The Impact of a Commensality Intervention on Physician Burnout.

Commensality, the act of eating together, when organized around facilitated discussion is an evidence-based intervention that can promote engagement and reduce physician burnout. The purpose of this pilot study is to evaluate the feasibility, acceptance, and impact of a commensality intervention for physicians. The Commensality Intervention was based on a Mayo Clinic model that consisted of 6, 2-hour dinner meetings at local restaurants over 6 months with facilitated discussion.

Onyx dilution reduces time to resolution of chronic subdural hematomas after middle meningeal artery embolization.

Background: The benefit of distal embolite penetration for middle meningeal artery (MMA) embolization in chronic subdural hematomas (cSDH) remains controversial.

Objective: To compare the use of diluted Onyx with undiluted Onyx in the management of cSDH.

Methods: This is a retrospective study of patients with cSDH who underwent MMA embolization using Onyx 18 at our institution.

A prospective multi-cohort study identifies and validates a 5-gene peripheral blood signature predictive of immunotherapy response in non-small cell lung cancer.

Background: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment landscape for non-small cell lung cancer (NSCLC). The variability in patient responses necessitates a blood-based, multi-cohort gene signature to predict ICI response in NSCLC.

Methods: We performed transcriptomic profiling of peripheral blood mononuclear cell (PBMC) and buffy coat (BC) samples from three independent cohorts of NSCLC patients treated with ICIs: a retrospective cohort (PMBCR, n = 59), a retrospective validation cohort (BC, n = 44), and a prospective validation cohort (PBMCP, n = 42).

FOXO3 Longevity Genotype Mitigates Risk Posed by Hypertension on Incident Coronary Artery Disease in Middle-Aged Men: Kuakini Honolulu Heart Program.

Background: This study tested whether the carriage of the longevity-associated G-allele of FOXO3 SNP rs2802292 (TG/GG) protects against incident coronary artery disease (CAD) in men with hypertension.

Methods: Subjects were American men residing on Oahu having Japanese (n = 5415) or Okinawan (n = 897) ancestry and free of CAD at baseline (1965-1968) when aged 45-68 years.

Results: During the follow-up, there were 1 629 incident CAD cases.

Representation of Native Hawaiian and Pacific Islander Individuals in Clinical Trials.

Importance: Having diverse participants in clinical trials ensures new drug products work well across different demographic groups, making health care safer and more effective for everyone. Information on the extent of Native Hawaiian and Pacific Islander participation in clinical trials is limited.

Objective: To examine representation of Native Hawaiian and Pacific Islanders in clinical trials leading to the first US Food and Drug Administration (FDA) approvals for the 10 drug products with the top worldwide sales forecasts in 2024.

Differences in Breast Cancer Subtypes among Racial/Ethnic Groups.

Background: Differences in the incidence of breast cancer subtypes among racial/ethnic groups have been evaluated as a contributing factor in disparities seen in breast cancer prognosis. We evaluated new breast cancer cases in Hawai'i to determine if there were subtype differences according to race/ethnicity that may contribute to known disparities.

Methods: We reviewed 4591 cases of women diagnosed with breast cancer from two large tumor registries between 2015 and 2022.

Progression of aortic calcification among Japanese in Japan and white and Japanese Americans: a prospective cohort study.

Aims: Continued low mortality from coronary heart disease in Japan, despite deleterious changes in traditional risk factors, remains unexplained. Since aortic calcification (AC) was an early predictor of cardiovascular mortality, we compared the progression and incidence of AC between Japanese in Japan, white Americans, and third-generation Japanese Americans in the ERA JUMP cohort. We examined whether higher blood levels of marine-derived n-3 fatty acids (FAs) in Japanese than in Americans accounted for the difference.

Dissemination of VMAT-2 Inhibitors: A New Class Drug for Tardive Dyskinesia and Huntington Disease.

Background And Objectives: In 2017, the FDA approved deutetrabenazine (AUSTEDO) for the treatment of tardive dyskinesia (TD) and chorea associated with Huntington disease (HD). Concurrently, valbenazine (INGREZZA) was approved specifically for TD. The adoption of new medications is influenced by various factors, including patient's medical needs, the prescriber's adoption of new practice, and external environmental factors (e.

The Vecta 46 intermediate catheter for mechanical thrombectomy of distal medium vessel occlusions: A single-center experience.

Introduction: With emerging evidence supporting the clinical efficacy and safety of mechanical thrombectomy (MT) for distal medium vessel occlusions (DMVOs), MT devices specifically designed to navigate through smaller caliber and more delicate tortuous distal cerebrovasculature are required. This study describes our single-center experience using the AXS Vecta 46 intermediate catheter for first-line thromboaspiration of DMVOs.

Methods: We identified all patients who underwent MT using the Vecta 46 for first-line thromboaspiration for primary or secondary DMVOs.

Survival Difference of Colorectal Adenocarcinoma Among Racial and Ethnic Minority Groups: A SEER Database Study.

