Establishing a Just Culture: Implications for the Veterans Health Administration Journey to High Reliability.

Background: To establish a culture of safety and improve patient care, the Veterans Health Administration (VHA) is identifying and implementing necessary parameters and objectives across the health care landscape to enhance services on its journey to becoming a high reliability organization (HRO).

Methods: This quality improvement initiative sought to increase the understanding of factors that influence the establishment and sustainment of a just culture and identify specific methods for improving their implementation. Focus groups of HRO leads at 16 VHA hospital facilities identified emergent themes, facilitators, and barriers to maintaining a just culture and developed recommendations for enhancing both psychological safety and accountabilitity.

Racial residential segregation is associated with ambient air pollution exposure after adjustment for multilevel sociodemographic factors: Evidence from eight US-based cohorts.

Objective: We examined if racial residential segregation (RRS) - a fundamental cause of disease - is independently associated with air pollution after accounting for other neighborhood and individual-level sociodemographic factors, to better understand its potential role as a confounder of air pollution-health studies.

Methods: We compiled data from eight large cohorts, restricting to non-Hispanic Black and White urban-residing participants observed at least once between 1999 and 2005. We used 2000 decennial census data to derive a spatial RRS measure (divergence index) and neighborhood socioeconomic status (NSES) index for participants' residing Census tracts, in addition to participant baseline data, to examine associations between RRS and sociodemographic factors (NSES, education, race) and residential exposure to spatiotemporal model-predicted PM and NO levels.

Mechanisms and technologies in cancer epigenetics.

Cancer's epigenetic landscape, a labyrinthine tapestry of molecular modifications, has long captivated researchers with its profound influence on gene expression and cellular fate. This review discusses the intricate mechanisms underlying cancer epigenetics, unraveling the complex interplay between DNA methylation, histone modifications, chromatin remodeling, and non-coding RNAs. We navigate through the tumultuous seas of epigenetic dysregulation, exploring how these processes conspire to silence tumor suppressors and unleash oncogenic potential.

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.

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.

Psychometric Validation of the German Version of the Rapid Assessment of Physical Activity (RAPA): A Secondary Analysis of Cross-Sectional Survey Data.

Background And Aims: Regular physical activity holds numerous health benefits for older people, yet the majority of older people do not meet the World Health Organization's physical activity recommendations. Brief physical activity screening tools can support healthcare professionals in identifying patients who would benefit from physical activity promotion and counselling. The Rapid Assessment of Physical Activity (RAPA) questionnaire is a validated brief physical activity screening tool designed for clinical practice.

Analytical validation of a novel bioassay for thyroid-stimulating immunoglobulin.

Background: A novel and rapid cell-based bioassay, Turbo TSI, for measurement of thyroid-stimulating immunoglobulins (TSI) was recently reported. An assessment of the analytical performance of this TSI bioassay is described herein.

Methods: Thawed cells from Turbo TSI kits were treated with different concentrations of a World Health Organization (WHO) international standard (IS) TSI-positive serum.

colonization and undernutrition in infants in rural eastern Ethiopia - a longitudinal community-based birth cohort study.

Background: is associated with environmental enteric dysfunction (EED) and malnutrition in children. infection could be a linchpin between livestock fecal exposure and health outcomes in low-resource smallholder settings.

Methods: We followed a birth cohort of 106 infants in rural smallholder households in eastern Ethiopia up to 13 months of age.

Developing a curriculum on antimicrobial stewardship for pediatric residents: a needs assessment.

Objective: Identify essential components of a curriculum on antimicrobial stewardship (AS) for pediatric residents.

Design: Survey.

Setting: Academic tertiary care children's hospital.

Comparison of sampling and culture methods for the recovery of yeast from hospital surfaces.

Objective: To compare the recovery of yeast from hospital surfaces from two different collection methods: Eswab moistened with molecular water, and premoistened stick-mounted sponge.

Design: Comparison of collection methods for the recovery of yeast in the hospital environment.

Setting: This study took place at intensive care units of a large academic medical center.

Age-Friendly Health Systems Transformation: A Whole Person Approach to Support the Well-Being of Older Adults.

Background: The Veterans Health Administration (VHA) adopted the Age-Friendly Health Systems (AFHS) framework in March 2020, an initiative that complements whole health core principles. The shift from disease-based treatment to what matters most to veterans helps them improve their health and well-being.

Observations: Whole health and AFHS focus on holistic patient-centered care that aims to enhance the overall health and well-being of patients.

Prone Transpsoas Lumbar Interbody Fusion for Degenerative Disc Disease.

Background: Prone transpsoas lumbar interbody fusion (PTP) is a newer technique to treat various spinal disc pathologies. PTP is a variation of lateral lumbar interbody fusion (LLIF) that is performed with the patient prone rather than in the lateral decubitus position. This approach offers similar benefits of lateral spinal surgery, which include less blood loss, shorter hospital stay, and quicker recovery compared with traditional open spine surgery.

Neuropsychiatric Manifestations of Syphilis.

Neurosyphilis is a condition characterized by insidious onset of encephalopathy and delirium. The infrequency with which it is encountered makes neurosyphilis a formidable diagnostic challenge. We present a rare case of a 71-year-old male with ischemic cardiomyopathy, chronic obstructive pulmonary disease (COPD), undifferentiated arthritis and alcohol use disorder who was brought to the emergency department after he was found altered, confused, and paranoid.

Hidradenitis Suppurativa and Peripheral Ulcerative Keratitis.

