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There are few data favoring the need for septotomy at the time of peroral endoscopic myotomy (POEM) or if POEM alone is sufficient. Our aim was to compare POEM outcomes with and without septotomy (POEM+S or POEM-S) in patients with symptomatic epiphrenic diverticula (ED) and an underlying motility disorder. This was an international, multicenter retrospective study involving 21 centers between January 2014 and January 2023. Patients with ED and an underlying motility disorder who underwent POEM were included. The primary outcome was clinical success (Eckardt score [ES] ≤3 or a 1-point drop in ES for patients with baseline ES <3) without the need for repeat surgical/endoscopic interventions during follow-up. A total of 85 patients (mean age, 64.29 ± 17.1 years; 32 [37.6%] female) with ED and underlying motility disorder underwent POEM+S (n = 47) or POEM–S (n = 38). Patients in the POEM+S group had a significantly higher mean pre-POEM ES (7.3 ± 2.1 vs 5.8 ± 2; P =.002). The most common indication for POEM was achalasia (51% in the POEM+S cohort and 51.8% in the POEM–S cohort; P =.7). A posterior approach was favored in the POEM+S group (76.6% vs 52.6%; P =.02). A similar rate of technical success was seen in both groups (97.9% vs 100%; P =.1). The rate of adverse events was similar between the 2 cohorts (4.2% vs 8.1%; P =.6). The median length of hospital stay after POEM–S was significantly longer compared with POEM+S (2 days [interquartile range (IQR), 1-4 days] vs 1 day [IQR, 1-2 days]; P =.005). Clinical success was equivalent between the 2 groups (83% vs 86.8%; P =.6) at a median follow-up duration of 8 months (IQR, 3-19 months). In patients with ED and an underlying motility disorder, both POEM+S and POEM–S are equally safe and effective, with similar procedure duration and a low recurrence rate at short-term follow-up. Future comparative prospective studies with long-term follow-up are required to validate these findings. [Display omitted] [ABSTRACT FROM AUTHOR]

Total hip arthroplasty (THA) for osteoarthritis (OA) is a major health system cost. Education and exercise (Edu + Ex) programs may reduce the number of THAs needed, but supporting data are limited. This study aimed to estimate the treatment effect of THA versus Edu + Ex on pain, function, and quality of life outcomes 3 and 12 months after treatment initiation for hip OA. Patients who had hip OA who underwent THA or an Edu + Ex program were included in this propensity-matched study. In 778 patients (Edu + Ex, n = 303; THA, n = 475), propensity scores were based on pretreatment characteristics, and patients were matched on a 1:1 ratio. Between-group treatment effects (pain, function, and quality of life) were estimated as the mean difference (MD) in change from pretreatment to 3-month and 12-month follow-up using linear mixed models. The matched sample consisted of 266 patients (Edu + Ex, n = 133; THA, n = 133) who were balanced on all pretreatment characteristics except opioid use. At 12-month follow-up, THA resulted in significantly greater improvements in pain (MD 35.4; 95% confidence interval [CI] 31.4 to 39.4), function (MD 30.5; 95% CI 26.3 to 34.7), and quality of life (MD 33.6; 95% CI 28.8 to 38.4). Between 17% and 30% of patients receiving Edu + Ex experienced a surgical threshold for clinically meaningful improvement in outcomes, compared to 84% and 90% of THA patients. A THA provides greater improvements in pain, function, and quality of life. A notable proportion of Edu + Ex patients had clinically meaningful improvements, suggesting Edu + Ex may result in THA deferral in some patients, but confirmatory trials are needed. [ABSTRACT FROM AUTHOR]

The accuracy and completeness of self-disclosures of the value of industry payments by authors publishing in radiology journals are not well known. The aim of this study was to assess the accuracy of financial disclosures by US authors in five prominent radiology journals. Financial disclosures provided by US-based authors in five prominent radiology journals from original research and review articles published in 2021 were reviewed. For each author, payment reports were extracted from the Open Payments Database (OPD) in the previous 36 months related to general, research, and ownership payments. Each author was analyzed individually to determine if the reported disclosures matched results from the OPD. A total of 4,076 authorships, including 3,406 unique authors, were selected from 643 articles across the five journals; 1,388 (1,032 unique authors) received industry payments within the previous 36 months, with a median total amount received per authorship of $6,650 (interquartile range, $355-$87,725). Sixty-one authors (4.4%) disclosed all industry relationships, 205 (14.8%) disclosed some of the OPD-reported relationships, and 1,122 (80.8%) failed to disclose any relationships. Undisclosed payments totaled $186,578,350, representing 67.2% of all payments. Radiology had the highest proportion of authorships disclosing some or all OPD-reported relationships (32.3%), compared with the Journal of Vascular and Interventional Radiology (18.2%), the American Journal of Neuroradiology (17.3%), JACR (13.1%), and the American Journal of Roentgenology (10.3%). Financial relationships with industry are common among US physician authors in prominent radiology journals, and nondisclosure rates are high. [Display omitted] [ABSTRACT FROM AUTHOR]

To assess the association between ambient heat and all-cause and cause-specific emergency department (ED) visits and acute hospitalizations among Medicare beneficiaries in the conterminous United States. Retrospective cohort study. Conterminous US from 2008 and 2019. 2% random sample of all Medicare fee-for-service beneficiaries eligible for Parts A, B, and D. All-cause and cause-specific (cardiovascular, renal, and heat-related) ED visits and unplanned hospitalizations were identified using primary ICD-9 or ICD-10 diagnosis codes. We measured the association between ambient temperature – defined as daily mean temperature percentile of summer (June through September) – and the outcomes. Hazard ratios and their associated 95% confidence intervals were estimated using multivariable Cox proportional hazards regression, adjusting for individual level demographics, comorbidities, healthcare utilization factors and zip-code level social factors. Among 809,636 Medicare beneficiaries (58% female, 81% non-Hispanic White, 24% <65), older beneficiaries (aged ≥65) exposed to >95th percentile temperature had a 64% elevated adjusted risk of heat-related ED visits (HR [95% CI], 1.64 [1.46,1.85]) and a 4% higher risk of all-cause acute hospitalization (1.04 [1.01,1.06]) relative to <25th temperature percentile. Younger beneficiaries (aged <65) showed increased risk of heat-related ED visits (2.69 [2.23,3.23]) and all-cause ED visits (1.03 [1.01,1.05]). The associations with heat related events were stronger in males and individuals dually eligible for Medicare and Medicaid. No significant differences were observed by climatic region. We observed no significant relationship between temperature percentile and risk of CV-related ED visits or renal-related ED visits. Among Medicare beneficiaries from 2008 to 2019, exposure to daily mean temperature ≥ 95th percentile was associated with increased risk of heat-related ED visits, with stronger associations seen among beneficiaries <65, males, and patients with low socioeconomic position. Further longitudinal studies are needed to understand the impact of heat duration, intensity, and frequency on cause-specific hospitalization outcomes. [ABSTRACT FROM AUTHOR]

