After-hours, Severity, and Distance are Associated with Non-VHA Emergency Department Use for Older Veterans: Insights from a Regional Health Information Exchange.

Background: Older adults treated in emergency departments (EDs) are at higher risk for adverse outcomes. Using multiple facilities can worsen this issue through service duplication and poor care transitions. Veterans with dual insurance coverage can access both Veterans Health Administration (VHA) and non-VHA EDs.

Ensifentrine in COPD patients taking long-acting bronchodilators: A pooled post-hoc analysis of the ENHANCE-1/2 studies.

Background: The efficacy and safety of ensifentrine, a novel PDE3/PDE4 inhibitor, were previously evaluated in the ENHANCE-1 (NCT04535986) and ENHANCE-2 (NCT04542057) trials. Here, we present a pooled post-hoc subgroup analysis of patients according to background chronic obstructive pulmonary disease (COPD) maintenance medication regimens.

Objective: This analysis aimed to explore the efficacy and safety of ensifentrine in patients receiving long-acting muscarinic antagonists (LAMA) or long-acting beta-agonists with inhaled corticosteroids (LABA + ICS).

The association between depressive symptoms and lower urinary tract symptoms and impact among women: Investigating behavioural, cognitive and physiological pathways.

Objective: Mechanistic studies are needed to understand why depressive symptoms are associated with poorer physical health. The objective of this study was to examine whether behavioural, cognitive and physiological factors mediated an association between depressive symptoms, measured in early adulthood, and lower urinary tract symptoms (LUTS) and their impact, a composite variable measured in mid-life adulthood, among women in the Coronary Artery Risk Development in Young Adults study, conducted in four regions of the United States.

Design: Prospective cohort study.

Brain Transcriptome Changes Associated With an Acute Increase of Protein O-GlcNAcylation and Implications for Neurodegenerative Disease.

Enhancing protein O-GlcNAcylation by pharmacological inhibition of the enzyme O-GlcNAcase (OGA) has been considered as a strategy to decrease tau and amyloid-beta phosphorylation, aggregation, and pathology in Alzheimer's disease (AD). There is still more to be learned about the impact of enhancing global protein O-GlcNAcylation, which is important for understanding the potential of using OGA inhibition to treat neurodegenerative diseases. In this study, we investigated the acute effect of pharmacologically increasing O-GlcNAc levels, using the OGA inhibitor Thiamet G (TG), in normal mouse brains.

Seizure outcomes after resection of temporal encephalocele in patients with drug-resistant epilepsy: A systematic review and meta-analysis.

Objective: Temporal encephaloceles (TEs) are seen in patients with drug-resistant epilepsy (DRE); yet they are also common incidental findings. Variability in institutional pre-surgical epilepsy practices and interpretation of epileptogenic network localization contributes to bias in existing epilepsy cohorts with TE, and therefore the relevance of TE in DRE remains controversial. We sought to estimate effect sizes and sample sizes necessary to demonstrate clinically relevant improvements in seizure outcome with different surgical approaches.

Instagram Versus Reality: Who Are Actually Plastic Surgeons?

Background: Instagram has become one of the most powerful marketing tools available to plastic surgeons because patients have increasingly turned to online resources to find physicians. Within, we review the online presence of self-ascribed plastic surgeons in the United States to identify potential misinformation and dishonest advertising.

Methods: The Inflact database was queried for the search terms: "plastic surgeon/surgery," "plastic and reconstructive surgeon/surgery," "aesthetic surgeon/surgery," and "cosmetic surgeon/surgery.

Patient Insights on Integrating Sleep Apnea Testing into Routine Stroke and TIA Care.

AHA/ASA guidelines recommend patients with ischemic stroke or transient ischemic attack (TIA) be considered for obstructive sleep apnea (OSA) evaluation, given the high prevalence of OSA and improved outcomes for cerebrovascular disease when OSA is treated. However, OSA testing has not been incorporated into routine cerebrovascular management. We interviewed 30 patients hospitalized for acute stroke/TIA at six Veterans Affairs facilities participating in a stepped-wedge implementation trial to improve timely OSA testing after stroke/TIA.

Patient preferences for location of cancer surgery in a community cancer affiliate network.

