Caregiving Network Characteristics and Mental Health Care Utilization by Older Adults.

Background: Rates of mental health service use are low among older adults. This study examined associations between mental health care utilization and caregiving network characteristics, including caregiving network size, caregiving intensity, the presence of formal helpers, and primary caregiver characteristics.

Methods: Using a sample of 692 respondents in the health and retirement study (HRS) with linkage to veterans affairs healthcare records (mean age = 78.

Perinatal Airway Risk for Individuals With Isolated Cleft Spectrum.

ObjectiveCleft spectrum anomalies are sometimes associated with airway obstruction at birth. Modified delivery may facilitate advanced treatment, but there is insufficient data examining its use in patients with isolated cleft lip (iCL), isolated cleft palate (iCP), or cleft lip and palate (CLP). This study aims to address this gap.

Using Machine Learning to Predict Weight Gain in Adults: an Observational Analysis From the All of Us Research Program.

Introduction: Obesity, defined as a body mass index ≥30 kg/m, is a major public health concern in the United States. Preventative approaches are essential, but they are limited by an inability to accurately predict individuals at highest risk of weight gain. Our objective was to develop accurate weight gain prediction models using the National Institutes of Health All of Us dataset.

Thyroid Cancer Incidence During 2020 to 2021 COVID-19 Variant Waves.

Importance: How rates of thyroid cancer diagnosis were affected by the emergence of COVID-19 variants during the 2020 to 2021 era of the pandemic has not been described.

Objective: To estimate the total number of undiagnosed cases of thyroid cancer, by histologic type, during the first 2 years of the COVID-19 pandemic (2020 and 2021) by comparing observed to expected incidence and to test for changes in size of cancer at incidence during the same period compared to prior years.

Design, Setting, And Participants: This longitudinal study analyzed trends in thyroid cancer diagnoses from 2016 to 2021 among US adults using data from the Surveillance, Epidemiology, and End Results 22 (SEER-22) program database.

Perinatal Airway Management Mandibular Anomalies: A National Inpatient Cohort Analysis.

Objective: To characterize incidence of mandibular anomalies (MAs) and compare gestational age, airway interventions, and complications among individuals with MA phenotypes (isolated retrognathia, isolated micrognathia, syndromic micrognathia, micrognathia plus cleft palate/cleft lip and palate, agnathia/micrognathia plus cervical auricle/otocephaly, and agnathia/micrognathia plus microstomia) and unaffected individuals.

Methods: The Healthcare Cost and Utilization Project Kids' Inpatient Database was used to collect data over a 20-year period beginning in 2000. Interventions were classified as perinatal when performed on day of life (DOL) 0 or 1 and subsequent when performed during the birth hospitalization after DOL 1.

Association of Caregiving Receipt With Mental Health Utilization in a National Cohort of Older Adults.

Objective: There exist significant age disparities in mental health (MH) utilization, such that older adults, including older veterans, are much less likely to use MH services. In-home caregivers represent a novel, yet understudied, pathway to increase appropriate utilization. We sought to examine the association between receiving caregiving assistance and MH utilization and test moderation effects of cognitive status and depression severity in a sample of older veterans.

Modeling Thyroid Cancer Epidemiology in the United States Using Papillary Thyroid Carcinoma Microsimulation Model.

Objectives: Thyroid cancer incidence increased over 200% from 1992 to 2018, whereas mortality rates had not increased proportionately. The increased incidence has been attributed primarily to the detection of subclinical disease, raising important questions related to thyroid cancer control. We developed the Papillary Thyroid Carcinoma Microsimulation model (PATCAM) to answer them, including the impact of overdiagnosis on thyroid cancer incidence.

Perinatal airway management in neonatal goiter: A healthcare cost and utilization project (HCUP) kids' inpatient database analysis.

Introduction: Fetal goiter is a rare congenital disorder that can present with life-threatening neonatal airway obstruction. Lifesaving and function-preserving airway management strategies are available, but routine delivery affords a limited window for intervention. Accordingly, fetal goiter is reported among the most common indications for ex-utero intrapartum treatment (EXIT).

Catastrophic health expenditure in nonneurological injury due to motor vehicle crash.

Background: Motor vehicle crashes (MVCs) are a leading cause of nonfatal injury in the United States and impose a high financial cost to the patient and the economy. For many patients, this cost may be financially devastating and contribute to worsening health outcomes after injury. We aimed to describe the population level risk of catastrophic health expenditure (CHE) and determine factors associated with risk of CHE.

Patients Follow Different Financial Hardship Trajectories in the Year after Injury.

Objective: To determine if distinct financial trajectories exist and if they are associated with quality-of-life outcomes.

