Census growth and challenges of a novel Hospital at Home program: A retrospective cohort study.

Background: Hospital at Home (HaH) is a growing care model requiring significant investments. Critical to starting a program is estimating census and enrollments. The objective of this study was to compare expected versus actual consults, enrollments, and barriers in a novel HaH program.

Variation between surgeons in reoperation rates following vertical strabismus surgery: Associations with patient and surgeon characteristics and adjustable sutures.

Purpose: To quantify inter-surgeon variation in vertical strabismus surgery reoperation rates, and to explore associations of reoperation rate with practice type and volume, surgical techniques, and patient characteristics.

Methods: Fee-for-service payments to providers in a national database for Medicare beneficiaries having vertical strabismus surgery between 2012 and 2020 were retrospectively analyzed to identify reoperations in the same calendar year. Predictors of the rate of reoperation for each surgeon were determined by multivariable linear regression.

Preventing central line-associated bloodstream infections: A position paper of the International Society for Infectious Diseases, 2024 update.

A panel of experts convened by the International Society for Infectious Diseases (ISID) has reviewed and consolidated current recommendations for preventing vascular catheter infections, particularly central line-associated bloodstream infections (CLABSIs). This review provides healthcare professionals with insights into key issues such as the rates of CLABSI in high-income countries and low- and middle-income countries, the attributable extra length of stay, cost and mortality, and risk factors. This position paper highlights evidence-based strategies for preventing infections, applicable to both high-income and low- and middle-income countries.

Surgical Predictors of Clinical Outcome 6 Years After Revision ACL Reconstruction.

Background: Revision anterior cruciate ligament (ACL) reconstruction has been documented to have inferior outcomes compared with primary ACL reconstruction. The reasons why remain unknown.

Purpose: To determine whether surgical factors performed at the time of revision ACL reconstruction can influence a patient's outcome at 6-year follow-up.

Matrix Metalloproteinase-9 Signaling Regulates Colon Barrier Integrity in Models of HIV Infection.

Infection with human immunodeficiency virus (HIV) increases risk for maladies of the gut barrier, which promotes sustained systemic inflammation even in virally controlled patients. We previously revealed morphological disorganization of colon epithelial barrier proteins in HIV-1 transgenic (Tg) rats. The current study evaluated mechanisms that may underlie gut barrier pathology induced by toxic HIV-1 proteins.

Familial coaggregation and shared genetic influence between major depressive disorder and gynecological diseases.

The mechanism underlying the co-occurrence of major depressive disorder (MDD) and gynecological diseases remains unclear. This study aimed to investigate the familial co-aggregation and shared genetic loading between MDD and gynecological diseases, namely dysmenorrhea, endometriosis, uterine leiomyomas (UL), and polycystic ovary syndrome (PCOS). Overall, 2,121,632 females born 1970-1999 with parental information were enrolled from the Taiwan National Health Insurance Research Database (NHIRD); 25,142 same-sex twins and 951,779 persons with full-sibling(s) were selected.

Chromatin structure and 3D architecture define the differential functions of PU.1 regulatory elements in blood cell lineages.

The precise spatiotemporal expression of the hematopoietic ETS transcription factor PU.1, a key determinant of hematopoietic cell fates, is tightly regulated at the chromatin level. However, how chromatin signatures are linked to this dynamic expression pattern across different blood cell lineages remains uncharacterized.

Latent factors underlying the symptoms of adult-onset myotonic dystrophy type 1 during the clinical course.

Background: Myotonic dystrophy type 1 (DM1) is a multisystem genetic disorder that classically presents with symptoms associated with myotonia, early onset cataracts, and muscular weakness, although the presentation and pattern of disease progression is quite varied. Presenting symptoms are well documented among adults with DM1. However, less is known about the co-occurrence of symptoms over time.

Mental disorders after myocardial infarction: potential mediator role for chemokines in heart-brain interaction?