• Temporomandibular disorders (TMDs) is an umbrella term that refers to group of disorders affecting musculoskeletal and neuromuscular conditions. • Osteoarthritis is most common degenerative joint disorder affecting TMJ. • Treatment approaches for TMJ disorders range from non-invasive to surgical interventions depending on the severity of degeneration. Degenerative Joint Disorders (DJD) of the Temporomandibular Joint (TMJ) represent a challenging and multifaceted group of conditions that severely impact the joint's function and quality of life. This comprehensive review delves into the etiology, pathogenesis, clinical manifestations, and contemporary management strategies of TMJ-OA. While systemic illnesses, aging processes, hormonal factors, and behavioral factors have been implicated in its development, recent evidence highlights the pivotal role of mechanical overloading in initiating a series of degenerative changes within the TMJ. Painful joints, a hallmark of TMJ-OA, result from the soft tissues around the affected joint and reflexive muscle spasm, following Hilton's law, which innervates the joint's muscles and overlying skin. This self-preservation reflex protects against further joint damage. Moreover, painful symptoms may arise from subchondral bone destruction. Recognizing the importance of understanding the biomechanical environment within the TMJ, this review underscores its relevance in identifying the mechanisms behind TMJ pain and disability. Furthermore, it discusses the potential application of tissue engineering in TMJ reconstruction, emphasizing the need to learn from past TMJ implant experiences. In the context of treatment, the review highlights the significance of managing TMJ-OA, focusing on restoring function and reducing pain. Treatment modalities span from non-invasive therapies to surgical options, with the latter reserved for cases unresponsive to conservative approaches and severely affecting an individual's quality of life. This review serves as a vital resource for both clinicians and researchers, offering insights into the multifaceted nature of TMJ-OA and the evolving landscape of its diagnosis and management, incorporating biomechanical considerations and potential advances in tissue engineering. Understanding the complexities of TMJ-OA is instrumental in enhancing the care and well-being of individuals affected by this condition. [ABSTRACT FROM AUTHOR]

The accuracy and completeness of self-disclosures by authors of imaging guidelines are not well known. The aim of this study was to assess the accuracy of financial disclosures by US authors of ACR appropriateness criteria. We reviewed financial disclosures provided by US-based authors of all ACR-AC published in 2019, 2021 and 2023. For each US- based author, payment reports were extracted from the Open Payments Database (OPD) in the previous 36 months related to general category and research payments categories. We analyzed each author individually to determine if the reported disclosures matched results from OPD. A total of 633 authorships, including 333 unique authors were included from 38 ACR AC articles in 2019, with 606 authorships (387 unique authors) from 35 ACR-AC articles published in 2021, and 540 authorships (367 unique authors) from 32 ACR AC articles published in 2023. Among authors who received industry payments, failure to disclose any financial relationship was seen in 125/147 unique authors in 2019, 142/148 authors in 2021 and 95/125 unique authors in 2023. The proportion of nondisclosed total value of payments was 86.1% in 2019, 88.6% in 2021 and 56.7% in 2023. General category payments were nondisclosed in 94.1% in 2019, 89.7% in 2021 and 94.4% in 2023 by payment value. Industry payments to authors of radiology guidelines are common and frequently undisclosed. [ABSTRACT FROM AUTHOR]

A single-center prospective randomized controlled study was conducted to assess the effect of targeted mild hypercapnia (TMH) on cerebral oxygen saturation (rSO 2) in patients undergoing off-pump coronary artery bypass grafting (CABG). A prospective randomized controlled study involving 100 patients undergoing off-pump CABG at U. N. Mehta Hospital, Ahmedabad, Gujarat, India. Patients were randomized to either the TMH (PaCO 2 45-55 mmHg) or the targeted normocapnia (TN; PaCO 2 35-45 mmHg) group, containing 50 patients in each group. Monitoring of rSO 2 , heart rate, mean arterial pressure (MAP), PaCO 2 , and peripheral oxygen saturation was done at baseline, after induction, after left internal mammary artery harvesting, at each grafting (distal and proximal), after protamine, and after shifting to the intensive care unit. The standardized minimental-state examination (SMMSE) was performed preoperatively and at 8, 12, and 24 hours postextubation. Data were analyzed using an independent sample t test. The TMH group had higher MAP during grafting (p < 0.001) and higher rSO 2 on both sides during distal and proximal grafting (p < 0.001) and after protamine (p < 0.05), as compared to the TN group. Compared to preoperative values, SMMSE scores in the TN group were significantly lower at 12 and 24 hours postextubation (p < 0.001). TMH during grafting increased the cerebral blood flow and rSO 2 when hemodynamic instability was very common. It has a protective role on the brain and helps maintain cognition postoperatively. [ABSTRACT FROM AUTHOR]

Incontinent pediatric neurogenic bladder (NB) patients face social ostracization and potential renal deterioration. Reconstructive surgery, after maximal medical therapy, requires a difficult decision-making process. Current literature for NB surgeries is difficult to interpret given definitions of dryness, use of augmentation cystoplasty (AC) and the lack of renal preservation. This study assesses the results of a defined surgical protocol to treat incontinent NB patients, using a new composite outcome measure, which includes upper tracts status and a definition of dryness. This is a retrospective cohort study assessing 33 consecutive incontinent NB patients (Spina bifida 31, Sacral agenesis- 2) who underwent one of 2 procedures between 2008 and 2021. AC with a Mitrofanoff procedure (MP) was performed in patients who had a high detrusor leak point pressure (DLPP) and significant bladder trabeculations (N = 21, Group 1). Children with a low DLPP and non-trabeculated bladders, underwent a modified Young-Dees-Leadbetter/Mitchell procedure with a 360° autologous rectus fascial sling (BOP) with concomitant AC and MP (N-12, Group 2). Post-operative success was defined using a composite grading of success assessing dryness, upper tract stability and medication use. The mean age at surgery was 11.6 years (SD = 6 years), with 21 in Group 1 and 12 in Group 2. Mean follow-up was 3.25 years, with a minimum 24-month follow-up period. Success rate was 90% in Group 1 and 66% in Group 2. No patient had upper tract deterioration following surgery. Redo-surgical intervention, was required in 38% of Group 1 and 50% of Group 2 patients. These include 3 bladder neck injections in Group 1 and 2 bladder neck closure in Group 2, with a final success rate to 95 % in Group 1 and 83 % in Group 2. Achieving dryness and preserving upper tracts is a challenge in incontinent NB patients. Dryness rates achieved in this study is comparable, given complications and redo-surgery. Primary bladder neck closure is a radical intervention, but Group 2 patients, may benefit from an upfront discussion of the pros and cons of a bladder neck closure primarily or as a secondary procedure. Isolated AC obtains acceptable results for a selected subset of incontinent NB patients with significant bladder trabeculation. For those requiring a BOP, the success rate is relatively lower with the higher rate of potential complications and need for redo-surgery. [ABSTRACT FROM AUTHOR]

Digital health literacy (DHL) is the confluence where health literacy meets digital literacy. DHL has been labelled as one of the digital determinants of health by the World Health Organization. The present study estimated and compared the DHL between Telangana's urban and rural ageing adults, and their potential determinants. A cross-sectional study was undertaken among 318 of the ageing individuals (≥45 years) of Hyderabad, visiting the primary health centres in the rural and urban field practice during March 2023. A Telugu version of the eHealth literacy scale (eHEALS) and health literacy scale tools were administered by the interviewers. Adjusted analysis was conducted by multiple linear regression method. Overall, 20.4% of the study participants had good DHL, with a similar proportion between rural and urban areas (rural-20.1% and urban-20.8%, p value-0.889). The median eHealth literacy score among the study participants was 8. While 36.5% and 45.9% had smartphones and standard analogue phones, respectively in urban areas, only 19.5% and 38.4% had smartphones and standard analogue phones, respectively in rural areas. Computer usage in the past month, higher educational qualification, and ownership of mobile phones were significant determinants of DHL. A mild but significant correlation between DHL and health literacy screening scores was found. Considering the low DHL among the ageing population, enabling environment with enhanced access to mobile phones/smartphones and familiarity with information and communication technology gadgets must be established to improve their DHL. [ABSTRACT FROM AUTHOR]

