Challenges and potential solutions to enrollment in a clinical trial of arteriovenous fistula vs arteriovenous graft vascular access strategy.

This article presents the rationale, challenges, and adaptive strategies employed during the initiation and execution of the arteriovenous (AV) access trial-a multicenter randomized controlled trial (RCT) comparing AV fistulas and AV grafts for hemodialysis in older adults with major comorbidities. Motivated by shifts in epidemiologic landscapes and evolving guidelines moving away from a fistula-first approach and to more patient-centric approaches, the objective of this randomized controlled trial was to fill critical knowledge gaps in determining the optimal vascular access for this complex patient population. We outline the challenges encountered in patient recruitment along with measures employed to overcome these obstacles in recruitment.

Disposition of emergency department patients presenting with angiotensin-converting enzyme inhibitor-induced angioedema.

Background: Angiotensin-converting enzyme inhibitors (ACEI) are the most common cause of drug-induced angioedema in the United States. Our primary objective was to provide descriptive evidence regarding emergency department (ED) disposition of ACEI-induced angioedema patients. Our secondary objective was to evaluate unique patterns in those with ACEI-induced angioedema at a tertiary referral center, including demographics, details of those requiring intubation, length of inpatient stay, and allergy documentation.

Palliative Care Consults in the Southeast: Lower Readmissions Despite Increased Length of Stay.

: Inpatient palliative care (PC) consultations are increasingly used to address operational challenges. We aimed to understand how PC consultations in a southeastern program, affected by pandemic-related care delays, impacted common clinical performance metrics. : This is a retrospective analysis of a tertiary system's adult patients who received PC consultations from December 2021 to August 2022.

Online Marketing of Alternative Medicine for Heart Failure: An Assessment of Amazon.com.

Background: A wide array of products in the category of complementary or alternative medicine products for cardiovascular disease and prevention are readily available on online retail platforms. However, a critical assessment of these products including their therapeutic claims has not been previously performed.

Methods: "Heart failure supplement" and similar terms were entered into the Amazon.

Image-Based Measures of Obesity are Associated with Alterations in Metabolic Pathways in Non-small Cell Lung Cancer.

Background: Studies suggest that the obesity paradox in non-small cell lung cancer (NSCLC) results from the use of body mass index (BMI) as a measure of obesity. However, the mechanistic basis linking body fat and lung cancer behavior remains unclear. We examined the association of image-based measures of obesity with tumor gene expression to identify transcriptional signatures concordant with adiposity and their underlying biology.

Recalibrating Perceptions and Attitudes Toward Nebulizers versus Inhalers for Maintenance Therapy in COPD: Past as Prologue.

Aerosol therapy administered via handheld inhaler or nebulizer device has long been standard for the treatment of chronic obstructive pulmonary disease (COPD), both for maintenance therapy and for management of acute exacerbations. Of the 2 options for drug delivery, inhaler devices are the most widely used for ambulatory patients with COPD as they are small, portable, and convenient and offer an array of medication options. They are, however, prone to suboptimal inhalation technique and use errors, which decrease the amount of medication delivered, compromise efficacy, and adversely affect clinical outcomes.

Outcomes of traumatically injured patients after nighttime transfer from the intensive care unit.

Background: Prior studies have associated nighttime transfer of patients from the intensive care unit (ICU) with increased morbidity. This study sought to examine this relationship in traumatically injured patients, as this has not been previously performed.

Methods: A retrospective review of traumatically injured patients admitted to a Level I Trauma Center's ICU from January 2021 to September 2022 was performed.

Neutrophils enhance the clearance of systemic amyloid deposits in a murine amyloidoma model.

Introduction: Amyloid-specific antibodies have been shown to opsonize and enhance amyloid clearance in systemic amyloidosis mouse models. However, the immunological mechanisms by which amyloid is removed have not been clearly defined. Previous reports from preclinical studies suggest polymorphonuclear cells (, neutrophils) can affect amyloid removal.

Examining HPV vaccination behavior among young adults: Insights from applying the Health Belief Model.

Background: Despite evidence-based recommendations for HPV vaccination, uptake among young adults is suboptimal. Limited research has explored factors that may influence HPV vaccination among young adults, as well as associated promotion and informational preferences in this group. This study aimed to examine factors associated with HPV vaccination among young adults and preferences for HPV vaccine information and promotion.

