Improving colonoscopy quality in the national VA healthcare system.

Background: Colorectal cancer (CRC) prevention is a Veterans Affairs (VA) priority. Colonoscopy quality, especially adenoma detection rate (ADR), is critical for effective screening. Our research indicates considerable variation in ADR among VA providers.

Developing Linkages Between PROMIS Physical Function CAT and QuickDASH Scores in Hand Surgery: A Crosswalk Study.

Background: There is no standardization within hand and upper-extremity surgery regarding which patient-reported outcome measures (PROMs) are collected and reported. This limits the ability to compare or combine cohorts that utilize different PROMs. The aim of this study was to develop a linkage model for the QuickDASH (shortened version of the Disabilities of the Arm, Shoulder and Hand) and PROMIS PF CAT (Patient-Reported Outcomes Measurement Information System Physical Function computerized adaptive testing) instruments to allow interconversion between these PROMs in a hand surgery population.

Metabolic Aging as an Increased Risk for Chronic Obstructive Pulmonary Disease.

Background/objectives: Both aging and chronic obstructive pulmonary disease (COPD) are strongly associated with changes in the metabolome; however, it is unknown whether there are common aging/COPD metabolomic signatures and if accelerated aging is associated with COPD.

Methods: Plasma from 5704 subjects from the Genetic Epidemiology of COPD study (COPDGene) and 2449 subjects from Subpopulations and intermediate outcome measures in COPD study (SPIROMICS) were profiled using the Metabolon global metabolomics platform (1013 annotated metabolites). Post-bronchodilator spirometry measures of airflow obstruction (forced expiratory volume at one second (FEV)/forced vital capacity (FVC) < 0.

Using T-Cell Subsets to Better Characterize Immunoresiliency and Immunodeficiency in Patients with Recurrent Infections.

Background/objectives: Common Variable Immunodeficiency Disease (CVID) and other immunodeficiencies can present in subtle and variable ways. Whether or not a genetic lesion can be identified, there are not well understood biomarkers that quantitatively describe how severe a deficiency is. Here we discuss two possible ranking systems, CD4/CD8 T cell ratios and Immune Health Grades, and how such data maybe applicable to some immunodeficiencies.

Behavioral Factors Related to Participation in Remote Blood Pressure Monitoring Among Adults With Hypertension: Cross-Sectional Study.

Background: Remote blood pressure (BP) monitoring (RBPM) or BP telemonitoring is beneficial in hypertension management. People with hypertension involved in telemonitoring of BP often have better BP control than those in usual care. However, most reports on RBPM are from intervention studies.

Inflammatory Markers and Measures of Cardiovascular Autonomic Neuropathy in Type 1 Diabetes.

Background: Cardiovascular autonomic neuropathy (CAN) and inflammation predict more severe outcomes in type 1 diabetes (T1D). However, the link between CAN and inflammation in T1D remains unclear. We examined associations between CAN measures and inflammatory biomarkers in individuals with T1D.

North American clinical practice guidelines for the medical management of hidradenitis suppurativa in special patient populations.

Background: Hidradenitis suppurativa (HS) affects different patient populations that require unique considerations in their management. However, no HS guidelines for these populations exist.

Objective: To provide evidence-based consensus recommendations for patients with HS in 7 special patient populations: (i) pregnancy, (ii) breastfeeding, (iii) pediatrics, (iv) malignancy, (v) tuberculosis infection, (vi) hepatitis B or C infection, and (vii) HIV disease.

The potential of Generative Pre-trained Transformer 4 (GPT-4) to analyse medical notes in three different languages: a retrospective model-evaluation study.

Background: Patient notes contain substantial information but are difficult for computers to analyse due to their unstructured format. Large-language models (LLMs), such as Generative Pre-trained Transformer 4 (GPT-4), have changed our ability to process text, but we do not know how effectively they handle medical notes. We aimed to assess the ability of GPT-4 to answer predefined questions after reading medical notes in three different languages.

Resource Realities: Exploring the Foundations of Successful Implementation in School-Based Drug Prevention.

Background: Comprehensive health education in schools can effectively prevent drug use and related outcomes, but successful implementation remains challenging. Contextual determinants, including intervention-setting compatibility, focus on the intervention, available resources, and leadership support, influence implementation success. This study investigates the impact of multilevel contextual determinants on Michigan Model for Health: (MMH) curriculum fidelity.

A method for the rapid detection of heavy metal mercury ions based on a novel mercury chelator N,N'-bis (2-mercaptoethyl) isophthalamide.

Mercury has caused severe harm to the environment and human health. A novel biological screen method was developed and identified a Hg chelator BDTH2. Both biological and chemical methods demonstrated BDTH2 displayed a high specificity and strong binding capacity for Hg.

Characterizing the Relationships Amongst Psychological Safety, the Learning Environment, and Well-Being in Surgical Faculty and Trainees.

