A model of care redesign within rheumatology: A mixed methods approach integrating nurse practitioners and physician assistants.

Background: Increasing patient demand and clinician burnout in rheumatology practices have highlighted the need for more efficient models of care (MOC). Interprofessional collaboration is essential for improving patient outcomes and clinician satisfaction.

Local Problem: Our current MOC lacks standardization and formal integration of Nurse Practitioners (NPs) and Physician Assistants (PAs), resulting in reduced clinician satisfaction and limited patient access.

Comparison of the 2023 ISCVID and ESC Duke clinical criteria for the diagnosis of infective endocarditis among patients with positive blood cultures for new typical microorganisms.

Purpose: To evaluate the performance of the Duke clinical criteria of the European Society of Cardiology (ESC; 2015 and 2023 versions) and the 2023 International Society for Cardiovascular Infectious Diseases (ISCVID) in diagnosing infective endocarditis (IE) among patients with bacteraemia/candidaemia by pathogens introduced for the first time as typical microorganisms by ISCVID.

Methods: Retrospective study.

Setting: This study included adult patients with bacteraemia/candidaemia by such pathogens (coagulase negative staphylococci, Abiotrophia spp.

Responsive cancer care in Asia: stigma and pain must be acknowledged and addressed.

Purpose: This study investigates whether cancer-related stigma and pain among patients with advanced cancer influences their perceptions of receiving responsive care.

Methods: We surveyed 2138 advanced cancer patients from 11 hospitals in eight Asian countries. Participants rated their most recent healthcare visit and a hypothetical patient's experience described in vignettes concerning dignity, clarity of information, and involvement in decision-making.

Point-counterpoint: should sedation be used for image-guided biopsies?

Cross-sectional interventional radiology procedures can be performed using a range of techniques with approaches varying across institutions. One area in which practices for these procedures may differ is in the use of moderate sedation. This perspective discusses the pros and cons of using moderate sedation for deep organ biopsies commonly experienced in radiology departments.

Systemic TRPV4 inhibition worsens retinal response to acute intraocular pressure elevation in older but not younger mice.

Significance: Previous evidence showed that transient receptor potential vanilloid 4 (TRPV4) inhibition was protective of retinal ganglion cell (RGC) loss after chronic intraocular pressure (IOP) elevation in young animals. However, the role of TRPV4 in mechanosensing IOP changes in the aging eye is not well understood.

Purpose: This study compared the recovery of retinal function and structure after acute IOP elevation in 3- and 12-month-old mouse eyes with and without TRPV4 inhibition.

Assessing the threat of harboring a multi-resistant IncC plasmid and the efficacy of an antibiotic targeting LpxC.

Self-transmissible IncC plasmids rapidly spread multidrug resistance in many medically important pathogens worldwide. A large plasmid of this type (pIP1202, ~80 Kb) has been isolated in a clinical isolate of , the agent of plague. Here, we report that pIP1202 was highly stable in infected mice and fleas and did not reduce virulence in these animals.

Emergent Carotid Stenting During Thrombectomy in Tandem Occlusions Secondary to Dissection: A STOP-CAD Secondary Study.

The optimal endovascular management of cervical carotid dissection causing tandem occlusion remains uncertain. We investigated the impact of emergent carotid stenting during endovascular treatment (EVT) for acute ischemic stroke (AIS) in patients with tandem occlusion secondary to cervical carotid artery dissection. This was a secondary analysis of patients treated with EVT for AIS due to occlusive carotid artery dissection and tandem occlusion included in the retrospective international Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection (STOP-CAD) study.

Impaired Exercise Capacity in High-Risk Diabetic Cardiomyopathy: The ARISE-HF Cardiopulmonary Exercise Testing Subanalysis.

Background: Objective indices of functional capacity in patients with diabetic cardiomyopathy and stage B heart failure (HF) have not been comprehensively defined. We sought to characterize the cardiopulmonary exercise characteristics of individuals with diabetic cardiomyopathy at high risk for overt HF.

Methods: The relationships from cardiopulmonary exercise testing with clinical and laboratory characteristics of participants with diabetic cardiomyopathy were evaluated using baseline data from the ARISE-HF trial (Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure).

Oral behaviors in Chinese temporomandibular disorder patients: insights from exploratory and confirmatory factor analyses.

Aim: This study aimed to evaluate the factor structure of the Oral Behaviors Checklist (OBC) in Chinese temporomandibular disorder (TMDs) patients and compare the outcomes with those of Western patients. Additionally, it examined the correlations between different OBC subscale scoring methods.

Methods: A total of 869 patients completed a survey that included demographic information, the Symptom Questionnaire, and OBC.

Promoting breastfeeding in Singapore-a case study.

The health and economic benefits of breastfeeding for mothers, infants and the broader community are well established; however, breastfeeding rates remain suboptimal in Singapore. This commentary reviews the journey Singapore, a high-income and well-resourced country, has taken over the past two decades to promote breastfeeding. We discuss where we are currently at, the measures implemented to achieve our targets and next steps ahead.

Modern perspective of the Rice Diet for hypertension and other metabolic diseases.

Background: In the early 1940s, before antihypertensive drugs were available, the Rice Diet Programme (RDP) was developed to treat severe hypertension and, later, diabetes and obesity. Despite significant advancements in dietary management for these conditions since then, debates remain regarding the proper guidelines for sodium and macronutrients intakes. The patient care records of RDP offer a unique source of longitudinal examination of a very low sodium (<10 mmol/day), fat, cholesterol and protein diet on blood pressure (BP), other health markers and survival.

