Association of antiphospholipid syndrome with infective endocarditis and sepsis induced by Staphylococcus aureus: A U.S. nationwide inpatient sample analysis.

BackgroundAntiphospholipid syndrome (APS) predisposes patients to thrombosis and cardiac valve lesions such as Libman-Sacks endocarditis. These vegetations are sterile yet can provide a nidus for infection; the risk of infective endocarditis (IE) and other serious infections in APS patients remains poorly quantified in large populations, representing a knowledge gap.ObjectiveTo quantify the risk of the primary outcome, IE, and secondary outcomes of MRSA sepsis and MSSA sepsis, associated with APS using a large, nationally representative inpatient database.

Patient Information Needs During Ambulatory Medication Changes: A Qualitative Study.

Purpose: We performed interviews with patients and caregivers to explore whole-person, whole-regimen information needs at times of routine outpatient medication changes. We categorized information needs in this relatively unstudied context and identified which needs were commonly recognized as insufficiently met.

Methods: We explored the content of the semi-structured interviews, which involved nine patients and two caregivers of pediatric patients, all of whom experienced a recent medication change in the outpatient setting of a large urban academic healthcare system.

Modulation of Filopodial Myosin Function.

MyTH-FERM (MF) myosins are essential for filopodia formation in both Metazoa and Amoebozoa ( DdMyo7; mammalian Myo10) but their roles in filopodia formation are not fully understood. Taking advantage of a mutation in the highly conserved actin binding interface of another MF myosin, the () mutation of Myo15A that reduces its function, the impact of altering the myosin-F-actin interaction on filopodia formation was investigated. The mutation, a D to G substitution (Gong et al, 2022, Sci Adv), was introduced into DdMyo7 or Myo10 and filopodia formation assessed by quantitative analysis of number, length and myosin tip enrichment.

Intubation in Eosinophilic Lung Disease: Predictors, Outcomes, and Characteristics from a National Inpatient Sample Analysis.

: Eosinophilic lung diseases (ELD) encompass disorders with an abnormally high number of polymorphonuclear eosinophils in the lungs. Presentation severity can range from low-grade fever and cough to life-threatening acute respiratory distress syndrome (ARDS). Due to the rarity of these conditions, no large sample studies have been performed to assess the characteristics of patients with pulmonary eosinophilia.

Changes in Youth Cholesterol Screening Rates in an Academic Center During the COVID-19 Pandemic.

Screening youth for hypercholesterolemia allows for detection of familial hypercholesterolemia that can predispose to premature heart disease, however guidelines provide conflicting recommendations regarding universal cholesterol screening. The COVID-19 pandemic and the perception of conflicting guideline recommendations (2011 National Heart, Lung, and Blood Institute guidelines and United States Preventive Services Task Force recommendations in 2016 and 2023) may have adversely affected youth cholesterol screening rates. This study examines screening rates during and after the COVID-19 pandemic and the most recent guideline update.

Centering Weight Management Clinical Decision Support in Primary Care on Patients With Obesity and Practitioners: A Proof-Of-Concept Study.

Background: Clinical decision support systems (CDSS) are electronic health record tools that support practitioners' decision-making at the point-of-care. CDSS may aid clinical care but are not often centered on patients or practitioners.

Aims: To develop and preliminarily test a CDSS designed to support evidence-based obesity treatment, promote a patient-centered experience, and integrate with clinical workflows.

Electronic health records tools for treating obesity among adult patients in primary care: A scoping review.

Background: Electronic health record (EHR)-based tools, such as clinical decision support systems (CDSS), support practitioners to promote evidence-based care, which may include obesity treatment. Our objective was to identify obesity-focused CDSS for adult patients in primary care settings to describe their designs, associated primary care practitioner (PCP) training, and outcomes among PCPs and patients.

Methods: We conducted a scoping review to identify and map available evidence using a search strategy for citations in MEDLINE from February 2009 to June 2024.

Opportunities for General Internal Medicine to Promote Equity in Obesity Care.

