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Due to differential training, nurse practitioners (NPs) and physicians may provide different quantities of services to patients.

To assess differences in the number of laboratory, imagining, and procedural services provided by primary care NPs and physicians.

Secondary analysis of 2012-2016 National Ambulatory Medical Care Survey (NAMCS), containing 308 NP-only and 73,099 physician-only patient visits, using multivariable regression and propensity score techniques.

On average, primary care visits with NPs versus physicians were associated with 0.521 fewer laboratory (95% CI -0.849, -0.192), and 0.078 fewer imaging services (95% CI -0.103,-0.052). Visits for routine and preventive care with NPs versus physicians were associated with 1.345 fewer laboratory (95% CI -2.037,-0.654), and 0.086 fewer imaging services (95% CI -0.118,-0.054) on average. Primary care visits for new problems with NPs versus physicians were associated with 0.051 fewer imaging services (95% CI -0.094,-0.007) on average.

NPs provide fewer laboratory and imaging services than physicians during primary care visits.
NPs provide fewer laboratory and imaging services than physicians during primary care visits.
There is a critical need to increase diversity in the nursing workforce to better address racial health disparities.

To provide academic institutions with practical recommendations to foster a collaborative environment and essential resources for and in support of Black, Indigenous, and People of Color (BIPOC) scholars.

We examine the experiences of three Black nurse scholars, at a research-intensive university in an urban area during the COVID-19 pandemic and civil unrest in the United States.

Findings suggest barriers exist, which negatively impact workplace climate, collaboration and mentoring for BIPOC nursing scholars. Guided by a Black feminist perspective and utilizing existing literature, we recommend strategies to enhance workplace climate, to develop culturally aware collaboration, and to center mentoring as the foundation for BIPOC nurse scholar success.

This article acknowledges that a crucial step in addressing health disparities is successful support of and collaboration with BIPOC nurse scholars.
This article acknowledges that a crucial step in addressing health disparities is successful support of and collaboration with BIPOC nurse scholars.
The authors aimed to measure population-based preventable emergency department (ED) visits related to infectious oral conditions (IOCs) in Massachusetts and to examine the associated sociodemographic factors to support prevention efforts.

A statewide retrospective analysis of ED visits related to IOCs in Massachusetts from 2014 through 2018 was conducted using a Center for Health Information and Analysis database. The authors described patients' characteristics, dental diagnoses frequencies, emergency severity, lengths of stay, associated treatment, and costs. Multilevel logistic regression was used to assess factors associated with IOC visits.

IOC visits in 2014 through 2018 were 1.2% (149,777) of the total ED visits, with an estimated cost of $159.7 million. There was an annual decline in the prevalence of IOC visits from 2014 through 2018. After adjusting for sociodemographic factors, odds of IOC were higher among males (adjusted odd ratio [AOR], 1.26; 95% CI, 1.24 to 1.27), non-Hispanic Blacks compaintegral for prevention.
The incidence of ankle fractures requiring surgical fixation is increasing. Although there has been increasing evidence to suggest that preoperative opioid use negatively impacts surgical outcomes, literature focusing primarily on ankle fractures is scarce. The purpose of this study was to investigate the relationship between preoperative opioid use and outcomes following ankle fracture open reduction and surgical fixation (ORIF). We hypothesized that patients prescribed higher preoperative oral morphine equivalents (OMEs) would have poorer postoperative outcomes.

The Truven Marketscan claims database was used to identify patients who underwent ankle fracture surgery from 2009 to 2018 based on CPT codes. We used preoperative opioid use status to divide patients into groups based on the average daily OMEs consumed in the 6 months before surgery opioid-naive,<1, 1-<5, 5-<10, and ≥10 OMEs per day. We retrieved 90-day complication, ER visit, and readmission rates. Opioid use groups were then comparedFurthermore this risk is greater with higher dose opioid use. The results of this study suggests that surgeons should encourage decreased opioid use prior to ankle fracture surgery.
Opioids use prior to ankle fracture surgery is a common scenario. Unfortunately preoperative opioid use is a risk factor for postoperative complications, ER visits, and readmissions. Furthermore this risk is greater with higher dose opioid use. The results of this study suggests that surgeons should encourage decreased opioid use prior to ankle fracture surgery.
To establish if detailed review of trauma reports with reference to coding manual improved accuracy of ISS and to establish if demonstrated changes in coding affected performance and tariff payment.

A study was undertaken which gathered data from 6 months across the five trusts with information on imaging undertaken, mechanism of injury (MOI), Injury Severity Score (ISS), and injury descriptors was included. Patients with ISS near to a best practice tariff boundary of 9 and 16 (5-8 and 11-15) then had their imaging reviewed by the Radiology Department with direct reference to the ISS coding manual. Injuries were then re-coded and ISS recalculated.

Over the 6-month period, 1,693 patients were admitted to the database from the five hospitals. One hundred and sixty-nine (9.9%) patients met the inclusion criteria for review. Thirty-five (20.7%) had a change in abbreviated (region specific) injury code, with 30 a change in the resultant ISS. Three had a decrease in ISS and 27 increased ISS with all 27 moving across an ISS best practice tariff and three moving across two payment tariff boundaries. With re-coding, there was a potential £15,000 of lost revenue from the major trauma centre (MTC) alone.