A conserved element in the first intron of has a lineage specific, TCR signal-responsive, canonical enhancer function that matches the timing of cell surface CD4 upregulation required to prevent lineage choice error.

Introduction: The regulation of expression during T-cell development and immune responses is essential for proper lineage commitment and function in the periphery. However, the mechanisms of genetic and epigenetic regulation are complex, and their interplay not entirely understood. Previously, we demonstrated the need for CD4 upregulation during positive selection to ensure faithful commitment of MHC-II-restricted T cells to the CD4 lineage.

Unraveling Histiocytic Disorders: Two Cases From Resource-Limited Settings.

Histiocytic disorders include a range of uncommon illnesses marked by the buildup of cells that have developed into macrophages, dendritic cells, or monocytes in diverse tissues and organs. Over 100 distinct subtypes have been documented, exhibiting a diverse array of clinical symptoms, presentations, and histologic features that can be confused with other clinical conditions leading to delayed diagnosis. They affect both children and adults, generating a variety of clinical symptoms that can be limited to one position, numerous areas within one system, or affect many systems in the body.

Cognitive Outcomes After Transcranial Magnetic Stimulation for the Treatment of Late-Life Depression: Résultats cognitifs après la stimulation magnétique transcrânienne pour le traitement de la dépression chez les personnes âgées.

Background: Late-life depression (LLD) is often accompanied by cognitive impairment, which may persist despite antidepressant treatment. Repetitive transcranial magnetic stimulation (rTMS) is an efficacious treatment for depression, with potential benefits on cognitive functioning. However, research on cognitive effects is inconclusive, relatively sparse in LLD, and predominantly focused on group-level cognitive changes.

Genetic ancestry concordant RNA splicing in prostate cancer involves oncogenic genes and associates with recurrence.

Black men suffer disproportionately from prostate cancer (PCa) compared to men of other races and ethnicities. Comparing the molecular landscape of PCa among Black and White patients has the potential to identify targets for development of new precision medicine interventions. Herein, we conducted transcriptomic analysis of prostate tumors and paired tumor-adjacent normals from self-reported Black and White PCa patients and estimated patient genetic ancestry.

Leveraging survival analysis and machine learning for accurate prediction of breast cancer recurrence and metastasis.

Breast cancer, with its high incidence and mortality globally, necessitates early prediction of local and distant recurrence to improve treatment outcomes. This study develops and validates predictive models for breast cancer recurrence and metastasis using Recurrence-Free Survival Analysis and machine learning techniques. We merged datasets from the Molecular Taxonomy of Breast Cancer International Consortium, Memorial Sloan Kettering Cancer Center, Duke University, and the SEER program, creating a comprehensive dataset of 272, 252 rows and 23 columns.

Three-dimensional diffractive acoustic tomography.

Acoustically probing biological tissues with light or sound, photoacoustic and ultrasound imaging can provide anatomical, functional, and/or molecular information at depths far beyond the optical diffusion limit. However, most photoacoustic and ultrasound imaging systems rely on linear-array transducers with elevational focusing and are limited to two-dimensional imaging with anisotropic resolutions. Here, we present three-dimensional diffractive acoustic tomography (3D-DAT), which uses an off-the-shelf linear-array transducer with single-slit acoustic diffraction.

Is there a mental health diagnostic crisis in primary care? Current research practices in global mental health cannot answer that question.

In low- and middle-income countries, fewer than 1 in 10 people with mental health conditions are estimated to be accurately diagnosed in primary care. This is despite more than 90 countries providing mental health training for primary healthcare workers in the past two decades. The lack of accurate diagnoses is a major bottleneck to reducing the global mental health treatment gap.

Social mixing patterns of United States healthcare personnel at a quaternary health center: a prospective observational study.

Background: Understanding healthcare personnel's (HCP) contact patterns are important to mitigate healthcare-associated infectious disease transmission. Little is known about how HCP contact patterns change over time or during outbreaks such as the COVID-19 pandemic.

Methods: This study in a large United States healthcare system examined the social contact patterns of HCP via standardized social contact diaries.

Characterization and Localization of Focal Atrial Tachycardia in Patients With Adult Congenital Heart Disease.

Background: In patients with structurally normal hearts, algorithms using surface electrocardiographic P-wave morphology are helpful to predict focal atrial tachycardia (FAT) location. However, these algorithms have not been formally assessed in patients with adult congenital heart disease (ACHD).

Objectives: This study sought to assess the efficacy of FAT-location prediction algorithms in an adult population of patients with ACHD.

Barriers and facilitators to global access to life-saving skills training: an international cross-sectional survey.

Introduction: Emergency care begins in the community, who are often the first on the scene. Where emergency care systems are nascent or absent, bystanders represent the only prehospital emergency care that victims might receive. It is important to equip bystanders through life-saving skills training (LST).

Starfield's 4Cs of NCD management in primary healthcare: a conceptual framework development from a case study of 19 countries.

Introduction: Faced with a backdrop of an increasing chronic disease burden from an ageing global population compounded with rising healthcare costs, health systems are required to implement cost-effective, safe and equitable care through efficient service delivery models. One approach to achieving this is through Starfield's 4Cs of primary healthcare (PHC), which delineates the key attributes of a high-performing PHC system that upholds the pillars of care coordination, first contact of care, continuity of care and comprehensive care. Therefore, this study aims to explore and elucidate the key themes and subthemes related to and extending beyond Starfield's 4Cs of PHC by integrating findings from a comprehensive literature review and a qualitative study.