The number and complexity of obesity treatments has increased rapidly in recent years. This is driven by the approval of new anti-obesity medications (AOMs) that produce larger degrees of weight loss than previously approved AOMs. Unfortunately, access to these highly effective therapies and to integrated team-based obesity care is limited by intra-/interpersonal patient, institutional/practitioner, community, and policy factors.

filoVision - using deep learning and tip markers to automate filopodia analysis.

Filopodia are slender, actin-filled membrane projections used by various cell types for environment exploration. Analyzing filopodia often involves visualizing them using actin, filopodia tip or membrane markers. Due to the diversity of cell types that extend filopodia, from amoeboid to mammalian, it can be challenging for some to find a reliable filopodia analysis workflow suited for their cell type and preferred visualization method.

Understanding the Information Needs of Pharmacy Staff Using CancelRx: A Qualitative Study of the Use of Prescription -cancellation.

Background: Although electronic prescription cancellation such as via CancelRx can facilitate critical communication between prescribers and pharmacy staff about discontinued medications, there is little work that explores whether CancelRx meets the needs of pharmacy staff users.

Objective: This study leverages qualitative interviews with pharmacy staff to address the following question:

Methods: We conducted an inductive thematic analysis of interviews with 11 pharmacy staff members (pharmacists and pharmacy technicians) across three outpatient community pharmacy sites within an academic health care system.

Results: Three information needs themes were consistently identified by both pharmacists and pharmacy technicians: prescriber intent when initiating the CancelRx, clinical rationale for the medication change, and intended medication regimen.

Prevalence of lifestyle-related behavioral information in claims data in the U.S.

Objective: Given their association with varying health risks, lifestyle-related behaviors are essential to consider in population-level disease prevention. Health insurance claims are a key source of information for population health analytics, but the availability of lifestyle information within claims data is unknown. Our goal was to assess the availability and prevalence of data items that describe lifestyle behaviors across several domains within a large U.

Obesity Management in Adults: A Review.

Importance: Obesity affects approximately 42% of US adults and is associated with increased rates of type 2 diabetes, hypertension, cardiovascular disease, sleep disorders, osteoarthritis, and premature death.

Observations: A body mass index (BMI) of 25 or greater is commonly used to define overweight, and a BMI of 30 or greater to define obesity, with lower thresholds for Asian populations (BMI ≥25-27.5), although use of BMI alone is not recommended to determine individual risk.

Fumarase Deficiency and Its Effect on Infertility: A Case Series.

Background: Fumarase deficiency is an autosomal recessive condition characterized by severe neurologic abnormalities due to homozygous mutations in the fumarate hydratase (FH) gene. Heterozygous carriers of FH mutations have increased risk of developing uterine fibroids that can be associated with hereditary leiomyomatosis and renal cell cancer (HLRCC). The association between FH mutations and infertility remains uncertain.

Use of medications associated with weight change among participants in the All of Us research programme.

Our objective was to describe the use of medications associated with weight change among US adults with overweight/obesity, including anti-obesity medications (AOMs), weight-loss-promoting and weight-gain-promoting medications. We performed a cross-sectional analysis of data from the nationwide All of Us Research Programme. We included adults with measured body mass index (BMI) ≥ 27 kg/m enrolled between 2018 and 2022 across the United States.

A Scoping Review of Integrated Medical Devices and Clinical Decision Support in the Acute Care Setting.

Background: Seamless data integration between point-of-care medical devices and the electronic health record (EHR) can be central to clinical decision support systems (CDSS).

Objective: The objective of this scoping review is to (1) examine the existing evidence related to integrated medical devices, primarily medication pump devices, and associated clinical decision support (CDS) in acute care settings and (2) to identify how acute care clinicians may use device CDS in clinical decision-making. The rationale for this review is that integrated devices are ubiquitous in the acute care setting, and they generate data that may help to contribute to the situational awareness of the clinical team necessary to provide individualized patient care.

