A comparison of gambling behaviors and beliefs in rural and urban populations in Pennsylvania.

Introduction: Little is known about the differences between rural and urban gamblers and potential vulnerabilities that may be unique to either population. This exploratory study aimed to evaluate differences between rural and urban Pennsylvanians' gambling behaviors and beliefs.

Methods: A dual-frame random digit dial survey was conducted in the US state of Pennsylvania.

Cangrelor Use for Viabahn Stent Graft Patency as Bridge to Coronary Artery Bypass Graft Surgery.

Utilization of cangrelor following coronary artery stent placement as a bridge to cardiac surgery has been previously described in the literature. However, the use of cangrelor as bridge therapy to cardiac surgery for endovascular revascularization is lacking. We describe a case involving a 47-year-old female who developed a left lower extremity tibioperoneal trunk non-obstructing arterial dissection following extracorporeal membrane oxygenation decannulation, requiring repair with a Viabahn endoprosthesis.

Single-cell RNA sequencing identifies CXADR as a fate determinant of the placental exchange surface.

The placenta is the critical interface between mother and fetus, and consequently, placental dysfunction underlies many pregnancy complications. Placental formation requires an adequate expansion of trophoblast stem and progenitor cells followed by finely tuned lineage specification events. Here, using single-cell RNA sequencing of mouse trophoblast stem cells during the earliest phases of differentiation, we identify gatekeepers of the stem cell state, notably Nicol1, and uncover unsuspected trajectories of cell lineage diversification as well as regulators of lineage entry points.

Long-Term Follow-Up and Overall Survival in NRG258, a Randomized Phase III Trial of Chemoradiation Versus Chemotherapy for Locally Advanced Endometrial Carcinoma.

This randomized phase III trial aimed to determine whether treatment with cisplatin and volume-directed radiation followed by carboplatin and paclitaxel for four cycles (chemoradiotherapy [C-RT]) increased recurrence-free survival (RFS) and overall survival (OS) when compared with carboplatin and paclitaxel for six cycles (chemotherapy [CT]) in locally advanced endometrial cancer (UC). Previously reported results showed that C-RT did not improve RFS compared with CT. Here we report the final OS analysis.

The relationship between social media use and pregnancy-related body image.

Background: Social media negatively affects body image, but few have investigated its impact on pregnancy-related body image. Pregnancy represents a vulnerable period for body image, and poor body image has negative implications for health.

Objectives: We aimed to (1) understand relations of social media and pregnancy-related body image variables, (2) examine differences in social media use and body image based on demographic characteristics, and (3) evaluate whether type of social media use (i.

Preserved Ratio Impaired Spirometry in US Primary Care Patients Diagnosed with Chronic Obstructive Pulmonary Disease.

Background: Preserved ratio impaired spirometry (PRISm) represents a population with spirometry results that do not meet standardized COPD obstruction criteria, yet present with high respiratory symptom burden and might benefit from respiratory management and treatment. We aimed to determine prevalence of PRISm in US primary care patients diagnosed with COPD, describe their demographic, clinical, and CT scan characteristics.

Methods: An observational registry study utilizing the US APEX COPD registry, composed of patients diagnosed with COPD aged 35+ years.

Is COVID-19 Still a Threat? An Expert Opinion Review on the Continued Healthcare Burden in Immunocompromised Individuals.

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a profound global impact. The emergence of several variants during the pandemic has presented numerous challenges in preventing and managing this disease. The development of vaccines has played a pivotal role in controlling the pandemic, with a significant portion of the global population being vaccinated.

Just-in-Time Simulation Training to Augment Overnight ICU Resident Education.

Patients who decompensate overnight experience worse outcomes than those who do so during the day. Just-in-time (JIT) simulation could improve on-call resident preparedness but has been minimally evaluated in critical care medicine (CCM) to date. To determine whether JIT training can improve residents' performance in simulation and if those skills would transfer to better clinical management in adult CCM.

Practice Advisory on the Implementation of Preoperative Anemia Management: The Society of Cardiovascular Anesthesiologists and the Society for the Advancement of Patient Blood Management.

Preoperative anemia is common and associated with worse outcomes in cardiac surgery including acute kidney injury, red blood cell transfusion, cardiovascular complications, stroke, infection, and death. Patient blood management programs, which include dedicated clinical programs to diagnose and treat anemia in advance of surgery (ie, preoperative anemia programs), have been highlighted as a means to optimize the blood health of each patient, thereby decreasing risk for allogeneic transfusion and improving clinical outcomes. However, there remain implementation challenges for preoperative anemia programs, including difficulties with education of patients and staff, short lead times to address anemia, infrastructure and staffing limitations, lack of clear leadership or ownership of preoperative anemia, the need to develop treatment algorithms and ensure appropriate infusion therapy support, lack of capital support, and insurance/reimbursement concerns, amongst others.

The power of lived experience in optimizing US policymakers' engagement with substance use research: A series of rapid-cycle randomized controlled trials.

Background: Research can inform policies on substance use/substance use disorders (SU/SUDs), yet there is limited experimental investigation into strategies for optimizing policymakers' engagement with SU/SUD research. This study tested the use of narratives to boost policymakers' research engagement.

Methods: In five rapid-cycle randomized controlled trials, SU/SUD research fact sheets were emailed to US legislative policymakers.

Self-Expandable Versus Balloon-Expandable Transcatheter Aortic Valve Replacement for Treatment of Patients With Small Aortic Annulus: An Updated Meta-Analysis of Reconstructed Individual Patient Data.

