pancreas: A Report of a Rare Variant and Review of the Literature.

The clear cell variant of solid pseudopapillary neoplasm (ccSPN) of the pancreas was first described in 2006. In this article, we report a case of this rare variant and review the few published reports. Both the current and previous reports show that ccSPN has several morphologic differences from conventional SPN, including clear vacuoles, fewer pseudopapillary formations, more solid/diffuse architecture, less hemorrhage, and fewer cholesterol clefts.

Specialty Drug Price Trends in the Federal 340B Drug Discount Program.

Background: The federal 340B Drug Discount Program provides access to significant drug price discounts for health care organizations in the United States that serve a disproportional share of disadvantaged patients.

Objective: To analyze trends over a 10-year period (2006~2016) in the price of specialty drugs, contrasting the market price with the price paid under the 340B program.

Methods: Pharmacy purchase records, including the 340B drug price and the wholesale acquisition cost (WAC), were collected from a 340B-contract pharmacy group in Southern California between 2006 and 2016.

Empowerment Through Difference: An Online Difference-Education Intervention Closes the Social Class Achievement Gap.

A growing body of work suggests that teaching college students a contextual understanding of difference-that students' different experiences in college are the result of participating in different contexts before college-can improve the academic performance of first-generation students (i.e., students whose parents do not have 4-year college degrees).

Diffuse Large B-Cell Lymphoma With Striking Intrasinusoidal Pseudoglandular Growth Pattern as a Diagnostic Dilemma Mimicking Metastatic Poorly Differentiated Pancreatic Adenocarcinoma in an Intraabdominal Lymph Node.

We report an unusual intrasinusoidal growth pattern of an intraabdominal diffuse large B-cell lymphoma both clinically and histologically mimicking a metastatic adenocarcinoma. A 66-year-old woman presented with a high-grade distal biliary stricture with multiple enlarged abdominal lymph nodes. Frozen section at the time of pancreatoduodenectomy ("Whipple") demonstrated cohesive nests of large atypical cells within a totally effaced lymph node presenting a diagnostic challenge.

Data Analyses When Sample Sizes Are Small: Modern Advances for Dealing With Outliers, Skewed Distributions, and Heteroscedasticity.

The paper reviews advances and insights relevant to comparing groups when the sample sizes are small. There are conditions under which conventional, routinely used techniques are satisfactory. But major insights regarding outliers, skewed distributions, and unequal variances (heteroscedasticity) make it clear that under general conditions they provide poor control over the type I error probability and can have relatively poor power.

Individual Differences in Locomotor Function Predict the Capacity to Reduce Asymmetry and Modify the Energetic Cost of Walking Poststroke.

Changes in the control of the lower extremities poststroke lead to persistent biomechanical asymmetries during walking. These asymmetries are associated with an increase in energetic cost, leading to the possibility that reducing asymmetry can improve walking economy. However, the influence of asymmetry on economy may depend on the direction and cause of asymmetry.

Understanding Risk Environments in Permanent Supportive Housing for Formerly Homeless Adults.

In this study, we used ethnographic methods and a risk environment framework to consider how contextual factors produce or reduce risk for substance use with a sample of 27 adults who recently moved into permanent supportive housing (PSH). Most apparent was how the social and physical environments interacted, because most participants focused on how having an apartment had dramatically changed their lives and how they interact with others. Specific themes that emerged that also involved economic and policy environments included the following: isolation versus social engagement; becoming one's own caseworker; and engaging in identity work.

Association of admission vs. nadir serum albumin concentration with short-term treatment outcomes in patients with acute heart failure.

Objectives Hypoalbuminemia occurs in 25% to 76% of patients hospitalized for acute heart failure (HF) and is associated with increased mortality. Hypoalbuminemia may predispose patients to intravascular volume depletion, hypotension, and acute worsening of renal function; however, its association with treatment outcomes during hospitalization is unknown. Methods This retrospective cohort study involved 414 adult patients hospitalized for HF requiring intravenous diuretics.

Accelerating Stroke Recovery: Body Structures and Functions, Activities, Participation, and Quality of Life Outcomes From a Large Rehabilitation Trial.

Background: Task-oriented therapies have been developed to address significant upper extremity disability that persists after stroke. Yet, the extent of and approach to rehabilitation and recovery remains unsatisfactory to many.

Objective: To compare a skill-directed investigational intervention with usual care treatment for body functions and structures, activities, participation, and quality of life outcomes.

Hospitalization Outcomes of Cleft Lip Repair in Neonates Across the United States.

