"No Matter the Age or Medical Complexity, People Benefit From That Intensity of Exercise": A Mixed-Methods Study Describing Rehabilitation Provider Perceptions of High-Intensity Resistance Training Among Veterans Receiving Post-Acute Care.

Background: In skilled nursing facilities (SNFs), i-STRONGER is a novel, high-intensity resistance training approach that incorporates progressive resistance training to promote greater improvements in patient function compared to usual care. To inform large-scale expansion of i-STRONGER as standard-of-care in SNFs, this mixed-methods study assessed rehabilitation providers' perceptions of i-STRONGER and purported needs for its adoption.

Methods: Forty-three rehabilitation providers participated in an 18-week, interactive i-STRONGER training program.

Consensus recommendations for measuring the impact of contraception on the menstrual cycle in contraceptive clinical trials.

Objective: We sought to develop consensus recommendations for measurement and analysis of data on contraceptive-induced menstrual changes (CIMCs) in contraceptive clinical trials. We built upon previous standardization efforts over the last 50 years and prioritized input from a variety of global experts and current regulatory authority guidance on patient-reported outcomes.

Study Design: We completed a formal consensus-building process with an interdisciplinary group of 57 experts from 30 organizations and 14 countries in five global regions who work across academia, nonprofit research organizations, the pharmaceutical industry, and funding agencies.

Increasing Serious Illness Conversations in Patients at High Risk of One-Year Mortality Using Improvement Science: A Quality Improvement Study.

Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores.

Reducing catheter-associated urinary tract infections with sterile, continuously closed drainage systems does not have to be costly.

Introduction: Catheter-associated urinary tract infections (CAUTIs) cause significant morbidity and financial strain in the pediatric intensive care unit (PICU). There is a significant incentive to reduce the rate of CAUTIs through multimodal quality improvement initiatives; however, these initiatives are often costly to implement.

Objective: This article examines the cost-savings associated with a novel "two-part, two-person" catheter insertion protocol implemented at a pediatric quaternary care center PICU which replaced costly pre-packaged, closed system urinary catheter kits with their individually packaged components, along with its impact on CAUTI rates and nursing satisfaction.

External Validation of Deep Learning Models for Classifying Etiology of Retinal Hemorrhage Using Diverse Fundus Photography Datasets.

Retinal hemorrhage (RH) is a significant clinical finding with various etiologies, necessitating accurate classification for effective management. This study aims to externally validate deep learning (DL) models, specifically FastVit_SA12 and ResNet18, for distinguishing between traumatic and medical causes of RH using diverse fundus photography datasets. A comprehensive dataset was compiled, including private collections from South Korea and Virginia, alongside publicly available datasets such as RFMiD, BRSET, and DeepEyeNet.

Life satisfaction around the world: Measurement invariance of the Satisfaction With Life Scale (SWLS) across 65 nations, 40 languages, gender identities, and age groups.

The Satisfaction With Life Scale (SWLS) is a widely used self-report measure of subjective well-being, but studies of its measurement invariance across a large number of nations remain limited. Here, we utilised the Body Image in Nature (BINS) dataset-with data collected between 2020 and 2022 -to assess measurement invariance of the SWLS across 65 nations, 40 languages, gender identities, and age groups (N = 56,968). All participants completed the SWLS under largely uniform conditions.

Medical Students' Observations of High Value and Potentially Wasteful Care Behaviors Modeled During Clinical Rotations.

Background: Medical student exposure to role-modeling of high-value care (HVC) behaviors may shape professional identity formation and future HVC practices.

Objective: To investigate the frequency and characteristics of HVC role-modeling witnessed by medical students during core clinical rotations.

Design: Cross-sectional survey study.

Functional capacity at rehabilitation discharge predicts physical activity characteristics twenty-four weeks later for people with total knee arthroplasty: a secondary analysis of a randomized controlled trial.

Objective: To determine the association between performance-based and patient-reported functional capacity at the conclusion of 12-week rehabilitation with average daily step counts and peak walking cadence 38 weeks following total knee arthroplasty (TKA).

Design: Secondary analysis of an RCT.

Setting: Veterans Affairs Medical Center.

Up-front resection for hepatocellular carcinoma: Assessing futility in the preoperative setting.

Objective: We sought to develop a predictive model to preoperatively identify patients with hepatocellular carcinoma (HCC) at risk of undergoing futile upfront liver resection (LR).

Methods: Patients undergoing curative-intent LR for HCC were identified from a large multi-institutional database. Futile LR was defined by death or disease recurrence within six months postoperatively.

Temperature-Controlled Radiofrequency Treatment of the Nasal Valve in Patients With Nasal Obstruction: Long-Term Outcomes.

Objective: To evaluate the efficacy, safety, and durability of temperature-controlled radiofrequency (TCRF) treatment of the nasal valve in patients with severe or extreme nasal airway obstruction (NAO).

Study Design: A long-term, prospective, multicenter, single-blind, randomized controlled trial.

Setting: Sixteen otolaryngologic clinics and academic centers.

