Prevalence and Outcomes of Emergency Presentations of Colorectal Cancer in Veterans Affairs Health Care System.

Background: Colorectal cancer (CRC) diagnoses are frequently made through emergency presentations (EPs), a new cancer diagnosis following an emergency care episode or unplanned inpatient admission. The extent and implications of EPs are not well known in the Veterans Affairs (VA) health system, where robust CRC screening protocols exist. The impact of the COVID-19 pandemic on the route of CRC diagnosis also remains unclear.

Reducing industrial pollution and inter-regional environmental inequality via the world's largest high-speed railway network.

Industrial pollution and the associated spatial environmental inequality increase health risks and hinder sustainable development, particularly in low- and middle-income countries. Large-scale public transportation infrastructure that connects developed and developing cities, exemplified by high-speed railway (HSR), has the potential to be an effective instrument. Here, we provide nationwide micro-level estimates for the overall and distributional environmental impacts of HSR in a middle-income context.

Nephrotoxicity in locally advanced head and neck cancer: when the end justifies the means to preserve nutritional status during chemoradiation.

Cisplatin is a nephrotoxic agent able to damage renal function both in acute and chronic phases. Radiotherapy concomitant with cisplatin 100 mg/m given once every 3 weeks is the curative standard of care for locally advanced head and neck cancer. A prospective evaluation of a wide range of biochemical and anthropometrical parameters, handgrip strength, risk of malnutrition, visual analogue scale of appetite, and body composition was performed before, during, and after concomitant chemoradiotherapy in 60 consecutive patients affected by locally advanced head and neck cancer.

Commercial influences on patient and public involvement: a renewed call for research and action.

Patient and public involvement is increasingly advocated in health policy, research and practice. Patients and people with lived experience, carers and the general public should have a say in how policy is generated, how services are delivered and how research is conducted. Through this perspective article, we hope to stimulate discussion and debate around industry influence in patient and public involvement, specifically pertaining to patient organizations, which often play a key role in patient and public involvement activities.

Diazoxide toxicity in congenital hyperinsulinism: A case report.

Background: Diazoxide is the sole approved drug for congenital hyperinsulinism; however, diuretic administration and vigilant monitoring are crucial to prevent and promptly identify potentially life-threatening adverse effects. This report aims to highlight a seldom-considered rare side effect of diazoxide. We believe that this brief report is of general interest to readership and increase the physicians' awareness of the guideline importance.

Telehealth and disparities in opioid use disorder treatment: Medicaid enrollees versus privately insured individuals.

Objective: To determine how the rise of telehealth during the COVID-19 pandemic impacted Medicaid enrollees' access to opioid use disorder (OUD) treatment.

Data Sources And Study Setting: Electronic health records from Northwestern Medicine, a large midwestern academic health system, from January 1, 2019 to December 31, 2021.

Study Design: The exposure was the expansion of telehealth services during the COVID-19 pandemic.

Serum levels of total bile acids are associated with an increased risk of HCC in patients with cirrhosis.

Background: Previous studies have reported higher circulating bile acid levels in patients with HCC compared to healthy controls. However, the association between prediagnostic bile acid levels and HCC risk among patients with cirrhosis is unclear.

Methods: We measured total BA (TBA) concentration in serum samples collected from a prospective cohort of patients with cirrhosis who were followed until the development of HCC, death, or last study date.

Cohort Profile: Baseline Characteristics of Veterans from Improving Veteran Access to Integrated Management of Back Pain (AIM-Back) - an Embedded Pragmatic, Cluster Randomized Trial in the United States.

Purpose: AIM-Back is an embedded pragmatic clinical trial (ePCT) with cluster randomization designed to increase access and compare the effectiveness of two different non-pharmacological care pathways for low back pain (LBP) delivered within the Veteran Administration Health Care System (VAHCS). This manuscript describes baseline characteristics of AIM-Back participants as well as the representativeness of those referred to the AIM-Back program by sex, age, race, and ethnicity, relative to Veterans with low back pain at participating clinics.

Participants: To be eligible for AIM-Back, Veterans were referred to the randomized pathway at their clinic by trained primary care providers (Referral cohort).

Retromode imaging in vitreoretinal lymphoma.

Purpose: The purpose of this study was to evaluate Retromode (Nidek Co., Gamagori, Japan) as an adjunct diagnostic tool in vitreoretinal lymphoma (VRL). By integrating Retromode findings with multimodal imaging, we aimed to enhance lesion detection of VRL lesions in the retina.

Fatal fall from a height: is it possible to apply artificial intelligence techniques for height estimation?

Fall from a height trauma is characterized by a multiplicity of injuries, related to multiple factors. The height of the fall is the factor that most influences the kinetic energy of the body and appears to be one of the factors that most affects the extent of injury. The purpose of this work is to evaluate, through machine learning algorithms, whether the autopsy injury pattern can be useful in estimating fall height.

Modulation of CCR5 expression and R5 HIV-1 infection in primary macrophages exposed to sera from HESN, LTNP, and chronically HIV-1 infected people with or without natural antibodies to CCR5.

CCR5 is the main co-receptor for HIV-1 cell entry and it plays key roles in HIV-1 mucosal transmission. Natural anti-CCR5 antibodies were found in HIV-1-exposed seronegative and long-term non-progressor subjects, suggesting a role in controlling viral replication in vivo. We assessed the effect of sera containing or not natural anti-CCR5 antibodies, on membrane CCR5 level and HIV-1 infection in primary macrophages.

