The impact of surprise billing laws on hospital-based physician prices and network participation.

Prior to the No Surprises Act (NSA), numerous states passed laws protecting patients from surprise medical bills from out-of-network (OON) hospital-based physicians supporting elective treatment in in-network hospitals. Even in non-emergency situations, patients have little ability to choose physicians such as anaesthesiologists, pathologists or radiologists. Using a comprehensive, multi-payer claims database, we estimated the effect of these laws on hospital-based physician reimbursement, charges, network participation and potential surprise billing episodes.

Daily glucose variability is associated with intrahepatic fat content, β cell sensitivity, and biomarkers of glycolysis in youth with obesity.

Objective: Pediatric obesity is associated with insulin resistance, which, in turn, impacts glucose and lipid metabolism. This study sought to assess how glucose variability relates to intrahepatic fat content, β cell insulin sensitivity, and glycolysis in youth with obesity.

Methods: A total of 27 youth with obesity (11 girls, BMI percentile, median [25th-75th percentiles]: 99.

Outcomes Following Fecal Diversion for Intractable Hirschsprung Associated Enterocolitis: A Study From the Pediatric Colorectal and Pelvic Learning Consortium.

Background: Hirschsprung associated enterocolitis (HAEC) is a challenging problem in a subset of children with Hirschsprung disease (HD). In refractory cases, fecal diversion may be required. The aim of this study was to characterize patients who require fecal diversion for HAEC management and examine their long-term outcomes.

Pediatric Obesity Treatment: Considerations for Diabetes Educators and Clinicians.

Prevalence rates of pediatric obesity and diabetes are rising, and pediatric health care professionals are ideally situated to address these chronic diseases using a patient- and family-centered approach. This article reviews key elements of evaluation that can inform treatment and emphasizes a comprehensive, team-based strategy. Treatment begins with motivational interviewing and building a foundation of intensive health behavior and lifestyle treatment, followed by pharmacotherapy and metabolic and bariatric surgery, when indicated.

Selective nitric oxide redistribution by phospholipid nanoparticles: A novel strategy to mitigate massive nitric oxide release and prevent reperfusion injury in septic shock.

Nitric oxide plays a critical role in regulating vascular tone, but excessive nitric oxide release during septic shock results in hypotension due to excessive vasodilation and the formation of toxic free radicals. VBI-S is a phospholipid nanoparticle based fluid composed of lipid bilayers formed primarily by phosphatidylcholine and micelles of soybean oil encapsulated by a monolayer of phosphatidylcholine. These nanoparticles offer a novel solution by absorbing and redistributing nitric oxide and nitrite, potentially mitigating the harmful effects of excessive nitric oxide in sepsis.

Understanding and addressing mental health challenges of families admitted to the neonatal intensive care unit.

This article reviews the psychological distress experienced by NICU families, including anxiety, postpartum depression (PPD), and post-traumatic stress disorder (PTSD), in addition to providing recommendations for clinicians at the individual, institutional, and national level. Currently, mental health screenings, specialized evaluations, and treatment options are not routinely offered to NICU families and are frequently under-utilized when offered. Here we provide expert opinion recommendations to address challenges in supporting universal screening, offering bedside interventions, including trained mental health professionals in care plans, updating neonatology training competencies, and advocating for policies that support the mental health of NICU families.

Rationale and design of the PE-TRACT trial: A multicenter randomized trial to evaluate catheter-directed therapy for the treatment of intermediate-risk pulmonary embolism.

Background: The optimal management of patients with intermediate-risk pulmonary embolism (PE), who have right heart dysfunction (determined by a combination of imaging and cardiac biomarkers) but a normal blood pressure, is uncertain. These patients suffer from reduced functional capacity and a lower quality of life over the long-term, despite use of anticoagulant therapy. Catheter-directed therapy (CDT) is a promising treatment for acute PE that rapidly removes thrombus and potentially improves cardiac dysfunction.

Neuroimaging markers and disability scales in multiple sclerosis: A systematic review and meta-analysis.

