Cervical Cancer Among Older Women: Analyses of Surveillance, Epidemiology and End Results Program Data.

Objective: To describe age-specific cervical cancer incidence rates based on demographic and clinical characteristics.

Methods: Women with cervical cancer in the SEER program were grouped into 3 age categories. Demographics, clinical characteristics, and incidence rates were obtained for each age group.

Safety, feasibility, and acceptability of patient-controlled anxiolysis with dexmedetomidine for burn-care dressing changes: an open-label, single-arm, pilot study.

Anxiety is common among patients with burn injury, occurring frequently surrounding wound care. Few pharmacologic interventions targeting anxiety in burn injury have been evaluated. This study aimed to evaluate patient-controlled anxiolysis using dexmedetomidine (PCA-DEX) in patients undergoing burn dressing changes.

Reduced intensity conditioning for acute myeloid leukemia using melphalan- vs busulfan-based regimens: a CIBMTR report.

There is a lack of large comparative study on the outcomes of reduced intensity conditioning (RIC) in acute myeloid leukemia (AML) transplantation using fludarabine/busulfan (FB) and fludarabine/melphalan (FM) regimens. Adult AML patients from Center for International Blood and Marrow Transplant Research who received first RIC allo-transplant between 2001 and 2015 were studied. Patients were excluded if they received cord blood or identical twin transplant, total body irradiation in conditioning, or graft-versus-host disease (GVHD) prophylaxis with in vitro T-cell depletion.

Percutaneous Closure of the Patent Ductus Arteriosus in Very-Low-Weight Infants.

In view of the known complications of drug therapy and open surgical ligation, and the potential for prolonged patent ductus arteriosus (PDA) exposure to be harmful, health care practitioners have sought new approaches to achieve definitive ductal closure. Interest in percutaneous (catheter-based) PDA closure has emerged within the neonatal community as a viable treatment option, because it has been fueled by recent procedural and device modifications, as well as mounting feasibility and safety data. Herein, we provide a contemporary review of percutaneous PDA closure among infants at the crux of the medical debate-very-low-weight infants (≤1,500 g), including: 1) characterization of traditional PDA treatments (drug therapy, open surgical ligation) and conservative (nonintervention) management options; 2) a general overview of the major procedural steps of percutaneous ductal closure, including efforts to reduce thrombotic complications and the emergence of a novel US Food and Drug Administration-approved device; 3) a systematic review and meta-analysis to better understand risk profiles of percutaneous PDA closure in this population; and 4) discussion of current gaps in our understanding of optimal PDA care, including the critical need for well-designed, randomized, controlled clinical trials.

Effect of Scan Strategies and Use of Support Structures on Surface Quality and Hardness of L-PBF AlSi10Mg Parts.

Additive manufacturing allows for a great degree of design freedom and is rapidly becoming a mainstream manufacturing process. However, as in all manufacturing processes, it has its limitations and specificities. Equipping engineers with this knowledge allows for a higher degree of optimization, extracting the most out of this technology.

Addressing the Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Hematopoietic Cell Transplantation: Learning Networks as a Means for Sharing Best Practices.

The full impact of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on the field of hematopoietic cell transplantation (HCT) is unknown. This perspective paper reviews the following: current COVID-19 epidemiology, diagnosis, and potential therapies; care considerations unique to HCT recipients; and the concept of a learning network to assimilate emerging guidelines and best practices and to optimize patient outcomes through facilitating shared learning and experience across transplantation centers.

Protocol for studying racial/ethnic disparities in depression care using joint information from participant surveys and administrative claims databases: an observational cohort study.

Introduction: Current evidence indicates that older racial/ethnic minorities encounter disparities in depression care. Because late-life depression is common and confers major adverse health consequences, it is imperative to reduce disparities in depression care. Thus, the primary objectives of this protocol are to: (1) quantify racial/ethnic disparities in depression treatment and (2) identify and quantify the magnitude of these disparities accountable for by a multifactorial combination of patient, provider and healthcare system factors.

Imaging Modalities in Genitourinary Emergencies.

Emergency physicians rely on a multitude of different imaging modalities in the diagnosis of genitourinary emergencies. There are many considerations to be taken into account when deciding which imaging modality should be used first, as oftentimes several diagnostic tools can be used for the same pathologic condition. These factors include radiation exposure, sensitivity, specificity, age of patient, availability of resources, cost, and timeliness of completion.

How Should Health Care Organizations and Communities Work Together to Improve Neighborhood Conditions?

In the past few decades, scholars have begun to establish ethical principles for public health engagement. A key tension has been how to reconcile public health improvement with local autonomy in decision making so as to express respect for community members' on-the-ground experience. This article describes the experience of one children's hospital in learning to ethically engage a surrounding community in conversations about housing development in partnership with a local faith-based development organization.

Should Hospital Emergency Departments Be Used as Revenue Streams Despite Needs to Curb Overutilization?

This case asks how a hospital should balance patients' health needs with its financial bottom line regarding emergency department utilization. Should hospitals engage in proactive population health initiatives if they result in decreased revenue from their emergency departments? Which values should guide their thinking about this question? Drawing upon emerging legal and moral consensus about hospitals' obligations to their surrounding communities, this commentary argues that treating emergency departments purely as revenue streams violates both legal and moral standards.

Can Sunscreens Harm Coral Reefs? Addressing Environmental Concerns and Offering Practical Recommendations.