Reporting with reference to ISS description improves the accuracy of ISS significantly. Radiologists improving the descriptions of specific injury patterns and adopting 'Trauma Audit and Research Network friendly' reporting strategies may improve data accuracy, performance, and payment of best practice tariffs to hospitals.
Reporting with reference to ISS description improves the accuracy of ISS significantly. Radiologists improving the descriptions of specific injury patterns and adopting 'Trauma Audit and Research Network friendly' reporting strategies may improve data accuracy, performance, and payment of best practice tariffs to hospitals.
To differentiate glioblastoma (GBM) from solitary brain metastases (MET) using radiomic analysis.

Two hundred and fifty-three patients with solitary brain tumours (157 GBM and 98 solitary brain MET) were split into a training cohort (n=178) and a validation cohort (n=77) by stratified sampling using computer-generated random numbers at a ratio of 73. After feature extraction, minimum redundancy maximum relevance (mRMR) and the least absolute shrinkage and selection operator (LASSO) were used to build the radiomics signature on the training cohort and validation cohort. Performance was assessed by radiomics score (Rad-score), receiver operating characteristic (ROC) curve, calibration, and clinical usefulness.

Eleven radiomic features were selected as significant features in the training cohort. The Rad-score was significantly associated with the differentiation between GBM and solitary brain MET (p<0.001) both in the training and validation cohorts. The radiomics signature yielded area under the curve (AUC) values of 0.82 and 0.81 in the training and validation cohorts to distinguish between GBM and solitary brain MET.

The radiomics model might be a useful supporting tool for the preoperative differentiation of GBM from solitary brain MET, which could aid pretreatment decision-making.
The radiomics model might be a useful supporting tool for the preoperative differentiation of GBM from solitary brain MET, which could aid pretreatment decision-making.
At the request of the Organización Médica Colegial, we have elaborated a new nomenclature of medical and surgical procedures in Otorhinolaryngology-Head & Neck Surgery (ENT-HNS) based on the International Classification of Diseases ICD-9-MC. We have defined new quantitative and qualitative criteria and indicators that may allow scale and remuneration to be determined in private medical practice.

Obsolete processes were eliminated from the current list of nomenclature, new ones were added or updated, procedures from other specialties that typically belong to ENT-HNS were imported, descriptions were modified accordingly, and others were transferred from one group to another for reasons of surgical complexity. In addition, it was requested that four quantitative criteria and indicators should be assigned for each procedure unit cost per group, professional training and complexity, professional responsibility, potential complications, and health value, assigning a final value as a product of the sum of eaonetary value in our specialty.
The new ENT-HNS nomenclature proposed by the SEORL-CCC updates and improves the previous outdated scale, adapting the current procedures to the ICD-9-CM and incorporating the new techniques developed. The updated scale establishes new evaluation criteria with quantitative and qualitative indicators to optimize the calculation of the value of a medical or surgical procedure that, eventually, will allow an assessment of its monetary value in our specialty.Inflammasomes are molecular machines that carry out inflammatory responses on challenges by pathogens and endogenous dangers. Dysregulation of inflammasome assembly and regulation is associated with numerous human diseases from autoimmunity to cancer. In recent years, significant advances have been made in understanding the mechanism of inflammasome signaling using structural approaches. Here, we review inflammasomes formed by the NLRP1, NLRP3, and NLRC4 sensors, which are well characterized structurally, and discuss the structural and functional diversity among them.The airway smooth muscle (ASM) cell plays a central role in the pathogenesis of asthma and constitutes an important target for treatment. These cells control muscle tone and thus regulate the opening of the airway lumen and air passage. Evidence indicates that ASM cells participate in the airway hyperresponsiveness as well as the inflammatory and remodeling processes observed in asthmatic subjects. Therapeutic approaches require a comprehensive understanding of the structure and function of the ASM in both the normal and disease states. This review updates current knowledge about ASM and its effects on airway narrowing, remodeling, and inflammation in asthma.
Lymphoedema after cancer treatment is a chronic and disabling complication that presents a significant health care burden during survivorship with limited treatment options. Vascularised lymph node transfer (VLNT) can reconstruct lymphatic flow to reduce limb volumes, but limited higher-order evidence exists to support its effectiveness.

The aim of the study was to systematically review and meta-analyse the effectiveness of VLNT in reducing upper limb (UL) or lower limb (LL)volume and cellulitis episodes in patients with cancer treatment-related lymphoedema (CTRL).

PubMed, Medline (Ovid) and Embase databases were searched between January 1974 and December 2019. Full-length articles where VLNT was the sole therapeutic procedure for CTRL, reporting volumetric limb, frequency of infection episodes and/or lymphoedema-specific quality-of-life data, were included in a random-effects meta-analysis of circumferential reduction rate (CRR). RU.521 cGAS inhibitor Methodological quality was assessed using STROBE/CONSORT, and a novel, lymphoedema-specific scoring tool was used to assess lymphoedema-specific methodological reporting.
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