Background: Multiple sclerosis (MS) is a central nervous system disorder marked by progressive neurological impairments. Magnetic resonance imaging (MRI) parameters are key paraclinical measures that play a crucial role in the diagnosis, prognosis, and monitoring of MS-related disability. This study aims to analyze and summarize the existing literature on the correlation between MRI parameters and disability in people with MS (pwMS).

Association of Plasma Omega-3 Levels With Incident Heart Failure and Related Mortalities.

Objective: To investigate the association between plasma omega-3 levels and incident heart failure (HF) and to examine their relationship with total and cardiovascular (CV) mortality among patients with preexisting HF.

Patients And Methods: The UK Biobank is an ongoing prospective cohort study of individuals recruited in the United Kingdom between April 1, 2007, and December 31. 2010.

Neural substrates of alerting dysfunction in females with Multiple Sclerosis.

MS is a disease characterised by demyelination of the central nervous system resulting in decreased quality of life, increased anxiety, depression, fatigue, and cognitive dysfunction. Attention is frequently impaired in MS. A previous study demonstrated impairment specifically in the attentional alerting domain.

Disaster Preparedness Intervention for Older Adults (Seniors' Positive Involvement in Community Emergencies): Protocol for a Quasi-Experimental Study.

Background: Older adults comprise a substantial proportion of the US population requiring support during disaster events. Previous research demonstrates that older adults are resilient but deficient in disaster preparedness and lacking in community engagement. There is a gap in high-quality research in this area.

A Comparison of the 2022 Versus 2011 National Institute of Child Health and Human Development Web-Based Risk Estimator for Bronchopulmonary Dysplasia.

Objective: To compare the predictive accuracy of the 2022 vs 2011 National Institute of Child Health and Human Development estimator for identifying infants at high risk for bronchopulmonary dysplasia (BPD).

Methods: We conducted a single-center retrospective study of infants ≤28 weeks' gestation. Demographic and respiratory support data were used to calculate risk for BPD or death by the BPD estimators.

Early Palliative Care in the Emergency Department: A Concept Clarification.

Introduction: : Healthcare advances have contributed to patients living longer with chronic illnesses and diseases with uncertain trajectories impacting quality of life (QOL). Palliative care (PC) is no longer only for dying oncology patients as many healthcare practitioners have adopted the PC concept in diverse care settings and the timing of PC implementation remains ambiguous. There is a need to develop an operational definition of early palliative care (EPC) by clarifying the phenomenon and bridging concepts with empirical data to develop and test possible interventions before integrating EPC into emergency care (EC).

Sociodemographic differences in treatment of acute respiratory infections in pediatric urgent cares.

Objective: To determine whether differences exist in antibiotic prescribing for respiratory infections in pediatric urgent cares (PUCs) by patient race/ethnicity, insurance, and language.

Design: Multi-center cohort study.

Setting: Nine organizations (92 locations) from 22 states and Washington, DC.

Comparative Analysis of Large Language Models and Spine Surgeons in Surgical Decision-Making and Radiological Assessment for Spine Pathologies.

Objective: This study aimed to investigate the accuracy of large language models (LLMs), specifically ChatGPT and Claude, in surgical decision-making and radiological assessment for spine pathologies compared to experienced spine surgeons.

Methods: The study employed a comparative analysis between the LLMs and a panel of attending spine surgeons. Five written clinical scenarios encompassing various spine pathologies were presented to the LLMs and surgeons, who provided recommended surgical treatment plans.

Prophylactic Vancomycin Leads to Fewer Device Removals in Sacral Neuromodulation.

Importance: Sacral neuromodulation (SNM) requires removal for infectious complications in 3-11%.

Objective: The objective of this study was to examine the effect of preoperative antibiotic choice on all-cause SNM device removal rates.

Study Design: This was a retrospective cohort analysis, using the Health Facts Database, representing more than 750 hospitals.

Omega-3 and Risk of atrial fibrillation: Vagally-mediated double-edged sword.

Objective: Studies regarding effects of omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on risk of atrial fibrillation (AF) have reported discordant results. The aim of this review is to clarify effects of marine omega-3 intake on risk of AF.

Patients And Methods: A PubMed search was performed using terms: atrial fibrillation, omega-3, EPA, DHA, vagal tone.