Alpelisib plus fulvestrant in PIK3CA-mutated, hormone receptor-positive advanced breast cancer after a CDK4/6 inhibitor (BYLieve): one cohort of a phase 2, multicentre, open-label, non-comparative study.

Background: Alpelisib, a PI3Kα-selective inhibitor and degrader, plus fulvestrant showed efficacy in hormone receptor-positive, HER2-negative, PIK3CA-mutated advanced breast cancer in SOLAR-1; limited data are available in the post-cyclin-dependent kinase 4/6 inhibitor setting. BYLieve aimed to assess alpelisib plus endocrine therapy in this setting in three cohorts defined by immediate previous treatment; here, we report results from cohort A.

Methods: This ongoing, phase 2, multicentre, open-label, non-comparative study enrolled patients with hormone receptor-positive, HER2-negative, advanced breast cancer with tumour PIK3CA mutation, following progression on or after previous therapy, including CDK4/6 inhibitors, from 114 study locations (cancer centres, medical centres, university hospitals, and hospitals) in 18 countries worldwide.

Financial Barriers to Rural Graduate Medical Education: Medicare Funding Methods for Sole Community and Medicare-Dependent Hospitals.

Purpose: Policymakers are exploring options to address rural-urban physician maldistribution, including reducing rural residency training barriers. This study estimated Medicare graduate medical education (GME) reimbursement that sole community hospitals (SCHs) and Medicare-dependent hospitals (MDHs) are disqualified from receiving compared with hospitals under the Prospective Payment System (PPS) and calculated the GME reimbursement per resident for MDHs and SCHs under different scenarios.

Method: This simulation study used Healthcare Cost Report Information System data on hospitals that had been SCHs or MDHs between 2011 and 2021 and did not have any resident full-time equivalents (FTEs) in the most recent year.

Uncommon primary nasosinusal B-cell lymphoma in children: A case report.

This review presents the case of a 9-year-old patient who reported headaches and unilateral nasal obstruction, without fever, and with a generally preserved condition. An endoscopic examination revealed a polypoid fleshy mass in the left nasal cavity, along with purulent secretions reaching the inferior turbinate. These findings prompted a facial CT scan to assess the nature of the lesion and the extent of infiltration into surrounding structures.

Collaboration strategies for bridging health, behavioral health, and social services in California's Medi-Cal Whole Person Care Pilot Program.

Objective: To identify collaboration strategies used to integrate health, behavioral health, and social services for Medicaid members in California's Medi-Cal Whole Person Care Pilot program (WPC).

Data Sources And Study Setting: WPC was a social care intervention implemented to identify and address eligible members' health, behavioral health, and social needs. Data included semi-structured key informant interviews conducted in 2018-2019 (n = 221) and 2021 (n = 167); pilot-level surveys; whole-network surveys of 507 organizations in all 25 pilots participating in WPC; and documents submitted by pilots to the state.

A call to unify cost and economic impact research of health professions education.

Yaros argues that advancing evidence on the costs and economic impacts of student-led clinics requires joining forces to build towards conceptual and methodological unity across all health professions education economic research.

Evaluation of the induction programme for newly qualified radiographers: A survey study.

Introduction: The role of radiographers is continuously expanding and holds a key position in the healthcare system due to the increasing complexity in patient care and support. Therefore, with a rise of demand for increasingly specialized and advanced skills, it is important to provide newly hired professionals with structured induction programs. This study proposes to explore the perceptions of newly qualified radiographers who have already experienced transition into practice.

Impact of alcohol use disorder on inpatient hospitalizations: A comparison of outcomes between urban and rural Veterans Affairs hospitals.

Background: Alcohol use disorder (AUD) is a leading cause of morbidity and mortality that disproportionately affects rural residents and Veterans.

Objective: To evaluate the burden of AUD in admissions at rural and urban hospitals within the Veterans Health Administration (VHA) comparing patient characteristics, clinical outcomes, and 1-, 3-, and 5-year mortality rates.

Methods: Retrospective cross-sectional study of patients admitted to VHA hospitals from 2016 to 2020, with a primary or secondary diagnosis related to AUD.

Semiautomatic volume measure of kidney vascular territories on CT angiography to plan aortic aneurysm repair in patients with horseshoe kidney.

Surgical repair of abdominal aortic aneurism (AAA) with horseshoe kidney (HK) is challenging because of several accessory renal arteries (RAs), variable in number, branches, and vascular territories, with subsequent variable renal damage. The identification of RAs and vascular territories could contribute to surgical planning. We developed a semiautomatic presurgical computed tomography angiography (CTA)-based model to measure the renal volume of each RA, validated on postsurgical CTA in patients with HK treated for AAA.

Training an Embedded Workforce to Realize Health System Impacts and the Promise of Learning Health Systems Comment on "Early Career Outcomes of Embedded Research Fellows: An Analysis of the Health System Impact Fellowship Program".

Learning health systems (LHSs) are designed to systematically integrate external evidence of effective practices with internal data and experience to put knowledge into practice as a part of a culture of continuous learning and improvement. Researchers embedded in health systems are an essential component of LHSs, with defined competencies. However, many of these competencies are not generated by traditional graduate/post-graduate training programs; evaluation of new LHS training programs has been limited.