Same goal, different perspectives: Stakeholder views on context for connected care technology implementation in an integrated healthcare system.

IntroductionThe Veterans Health Administration (VHA) prioritizes use of connected care technologies to enhance access and outcomes. The context in which connected care is implemented is crucial, yet difficult to measure, due to its subjective and complex nature. This evaluation examined alignment among stakeholder perceptions of context related to connected care implementation across VHA.

Caudal fin shape imprinted during late zebrafish embryogenesis is re-patterned by the Sonic hedgehog pathway.

Appendage shape is formed during development-and re-established during regeneration-according to spatial and temporal cues that orchestrate local cell behaviors. The caudal fin is the primary appendage used for propulsion in most fishes, and the organ exhibits a range of distinct morphologies adapted for different swimming strategies. The external caudal fin of the zebrafish develops with a forked shape, with longer supportive bony rays at the periphery and shorter rays at the center of the organ.

What Matters Most to Veterans When Deciding to Use Technology for Health: Cross-Sectional Analysis of a National Survey.

Background: There is an increasingly diverse range of mobile apps and digital health devices available to help patients manage their health. Despite evidence for the effectiveness of such technologies, their potential has not been fully realized because adoption remains low. Such limited uptake can have direct implications for the intended benefits of these technologies.

Psychometric evaluation of the exercise self-regulatory efficacy scale using objective measures of physical functioning in persons with chronic obstructive pulmonary disease.

Introduction: Physical activity (PA) promotion is an essential component of managing chronic obstructive pulmonary disease (COPD). Exercise self-efficacy is a primary indicator of exercise engagement. The Exercise Self-Regulatory Efficacy scale (Ex-SRES) was developed and validated in persons with COPD recruited at pulmonary rehabilitation programs who self-reported exercise behaviors.

Developing Infrastructure to Realize the Value of Patient-Generated Health Data in a Large Integrated Health Care System: The Veterans Health Administration Experience.

Patient-generated health data (PGHD) encompass health-related information created, recorded, and gathered by patients in their daily lives, and are distinct from data collected in clinical settings. PGHD can offer insight into patients' everyday health behaviors and conditions, supporting health management and clinical decision-making. The Veterans Health Administration (VHA) has developed a robust infrastructure to collect PGHD, including automatically collected data from digital sensors and patient-entered data.

Linking Patient Perceptions of Shared Decision Making to Satisfaction in Lung Cancer Screening Decisions.

IntroductionLung cancer is especially prevalent among US veterans, and lung cancer mortality can be reduced through lung cancer screening (LCS). LCS guidelines recommend shared decision making (SDM) to help patients weigh the benefits and harms of LCS and make informed, values-based decisions about screening. Yet some question whether SDM affects patient outcomes.

Change in self-efficacy mediates the effect of a physical activity intervention in COPD.

https://bit.ly/4dJL8iX.

Veteran Preferences and Willingness to Share Patient-Generated Health Data.

Background: Technologies, including mobile health applications (apps) and wearables, offer new potential for gathering patient-generated health data (PGHD) from patients; however, little is known about patient preferences for and willingness to collect and share PGHD with their providers and healthcare systems.

Objective: Describe how patients use their PGHD and factors important to patients when deciding whether to share PGHD with a healthcare system.

Design: Cross-sectional mailed longitudinal survey supplemented with administrative data within the Veterans Health Administration (VHA).

Adult caudal fin shape is imprinted in the embryonic fin fold.

Appendage shape is formed during development (and re-formed during regeneration) according to spatial and temporal cues that orchestrate local cellular morphogenesis. The caudal fin is the primary appendage used for propulsion in most fish species, and exhibits a range of distinct morphologies adapted for different swimming strategies, however the molecular mechanisms responsible for generating these diverse shapes remain mostly unknown. In zebrafish, caudal fins display a forked shape, with longer supportive bony rays at the periphery and shortest rays at the center.

Physical Activity and Systemic Biomarkers in Persons With COPD: Insights from a Web-Based Pedometer-Mediated Intervention.

Background: The relationships between physical activity (PA) and exercise performance and systemic biomarkers in persons with chronic obstructive pulmonary disease (COPD) have not been well characterized. The impact of PA promotion on biomarkers reflecting myocardial stress, systemic inflammation, and muscle injury is unclear.

Methods: This secondary analysis used 3 previously published studies in persons with COPD (2 examined a PA intervention that promoted community-based walking for 3 months) to explore these relationships.

Molecular glues and induced proximity: An evolution of tools and discovery.

Small molecule molecular glues can nucleate protein complexes and rewire interactomes. Molecular glues are widely used as probes for understanding functional proximity at a systems level, and the potential to instigate event-driven pharmacology has motivated their application as therapeutics. Despite advantages such as cell permeability and the potential for low off-target activity, glues are still rare when compared to canonical inhibitors in therapeutic development.

Factors Associated with Veteran Self-Reported Use of Digital Health Devices.

Background: Digital health devices (DHDs), technologies designed to gather, monitor, and sometimes share data about health-related behaviors or symptoms, can support the prevention or management of chronic conditions. DHDs range in complexity and utility, from tracking lifestyle behaviors (e.g.

Improving Veteran Engagement with Virtual Care Technologies: a Veterans Health Administration State of the Art Conference Research Agenda.