• The presence of multiple elements, each with distinct mixing affinities, promotes an accelerated amorphization. The energetic state and atomic size disparities among these elements render the amorphous phase resistant to crystalline reversion upon annealing. • The formation energies reveal that the amorphous structure assumes the most stable configuration and is energetically favorable relative to crystalline phases like BCC, FCC, and HCP, thereby driving the transformations. • High-energy mechanical milling induces distortion, antisite defects, and the formation of nanograin boundaries in the intermetallic phase, disrupting the order in atomic configuration and promoting amorphization. We describe a novel mechanism for the synthesis of a stable high-entropy alloy powder from an otherwise immiscible Mg-Ti rich metallic mixture by employing high-energy mechanical milling. The presented methodology expedites the synthesis of amorphous alloy powder by strategically injecting entropic disorder through the inclusion of multi-principal elements in the alloy composition. Predictions from first principles and materials theory corroborate the results from microscopic characterizations that reveal a transition of the amorphous phase from a precursor intermetallic structure. This transformation, characterized by the emergence of antisite disorder, lattice expansion, and the presence of nanograin boundaries, signifies a departure from the precursor intermetallic structure. Additionally, this phase transformation is accelerated by the presence of multiple principal elements that induce severe lattice distortion and a higher configurational entropy. The atomic size mismatch of the dissimilar elements present in the alloy produces a stable amorphous phase that resists reverting to an ordered lattice even on annealing. [Display omitted] [ABSTRACT FROM AUTHOR]

Radiology has always gone hand-in-hand with technology and artificial intelligence (AI) is not new to the field. While various AI devices and algorithms have already been integrated in the daily clinical practice of radiology, with applications ranging from scheduling patient appointments to detecting and diagnosing certain clinical conditions on imaging, the use of natural language processing and large language model based software have been in discussion for a long time. Algorithms like ChatGPT can help in improving patient outcomes, increasing the efficiency of radiology interpretation, and aiding in the overall workflow of radiologists and here we discuss some of its potential applications. [ABSTRACT FROM AUTHOR]

To compare thrombus removal and residual venous symptoms and signs of disease following interventional treatment of iliofemoral deep vein thrombosis (DVT) with mechanical thrombectomy (MT) and pharmacomechanical catheter directed thrombolysis (PCDT). Retrospective cohort analysis of propensity score matched subgroups from the multicentre prospective MT ClotTriever Outcomes registry and the PCDT arm of the randomised Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter Directed Thrombolysis trial. Patients with bilateral DVT, symptom duration greater than four weeks, isolated femoral–popliteal disease, or incomplete case data were excluded. Patients with iliofemoral DVT were propensity score matched (1:1) on 10 baseline covariables, including race, sex, age, body mass index, leg treated, prior thromboembolism, Marder score, symptom duration, provoked deep vein thrombosis status, and Villalta score. Reduction in post-procedure thrombus burden (i.e., Marder scores), assessment of venous symptoms and signs (i.e., Villalta scores) at 12 months, and healthcare resource utilisation were compared between subgroups. Propensity score matching resulted in 130 patient pairs with no significant differences in baseline characteristics between the MT and PCDT groups. MT was associated with a greater reduction in Marder scores (91.0% vs. 67.7%, p <.001), and a greater proportion of patients at 12 months with no post-thrombotic syndrome (83.1% vs. 63.6%, p =.007) compared with matched patients receiving PCDT. No differences in rates of adjunctive stenting or venoplasty were identified (p =.27). Higher rates of single session treatment were seen with MT (97.7% vs. 26.9%, p <.001), which also showed shorter mean post-procedure hospital stays (1.81 vs. 3.46 overnights, p <.001), and less post-procedure intensive care unit utilisation (2.3% vs. 52.8%, p <.001). Compared with PCDT, MT was associated with greater peri-procedural thrombus reduction, more efficient post-procedure care, and improved symptoms and signs of iliofemoral vein disease at 12 months. [ABSTRACT FROM AUTHOR]

• As of August 18th, 2022, the COVID-19 pandemic has claimed over 6,400,000 lives worldwide and over 1,000,000 lives in the United States. • Prior retrospective studies exist in the literature, documenting that statins have a mortality benefit in patients hospitalized with COVID-19. These studies have focused on populations with a high proportion of Caucasians. • This retrospective study examines a population that is majority African American and found no benefit of statins in patients hospitalized with COVID-19 in mortality, survival time, need for ICU care, length of ICU stay, need for ventilator, duration of intubation, or need for dialysis. • Further research should be done examining the interplay between COVID-19, statins, and race/ethnicity to better elucidate whether statins have any beneficial effect in decreasing mortality caused by COVID-19. The COVID-19 pandemic has claimed over 6.4 million lives globally. Finding effective medications to reduce mortality in hospitalized COVID-19 patients remains critical. No previous study has been published on the effects of statin use in a majority African American COVID-19 patient population. This study aims to assess the relationship between in-hospital statin use and mortality in this population. A retrospective chart review of patients diagnosed with COVID-19 from March 2020 to June 2020 admitted to the Phoebe Putney Health System in Albany, Georgia, an early epicenter of the COVID-19 pandemic, was conducted. The outcomes of 735 hospitalized COVID-19 positive patients from over 40 counties in Georgia were analyzed. The primary outcome of interest was all-cause mortality, with secondary outcomes of interest of ICU care, length of ICU stay, need for mechanical ventilator, duration of intubation, and need for dialysis. Multivariate logistic regression and Cox proportional hazards analysis were conducted to examine the effect of in-hospital statin use and mortality. 186 of 735 total patients were prescribed statins in-hospital. 83.8% were African American. Multivariate logistic regression found in-hospital statin use was not significantly associated with the primary outcome – all-cause mortality (p=0.23). Similar findings were seen in need for ICU care, length of ICU stay, need for mechanical ventilator, duration of intubation, and need for dialysis (p>0.05). Additionally, results from a Cox proportional hazards model found in-hospital statin use was not associated with survival time. Sensitivity analysis conducted on only African American patients validated that in-hospital statin use was not associated with all-cause mortality in these patients. Of note, immunosuppression and severe disease presentation were associated with a six-fold increase in risk of mortality and the largest decreases in survival time. It is possible statins have no mortality benefit for this patient population, but further research beyond this association study would need to be conducted to determine this conclusively. From this study, the best clinical recommendation would be to continue statins for COVID-19 patients with pre-hospital statin use and to launch a randomized clinical trial to definitively determine the efficacy of statins in the treatment of hospitalized COVID-19 patients. [ABSTRACT FROM AUTHOR]

