High-dimensional multiple imputation (HDMI) for partially observed confounders including natural language processing-derived auxiliary covariates.

Multiple imputation (MI) models can be improved with auxiliary covariates (AC), but their performance in high-dimensional data remains unclear. We aimed to develop and compare high-dimensional MI (HDMI) methods using structured and natural language processing (NLP)-derived AC in studies with partially observed confounders. We conducted a plasmode simulation with acute kidney injury as outcome and simulated 100 cohorts with a null treatment effect, incorporating creatinine labs, atrial fibrillation (AFib), and other investigator-derived confounders in the outcome generation.

Bacillus Calmette-Guerin (BCG) infections following intravesical BCG immunotherapy: a systematic review protocol.

Background: Although intravesical Bacillus Calmette-Guerin (BCG) immunotherapy usually exhibits a favorable safety profile, it can lead to the development of BCG infections, both localized and disseminated. Understanding of BCG infections following intravesical BCG immunotherapy is limited because of the lack of consensus definitions of BCG infections and limited post-instillation follow-up. We aim to perform a systematic review of the literature of BCG infections following intravesical BCG immunotherapy to elucidate the epidemiology, risk factors, and outcomes of BCG infections.

Depressive symptoms among middle-aged and older adults in China: The interaction of physical activity and sleep duration.

Background: Previous research on the interaction of physical activity and sleep on depressive symptoms was mostly cross-sectional or conducted with children or young adults. This study examines the main and interactive associations of physical activity and sleep duration with depressive symptoms over a 3-year period among middle-aged and older Chinese adults.

Methods: Data from 4269 Chinese adults aged 45 or older from the China Health and Retirement Longitudinal Study (CHARLS) were used.

The PRO-AGE Tool and Its Association With Post Discharge Outcomes in Older Adults Admitted From the Emergency Department.

Background: Existing risk scores assessing geriatric vulnerability in the emergency department (ED) have shown limited predictive power, especially in diverse populations. We investigated the relationship of a quick and easy-to-administer geriatric vulnerability scoring system with functional decline and mortality in older patients admitted to multiple hospitals through the ED in the United States (US) and Brazil (BR).

Method: Federated, international, multicenter observational study of hospitalized ED patients aged ≥ 65 from US and BR.

Differences in Care and Outcomes in Cardiogenic Shock in Cardiac Intensive Care Units in the United States and Canada: CCCTN Registry Insights.

Background: Mortality in cardiogenic shock (CS) remains high. Significant inter-hospital heterogeneity in critical care therapies have been described, which reflects the lack of high-quality evidence to guide optimal treatment. We aimed to describe differences in practices and clinical outcomes among patients with CS in the United States (US) and Canada.

Breast milk delivery of an engineered dimeric IgA protects neonates against rotavirus.

Dimeric IgA (dIgA) is the dominant antibody in many mucosal tissues. It is actively transported onto mucosal surfaces as secretory IgA (sIgA) which plays an integral role in protection against enteric pathogens, particularly in young children. Therapeutic strategies that deliver engineered, potently neutralizing antibodies directly into the infant intestine through breast milk could provide enhanced antimicrobial protection for neonates.

Late-Onset Sepsis Among Extremely Preterm Infants During the COVID-19 Pandemic.

Objectives: To compare incidence of late-onset sepsis (LOS) among extremely preterm infants before and during the COVID-19 pandemic.

Methods: Multicenter cohort study of infants with birthweight 401 to 1000 g or gestational age 22 to 28 weeks. LOS was defined as a bacterial or fungal pathogen isolated from blood or cerebrospinal fluid culture obtained after 72 hours of age.

Characterisation of pregnancy-induced alterations in apolipoproteins and their associations with maternal metabolic risk factors and offspring birth outcomes: a preconception and longitudinal cohort study.

Background: Apolipoproteins as an integral part of lipoproteins are crucial for the transport and metabolism of lipids. However, there is a lack of longitudinal studies to quantify the concentrations of maternal apolipoproteins from preconception to postpartum and their associations with maternal metabolic health and offspring birth outcomes.

Methods: Quantification of apolipoproteins was performed on maternal plasma samples (N = 243 trios) collected at preconception, 26-28 weeks' pregnancy, and three months postpartum in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) cohort study.

Echocardiogram utilization in hospitalized adults with isolated traumatic brain injury: Propensity-matched analysis of the national inpatient sample 2016-2020.

Background: Early left ventricular systolic dysfunction is common after moderate-severe traumatic brain injury (TBI). Echocardiography (Echo) can evaluate cardiac function across various clinical scenarios; however, its utilization in isolated TBI remains poorly understood. To address this gap, we aim to examine Echo utilization in hospitalized adults with isolated TBI.

Building Surgical Character: A Dynamic Simulation Curriculum for Nontechnical Skills.

