Screening and Referral for Social Needs Among Veterans: A Randomized Controlled Trial.

Background: Healthcare-based social need screening and referral (S&R) among adult populations has produced equivocal results regarding social need resource connection.

Objective: Assess the efficacy of S&R on resource connection (primary outcome) and unmet need reduction (secondary outcome).

Design: Intention-to-treat randomized controlled trial.

Performance of Radiomics-based machine learning and deep learning-based methods in the prediction of tumor grade in meningioma: a systematic review and meta-analysis.

Currently, the World Health Organization (WHO) grade of meningiomas is determined based on the biopsy results. Therefore, accurate non-invasive preoperative grading could significantly improve treatment planning and patient outcomes. Considering recent advances in machine learning (ML) and deep learning (DL), this meta-analysis aimed to evaluate the performance of these models in predicting the WHO meningioma grade using imaging data.

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.

The efficacy and safety of Bevacizumab-based treatments in Optic Pathway Glioma among pediatric population: a systematic review and meta-analysis.

The optimal therapeutic intervention for pediatrics with optic pathway glioma (OPG) remained controversial in the literature. Recently, due to substantial adverse events (AEs) of chemotherapy and its impact on children's lives, the efficacy of other options has been investigated. Bevacizumab (BVZ) is an anti-vascular endothelial growth factor (VEGF) agent that alters the lesion microenvironment.

C. neoformans meningitis without pleocytosis, hyperproteinorrachia, and hypoglycorrhachia on cerebrospinal fluid studies.

Diagnosis of cryptococcal meningitis is typically aided through CSF analysis obtained via lumbar puncture (LP), revealing elevated WBCs, increased protein, decreased glucose, and increased opening pressure. While CSF culture confirms the diagnosis, it takes days, prompting reliance on these adjuncts. AIDS from Human Immunodeficiency Virus is less commonly diagnosed in the emergency setting due to advances in testing and treatment.

Malperfusion in Patients with Acute Type A Aortic Dissection: A Nationwide Analysis.

Background: This study describes in detail the clinical burden of malperfusion associated with acute Type A aortic dissection (ATAAD) in a large, national cohort and the effect of treatment strategy on outcomes.

Methods: All patients undergoing repair of ATAAD between 2017 and 2020 in the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database were studied. Malperfusion was defined using STS definitions based on imaging or surgeon's evaluation.

Risk of bias assessment tools often addressed items not related to risk of bias and used numerical scores.

Objective: We aimed to determine whether the existing risk of bias assessment tools addressed constructs other than risk of bias or internal validity, and whether they used numerical scores to express quality, which is discouraged and may be a misleading approach.

Methods: We searched Ovid MEDLINE and Embase to identify quality appraisal tools across all disciplines in human health research. Tools designed specifically to evaluate reporting quality were excluded.

Association between adverse perinatal events and postpartum depressive symptoms in a North American prospective preconception cohort study.

Background: Identifying risk factors for postpartum depression (PPD) is critical to inform early intervention efforts. This study investigated the impact of adverse perinatal events on PPD.

Methods: We analyzed data from the Pregnancy Study Online (PRESTO), a North American prospective preconception cohort study.

Wound Healing in Older Adults After Major Lower Extremity Amputation.

Introduction: The higher prevalence of multiple chronic conditions and frailty among older adults may increase the physiologic demand required for wound healing after a major lower extremity amputation (LEA). After below knee amputations (BKA), patients generally have improved prosthetic fitting rates, postoperative ambulation, and quality of life compared to an above knee amputation (AKA). However, the benefit of a BKA must be weighed against the risk of wound complications.

Comparing gestational carrier to uterine transplantation in uterine-factor infertility: a cost-effectiveness analysis.

Objective: To compare the cost-effectiveness of a gestational carrier to a uterine transplantation in the treatment of absolute uterine-factor infertility.

Design: We performed a cost-effectiveness analysis using a decision-tree mathematical model comparing a gestational carrier to a uterine transplantation.

Subjects: Published literature was used to derive costs for solid organ transplant, immunosuppression, gestational carrier obtainment, in vitro fertilization, preimplantation genetic testing, and frozen embryo transfer.

