Deconstructing the intercellular interactome in vascular dementia with focal ischemia for therapeutic applications.

Vascular dementia (VaD), the second-leading cause of dementia, is primarily a white matter ischemic disease with no direct therapies. Cell-cell interactions within lesion sites dictate disease progression or repair. To elucidate key intercellular pathways, we employ a VaD mouse model with focal ischemia replicating many elements of the complex pathophysiology of human VaD combined with transcriptomic and functional analyses.

Over One-Third of Surgical Patients Report Inadequate Shared Decision-Making: Opportunities for Improvement From the ACS NSQIP PROMs Project.

Objective: This study aimed to identify patient, surgeon, and hospital characteristics associated with inadequate shared decision-making (SDM) after surgery.

Background: SDM that incorporates patients' preferences, values, and goals is integral to setting expectations and delivering high-quality patient-centered surgical care.

Methods: This retrospective cohort study of 65 US hospitals analyzed data from the American College of Surgeons National Surgical Quality Improvement Program Patient-Reported Outcomes Measures Project.

Medication underuse in real-life practice: the impact of galcanezumab towards achieving very low frequency episodic migraine in a southeast Asian middle-income nation.

Background: Migraine progression, particularly from episodic to chronic migraine (CM), increases disease burden and healthcare costs. Understanding the new concept of "Medication Underuse Headache" should encourage the health care provider to consider early intervention with calcitonin gene-related peptide (CGRP) monoclonal antibodies. Galcanezumab given early in the course of the disease, may prevent migraine chronification and have a robust response, moreso than when initiated in later stages of migraine.

Hepatic and Pancreatic Cellular Response to Early Life Nutritional Mismatch.

To determine the basis for perinatal nutritional mismatch causing metabolic dysfunction-associated steatotic liver disease and diabetes mellitus, we examined adult phenotype, hepatic transcriptome, and pancreatic β-islet function. In prenatal caloric-restricted rats with intrauterine growth restriction (IUGR) and postnatal exposure to high fat with fructose (HFhf) or high carbohydrate, we investigated male and female IUGR-HFhf and IUGR-high carbohydrate, vs HFhf and control offspring. Males more than females displayed adiposity, glucose intolerance, insulin resistance, hyperlipidemia, and hepatomegaly with hepatic steatosis.

Integrated Care in a Large Public System Improves Simple Kidney Stone Management.

Introduction: In the Los Angeles County Department of Health Services-the second largest public health care system in the United States-clinical integration allows specialists and primary care providers to collaboratively provide specialty care. We used time-driven activity-based costing to compare patient burden and cost of kidney stone diagnosis, workup, and management with and without clinical integration.

Methods: We interviewed and observed teams of physicians and staff to understand workflow practices and personnel, space, material, and device requirements for stone care in the 2 models.

Exploring the Association Between Heart Rate Control and Rehospitalization: A Real-World Analysis of Patients Hospitalized with Heart Failure with Reduced Ejection Fraction.

Background: In patients with heart failure with reduced ejection fraction (HFrEF), lower discharge heart rate (HR) is known to be associated with better outcomes. However, the effect of HR control on patient outcomes, and the demographic and clinical determinants of this association, are not well documented.

Objectives: The purpose of this work was to evaluate the association between the HR control and the risk of post-discharge rehospitalization in patients hospitalized with HFrEF.

Patient-Reported Outcome Measures Within a National Multispecialty Surgical Quality Improvement Program.

Importance: Patient-reported outcome measures (PROMs) are increasingly recognized for their ability to promote patient-centered care, but concerted health information technology (HIT)-enabled PROM implementations have yet to be achieved for national surgical quality improvement.

Objective: To evaluate the feasibility of collecting PROMs within a national surgical quality improvement program.

Design, Setting, And Participants: This was a pragmatic implementation cohort study conducted from February 2020 to March 2023.

Preferences and perceptions of 617 migraine patients on acute and preventive migraine treatment attributes and clinical trial endpoints.

Background: To identify the preferences and perceptions of migraine patients for acute and preventive treatment options and to investigate which treatment outcomes are the most important.

Design And Methods: The authors performed a choice-format survey in a cohort of migraine patients from Greece and Cyprus. A self-administered questionnaire developed in collaboration with the Greek Society of Migraine Patients was used.

Adding Patient-reported Outcomes to the American College of Surgeons National Surgical Quality Improvement Program: Results of the First 33,842 Patients From 65 Hospitals.

Objective: To investigate the initial set of patient-reported outcomes (PROs) in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) and their associations with 30-day surgical outcomes.

Background: PROs provide important information that can be used to improve routine care and facilitate quality improvement. The American College of Surgeons conducted a demonstration project to capture PROs into the NSQIP to complement clinical data.

Management of race, ethnicity, and language data in the pediatric emergency department.

In this secondary analysis of a multicenter investigation, we describe several gaps in the collection and management of pediatric race, ethnicity, and language data. These findings highlight the ongoing need for reliable data management processes as a crucial step toward advancing pediatric health equity.

Antibiotic Switches in Urinary Tract Infection Are Associated With Atypical Symptoms and Emergent Care.

Importance: Given worsening global antibiotic resistance, antimicrobial stewardship aims to use the shortest effective duration of the most narrow-spectrum, effective antibiotic for patients with specific urinary symptoms and laboratory testing consistent with urinary tract infection (UTI). Inappropriate treatment and unnecessary antibiotic switching for UTIs harms patients in a multitude of ways.

Objective: This study sought to analyze antibiotic treatment failures as measured by antibiotic switching for treatment of UTI in emergent and ambulatory care.

Evaluating the Use of IncobotulinumtoxinA in Combination with Calcium Hydroxylapatite with Integral Lidocaine for Improving Chin Profile Projection Aesthetics.

Background: Microgenia resulting from congenital deficiency or aging can significantly affect the facial profile and render it less attractive. This study assessed the effectiveness of treatment with incobotulinumtoxinA (Inco) and calcium hydroxylapatite with integral lidocaine (CaHA[+]) for improving chin profile.

Methods: Subjects with a hyperactive mentalis and at least moderate chin retrusion according to the Asian Chin Projection Scale (ACPS) were recruited.

Contaminant Organism Growth in Febrile Infants at Low Risk for Invasive Bacterial Infection.

In this multicenter, cross-sectional, secondary analysis of 4042 low-risk febrile infants, nearly 10% had a contaminated culture obtained during their evaluation (4.9% of blood cultures, 5.0% of urine cultures, and 1.

Targeting HER2-mutant metastatic cervical cancer with neratinib: Final results from the phase 2 SUMMIT basket trial.

Objective: HER2 mutations are associated with poor prognosis and are detected in 3-6% of cervical cancers. Neratinib, an irreversible pan-HER tyrosine kinase inhibitor, had activity in several HER2-mutant cancer types in the phase 2 SUMMIT basket study. We present updated and final results from the cervical cancer cohort of SUMMIT.

Diffuse large B-cell lymphoma presenting as postmenopausal bleeding.

Key Clinical Message: Endometrial lymphoma is a rare etiology of abnormal uterine bleeding and endometrial thickening, and often shares similar clinical and imaging characteristics with other uterine malignancies such as endometrial carcinoma. Chemotherapy appears adequate for treating primary endometrial lymphoma.

Abstract: We report a case of primary endometrial diffuse large B-cell lymphoma to increase awareness of this condition which is essential for correct diagnosis and treatment.