Objective: Previous simulation curricula of nontechnical skills have focused on communication skills or empathy in isolation from technical skills, using feedback from one rater. We aimed to develop and pilot an expanded simulation curriculum focused on situational performance of select character attributes with the goal of determining curricular feasibility, use of a novel psychometric rating tool, and receptivity of curriculum by participants.

Design: The simulation consisted of 2 contiguous parts requiring demonstration of both technical and nontechnical skills.

Emerging of non-vaccine Streptococcus pneumoniae serotypes colonizing the nasopharynx of children under the age of five years in the 13-vallent pneumococcal conjugate vaccine era in Moshi district, Tanzania. A short communication.

In this study, we describe S. pneumoniae serotype distribution before and after PCV13 rollout in Tanzania. We serotyped S.

Risk-stratified Care Improves Pain-related Knowledge and Reduces Psychological Distress for Low Back Pain: A Secondary Analysis of a Randomized Trial.

Background: A number of efforts have been made to tailor behavioral healthcare treatments to the variable needs of patients with low back pain (LBP). The most common approach involves the STarT Back Screening Tool (SBST) to triage the need for psychologically informed care, which explores concerns about pain and addresses unhelpful beliefs, attitudes, and behaviors. Such beliefs that pain always signifies injury or tissue damage and that exercise should be avoided have been implied as psychosocial mediators of chronic pain and can impede recovery.

Top Ten Tips Palliative Care Clinicians Should Know About Rheumatology.

Systemic autoimmune rheumatic diseases (SARDs) consist of a broad range of immune-mediated multisystem diseases. They are chronic, incurable illnesses that often present in early to mid-life and can be associated with a high symptom burden, disability, and early mortality. Treatment guidelines for similar chronic, life-limiting conditions with uncertain disease courses now recommend palliative care (PC) assessment at the time of diagnosis.

Medicaid Spending in Coordination-Only Dual-Eligible Special Needs Plans.

Importance: More than 4 million Medicare beneficiaries have enrolled in dual-eligible Special Needs Plans (D-SNPs), and coordination-only D-SNPs are common. Little is known about the impact of coordination-only D-SNPs on Medicaid-covered services and spending, including long-term services and supports, which are financed primarily by Medicaid.

Objective: To evaluate changes in Medicaid fee-for-service (FFS) spending before and after new enrollment in coordination-only D-SNPs vs new enrollment in non-D-SNP Medicare Advantage (MA) plans among community-living beneficiaries enrolled in both Medicare and North Carolina Medicaid.

Impact and Recovery of VHA Epilepsy Care Services During the COVID-19 Pandemic.

Background: The Epilepsy Centers of Excellence (ECoE) is a network of facilities within the Veterans Health Administration that evaluates and treats veterans with epilepsy and seizure disorders. This article outlines how the COVID-19 pandemic impacted ECoE services and recovery.

Methods: Directors of 17 ECoEs were surveyed 4 times between May 2020 and July 2022 on 5 domains: functioning of outpatient epilepsy clinics, outpatient electroencephalogram, epilepsy monitoring unit, anticipated permanent operational changes, and utility of national and local recommendations.

Associations of Concordant and Shared Lung Cancer Screening Decision Making with Decisional Conflict: A Multi-Institution Cross-Sectional Analysis.

Unlabelled: Many organizations recommend structured communication processes, including formal shared decision making (SDM), for patients undergoing lung cancer screening (LCS) using low-dose computed tomography (LDCT). We sought to understand if concordant and shared LCS decision making was associated with decisional conflict. In this prospective, observational study, we enrolled patients from 3 medical centers (2 Veterans Health Administration, 1 academic facility) after a decision-making interaction about undergoing LCS but before receiving the LDCT.

The Role of Interventional Radiology in Managing Placenta Accreta Spectrum Disorder.

Interventional Radiology (IR) can be a crucial player in managing placenta accrete spectrum disorder (PAS), offering minimally invasive angiographic techniques that can prevent or control hemorrhage and preserve fertility. These include prophylactic balloon occlusion of the aorta or iliac arteries, preoperative catheter placement in the iliac or uterine arteries for subsequent embolization, or pre-emptive arterial embolization preceding hysterotomy and delivery. This review provides obstetricians with an overview of IR's role in the management of PAS by describing specific endovascular techniques; existing outcomes data; and considerations for protocol development, preoperative planning, and intraoperative dynamics for when IR assists with PAS cases.

Targeting allograft inflammatory factor-1 reprograms kidney macrophages to enhance repair.

The role of macrophages remains incompletely understood in kidney injury and repair. Their plasticity offers an opportunity to polarize them towards mediating injury resolution in both native and transplanted kidneys undergoing ischemia and/or rejection. Here, we show that infiltrating kidney macrophages augmented their AIF-1 expression after injury.