Infrainguinal bypass for limb salvage has comparable mortality and affords a better chance of home discharge than amputation among octogenarians.

Background: Infrainguinal bypass for chronic limb-threatening ischemia (CTLI) in octogenarians is considered a high-risk procedure due to the presumed associated frailty of the patient population. However, the alternative which is major amputation may not be a better option. This study retrospectively compares the outcomes of bypass versus major amputation for functionally independent and partially dependent patients.

Rethinking the rise of early onset gastrointestinal cancers: a call to action.

Since the early 1990s, there has been a dramatic rise in gastrointestinal cancers diagnosed in patients under age 50 for reasons that remain poorly understood. The most significant change has been the increase in incidence rates of early-onset colorectal cancer, especially rates of left-sided colon and rectal cancers. Increases in gastric, pancreatic, and other gastrointestinal cancer diagnoses have further contributed to this trend.

Improving Newborn Professional Billing at a Community Hospital.

Introduction: In community hospital medicine programs, newborns often represent a large patient population with diverse clinical needs. Capturing the care provided through professional billing provides the foundation for division revenue; however, provider knowledge on how to optimally bill is often lacking. Our group underused Hospital Care current procedural terminology (CPT) evaluation and management (E/M) codes for newborns requiring increased monitoring, diagnostic interventions, or therapy.

The partisanship of mayors has no detectable effect on police spending, police employment, crime, or arrests.

In this paper, we examine whether mayors' partisan affiliations lead to differences in crime and policing. We use a large new dataset on mayoral elections and three different modern causal inference research designs (a regression discontinuity design centered around close elections and two robust difference-in-differences methods) to determine the causal effect of mayoral partisanship on crime, arrests, and racial differences in arrest patterns in medium and large US cities. We find no evidence that mayoral partisanship affects police employment or expenditures, police force or leadership demographics, overall crime rates, or numbers of arrests.

A distributed subcortical circuit linked to instrumental information-seeking about threat.

Daily life for humans and other animals requires switching between periods of threat- and reward-oriented behavior. We investigated neural activity associated with spontaneous switching, in a naturalistic task, between foraging for rewards and seeking information about potential threats with 7T fMRI in healthy humans. Switching was driven by estimates of likelihood of threat and reward.

Harnessing Internet Search Data as a Potential Tool for Medical Diagnosis: Literature Review.

Background: Access to accurate medical diagnosis has been hindered by socioeconomic disparities, limited availability of specialized medical professionals, and lack of patient education, among other factors. Inequities in access to high-quality healthcare services exacerbate these challenges, often leading to disparities in health outcomes. Missed or inaccurate diagnoses can lead to delayed or unnecessary treatments, risking worsening of the condition.

MAL2 and rab17 selectively redistribute invadopodia proteins to laterally-induced protrusions in hepatocellular carcinoma cells.

MAL2 (myelin and lymphocyte protein 2) and rab17 have been identified as hepatocellular carcinoma tumor suppressors. However, little is known how their functions in hepatic polarized protein sorting/trafficking translates into how they function in the epithelial to mesenchymal transition and/or the mesenchymal to epithelial transition in metastases. To investigate this, we expressed MAL2 and rab17 alone or together in hepatoma-derived Clone 9 cells (that lack endogenous MAL2 and rab17).

Restorative Neurostimulation Therapy Compared to Optimal Medical Management: A Randomized Evaluation (RESTORE) for the Treatment of Chronic Mechanical Low Back Pain due to Multifidus Dysfunction.

Introduction: Many interventional strategies are commonly used to treat chronic low back pain (CLBP), though few are specifically intended to target the distinct underlying pathomechanisms causing low back pain. Restorative neurostimulation has been suggested as a specific treatment for mechanical CLBP resulting from multifidus dysfunction. In this randomized controlled trial, we report outcomes from a cohort of patients with CLBP associated with multifidus dysfunction treated with restorative neurostimulation compared to those randomized to a control group receiving optimal medical management (OMM) over 1 year.

Quantification of Particle-Associated Viruses in Secondary Treated Wastewater Effluent.

Viruses can interact with a broad range of inorganic and organic particles in water and wastewater. These associations can protect viruses from inactivation by quenching chemical disinfectants or blocking ultraviolet light transmission, and a much higher dosage of disinfectants is required to inactivate particle-associated viruses than free viruses. There have been only few studies of the association of viruses with particles in wastewater, particularly in secondary treated effluent.

Trends in screening and treatment of osteoporosis after periprosthetic fractures from 2010 to 2020.

Unlabelled: Osteoporosis is often underrecognized and undertreated following periprosthetic fractures (PPF). Our study found that between 2010 and 2020, there has been no significant change in the rates of osteoporosis screening or treatment within 1 year following PPF. Orthopedic surgeons can play an integral role in helping to curtail the osteoporosis epidemic.

Transcriptomic and functional characterization of megakaryocytic-derived platelet-like particles: impaired aggregation and prominent anti-tumor effects.

Platelet-like particles (PLPs), derived from megakaryocytic cell lines MEG-01 and K-562, are widely used as a surrogate to study platelet formation and function. We demonstrate by RNA-Seq that PLPs are transcriptionally distinct from platelets. Expression of key genes in signaling pathways promoting platelet activation/aggregation, such as the PI3K/AKT, protein kinase A, phospholipase C, and α-adrenergic and GP6 receptor pathways, was missing or under-expressed in PLPs.

Managing Expectations: Understanding Parents' Perceptions of Their Child's Serious Illness.

