Not Just 9-1-1: The Expanded Work Environment of United States Emergency Medical Service Clinicians.

Introduction: Recently, there have been annual increases in emergency medical service (EMS) demand with concurrent clinician shortages. Understanding the diverse number of EMS clinicians available for emergent roles is vital for planning and resource management. Our study aims to understand the roles and environments of US EMS clinicians.

Editorial Commentary: Repair of "Degenerative" Horizontal Cleavage Meniscus Tears Is Cost-effective, Is Chondroprotective, and Shows Healing Rates Similar to Other Meniscal Tear Patterns.

Over the past 15 years, there has been a shift toward meniscus preservation even for previously believed irreparable patterns like bucket handle, radial, meniscus root, vertical, and horizontal cleavage tears (HCTs). HCTs are a common tear pattern, especially as we age, and are estimated to occur in 23% to 32% of meniscus tears. They occur in both males and females, are more common on the medial than the lateral side, and most often occur with minor to normal trauma in an anterior cruciate ligament intact knee.

The effect of smokeless tobacco (SLT) excise taxes on SLT use among youth.

Background: Smokeless Tobacco (SLT) use prevalence among youth in the United States (US) is comparable to youth prevalence of cigarette smoking. However, it is in general understudied compared to cigarettes and draws less attention nowadays compared to e-cigarettes (ECs).

Aim: We estimate the own- and cross-tax elasticities of SLT use among US youth and explicitly test how SLT use changes in response to taxes on SLT, cigarettes, ECs, and beer.

Impact of Preoperative Systemic Therapy on Cytoreductive Nephrectomy Outcomes in the National Surgical Quality Improvement Program (NSQIP).

Introduction: Management of metastatic renal cell carcinoma (mRCC) is highly individualized and often involves cytoreductive nephrectomy (CN) and systemic therapy (ST). The optimal sequencing of CN and ST is uncertain. A difference in perioperative outcomes based on sequence of CN and ST could influence decisionmaking.

Analyzing the interaction between time to surgery and tumor burden score in hepatocellular carcinoma.

Background: The effect of "time to surgery (TTS)" on outcomes for curative-intent hepatectomy of hepatocellular carcinoma (HCC) remains debated. The interaction between tumor burden score (TBS) and TTS remains unclear. We sought to evaluate the effects of TBS and TTS on long-term HCC outcomes.

National Study Examining Excellence and Value in Physical Therapist Residency Education: Part 1-Design, Methods, and Results.

Objective: A challenge in health professions is training practitioners to navigate health care complexities, promote health, optimize outcomes, and advance their field. Physical therapist residency education offers a pathway to meet these needs in ways that "entry-level" (professional) education may not. Identifying key aspects of excellence in residency education and understanding its value in developing adaptive expertise will help devise strategies to enhance program, resident, and patient outcomes.

National Study Examining Excellence and Value in Physical Therapist Residency Education: Part 2-A Call to Action.

This Perspective provides a crucial set of actions with corresponding recommendations aimed at propelling the physical therapy profession toward excellence in residency education. The conceptual model includes elements of excellence in the delivery and outcomes of physical therapist residency education and the domain of value experienced by stakeholders impacted by physical therapist residency education. Linked to the conceptual model, the 15 actions, and 28 recommendations draw from (1) the Physical Therapist Residency Excellence and Value (PT-REV) study, (2) the Physical Therapist Education for the 21st Century (PTE-21) study, and (3) research in the learning sciences.

Stop The Falls! A framework for injury prevention outreach for older adults presented by the American Association for the Surgery of Trauma Geriatric Trauma and Injury Prevention Committees.

With the increasing age of the population in the USA, fall prevention events to target older patients are imperative. The American Association for the Surgery of Trauma hosted a fall prevention event at the host city of the 2023 Annual Meeting. We review the planning and implementation of this "Stop the Falls" event, in hopes that other institutions may benefit and sustainably effectuate fall prevention events for an increasingly geriatric population.

Association of transplant recipient status with clinical and financial outcomes among patients undergoing major surgery.

Background: Transplant recipients undergoing surgery may represent a vulnerable population because of transplant-related comorbidities as well as reliance on immunosuppressive medications. We sought to characterize the association of prior transplant status on postoperative outcomes among patients undergoing major non-transplant-related surgical procedures.

Methods: Data on patients who underwent a major surgical procedure (pneumonectomy, coronary artery bypass graft, abdominal aortic aneurysm repair, Whipple, colectomy) between 2016 and 2020 were obtained from the Nationwide Readmission Database.

