Impact of Expanded Eligibility for Veterans With Other Than Honorable Discharges on Treatment Courts and VA Mental Health Care.

Background: US Department of Veterans Affairs (VA) eligibility policies now allow comprehensive mental and behavioral health care services to be provided to veterans who received an Other Than Honorable (OTH) discharge upon separation from service. Research has shown a disproportionate mental health burden and elevated rates of criminal-legal involvement among these veterans. Eligibility policy shifts may impact programs and services designed to support veterans with criminal-legal involvement, such as veterans treatment courts.

Initial clinical experience with [Lu]Lu-PNT2002 radioligand therapy in metastatic castration-resistant prostate cancer: dosimetry, safety, and efficacy from the lead-in cohort of the SPLASH trial.

Introduction: SPLASH (NCT04647526) is a multicenter phase III trial evaluating the efficacy and safety of [Lu]Lu-PNT2002 radioligand therapy in metastatic castration-resistant prostate cancer (mCRPC). This study leveraged a lead-in phase to assess tissue dosimetry and evaluate preliminary safety and efficacy, prior to expansion into a randomized phase. Here we report those results.

Histopathology of incidental non-neoplastic findings in transgenic CByB6F1-Tg(HRAS)2Jic mice used in toxicity studies.

This technical report presents a collection of illustrative images and concise descriptions of non-neoplastic microscopic findings noted in transgenic CByB6F1-Tg(HRAS)2Jic (Tg.rasH2) mice from 26-week-carcinogenicity studies. A unique finding in the Tg.

A Group Approach to Clinical Research Mentorship at a Veterans Affairs Medical Center.

Background: The US Department of Veterans Affairs (VA) is committed to conducting research that improves the health and quality of life of veterans. Mentorship is vital for developing and advancing a novice VA investigator's research agenda; however, there are several barriers to effective research mentorship.

Observations: The VA Clinical Research Mentorship Program was developed to assist clinician investigators with writing and submitting competitive grant applications.

Impact and Recovery of VHA Epilepsy Care Services During the COVID-19 Pandemic.

Background: The Epilepsy Centers of Excellence (ECoE) is a network of facilities within the Veterans Health Administration that evaluates and treats veterans with epilepsy and seizure disorders. This article outlines how the COVID-19 pandemic impacted ECoE services and recovery.

Methods: Directors of 17 ECoEs were surveyed 4 times between May 2020 and July 2022 on 5 domains: functioning of outpatient epilepsy clinics, outpatient electroencephalogram, epilepsy monitoring unit, anticipated permanent operational changes, and utility of national and local recommendations.

Associations of Concordant and Shared Lung Cancer Screening Decision Making with Decisional Conflict: A Multi-Institution Cross-Sectional Analysis.

Unlabelled: Many organizations recommend structured communication processes, including formal shared decision making (SDM), for patients undergoing lung cancer screening (LCS) using low-dose computed tomography (LDCT). We sought to understand if concordant and shared LCS decision making was associated with decisional conflict. In this prospective, observational study, we enrolled patients from 3 medical centers (2 Veterans Health Administration, 1 academic facility) after a decision-making interaction about undergoing LCS but before receiving the LDCT.

The Impact of a Metformin Recall on Patient Hemoglobin A1c Levels at a VA Network.

Background: In May 2020, the US Food and Drug Administration (FDA) asked 5 pharmaceutical companies to voluntarily recall some formulations of metformin due to contamination. This observational study sought to provide insight changes in hemoglobin A (HbA) levels when veterans switched to alternative antihyperglycemic agents following the recall.

Methods: This study included veterans aged ≥ 18 years with type 2 diabetes who were receiving health care from Veterans Integrated Service Network 6 and had an active metformin sustained-action (SA) prescription as of June 1, 2020.

Multidisciplinary Amputation Prevention at the DeBakey VA Hospital: Our First Decade.

Background: In 2011, the Veterans Health Administration (VHA) undertook multidisciplinary efforts to improve care for patients with nonhealing foot ulcers and reduce leg amputation rates. This article examines the impact of interdisciplinary care for amputation prevention in the VHA.

Methods: The VHA patient population was characterized using internal registries.

Unraveling the interconnectedness between physician burnout and symptoms of depression, anxiety, and stress: a network analysis among Chinese psychiatrists.

Background: The COVID-19 pandemic significantly increased the levels of burnout and symptoms of depression, anxiety, and stress among healthcare professionals. However, research on the interrelations between burnout and psychological symptoms is scarce, particularly among psychiatrists. This study addresses this gap in a national sample.

Management of a COVID-19 outbreak using a multidisciplinary approach and infection prevention control practices at a community living center in Veterans Administration Hospital, North Texas.