Equity in faculty compensation in U.S. academic radiology physicians relative to other specialties is not well known. The aim of this study is to assess salary equity in U.S. academic radiology physicians at different ranks relative to other clinical specialties. The American Association of Medical Colleges (AAMC) Faculty Salary Survey was used to collect information for full-time faculty at U.S. medical schools. Financial compensation data were collected for 2023 for faculty with MD or equivalent degree in medical specialties, stratified by gender and rank. The AAMC Faculty Salary Survey data for 2023 included responses for 97,224 faculty members in clinical specialties, with 5847 faculty members in Radiology departments. In radiology, compared to men (n = 3839), the women faculty members (n = 1763) had a lower median faculty compensation by 6% at the rank of Assistant Professor, 3% for Associate Professors, 4% for Professors and 6% for Section Chief positions. Surgery had the highest difference in median compensation with 21%, 24%, 22% and 19% lower faculty compensation, respectively, for women faculty members at corresponding ranks. Pathology had the lowest percent difference (< 1%) in median compensation for all professor ranks. Salary inequity in radiology was lower compared to most other specialties. From assistant to full professors, all other clinical specialties except Pathology and Psychiatry, had a greater salary inequity than Radiology. The salary inequity in academic radiology faculty is lower than most other specialties. Further efforts should be made to reduce salary inequities as broader efforts to provide a more diverse, equitable and inclusive environment. Salary inequity in academic radiology faculty is lower than most other specialties. [ABSTRACT FROM AUTHOR]

Heart failure is a significant global cause of mortality and morbidity. This research article aims to evaluate the performance of decision tree (DTree) and support vector machine (SVM) methods in predicting heart disease. The study utilizes a dataset with diverse features and employs exploratory data analysis (EDA), clustering, and classification techniques to gain insights and evaluate the performance of the two methods. The results demonstrate the effectiveness of both DTree and SVM in predicting heart disease. Notably, SVM outperforms DTree in terms of accuracy, precision, recall, and F1-score. However, the performance of these methods is influenced by the preprocessing steps applied, indicating the importance of selecting appropriate data preprocessing techniques for optimal performance with specific machine learning algorithms. This study emphasizes the potential of machine learning algorithms in predicting heart disease and underscores the significance of thoughtful preprocessing technique selection to enhance performance. [ABSTRACT FROM AUTHOR]

Iron deficiency in patients with heart failure (HF) is underdiagnosed and undertreated. The role of intravenous (IV) iron is well-established to improve quality of life measures. Emerging evidence also supports its role in preventing cardiovascular events in patients with HF. We conducted a literature search of multiple electronic databases. Randomized controlled trials that compared IV iron to usual care among patients with HF and reported cardiovascular (CV) outcomes were included. Primary outcome was the composite of first heart failure hospitalization (HFH) or CV death. Secondary outcomes included HFH (first or recurrent), CV death, all-cause mortality, hospitalization for any cause, gastrointestinal (GI) side effects, or any infection. We performed trial sequential and cumulative meta-analyses to evaluate the effect of IV iron on the primary endpoint, and on HFH. Nine trials enrolling 3337 patients were included. Adding IV iron to usual care significantly reduced the risk of first HFH or CV death [risk ratio (RR) 0.84; 95 % confidence interval (CI) 0.75–0.93; I2 = 0 %; number needed to treat (NNT) 18], which was primarily driven by a reduction in the risk of HFH of 25 %. IV iron also reduced the risk of the composite of hospitalization for any cause or death (RR 0.92; 95 % CI 0.85–0.99; I2 = 0 %; NNT 19). There was no significant difference in the risk of CV death, all-cause mortality, adverse GI events, or any infection among patients receiving IV iron compared to usual care. The observed benefits of IV iron were directionally consistent across trials and crossed both the statistical and trial sequential boundaries of benefit. In patients with HF and iron deficiency, the addition of IV iron to usual care reduces the risk of HFH without affecting the risk of CV or all-cause mortality. CI, confidence intervals; CV, cardiovascular; HFH, heart failure hospitalization; RCTs, randomized controlled trials; RR, risk ratios. [Display omitted] • 9 RCTs evaluated outcomes of IV iron in patients with heart failure and anemia. • IV iron lowers risk of heart failure hospitalization or cardiovascular death by 16 %. • IV iron leads to a significant reduction in heart failure hospitalization by 25 %. • No significant difference in cardiac or mortality, GI events, or infection. • Benefits of IV iron were consistent across trials. [ABSTRACT FROM AUTHOR]

Opioids may play a part in the development of atrial fibrillation (AF). Understanding the relationship between opioid exposure and AF can help providers better assess the risk and benefits of prescribing opioids. To assess the incidence of AF as a function of prescribed opioids and opioid type. We performed unadjusted and adjusted time-updated Cox regressions to assess the association between opioid exposure and incident AF. The national study sample was comprised of Veterans enrolled in the Veterans Health Administration (VHA) who served in support of post-9/11 operations. The main predictor of interest was prescription opioid exposure, which was treated as a time-dependent variable. The first was any opioid exposure (yes/no). Secondary was opioid type. The outcome, incident AF, was identified through ICD-9-CM diagnostic codes at any primary care visit after the baseline period. A total of 609,763 veterans (mean age: 34 years and 13.24% female) were included in our study. Median follow-up time was 4.8 years. Within this cohort, 124,395 veterans (20.40%) were prescribed an opioid. A total of 1,455 Veterans (0.24%) were diagnosed with AF. In adjusted time-updated Cox regressions, the risk of incident AF was higher in the veterans prescribed opioids (hazard ratio [HR]: 1.47; 95% confidence interval [CI]: 1.38-1.57). In adjusted time-updated Cox regressions, both immunomodulating and nonimmunomodulating opioid type was associated with increased risk of incident AF (HR: 1.40; 95% CI: 1.25-1.57 and HR: 1.49; 95% CI: 1.39-1.60), compared to no opioid use, respectively. Our findings suggest opioid prescription may be a modifiable risk factor for the development of AF. [ABSTRACT FROM AUTHOR]

This research introduces a pioneering approach to address the intricate challenge of identifying kidney abnormalities in medical imaging. By synergizing the strengths of transfer learning and federated learning (FL), the study propels the evolution of diagnostic capabilities within decentralized healthcare systems. Within the realm of patient data privacy, the federated transfer learning architecture operates harmoniously, collectively learning from geographically dispersed renal imaging datasets. This collaborative strategy empowers healthcare providers to unite their efforts while retaining ownership of their individual databases. This innovative methodology holds immense promise for augmenting the precision and efficacy of renal abnormality detection in medical imaging. Leveraging the wealth of knowledge embedded in transfer learning models, the approach adapts and refines these insights for the specific nuances of renal imaging data. This adaptive learning process occurs without compromising patient confidentiality and fortifies data security. This convergence of deep learning, federated learning, and transfer learning represents a transformative leap in healthcare. By facilitating a more efficient, compassionate, and decentralized approach to managing kidney-related health issues, this study charts a compelling path toward the future of medical image analysis. In doing so, it not only addresses the current challenges in identification of renal abnormality but also paves the way for a new era of collaborative and privacy-preserving healthcare solutions in decentralized healthcare systems. [ABSTRACT FROM AUTHOR]

