Balancing High Clinical Volumes and Non-RVU Generating Activities in Radiology, Part ll: Future Directions.

The Radiology Research Alliance (RRA) of the Association of Academic Radiology (AAR) creates task forces to study emerging trends shaping the future of radiology. This article highlights the findings of the AAR-RRA Task Force on Balancing High Clinical Volumes and non-relative value unit (Non-RVU)-Generating Activities. The Task Force's mission was to evaluate and emphasize the value of non-RVU-generating activities that academic radiologists perform.

Interpretation of p16 and p53 in the Classification of Squamous Cell Carcinoma of the Vulva-An Interobserver Agreement Study.

Squamous cell carcinoma of the vulva (vSCC) is currently categorized either as human papillomavirus (HPV) associated or independent. Immunohistochemical stains, p16INK4a (p16) and p53 are helpful biomarkers to support the designation of vSCC into 1 of the 3 tumor pathways: (1) HPV-associated, (2) HPV-independent, TP53 mutant, or (3) HPV-independent, TP53 wild type. Recently, a framework of p53 expression patterns in vSCC was proposed.

COVID-19 vaccine hesitancy in a small rural southern state: Results of a weighted random sample survey.

Objective: COVID-19 remains a significant health threat to the United States (U.S.) and the world even after the development of effective vaccines.

Physical Activity Monitoring in Children in the 1-Year After 3 or More Days of Invasive Ventilation: Feasibility of Using Accelerometers.

Objectives: To measure physical activity in a cohort of children who survived greater than or equal to 3 days of invasive ventilation.

Design: Prospective cohort study (2018-2021).

Setting: Quaternary children's hospital PICU.

When clinicians and patients disagree on vaccination: what primary care clinicians can learn from COVID-19-vaccine-hesitant patients about communication, trust, and relationships in healthcare.

Background: In the United States, discourse on COVID-19 vaccination has become polarized, and the positions of public health officials are met with skepticism by many vaccine-hesitant Americans. This polarization may impact future vaccination efforts as well as clinician-patient relationships.

Methods: We interviewed 77 vaccine-hesitant patients and 41 clinicians about COVID-19 vaccination communication in primary care as part of a Veterans Affairs (VA) trial evaluating a vaccine-communication intervention.

Randomized controlled trial of a pilot PrEP linkage intervention for individuals leaving incarceration in a southern state: Design and baseline characteristics.

Objective: We report baseline characteristics of a pilot intervention, PrEP-Link, which uses a community health worker (CHW) model to provide navigation to PrEP, the daily HIV preventative medication, and other medical and social services upon release from incarceration.

Trial Design And Methods: This pilot study uses a randomized controlled trial design. The control group receives enhanced standard of care, and the intervention receives enhanced standard of care plus personalized navigation services from the CHW for up to one year.

Characteristics of Young Children Associated with Diagnostic Utility of the Autism Diagnostic Observation Schedule: A DBPNet Study.

Objective: The aim of this study is to identify characteristics of children for whom a developmental-behavioral pediatrician's (DBP) diagnostic impressions of autism spectrum disorder (ASD) or non-ASD were changed by Autism Diagnostic Observation Schedule (ADOS) results.

Method: A prospective study of children 1½ to <6 years consecutively referred to 8 sites for possible ASD. Cognitive/developmental, language, and adaptive testing varied, as each site followed its usual clinical approach.

Abnormal Exercise Gas Exchange Before Pulmonary Emboli Diagnosis.

A 20-year-old male underwent diagnostic testing due to unexplained shortness of breath and chest discomfort. He had no previous medical problems and was not taking any medications. Initial evaluations included cardiopulmonary exercise testing (CPET), which yielded results that were reported as normal.

Cardiac Function Decline After General Anesthesia and Cardiac Catheterization in Pediatric Cardiac Transplant Recipients.

Background: Pediatric cardiac transplant recipients undergo elective cardiac catheterization and endomyocardial biopsy (CC/EMB) for graft dysfunction surveillance often facilitated by general anesthesia (GA). GA and positive pressure ventilation (PPV) also depress cardiac function confounding the graft's functional assessment. We aimed to evaluate the frequency of cardiac function decline, going from the awake to the anesthetized state, and determine its association with anesthetic and patient-related factors.

Immune digital twins for complex human pathologies: applications, limitations, and challenges.

Digital twins represent a key technology for precision health. Medical digital twins consist of computational models that represent the health state of individual patients over time, enabling optimal therapeutics and forecasting patient prognosis. Many health conditions involve the immune system, so it is crucial to include its key features when designing medical digital twins.