The association between county-level social determinants of health and cardio-kidney-metabolic disease attributed all-cause mortality in the US: A cross sectional analysis.

Background: The American Heart Association recently defined cardio-kidney-metabolic (CKM) syndrome as the intersection between metabolic, renal, and cardiovascular disease. Understanding the contemporary estimates of CKM related mortality in the US is essential for developing targeted public interventions.

Methods: We analyzed state-level and county-level CKM-associated all-cause mortality data (2010-2019) from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER).

Respiratory syncytial virus vaccine effectiveness among US veterans, September, 2023 to March, 2024: a target trial emulation study.

Background: New respiratory syncytial virus (RSV) vaccines have been approved in the USA for the prevention of RSV-associated lower respiratory tract disease in adults aged 60 years and older. Information on the real-world effectiveness of these vaccines is needed.

Methods: We used electronic health records in the Veterans Health Administration to emulate a target trial comparing a single dose of a recombinant stabilised prefusion F protein RSV vaccine versus no vaccination among veterans aged 60 years and older.

The bidirectional relationship between pain and tobacco use: Insights from the longitudinal Population Assessment of Tobacco and Health (PATH) study.

Background: Tobacco smoking remains the leading preventable cause of death, whereas chronic pain is the leading cause of disability. Chronic pain and tobacco smoking are closely interrelated. We investigated whether pain predicts daily cigarette smoking and if daily cigarette smoking predicts the development of pain.

Fluid fluctuations assessed with artificial intelligence during the maintenance phase impact anti-vascular endothelial growth factor visual outcomes in a multicentre, routine clinical care national age-related macular degeneration database.

Aim: To evaluate the impact of fluid volume fluctuations quantified with artificial intelligence in optical coherence tomography scans during the maintenance phase and visual outcomes at 12 and 24 months in a real-world, multicentre, national cohort of treatment-naïve neovascular age-related macular degeneration (nAMD) eyes.

Methods: Demographics, visual acuity (VA) and number of injections were collected using the Fight Retinal Blindness tool. Intraretinal fluid (IRF), subretinal fluid (SRF), pigment epithelial detachment (PED), total fluid (TF) and central subfield thickness (CST) were quantified using the RetinAI Discovery tool.

Does routine use of sporicidal disinfectants for all post-discharge hospital rooms reduce environmental contamination with Clostridioides difficile spores?

In a culture survey of 30 U.S. hospitals, rates of Clostridioides difficile spore contamination after cleaning and disinfection of non-C.

Staffing Paradigm for Infection Prevention and Control in the Era of Antimicrobial Resistance: the Veterans Health Administration Experience.

Antimicrobial resistance and other emerging healthcare complexities continue to challenge infection prevention and control (IPC) resources. The Veterans Health Administration developed a comprehensive prevention approach to address multidrug-resistant organisms (MDROs), including a unique staffing model to complement infection preventionists. In particular, the MDRO Prevention Coordinator was established to support MDRO prevention initiatives.

Cancellations in primary care in the Veterans Affairs Health Care System.

Objectives: Unused medical appointments affect both patient care and clinic operations, and the frequency of cancellations due to clinic reasons is underreported. The prevalence of these unused appointments in primary care in the Veterans Affairs Health Care System (VA) is unknown. This study examined the prevalence of unused primary care appointments and compared the relative frequency of cancellations and no-shows for patient and clinic reasons.

How Health Systems World-wide Fail Type 2 Diabetics.

For over 50 years, health systems the world over have failed people with type 2 diabetes mellitus (T2DM). The WHO documents a quadrupling of people with diabetes in a 34-year period to 422 million in 2014, the overwhelming majority of whom were T2DM. This happened despite extensive scientific literature on the causes of, as well as proven treatments for, this disease.

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).

Variable impacts of land-based climate mitigation on habitat area for vertebrate diversity.

Pathways to achieving net zero carbon emissions commonly involve deploying reforestation, afforestation, and bioenergy crops across millions of hectares of land. It is often assumed that by helping to mitigate climate change, these strategies indirectly benefit biodiversity. Here, we modeled the climate and habitat requirements of 14,234 vertebrate species and show that the impact of these strategies on species' habitat area tends not to arise through climate mitigation, but rather through habitat conversion.