Quality Improvement Methodologies: An Application in Cardiac Anesthesiology.

Quality improvement (QI) in medicine serves as the cornerstone of best practices. It enhances medical care by maximizing safety and efficiency while minimizing errors and waste. For a QI initiative to succeed it requires careful strategizing and effective change management plans, including the application of established QI methodologies to ensure sustainable success.

The Minority Tax: Stories from Family Physicians.

The minority tax has been defined as a set of disparities that those who are underrepresented in medicine face in addition to clinical care, education, and research responsibilities. These taxes include systemic racism, diversity efforts, clinical and promotion disparities, lack of faculty development, and isolation. Much has been added to the literature to better define and characterize the minority tax and propose suggestions for mitigations.

Balloon-mounted versus self-expandable stent in failed neurothrombectomy: a post hoc analysis of the SAINT study.

Background: Previous studies have shown that when thrombectomy has failed, rescue intracranial stenting is associated with better clinical outcomes compared with failed reperfusion. However, comparative data regarding stent type are lacking.

Objective: To compare the procedural and clinical outcomes of balloon-mounted stents (BMS) with those of self-expandable stents (SES).

Comparative efficacy and safety of stent retrievers as a bailout strategy following failed contact aspiration technique in acute stroke thrombectomy.

Background: The contact aspiration (CA) technique is often used to perform endovascular thrombectomy (EVT) for acute ischemic stroke (AIS); however, rescue strategies are necessary if CA fails to achieve recanalization. This study investigates the outcomes of incorporating stent retriever (SR) thrombectomy in the rescue strategy following failed CA.

Methods: EVT patients with failed CA attempts were identified from a large multicenter registry and stratified by rescue technique: CA alone or incorporating SR in the rescue strategy.

Comparative analysis of the physiological and transport functions of various sources of renal proximal tubule cells under static and fluidic conditions in PhysioMimix T12 platform.

In vitro models that can faithfully replicate critical aspects of kidney tubule function such as directional drug transport are in high demand in pharmacology and toxicology. Accordingly, development and validation of new models is underway. The objective of this study was to characterize physiologic and transport functions of various sources of human renal proximal tubule epithelial cells (RPTECs).

Side-by-Side Comparison of the In Vivo Performance of [Pb]Pb-DOTAMTATE and Other SSTR2-Targeting Compounds.

There are numerous versions of octreotide and octreotate, including DOTAMTATE, DOTATATE, JR11, and lead-specific chelator (PSC)-PEG2-TOC. These peptides, which can be either analogs or antagonists, are used in nuclear medicine for diagnostic imaging or targeted radionuclide therapy of neuroendocrine tumors that are positive for somatostatin receptors (SSTRs). Despite their structural and targeting similarities, they have distinct properties and clinical uses.

Electrochemical Removal of Se(IV) from Wastewater Using RuO-Based Catalysts.

The removal of selenite (SeO) from water is challenging due to the risk of secondary pollutants. To address this, we developed RuO-based nanocatalysts on the titanium plate (RuO/TP) for direct electrochemical reduction of Se(IV) to elemental selenium [Se(0)]. Optimizing Sn doping in RuO nanoparticles to induce charge redistribution enabled the RuSnO/TP catalyst to achieve ∼90% Se(IV) removal across concentrations of 0.

Postpartum Dams Exposed to a Low-Resource Environment Display Neuroinflammation, Elevated Corticosterone, and Anhedonia-like Behavior.

Women living in an impoverished environment after birth have an increased risk of developing postpartum depression (PP-Dep) and hypertension (PP-HTN). The mechanisms underlying these heightened risks are unknown and understudied. To examine the relation between reduced environmental resources, PP-Dep, and PP-HTN; postpartum rodent dams were exposed to the low-resource limited bedding and nesting (LBN) chronic stress model during weaning.

Outcomes of Patients Treated with Double-Wide Scallop vs Fenestrations for Celiac Artery Incorporation During Repair of Complex Abdominal Aortic Aneurysms.

Objectives: Celiac artery (CA) incorporation during FB-EVAR for complex abdominal aortic aneurysms (cAAA) is typically performed with fenestrations. Double-wide scallops (DWS) can be used when appropriate. We aimed to assess outcomes of patients treated with DWS for the CA during FB-EVAR for cAAA.

Ultrasonographic Changes in the Anterior Scalene Muscle in Neurogenic Thoracic Outlet Syndrome.

Introduction: Thoracic outlet syndrome (TOS) encompasses multiple symptoms produced by compression of the neurovascular bundle within the thoracic outlet. The subtypes of thoracic outlet are termed for the major affected structure including neurogenic (nTOS), venous (vTOS), and arterial (aTOS) thoracic outlet syndrome. Neurogenic thoracic outlet syndrome accounts for over 95 percent of thoracic outlet syndrome cases and occurs from compression of the brachial plexus.

Report on the Development of the Accreditation Council for Education in Nutrition and Dietetics' Academic "Accreditation Standards for Advanced Practice Doctoral Education in Nutrition and Dietetics".

The dietetics profession is facing a shortage of registered dietitian nutritionists (RDNs) with a terminal degree. The need for doctoral prepared RDNs was augmented with the entry-level RDN requiring a graduate degree and exacerbated by the number of retirees from the baby boomer generation. Advanced practice doctoral (APD) programs can assist in meeting the increased need for doctoral prepared RDNs.

Microscopic Origin of the Spatial and Temporal Precision in Biological Systems.

All living systems display remarkable spatial and temporal precision, despite operating in intrinsically fluctuating environments. It is even more surprising given that biological phenomena are regulated by multiple chemical reactions that are also random. While the underlying molecular mechanisms of surprisingly high precision in biology remain not well understood, a novel theoretical picture that relies on the coupling of relevant stochastic processes has been recently proposed and applied to explain different phenomena.