A comprehensive review of evolving treatment strategies for Dravet syndrome: Insights from randomized trials, meta-analyses, real-world evidence, and emerging therapeutic approaches.

Dravet syndrome (DS) is a severe genetic developmental and epileptic encephalopathy, primarily caused by SCN1A gene mutations. Historically, treatments like clobazam and valproate have been used without evidence from randomized controlled trials (RCTs). However, the therapeutic landscape of DS has evolved with multiple RCTs demonstrating the efficacy and safety of three antiseizure medications (ASMs): stiripentol, cannabidiol (CBD), and fenfluramine.

Molecular dynamics studies reveal the structural impacts of LRRK2 R1441C and LRRK2 D1994A mutations in Parkinson's disease.

Parkinson's Disease (PD) is a continuingly deteriorating neurological ailment affecting over 8.5 million patients globally as of 2019, and the numbers are expected to keep rising. To aid in identifying therapeutic targets, molecular dynamics simulations are convenient and cost-effective methods for enriching our knowledge of the molecular pathophysiology of diseases.

Comparative efficacy of intravenous treatments for perioperative shivering in patients undergoing caesarean delivery under neuraxial anaesthesia: A systematic review and Bayesian network meta-analysis of randomised-controlled trials.

Introduction: Shivering affects 52 % of patients undergoing caesarean delivery under neuraxial anaesthesia. Despite extensive research focused on its prevention, there is still no consensus regarding optimal pharmacological treatment. This systematic review and network meta-analysis aims to compare available intravenous treatments of perioperative shivering in patients undergoing caesarean delivery under neuraxial anaesthesia.

Consideration of the role of protein quality in determining dietary protein recommendations.

The quality of a dietary protein refers to its ability to provide the EAAs necessary to meet dietary requirements. There are 9 dietary amino acids that cannot be metabolically produced in the body and therefore must be consumed as part of the diet to avoid adverse metabolic consequences. These (EAAs) serve a variety of roles in the body.

Metabolomic Profiling and Machine Learning Models for Tumor Classification in Patients with Recurrent IDH-Wild-Type Glioblastoma: A Prospective Study.

Background/objectives: The recurrence of glioblastoma is an inevitable event in this disease's course. In this study, we sought to identify the metabolomic signature in patients with recurrent glioblastomas undergoing surgery and radiation therapy.

Methods: Blood samples collected prospectively from six patients with recurrent IDH-wildtype glioblastoma who underwent one surgery at diagnosis and a second surgery at relapse were analyzed using untargeted gas chromatography-time-of-flight mass spectrometry to measure metabolite abundance.

Use of 1 mm Cerclage Cables in Surgical Treatment of Periprosthetic Femur Fractures.

Introduction: 1 mm cerclage cables have been introduced that can be placed under plates and hold reduction of periprosthetic femur fractures (PPFFx) around total hip arthroplasty (THA). Their utilization remains controversial due to the risk of nonunion secondary to periosteal stripping associated for their application. We compared surgical outcomes in patients with THA PPFFx treated with open reduction internal fixation (ORIF) and cables vs patients with PPFFx treated with ORIF without cables.

Outcomes of free flap reconstruction for mandibular ORN: Systematic review and meta-analysis.

Objective: This study aims to evaluate the success rates and complications associated with different free flap donor sites used in surgical reconstruction for mandibular osteoradionecrosis, providing insights to aid clinical decision-making.

Data Sources: MEDLINE, Embase, Cochrane, and Web of Science.

Review Methods: Comprehensive database searches were conducted up to October 2023.

Robotic Assistance Is Not Associated With Decreased Early Revisions in Cementless TKA: An Analysis of the American Joint Replacement Registry.

Background: Previously, we conducted a retrospective study of American Joint Replacement Registry (AJRR) data that examined the 2-year odds of revision between robotic-assisted and nonrobotic-assisted TKA, and we found no benefit to robotic assistance. However, proponents of robotic assistance have suggested that robot platforms confer more accurate bone cuts and precise implant sizing that might promote osteointegration of cementless implants by limiting micromotion at the bone-implant interface that could lead to aseptic loosening. Therefore, it seems important specifically to evaluate the odds of revision among patients with cementless implants only within our previous study population.

Salivary cortisol is not associated with dexamethasone response in preterm infants with evolving bronchopulmonary dysplasia.

Objective: Short-term treatment efficacy of systemic dexamethasone (DEX) in preterm infants with bronchopulmonary dysplasia (BPD) is highly variable. Our objective was to assess if salivary cortisol may serve as a reliable biomarker of steroid response.

Study Design: Multi-site prospective observational cohort study.