Development of a core outcome set for recurrent acute and chronic pancreatitis: Results of a Delphi poll.

Background/objective: Recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP) lack effective therapies. There is no consensus or guidance on which endpoints or outcome measures should be used in clinical trials. This study aimed to develop a core outcome set aligned with both patient and provider priorities for RAP and CP.

Presentation, Treatment, and Survival Among Asians With Gastric Cancer.

Introduction: In aggregate, Asian patients have a higher incidence and mortality from gastric cancer (GC) than Non-Hispanic White (NHW) patients. However, there is a lack of data regarding outcomes among Asian-American subpopulations with GC.

Methods: The National Cancer Database was used to identify patients with GC between 2004 and 2020.

Factors influencing pursuit of management roles by clinically trained pharmacists: A modified Delphi survey.

Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

A Matched Design for Causal Inference With Survey Data: Evaluation of Medical Marijuana Legalization in Kentucky and Tennessee.

A concern surrounding marijuana legalization is that driving after marijuana use may become more prevalent. Survey data are valuable for estimating policy effects, however their observational nature and unequal sampling probabilities create challenges for causal inference. To estimate population-level effects using survey data, we propose a matched design and implement sensitivity analyses to quantify how robust conclusions are to unmeasured confounding.

Anhedonia in flux: Understanding the associations of emotion regulation and anxiety with anhedonia dynamics in a sample with major depressive disorder.

Negative rumination and emotion regulation difficulties have been consistently linked with depression. Despite anhedonia-the lack of interest in pleasurable experiences-being a cardinal symptom of depression, emotion regulation of positive emotions, including dampening, are considered far less in the literature. Given that anhedonia may manifest through blunted responses to previously positive or enjoyable experiences, it is vital to understand how different positive emotion regulation strategies impact anhedonia symptom severity and how it can vary or change over time.

Sex Differences in Opioid-Sparing Regimen Prescribing Following Ventral Hernia Repair.

Introduction: While sex differences are known to have a clinically relevant impact on the response to pain therapy, current data are still largely equivocal on sex-specific postoperative pain management. The aim of this study is to determine whether sex predicts differences in pain management in patients undergoing ventral hernia repair (VHR).

Methods: This was a retrospective analysis of prospectively collected data for VHR from the Abdominal Core Health Quality Collaborative.

Necrotizing Fasciitis of the Orbit Managed With Temporary Indwelling Retrobulbar Catheter.

Necrotizing fasciitis is a rapidly progressive soft tissue infection with high mortality. Aggressive and often repeated surgical debridements are considered the mainstay of treatment, but these interventions may cause significant postoperative morbidity. In this article, the authors present a rare case of orbital necrotizing fasciitis, which was treated with the use of a temporary indwelling retrobulbar drain for antibiotic delivery to deep orbital tissues, in lieu of aggressive debridement.

Safety of enoxaparin in patients implanted with continuous flow left ventricular assist devices.

Background: The objective of this study is to determine the incidence of major bleeding events in patients implanted with continuous flow left ventricular assist devices (CF-LVADs) bridged with enoxaparin (LMWH) compared to intravenous unfractionated heparin (IV UFH) for a subtherapeutic INR on warfarin.

Methods: A single-center, retrospective, cohort study was conducted including patients with CF-LVADs implanted between January 1, 2012 and July 1, 2020 who received at least one inpatient dose or outpatient prescription for LMWH or IV UFH at least 60 days after CF-LVAD implantation. The primary endpoint was the incidence of major bleeding.

The Tax Incidence and Tax Pass-Through of Smokeless Tobacco in the US.

Background: States adopt different tax bases for smokeless tobacco (SLT), making tax incidence on SLT not directly comparable across states. In addition, how taxes are passed through to SLT prices among states that impose specific taxes, and whether the pass-through rates for SLT are affected by the uptake and evolution of e-cigarettes, is unknown.

Objective: This study will calculate the tax incidence on SLT and investigate how SLT taxes are passed to prices at the 25th, 50th, and 75th percentile levels, as well as whether these pass-through rates vary by e-cigarette uptake and evolution.

Precision Medicine for Metastatic Colorectal Cancer: Where Do We Stand?

Metastatic colorectal cancer is a leading cause of cancer-related death across the world. The treatment paradigm has shifted away from systemic chemotherapy alone to include targeted therapy and immunotherapy. The past two decades have been characterized by increased investigation into molecular profiling of colorectal cancer.