Home-Based Cardiac Rehabilitation Among Attendees From a Large Health Care System During the Covid-19 Pandemic.

Background: Few studies have evaluated home-based cardiac rehabilitation (HBCR) during the pandemic, compared to prepandemic center-based CR (CBCR), with respect to patient characteristics, participation rates, and its efficacy on clinical metrics, health-related quality of life (QoL), and modifiable risk factors.

Objectives: We aimed to describe patient characteristics and participation rates for those attending HBCR compared to patients who attended CBCR and compare the effects of HBCR vs CBCR on clinical metrics, health-related QoL, and modifiable risk factors in CR patients pre vs during the COVID-19 pandemic.

Methods: A retrospective cohort study comparing 511 HBCR patients and 765 CBCR patients from the Mayo Clinic Health System.

Photoreceptor metabolic window unveils eye-body interactions.

Photoreceptors are specialized neurons at the core of the retina's functionality, with optical accessibility and exceptional sensitivity to systemic metabolic stresses. Here we show the ability of risk-free, in vivo photoreceptor assessment as a window into systemic health and identify shared metabolic underpinnings of photoreceptor degeneration and multisystem health outcomes. A thinner photoreceptor layer thickness is significantly associated with an increased risk of future mortality and 13 multisystem diseases, while systematic analyses of circulating metabolomics enable the identification of 109 photoreceptor-related metabolites, which in turn elevate or reduce the risk of these health outcomes.

Longitudinal qualitative assessment of meaningful symptoms and relevance of WATCH-PD digital measures for people with early Parkinson's.

Background: Longitudinal qualitative data on what matters to people with Parkinson's disease are lacking and needed to guide patient-centered clinical care and development of outcome measures.

Objective: To evaluate change over time in symptoms, impacts, and relevance of digital measures to monitor disease progression in early Parkinson's.

Methods: In-depth, online symptom mapping interviews were conducted with 33 people with early Parkinson's at baseline and 1 year later to evaluate (A) symptoms, (B) impacts, and (C) relevance of digital measures to monitor personally relevant symptoms.

Longitudinal visual outcomes in idiopathic intracranial hypertension: the role of early prognostic indicators and risk stratification in disease management.

Background: Idiopathic intracranial hypertension (IIH) is increasingly prevalent, yet longitudinal outcome data are scarce. This study aimed to characterise demographic and longitudinal clinical changes in a cohort of patients with IIH.

Methods: Retrospective cohort analysis on adult patients diagnosed with IIH (Friedman criteria) enrolled in the neuro-ophthalmology database (NODE) across two tertiary centres.

Factors associated with willingness to perform expedited excisional treatment for patients at high risk for cervical precancer.

Background: The 2019 ASCCP Risk-Based Management Consensus Guidelines prefer expedited treatment, defined as proceeding to excisional treatment without first performing colposcopic biopsy, for patients with screening results indicating a high risk of cervical precancer. In this mixed methods study, we explored clinician attitudes toward expedited treatment.

Methods: In 2021, a national sample of 671 clinicians who performed colposcopy completed surveys; a subset (n = 41) of clinicians who performed colposcopy and/or directed patient treatment completed qualitative interviews.

Evidence summary on management strategies for gastroesophageal reflux symptoms in patients following esophageal cancer surgery.

Objective: This study aimed to summarize evidence-based strategies for the self-management of gastroesophageal reflux symptoms (GERS) at home among patients who have undergone esophageal cancer surgery, providing practical references for clinical practice.

Methods: A systematic evidence summary was conducted based on the reporting standards of the Fudan University Center for Evidence-based Nursing. Literature was retrieved from international and Chinese databases, including guidelines, expert consensus, systematic reviews, and original studies.

Understanding the scale and nature of avoidable healthcare-associated harm for prisoners in England: protocol for a retrospective cross-sectional study.

Introduction: Around 1 in 20 patients experience avoidable healthcare-associated harm worldwide. Despite longstanding concerns, there is insufficient information available about the safety of healthcare for prisoners. To address this, this study will investigate the scale and nature of avoidable healthcare-associated harm for prisoners in England.

The effect of physical activity on markers of oxidative and antioxidant stress in cancer patients: a systematic review and meta-analysis.

Background: Prescribing physical exercise as part of the clinical treatment of cancer patients has become an important strategy in the therapeutic arsenal available in the main health centers specialized in neoplastic diseases, but there is still uncertainty regarding the role of regular physical activity in modifying oxidative stress markers and antioxidants, as high levels of oxidative stress can lead to the development of carcinogens. Therefore, we assessed the effect of physical activity versus absence of physical activity on markers of oxidative stress and antioxidants in cancer patients.