Postpartum Pharmacologic Thromboprophylaxis and Venous Thromboembolism in a U.S. Cohort.

Objective: To evaluate the effect of administering postpartum heparin-based pharmacologic thromboprophylaxis on the incidence of postpartum venous thromboembolism (VTE) and complications.

Methods: This was a multicenter retrospective cohort study of all individuals delivering at more than 20 weeks of gestation at four U.S.

Discovery of Methylated DNA Biomarkers for Potential Non-Endoscopic Detection of Barrett's Esophagus and Esophageal Adenocarcinoma.

Background And Aims: We sought to develop a minimally-invasive, robust, accessible nonendoscopic strategy to diagnose Barrett's esophagus (BE), esophageal adenocarcinoma (EAC), and its immediate precursor lesion, high-grade dysplasia (HGD) based on methylated DNA biomarkers applied to a retrievable sponge-capsule device in a cohort representative of the BE population (i.e., mostly short-segment, non-dysplastic BE, NDBE).

d-Limonene inhibits cytokines and chemokines expression by regulating NF-kappaB and STAT in HaCat cells and DNCB-induced atopic dermatitis in BALB/c mice.

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by itching and redness, affecting individuals of all ages and significantly impairing their quality of life. The prevalence of AD is rising, posing serious health concern. Relief of itching is a primary treatment objective; however, steroid treatments can lead to adverse effects, including skin barrier thinning.

Assessing Clinical Improvement of Infants Hospitalized for Respiratory Syncytial Virus-Related Critical Illness.

Background: Pediatric respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (LRTI) commonly requires hospitalization. The Clinical Progression Scale Pediatrics (CPS-Ped) measures level of respiratory support and degree of hypoxia across a range of disease severity, but it has not been applied in infants hospitalized with severe RSV-LRTI.

Methods: We analyzed data from a prospective surveillance registry of infants hospitalized for RSV-related complications across 39 U.

Evaluating Delta-8-THC-Induced Psychosis: A Systematic Review.

Objectives: This study reviews literature on the psychiatric effects of delta-8-THC, particularly psychosis and severe mental health outcomes, to highlight the need for further research and regulation.

Background: Marijuana, the most widely used illicit drug in the United States, sees increasing use due to legalization. Although moderate use is generally safe, adverse effects can occur, especially in those with preexisting conditions.

Systematic Review: Efficacy of Medical Therapy on Outcomes Important to Pediatric Patients with X-Linked Hypophosphatemia.

Objective: To examine the evidence addressing the management of X-linked hypophosphatemia (XLH) in children to inform treatment recommendations.

Methods: We searched Embase, MEDLINE, Web of Science, and Cochrane Central up to May 2023. Eligible studies included RCTs and observational studies of individuals less than 18yrs with clinically or genetically confirmed XLH.

Evaluation of the Patient Global Impression of Symptom Severity (PGISS) Score as a Subjective and Objective Measure of Disease Activity in Chronic Rhinosinusitis.

Background: The Sino-nasal Outcome Test (SNOT-22) is a 22-question survey that is utilized to evaluate health-related quality of life of patients with chronic rhinosinusitis (CRS). The Patient Global Impression Symptom Severity (PGISS) is a similar yet versatile instrument that combines features of both a Likert scale and a visual analog to assess symptom severity in CRS patients. While previous studies have evaluated the validity of SNOT-22 as an instrument to measure CRS patients' symptom severity, no studies have evaluated PGISS scale's ability to evaluate and guide treatment plans for CRS patients.

Metronidazole-Associated Peripheral Neuropathy in a Patient With End-Stage Renal Failure.

Metronidazole is a broad-spectrum antimicrobial that is associated with 0.16% 100-day incidence rates for peripheral neuropathy. In this report, we present an interesting and rare presentation of peripheral neuropathy secondary to metronidazole use for bacteremia and sepsis in a patient with end-stage renal failure.

Remplissage Using Percutaneous Needle Navigation With Knotless Anchors in a Suture Staple Configuration.

Remplissage is a procedure that decreases the rate of recurrent instability after arthroscopic stabilization in patients with an engaging Hill-Sachs lesion. This technique involves capsulotenodesis of the infraspinatus tendon and posterior capsule into the Hill-Sachs lesion using 2 knotless anchors with suture passage through the infraspinatus tendon guided by a percutaneous needle. Previously described techniques use knots or anchor placement through the infraspinatus, which can be challenging to control and irreversible if tendon penetration occurs in an undesirable location.

Endothelialectomy With Trypan Blue Staining to Enhance Descemetorhexis Visualization.

Purpose: To describe a technique involving combined endothelialectomy and trypan blue staining to allow for improved visualization and Descemet membrane (DM) removal during endothelial keratoplasty.

Methods: Endothelialectomy with 2 disposable endothelial irrigating cannulas (Vortex and Sterimedix) and an irrigation-aspiration handpiece are described. Several passes over the desired area are made to ensure adequate endothelialectomy treatment.