Impact of the Implementation of a Short Stay Observation Unit Associated With Admitter-Rounder Model Onto Other Internal Medicine Units in a French University Hospital.

Introduction: Few data on the impact of specific interventions against Emergency Rooms 'or Hospitals overcrowding are available in France.

Methods: In the present report, we retrospectively investigated the impact of the implementation of a short-stay observation unit associated with the admitter-rounder model, especially onto the other in-patient internal medicine units in a French University Hospital.

Results: During the first 100 days, 242 patients were admitted into the short-stay observation unit.

National survey of financial burden and experience among patients with cancer and autoimmune disease receiving charitable copay assistance.

Background: Little is known about the role that charitable copay assistance (CPA) plays in addressing access to care and financial distress. The study sought to evaluate financial distress and experience with CPA among patients with cancer and autoimmune disease.

Methods: This is a national cross-sectional self-administered anonymous electronic survey conducted among recipients of CPA to cover the costs of a drug for cancer or autoimmune disease.

A Supervised Explainable Machine Learning Model for Perioperative Neurocognitive Disorder in Liver-Transplantation Patients and External Validation on the Medical Information Mart for Intensive Care IV Database: Retrospective Study.

Background: Patients undergoing liver transplantation (LT) are at risk of perioperative neurocognitive dysfunction (PND), which significantly affects the patients' prognosis.

Objective: This study used machine learning (ML) algorithms with an aim to extract critical predictors and develop an ML model to predict PND among LT recipients.

Methods: In this retrospective study, data from 958 patients who underwent LT between January 2015 and January 2020 were extracted from the Third Affiliated Hospital of Sun Yat-sen University.

The employment of recommended root canal treatment procedures by dentists in Croatia and the Czech Republic.

Aim: This study aimed to evaluate the compliance of dentists in Croatia and the Czech Republic with endodontic recommendations and identify the subjective and objective factors influencing their adherence to them.

Methodology: A total of 1386 dentists from Croatia and the Czech Republic participated in an online survey through a self-administered, author-designed questionnaire. After excluding those who did not perform root canal treatments (RCT), 1376 responses (394 from Croatia and 982 from the Czech Republic) were statistically analysed.

Cardiomeds, an mHealth App for Self-Management to Support Swiss Patients With Heart Failure: 2-Stage Mixed Methods Usability Study.

Background: Mobile health apps have shown promising results in improving self-management of several chronic diseases in patients. We have developed a mobile health app (Cardiomeds) dedicated to patients with heart failure (HF). This app includes an interactive medication list; daily self-monitoring of symptoms, weight, blood pressure, and heart rate; and educational information on HF delivered through various formats.

Continuous Instrument Tracking in a Cerebral Corticectomy Ex Vivo Calf Brain Simulation Model: Face and Content Validation.

Background And Objectives: Subpial corticectomy involving complete lesion resection while preserving pial membranes and avoiding injury to adjacent normal tissues is an essential bimanual task necessary for neurosurgical trainees to master. We sought to develop an ex vivo calf brain corticectomy simulation model with continuous assessment of surgical instrument movement during the simulation. A case series study of skilled participants was performed to assess face and content validity to gain insights into the utility of this training platform, along with determining if skilled and less skilled participants had statistical differences in validity assessment.

Impact of Frailty on Surgical Outcomes of Patients With Cushing Disease Using the Multicenter Registry of Adenomas of the Pituitary and Related Disorders Registry.

Background And Objectives: Despite growing interest in how patient frailty affects outcomes (eg, in neuro-oncology), its role after transsphenoidal surgery for Cushing disease (CD) remains unclear. We evaluated the effect of frailty on CD outcomes using the Registry of Adenomas of the Pituitary and Related Disorders (RAPID) data set from a collaboration of US academic pituitary centers.

Methods: Data on consecutive surgically treated patients with CD (2011-2023) were compiled using the 11-factor modified frailty index.

Vesalius and His Manikin: An Enduring Influence on Modern Anatomic Teaching.

Anatomic teaching has long informed surgical knowledge, experience, and skills. One tool for teaching that emerged during the Renaissance was the fugitive anatomic sheet, which used flap layers to reveal different levels of anatomy. In 1538, Vogtherr introduced the first fugitive sheets, which included illustrations of male and female figures with a torso paper flap that, when lifted, revealed the internal organs in a cartoonish style.

Impact of sodium-glucose cotransporter inhibitors in acute coronary syndrome patients on endothelial function and atherosclerosis related-biomarkers: ATH-SGLT2i pilot study.

Little is known about the effects of sodium-glucose co-transporter 2 inhibitors (SGLT2i) on atherosclerosis. We aimed to determine if a 90-day intake of Dapagliflozin could improve atherosclerosis biomarkers (namely endothelial function assessed by flow-mediated dilatation [FMD] and carotid intima-media thickness [CIMT]) in diabetic and non-diabetic acute coronary syndrome (ACS) patients when initiated in the early in-hospital phase. ATH-SGLT2i was a prospective, single-center, observational trial that included 113 SGLT2i naive patients who were admitted for ACS and who were prescribed Dapagliflozin at a fixed dose of 10 mg during their hospital stay for either type 2 diabetes or for heart failure.