Methods: We looked for randomized controlled trials that included adult with any type of cancer performing some physical activity and compared them to a control group of cancer patients with no physical activity.

A qualitative study exploring the feasibility and acceptability of embedding an overdose prevention sites in a U.S. hospital.

Introduction: Community-based overdose prevention sites (OPS) are recognized for reducing overdose deaths and the spread of HIV and hepatitis C among people who use drugs (PWUD). While some hospitals in Europe and Canada have successfully integrated OPS into their facilities, such integration remains illegal in the United States. This study explores the feasibility and acceptability of implementing an OPS at the Hospital of the University of Pennsylvania (HUP), situated in an urban area with high rates of overdose.

Antiviral Medications for Treatment of Nonsevere Influenza: A Systematic Review and Network Meta-Analysis.

Importance: The optimal antiviral drug for treatment of nonsevere influenza remains unclear.

Objective: To compare effects of antiviral drugs for treating nonsevere influenza.

Data Sources: MEDLINE, Embase, CENTRAL, CINAHL, Global Health, Epistemonikos, and ClinicalTrials.

Informal care for people with dementia in Europe.

Introduction: Informal care estimates for use in health-economic models are lacking. We aimed to estimate the association between informal care time and dementia symptoms across Europe.

Methods: A secondary analysis was performed on 13,529 observations in 5,369 persons from 9 European pooled cohort or trial studies in community-dwelling persons with dementia.

Associations of daily step count with all-cause mortality and cardiovascular mortality in hypertensive US adults: a cohort study from NHANES 2005-2006.

Background: The health benefits of physical activity, including walking, are well-established, but the relationship between daily step count and mortality in hypertensive populations remains underexplored. This study investigates the association between daily step count and both all-cause and cardiovascular mortality in hypertensive American adults.

Methods: We used data from the National Health and Nutrition Examination Survey 2005-2006, including 1,629 hypertensive participants with accelerometer-measured step counts.

Risk of SARS-CoV-2 infection and adverse outcomes among vaccinated patients with tuberculosis.

Objectives: Limited data are available to assess breakthrough SARS-CoV-2 infections, medical utilization, and mortality in patients with tuberculosis (TB). The aim of this study was to examine the risk of COVID-19 and severe outcomes in patients with TB between January 2020 and March 2022.

Study Design: US electronic medical records were used to identify TB and non-TB patients who completed the primary series of vaccination and had no prior COVID-19.

Digital Solutions for the Optimization of Pharmacologic Therapy for Heart Failure.

Data from large-scale, randomized, controlled trials demonstrate that contemporary treatments for heart failure (HF) can substantially improve morbidity and mortality. Despite this, observed outcomes for patients living with HF are poor, and they have not improved over time. The are many potential reasons for this important problem, but inadequate use of optimal medical therapy for patients with HF, an important component of guideline-directed medical therapy, in routine practice is a principal and modifiable contributor.

Optimal timing for epinephrine administration in adult patients with out-of-hospital cardiac arrest: A retrospective observational study.

Background: This study aimed to clarify the appropriate timing for epinephrine administration in adults with out-of-hospital cardiac arrest (OHCA), particularly those cases with nonshockable rhythms, by addressing resuscitation time bias.

Methods: We performed a retrospective observational study utilizing a multicenter OHCA registry involving 95 hospitals in Japan between June 2014 and December 2020. We included patients with OHCA and nonshockable rhythms who received epinephrine during resuscitation.

Microvascular decompression: a contemporary update.

Background: Microvascular decompression (MVD) is the gold-standard surgical treatment for cranial nerve compression disorders, including trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN). This review synthesizes historical milestones, recent advances, and evolving techniques in MVD, with a primary focus on these conditions.

Methods: A comprehensive literature review was conducted using databases such as PubMed, SpringerLink, Google Scholar, BioMed Central, Scopus, and ScienceDirect.

Hospital Medicare Spending per Beneficiary: A Longitudinal Study.

Goal: While studies have examined quality and health outcomes related to the Centers for Medicare & Medicaid Services' (CMS's) Hospital Value-Based Purchasing (HVBP) Program, a significant gap exists in the literature regarding the relationship between pay-for-performance initiatives and hospital financial performance in the program's Efficiency and Cost Reduction domain. This study examined the association between hospitals' cost inefficiency and participation in the HVBP Program by estimating the probability and magnitude of improvement or achievement in the program's Efficiency and Cost Reduction domain.

Methods: The 2014-2019 Efficiency and Cost Reduction domain data were obtained from CMS and merged with the American Hospital Association's Annual Survey Database.

Impact of Nurse Staffing Levels on Patient Fall Rates: A Retrospective Cross-Sectional Study in General Wards in Japan.