Effects of the Strong Hearts program at two years post program completion.

Context: This is a follow-up to the original published article, Effects of the Strong Hearts Program after a Major Cardiovascular Event in Patients with Cardiovascular Disease.

Objectives: This study evaluated the long-term efficacy of the Strong Hearts program up to 2 years after program completion.

Methods: All study participants who initially completed the Strong Hearts program between 2020 and 2021 (n=128) were contacted at 12 months and 24 months following the date of program completion.

Electrospun PCL Nerve Wrap Coated with Graphene Oxide Supports Axonal Growth in a Rat Sciatic Nerve Injury Model.

Peripheral nerve injuries (PNIs) are a debilitating problem, resulting in diminished quality of life due to the continued presence of both chronic and acute pain. The current standard of practice for the repair of PNIs larger than 10 mm is the use of autologous nerve grafts. Autologous nerve grafts have limitations that often result in outcomes that are not sufficient to remove motor and sensory impairments.

Prevalence and impact of remote and hybrid work in academic health sciences libraries.

Objective: This study assesses the prevalence, usage, and impact of remote/hybrid work in academic health science libraries in 2022 and 2023. Due to differences in survey distribution, we focus primarily on the results of the second survey.

Methods: Researchers surveyed administrators at Association of Academic Health Sciences Libraries (AAHSL) member libraries in the United States in March 2022 and library staff at academic health sciences libraries in March 2023.

Understanding the Values, Qualities, and Preferences of Patients in Their Relationships With Obstetrics and Gynecology Providers: Cross-Sectional Survey With a Mixed Methods Approach.

Background: The patient-provider relationship in obstetrics and gynecology (OBGYN) is uniquely complex due to the sensitive nature of examinations and topics. Patients often prefer health care providers who share similar racial, ethnic, gender, or linguistic backgrounds, particularly in sensitive health care situations, to improve communication and comfort, though historically, specific gender preferences for OBGYNs have not been evident.

Objective: This study aims to describe the values, qualities, and preferences of patients in their relationships with OBGYN providers.

Tennessee Medicaid patient immediate postpartum long-acting reversible contraception utilization.

Objectives: To understand immediate postpartum long-acting reversible contraception (IPP LARC) desire and utilization trends among publicly insured patients delivering at one academic hospital in a state with health care barriers and high short-interval birth rates.

Study Design: We conducted a retrospective cohort study of electronic delivery records between March 2018 and June 2023 for publicly insured patients. Patient demographics, IPP LARC desire and utilization trends were compared using χ or Fisher exact tests.

A Comparison of Rural and Urban Differences in Geographic Proximity to Outpatient Stroke Rehabilitation Services in Tennessee.

Purpose: Great travel distances and long travel times can be barriers to outpatient stroke rehabilitation services (OSR) receipt, but there is limited information on differences in proximity to specific OSR services between urban and potentially medically underserved rural areas. Accordingly, we compared travel distance and time to the nearest service for different OSR services between rural and urban counties in Tennessee.

Methods: We conducted data scraping on Google Maps to locate Tennessee facilities offering any of the 13 American Heart Association recognized OSR services.

Relacorilant plus nab-paclitaxel for the treatment of metastatic pancreatic ductal adenocarcinoma: results from the open-label RELIANT study.

Background: Modulation of glucocorticoid receptor (GR) activity in tumor cells enhances chemotherapy efficacy. We evaluated the selective GR modulator relacorilant plus nab-paclitaxel in patients with metastatic pancreatic ductal adenocarcinoma (mPDAC) who had received at least 2 prior therapy lines.

Patients And Methods: In this open-label, single-arm, phase III study, patients received once-daily oral relacorilant (100 mg, titrated to 150 mg in 25 mg increments/cycle) and nab-paclitaxel (80 mg/m2) on days 1, 8, and 15 of 28-day cycles.

Glucagon-like peptide-1 (GLP-1) receptor agonists for weight management: A review for the gynecologic oncologist.

The use of glucagon-like peptide-1 receptor agonists (GLP-1RA) has experienced rapid growth amidst the obesity epidemic in the United States. While originally developed for glucose control in Type 2 Diabetes Mellitus, the scope of these agents now extends to encompass weight loss and cardiovascular risk reduction. GLP-1RAs have the potential to induce significant weight loss, in combination with lifestyle modifications, among adults who are overweight or obese.