Objective: Learning environments affect the well-being of surgical faculty and trainees. Psychological safety (PS) has been linked with learning behaviors and aspects of well-being within medicine; however, given the unique challenges inherent to the surgical learning environment, there is a need to more closely examine these concepts for surgical faculty and trainees. The objective of this study is to examine the relationships between learning environment and PS, as well as PS and well-being with surgery.

Pancreaticoduodenectomy in trauma patients with grade IV-V duodenal or pancreatic injuries: a post hoc analysis of an EAST multicenter trial.

Introduction: The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries.

Methods: This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020.

Discontinuation of SGLT-2i and GLP-1RA among persons with Type 2 diabetes and atherosclerotic cardiovascular disease treated in US cardiology clinics.

Background: SGLT-2i and GLP-1RA are recommended for persons with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD); for those prescribed, little is known about reasons for discontinuation.

Methods: From the COORDINATE-Diabetes randomized trial database, the frequency and reasons for discontinuation of SGLT2i or GLP-1RA were analyzed.

Results: 1045 participants were enrolled 7/2019 to 5/2022; 290 (27.

SOX2-induced IL1α-mediated immune suppression drives epithelial dysplasia malignant transformation.

Squamous cell carcinomas (SCC) are often preceded by potentially malignant precursor lesions, most of which remain benign. The terminal exhaustion phenotypes of effector T-cells and the accumulation of myeloid-derived suppressor cells (MDSC) have been thoroughly characterized in established SCC. However, it is unclear what precancerous lesions harbor a bona fide high risk for malignant transformation and how precancerous epithelial dysplasia drives the immune system to the point of no return.

Considerations for Measurements of Aggregate PFAS Exposure in Precision Environmental Health.

Per- and polyfluoroalkyl substances (PFAS) have become a major focus of research due to their widespread environmental presence and adverse health effects associated with human exposure. PFAS include legacy and emerging structures and are characterized by a range of functional groups and carbon-fluorine chains that vary in length (from fewer than 3 carbons to more than 7 carbons). Research has linked PFAS exposure to an array of health concerns, ranging from developmental and reproductive disorders to immune system impairments and an increased risk of certain cancers.

Applying Health Systems Science Competencies to Contribute to the COVID-19 Pandemic Response.

In the first quarter of 2020, nearly all U.S. medical schools transitioned to virtual instruction and removed medical students from clinical settings because of the emerging COVID-19 pandemic.

Associations of Body Condition Score, Body Condition Score Change, and Hyperketonemia with Mastitis, Reproduction, and Milk Production.

Body condition score (BCS) and hyperketonemia (HYK) have been associated with diseases, fertility, and culling but data are contradictory about their association with pregnancy loss. Our objective was to conduct a retrospective cohort study to investigate associations between BCS, BCS change (ΔBCS), blood β-hydroxybutyrate (BHB), and HYK with mastitis, pregnancy/artificial insemination (P/AI), pregnancy loss (PGL), milk yield, and risk of leaving the herd on a Michigan dairy farm that uses an automated milking system (AMS). We recorded BCS for cows prepartum (14 d before calving), postpartum (14-21 DIM), and multiparous cows were evaluated for HYK between 3 and 7 DIM.

Proactive Approaches for a Wheelchair User in Pediatric Residency: A Case Study for Disability Inclusion.

Objective: Despite encountering many barriers to inclusion, people with disabilities are entering residency training in increasing numbers. However, the increase in representation among people with physical disabilities remains low and published case studies and accommodations processes for wheelchair users in pediatric residency are absent in the literature. To support the inclusion of residents with physical disabilities in residency, we outline a proactive approach to the accommodations process and inclusion of a resident with a physical disability in pediatric residency.

The association between obesity and efficacy of psoriasis therapies: An expert consensus panel.

Background: Psoriasis is a chronic inflammatory skin disease often associated with obesity. Psoriasis therapies may be less effective in patients with obese. The purpose of this expert consensus panel is to evaluate the relationship between obesity and efficacy of psoriasis therapies, thereby optimizing patient care.

Health System Purchasing Professionals' Approaches to Considering Equity in Procurement.

Background: Continuing data on racial bias in pulse oximeters and artificial intelligence has sparked calls for health systems to drive innovation against racial bias in healthcare device and artificial intelligence markets by incorporating equity concerns explicitly into purchasing decisions.

Research Question: How do healthcare purchasing professionals integrate equity concerns into purchasing decision-making?

Study Design And Methods: Between 8/2023-3/2024, we conducted semi-structured interviews via videoconferencing with healthcare purchasing professionals about purchasing processes for pulse oximeters and other devices-and whether and where equity concerns arise in decision-making. An abductive approach was used to analyze perspectives on how equity and disparity concerns are currently integrated into healthcare purchasing decision-making.

Teaching conflict management to medical students: a randomized controlled trial.

Background: Conflict is an inevitable aspect of healthcare team collaboration. Effective conflict management training can improve the performance of healthcare teams. This study aimed to investigate the effect of conflict management education based on the Fogg model on the attitude of medical students toward conflict management.