The co-occurrence of inflammatory eye disease and hidradenitis suppurativa (HS) is uncommon; ocular involvement typically manifests as anterior uveitis. In this report, we present a unique case of peripheral ulcerative keratitis (PUK) where both infectious and rheumatological workup was negative, leading us to consider the possibility of an association between this condition and severe HS. As far as we are aware, there have only been six documented cases of PUK associated with HS.

Beneath the Surface: Diagnosing Gastric Linitis Plastica.

Gastric Linitis plastica is characterized by extensive infiltration of gastric wall by poorly differentiated tumor cells, creating a "leather-bottle stomach" appearance. We describe a case involving a 71-year-old male presenting with globus sensation, early satiety and weight loss. Recent EGD had revealed chronic gastritis with polypoid mucosa at the GE junction, and subsequent FDG-PET indicated asymmetric FDG localization.

Interfacial Properties of Gold and Cobalt Oxyhydroxide in Plasmon-Mediated Oxygen Evolution Reaction.

Water electrolysis is a green method of storing electrical energy in the chemical bonds of high-energy hydrogen gas (H). However, the anodic oxygen evolution reaction (OER) requires a significant kinetic overpotential, limiting the electrolysis rate. Recently, plasmonic gold nanoparticles (Au NPs) have been introduced to improve charge transfer at the interface between the OER electrocatalysts and the electrolyte under light illumination.

Clinical Sensitivity and Specificity of the PROSTest in an American Cohort.

Introduction: Prostate cancer (PCa) is the most commonly diagnosed cancer in men in the United States, following skin cancer, with an incidence rate of 112.7 per 100,000 men per year. The need for a reliable, non-invasive diagnostic tool for early PCa detection (screening, biochemical residual disease) remains unmet due to the limitations of PSA testing, which often leads to overdiagnosis and overtreatment.

Review and meta-analysis of gene expression biomarkers predictive of chemical-induced genotoxicity in vivo.

There is growing recognition across broad sectors of the toxicology community that gene expression biomarkers have the potential to identify genotoxic and nongenotoxic carcinogens through a weight-of-evidence approach, providing opportunities to reduce reliance on the 2-year bioassay to identify carcinogens. In August 2022, a workshop within the International Workshops on Genotoxicity Testing (IWGT) was held to critically review current methods to identify genotoxicants using various 'omics profiling methods. Here, we describe the findings of a workshop subgroup focused on the state of the science regarding the use of biomarkers to identify chemicals that act as genotoxicants in vivo.

MaveDB 2024: a curated community database with over seven million variant effects from multiplexed functional assays.

Multiplexed assays of variant effect (MAVEs) are a critical tool for researchers and clinicians to understand genetic variants. Here we describe the 2024 update to MaveDB ( https://www.mavedb.

Endothelial cells under disturbed flow release extracellular vesicles to promote inflammatory polarization of macrophages and accelerate atherosclerosis.

Background: Extracellular vesicles (EVs) derived from endothelial cells (ECs) are increasingly recognized for their role in the initiation and progression of atherosclerosis. ECs experience varying degrees and types of blood flow depending on their specific arterial locations. In regions of disturbed flow, which are predominant sites for atherosclerotic plaque formation, the impact of disturbed flow on the secretion and function of ECs-derived EVs remains unclear.

Perceived Discrimination in the Healthcare Setting and Medical Mistrust: Findings from the Health Information National Trends Survey, 2022.

Background: Perceived discrimination and medical mistrust are barriers to care that impact both individual and population health.

Objective: This study aims to characterize the prevalence of perceived racial or ethnic discrimination in healthcare as well as mistrust in the medical system and explore their associations with race and ethnicity.

Design: Cross-sectional study of nationally representative data from the Health Information National Trends Survey (fielded March-November 2022).

Wellbeing and quality of life among parents of individuals with Fontan physiology.

Purpose: To examine global and health-related quality of life (QOL) among parents of individuals with Fontan physiology and determine associations with sociodemographic, parent and child-related health, psychological, and relational factors.

Methods: Parents participating in the Australian and New Zealand Fontan Registry (ANZFR) QOL Study (N = 151, Parent Mean age = 47.9 ± 10.

Interactive and unimodal relationships between plant biomass, abiotic factors, and plant diversity in global grasslands.

Grasslands cover approximately a third of the Earth's land surface and account for about a third of terrestrial carbon storage. Yet, we lack strong predictive models of grassland plant biomass, the primary source of carbon in grasslands. This lack of predictive ability may arise from the assumption of linear relationships between plant biomass and the environment and an underestimation of interactions of environmental variables.

Performance and reliability comparison: original vs. revised bone reporting and data system (Bone-RADS).

Objective: To propose a revised bone reporting and data system (Bone-RADS) and evaluate its diagnostic performance and inter-reader reliability compared to the original Bone-RADS for solitary bone lesions on CT.

Materials And Methods: This retrospective study included 159 adult patients (mean age: 56 ± 19 years; 88 men) who underwent bone biopsy for solitary bone lesions between March 2005 and September 2021. Two radiologists (R1/2) independently categorized the lesions twice, once using the original Bone-RADS and once using the revised version.

Thiamine deficiency in US veterans with obesity.

Introduction: Thiamine deficiency is common after bariatric surgery, but patients with obesity may be deficient in thiamine even before surgery. The purpose of this research was to determine the prevalence of thiamine deficiency in patients with obesity at a medical weight-management clinic and assess the relationship between recent weight loss and thiamine deficiency.

Methods: For this observational study, medical records were reviewed for patients (n = 146) at the nonsurgical obesity medicine and preoperative bariatric surgery clinic at a Veterans Affairs Medical Center between January 1, 2012, and January 31, 2019.