Parenting a seriously ill child is complex and emotionally intense. To further develop Hinds and colleagues' Good Parent themes: "Keeping a Positive Outlook" and "Keeping a Realistic Outlook," we reviewed grounded theories published in English language journals from January 2006 to April 2021 identifying 18 studies with relevant results. Parents' efforts to keep a positive outlook included cognitive (e.

Building a Fast Response Capability for Emerging Infectious Diseases Within the Biomedical Advanced Research and Development Authority.

From influenza to COVID-19, emerging infectious diseases have taken a heavy toll on lives and resources. Emerging infectious diseases represent one of the largest threats to national security. The primary mission of the Center for Biomedical Advanced Research and Development Authority (BARDA), within the US Administration for Strategic Preparedness and Response, is to support the advanced development of medical countermeasures (MCMs) for public health security threats, including select infectious diseases.

Effectiveness of interventions to prevent drowning among children under age 20 years: a global scoping review.

Background: Drowning is a leading cause of death among young children. The United Nations Resolution on global drowning prevention (2021) and World Health Assembly Resolution in 2023 have drawn attention to the issue. This scoping review synthesizes the current evidence on the effectiveness of child drowning prevention interventions since the 2008 World Report on Child Injury Prevention and implications for their implementation.

Patient Perspective on Robotic-Assisted Total Joint Arthroplasty.

Background: Robotic-assisted total joint arthroplasty (TJA) has gained popularity in recent years. Despite mixed patient and surgeon perceptions, conflicting evidence regarding efficacy and cost-effectiveness in comparison to manual TJA exists. Patients' beliefs surrounding robotic-assisted TJA remain unclear.

The impact of task-sharing scalable mental health interventions on non-specialist providers: a scoping review.

Task-sharing approaches that train non-specialist providers (NSPs), people without specialized clinical training, are increasingly utilized to address the global mental health treatment gap. This review consolidates findings from peer reviewed articles on the impact of task-sharing mental health interventions on NSPs at the individual, family and community level. Studies that highlighted facilitators, barriers and recommendations for improving the experiences of NSPs were also included in the review.

Pay talk in contemporary workplaces.

Drawing on a unique survey of US workers with information about their employers' policies on pay discussions and whether workers engage in such talk with their coworkers, we provide the most comprehensive investigation into pay talk in workplaces to date. Unlike existing treatments, we focus on core organizational and relational factors that influence whether workers talk about pay. We theorize pay talk as a challenge to managerial discretion, and we hypothesize that organizational attributes related to pay-setting influence workers' willingness to discuss wages and salaries with colleagues.

Robust RNA secondary structure prediction with a mixture of deep learning and physics-based experts.

A mixture-of-experts (MoE) approach has been developed to mitigate the poor out-of-distribution (OOD) generalization of deep learning (DL) models for single-sequence-based prediction of RNA secondary structure. The main idea behind this approach is to use DL models for in-distribution (ID) test sequences to leverage their superior ID performances, while relying on physics-based models for OOD sequences to ensure robust predictions. One key ingredient of the pipeline, named MoEFold2D, is automated ID/OOD detection via consensus analysis of an ensemble of DL model predictions without requiring access to training data during inference.

Family physicians' perspectives on outcomes, processes, and policies in dementia care.

The rapid rise in numbers of people living with Alzheimer's disease and related disorders (ADRD) poses major challenges to health systems and policy. Although primary care clinicians provide ongoing medical care for 80% of affected individuals, they face persistent barriers to providing high-quality dementia care. We conducted qualitative interviews with family physicians ( = 20) to understand what core outcomes they consider most important and what care processes and systems and policy strategies they propose to achieve them.

Medicaid billing for community health worker services growing, but remains low, 2016-2020.

Despite the recognized value of Community Health Workers (CHWs) in improving health outcomes, the integration of CHWs into Medicaid continues to be a challenge. This study examines the trends in CHW billing for Medicaid services across states from 2016 to 2020. We conducted an exploratory descriptive analysis of the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) 2016-2020 to identify trends in direct billing for CHW services, including beneficiaries served, total services rendered, payment type, place of service, and procedure codes used for services billed by CHWs.

Development of an agenda for research and action on climate change and health in the Caribbean.

This paper delineates the development of the Caribbean Research for Action Agenda which aims to empower Caribbean Small Island Developing States to reduce their vulnerabilities to the effects of climate change on health. The Caribbean Research for Action Agenda emerged from collaboration between nongovernmental organizations, academic institutions, and multilateral agencies that organized a conference on climate change and health in the Caribbean. This Agenda was formulated by prioritizing research areas, synthesizing evidence from conference presentations and scientific literature, and holding consultations with stakeholders and experts.

Hospital-based health technology assessment (HTA) in Latin America and the Caribbean: a scoping review.

Objective: To provide an overview of hospital-based health technology assessment (HB-HTA) activities in Latin America and the Caribbean, including the technologies assessed, resources utilized, evaluation methods employed, and challenges encountered.

Methods: A scoping review focused on HB-HTA using frameworks from the Joanna Briggs Institute was conducted across databases and gray literature.

Results: Seventeen studies were identified, and another two documents were retrieved manually at a conference, totaling 19 files.

Patterns of Care in Adjuvant Radiation Therapy for Stage II Endometrioid Endometrial Adenocarcinoma: A National Cancer Database Analysis.

Purpose: Treating stage II endometrial cancer involves total hysterectomy, bilateral salpingo-oophorectomy, and risk-adapted adjuvant therapy. Professional guidelines support various adjuvant treatments, but high-level data supporting specific options are conflicting. We sought to evaluate adjuvant radiation therapy (RT) trends for these patients, hypothesizing increased utilization of pelvic external beam RT (EBRT) over time.