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Adult Neurology Rotations for Child Neurology Residents: A Survey of Program Directors.

Neurology 2022 May 26. Epub 2022 May 26.

Division of Child Neurology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.

Background And Objectives: We aimed to identify how child neurology and neurodevelopmental disabilities residency program directors (PDs) implemented revised Accreditation Council for Graduate Medical Education requirements for adult neurology training for child neurology residents. Prior to 2014, American Board of Psychiatry and Neurology certification for child neurology required an "adult year," with no specified rotation requirements. At that point, programs scheduled a median of 10 months of adult neurology rotations during the third postgraduate year (PGY-3). Read More

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Microinfarcts in the Deep Gray Matter on 7T MRI: Risk Factors, MRI Correlates, and Relation to Cognitive Functioning-The SMART-MR Study.

AJNR Am J Neuroradiol 2022 May 26. Epub 2022 May 26.

Julius Center for Health Sciences and Primary Care (R.G., I.R., M.I.G.)

Background And Purpose: The clinical relevance of cortical microinfarcts has recently been established; however, studies on microinfarcts in the deep gray matter are lacking. We examined the risk factors and MR imaging correlates of microinfarcts in the deep gray matter on 7T MR imaging and their relation to cognitive functioning.

Materials And Methods: Within the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study, 213 patients (mean age, 68 [SD, 8] years) had a risk-factor assessment, 7T and 1. Read More

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Views about Primary Care health checks for autistic adults: UK survey findings.

BJGP Open 2022 May 26. Epub 2022 May 26.

Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Morpeth, UK.

Background: Compared to the general population, autistic adults experience higher rates of physical and mental health conditions, premature morbidity and mortality, and barriers to healthcare. A health check for autistic people may improve their health outcomes.

Aim: To establish the views of autistic people toward a primary care health check for autistic people. Read More

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Current Landscape of Produce Prescription Programs in the US.

J Nutr Educ Behav 2022 Jun;54(6):575-581

Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA.

Objective: To understand the design and implementation models of US produce prescription programs.

Methods: In a mixed-methods study, program providers completed an online survey and an individual phone interview regarding their 2019 programming.

Results: Twenty-three programs completed surveys; 20 completed interviews. Read More

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Increased risk of incident knee osteoarthritis in those with greater work-related physical activity.

Occup Environ Med 2022 May 26. Epub 2022 May 26.

Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts, USA.

Objective: Occupations involving greater physical activity may increase risk for knee osteoarthritis (OA). Existing studies have not evaluated work-related physical activity before OA onset. Hence, we aimed to evaluate the association between work-related physical activity and knee OA incidence. Read More

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[Supportive and palliative care: Where do we stand?]

Carole Bouleuc

Bull Cancer 2022 May;109(5):514-515

Unité mobile d'accompagnement, Institut Curie, Paris, France. Electronic address:

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[Improving cancer care necessarily involves the development of supportive care].

Ivan Krakowski

Bull Cancer 2022 May;109(5):511-513

Association francophone pour les soins oncologiques de support, 33000 Bordeaux, France. Electronic address:

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Immune determinants of endometrial receptivity: a biological perspective.

Fertil Steril 2022 Jun;117(6):1107-1120

Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.

Immune cells are essential for endometrial receptivity to embryo implantation and early placental development. They exert tissue-remodeling and immune regulatory roles-acting to promote epithelial attachment competence, regulate the differentiation of decidual cells, remodel the uterine vasculature, control and resolve inflammatory activation, and suppress destructive immunity to paternally inherited alloantigens. From a biological perspective, the endometrial immune response exerts a form of "quality control"-it promotes implantation success when conditions are favorable but constrains receptivity when physiological circumstances are not ideal. Read More

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Call for Formalized Pathways in Vascular Medicine Training: JACC Review Topic of the Week.

J Am Coll Cardiol 2022 May;79(21):2129-2139

Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

The burden of vascular diseases and complexity of their management have been growing. Vascular medicine specialists may help to bridge gaps in care, especially as part of multidisciplinary teams. However, there is a limited number of vascular medicine specialists because of constraints in training. Read More

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Gender Differences in Takotsubo Syndrome.

J Am Coll Cardiol 2022 May;79(21):2085-2093

University of Foggia, Department of Medical and Surgical Sciences, Foggia, Italy.

Background: Male sex in takotsubo syndrome (TTS) has a low incidence and it is still not well characterized.

Objectives: The aim of the present study is to describe TTS sex differences.

Methods: TTS patients enrolled in the international multicenter GEIST (GErman Italian Spanish Takotsubo) registry were analyzed. Read More

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Fracture Risk of Sodium-Glucose Cotransporter-2 Inhibitors in Chronic Kidney Disease.

