Precision Medicine for Pulmonary Vascular Disease: The Future Is Now (2023 Grover Conference Series).

Pulmonary vascular disease is not a single condition; rather it can accompany a variety of pathologies that impact the pulmonary vasculature. Applying precision medicine strategies to better phenotype, diagnose, monitor, and treat pulmonary vascular disease is increasingly possible with the growing accessibility of powerful clinical and research tools. Nevertheless, challenges exist in implementing these tools to optimal effect.

Shared Medical Appointments in Heart Failure for Post Acute Care Follow-Up: A Randomized Controlled Trial.

Background: Shared medical appointments (SMAs) in heart failure (HF) are medical visits where several patients with HF meet with multidisciplinary providers at the same time for efficient and comprehensive care. It is unknown whether HF-SMAs can improve overall and cardiac health status for high-risk patients with HF discharged from acute care.

Methods And Results: A 3-site, open-label, randomized-controlled-trial was conducted.

Reduced exercise capacity occurs before intrinsic skeletal muscle dysfunction in experimental rat models of pulmonary hypertension.

Reduced exercise capacity in pulmonary hypertension (PH) significantly impacts quality of life. However, the cause of reduced exercise capacity in PH remains unclear. The objective of this study was to investigate whether intrinsic skeletal muscle changes are causative in reduced exercise capacity in PH using preclinical PH rat models with different PH severity.

Statistical harmonization of everyday functioning and dementia-related behavioral measures across nine surveys and trials.

Introduction: Efforts to harmonize measures of everyday function and dementia-related behaviors are needed to synthesize across studies in dementia research. There have been some psychometric attempts to harmonize everyday function for secondary analysis, but far less for dementia-related behaviors.

Methods: Statistical co-calibration was performed to generate factor scores representing everyday function and dementia-related behaviors for participants with dementia.

Development of a rehabilitation researcher survey of knowledge and interest in learning health systems research.

Introduction: LeaRRn, an NIH-funded rehabilitation resource center, is dedicated to developing learning health systems (LHS) research competencies within the rehabilitation community. To appropriately target resources and training opportunities for rehabilitation researchers, we developed and pilot tested a survey based on AHRQ LHS research core competencies to assess the training needs of rehabilitation researchers interested in LHS research.

Methods: Survey items were developed by the investigative team and iteratively refined with the assistance of an expert panel using two rounds of content validation.

Age at Diagnosis of Heart Failure in United States Veterans With and Without HIV Infection.

Background Although HIV is associated with increased risk of heart failure (HF), it is not known if people living with HIV develop HF at a younger age compared with individuals without HIV. Crude comparisons of age at diagnosis of HF between individuals with and without HIV does not account for differences in underlying age structures between the populations. Methods and Results We used Veterans Health Administration data to compare the age at HF diagnosis between veterans with and without HIV, with adjustment for difference in population age structure.

Palliative Care Consultation Reduces Heart Failure Transitions: A Matched Analysis.

Background Palliative care supports quality of life, symptom control, and goal setting in heart failure (HF) patients. Unlike hospice, palliative care does not restrict life-prolonging therapy. This study examined the association between palliative care during hospitalization for HF on the subsequent transitions and procedures.

Gender Differences in Risk Factors Associated With Pulmonary Artery Systolic Pressure, Heart Failure, and Mortality in Blacks: Jackson Heart Study.

Background Pulmonary hypertension is prevalent in black individuals, especially women. Elevated pulmonary artery systolic pressure (PASP) is associated with significant morbidity and mortality. Methods and Results We developed linear and proportional hazards models to examine potential gender-related differences in risk factors for elevated PASP (estimated by transthoracic echocardiography) and PASP-associated clinical outcomes (incident heart failure admissions and mortality) in JHS (Jackson Heart Study) participants.

Association between risk factors and detection of cutaneous melanoma in the setting of a population-based skin cancer screening.

Early detection is considered to improve the prognosis of cutaneous melanoma. The value of population-based screening for melanoma, however, is still controversial. The aim of this study was to evaluate the predictive power of established risk factors in the setting of a population-based screening and to provide empirical evidence for potential risk stratifications.

Transcranial direct current stimulation may modulate extinction memory in posttraumatic stress disorder.

Background: Abnormalities in fear extinction and recall are core components of posttraumatic stress disorder (PTSD). Data from animal and human studies point to a role of the ventromedial prefrontal cortex (vmPFC) in extinction learning and subsequent retention of extinction memories. Given the increasing interest in developing noninvasive brain stimulation protocols for psychopathology treatment, we piloted whether transcranial direct current stimulation (tDCS) during extinction learning, vs.

Trends of keratinocyte carcinoma mortality rates in the United States as reported on death certificates, 1999 through 2010.

Background: From 1969 to 1998, keratinocyte carcinoma (KC) mortality rates declined as reported on death certificates, despite increasing incidence of KC.

Objective: To estimate KC mortality trends from 1999 to 2010 in the United States.

Methods: Descriptive and linear regression analysis using population-based death certificate data from the US National Center for Health Statistics.

Non-melanoma skin cancer incidence and impact of skin cancer screening on incidence.

Non-melanoma skin cancer (NMSC) is the most common malignancy, whose public health significance is often unrecognized. This analysis has two objectives: first, to provide up-to-date incidence estimates by sex, age group, histological type, and body site; and second, to study the impact of skin cancer screening. The impact of screening on NMSC incidence in Schleswig-Holstein, Germany, is analyzed by comparing four time periods of different screening settings (no screening (1998-2000), pilot project (Skin Cancer Research to Provide Evidence for Effectiveness of Screening in Northern Germany, SCREEN, 2003-2004), after SCREEN (2004-2008), and nation-wide skin cancer screening (2008-2010)) to a reference region (Saarland, Germany).

Predictors of basal cell carcinoma in high-risk patients in the VATTC (VA Topical Tretinoin Chemoprevention) trial.

Basal cell carcinoma (BCC) is the most common cancer in the United States today, and patients who have had one are likely to have multiple carcinomas over time. Predictors of new BCCs on the face and ears among those at very high risk have not been studied in detail. We sought to do so prospectively in the context of a 6-year trial.

Melanoma early detection with thorough skin self-examination: the "Check It Out" randomized trial.

Background: Monthly thorough skin self-examination (TSSE) is an important practice for early melanoma detection that is performed by a small minority of the population.

Design: A randomized trial was conducted to determine whether a multicomponent intervention can increase TSSE performance and to describe the effects on performance of skin surgeries compared with a similar control intervention focused on diet.

Setting/participants: One thousand three hundred fifty-six patients attending a routine primary care visit in southeastern New England participated in this trial.