From Policy to Practice: Challenges in Implementing PROMs Reporting Under the New CMS Mandate.

The Centers for Medicare & Medicaid Services (CMS) recently introduced mandatory reporting of patient-reported outcomes (PROs) following primary, elective total joint arthroplasty (TJA) procedures. This article explores the implications and implementation challenges of this policy shift in the field of orthopaedic surgery. With a review of the existing literature, we analyze the potential benefits and limitations of PROs, discuss the role of CMS in health-care quality improvement initiatives, explain the predicted difficulties in the successful implementation of this new mandate, and provide recommendations for the successful integration of the reporting of PROs in clinical practice.

Perceived problems associated with perioperative blood product preparation.

Timely blood product preparation is important for patients undergoing surgery with a high risk of blood loss. However, in circumstances where no blood refrigerators exist in the operating room theatre complex, numerous potential problem sources during blood product preparation may lead to delays, and tense interpersonal interactions between anaesthesia and blood bank personnel can ensue. To evaluate this at our institution, an anonymous online survey was sent to anaesthesia providers and blood bank technologists.

Characterization of the Phenotypic Consequences of the Duffy-Null Genotype.

A wealth of research focused on African American populations has connected rs2814778-CC ("Duffy-null") to decreased neutrophil (neutropenia) and leukocyte counts (leukopenia). While it has been proposed that this variant is benign, prior studies have shown that the misinterpretation of Duffy-null associated neutropenia and leukopenia can lead to unnecessary bone marrow biopsies, inequities in cytotoxic and chemotherapeutic treatment courses, under-enrollment in clinical trials, and other disparities. To investigate the phenotypic correlates of Duffy-null status, we conducted a phenome-wide association study (PheWAS) across more than 1,400 clinical conditions in All of Us, the Vanderbilt University Medical Center's Biobank, and the Million Veteran Program.

Virtual assessment of internal rotation in reverse shoulder arthroplasty based on statistical shape models of scapular size.

Background: The purpose of this study was to assess impingement-free internal rotation (IR) in a virtual reverse shoulder arthroplasty simulation using a Statistical Shape Model based on scapula size.

Methods: A database of over 10,000 scapulae utilized for preoperative planning for shoulder arthroplasty was analyzed with a Statistical Shape Model to obtain 5 scapula sizes including the mean and 2 standard deviations. For each scapula model, one glenosphere size (33-42 mm) was selected as the best fit based on consensus among 3 shoulder surgeons.

Utilization of Total Knee Arthroplasty in the United States by Settlement Type: Is There Equity of Access?

Introduction: Total knee arthroplasty (TKA) is one of the most commonly performed orthopaedic surgeries in the United States, yet little information exists regarding its utilization in different settlement types. This study aimed to determine the number of TKA-performing surgeons by settlement type and assess trends in the volume of TKAs in urban, micropolitan, small town, and rural settings.

Methods: Using the Medicare Provider Utilization and Payment Data: Physician and Other Practitioners database, the number of orthopaedic surgeons performing primary and revision TKAs from 2013 to 2020 was determined.

A semi-empirical Bayes approach for calibrating weak instrumental bias in sex-specific Mendelian randomization studies.

Strong sex differences exist in sleep phenotypes and also cardiovascular diseases (CVDs). However, sex-specific causal effects of sleep phenotypes on CVD-related outcomes have not been thoroughly examined. Mendelian randomization (MR) analysis is a useful approach for estimating the causal effect of a risk factor on an outcome of interest when interventional studies are not available.

Trends in treatment and epidemiology of radial head fractures.

Objective: We aimed to assess the recent trends in the demographics of radial head and neck fractures and their management based on displacement.

Methods: TriNetX was queried for cases from 1 January 2017, through 31 December 2022. ICD diagnosis codes were used to define patient cohorts with radial head or neck fractures.

Fuel accumulation shapes post-fire fuel decomposition through soil heating effects on plants, fungi, and soil chemistry.

Forty percent of terrestrial ecosystems require recurrent fires driven by feedbacks between fire and plant fuels. The accumulation of fine fuels in these ecosystems play a key role in fire intensity, which alters soil nutrients and shapes soil microbial and plant community responses to fire. Changes to post-fire plant fuel production are well known to feed back to future fires, but post-fire decomposition of new fuels is poorly understood.

Clarifying the Qualifications for Nurse Scientists.

The roles of PhD- and DNP-prepared nurses are very different.

A Characterization of Optimal Prefix Codes.

A property of prefix codes called strong monotonicity is introduced, and it is proven that for a given source, a prefix code is optimal if and only if it is complete and strongly monotone.

TMS-induced modulation of brain networks and its associations to rTMS treatment for depression: a concurrent fMRI-EEG-TMS study.

Transcranial magnetic stimulation (TMS) over the left dorsolateral prefrontal cortex (L-DLPFC) is an established intervention for treatment-resistant depression (TRD), yet the underlying therapeutic mechanisms remain not fully understood. This study employs an integrative approach that combines TMS with concurrent functional magnetic resonance imaging (fMRI) and electroencephalography (EEG), aimed at assessing the acute/immediate effects of TMS on brain network dynamics and their correlation with clinical outcomes. Our study demonstrates that TMS acutely modulates connectivity within vital brain circuits, particularly the cognitive control and default mode networks.

Dietary cinnamon promotes longevity and extends healthspan via mTORC1 and autophagy signaling.

