Examining the implementation of a multi-site evidence-based intervention to reduce fluoroquinolone usage: A qualitative content analysis of staff interviews to identify facilitators and barriers.

Unlabelled: Clostridioides difficile infection is the most common healthcare-associated infection, causing almost half a million infections in the United States annually. Inappropriate antibiotic usage is a known risk factor. Antibiotic stewardship efforts aim to optimize prescribing.

The ZFHX3 GGC Repeat Expansion Underlying Spinocerebellar Ataxia Type 4 has a Common Ancestral Founder.

Background: The identification of a heterozygous exonic GGC repeat expansion in ZFHX3 underlying spinocerebellar ataxia type 4 (SCA4) has solved a 25-year diagnostic conundrum. We used adaptive long-read sequencing to decipher the pathogenic expansion in the index Utah family and an unrelated family from Iowa of Swedish ancestry. Contemporaneous to our discovery, other groups identified the same repeat expansion in affected individuals from Utah, Sweden, and Germany, highlighting the current pivotal time for detection of novel repeat expansion disorders.

Predicting Nephrotoxic Acute Kidney Injury in Hospitalized Adults: A Machine Learning Algorithm.

Rationale And Objective: Acute kidney injury (AKI) is a common complication among hospitalized adults, but AKI prediction and prevention among adults has proved challenging. We used machine learning to update the nephrotoxic injury negated by just-in time action (NINJA), a pediatric program that predicts nephrotoxic AKI, to improve accuracy among adults.

Study Design: A retrospective cohort study.

The optic nerve in spaceflight: novel concepts in the pathogenesis of optic disc edema in microgravity.

Purpose Of Review: Spaceflight-associated neuro-ocular syndrome (SANS) encompasses a unique constellation of neuro-ocular findings in astronauts, including optic disc edema (ODE), globe flattening, chorioretinal folds, and hyperopic refractive shift. Although there are numerous neuro-ocular findings in SANS, the purpose of this review is to describe the novel, emerging concepts of the pathogenesis for the ODE specifically in SANS.

Recent Findings: While the initial hypotheses on the pathogenesis of ODE in SANS focused on possible elevated intracranial pressures (i.

Effects of multi directional chin tuck against resistance exercise on tongue pressure and thickness and suprahyoid muscle activity.

The chin tuck against resistance (CTAR) exercise is a therapeutic method developed to activate and strengthen the oropharyngeal muscles related to swallowing in patients experiencing post-stroke dysphagia. However, existing CTAR exercises could be improved by considering the complex characteristics of the suprahyoid muscles. To investigate the efficacy of multidirectional (md-) CTAR on tongue pressure and suprahyoid muscle activity in older adults.

American College of Surgeons Cancer Program Annual Report from 2021 Participant User File.

The National Cancer Database (NCDB) collects data from approximately 1,500 Commission on Cancer (CoC) facilities and represent 73.7% of newly diagnosed cancers nationwide. The American College of Surgeons Cancer Program developed it first annual report from the NCDB 2021 participant user file reporting new observations and recent trends of cancer diagnoses, patient demographics, and treatments as well as an in-depth report on treatment and outcomes in breast, pancreas, and colon cancers.

Dural arteriovenous fistula (DAVF) after venous sinus stent (VSS) for presumed idiopathic intracranial hypertension (IIH): A case report and literature review.

Dural arteriovenous fistulas (DAVFs) are rare but significant intracranial vascular malformations that are usually idiopathic and can lead to severe complications like venous hypertension and intracranial hemorrhage. We present 2 cases of DAVF occurring after venous sinus stenting (VSS) for presumed idiopathic intracranial hypertension (IIH) in a 51-year-old and a 52-year-old female. In both patients, Cognard type 1 DAVF was detected by Catheter angiography and successfully obliterated with Onyx™ embolization.

Outcomes of Concomitant Atrial Fibrillation Ablation and Left Atrial Appendage Closure: A Retrospective Single-Center Experience.

Background: Catheter ablation is an effective therapy in the management of atrial fibrillation (AF). Left atrial appendage closure (LAAC) is an alternative to anticoagulation for stroke prevention in patients with bleeding risks.