The maintenance bundle of care for all venous access devices (peripheral intravenous catheters, PIVC; central venous catheters, CVCs; hemodialysis ports) is important to prevent secondary sepsis in critically ill patients. This quality improvement project analyzed the effect of intensive training and education of health care workers (HCWs) on maintenance bundles for venous access devices. The study period comprising of preintervention phase (3-months) included 25 random visits to the intensive care unit for point observations regarding maintenance of all venous access devices in-situ in all intensive care unit patients on the day of the visit. The observations were categorized as appropriate or inappropriate practices based on American Society of Anesthesiologists (ASA) guidelines for CVC 2020, INICC guidelines for PIVC 2017, and Australian Commission on Safety and Quality in Health Care (ACQHCS) for PIVC and hemodialysis ports, December 2019. While the intervention phase (1-month) comprised intensive training and education of HCWs, postintervention phase 3 (3-months) included similar visits and point observations as during the preintervention phase. The maintenance of PIVC improved significantly in terms of the condition of site (from 82.7% appropriate observations to 97.8%, P <.05); condition of connectors (45.7%-56.8%, P <.05), and any attached unused IV sets (90.5%-98.56%, P <.05). For CVC, there was significant improvement in condition of insertion site (66%-94%, P <.01); condition of connectors (0%-44.37%, P <.01); fixation (91%-99.3%, P <.05); any attached unused IV sets (38.9%-97.3%, P <.01) and knowledge of HCW (96.52%-100%, P =.05). For hemodialysis ports, no significant improvement was observed. Intensive training and education of HCWs led to significant improvement in the maintenance bundle of care for PIVC and CVC. • First study evaluating effect of training on maintenance bundle of venous devices. • All devices, PIVC, CVC, and HD ports assessed for improvement in maintenance bundle. • Predefined checklist of appropriate practices of maintenance of vascular devices. • Significant improvement in PIVC and CVC care in the postintervention phase. [ABSTRACT FROM AUTHOR]

After total knee arthroplasty (TKA), ∼30% of knee osteoarthritis (KOA) patients show little symptomatic improvement. Earlier studies have correlated urinary (u) type 2 collagen C terminal cleavage peptide assay (C2C-HUSA), which detects a fragment of cartilage collagen breakdown, with KOA progression. This study determines whether C2C levels in urine, synovial fluid, or their ratio, are associated with post-surgical outcomes. From a large sample of 489 subjects, diagnosed with primary KOA undergoing TKA, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function scores were collected at baseline (time of surgery) and one-year post-TKA. Baseline urine (u) and synovial fluid (sf) were analysed using the IBEX-C2C-HUSA assay, with higher values indicating higher amounts of cartilage degradation. For urine, results were normalised to creatinine. Furthermore, subjects' changes in WOMAC scores were categorised based on percent reduction in pain or improvement in function, compared to baseline, such that >66.7%, >33.3 to ≤66.7%, and ≤33.3% denoted "strong", "moderate" and "mild/worse" responses, respectively. Associations of individual biofluid C2C-HUSA levels, or their ratio, with change in WOMAC pain and function scores up to one-year post-TKA, or category of change, were analysed by linear, logistic, or cumulative odds models. Higher baseline uC2C-HUSA levels or a lower ratio of baseline sfC2C-HUSA to uC2C-HUSA were associated with improvements in WOMAC pain by linear multivariable modelling [odds ratio −0.40 (95% confidence interval −0.76, −0.05) p = 0.03; 0.36 (0.01, 0.71), p = 0.04, respectively], while sfC2C-HUSA alone was not. However, lower ratios of sfC2C-HUSA to uC2C-HUSA were associated with improvements in WOMAC function [1.37 (0.18, 2.55), p = 0.02], while sfC2C-HUSA and uC2C-HUSA alone were not. Lower ratios of sfC2C-HUSA to uC2C-HUSA were also associated with an increased likelihood of a subject being categorised in a group where TKA was beneficial in both univariable [pain, 0.81 (0.68, 0.96), p = 0.02; function, 0.92 (0.85, 0.99), p = 0.035] and multivariable [pain, 0.81 (0.68, 0.97) p = 0.02; function, 0.92 (0.85, 1.00), p = 0.043] ordinal modelling, while sfC2C-HUSA and uC2C-HUSA alone were not. Overall, ratios of baseline sfC2C-HUSA to uC2C-HUSA, and baseline uC2C-HUSA, may play an important role in studying post-TKA surgical outcomes. [ABSTRACT FROM AUTHOR]

Gastric intestinal metaplasia (GIM) is associated with a higher risk of noncardia intestinal gastric adenocarcinoma (GA). The aim of this study was to estimate lifetime benefits, complications, and cost-effectiveness of GIM surveillance using esophagogastroduodenoscopy (EGD). We developed a semi-Markov microsimulation model of patients with incidentally detected GIM, to compare the effectiveness of EGD surveillance with no surveillance at 10-year, 5-year, 3-year, 2-year, and 1-year intervals. We modeled a simulated cohort of 1,000,000 US individuals aged 50 with incidental GIM. Outcome measures were lifetime GA incidence, mortality, number of EGDs, complications, undiscounted life-years gained, and incremental cost-effectiveness ratio with a willingness-to-pay threshold of $100,000/quality-adjusted life-year (QALY). In the absence of surveillance, the model simulated 32.0 lifetime GA cases and 23.0 lifetime GA deaths per 1000 individuals with GIM, respectively. Among surveilled individuals, simulated lifetime GA incidence (per 1000) decreased with shorter surveillance intervals (10-year to 1-year, 11.2–6.1) as did GA mortality (7.4–3.6). Compared with no surveillance, all modeled surveillance intervals yielded greater life expectancy (87–190 undiscounted life-years gained per 1000); 5-year surveillance provided the greatest number of life-years gained per EGD performed and was the cost-effective strategy ($40,706/QALY). In individuals with risk factors of family history of GA or anatomically extensive, incomplete-type GIM intensified 3-year surveillance was cost-effective (incremental cost-effectiveness ratio $28,156/QALY and $87,020/QALY, respectively). Using microsimulation modeling, surveillance of incidentally detected GIM every 5 years is associated with reduced GA incidence/mortality and is cost-effective from a health care sector perspective. Real-world studies evaluating the impact of GIM surveillance on GA incidence and mortality in the United States are needed. [Display omitted] [ABSTRACT FROM AUTHOR]

The frequency, magnitude, and distribution of industry payments to radiologists are not well understood. The aim of this study was to analyze the distribution of industry payments to physicians working in diagnostic radiology, interventional radiology, and radiation oncology, study the categories of payments and determine their correlation. The Open Payments Database from the Centers for Medicare & Medicaid Services was accessed and analyzed for the period from January 1, 2016 to December 31, 2020. Payments were grouped into six categories: consulting fees, education, gifts, research, speaker fees, and royalties/ownership. The total amount and types of industry payments going to the top 5% group were determined overall and for each category of payment. From 2016 to 2020, a total of 513 020 payments, amounting to $370 782 608, were made to 28 739 radiologists suggesting that approximately 70% of the 41 000 radiologists in the US received at least one industry payment during the 5-year period. The median payment value was $27 (IQR: $15-$120) and the median number of payments per physician over the 5-year period was 4 (IQR: 1-13). Gifts were the most frequent payment type made (76.4%), but accounted for only 4.8% of payment value. The median total value of payments earned by members of the top 5% group over the 5-year period was $58 878 (IQR: $29 686-$162 425) ($11 776 per year) compared to $172 (IQR: $49-877) ($34 per year) in the bottom 95% group. Members of the top 5% group received a median of 67 (IQR: 26-147) individual payments (13 payments per year) while members of the bottom 95% group received a median of 3 (IQR: 1-11) (0.6 payments per year). Between 2016 and 2020, industry payments to radiologists were highly concentrated both in terms of number/frequency and value of payments. [ABSTRACT FROM AUTHOR]

