In-Hospital Outcomes Associated With Initial Fibrinolysis Versus Primary Percutaneous Coronary Intervention Among Patients Residing in Rural Areas Presenting With ST-Segment Elevation Myocardial Infarction.

Fibrinolysis is more commonly used to manage ST-segment elevation myocardial infarction (STEMI) in rural versus urban areas. However, little is known about the outcomes associated with this treatment strategy in rural individuals. We sought to compare in-hospital outcomes associated with the use of fibrinolysis versus primary percutaneous coronary intervention (PCI) among patients residing in rural areas presenting with STEMI.

Sex and Gender Health Education Tenets: An Essential Paradigm for Inclusivity in Dentistry.

Sex and gender are essential components of person-centered care. This article presents and discusses four important tenets regarding sex and gender health that should be incorporated into dental education and oral health care to foster inclusivity and improve care for all patients, including a sex and gender-diverse patient population.

Significant Within-Individual Variability in VCTE Liver Stiffness Measurements at Two Intercostal Spaces in Subjects with MASLD: Implications for Evaluating Improvement in Liver Fibrosis After Weight-Loss or Liver-Directed Therapy.

Introduction: Studies have compared the group-averages of liver stiffness measures (LSMs) from multiple rib spaces by vibration-controlled transient elastography (VCTE) to stage liver fibrosis. No previous study has assessed within-individual liver stiffness variation from two rib spaces in individuals with metabolic-dysfunction associated steatotic liver disease (MASLD).

Methods: We evaluated within-individual LSM variation according to body weight classification and its clinical implication.

Noise-Induced Hearing Loss in Orthopaedic Surgery: A Review Article.

There are many sources of noise production in the operating room, including conversations among the surgical team, background music, electric monitors and alarms, surgical power tools, surgical instrument clattering and hammering, and suction devices. These sources introduce occupational hazards by producing damaging noise levels that exceed noise exposure level guidelines set by the National Institute of Occupational Safety and Health and the Health and Safety Executive. Noise-induced hearing loss affects up to 50% of orthopaedic staff, but few preventative measures are regularly followed in the orthopaedic setting.

Disparities in Breast Cancer Treatment and Reconstruction Among Native Hawaiian and Pacific Islander Women: Systematic Review and Meta-Analysis.

Background: Native Hawaiian and Pacific Islander (NHPI) women experience significant disparities in breast cancer treatment and outcomes, including lower rates of postmastectomy reconstruction, higher refusal rates of radiation therapy, and delays in surgical care. These disparities contribute to poorer survival and increased complications compared to other racial/ethnic groups. This systematic review and meta-analysis aim to quantify these disparities and assess their impact on breast cancer outcomes in NHPI women.

Principles and Practice of Internal Medicine Point-of-Care Ultrasound.

While point-of-care ultrasound (POCUS) use is expanding within Internal Medicine, basic yet important practices and key infrastructure are frequently underutilized. This is appropriately raising concerns that patients may be unintentionally harmed by POCUS. To mitigate this risk, this article advocates for ensuring POCUS users have adequate training to include understanding limitations and pitfalls arising from acquisition, interpretation, and clinical integration.

Through Their Eyes: Using Photovoice to Capture the Capacity-Building Journey of Long Covid Patient Experts.

Background: Long Covid, characterised by persistent symptoms following the coronavirus disease 2019 (COVID-19) infection, significantly impacts the quality of life. Engaging patients in research and care through participatory methods can enhance a shared understanding of illness and improve the relevance of research.

Objective: We define Patient Experts (PEs) as persons (including patients, caregivers and providers) who have completed a series of training sessions on team building, research methods and communication at the Patient Engagement Studio, University of South Carolina (PES USC).

A Proposed Patient Selection Algorithm for Total Joint Arthroplasty Same-Day Discharge From an Ambulatory Surgery Center.

Background: Identifying appropriate patients for same-day discharge (SDD) total joint arthroplasty (TJA) is critical for maintaining optimal patient safety and outcomes. This study investigated patient outcomes after SDD TJA at a single ambulatory surgery center (ASC) and proposes a TJA patient-selection algorithm based on findings and existing literature.

Methods: A retrospective chart review of 660 patients was performed between July 2019 and October 2021 for all patients who underwent primary TJA in a single ASC.

Examining childhood and adulthood stressors as risk factors for gestational diabetes mellitus in working pregnant individuals: A prospective cohort study.

Aims: This study aimed to examine the individual and joint associations of adverse childhood experiences (ACEs) and maternal work and non-work related stressors with the risk of gestational diabetes mellitus (GDM).

Methods: Working pregnant individuals (n = 1163) from a United States (U.S.

Influence of polysubstance use on the health-related quality of life among people who inject drugs undergoing opioid agonist treatment following treatment for hepatitis c virus.

Background: Treating hepatitis C virus (HCV) in people who inject drugs (PWID) has been associated with increased health-related quality of life (HRQOL). Polysubstance use (PSU) is common among PWID, but no studies have investigated PSU influence on PWID's HRQOL HCV treatment.

Methods: Participants included 150 PWID receiving HCV treatment at opioid agonist treatment clinics in Bronx, NY.

Cannabinoids for obstructive sleep apnea: A systematic review.

Cannabinoids have emerged as a potential treatment for obstructive sleep apnea (OSA). This systematic review aimed to summarize the efficacy and safety of cannabinoids to treat OSA. Databases including Ovid MEDLINE, EMBASE, Scopus, PsycINFO, and International Pharmaceutical Abstracts were searched; experimental and observational studies were eligible for inclusion.