Clin J Am Soc Nephrol 2022 May 26. Epub 2022 May 26.

Institute for Clinical and Evaluative Sciences (ICES), London, Ontario, Canada.

Background And Objectives: Sodium-glucose cotransporter-2 (SGLT2) inhibitors have been associated with a higher risk of skeletal fractures in some randomized, placebo-controlled trials. Secondary hyperparathyroidism and increased bone turnover (also common in CKD) may contribute to the observed fracture risk. We aimed to determine if SGLT2 inhibitor use associates with a higher risk of fractures compared with dipeptidyl peptidase-4 (DPP-4) inhibitors, which have no known association with fracture risk. Read More

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Mediator or moderator? The role of obesity in the association between age at menarche and blood pressure in middle-aged and elderly Chinese: a population-based cross-sectional study.

BMJ Open 2022 May 26;12(5):e051486. Epub 2022 May 26.

Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, Wuhu, Anhui, China.

Objective: We investigated the moderation/mediation between the age of menarche and obesity parameters in predicting blood pressure (BP) in middle-aged and elderly Chinese.

Design: Our study is a population-based cross-sectional study.

Setting: Participants in this study came from the China Health and Retirement Longitudinal Study (CHARLS). Read More

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Preferences of Australian healthcare providers regarding education on long-term health after hypertensive disorders of pregnancy: a qualitative study.

BMJ Open 2022 May 26;12(5):e055674. Epub 2022 May 26.

Discipline of Women's Health, University of New South Wales Faculty of Medicine and Health, Sydney, New South Wales, Australia.

Objectives: To explore Australian healthcare providers' (HCPs') preferred content, format and access to education regarding long-term health after hypertensive disorder of pregnancy (HDP), in order to guide the development of education programmes.

Design And Setting: A qualitative study using a framework analysis was undertaken. Registered HCP who were practising in Australia and previously completed a survey about long-term health after HDP were invited to participate. Read More

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Emergency department and urgent care clinician perspectives on digital access to past medical histories.

BMJ Health Care Inform 2022 May;29(1)

Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.

Objective: To explore emergency department (ED) and urgent care (UC) clinicians' perceptions of digital access to patients' past medical history (PMH).

Methods: An online survey compared anticipated and actual value of access to digital PMH. UTAUT2 (Unified Theory of Acceptance and Use of Technology 2) was used to assess technology acceptance. Read More

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Teledermatology to reduce face-to-face appointments in general practice during the COVID-19 pandemic: a quality improvement project.

BMJ Open Qual 2022 May;11(2)

School of Medicine, University of St Andrews, St Andrews, UK.

Teledermatology is an important subspecialty of telemedicine that continues to evolve with advances in telecommunication and mobile phone technology. A 19-week primary care quality improvement project collected baseline data and tested three change ideas, using the Model for Improvement method, with primary and secondary aims: to increase the weekly percentage of remote dermatological consultations with supporting images that were successfully concluded remotely to greater than 80% and to reduce the weekly percentage of dermatological face-to-face consultations to less than 50%. We hypothesised that by improving the quality of patient images and the confidence of reception staff in triaging skin complaints, there would be a decrease in the weekly number of face-to-face dermatological appointments, thereby decreasing the risk of COVID-19 transmission within the practice and community. Read More

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Improving referrals to community mental health services in the liaison setting.

BMJ Open Qual 2022 May;11(2)

Newham Mental Health Liaison and Psychological Medicine Team, Barts Health NHS Trust, London, UK.

The East London Foundation Trust (ELFT) psychiatric liaison team (PLT) at Newham University Hospital (NUH) is responsible for referring adult patients they have reviewed, on to community mental health services on discharge where appropriate, and also to notify their existing team for follow-up on discharge when already under the care of a community service. This should then lead to appropriate ongoing management of the patient's mental health needs in terms of continued support and assessment of risk, further assessment of mental state, titration of medications and prevention of further admissions.Following an ELFT incident review where it was noted that a patient was not referred to community services on discharge, a retrospective case note review was undertaken over an 11-month period to define the baseline efficacy of current referrals. Read More

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Trans-inguinal pelvic lymphadenectomy in vulvar cancer patients: TRIPLE pilot study.

Int J Gynecol Cancer 2022 May 26. Epub 2022 May 26.

Dipartimento Universitario Scienze della Vita e Sanità Pubblica - Sezione di Ginecologia ed Ostetricia - Università Cattolica del Sacro Cuore, Rome, Italy.

