19043 research outputs found
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Resilience in Crisis: Exploring the Lived Experiences of Homeless Mothers During the COVID-19 Pandemic
No full textPreodolevshie Simvolizm Mandel’shtam I Paund [Those Who Overcame Symbolism: Osip Mandelstam and Ezra Pound]
No full textMinimal Information for Studies of Extracellular Vesicles (MISEV2023): From Basic to Advanced Approaches
No full textInstitutional Support for the Career Advancement of Women Faculty in Science and Academic Medicine: Successes, Challenges, and Future Directions
No full textOvercoming Isolation: Online Collaboration Among Rural Primary School Principals in New Zealand
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Reaching the Hard to Reach: Effective Early Detection of Breast Cancer in Low Income Communities
No full textBackground: Breast cancer disproportionately affects low-income communities. A handheld, portable breast scanner (iBE, Intelligent Breast Exam) offers access to breast screening to improve early detection rates for these populations. The objective of this study is to assess usefulness of a handheld breast scanner, iBE, in screening breast lesions as a public health initiative in communities with historically low rates of breast cancer screening. Methods: Women presenting to inner city and suburban community center outreach events May 2021 through October 2021 were recruited. Women overdue for mammography or with positive clinical breast exams (CBE) and/or iBE were referred for mammography. The primary endpoint was assessment of accuracy and area under ROC curve for iBE in breast lesion detection compared to the gold standard of mammography. Study endpoints were determination of breast screening rates, lesion detection and accuracy of iBE for detection of clinically relevant breast lesions. Results: A total of 133 women enrolled resulting in 266 iBE and CBE. Mean (SD) age was 49.5 (13) years. Women were educated on breast health and received iBE in 5 min and CBE in 15 min. Of 266 exams, 30 had completion mammography. Accuracy and area under ROC curve were 0.66 for iBE, 0.56 for CBE, and 0.70 for iBE ± CBE. Conclusions: Outreach events are successful in reaching hard to reach communities but remain challenged in retaining women for completion of care. Health policy objectives for populations at risk should be aimed at access to services but equally important health service utilization
Use of the DASH Diet and Coronary Artery Disease
No full textInitial dietary approach to stop hypertension (DASH) diet feeding trials showed blood pressure (BP)-lowering effects that corresponded to higher degrees of concordance with the diet. These results popularized the idea that adherence to a DASH diet could reduce coronary artery disease (CAD) risk for patients. Recent evidence shows that the impact of DASH on CAD incidence and risk is less clear. While many studies show that the DASH diet impacts CAD risk factors, others suggest that these effects do not remain when important confounders are controlled. Also, the evidence from meta-analyses that the DASH diet impacts incident CAD is still inconclusive. Reassessment of the DASH diet, and the search for an ideal diet to prevent CAD will require a better understanding of the mechanisms through which the DASH diet works. Proposed mechanisms for its benefit include preventing inflammation and atherosclerosis progression as well as providing a heathy balance of dietary sodium and potassium intake
Safety and Preliminary Efficacy of Cervical Paraspinal Interfascial Plane Block for Postoperative Pain After Pediatric Chiari Decompression
No full textBackground: Surgery for lesions of the posterior fossa is associated with significant postoperative pain in pediatric patients related to extensive manipulation of the suboccipital musculature and bone. In this study, we assess the preliminary safety, effect on neuromonitoring, and analgesic efficacy of applying a cervical paraspinal interfascial plane block in pediatric patients undergoing posterior fossa surgery. Methods: In this prospective case series, we enrolled five patients aged 2–18 years undergoing surgery for symptomatic Chiari type I malformation. An ultrasound-guided cervical cervicis plane (CCeP) block was performed prior to the incision. A local anesthetic agent (bupivacaine) and a steroid adjuvant (dexamethasone) were injected into the fascial planes between the cervical semispinalis capitis and cervical semispinalis cervicis muscles at the level of the planned suboccipital decompression and C1 laminectomy. Motor-evoked and somatosensory-evoked potentials were monitored before and after the block. Patients were assessed for complications from the local injection in the intraoperative period and for pain in the postoperative period. Results: No adverse events were noted intraoperatively, and there were no changes in neuromonitoring signals. Pain scores were low in the immediate postoperative period, and rescue medications were minimal. No complaints of incisional pain or need for narcotics were noted at the time of the 3-month postsurgical follow-up. Conclusions: In this study, we demonstrate the preliminary safety and analgesic efficacy of a novel application of a CCeP block to pediatric patients undergoing suboccipital surgery. Larger studies are needed to further validate the use of this block in children
Predictors of Outcomes and a Weighted Mortality Score for Moderate to Severe Subdural Hematoma
No full textAs the incidence of subdural hematoma is increasing, it is important to understand symptomatology and clinical variables associated with treatment outcomes and mortality in this population; patients with subdural hematoma were selected from the National Inpatient Sample (NIS) Database between 2016 and 2020 using International Classification of Disease 10th Edition (ICD10) codes. Moderate-to-severe subdural hematoma patients were identified using the Glasgow Coma Scale (GCS). Multivariate regression was first used to identify predictors of in-hospital mortality and then beta coefficients were used to create a weighted mortality score. Of 29,915 patients admitted with moderate-to-severe subdural hematomas, 12,135 (40.6%) died within the same hospital admission. In a multivariate model of relevant demographic and clinical covariates, age greater than 70, diabetes mellitus, mechanical ventilation, hydrocephalus, and herniation were independent predictors of mortality (p \u3c 0.001 for all). Age greater than 70, diabetes mellitus, mechanical ventilation, hydrocephalus, and herniation were assigned a “1” in a weighted mortality score. The ROC curve for our model showed an area under the curve of 0.64. Age greater than 70, diabetes mellitus, mechanical ventilation, hydrocephalus, and herniation were predictive of mortality. We created the first clinically relevant weighted mortality score that can be used to stratify risk, guide prognosis, and inform family discussions