Acute myocardial infarction (MI) remains one of the leading causes of mortality and morbidity in the global communities. A prevailing topic that has attracted increasing attentions over the past few decades is the so-called heart-brain interaction, in particular following a major traumatic event such as MI. Increased prevalence of depression and other mental disorders has been recognized in cardiac patients after MI, coronary catheterization, or cardiothoracic surgeries.

Academic Career Exploration: Learner Opportunities Through the Office of Faculty Affairs.

Introduction: Early exposure to medical school offices can help to facilitate interest in academic medicine and senior leadership positions. This workshop provides an overview of the roles, responsibilities, and activities within the Office of Faculty Affairs (OFA) and highlights opportunities for trainee engagement and leadership.

Methods: The Kern model was applied in the design of a 60-minute interactive module for medical students.

AAAAI Position Statement on Changing Electronic Health Record Allergy Documentation to "Alerts" to Lead to Easily Understood, Actionable Labels.

The term "allergy" is inaccurate for the vast majority of the contents in the current allergy fields of electronic health records (EHRs). While EHRs have transformed access to health information and streamlined the delivery of care, their ability to reliably indicate medications, vaccines, or foods that mandate avoidance versus preferences or mild intolerances, is suboptimal. The current systems are reactive instead of being proactive and frequently fail to communicate the appropriate course of action.

The impact of electronic cigarette aerosol exposure on spatial memory formation: Modulation by orally administered vitamin E.

The use of electronic cigarettes (ECIGs) has grown exponentially among young adolescents. Tobacco smoking, in general and ECIG use in particular, has been linked to disruption of the oxidative system, resulting in organ damage. The current investigation intends to evaluate if orally administered Vitamin E (VitE) can protect from learning and cognitive impairment induced by ECIG aerosol exposure in a rat model.

Distinct comorbidity phenotypes among post-9/11 Veterans with epilepsy are linked to diverging outcomes and mortality risks.

Objective: To investigate phenotypes of comorbidity before and after an epilepsy diagnosis in a national cohort of post-9/11 Service Members and Veterans and explore phenotypic associations with mortality.

Methods: Among a longitudinal cohort of Service Members and Veterans receiving care in the Veterans Health Administration (VHA) from 2002 to 2018, annual diagnoses for 26 conditions associated with epilepsy were collected over 5 years, ranging from 2 years prior to 2 years after the year of first epilepsy diagnosis. Latent class analysis (LCA) was used to identify probabilistic comorbidity phenotypes with distinct health trajectories.

Vaccines: Do they have a role in orthopedic trauma?

Although vaccines have been hailed as one of the greatest advances in medicine based on their unparalleled cost-effectiveness in eradicating life-threatening infectious diseases, their role in orthopedic trauma-related infections is unclear. This is largely because vaccines are primarily made against pathogens that cause communicable diseases rather than opportunistic infections secondary to trauma, and most successful vaccines are against viruses rather than biofilm forming bacteria. Nonetheless, the tremendous costs to patients and healthcare systems warrant orthopedic trauma vaccine research, which has been a focal topic in recent international consensus meetings on musculoskeletal infection.

Health equity engineering: Optimizing hope for a new generation of healthcare.

Medical researchers are increasingly prioritizing the inclusion of underserved communities in clinical studies. However, mere inclusion is not enough. People from underserved communities frequently experience chronic stress that may lead to accelerated biological aging and early morbidity and mortality.

Monoallelic loss-of-function variants in GSK3B lead to autism and developmental delay.

De novo variants adjacent to the canonical splicing sites or in the well-defined splicing-related regions are more likely to impair splicing but remain under-investigated in autism spectrum disorder (ASD). By analyzing large, recent ASD genome sequencing cohorts, we find a significant burden of de novo potential splicing-disrupting variants (PSDVs) in 5048 probands compared to 4090 unaffected siblings. We identified 55 genes with recurrent de novo PSDVs that were highly intolerant to variation.