Multimodal Therapy May be Key to Improving Survival for Octogenarians Undergoing Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma: An American Multicenter Analysis.

Background: As the population ages, the number of octogenarians with pancreatic ductal adenocarcinoma (PDAC) continues to rise. Morbidity and mortality following pancreatectomy have improved owing to safer surgery and better chemoradiation regimens. This study compares the outcomes and multimodality utilization in octogenarians (≥80 years) who underwent pancreaticoduodenectomy (PD) for PDAC, with a younger cohort.

Supporting Unhealthy Substance use care Through a whole person Approach and user centered INtegration into primary care (SUSTAIN): Study protocol for a type 2 hybrid effectiveness-implementation trial.

Background: Unhealthy substance use (USU) is common and ranges from use above guideline-recommended levels to severe substance use disorder. USU results in substantial morbidity and mortality yet primary care practices rarely systematically screen, diagnose, and treat USU. Supporting Unhealthy Substance use care Through a whole person Approach and user centered INtegration into primary care (SUSTAIN) tests whether the implementation of a co-designed change package for USU improves patient function.

Functional independence trajectories over 5 years in older veterans with traumatic brain injury: A model systems study.

Background: Research on older adults who sustain a traumatic brain injury (TBI) has predominantly been on civilian, nonveteran populations. Military populations experience higher rates of TBI and often experience the additive effects of TBI and other comorbid disorders, including posttraumatic stress disorder and/or substance use that may increase disability over time.

Objective: To investigate predictors of functional independence trajectories over the 5 years after TBI in veterans 55 years or older at injury.

Genetic Services in Appalachia Conference Series.

This study examined the data generated as part of a seven-session webinar series that focused on genetics care provision in the medically underserved, rural Appalachian region and examined how these services have adapted to challenging practice environments. Barriers and facilitators to care in our region were considered. Data included a baseline survey of registrants, transcripts of sessions, and feedback about sessions.

"No Matter the Age or Medical Complexity, People Benefit From That Intensity of Exercise": A Mixed-Methods Study Describing Rehabilitation Provider Perceptions of High-Intensity Resistance Training Among Veterans Receiving Post-Acute Care.

Background: In skilled nursing facilities (SNFs), i-STRONGER is a novel, high-intensity resistance training approach that incorporates progressive resistance training to promote greater improvements in patient function compared to usual care. To inform large-scale expansion of i-STRONGER as standard-of-care in SNFs, this mixed-methods study assessed rehabilitation providers' perceptions of i-STRONGER and purported needs for its adoption.

Methods: Forty-three rehabilitation providers participated in an 18-week, interactive i-STRONGER training program.

Predicting the impact of targeted fence removal on connectivity in a migratory ecosystem.

Fencing is one of the most widely utilized tools for reducing human-wildlife conflict in agricultural landscapes. However, the increasing global footprint of fencing exceeds millions of kilometers and has unintended consequences for wildlife, including habitat fragmentation, movement restriction, entanglement, and mortality. Here, we present a novel and quantitative approach to prioritize fence removal within historic migratory pathways of white-bearded wildebeest (Connochaetes taurinus) across Kenya's Greater Masai Mara Ecosystem.

De Quervain's Tenosynovitis Virally Exacerbated by SARS-CoV-2 and Influenza Infections: A Case Report.

We present the case of a fully vaccinated 39-year-old male with no pertinent past medical history who initially presented with De Quervain's tenosynovitis which was successfully treated with a corticosteroid injection. His symptoms recurred during a COVID-19 infection, which was treated with a repeat corticosteroid injection. Symptoms recurred during an influenza infection and were subsequently treated with a first dorsal compartment release.

Empowerment through knowledge: Qualitative perceptions of 'undetectable equals Untransmittable' among people living with HIV and tuberculosis in South Africa.