The number of FDA-cleared artificial intelligence (AI) algorithms for neuroimaging has grown in the past decade. The adoption of these algorithms into clinical practice depends largely on whether this technology provides value in the clinical setting. The objective of this study was to analyze trends in FDA-cleared AI algorithms for neuroimaging and understand their value proposition as advertised by the AI developers and vendors. A list of AI algorithms cleared by the FDA for neuroimaging between May 2008 and August 2022 was extracted from the ACR Data Science Institute AI Central database. Product information for each device was collected from the database. For each device, information on the advertised value as presented on the developer's website was collected. A total of 59 AI neuroimaging algorithms were cleared by the FDA between May 2008 and August 2022. Most of these algorithms (24 of 59) were compatible with noncontrast CT, 21 with MRI, 9 with CT perfusion, 8 with CT angiography, 3 with MR perfusion, and 2 with PET. Six algorithms were compatible with multiple imaging techniques. Of the 59 algorithms, websites were located that discussed the product value for 55 algorithms. The most widely advertised value proposition was improved quality of care (38 of 55 [69.1%]). A total of 24 algorithms (43.6%) proposed saving user time, 9 (15.7%) advertised decreased costs, and 6 (10.9%) described increased revenue. Product websites for 26 algorithms (43.6%) showed user testimonials advertising the value of the technology. The results of this study indicate a wide range of value propositions advertised by developers and vendors of AI algorithms for neuroimaging. Most vendors advertised that their products would improve patient care. Further research is necessary to determine whether the value claimed by developers is actually demonstrated in clinical practice. [Display omitted] [ABSTRACT FROM AUTHOR]

This review aims to identify in vivo studies investigating the potential of plant substances and their natural molecules in managing inflammatory bowel disease (IBD). Specifically, the objective is to examine the impact of these substances on interleukins and other key inflammatory signaling markers. Relevant articles published up to December 2022 were identified through a search of the PubMed, Scopus, Web of Science, and Embase databases. The search used keywords including "inflammatory bowel disease", "medicinal plants", "natural molecules", "anti-inflammatory", and "ulcerative colitis", and identified 1,878 potentially relevant articles, of which 89 were included in this review after completion of the selection process. This study provides preclinical data on natural products (NPs) that can potentially treat IBD, including ulcerative colitis. The main actions of these NPs relate to their effects on nuclear factor kappa B (NF-κB), the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) signaling pathway, the regulation of T helper 17/regulatory T cells balance, and oxidative stress. The ability of these NPs to inhibit intestinal inflammation appears to be dependent on lowering levels of the pro-inflammatory cytokines tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, and IL-17, via the Jun N-terminal kinase (JNK)1, NF-κβ-p65, and STAT3 pathways. In addition, NPs were shown to reduce oxidative stress and the severity of ulcerative colitis, as well as increase the activity of antioxidant enzymes. These actions suggest that NPs represent a promising treatment for IBD, and potentially have greater efficacy and safety than current treatments. [Display omitted] • Preclinical evidence suggests that natural products (NPs) can reduce IBD progression. • NPs decrease pro-inflammatory cytokines and inhibit intestinal inflammation. • NPs can be used to regulate interleukins in the treatment of IBD. • NPs regulate NF-κB, JAK-STAT signaling, and T helper 17/regulatory T cells imbalance. • NPs lessen oxidative stress and ulcerative colitis severity. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess diversity among radiology residents relative to other specialties and compare it with historical trends. The Graduate Medical Education results from 2010-2011 to 2020-2021 were accessed for demographic information for major medical specialties (number of residents > 500 as of the 2020-2021 report). Subspecialties and fellowship programs were not included in this analysis. The racial and ethnicity breakdowns were extracted, including Black, White/Caucasian, Asian, Hispanic, and others. The changes in racial and ethnicity composition of residents in radiology was compared to other specialties using the Chi Squared test using a significance level of p < 0.05. In 2020-2021, radiology ranked ninth in total resident enrollment among the 21 largest ACGME training programs, unchanged when compared to 2010-2011. Amongst all specialties, Radiology ranked 10th for Black and 9th for Hispanic representation in 2020-2021.The percentage of Black residents increased from 3.07% in 2010-2011 to 3.83% in 2020-2021. The percentage of Hispanic Radiology residents increased from 4.83% to 7.35%, constituting the third largest increase amongst all specialties. The representation of Blacks and Hispanics in Radiology has improved relative to other medical specialties in the last decade. [ABSTRACT FROM AUTHOR]

Dengue fever is a zoonotic viral infection that raises a global alarm in the tropics and subtropics, with the potentially escalating into newer geographical regions. Severe dengue may be associated with fatal complications such as myocarditis. There is a paucity of available data on the prevalence of dengue-associated myocarditis. The objective of this systematic review and meta-analysis was to estimate the global prevalence of dengue-associated myocarditis. A systematic search was conducted utilizing the Cochrane library, PubMed, Scopus, ProQuest, Web of Science, and Preprint servers such as arXiv, medRxiv, bioRxiv, BioRN, ChiRN, ChiRxiv, and SSRN as of November 25, 2022. All primary studies (case series, cross-sectional, retrospective, and prospective) that reported confirmed cases of dengue myocarditis were included. The I 2 statistic test assessed the heterogenic characteristics and publication bias was evaluated using Doi plot and Egger regression tests. A total of 12 studies conducted between 2007 and 2022 with 2795 laboratory-confirmed dengue patients were included. Of the included cases, 502 were positive for myocarditis, with a prevalence of 2.4–78%. The pooled prevalence of dengue-induced myocarditis in the studied population was 21.0% (95% CI, 9 – 38%). The prediction interval was estimated to be 0.00 - 0.81. Myocarditis in dengue patients is a significant and understudied complication in many aspects. To prevent dengue-associated myocarditis, appropriate measures such as early detection of cases and signs, symptoms-based diagnosis via electrocardiography and echocardiography, as well as relevant vector control policies must be implemented. [ABSTRACT FROM AUTHOR]

To maximize patient safety, surgical skills education is increasingly adopting simulation-based curricula for formative skills assessment and training. However, many standardized assessment tools rely on human raters for performance assessment, which is resource-intensive and subjective. Simulators that provide automated and objective metrics from sensor data can address this limitation. We present an instrumented bench suturing simulator, patterned after the clock face radial suturing model from the Fundamentals of Vascular Surgery, for automated and objective assessment of open suturing skills. For this study, 97 participants (35 attending surgeons, 32 residents, and 30 novices) were recruited at national vascular conferences. Automated hand motion metrics, especially focusing on rotational motion analysis, were developed from the inertial measurement unit attached to participants' hands, and the proposed suite of metrics was used to differentiate between the skill levels of the 3 groups. Attendings' and residents' performances were found to be significantly different from novices for all metrics. Moreover, most of our novel metrics could successfully distinguish between finer skill differences between attending and resident groups. In contrast, traditional operative skill metrics, such as time and path length, were unable to distinguish attendings from residents. This study provides evidence for the effectiveness of rotational motion analysis in assessing suturing skills. The suite of inertial measurement unit-based hand motion metrics introduced in this study allows for the incorporation of hand movement data for suturing skill assessment. [ABSTRACT FROM AUTHOR]

