Association between tumor location and toxicity outcomes after stereotactic radiosurgery for brain metastases.

Purpose: Toxicities associated with stereotactic radiosurgery (SRS) are important when considering treatment and supportive management for patients with brain metastases. We herein assessed the association between brain metastasis location and risk of toxicity after SRS.

Methods: We conducted a retrospective institutional review of patients treated with SRS for brain metastases between 2008 and 2023.

The Role of Sex and Gender in Precision Emergency Medicine: A Scoping Review and Proposed Hierarchy.

Background: Precision medicine utilizes individual patient data to guide decision making. Sex and gender medicine is likewise focused on individual patients' biological sex or sociocultural gender as determinants of disease. How these two fields intersect with one another and with acute care medicine is unclear.

Infective Endocarditis Outcomes in Congestive Heart Failure Patients.

Background/objectives: The aim of this study is to analyze the difference in hospital outcomes for infective endocarditis (IE) admissions with and without comorbid congestive heart failure (CHF).

Methods: The National Inpatient Sample (NIS) was the database we used to find and sort patient data from inpatient hospitalizations. We then used logit probit regression to analyze the association between patients admitted for IE with and without CHF and their all-cause mortality rates.

A genome-wide association study identifies genetic determinants of hemoglobin glycation index with implications across sex and ethnicity.

Introduction: We investigated the genetic determinants of variation in the hemoglobin glycation index (HGI), an emerging biomarker for the risk of diabetes complications.

Methods: We conducted a genome-wide association study (GWAS) for HGI in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial ( = 7,913) using linear regression and additive genotype encoding on variants with minor allele frequency greater than 3%. We conducted replication analyses of top findings in the Atherosclerosis Risk in Communities (ARIC) study with inverse variance-weighted meta-analysis.

An international core outcome set for primary progressive aphasia (COS-PPA): Consensus-based recommendations for communication interventions across research and clinical settings.

Introduction: Interventions to treat speech-language difficulties in primary progressive aphasia (PPA) often use word accuracy as a highly comparable outcome. However, there are more constructs of importance to people with PPA that have received less attention.

Methods: Following Core Outcome Set Standards for Development Recommendations (COSSTAD), this study comprised: Stage 1 - systematic review to identify measures; Stage 2 - consensus groups to identify important outcome constructs for people with PPA (n = 82) and care partners (n = 91); Stage 3 - e-Delphi consensus with 57 researchers.

Evidence of SARS-CoV-2 Spread in Rural Tanzania During the First 6 Months of the Global COVID-19 Pandemic.

In the first 6 months of the coronavirus disease 2019 pandemic, limited testing clouded understanding of the extent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in Africa. In particular, Tanzania halted all testing and reporting of SARS-CoV-2 cases after May 2020, not resuming until June 2021. In July-August 2020, we performed a seroprevalence survey in rural Bagamoyo district, 40 km outside Dar es Salaam.

Electroconvulsive Therapy in a Left Ventricular Assist Device Recipient With Treatment-Resistant Depression.

Depression and heart failure are highly comorbid, with up to 35% of heart failure patients suffering from comorbid depression. Left ventricular assist devices (LVADs) serve as a major lifeline for patients with heart failure; however, despite the drastic improvement in cardiac function following LVAD implantation, up to 24% of LVAD recipients suffer from depression. Depression management in LVAD recipients is often complicated by the recipient's increased risk for antidepressant side effects, adverse drug reactions, and inability to safely receive certain interventional psychiatry therapies, as the LVAD is either a relative or absolute contraindication.

Medical Board Discipline of Physicians for Spreading Medical Misinformation.

Importance: False medical information disseminated dangerously during the COVID-19 pandemic, with certain physicians playing a surprisingly prominent role. Medical boards engendered widespread criticism for not imposing forceful sanctions, but considerable uncertainty remains about how the professional licensure system regulates physician-spread misinformation.

Objective: To compare the level of professional discipline of physicians for spreading medical misinformation relative to discipline for other offenses.

Through Their Eyes: Using Photovoice to Capture the Capacity-Building Journey of Long Covid Patient Experts.

Background: Long Covid, characterised by persistent symptoms following the coronavirus disease 2019 (COVID-19) infection, significantly impacts the quality of life. Engaging patients in research and care through participatory methods can enhance a shared understanding of illness and improve the relevance of research.

Objective: We define Patient Experts (PEs) as persons (including patients, caregivers and providers) who have completed a series of training sessions on team building, research methods and communication at the Patient Engagement Studio, University of South Carolina (PES USC).

Challenges in Radial Forearm Free Flap Surgery: A Comprehensive Case Analysis of Septic Complications at the Donor Site.

The radial forearm free flap (RFFF) has emerged as a leading option for microvascular reconstruction of head and neck soft-tissue defects. Despite the favorable outcomes conferred by RFFFs, complications such as skin graft loss and tendon exposure can occur. We present the case of a 77-year-old man who underwent RFFF reconstruction after excision of squamous cell carcinoma from the head and neck.