Despite advances in diagnosis and treatment, racial disparities continue to exist in colorectal cancer (CRC) survival. This study aims to characterize the CRC survival differences among racial and ethnic minority groups. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify adults diagnosed with CRC from 2015 to 2019.

Comparison of 6 handheld ultrasound devices by point-of-care ultrasound experts: a cross-sectional study.

Background: Point-of-care ultrasound (POCUS) has emerged as an essential bedside tool for clinicians, but lack of access to ultrasound equipment has been a top barrier to POCUS use. Recently, several handheld ultrasound devices ("handhelds") have become available, and clinicians are seeking data to guide purchasing decisions. Few comparative studies of different handhelds have been done.

A Rural Community Readiness Assessment of Prehospital Telestroke Services in the Ambulance.

The research team assessed community acceptability of prehospital stroke telemedicine services in rural O'ahu communities. Tools were developed to evaluate patient-centered goals about implementing ambulance-based telemedicine which aimed to retain appropriate patients in community hospitals and improve thrombolytic treatment times. Using a mixed methods approach, the team surveyed well-appearing adults (ie, able to complete survey and interview) at O'ahu community events.

DARES: A Phase II Trial of Durvalumab and Ablative Radiation in Extensive-Stage Small Cell Lung Cancer.

Background: Immunotherapy in combination with chemotherapy is first-line treatment for patients with extensive-stage small-cell lung cancer (ES-SCLC). Growing evidence suggests that radiation, specifically stereotactic body radiation therapy (SBRT), may enhance the immunogenic response as well as cytoreduce tumor burden. The primary objective of the study is to determine the progression free survival for patients with newly diagnosed ES-SCLC treated with combination multisite SBRT and chemo-immunotherapy (carboplatin, etoposide, and durvalumab).

Sex Differences in Changes in Cardiorespiratory Fitness and Additional Health Outcomes Following Exercise Training in Adults With Atrial Fibrillation: A Systematic Review and Meta-Analysis.

Purpose: Improving cardiorespiratory fitness (CRF) through exercise training is associated with lower morbidity and mortality in patients with atrial fibrillation (AF). Smaller CRF improvements have been suggested in females than males with cardiovascular disease following exercise training. This systematic review compared changes in CRF (primary) and additional physical and mental health outcomes following exercise training between females and males with AF.

Post-acute sequelae of COVID infection and cerebral venous outflow disorders: Overlapping symptoms and mechanisms?

Neurological long Covid (NLC) is a major post-acute sequela of SARS-CoV-2 infection, affecting up to 10% of infected patients. The clinical presentation of patients with NLC is varied, but general NLC symptoms have been noted to closely mimic symptoms of cerebral venous outflow disorders (CVD). Here we review key literature and discuss evidence supporting this comparison.

Mortality in Patients With Sepsis Treated With Esmolol or Landiolol: A Systematic Review and Meta-Analysis of Randomized Controlled Trials With Trial Sequential Analysis.

Background: The latest meta-analysis indicated potential survival benefits from ultra-short-acting β-blockers in patients with sepsis with persistent tachycardia. However, subsequent multicenter randomized controlled trials (RCTs) have reported conflicting findings, prompting the need for an updated meta-analysis to incorporate these newly published RCTs.

Research Question: Does the use of ultra-short-acting β-blockers (esmolol or landiolol) in patients with sepsis with persistent tachycardia improve mortality?

Study Design And Methods: We conducted an updated systematic search through April 2, 2024, exploring the MEDLINE, Cochrane Central Register of Controlled Trials, and Embase databases for RCTs reporting mortality in adult patients with sepsis treated with esmolol or landiolol as compared with those treated with neither of these or receiving placebo and published in English.

A General Neurologist's Practical Diagnostic Algorithm for Atypical Parkinsonian Disorders: A Consensus Statement.

Purpose Of Review: The most common four neurodegenerative atypical parkinsonian disorders (APDs) are progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal syndrome (CBS), and dementia with Lewy bodies (DLB). Their formal diagnostic criteria often require subspecialty experience to implement as designed and all require excluding competing diagnoses without clearly specifying how to do that. Validated diagnostic criteria are not available at all for many of the other common APDs, including normal pressure hydrocephalus (NPH), vascular parkinsonism (VP), or drug-induced parkinsonism (DIP).

The seasonal distribution of immune thrombotic thrombocytopenic purpura is influenced by geography: Epidemiologic findings from a multi-center analysis of 719 disease episodes.

Prior studies have suggested that immune thrombotic thrombocytopenic purpura (iTTP) may display seasonal variation; however, methodologic limitations and sample sizes have diminished the ability to perform a rigorous assessment. This 5-year retrospective study assessed the epidemiology of iTTP and determined whether it displays a seasonal pattern. Patients with both initial and relapsed iTTP (defined as a disintegrin and metalloprotease with thrombospondin type motifs 13 activity <10%) from 24 tertiary centers in Australia, Canada, France, Greece, Italy, Spain, and the US were included.