Background: The increase in severe acute respiratory coronavirus virus 2 (SARS-CoV-2) cases due to the omicron strain led to reduced acute care hospital beds at the Veterans Administration (VA) Hospital, North Texas; veterans with non-severe coronavirus disease 2019 (COVID-19) disease were managed at a community living center (CLC), a VA nursing home. The management of non-severe COVID-19 in VA nursing homes has not been extensively described.

Methods: We describe resident characteristics and outcomes, and infection control practices implemented during 2 COVID-19 outbreak periods (January 12-February 15, 2022, June 28-July 14, 2023).

Association of neighborhood-level socioeconomic disadvantage and Life's Essential 8 in early pregnancy.

We examined whether neighborhood-level socioeconomic disadvantage per the Area Deprivation Index (ADI) was associated with maternal cardiovascular health (CVH) in early pregnancy per the American Heart Association Life's Essential 8 (LE8). This is a cross-sectional analysis from the prospective Nulliparous Pregnancy Outcomes Study-Monitoring Mothers-to-Be Heart Health Study (nuMoM2b-HHS) cohort. The exposure was the ADI in tertiles (T) from least (T1) to most (T3) socioeconomic disadvantage.

The association between depressive symptoms and lower urinary tract symptoms and impact among women: Investigating behavioural, cognitive and physiological pathways.

Objective: Mechanistic studies are needed to understand why depressive symptoms are associated with poorer physical health. The objective of this study was to examine whether behavioural, cognitive and physiological factors mediated an association between depressive symptoms, measured in early adulthood, and lower urinary tract symptoms (LUTS) and their impact, a composite variable measured in mid-life adulthood, among women in the Coronary Artery Risk Development in Young Adults study, conducted in four regions of the United States.

Design: Prospective cohort study.

Deep Learning-assisted Diagnosis of Extrahepatic Common Bile Duct Obstruction Using MRCP Imaging and Clinical Parameters.

Background: Extrahepatic Common Bile Duct Obstruction (EHBDO) is a serious condition that requires accurate diagnosis for effective treatment. Magnetic Resonance Cholangiopancreatography (MRCP) is a widely used noninvasive imaging technique for visualizing bile ducts, but its interpretation can be complex.

Objective: This study aimed to develop a deep learning-based classification model that integrates MRCP images and clinical parameters to assist radiologists in diagnosing EHBDO more accurately.

Artificial intelligence assisted risk prediction in organ transplantation: a UK Live-Donor Kidney Transplant Outcome Prediction tool.

Predicting the outcome of a kidney transplant involving a living donor advances donor decision-making donors for clinicians and patients. However, the discriminative or calibration capacity of the currently employed models are limited. We set out to apply artificial intelligence (AI) algorithms to create a highly predictive risk stratification indicator, applicable to the UK's transplant selection process.

Rapid Adaptation to Prevent Drug Use (RAPD): protocol of a pilot randomized trial to enhance the impact of an evidence-based intervention for youth.

Background: Drug use trends change rapidly among youth, leaving intervention experts struggling to respond promptly. Delays in responses can lead to preventable morbidity and mortality. The COVID-19 pandemic underscored the need for implementation science to facilitate rapid, equitable responses using existing treatment and prevention efforts.

Emergency department crowding in the Netherlands; evaluation of a real-time ambulance diversion dashboard.

Background: Emergency department (ED) crowding is a growing concern worldwide and associated with negative effects. In 2013, 68% of Dutch ED-managers experienced crowding on several days of the week. This resulted into the introduction in phases of an ambulance diversion dashboard, in order to influence ED input.

Medical Students' Observations of High Value and Potentially Wasteful Care Behaviors Modeled During Clinical Rotations.

Background: Medical student exposure to role-modeling of high-value care (HVC) behaviors may shape professional identity formation and future HVC practices.

Objective: To investigate the frequency and characteristics of HVC role-modeling witnessed by medical students during core clinical rotations.

Design: Cross-sectional survey study.

A Cross-scale Attention-Based U-Net for Breast Ultrasound Image Segmentation.

Breast cancer remains a significant global health concern and is a leading cause of mortality among women. The accuracy of breast cancer diagnosis can be greatly improved with the assistance of automatic segmentation of breast ultrasound images. Research has demonstrated the effectiveness of convolutional neural networks (CNNs) and transformers in segmenting these images.

A network-based systems genetics framework identifies pathobiology and drug repurposing in Parkinson's disease.

Parkinson's disease (PD) is the second most prevalent neurodegenerative disorder. However, current treatments only manage symptoms and lack the ability to slow or prevent disease progression. We utilized a systems genetics approach to identify potential risk genes and repurposable drugs for PD.