A Proposed Patient Selection Algorithm for Total Joint Arthroplasty Same-Day Discharge From an Ambulatory Surgery Center.

Background: Identifying appropriate patients for same-day discharge (SDD) total joint arthroplasty (TJA) is critical for maintaining optimal patient safety and outcomes. This study investigated patient outcomes after SDD TJA at a single ambulatory surgery center (ASC) and proposes a TJA patient-selection algorithm based on findings and existing literature.

Methods: A retrospective chart review of 660 patients was performed between July 2019 and October 2021 for all patients who underwent primary TJA in a single ASC.

A cross-sectional study of point-of-care lactate testing in integrated community care management (ICCM) for children with acute respiratory illness in rural uganda.

Background: Integrated community case management (iCCM) programs leverage lay village health workers (VHWs) to carry out the initial evaluation of children with common conditions including malaria, pneumonia and diarrhea. Therefore, it is imperative that VHWs are able to identify children who are critically ill and require referral to a health facility. Elevated venous lactate levels have been associated with severe illness and adverse health outcomes, including death.

Dysregulation of Noradrenergic Activity: Its Role in Conceptualizing and Treating Major Depressive Disorder, Schizophrenia, Agitation in Alzheimer's Disease, and Posttraumatic Stress Disorder.

When discussing neurotransmitters whose signaling plays an important role in psychiatric illnesses, serotonin and dopamine may be the first that come to mind. Although serotonin and dopamine have significant roles, the impact of norepinephrine signaling is often overlooked. A growing body of evidence suggests that hyperactivity of norepinephrine signaling is an underlying issue in psychiatric disorders; conversely, there is evidence to suggest that deficits in the noradrenergic system are just as significant.

Noninferiority Randomized Clinical Trial: KIM Sling With Reusable Trocars Versus TVT Exact Sling.

Importance: The Neomedic Knotless Incontinence Mesh (KIM) sling with sterilizable trocars decreases medical waste versus midurethral slings with disposable trocars. Limited comparative data exist.

Objective: The aim of the study was to assess to the success of the retropubic KIM sling compared to the Gynecare TVT Exact sling.

Entrustable professional activities (EPAs) in surgical pathology: implementation experience and longitudinal observations of resident development.

Entrustable professional activities (EPAs) have been implemented in various medical specialties, and the Pathology National EPA Working Group has piloted the implementation of four pathology EPAs. We recently published the development of EPAs within our surgical pathology rotation. Following a six-month pilot, a survey demonstrated that faculty and residents found the forms helpful and easy to use and easy to understand, and EPAs have been fully incorporated into our surgical pathology rotation.

Postpartum Acute Care Utilization in a Health Care System in the Southeastern United States.

Postpartum acute care utilization (PACU), including visits to an emergency department, obstetric triage, or urgent care ("outpatient"), and hospital readmissions, may indicate medical complications and signal unmet health needs. We estimated the incidence of PACU and examined patterns by sociodemographic factors, pregnancy and birth characteristics, time since discharge from the birth hospitalization, and medical indications. We constructed a retrospective cohort of people aged ≥18 years who delivered ≥1 liveborn infant >20 weeks of gestation from July 1, 2021, to December 31, 2022, using electronic health record data from a quaternary maternity hospital in the Southeastern United States PACU data throughout the health care system were collected through March 31, 2023.

Harmonizing data across the accelerating colorectal cancer screening and follow-up through implementation science (ACCSIS) program to enhance data quality and promote data sharing.

Background: The purpose of the Accelerating Colorectal Cancer Screening and Follow-up through Implementation Science (ACCSIS) Program, a Cancer Moonshot℠ Initiative, is to support research to build the evidence base on multilevel interventions that increase rates of colorectal cancer screening, follow-up, and referral to care to address disparities in colorectal cancer screening. The National Cancer Institute funded eight Research Projects to implement multilevel interventions to improve colorectal cancer screening among communities who traditionally have been medically underserved. To analyze the impact of ACCSIS across Research Projects, the consortium developed a set of common data elements.

Examining childhood and adulthood stressors as risk factors for gestational diabetes mellitus in working pregnant individuals: A prospective cohort study.

Aims: This study aimed to examine the individual and joint associations of adverse childhood experiences (ACEs) and maternal work and non-work related stressors with the risk of gestational diabetes mellitus (GDM).

Methods: Working pregnant individuals (n = 1163) from a United States (U.S.

Medicaid expansion and medications to treat opioid use disorder in outpatient specialty care from 2010 to 2020.

Introduction: Medications for opioid use disorder (MOUD) are considered the first line treatment for opioid use disorder. As states expanded Medicaid beginning in 2014 under the Affordable Care Act, policymakers and public health officials were interested in the potential for expansion to increase access to MOUD. This study examined whether there were changes in MOUD use within outpatient admissions to specialty treatment facilities in Medicaid expansion states beyond the initial expansion period.