Objective: The goal of this study was to assess the feasibility and safety of a retrograde extraperitoneal trans-inguinal novel approach to pelvic lymphadenectomy in vulvar cancer patients. The secondary objectives were to assess complications (early and late) and oncological outcomes.

Methods: In this pilot study, all patients referred to our institution from November 2019 to May 2021 were evaluated. Read More

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The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good.

BMJ Glob Health 2022 May;7(5)

Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.

Vaccination policies have shifted dramatically during COVID-19 with the rapid emergence of population-wide vaccine mandates, domestic vaccine passports and differential restrictions based on vaccination status. While these policies have prompted ethical, scientific, practical, legal and political debate, there has been limited evaluation of their potential unintended consequences. Here, we outline a comprehensive set of hypotheses for why these policies may ultimately be counterproductive and harmful. Read More

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Assessing the burden of COVID-19 in developing countries: systematic review, meta-analysis and public policy implications.

BMJ Glob Health 2022 May;7(5)

Western Sydney Diabetes, Western Sydney Local Health District, Blacktown, New South Wales, Australia

Introduction: The infection fatality rate (IFR) of COVID-19 has been carefully measured and analysed in high-income countries, whereas there has been no systematic analysis of age-specific seroprevalence or IFR for developing countries.

Methods: We systematically reviewed the literature to identify all COVID-19 serology studies in developing countries that were conducted using representative samples collected by February 2021. For each of the antibody assays used in these serology studies, we identified data on assay characteristics, including the extent of seroreversion over time. Read More

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Optimizing Post-Acute Care Patient Safety: A Scoping Review of Multifactorial Fall Prevention Interventions for Older Adults.

J Appl Gerontol 2022 May 26:7334648221104375. Epub 2022 May 26.

Department of Sociology, 14669California State University Los Angeles, Los Angeles, CA, USA.

Accidental falls are preventable adverse events for older post-acute care (PAC) patients. Yet, due to the functional and medical care needs of this population, there is little guidance to inform multidisciplinary prevention efforts. This scoping review aims to characterize the evidence for multifactorial PAC fall prevention interventions. Read More

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Responding to emerging oral healthcare needs with CARE: Design of the CARE curriculum model.

J Dent Educ 2022 May 26. Epub 2022 May 26.

Department of Primary Care, High Point University Workman School of Dental Medicine, High Point, North Carolina, USA.

The release of the National Institutes of Health report, Oral Health in America: Advances and Challenges, in 2022 identified a pressing concern about oral healthcare and that "the job is far from finished." The High Point University Workman School of Dental Medicine utilized this report as inspiration to facilitate the design of the Clinician-Advocate-Researcher-Entrepreneur Curriculum. The aspiration was to create a novel curriculum and experiential model to prepare learners for the future of dental medicine, including addressing these public oral healthcare needs. Read More

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Association of Ankle Sprain Frequency With Body Mass and Self-Reported Function: A Pooled Multisite Analysis.

J Sport Rehabil 2022 May 26:1-6. Epub 2022 May 26.

School of Health and Kinesiology, University of Nebraska, Omaha, NE,USA.

Context: Ankle sprains result in pain and disability. While factors such as body mass and prior injury contribute to subsequent injury, the association of the number of ankle sprains on body anthropometrics and self-reported function are unclear in this population. Therefore, the purpose of this investigation was to assess differences in anthropometric measurements and self-reported function between the number of ankle sprains utilizing a large, pooled data set. Read More

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Association between thoracic epidural block and major complications after pleurectomy/decortication for malignant pleural mesothelioma under general anesthesia.

Reg Anesth Pain Med 2022 May 20. Epub 2022 May 20.

Department of Anesthesiology and Pain Medicine, Hyogo Medical University, School of Medicine, Nishinomiya, Hyogo, Japan

Introduction: A curative-intent surgical procedure, pleurectomy/decortication, for malignant pleural mesothelioma is accompanied by a high incidence of major postoperative complications. Although epidural block, which suppresses nociception during and after surgery, reportedly has both benefits and disadvantages in terms of outcomes after thoracic surgery for other diseases, the effects of epidural block on major complications after pleurectomy/decortication have not been evaluated. The aim of this study was to evaluate the association between epidural block and major postoperative complications following pleurectomy/decortication. Read More

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An emerging phenotype of pulmonary arterial hypertension patients carrying variants.

Eur Respir J 2022 May 26. Epub 2022 May 26.

Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.

Introduction: The phenotype of pulmonary arterial hypertension (PAH) patients carrying pathogenic variants remains mostly unknown.

Methods: We report the genetic analysis findings, characteristics and outcomes of patients with heritable PAH carrying variants from the French Pulmonary Hypertension Network.

Results: Twenty patients and eight unaffected relatives were identified. Read More

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