Introduction: Undetectable equals untransmittable (U=U) is an education campaign promoting science that people living with human immunodeficiency virus (HIV) who maintain an undetectable viral load cannot transmit HIV to others. Researchers theorize that undetectable equals untransmittable messaging will decrease HIV stigma by reducing fears of HIV transmission and providing evidence to dismantle discriminatory policies. However, little is known about how people with HIV in South Africa interpret the results of their viral load tests, undetectable equals untransmittable messaging, or its impact on stigma.

Real World Evidence From 2 Decades of First-Line TKI Therapy in Chronic Myeloid Leukemia (CML): Insights From ACHO's RENEHOC Registry.

Background: Chronic myeloid leukemia (CML) treatment has significantly evolved with the introduction of tyrosine kinase inhibitors. However, access to these treatments and outcomes vary globally. This study examines 2 decades of CML management in Colombia using the RENEHOC registry, focusing on TKI efficacy, safety, and healthcare system challenges.

MicroRNA Expression Profile in Acute Ischemic Stroke.

Acute ischemic stroke with large vessel occlusion (LVO) continues to present a considerable challenge to global health, marked by substantial morbidity and mortality rates. Although definitive diagnostic markers exist in the form of neuroimaging, their expense, limited availability, and potential for diagnostic delay can often result in missed opportunities for life-saving interventions. Despite several past attempts, research efforts to date have been fraught with challenges likely due to multiple factors, such as the inclusion of diverse stroke types, variable onset intervals, differing pathobiologies, and a range of infarct sizes, all contributing to inconsistent circulating biomarker levels.

Reducing catheter-associated urinary tract infections with sterile, continuously closed drainage systems does not have to be costly.

Introduction: Catheter-associated urinary tract infections (CAUTIs) cause significant morbidity and financial strain in the pediatric intensive care unit (PICU). There is a significant incentive to reduce the rate of CAUTIs through multimodal quality improvement initiatives; however, these initiatives are often costly to implement.

Objective: This article examines the cost-savings associated with a novel "two-part, two-person" catheter insertion protocol implemented at a pediatric quaternary care center PICU which replaced costly pre-packaged, closed system urinary catheter kits with their individually packaged components, along with its impact on CAUTI rates and nursing satisfaction.

One hundred thirty-four germ line PU.1 variants and the agammaglobulinemic patients carrying them.

Leukopoiesis is lethally arrested in mice lacking the master transcriptional regulator PU.1. Depending on the animal model, subtotal PU.

Long-Term Family Needs After a Traumatic Brain Injury: A VA TBI Model Systems Study.

Objective: To describe the self-reported needs of family caregivers of service members and veterans (SMVs) with traumatic brain injury (TBI) at 10 to 15 years post-injury and to identify unique predictors of unmet family needs.

Setting: Five Department of Veterans Affairs Polytrauma Rehabilitation Centers.

Participants: A total of 209 family caregivers of SMVs with TBI from the VA TBI Model Systems national database who completed a 10- or 15-year follow-up assessment.

The Rise of Pluripotent Stem Cell-Derived Glia Models of Neuroinflammation.

Neuroinflammation is a blanket term that describes the body's complex inflammatory response in the central nervous system (CNS). It encompasses a phenotype shift to a proinflammatory state, the release of cytokines, the recruitment of peripheral immune cells, and a wide variety of other processes. Neuroinflammation has been implicated in nearly every major CNS disease ranging from Alzheimer's disease to brain cancer.

Reverse Shoulder Arthroplasty Baseplate Stability Is Affected by Bone Density and the Type and Amount of Augmentation.

Objective: This study evaluated the effects of bony increased offset (BIO) and metallic augments (MAs) on primary reverse shoulder arthroplasty (RSA) baseplate stability in cadaveric specimens with variable bone densities.

Methods: Thirty cadaveric specimens were analyzed in an imaging and biomechanical investigation. Computed tomography (CT) scans allowed for preoperative RSA planning and bone density analysis.

The case for value-based care in kidney transplantation: insights into geography, growth, and financial models.

