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Introduction: Automated models that predict cognitive risk in older adults can aid decisions about which patients to screen in busy primary care settings.
Methods: In this retrospective prediction model development study, we conducted formal cognitive testing on 337 older primary care patients to establish cognitive status. We used up to 5 years of prior discrete-field electronic health record (EHR) data to develop a multivariable prediction model that differentiates patients with impaired versus intact cognition.
Results: The final model included seven easily extractable variables with known associations to cognitive decline: age, race, pulse, systolic blood pressure, non-steroidal anti-inflammatory use, history of mood disorder, and family history of neurological disease. The model demonstrated good discrimination of cognitive status (concordance statistic = 0.72).
Discussion: The cognitive risk model may be useful clinically to prompt for objective cognitive screening in high-risk patients. The use of common, discrete variables ensures relative ease of implementation in EHRs.
Highlights: 337 older primary care patients completed full neuropsychological assessment.Risk modeling used data available in a typical primary care record.The model successfully differentiated patients with/without cognitive impairment.This EHR model offers a passive workflow to identify patients at cognitive risk.
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http://dx.doi.org/10.1002/dad2.70136 | DOI Listing |
JCI Insight
September 2025
Division of Nephrology, Boston University Chobanian & Avedisian School of Medicine, Boston, United States of America.
Background: Active vitamin D metabolites, including 25-hydroxyvitamin D (25D) and 1,25-dihydroxyvitamin D (1,25D), have potent immunomodulatory effects that attenuate acute kidney injury (AKI) in animal models.
Methods: We conducted a phase 2, randomized, double-blind, multiple-dose, 3-arm clinical trial comparing oral calcifediol (25D), calcitriol (1,25D), and placebo among 150 critically ill adult patients at high-risk of moderate-to-severe AKI. The primary endpoint was a hierarchical composite of death, kidney replacement therapy (KRT), and kidney injury (baseline-adjusted mean change in serum creatinine), each assessed within 7 days following enrollment using a rank-based procedure.
Kidney360
September 2025
Department of Pediatrics, Division of Pediatric Nephrology, Baylor College of Medicine, Houston, TX, United States.
Background: Dialysis in neonates with ESKD is often associated with multiple comorbidities and the need for more intensified dialysis regimens. With recent advances in prenatal interventions and infant specific KRT, survival of neonates with ESKD has improved over the last decade. Little is known however about the impact on the health care system of improved survival in this population.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Importance: Exposure to inflammation from chorioamnionitis places the fetus at higher risk of premature birth and may increase the risk of neurodevelopmental impairments, though the evidence for the latter is mixed.
Objective: To evaluate whether moderate to severe histologic chorioamnionitis (HCA) is directly associated with adverse motor performance, independent of the indirect mediating effects of premature birth.
Design, Setting, And Participants: This prospective, population-based cohort study recruited participants between September 16, 2016, and November 19, 2019, from referral and nonreferral neonatal intensive care units of 5 southwestern Ohio hospitals.
Purpose: The purpose of this document is to review current methods for cervical ripening and to summarize the effectiveness of these approaches based on appropriately conducted outcomes-based research. This document focuses on cervical ripening in individuals with term, singleton, vertex pregnancies with membranes intact, because this is the population in whom most studies were conducted. For more information on recommended timing of delivery based on maternal, fetal, and obstetric conditions and on labor management, refer to: American College of Obstetricians and Gynecologists (ACOG) Committee Opinion No.
View Article and Find Full Text PDFAge Ageing
August 2025
Department of Nursing Health Services Research, Graduate School of Health Care Sciences, Institute of Science Tokyo, Yushima, Bunkyo-ku, Tokyo, Japan.
Background: Little is known about how ambulatory care sensitive condition (ACSC)-related readmissions can be reduced in acute care settings.
Objective: This study examined the association between transitional care for hospitalised older patients with ACSC and ACSC-related readmissions.
Methods: This retrospective observational cohort study included patients aged 65 years and older admitted with ACSC as the primary diagnosis from 1 April 2022 to 31 January 2023, using linked data from the Diagnosis Procedure Combination and the medical functions of the hospital beds database.