: Falls are common adverse events among hospitalized patients, affecting outcomes and placing a financial burden on patients and hospitals. This study investigated the relationship between nurse staffing/workload and patient falls during hospitalization. : The patients studied were hospitalized in the general wards (excluding pediatrics and obstetrics/gynecology) of 11 National Hospital Organization institutions between April 2019 and March 2020.

Best Evidence Summary for the Improvement and Management of Disorders of Consciousness in Patients With Severe Brain Injury.

Background And Purpose: The treatment effect of consciousness after brain injury is currently uncertain. Thus, this study aimed to retrieve the evidence from neurologists around the world on the management of consciousness disorders in patients with severe brain injury and evaluate and summarize the evidence, providing the guidance on the related management for clinicians.

Methods: Following the evidence summary report standard of Fudan University Center for Evidence-Based Nursing, clinical guidelines, expert consensuses, systematic reviews, and evidence summaries were systematically retrieved from UpToDate; BMJ Best Practice; Guidelines International Network; the Cochrane Library; Embase; PubMed; Sinomed; Web of Science; CNKI; WanFang database; American Academy of Neurology (AAN); American Congress of Rehabilitation Medicine (ACRM); European Academy of Neurology; and National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).

Scaling and spreading age-friendly care: Early lessons from the VA National Age-Friendly Action Community.

Background: The Age-Friendly Health System (AFHS) initiative seeks to improve care for older adults through assessing and acting on the 4Ms (What Matters, Medication, Mentation, Mobility). The Department of Veterans Affairs (VA) joined the initiative in 2020, and from 2022 to 2023, VA led its first Age-Friendly Action Community, a 7-month online educational series to teach clinicians about implementing the 4Ms across VA care settings.

Methods: The VA Action Community was designed to spread awareness about Age-Friendly care for older Veterans, improve interprofessional team knowledge for providing care guided by the 4Ms, and support AFHS implementation across multiple care settings.

Pain Coping Skills Training for Patients Receiving Hemodialysis: The HOPE Consortium Randomized Clinical Trial.

Importance: Chronic pain is common among individuals with dialysis-dependent kidney failure.

Objective: To evaluate the effectiveness of pain coping skills training (PCST), a cognitive behavioral intervention, on pain interference.

Design, Setting, And Participants: This multicenter randomized clinical trial of PCST vs usual care was conducted across 16 academic centers and 103 outpatient dialysis facilities in the US.

Remotely delivered weight management for people with long COVID and overweight: the randomized wait-list-controlled ReDIRECT trial.

Long COVID (LC) is a complex multisymptom condition with no known disease-modifying treatments. This wait-list-controlled open-label trial tested whether a remotely delivered structured weight management program could improve respective LC symptoms in people living with overweight. Adults with LC (symptoms >12 weeks) and body mass index >27 kg m (>25 kg m for South Asians) were randomized (n = 234, 1:1) to control (n = 116, usual care) or the remotely delivered structured weight management (n = 118, total diet replacement (850 kcal per day) for 12 weeks, followed by food reintroduction and weight loss maintenance support) via minimization and randomization (80:20) to balance dominant LC symptom, sex, age, ethnicity and postcode-based index of multiple deprivation between groups.

Patients' Use of e-Consultations as an Alternative to Other General Practitioner Services: Cross-Sectional Survey Study.

Background: e-Consultations, defined as asynchronous text-based messaging, have transformed how patients interact with their general practitioner (GP). While e-consultations can improve patient access to GP care, concerns about increased workload for GPs are raised.

Objective: This study aimed to address three research questions: (1) For what purpose and with what expectations do patients initiate e-consultations? (2) If e-consultations had not been available, what alternative actions would the patient have taken? and (3) How are the alternative actions associated with patient and e-consultation characteristics?

Methods: A cross-sectional study was conducted through a web-based survey on Helsenorge.

Return to work in young and middle-aged colorectal cancer survivors: Factors influencing self-efficacy, fear, resilience, and financial toxicity.

Background: Return to work (RTW) serves as an indication for young and middle-aged colorectal cancer (CRC) survivors to resume their normal social lives. However, these survivors encounter significant challenges during their RTW process. Hence, scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors.

Contralateral Neurovascular Coupling in Patients with Ischemic Stroke After Endovascular Thrombectomy.

Background: Neurovascular coupling (NVC) refers to the process of aligning cerebral blood flow with neuronal metabolic demand. This study explores the potential of contralateral NVC-linking neural electrical activity on the stroke side with cerebral blood flow velocity (CBFV) on the contralesional side-as a marker of physiological function of the brain. Our aim was to examine the association between contralateral NVC and neurological outcomes in patients with ischemic stroke following endovascular thrombectomy.