The crucial role sunscreen plays in preventing sunburns, photoaging, and skin cancer is unquestionable, and as a result, it is incumbent upon dermatologists to influence patients to appropriately use sunscreens. In addition to explaining the benefits of sunscreen use and how to properly use sunscreen, dermatologists must also address possible barriers or concerns that patients may have regarding sunscreen. One concern that has gained increasing media attention in the recent years has been the environmental impact of sunscreens, especially the impact on coral reefs.

Positive Airway Pressure Therapy for Hyperventilatory Central Sleep Apnea: Idiopathic, Heart Failure, Cerebrovascular Disease, and High Altitude.

Central sleep apnea (CSA) and Hunter-Cheyne-Stokes breathing (HCSB) are caused by failure of the pontomedullary pacemaker generating breathing rhythm. CSA/HCSB may complicate several disorders causing recurrent arousals and desaturations. Common causes of CSA in adults are congestive heart failure, stroke, and chronic use of opioids; opioids have hypoventilatory effects.

Ethnic disparities in cancer incidence and survival among the oldest old in the United States.

To examine potential ethnic disparities in cancer incidence and survival rates among the oldest old using data from the SEER Program. Cases diagnosed with one of the leading four cancer sites (lung and bronchus, colon and rectum, female breast, prostate) and four cancer sites (stomach, liver and intrahepatic bile duct, gallbladder, and cervical) that disproportionally affect Hispanics were reported to one of 18 SEER registries. Differences in cancer incidence were examined for cases aged ≥85 years diagnosed during the most recent 5-year time period (2009-2013) and, to examine changes over time, from 1992 to 2013.

Oral rehabilitation with implant-supported fixed dental prostheses of a patient with cleidocranial dysplasia.

This clinical report describes the oral rehabilitation with implant-supported fixed dental prostheses in the maxilla and mandible of a patient with cleidocranial dysplasia. Cone-beam computed tomography and a tilted implant protocol in the mandible helped to establish a conservative approach for bone preservation, prevent surgical complications, enable proper implant positioning to avoid anatomic structures, and support the fixed dental prostheses.

Active Use of Electronic Health Records (EHRs) and Personal Health Records (PHRs) for Epidemiologic Research: Sample Representativeness and Nonresponse Bias in a Study of Women During Pregnancy.

Introduction: With the growing use of electronic medical records, electronic health records (EHRs), and personal health records (PHRs) for health care delivery, new opportunities have arisen for population health researchers. Our objective was to characterize PHR users and examine sample representativeness and nonresponse bias in a study of pregnant women recruited via the PHR.

Design: Demographic characteristics were examined for PHR users and nonusers.

Auditory Discrimination of Lexical Stress Patterns in Hearing-Impaired Infants with Cochlear Implants Compared with Normal Hearing: Influence of Acoustic Cues and Listening Experience to the Ambient Language.

Objectives: To assess discrimination of lexical stress pattern in infants with cochlear implant (CI) compared with infants with normal hearing (NH). While criteria for cochlear implantation have expanded to infants as young as 6 months, little is known regarding infants' processing of suprasegmental-prosodic cues which are known to be important for the first stages of language acquisition. Lexical stress is an example of such a cue, which, in hearing infants, has been shown to assist in segmenting words from fluent speech and in distinguishing between words that differ only the stress pattern.

Osteopathic medical students' understanding of the Patient Protection and Affordable Care Act: a first step toward a policy-informed curriculum.

Context: Current osteopathic medical students will play an important role in implementing, modifying, and advocating for or against the Patient Protection and Affordable Care Act (ACA) of 2010. Accordingly, medical educators will need to address curricular gaps specific to the ACA and medical practice. Research that gauges osteopathic medical students' level of understanding of the ACA is needed to inform an evidence-based curriculum.

Relationship between hypothermia and blood loss in adult patients undergoing open lumbar spine surgery.

Context: Intraoperative blood loss during open lumbar spine surgery is associated with adverse events and is a contributor to higher medical costs. Intraoperative hypothermia has been shown to increase blood loss and postoperative allogeneic blood transfusion rates in other realms of orthopedic surgery, but it has not been studied extensively in patients undergoing spine surgery.

Objective: To determine whether a clinically relevant association exists between intraoperative core body temperature and blood loss or transfusion rates in adult patients undergoing open lumbar spine surgery.

Multilocus species delimitation in a complex of morphologically conserved trapdoor spiders (mygalomorphae, antrodiaetidae, aliatypus).

Species are a fundamental unit for biological studies, yet no uniform guidelines exist for determining species limits in an objective manner. Given the large number of species concepts available, defining species can be both highly subjective and biased. Although morphology has been commonly used to determine species boundaries, the availability and prevalence of genetic data has allowed researchers to use such data to make inferences regarding species limits.

Family inclusion in diabetes education: a nationwide survey of diabetes educators.

Purpose: The purpose of this study was to investigate perceptions about family inclusion and support in diabetes self-management education.

Methods: Surveys were mailed to certified diabetes educators (CDEs) in all 50 states and the District of Columbia, with a return of 225 surveys. Descriptive and inferential statistics (eg, t test, analysis of variance, correlation, and chi-square) were used as appropriate.

A Model of Community-Based Behavioral Intervention for Depression in Diabetes: Program ACTIVE.

Depression affects one in four people with diabetes and significantly affects diabetes health. Earlier studies of the treatment of depression have documented that cognitive behavioral therapy (CBT) and exercise have each been found to be effective in treating depression in people with and without diabetes in the context of medical settings. Individuals in rural areas lack regular access to medical centers and require treatment options that may be adapted for local communities.