Transcatheter aortic valve replacement has emerged as an effective alternative to surgery in selected patients with aortic stenosis. It needs to be made clear which type of valve has better results in patients with small aortic annulus. We searched PubMed, Scopus, Embase, Cochrane Library, and Web of Science, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Successful Transcatheter Mitral Valve Mass Extraction With Complete Resolution of the Severe Mitral Regurgitation.

Interest has arisen in exploring the off-label application of left-sided percutaneous mechanical aspiration, where conventional management strategies may not suffice. Percutaneous mechanical aspiration has been shown to be effective as a diagnostic and therapeutic intervention in select patients with infective endocarditis. This paper hereby reports the first case of a successful transeptal large bore manual aspiration device (AlphaVac; Angiodynamics) for nonbacterial thrombotic endocarditis with total resolution of associated severe mitral valve regurgitation.

Cardiac Amyloidosis Versus Other Restrictive Cardiomyopathies: A Retrospective Analysis of Cardiovascular Outcomes and Arrhythmic Burden.

Background: The arrhythmic burden and cardiovascular risks of cardiac amyloidosis compared with other types of restrictive cardiomyopathies (RCM), such as hemochromatosis and cardiac sarcoid, have not been well characterized in the literature. An increase in emphasis on screening has resulted in more diagnoses of cardiac amyloidosis and a larger data pool to analyze the cardiovascular outcomes of this cardiomyopathy.

Methods And Results: We queried the National Inpatient Sample (NIS) database to identify all adult patients diagnosed with cardiac amyloidosis or other RCM between the years 2016 and 2019.

Sex Differences in Opioid-Sparing Regimen Prescribing Following Ventral Hernia Repair.

Introduction: While sex differences are known to have a clinically relevant impact on the response to pain therapy, current data are still largely equivocal on sex-specific postoperative pain management. The aim of this study is to determine whether sex predicts differences in pain management in patients undergoing ventral hernia repair (VHR).

Methods: This was a retrospective analysis of prospectively collected data for VHR from the Abdominal Core Health Quality Collaborative.

Apparent Diffusion Coefficient of the Optic Nerve Head in Idiopathic Intracranial Hypertension.

Idiopathic Intracranial Hypertension (IIH) is a condition in which patients have elevated intracranial pressure which does not have an apparent cause. To diagnose IIH, evaluation excluding other causes of elevated pressure must be performed. This typically includes magnetic resonance imaging (MRI) of the brain and venous sinuses.

Safety and tolerability of ubrogepant for the acute treatment of migraine in participants taking atogepant for the preventive treatment of episodic migraine: Results from the TANDEM study.

Objective: To evaluate the safety and tolerability of ubrogepant for the acute treatment of migraine in participants taking atogepant for the preventive treatment of episodic migraine (EM).

Background: Atogepant is an oral calcitonin gene-related peptide (CGRP) receptor antagonist approved for the preventive treatment of migraine in adults and ubrogepant is an oral CGRP receptor antagonist approved for the acute treatment of migraine in adults, with or without aura. The safety and tolerability of the concomitant use of ubrogepant and atogepant have not been previously evaluated in a clinical setting.

Andexanet Alfa-Associated Heparin Resistance in Cardiac Surgery: Mechanism and In Vitro Perspectives.

Background: Andexanet alfa (andexanet) is the only Food and Drug Administration-approved antidote for direct FXa (factor Xa) inhibitors but has been reported to cause resistance to unfractionated heparin (UFH). This has delayed anticoagulation for procedures requiring cardiopulmonary bypass. The mechanism, andexanet and UFH dose dependence, and thrombotic risk of andexanet-associated heparin resistance are unknown.

Safe-Guarding Youth from Online Sexual Exploitation in the Digital Era: A Role for Primary Care.

Online child sexual exploitation refers to the use of technology to sexually exploit or harm a person under age 18. In 2020, over 21.7 million reports of online child sexual enticement were filed with law enforcement, highlighting the alarming prevalence of this form of exploitation.

Efficacy and safety of dostarlimab in combination with chemotherapy in patients with dMMR/MSI-H primary advanced or recurrent endometrial cancer in a phase 3, randomized, placebo-controlled trial (ENGOT-EN6-NSGO/GOG-3031/RUBY).

Objectives: Part 1 of the RUBY trial (NCT03981796) demonstrated improved survival in patients with primary advanced or recurrent endometrial cancer (EC) treated with dostarlimab plus carboplatin-paclitaxel versus placebo plus carboplatin-paclitaxel. Here, we examine additional efficacy and safety data from patients with mismatch repair deficient/microsatellite instability-high (dMMR/MSI-H) EC in the RUBY trial.

Methods: Patients were randomized 1:1 to dostarlimab 500 mg or placebo plus carboplatin-paclitaxel every 3 weeks for 6 cycles followed by dostarlimab or placebo every 6 weeks for up to 3 years.

Multimedia-Based Education Led to Improvement in Disease Knowledge Among Patients with Cirrhosis.

Background: Current evidence shows limited patient understanding of liver disease, coupled with no standard guidelines or methods to offer patient education in a busy clinical environment. We developed multimedia-based education (MBE) for those with cirrhosis & tested its effectiveness in improving patient knowledge from baseline to 1 month.

Methods: This prospective study enrolled cirrhotic patients who had a scheduled visit with a hepatologist at an ambulatory academic practice or were admitted to the liver inpatient service.