To measure trends in the rates and costs of hospitalizations over a 15-year period among young adults with physical and/or psychiatric disorders. This population-based, repeated cross-sectional study identified all 18- to 26- year-olds hospitalized in Ontario, Canada from April 1, 2003 and March 31, 2018 (fiscal years 2003–2017). Using discharge diagnoses, we assigned hospitalizations to one of four categories: 1) psychiatric disorder only; 2) primary psychiatric disorder with comorbid physical illness; 3) primary physical with comorbid psychiatric disorder; and 4) physical illness only. We compared health service utilization and changes in rates of hospitalizations over time using restricted cubic spline regression. Secondary outcome measures included change in hospital costs for each hospitalization category over the study period. Of 1,076,951 hospitalizations in young adults (73.7% female), 195,726 (18.2%) had a psychiatric disorder (either primary or comorbid). There were 129,676 hospitalizations (12.0%) with psychiatric disorders only, 36,287 (3.4%) with primary psychiatric and comorbid physical disorders, 29,763 (2.8%) with primary physical and comorbid psychiatric disorders, and 881,225 (81.8%) with physical disorders only. Rates of hospitalization for psychiatric disorders only increased 81% from 4.32 to 7.84/1,000 population, and those with physical health disorders with comorbid psychiatric disorders increased 172% from 0.47 to 1.28/1,000 population. Substance-related disorders were the most common comorbid psychiatric disorders among youth hospitalized for physical illness and increased 260% from 0.9 to 3.3/1,000 population. Hospitalizations among young adults with primary and comorbid psychiatric disorders have increased significantly over the past 15 years. Health system resources should be adequately directed to meet the shifting and complex needs of hospitalized young adults. [ABSTRACT FROM AUTHOR]

Proximal humerus fractures account for approximately 6% of adult fractures and the incidence of these injuries is increasing. The clinical consequences are significant, with rehabilitation taking several months and many reporting chronic pain following treatment. Several systems are used to classify these injuries. Disruption of the vascular supply to the humeral head is an important consideration. Fracture morphology and other anatomical fracture characteristics may help predict ischaemia and therefore guide management. Non-operative management consists of immobilization and rehabilitation. Surgical management is typically fixation or arthroplasty. There is considerable variation in practice with respect to treatment strategy and rehabilitation protocols. Our evidence-based assessment suggests that early mobilization of conservatively managed fractures may confer an earlier and quicker recovery. Surgery does not appear to provide any functional or quality of life benefit in comparison to non-operative treatment for patients with displaced two-part proximal fractures. Furthermore, surgery has an additional cost and higher complication risk. The use of locking plates does not appear to be superior to locking nails with respect to functional outcomes. The use of proximal humerus arthroplasty in trauma is increasing and there is some suggestion that reverse total shoulder replacement may improve function, pain and range of movement when compared to hemiarthroplasty. The ProFHER 2 trial will compare these two arthroplasty options and evaluate if these methods are more effective than non-surgical treatment. [ABSTRACT FROM AUTHOR]

Quad zygomatic implants have been used as a treatment option for patients with a severely resorbed maxilla. However, data on the average rate of success of the prosthesis, survival of the zygomatic implants, and associated complications are sparse. The purpose of this systematic review and meta-analysis was to assess prosthetic and zygomatic implant success of treating severe maxillary resorption with prostheses supported by 4 zygomatic implants, with an additional review on potential complications. A comprehensive search of studies published in English between January 2001 and December 2020 was performed in the PubMed, OVID, EBSCO, and EMBASE databases according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42021219468). The population, intervention, comparison, and outcome (PICO) question was "What is the effectiveness of oral rehabilitations using only 4 zygomatic implants placed in severely resorbed maxillae?" The search results were subjected to a systematic review for articles reporting prosthetic success and zygomatic implant survival. Prosthetic success was analyzed by using a fixed-effects inverse-variance model. The random-effects model was adopted for meta-analysis as moderate heterogeneity was identified among studies that reported implant survival in quad zygoma treatments. The quality of publications was appraised by using the Critical Appraisal Skills Program (CASP) checklists. Of the 82 titles, 7 studies that met the inclusion criteria without an overlap of patient cohorts were quantitatively analyzed for the average rate of prosthetic success and implant survival. All prostheses in the aggregated studies were immediately loaded with acrylic resin interim prostheses replaced by a definitive prosthesis, which consisted of overdentures retained by bar splinting (n=2), metal bar–reinforced prostheses (n=2), fixed screw–retained acrylic resin prostheses (n=34), and screw-retained titanium prostheses with ceramic or acrylic resin teeth (n=75). Technical complications of zygomatic implants included mobility associated with a machined surface and fracture of the abutment screw. The most common prosthetic complications reported were fracture of the definitive prosthesis and loss of the interim prosthesis subsequent to the failure of at least 1 zygomatic implant. The results showed that prostheses supported by quad zygoma implants displayed an overall success of 100% (CI=95%, I2=0.00%, P =.850), whereas zygomatic implants showed a survival rate of 98% (CI=95%, I2=60.48%, P =.040) with minimal implant failures and few complications. Although the data analysis showed favorable results for rehabilitating severely resorbed maxillae by using quad zygoma with high prosthetic success and high implant survival rate, further long-term clinical studies are required to strengthen the evidence. However, potential implant and prosthetic complications should be considered while planning this treatment approach. [ABSTRACT FROM AUTHOR]

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The aim of this study is to assess the trends in industry payments to radiologists and the impact of the COVID-19 pandemic, including trends in different categories of payments. The Open Payments Database from CMS was accessed and analyzed for the period from January 1, 2016, to December 31, 2021. Payments were grouped into six categories: consulting fees, education, gifts, research, speaker fees, and royalties or ownership. The total number, value, and types of industry payments to radiologists were subsequently determined and compared pre- and postpandemic from 2016 to 2021. The total number of industry payments and the number of radiologists receiving these payments dropped by 50% and 32%, respectively, between 2019 and 2020, with only partial recovery in 2021. However, the mean payment value and total payment value increased by 177% and 37%, respectively, between 2019 and 2020. Gifts and speaker fees experienced the largest decreases between 2019 and 2020 (54% and 63%, respectively). Research and education grants were also disrupted, with the number of payments decreasing by 37% and 36% and payment value decreasing by 37% and 25%, respectively. However, royalty or ownership increased during the first year of the pandemic (8% for number of payments and 345% for value of payments). There was significant decline in overall industry payments coinciding with the COVID-19 pandemic, with biggest declines in gifts and speaker fees. The impact on the different categories of payments and recovery in the last 2 years has been heterogeneous. [ABSTRACT FROM AUTHOR]