Cinnamon, renowned for its aromatic flavor, represents one of the most widely used spices worldwide. Cinnamon is also considered beneficial to human health with therapeutic potential for treating various diseases, ranging from diabetes and cancer to neurodegenerative diseases. However, the mechanisms underlying cinnamon's health benefits remain elusive.

Intraoperative Patellar Tendon Injuries during Total Knee Arthroplasty: A Comprehensive Review of Incidence, Risk Factors, and Management Strategies.

Patellar tendon rupture (PTR) is a rare and severe postoperative complication of total knee arthroplasty (TKA). Even rarer is the intraoperative occurrence of PTR during TKA. PTR is a major complication as it can lead to chronic disability, functional limitations, and postoperative morbidity.

Disentangling Sources of Momentum Fluctuations in Xe+Xe and Pb+Pb Collisions with the ATLAS Detector.

High-energy nuclear collisions create a quark-gluon plasma, whose initial condition and subsequent expansion vary from event to event, impacting the distribution of the eventwise average transverse momentum [P([p_{T}])]. Disentangling the contributions from fluctuations in the nuclear overlap size (geometrical component) and other sources at a fixed size (intrinsic component) remains a challenge. This problem is addressed by measuring the mean, variance, and skewness of P([p_{T}]) in ^{208}Pb+^{208}Pb and ^{129}Xe+^{129}Xe collisions at sqrt[s_{NN}]=5.

Effectiveness of an online food shopping intervention to reduce salt purchases among individuals with hypertension - findings of the SaltSwitch Online Grocery Shopping (OGS) randomised trial.

Background: Online grocery shopping is a growing source of food purchases in many countries. We investigated the effect of nudging consumers towards purchases of lower sodium products using a web browser extension.

Methods: This trial was conducted among individuals with hypertension who shopped for their groceries online in Australia.

Private, public, and bottled drinking water: Shared contaminant-mixture exposures and effects challenge.

Background: Humans are primary drivers of environmental-contaminant exposures worldwide, including in drinking-water (DW). In the United States, point-of-use DW (POU-DW) is supplied via private tapwater (TW), public-supply TW, and bottled water (BW). Differences in management, monitoring, and messaging and lack of directly-intercomparable exposure data influence the actual and perceived quality and safety of different DW supplies and directly impact consumer decision-making.

Trends in cardiovascular and cerebrovascular health scores in the Kailuan population from 2006 to 2011.

Background: The American Heart Association defines cardiovascular health in terms of four behaviors (smoking, diet, physical activity, and body weight) and three factors (plasma glucose, cholesterol, and blood pressure). By this definition, the prevalence of ideal cardiovascular health behaviors and factors (ICHBF) is negatively correlated with all-cause mortality and risks of cardiovascular and cerebrovascular diseases and malignancy.

Aim: To investigate the changing trends of cardiovascular and cerebrovascular health scores in the Kailuan study population from 2006 to 2011.

Conceptualizing patient-level adverse effects in implementation trials.

Background: Identifying and monitoring adverse effects (AEs) are integral to ensuring patient safety in clinical trials. Research sponsors and regulatory bodies have put into place a variety of policies and procedures to guide researchers in protecting patient safety during clinical trials. However, it remains unclear how these policies and procedures should be adapted for trials in implementation science.

Robotic-Assisted Conversion of Unicompartmental Knee Arthroplasty to Total Knee Arthroplasty.

Background: Unicompartmental knee arthroplasty (UKA) procedures have become much more common in the United States in recent years, with >40,000 UKAs performed annually. However, it is estimated that 10% to 40% of UKAs fail and thus require conversion to total knee arthroplasty (TKA). In the field of total joint arthroplasty, robotic-assisted surgeries have demonstrated advantages such as better accuracy and precision of implant positioning and improved restoration of a neutral mechanical axis.

Stepping up recovery: integrating patient reported outcome measures and wearable technology for 90-day rehabilitation following total hip arthroplasty.

Introduction: There is conflicting data in the literature regarding the clinical utility of wearable devices. This study examined the association between patient reported outcome measures (PROMs) and step and stair flight counts obtained from wearable devices in postoperative total hip arthroplasty (THA) patients.

Methods: Data was collected from a multicenter prospective longitudinal cohort study from October 2018 to February 2022.

Adaptive Compression and Reconstruction for Multidimensional Medical Image Data: A Hybrid Algorithm for Enhanced Image Quality.

Spatial regions within images typically hold greater priority over adjacent areas, especially in the context of medical images (MI) where minute details can have significant clinical implications. This research addresses the challenge of compressing medical image dimensions without compromising critical information by proposing an adaptive compression algorithm. The algorithm integrates a modified image enhancement module, clustering-based segmentation, and a variety of lossless and lossy compression techniques.

Applying Large Language Models to Assess Quality of Care: Monitoring ADHD Medication Side Effects.

Objective: To assess the accuracy of a large language model (LLM) in measuring clinician adherence to practice guidelines for monitoring side effects after prescribing medications for children with attention-deficit/hyperactivity disorder (ADHD).

Methods: Retrospective population-based cohort study of electronic health records. Cohort included children aged 6 to 11 years with ADHD diagnosis and 2 or more ADHD medication encounters (stimulants or nonstimulants prescribed) between 2015 and 2022 in a community-based primary health care network (n = 1201).

Not the Silver Bullet: Uncovering the Unexpected Limited Impacts of Silver-Containing Showerheads on the Drinking Water Microbiome.

The incidence of waterborne disease outbreaks in the United States attributed to drinking water-associated pathogens that can cause infections in the immunocompromised DWPIs (e.g., , nontuberculous mycobacteria (NTM), and , among others) appears to be increasing.