Objectives: The purpose of this study was to assess the safety and efficacy of combining AF ablation and LAAC in a single procedure.

Impact of alcohol use disorder on inpatient hospitalizations: A comparison of outcomes between urban and rural Veterans Affairs hospitals.

Background: Alcohol use disorder (AUD) is a leading cause of morbidity and mortality that disproportionately affects rural residents and Veterans.

Objective: To evaluate the burden of AUD in admissions at rural and urban hospitals within the Veterans Health Administration (VHA) comparing patient characteristics, clinical outcomes, and 1-, 3-, and 5-year mortality rates.

Methods: Retrospective cross-sectional study of patients admitted to VHA hospitals from 2016 to 2020, with a primary or secondary diagnosis related to AUD.

Racial Differences in Systemic Immune Parameters in Individuals With Lung Cancer.

Introduction: Racial and ethnic disparities in the presentation and outcomes of lung cancer are widely known. To evaluate potential factors contributing to these observations, we measured systemic immune parameters in Black and White patients with lung cancer.

Methods: Patients scheduled to receive cancer immunotherapy were enrolled in a multi-institutional prospective biospecimen collection registry.

The MED13L Foundation strategic research plan: a roadmap to the future.

A strategic research plan (SRP) serves as a compass for the patient advocacy organizations driving the therapeutic options for their rare disorder. The MED13L Foundation commissioned the SRP in 2022 through COMBINEDBrain, a consortium of patient advocacy organizations of rare neurodevelopmental disorders, working toward clinical trial readiness. The MED13L Foundation SRP is an objective evaluation of MED13L literature including clinical and basic science knowledge interwoven with an assessment of preclinical trial readiness tools necessary for achieving therapeutic interventions.

Diagnostic stewardship and dermatology consultation in cellulitis management: a systematic literature review and meta-analysis.

Cellulitis is a common skin infection often requiring antibiotic treatment. However, misdiagnosis and inappropriate antibiotic use contribute to antibiotic resistance and healthcare costs. We aimed to evaluate the impact of dermatology consultation on treatment modification in patients with suspected cellulitis and to determine whether dermatologists' evaluation can be used as a reference to diagnose suspected cellulitis.

Anatomical and Micro-CT Assessment of the First Metatarsal Head Vascularization and Soft Tissue Envelope Following Minimally Invasive Chevron Osteotomy for Hallux Valgus Deformity.

Background: Minimally invasive surgical (MIS) chevron-type osteotomy for hallux valgus (HV) treatment offers a surgical alternative to open surgery with minimal surgical dissection and a hypothetical decreased risk for soft tissue complications. The objectives of this study were to assess the incidence of injuries to the soft tissue envelope and to the blood supply of the first metatarsal head through gross dissection and, using micro-computed tomography (micro-CT), to identify the safe position to perform the MIS chevron-type osteotomy of the first metatarsal head based on the anatomical data.

Methods: Twenty cadaveric specimens with HV were used for the study.

Alleviating radiologists' childcare woes: A roadmap for the 21st century.

This manuscript illuminates the need for childcare support for trainees and faculty in the field of radiology, highlighting the essential need for access, affordability, and high-quality childcare services. For over four decades, women radiologists have voiced the challenges of meeting both childcare and professional responsibilities. The COVID-19 pandemic highlighted systemic inadequacies in the childcare infrastructure, exacerbating the challenges of this long-standing balancing act.

Benefit of early oseltamivir therapy for adults hospitalized with influenza A: an observational study.

Background: clinical guidelines recommend initiation of antiviral therapy as soon as possible for patients hospitalized with confirmed or suspected influenza.

Methods: A multicenter US observational sentinel surveillance network prospectively enrolled adults (aged ≥18 years) hospitalized with laboratory-confirmed influenza at 24 hospitals during October 1, 2022-July 21, 2023. A multivariable proportional odds model was used to compare peak pulmonary disease severity (no oxygen support, standard supplemental oxygen, high-flow oxygen/non-invasive ventilation, invasive mechanical ventilation, or death) after the day of hospital admission among patients starting oseltamivir treatment on the day of admission (early) versus those who did not (late or not treated), adjusting for baseline (admission day) severity, age, sex, site, and vaccination status.