Purpose: Cancer centers are increasingly affiliating with regional hospitals, creating hub-spoke models for care delivery. Patient perspectives on accessing surgical cancer care within these systems are not well understood. The study purpose was to understand patient perceptions of hub-spoke models of care delivery and how they influence decisions regarding where to seek surgical care for cancer.

Employment outcomes among clients with stroke utilizing public vocational rehabilitation services in the United States.

Objective: To examine the correlations between individual characteristics among clients with stroke within public vocational rehabilitation (VR) and the employment outcome, as well as the utilization of VR services and their employment outcomes after VR services.

Design: Observational cohort study SETTING: Nationwide vocational rehabilitation data from the Rehabilitation Service Administration Case Service Report (RSA-911) for fiscal year 2022.

Participants: Individuals with stroke as primary cause of disability MAIN OUTCOME MEASURES: employment status and VR service types RESULTS: Of those with stroke who received VR services (n = 1,793), 653 (36.

Incidence of and Risk Factors for Cutaneous Malignant Neoplasms After Blood or Marrow Transplant.

Importance: Cutaneous malignant neoplasms are the most common subsequent neoplasm after blood or marrow transplant (BMT), but a full assessment among survivors is lacking.

Objective: To identify risk factors for subsequent cutaneous malignant neoplasms using the BMT Survivor Study (BMTSS).

Design, Setting, And Participants: This retrospective cohort study included patients who underwent transplant from 1974 to 2014 at City of Hope, University of Minnesota, or University of Alabama at Birmingham and survived 2 years or longer, as well as a comparison cohort of siblings.

White matter hyperintensities and headache in United States military veterans with mild traumatic brain injury.

Objective: The objective of this study was to examine the association between white matter hyperintensities and migraine-like headache in United States military veterans with a history of mild traumatic brain injury.

Background: White matter hyperintensities on magnetic resonance imaging (MRI) may be associated with migraine; however, little is currently known about the relationship between white matter hyperintensities and headache following mild traumatic brain injury in military veterans.

Methods: This cross-sectional study consisted of a retrospective chart review of veterans from a Southeastern Department of Veterans Affairs polytrauma clinic who had a verified history of mild traumatic brain injury.

Phenotypes and Trajectories of Tobacco-exposed Persons with Preserved Spirometry: Insights from Lung Volumes.

Among tobacco-exposed persons with preserved spirometry (TEPS), we previously demonstrated that different lung volume indices, specifically elevated total lung capacity (TLC) versus elevated ratio of functional residual capacity-to-TLC (FRC/TLC), identify different lung disease characteristics in the COPDGene cohort. Determine differential disease characteristics and trajectories associated with the lung volume indices among TEPS in the SPIROMICS cohort. We categorized TEPS (n=814) by tertiles (low, intermediate, high) of TLC or residual volume-to-TLC (RV/TLC) derived from baseline CT images, and then examined clinical and spirometric disease trajectories in mutually exclusive categories of participants with high TLC without high RV/TLC ([TLC]) versus high RV/TLC without high TLC ([RV/TLC]).

Surgical management of achalasia.

Achalasia is a chronic esophageal motility disorder comprised of ineffective esophageal peristalsis and incomplete relaxation of the lower esophageal sphincter. This disease had historically been managed through medical means as well as endoscopic dilations. However, surgical interventions are now considered standard of care, including minimally invasive Heller myotomy, which was popularized in 1990s, followed by per oral endoscopic myotomy in the 2010s.

Impact of Social Determinants of Health on Melanoma Nodal Surveillance in a Multi-institutional Cohort.

Background: Nodal surveillance (NS) has overtaken completion lymphadenectomy as the preferred management for sentinel node-positive (SLN+) melanoma, but requires frequent exams and nodal ultrasound (US). Social determinants of health (SDoH) may affect US adherence in real-world populations, and evaluation of these potential impacts is needed.

Methods: Adults with SLN+ melanoma diagnosed from July 2017 to December 2019 who received NS at nine cancer centers were identified retrospectively.

Clinic personnel attitudes and baseline implementation outcomes of a lupus decision aid.

To examine the association between clinical personnel's general attitudes towards new interventions and implementation outcomes related to an evidence-based individualized, culturally tailored, computerized decision aid (DA) for the management of lupus. To assess attitudes, the validated Evidence-Based Practice Attitudes Scale (EBPAS) survey was emailed to personnel in 15 rheumatology clinics across the U.S.