Scientometrics is the study of measuring and analyzing scholarly literature. Scientometric analysis to determine the impact of prosthodontic journals on scientific contributions is lacking. The purpose of this analysis was to compare the quality of prosthodontic journals based on performance indicators over 10 years (2010 to 2019). The SCImago Journal and Country Rank portal was used to identify various prosthodontic journals under the subject of dentistry. Seven journals publishing in the English language with "Prosthetics" and "Prosthodontics" in the title were identified and analyzed. The statistical analyses of the scientometric indicators for the 7 highest-ranked journals were performed with 1-way analysis of variance (ANOVA) and the Tukey post hoc tests (α=.05). The absolute SCImago journal rank (SJR) was highest at various time periods for the Journal of Prosthetic Dentistry (JPD), International Journal of Prosthodontics (IJP), and Journal of Prosthodontic Research (JPR). The JPD and IJP scored higher SJR than other journals during this period (P <.05). The mean cites per document and the h-index were highest for JPD (P <.05). Scientometric tools enable the evaluation of journal performance to aid researchers when choosing a journal to which to submit their work. Analysis of the 7 prosthodontic journals revealed the performance of various journals and gives an insight into the journal characteristics for future researchers who wish to submit their scholarly work. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the 9-month cost and health-related quality of life (HRQOL) outcomes of resistance versus viral load testing strategies to manage virological failure in low-middle income countries. We analyzed secondary outcomes from the REVAMP clinical trial: a pragmatic, open label, parallel-arm randomized trial investigating resistance versus viral load testing for individuals failing first-line treatment in South Africa and Uganda. We collected resource data, valued according to local cost data and used the 3-level version of EQ-5D to measure HRQOL at baseline and 9 months. We applied seemingly unrelated regression equations to account for the correlation between cost and HRQOL. We conducted intention-to-treat analyses with multiple imputation using chained equations for missing data and performed sensitivity analyses using complete cases. For South Africa, resistance testing and opportunistic infections were associated with statistically significantly higher total costs, and virological suppression was associated with lower total cost. Higher baseline utility, higher cluster of differentiation 4 (CD4) count, and virological suppression were associated with better HRQOL. For Uganda, resistance testing and switching to second-line treatment were associated with higher total cost, and higher CD4 was associated with lower total cost. Higher baseline utility, higher CD4 count, and virological suppression were associated with better HRQOL. Sensitivity analyses of the complete-case analysis confirmed the overall results. Resistance testing showed no cost or HRQOL advantage in South Africa or Uganda over the 9-month REVAMP clinical trial. • We analyzed cost and health-related quality of life (HRQOL) data using seemingly unrelated regression equations to account for joint correlation: this method is not widely published. • We undertook analysis in the context of a marginal, nonsignificant benefit in clinical primary outcome, proceeding based on strong economic hypotheses suggesting cost and HRQOL benefits for resistance testing. • Our study benefits from rich, primary, individual patient-level data to compare baseline and 9-month cost and HRQOL. • Notably, in contrast to high-income countries, resistance testing showed no 9-month cost or HRQOL advantage compared with viral load testing in low-middle income countries. • Results are key to informing multinational partners, nongovernment organizations, and public health policy makers about the use of resistance testing in clinical practice. • They are also important for informing the lifetime cost-effectiveness analysis of resistance testing in the era of new resistance testing methods and treatment regimens. [ABSTRACT FROM AUTHOR]

We examined how breast cancer-related lymphedema (BCRL) affects health-related quality of life (HRQOL), productivity, and compliance with therapeutic interventions to guide structuring BCRL screening programs. We prospectively followed consecutive breast cancer patients who underwent axillary lymph node dissection (ALND) with arm volume screening and measures assessing patient-reported health-related quality of life (HRQOL) and perceptions of BCRL care. Comparisons by BCRL status were made with Mann-Whitney U, Chi-square, Fisher's exact, or t tests. Trends over time from ALND were assessed with linear mixed-effects models. With a median follow-up of 8 months in 247 patients, 46% self-reported ever having BCRL, a proportion that increased over time. About 73% reported fear of BCRL, which was stable over time. Further in time from ALND, patients were more likely to report that BCRL screening reduced fear. Patient-reported BCRL was associated with higher soft tissue sensation intensity, biobehavioral, and resource concerns, absenteeism, and work/activity impairment. Objectively measured BCRL had fewer associations with outcomes. Most patients reported performing prevention exercises, but compliance decreased over time; patient-reported BCRL was not associated with exercise frequency. Fear of BCRL was positively associated with performing prevention exercises and using compressive garments. Both incidence and fear of BCRL were high after ALND for breast cancer. Fear was associated with improved therapeutic compliance, but compliance decreased over time. Patient-reported BCRL was more strongly associated with worse HRQOL and productivity than was objective BCRL. Screening programs must support patients' psychological needs and aim to sustain long-term compliance with recommended interventions. • Both incidence and fear of BCRL were high after ALND for breast cancer. • Fear of BCRL was associated with improved therapeutic compliance. • Compliance with preventive/therapeutic interventions decreased over time. • Patient-reported BCRL is more strongly associated than objective BCRL with HRQOL. • Screening programs must support psychological needs to sustain long-term compliance. [ABSTRACT FROM AUTHOR]

As the world has rapidly changed during the COVID-19 pandemic, doctor of pharmacy (PharmD) students' overall well-being has been prioritized. This study aimed to evaluate PharmD students' well-being and perceived academic engagement when moved involuntarily to a majority asynchronous and virtual curriculum during the 2020–2021 academic year in response to the COVID-19 pandemic. Additionally, this study aimed to assess demographic predictors relating student well-being and academic engagement. A survey administered via Qualtrics (SAP) was sent to three cohorts of professional students (Classes of 2022 to 2024) enrolled in the PharmD program at The Ohio State University College of Pharmacy. These cohorts were engaged in a primarily asynchronous and virtual curriculum due to COVID-19. Although students displayed mixed results on how asynchronous learning affected their well-being, students replied that they would want to continue learning via a hybrid model (53.3%) or completely asynchronous (24%), while 17.3% wanted primarily synchronous and 5.3% did not reply. Our results indicated that aspects of the majority asynchronous and virtual learning environment were favored by students. Through student responses, our faculty and staff can take into consideration students' opinions when making future changes to the curriculum. We provided this data for others to consider when evaluating well-being and engagement with a virtual and asynchronous curriculum. [ABSTRACT FROM AUTHOR]

Primary stability is an important factor in influencing the outcome of dental implants. Osteotomy modification techniques mentioned, include osteotomes for bone condensation, under-preparation of osteotomy and Osseodensification (OD). The objective of our twin arm study was to assess how two different implant designs respond to conventional osteotomy drilling and how these values obtained compare with OD. The study comprised a total of 80 implants inserted in pig tibia bone. Group 1a (n = 20) consisted of tapered internal implants and group 1b (n = 20) consisted of tapered pro implants, both inserted with conventional drilling. Group 2a (n = 20) consisted of tapered internal implants and group 2b (n = 20) consisted of tapered pro implants, both inserted with OD. Each implant inserted was measured for implant stability quotient (ISQ), insertion torque and removal torque. Group 1a showed a significantly lower ISQ, mean insertion and removal torque and as compared to Group 1b. Group 2a and 2b had comparable mean values for all the three parameters. Inter-group comparison showed a higher ISQ and insertion torque value for group 2 than group 1. Intra-group assessment showed a significantly lower value for all parameters for sub-group a than b. OD enhances primary stability of implants in bone; but when no OD is used, the tapered pro implant design offers a better primary stability. This may be attributed to the active thread design. [Display omitted] [ABSTRACT FROM AUTHOR]