Purpose Of Review: Kidney transplantation (KT) is the preferred treatment for end-stage renal disease (ESRD), yet systemic challenges, including geographic disparities, impede equitable access. This review evaluates transplant center activity and regional disparities using recent trends and discusses the potential of value-based care (VBC) models like the proposed Increasing Organ Transplant Access (IOTA) model to address these challenges.

Recent Findings: Analysis of Organ Procurement and Transplantation Network (OPTN) data from 2021 to 2023 identified 185 of 322 transplant centers as potentially eligible for VBC inclusion.

A longitudinal, multimodal palliative care curriculum for obstetrics and gynecology residents.

Objectives: To incorporate a longitudinal palliative care curriculum into obstetrics and gynecology (Ob-Gyn) residency that could become standardized to ensure competencies in providing end of life (EOL) care.

Methods: This was a prospective cohort study conducted among 23 Ob-Gyn residents at a tertiary training hospital from 2021 to 2022. A curriculum intervention was provided via lecture and simulation.

Post-Traumatic Stress Across Color Lines: A History of Anti-Black Exclusion & PTSD.

Black Americans with Posttraumatic Stress Disorder have less access to mental healthcare compared to White Americans. Many factors contribute to this inequity, including broader disparities within the healthcare system driven by systemic racism, and an underutilization of mental health services by Black Americans due to provider bias and stigma around mental health care. These disparities are rooted in a racist historical context of exclusion and abuse of the Black community by the White psychiatric establishment, and a perpetration of further trauma on Black clients, a context that is largely missing from traditional mental health education and literature on Black mental health today.

Development and Implementation of Oral Anticancer Agent Tools for a Thematic Quality Improvement Program: A Collaboration Between Hematology Oncology Pharmacist Association and ASCO Quality Training Program.

Purpose: The Hematology Oncology Pharmacist Association Oral Chemotherapy Collaborative (HOPA OCC) developed practice-based tools to use in program development and improvement for the management of patients receiving oral anticancer agents (OAAs).

Methods: These tools include a baseline OAA program assessment, clinical OAA adherence tool, and OAA dashboard. HOPA OCC distributed these tools to teams participating in the 6-month HOPA ASCO Quality Training Programs (QTPs).

High-grade liver injury: outcomes with a trauma surgery-liver surgery collaborative approach.

Background: Operative mortality for high-grade liver injury (HGLI) remains 42% to 66%, with near-universal mortality after retrohepatic caval injury. The objective of this study was to evaluate mortality and complications of operative and nonoperative management (OM and NOM) of HGLI at our institution, characterized by a trauma surgery-liver surgery collaborative approach to trauma care.

Methods: This was an observational cohort study of adult patients (age ≥16) with HGLI (The American Association for Surgery of Trauma (AAST) grades IV and V) admitted to an urban level I trauma center from January 2010 to November 2021.

Corrigendum: Combining Charlson comorbidity and VACS indices improves prognostic accuracy for all-cause mortality for patients with and without HIV in the Veterans Health Administration.

[This corrects the article DOI: 10.3389/fmed.2023.

Original Research: Nurses' Perceptions of the Role of Nursing Organizations in Promoting Engagement with the Sustainable Development Goals: A Global Study.

Background: RNs are integral to achieving the United Nations' 17 Sustainable Development Goals (SDGs). Professional nursing organizations can play a significant role in educating and preparing nurses to work more effectively toward achieving the SDGs. While there is much literature that speaks to the importance of nurses engaging in these goals, there is a lack of research that has explored nurses' perceptions of the role of professional nursing organizations in promoting SDG-related knowledge and engagement.

Genomics yields biological and phenotypic insights into bipolar disorder.

Bipolar disorder is a leading contributor to the global burden of disease. Despite high heritability (60-80%), the majority of the underlying genetic determinants remain unknown. We analysed data from participants of European, East Asian, African American and Latino ancestries (n = 158,036 cases with bipolar disorder, 2.