Recurrence Patterns and Management after Pleurectomy Decortication for Pleural Mesothelioma.

Objective: We hypothesize that recurrence following pleurectomy decortication (PD) is primarily local. We explored factors associated with tumor recurrence patterns, disease-free interval (DFI), and post-recurrence survival (PRS).

Summary Background Data: Tumor recurrence is a major barrier for long-term survival after pleural mesothelioma (PM) surgery.

Artificial Intelligence-Guided Lung Ultrasound by Nonexperts.

Importance: Lung ultrasound (LUS) aids in the diagnosis of patients with dyspnea, including those with cardiogenic pulmonary edema, but requires technical proficiency for image acquisition. Previous research has demonstrated the effectiveness of artificial intelligence (AI) in guiding novice users to acquire high-quality cardiac ultrasound images, suggesting its potential for broader use in LUS.

Objective: To evaluate the ability of AI to guide acquisition of diagnostic-quality LUS images by trained health care professionals (THCPs).

Association Between Surgeon Stress and Major Surgical Complications.

Importance: Surgeon stress can influence technical and nontechnical skills, but the consequences for patient outcomes remain unknown.

Objective: To investigate whether surgeon physiological stress, as assessed by sympathovagal balance, is associated with postoperative complications.

Design, Setting, And Participants: This multicenter prospective cohort study included 14 surgical departments involving 7 specialties within 4 university hospitals in Lyon, France.

Safety and Efficacy of Tranexamic Acid in General Surgery.

Importance: Perioperative bleeding is common in general surgery. The POISE-3 (Perioperative Ischemic Evaluation-3) trial demonstrated efficacy of prophylactic tranexamic acid (TXA) compared with placebo in preventing major bleeding without increasing vascular outcomes in noncardiac surgery.

Objective: To determine the safety and efficacy of prophylactic TXA, specifically in general surgery.

Age- and Sex-Specific Regulation of Serine Racemase in the Retina of an Alzheimer's Disease Mouse.

Purpose: Changes associated with Alzheimer's disease (AD) may have measurable effects on the retina, which may facilitate early detection due to the eye's accessibility. Retinal pathology and the regulation of serine racemase (SR) were investigated in the retinas of APP(SW)/PS1(∆E9) mice.

Methods: SR in the retinas and the content of D-serine in the aqueous humor were analyzed.

Acne Relapse and Isotretinoin Retrial in Patients With Acne.

Importance: Isotretinoin is the only medical acne treatment capable of inducing acne remission; however, some patients experience acne relapse and require retrials of isotretinoin. There is a need to understand who is most at risk and how daily dose and cumulative dosage can influence outcomes.

Objective: To assess rates of acne relapse and isotretinoin retrial and to identify associated factors among patients with acne who received an isotretinoin treatment course.

Multicomponent Deimplementation Strategy to Reduce Low-Value Preoperative Testing.

Importance: Routine preoperative blood tests and electrocardiograms before low-risk surgery do not prevent adverse events or change management but waste resources and can cause patient harm. Given this, multispecialty organizations recommend against routine testing before low-risk surgery.

Objective: To determine whether a multicomponent deimplementation strategy (the intervention) would reduce low-value preoperative testing before low-risk general surgery operations.

Evaluating a Public Health Assessment and Response Framework: SARS-CoV-2 Spread Under the Controlled Distancing Model of Rio Grande do Sul, Brazil.

In early 2020, to halt the spread of SARS-CoV-2, the state government of Rio Grande do Sul in Brazil established a public health assessment and response framework known as a "controlled distancing model." Using this framework, the government divided the state into 21 regions and evaluated them against a composite index of disease transmission and health service capacity. Regions were assessed using a color-coded scale of flags that was updated on a weekly basis and used to guide the adoption of nonpharmaceutical interventions.

Palliative Care Initiated in the Emergency Department: A Cluster Randomized Clinical Trial.

Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.

Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.

Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.

Gender Disparities and Lung Cancer Screening Outcomes Among Individuals Who Have Never Smoked.

Importance: Lung cancer in individuals who have never smoked (INS) is a growing global concern, with a rapidly increasing incidence and proportion among all lung cancer cases. Particularly in East Asia, opportunistic lung cancer screening (LCS) programs targeting INS have gained popularity. However, the sex-specific outcomes and drawbacks of screening INS remain unexplored, with data predominantly focused on women.

Blood Culture Use in Medical and Surgical Intensive Care Units and Wards.

Importance: Blood culture (BC) use benchmarks in US hospitals have not been defined.

Objective: To characterize BC use in adult intensive care units (ICUs) and wards in US hospitals.

Design, Setting, And Participants: A retrospective cross-sectional study of BC use in adult medical ICUs, medical-surgical ICUs, medical wards, and medical-surgical wards from acute care hospitals from the 4 US geographic regions was conducted.

Patient Complexity, Social Factors, and Hospitalization Outcomes at Academic and Community Hospitals.

Importance: There have been limited evaluations of the patients treated at academic and community hospitals. Understanding differences between academic and community hospitals has relevance for the design of clinical models of care, remuneration for clinical services, and health professional training programs.

Objective: To evaluate differences in complexity and clinical outcomes between patients admitted to general medical wards at academic and community hospitals.