Summary Of Background Data: Financial hardship after injury measurably impacts Health-Related Quality of Life outcomes. Financial hardship, encompassing material losses, financial worry, and poor coping mechanisms, is associated with lower quality of life and increased psychological distress.

Association between neighborhood food environments and bariatric surgery outcomes.

Background: Individual characteristics associated with weight loss after bariatric surgery are well established, but the neighborhood characteristics that influence outcomes are unknown.

Objectives: The objective of this study was to determine if neighborhood characteristics, including social determinants and lifestyle characteristics, were associated with weight loss after bariatric surgery.

Setting: Single university healthcare system, United States.

A Statewide Approach to Reducing Re-excision Rates for Women With Breast-conserving Surgery.

Objective: Test the effectiveness of benchmarked performance reports based on existing discharge data paired with a statewide intervention to implement evidence-based strategies on breast re-excision rates.

Background: Breast-conserving surgery (BCS) is a common breast cancer surgery performed in a range of hospital settings. Studies have demonstrated variations in post-BCS re-excision rates, identifying it as a high-value improvement target.

Obesity and "obesity-related" cancers: are there body mass index cut-points?

Background: Despite compelling links between excess body weight and cancer, body mass index (BMI) cut-points, or thresholds above which cancer incidence increased, have not been identified. The objective of this study was to determine if BMI cut-points exist for 14 obesity-related cancers.

Subjects/methods: In this retrospective cohort study, patients 18-75 years old were included if they had ≥2 clinical encounters with BMI measurements in the electronic health record (EHR) at a single academic medical center from 2008 to 2018.

Obesity and BMI Cut Points for Associated Comorbidities: Electronic Health Record Study.

Background: Studies have found associations between increasing BMIs and the development of various chronic health conditions. The BMI cut points, or thresholds beyond which comorbidity incidence can be accurately detected, are unknown.

Objective: The aim of this study is to identify whether BMI cut points exist for 11 obesity-related comorbidities.

Protocol and short-term results for a feasibility randomized controlled trial of a video intervention for Veterans with obesity: The TOTAL (Teaching Obesity Treatment Options to Adult Learners) pilot study.

Introduction: All three evidence-based treatment options for adults with severe obesity - behavioral weight management, weight management medications (WMM), and bariatric surgery - are underutilized in the Veterans Health Administration (VHA) system. Our objective in this study was to develop and pilot-test the TOTAL (Teaching Obesity Treatment Options to Adult Learners) intervention, which seeks to increase Veteran participation in obesity treatment.

Methods: In this single-site, parallel, pilot RCT, Veterans with severe obesity with an upcoming behavioral weight management visit were sent a recruitment letter after meeting inclusion/exclusion criteria via electronic health record screening.

Perioperative Cost Differences Between Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass: A Single Institutional Review.

Minimizing bariatric surgery care costs is important since more than 250,000 patients undergo bariatric surgery annually in the United States. The study objective was to compare perioperative costs for the two most common bariatric procedures: laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). In addition, we sought to identify predictors of high-cost perioperative care.

Association Between Medicaid Status, Social Determinants of Health, and Bariatric Surgery Outcomes.

Objective: To compare outcomes after bariatric surgery between Medicaid and non-Medicaid patients and assess whether differences in social determinants of health were associated with postoperative weight loss.

Background: The literature remains mixed on weight loss outcomes and healthcare utilization for Medicaid patients after bariatric surgery. It is unclear if social determinants of health geocoded at the neighborhood level are associated with outcomes.

pH Impedance Parameters Associated with Improvement in GERD Health-Related Quality of Life Following Anti-reflux Surgery.

Introduction: pH impedance testing is the most sensitive diagnostic test for detecting gastroesophageal reflux disease (GERD). The literature remains inconclusive on which preoperative pH impedance testing parameters are associated with an improvement in heartburn symptoms after anti-reflux surgery. The objective of this study was to evaluate which parameters on preoperative pH impedance testing were associated with improved GERD health-related quality of life (GERD-HRQL) following surgery.

Weight Loss for Patients With Obesity: An Analysis of Long-Term Electronic Health Record Data.

Background: Numerous studies have reported that losing as little as 5% of one's total body weight (TBW) can improve health, but no studies have used electronic health record data to examine long-term changes in weight, particularly for adults with severe obesity [body mass index (BMI) ≥35 kg/m].

Objective: To measure long-term weight changes and examine their predictors for adults in a large academic health care system.

Research Design: Observational study.

Long-term dysphagia resolution following POEM versus Heller myotomy for achalasia patients.

Background: Heller myotomy (HM) has historically been considered the gold standard treatment for achalasia. Peroral endoscopic myotomy (POEM) is a less-invasive procedure and offers a quicker recovery. Although some studies have compared short-term outcomes of HM and POEM, predictors of long-term dysphagia resolution remain unclear.