Homophilic Interaction Between Transmembrane-JAM-A and Soluble JAM-A Regulates Thrombo-Inflammation: Implications for Coronary Artery Disease.

Genetic predisposition through single-nucleotide variation (SNV) influences circulatory soluble junctional adhesion molecule-A (sJAM-A) levels in coronary artery disease (CAD) patients. Homozygous carriers of the minor alleles (SNVs rs2774276, rs790056) show enhanced levels of thrombo-inflammatory sJAM-A. Both SNVs and sJAM-A are associated with worse prognosis for recurrent myocardial infarction in CAD patients.

Utility of an Electronic Health Record Report to Identify Patients with Delays in Testing for Poorly Controlled Diabetes.

Background: Reducing hemoglobin A1c (HbA1c) is essential for patients with poorly controlled diabetes. However, delays in HbA1c testing are common, and incomplete electronic health record (EHR) reports hinder identification of patients who are overdue. This study sought to quantify how often an EHR report correctly identifies patients with HbA1c testing delays and to describe potential contributing factors.

Factors Influencing Clinician Trust in Predictive Clinical Decision Support Systems for In-Hospital Deterioration: Qualitative Descriptive Study.

Background: Clinician trust in machine learning-based clinical decision support systems (CDSSs) for predicting in-hospital deterioration (a type of predictive CDSS) is essential for adoption. Evidence shows that clinician trust in predictive CDSSs is influenced by perceived understandability and perceived accuracy.

Objective: The aim of this study was to explore the phenomenon of clinician trust in predictive CDSSs for in-hospital deterioration by confirming and characterizing factors known to influence trust (understandability and accuracy), uncovering and describing other influencing factors, and comparing nurses' and prescribing providers' trust in predictive CDSSs.

Identification of Prediabetes Discussions in Unstructured Clinical Documentation: Validation of a Natural Language Processing Algorithm.

Background: Prediabetes affects 1 in 3 US adults. Most are not receiving evidence-based interventions, so understanding how providers discuss prediabetes with patients will inform how to improve their care.

Objective: This study aimed to develop a natural language processing (NLP) algorithm using machine learning techniques to identify discussions of prediabetes in narrative documentation.

Predictors of posttraumatic growth among hematopoietic cell transplant recipients.

Objective: Prior research has shown that cancer survivors often report positive psychological changes from the experience of cancer, or posttraumatic growth (PTG). However, few studies have focused on PTG in cancer patients recovering from hematopoietic cell transplantation (HCT). The present study measured PTG at specific milestones during the year following HCT and investigated psychosocial and treatment-related factors that may hinder or facilitate PTG.

The Communicating Narrative Concerns Entered by Registered Nurses (CONCERN) Clinical Decision Support Early Warning System: Protocol for a Cluster Randomized Pragmatic Clinical Trial.

Background: Every year, hundreds of thousands of inpatients die from cardiac arrest and sepsis, which could be avoided if those patients' risk for deterioration were detected and timely interventions were initiated. Thus, a system is needed to convert real-time, raw patient data into consumable information that clinicians can utilize to identify patients at risk of deterioration and thus prevent mortality and improve patient health outcomes. The overarching goal of the COmmunicating Narrative Concerns Entered by Registered Nurses (CONCERN) study is to implement and evaluate an early warning score system that provides clinical decision support (CDS) in electronic health record systems.

Clinician and Health Care Leaders' Experiences with-and Perceptions of-COVID-19 Documentation Reduction Policies and Practices.

Background: Substantial strategies to reduce clinical documentation were implemented by health care systems throughout the coronavirus disease-2019 (COVID-19) pandemic at national and local levels. This natural experiment provides an opportunity to study the impact of documentation reduction strategies on documentation burden among clinicians and other health professionals in the United States.

Objectives: The aim of this study was to assess clinicians' and other health care leaders' experiences with and perceptions of COVID-19 documentation reduction strategies and identify which implemented strategies should be prioritized and remain permanent post-pandemic.