Unlocking insights: Clinical associations from the largest 6-minute walk test collection via the my Heart Counts Cardiovascular Health Study, a fully digital smartphone platform.

Background: The six-minute walk test (6MWT) is a prognostic sub-maximal exercise test used clinically as a measure of functional capacity. With the emergence of advanced sensors, 6MWTs are being performed remotely via smartphones and other devices. The My Heart Counts Cardiovascular Health Study is a smartphone application that serves as a digital platform for studies of human cardiovascular health, and has been used to perform 30,475 6MWTs on 8922 unique participants.

Associations between Advanced Paternal Age and Adverse Reproductive Outcomes in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b).

Objective:  The association between paternal age and adverse pregnancy outcomes (APOs) has not been well studied. We sought to determine whether advanced paternal age (APA) is associated with adverse maternal or neonatal outcomes.

Study Design:  Secondary analysis of 8,863 pregnancies from the Nulliparous Pregnancy Outcomes Study Monitoring Mothers-to-Be (nuMoM2b) prospective cohort in which both maternal and paternal age at conception were known.

Structure of a zoonotic H5N1 hemagglutinin reveals a receptor-binding site occupied by an auto-glycan.

Highly pathogenic avian influenza has spilled into many mammals, most notably cows and poultry, with several dozen human breakthrough infections. Zoonotic crossovers, with hemagglutinins mutated to enhance viral ability to use human α2-6-linked sialic acid receptors versus avian α2-3-linked ones, highlight the pandemic risk. To gain insight into these crossovers, we determined the cryoelectron microscopy (cryo-EM) structure of the hemagglutinin from the zoonotic H5N1 A/Texas/37/2024 strain (clade 2.

International Society for Pediatric and Adolescent Diabetes Clinical Practice Consensus Guidelines 2024 Diabetes Technologies: Glucose Monitoring.

The International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines represent a rich repository that serves as the only comprehensive set of clinical recommendations for children, adolescents, and young adults living with diabetes worldwide. This chapter builds on the 2022 ISPAD guidelines, and summarizes recent advances in the technology behind glucose monitoring, and its role in glucose-responsive integrated technology that is feasible with the use of automated insulin delivery (AID) systems in children and adolescents.

Sustainable removal of gaseous Hg using sulfur functionalized biochar: Adsorption experiment and life cycle assessment.

Maximizing the sorption capacity of gaseous Hg by sulfur-functionalized biochar can lead to increased energy consumption and the production of secondary environmental pollutants such as greenhouse gases. This study evaluates the environmental impact of producing sulfurized biochar through a life cycle assessment (LCA), weighing these impacts against the benefits of enhanced Hg removal efficiencies. The biochar's Hg adsorption capacity, which ranges between 3 and 22 μg-Hg/g-biochar, is influenced by several factors: it increases with higher sulfur loading (0-15 %), higher O levels (0-21 %), and longer pyrolysis times (1-5 h).

Recreational marijuana legalization's impact and opioid death rates: A synthetic control approach.

Objectives: To develop a more robust understanding of the relationship between increased recreational marijuana access and opioid overdose deaths. Increasing opioid-related deaths in conjunction with the rising popularity of liberalized marijuana laws make additional research examining the interrelation of both a timely and insightful question.

Study Design: We use synthetic control method to assess the impact of opening recreational marijuana dispensaries via recreational marijuana legalization (RML) on opioid death rates in Colorado, Washington, and Oregon.

Alemtuzumab and thrombotic thrombocytopenic purpura: Analysis of an international surveillance database and systematic literature review.

Objectives: Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy associated with severe deficiency in ADAMTS13. ADAMTS13 deficiency may be secondary to absent or dysfunctional protein production due to mutations in the ADAMTS13 gene (congenital TTP) or autoantibody-mediated clearance and/or inhibition (immune-mediated TTP). This autoimmunity may, albeit rarely, occur secondary to certain medications (eg, ticlopidine).

Deep learning-based quick MLC sequencing for MRI-guided online adaptive radiotherapy: a feasibility study for pancreatic cancer patients.

One bottleneck of MRI-guided Online Adaptive Radiotherapy (MRoART) is the time-consuming daily online replanning process. The current leaf sequencing method takes up to 10 minutes, with potential dosimetric degradation and small segment openings that increase delivery time. This work aims to replace this process with a fast deep learning-based method to provide deliverable MLC sequences almost instantaneously, potentially accelerating and enhancing online adaption.

Impact of Vein-to-vein Time in Patients With R/R LBCL Treated With Axicabtagene Ciloleucel.

Chimeric antigen receptor (CAR) T-cell products axicabtagene ciloleucel (axi-cel), tisagenlecleucel (tisa-cel), and lisocabtagene maraleucel (liso-cel) are approved for relapsed/refractory large B-cell lymphoma (R/R LBCL). Emerging evidence indicates that delayed CAR T-cell infusion, including prolonged time from leukapheresis to infusion, known as vein-to-vein time (V2Vt), may adversely impact clinical outcomes. We conducted a systematic literature review (SLR) and meta-analysis to identify differences in V2Vt in patients with R/R LBCL treated with axi-cel, tisa-cel, or liso-cel.

Relationship Among Macronutrients, Dietary Components, and Objective Sleep Variables Measured by Smartphone Apps: Real-World Cross-Sectional Study.

Background: Few studies have explored the relationship between macronutrient intake and sleep outcomes using daily data from mobile apps.

Objective: This cross-sectional study aimed to examine the associations between macronutrients, dietary components, and sleep parameters, considering their interdependencies.

Methods: We analyzed data from 4825 users of the Pokémon Sleep and Asken smartphone apps, each used for at least 7 days to record objective sleep parameters and dietary components, respectively.