Cortical calretinin-positive neurons: Functional and ontogenetic characteristics and their relationship to brain pathologies.

Cortical GABAergic interneurons can be classified according to electrophysiological, biochemical, and/or morphological criteria. In humans, the use of calcium-binding proteins allows us to differentiate three subpopulations of GABAergic interneurons with minimal overlap. Cortical calretinin-positive neurons mainly include bipolar and double-bouquet morphologies, with a largely non-rapid and adaptive firing pattern, originating from the ganglionic eminence and the ventricular and subventricular regions of the developing brain.

Effects of E-Cigarettes on Combustible Cigarette Smoking Among Adults with Opioid Use Disorder on Buprenorphine: Single Arm ERASER Pilot Trial.

Introduction: People with opioid use disorder (OUD) on buprenorphine smoke at high rates and have low cessation rates, even with evidence-based medications. Electronic cigarettes (EC) are a promising harm reduction strategy for combusted cigarette (CC) smokers unable to quit. Unfortunately, people with OUD are underrepresented in EC research.

3-Factor prothrombin complex concentrate versus 4-factor prothrombin complex concentrate for the reversal of oral factor Xa inhibitors.

Multiple agents exist for the reversal of oral Factor Xa inhibitor (FXa) associated bleeding, including Coagulation FXa Recombinant, Inactivated zhzo (andexanet alfa) and 4-factor prothrombin complex concentrate (4F-PCC). While classified as a 3F-PCC product, Profilnine contains up to 35 IU of Factor VII (per 100 IU of Factor IX) in addition to therapeutic levels of Factors II, IX, and X, and has demonstrated a similar impact on prothrombin time and blood product usage in non-warfarin related bleeding. This was a retrospective, multicenter study at four medical centers of adult patients who presented with major bleeding associated with oral FXa inhibitors and received either 4F-PCC (n = 64) or 3F-PCC (n = 61).

A Working Framework to Address Diversity, Equity, and Inclusion in Undergraduate Medical Education.

Health disparities exist among groups that are based on race, ethnicity, gender, socioeconomic status, and geography. Often, interventions directed at addressing these disparities are episodically incorporated into health professions education as opposed to a more uniform integration throughout a curriculum. Thus, a working framework for integrating and assessing diversity, equity, and inclusion (DEI) specifically into foundational science teaching in health professions' education is needed.

Mobile health clinics for distribution of vaccinations to underserved communities during health emergencies: A COVID-19 case study.

Objectives: Mobile health clinics (MHCs) effectively provide healthcare to underserved communities. However, their application during health emergencies is understudied. We described the implementation of an MHC program delivering vaccinations during the COVID-19 pandemic, examined the program's reach to medically underserved communities, and investigated characteristics of vaccination uptake in order to inform the utility of MHCs during health emergencies.

Pregnancy Anxiety and Risk of Gestational Diabetes Mellitus Among a Diverse U.S. Cohort.

Pregnancy anxiety increases the risk of preterm birth but less is known about the impacts on glucose intolerance during pregnancy, such as gestational diabetes mellitus (GDM). The present study examined the relationship between pregnancy anxiety and the risk of GDM in a prospective cohort Centering and Racial Disparities (CRADLE) study of racially diverse pregnant women in the United States. This is a prospective analysis among racially diverse pregnant women in the United States who enrolled in the CRADLE study.

Understanding the challenges of robotic-assisted surgery adoption: Perspectives from stakeholders and the general population on human-interaction, built environment, and training.

This study aims to explore adoption barriers from three aspects critical to facilitating robotic-assisted-surgery (RAS) adoption: the human-robot-interaction, built-environment, and training. Guidelines for research and design are identified from these perspectives. This study consisted of three phases: 1) surveys to RAS stakeholders and a crowd-sourcing survey; 2) stakeholder focus groups; and 3) a workshop with subject-matter experts to prioritize future research for RAS.

Understanding the Values, Qualities, and Preferences of Patients in Their Relationships With Obstetrics and Gynecology Providers: Cross-Sectional Survey With a Mixed Methods Approach.

Background: The patient-provider relationship in obstetrics and gynecology (OBGYN) is uniquely complex due to the sensitive nature of examinations and topics. Patients often prefer health care providers who share similar racial, ethnic, gender, or linguistic backgrounds, particularly in sensitive health care situations, to improve communication and comfort, though historically, specific gender preferences for OBGYNs have not been evident.

Objective: This study aims to describe the values, qualities, and preferences of patients in their relationships with OBGYN providers.

Adverse Childhood Events Significantly Impact Depression and Mental Distress in Adults with a History of Cancer.

Adverse childhood experiences (ACEs) are linked to a heightened risk of depression. We explored the relationship between ACEs and both depression and mental distress among cancer survivors. This was a cross-sectional analysis using the 2022 Behavioral Risk Factor Surveillance System database of cancer survivors aged ≥18 (n = 14,132).

Medical Student Preferences on Examination Scheduling at a US Allopathic Medical School - Survey Study.

Introduction: This study at the University of South Carolina School of Medicine Greenville examines medical students' preferences and concerns regarding exam scheduling, focusing on the schedule's impact on student academic performance and well-being.

Methods: A cross-sectional survey was administered to second, third, and fourth year medical students, receiving a 53% response rate. The survey, consisting of 11 multiple-choice questions and one open-ended question, assessed preferences for exam days, weeks, sequence of different types of exams, and the timing of schedule releases.