Although the availability of virtual care technologies in the Veterans Health Administration (VHA) continues to expand, ensuring engagement with these technologies among Veterans remains a challenge. VHA Health Services Research & Development convened a Virtual Care State of The Art (SOTA) conference in May 2022 to create a research agenda for improving virtual care access, engagement, and outcomes. This article reports findings from the Virtual Care SOTA engagement workgroup, which comprised fourteen VHA subject matter experts representing VHA clinical care, research, administration, and operations.

A high-throughput 3D X-ray histology facility for biomedical research and preclinical applications.

Background: The University of Southampton, in collaboration with the University Hospital Southampton (UHS) NHS Foundation Trust and industrial partners, has been at the forefront of developing three-dimensional (3D) imaging workflows using X-ray microfocus computed tomography (μCT) -based technology. This article presents the outcomes of these endeavours and highlights the distinctive characteristics of a μCT facility tailored explicitly for 3D X-ray Histology, with a primary focus on applications in biomedical research and preclinical and clinical studies.

Methods: The UHS houses a unique 3D X-ray Histology (XRH) facility, offering a range of services to national and international clients.

Stakeholder Perceptions of a Web-Based Physical Activity Intervention for COPD: A Mixed-Methods Study.

Technology-based physical activity interventions have been shown to be efficacious in chronic obstructive pulmonary disease (COPD), though their potential impact has not been fully realized due to ineffective implementation. We used a convergent, parallel mixed-methods design to identify patient- and provider-facing barriers and facilitators to implementing a rigorously studied web-based physical activity intervention for COPD. Quantitative surveys (based on the unified theory of acceptance and use of technology; range 1 (poor usability)-5 (high usability)) and semi-structured interviews (guided by the practical robust implementation and sustainability model) assessed the perspectives of 15 patients and 15 health care providers.

Acute stress symptoms 1-2 weeks after stroke predict the subsequent development of post-traumatic stress symptoms: A prospective cohort study.

Objective: To date no research has examined the potential influence of acute stress symptoms (ASD) on subsequent development of post-traumatic stress disorder (PTSD) symptoms in stroke survivors. Our objective was to examine whether acute stress symptoms measured 1-2 weeks post-stroke predicted the presence of post-traumatic stress symptoms measured 6-12 weeks later.

Design: Prospective within-groups study.

Value of Information Analysis of a Web-Based Self-Management Intervention for Chronic Obstructive Pulmonary Disease.

Technology-based programs can be cost-effective in the management of chronic obstructive pulmonary disease (COPD). However, cost-effectiveness estimates always contain some uncertainty, and decisions based upon them carry some risk. We conducted a value of information (VOI) analysis to estimate the value of additional research of a web-based self-management intervention for COPD to reduce the costs associated with uncertainty.

High-throughput functional characterization of combinations of transcriptional activators and repressors.

Despite growing knowledge of the functions of individual human transcriptional effector domains, much less is understood about how multiple effector domains within the same protein combine to regulate gene expression. Here, we measure transcriptional activity for 8,400 effector domain combinations by recruiting them to reporter genes in human cells. In our assay, weak and moderate activation domains synergize to drive strong gene expression, whereas combining strong activators often results in weaker activation.

Engaging Operational Partners Is Critical for Successful Implementation of Research Products: a Coincidence Analysis of Access-Related Projects in the Veterans Affairs Healthcare System.

Background/objective: The Veterans Health Administration (VHA) has prioritized timely access to care and has invested substantially in research aimed at optimizing veteran access. However, implementing research into practice remains challenging. Here, we assessed the implementation status of recent VHA access-related research projects and explored factors associated with successful implementation.

Depression Symptoms and Physical Activity in Veterans With COPD: Insights From a Web-Based, Pedometer-Mediated Physical Activity Intervention.

Background: Depression is known to limit physical activity (PA) among individuals with chronic obstructive pulmonary disease (COPD). However, whether and how depression influences the effectiveness of PA interventions is unknown.

Purpose: The study examined the association between baseline depression symptoms and change in daily step count and whether group assignment to a web-based, pedometer-mediated PA intervention moderated the association between baseline depression symptoms and change in daily step count.

Rural disparities impact response to a web-based physical activity self-management intervention in COPD: A secondary analysis.

Purpose: This secondary exploratory analysis examined rural-urban differences in response to a web-based physical activity self-management intervention for chronic obstructive pulmonary disease (COPD).

Methods: Participants with COPD (N = 239 US Veterans) were randomized to either a multicomponent web-based intervention (goal setting, iterative feedback of daily step counts, motivational and educational information, and an online community forum) or waitlist-control for 4 months with a 12-month follow-up. General linear modeling estimated the impact of rural/urban status (using Rural-Urban Commuting Area [RUCA] codes) on (1) 4- and 12-month daily step-count change compared to waitlist-control, and (2) intervention engagement (weekly logons and participant feedback).

Secure Messaging for Diabetes Management: Content Analysis.

Background: Secure messaging use is associated with improved diabetes-related outcomes. However, it is less clear how secure messaging supports diabetes management.

Objective: We examined secure message topics between patients and clinical team members in a national sample of veterans with type 2 diabetes to understand use of secure messaging for diabetes management and potential associations with glycemic control.