Objective: Cleft lip repair surgeries in neonates have shown to be effective and safe, resulting in less scarring and excellent aesthetic outcomes. However, existing studies are based on single-center experiences with limited numbers of patients and surgeons. Complication rates and hospital outcomes of neonatal lip repair have not yet been established at the national level.

A Pilot Study of the ¡Vivir Mi Vida! Lifestyle Intervention for Rural-Dwelling, Late-Midlife Latinos: Study Design and Protocol.

Older, rural-dwelling Latinos face multiple health disparities. We describe the protocol of a pilot study of a community health worker-occupational therapist-led lifestyle program, ¡Vivir Mi Vida! ( ¡VMV!), designed for delivery in primary care and adapted for late-midlife, Latino rural-living patients. Using mixed methods, we collected feasibility, acceptability, and preliminary efficacy data on ¡VMV!.

Runners With Patellofemoral Pain Exhibit Greater Peak Patella Cartilage Stress Compared With Pain-Free Runners.

The primary purpose of this study is to determine whether recreational runners with patellofemoral pain (PFP) exhibit greater peak patella cartilage stress compared with pain-free runners. A secondary purpose was to determine the kinematic and/or kinetic predictors of peak patella cartilage stress during running. A total of 22 female recreational runners (12 with PFP and 10 pain-free controls) participated in this study.

Distal Scaphoid Excision in Treatment of Symptomatic Scaphoid Nonunion: Systematic Review and Meta-analysis.

Current treatment options for persistent scaphoid nonunion are limited to salvage procedures such as proximal row carpectomy (PRC) or 4-corner fusion (4CF). Several small studies have demonstrated that distal scaphoid excision may provide a simpler alternative with faster recovery. The purpose of this study was to determine the efficacy of distal scaphoid excision as a treatment option for symptomatic scaphoid nonunion.

Investigation Into the Optimal Number of Intercostal Nerve Transfers for Musculocutaneous Nerve Reinnervation: A Systematic Review.

Background: The purpose of this study was to systematically review outcomes following intercostal nerve (ICN) transfer for restoration of elbow flexion, with a focus on identifying the optimal number of nerve transfers.

Methods: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify studies describing ICN transfers to the musculocutaneous nerve (MCN) for traumatic brachial plexus injuries in patients 16 years or older. Demographics were recorded, including age, time to operation, and level of brachial plexus injury.

Lifetime Consequences of Early-Life and Midlife Access to Health Insurance: A Review.

Over the past decade, the number of studies examining the effects of health insurance has grown rapidly, along with the breadth of outcomes considered. In light of growing research in this area and the intense policy focus on coverage expansions in the United States, there is need for an up-to-date and comprehensive literature review and synthesis of lessons learned. We reviewed 112 experimental or quasi-experimental studies on the effects of health insurance prior to people becoming eligible for Medicare on a broad set of outcomes.

Community Context and Child Health: A Human Capital Perspective.

Human capital theory suggests that education benefits individuals' and their children's health through the educational skills people acquire in school. This perspective may also be relevant at the community level: the greater presence of adults with educational skills in a community may be a reason why living in a more highly educated setting benefits health. I use Demographic and Health Survey data for 30 sub-Saharan African countries to investigate whether the percentage of literate adults-specifically women-in a community is associated with children's likelihood of survival.

Understanding parents' concerns about their children with autism taking public school transportation in Los Angeles County.

There are a number of recent US news media reports of children and youth with autism becoming lost, injured, or even dying while taking public school transportation, yet research on this problem is scarce. This ethnographic study examines the experiences of 14 parents whose children with autism take public school transportation in Los Angeles County. We present two case studies of children with autism being "lost" while in transit from school to home on the bus to (1) describe how the situation was experienced, responded to, and managed by the parents; (2) consider three interrelated themes that emerged from interviews with 14 parents, related to children's safety, independence, and participation, across multiple contexts and analytic levels; and (3) discuss the findings in relation to US news media reports of incidents involving children with autism on school buses to identify specific weaknesses in school transportation infrastructure, particularly in the context of privatization, that create conditions in which children with autism can "fall through the cracks" in potentially life-threatening ways.

Percutaneous Thermal Ablation of Spinal Metastases: Recent Advances and Review.

Objective: The purpose of this study was to review the available armamentarium and most recent advances in minimally invasive, image-guided percutaneous thermal ablation for treatment of spinal metastases.

Conclusion: Minimally invasive percutaneous spine thermal ablation technologies have proved safe and effective in management of selected patients with spinal metastases. Special attention to procedure techniques including choice of ablation modality, thermoprotection, adequacy of treatment, and postablation imaging is essential for improved patient outcomes.