Search

Cash register receipts made of thermal paper expose workers and shoppers to endocrine-disrupting chemicals and contaminate paper recycling streams. In 2022, 571 receipts were collected from retail stores in the United States and tested for developer chemicals using attenuated total reflection infrared spectroscopy. The results were compared to a 2017 study of 167 receipts to determine changes in color developer use over time. Receipts were tested as-is and a subset were additionally subjected to a simple extraction that improved detection of receipt chemicals. Bisphenol S was the most frequently detected developer (85% of tested receipts), followed by Pergafast 201 (12%), bisphenol A (1%); and Appvion Alpha Free, D-8, and NKK-1304 (each below 1%). NKK-1304 is reported here for the first time in a scientific journal. The frequency of bisphenol A usage in receipts decreased and the frequency of bisphenol S and Pergafast 201 increased between 2017 and 2022, particularly among large companies. National retailers were more likely than regional or local retailers to have adopted non-bisphenol alternatives. Potential health and environmental hazards of the detected developer chemicals and strategies for reduction are discussed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Abstract: Providers are charged with responsibility to maintain their own health and wellness; however, well-being is multifactorial and the construct lacks clarity. In the current state of health care, burnout is on the rise with increasing demands for clinical productivity and strained system resources. The health care industry has recognized wellness's patient safety and financial impact, recently applying research and resources to identify sustainable solutions. We reviewed the wellness literature with a focus on systems to provide a framework for consensus building for a quality acute care surgery system. Our review revealed several areas within system wellness for consideration: (1) provider wellness, (2) culture of safety, (3) learning health systems, and (4) organizational perspectives. We provide specific system recommendations for the acute care surgery practice to preserve our workforce by creating a system that works for its providers., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies. The primary goal of FLD was to create the first surgeon-focused leadership curriculum dedicated to DEI. The rationale/development of this curriculum and its evaluation/feedback methods are detailed in this White Paper., Methods: The FLD curriculum was developed by a multidisciplinary task force that included surgeons, education experts, and diversity consultants. The curriculum development followed the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional design model and utilized a problem-based learning approach. Competencies were identified, and specific learning objectives and assessments were developed. The implementation of the curriculum was designed to be completed in short intervals (virtual and in-person). Post-course surveys used the Kirkpatrick's model to evaluate the curriculum and provide valuable feedback., Results: The curriculum consisted of interactive online modules, an online discussion forum, and small group interactive sessions focused in three key areas: (1) increasing pipeline of underrepresented individuals in surgical leadership, (2) healthcare equity, and (3) conflict negotiation. By focusing on positive action items and utilizing a problem-solving approach, the curriculum aimed to provide a framework for surgical leaders to make meaningful changes in their institutions and organizations., Conclusion: The FLD curriculum is a novel leadership curriculum that provided surgeon leaders with the knowledge and tools to improve diversity in three areas: pipeline improvement, healthcare equity, and conflict negotiation. Future directions include using pilot course feedback to enhance curricular effectiveness and delivery., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

While the literature is abundant on hand therapy assessment and treatment of nonsurgical thumb carpometacarpal (CMC) osteoarthritis (OA), clarity and uniformity are meager, making it a desirable diagnosis to establish expert consensus. This study aimed to ascertain if consensus exists for the assessment and treatment of nonsurgical management of thumb CMC OA in the hand therapy clinical setting. This was a consensus paper via the modified Delphi approach. A modified Delphi method was used to determine consensus among an expert panel, including hand therapists and hand surgeons, via two online surveys. A consensus paper steering committee (from the American Society of Hand Therapist's research division) designed the surveys and analyzed responses. Consensus was established as 75% agreement among the expert panel. Demographic information was collected from the expert panel. The expert panel included 34 hand therapists and seven hand surgeons. The survey response rates were 93.6% for the first survey and 90.2% for the second survey. Consensus recommendations were classified according to the World Health Organization categorization. These included evaluating the body structures for clinical signs/clinical testing and body functions for pain, range of motion for palmar abduction, radial abduction, opposition, and thumb metacarpal phalangeal flexion/extension, and grip and tripod pinch strength. Further consensus recommendations were for the assessment of function using a region-specific, upper extremity patient-reported outcome measure (activity and participation), environmental factors, outcome expectation, and illness perception within the patient's unique environmental and social contexts. Treatment recommendations included the use of an orthosis during painful activities, a dynamic stability program (stable C posture, release of tight adductors, and strengthening of stabilizers), patient education, joint protection techniques, adaptive equipment, and functional-based intervention. The findings describe the consensus of a group of experts and provide a clinical reference tool on the hand therapy assessment and treatment of nonsurgical thumb CMC joint OA. • A consensus paper using a modified Delphi process to determine consensus on non-surgical assessment and treatment of thumb CMC OA. • Assessment recommendations: evaluate clinical signs/testing, pain, thumb range of motion grip and tripod pinch, a region-specific PROM, environmental factors, outcome expectation, and illness perception. • Treatment: orthosis during painful activities as needed, a dynamic stability program, patient education, joint protection techniques, adaptive equipment, and functional based intervention. • Findings provide a clinical reference tool on hand therapy assessment and treatment of non-surgical CMC joint OA. [ABSTRACT FROM AUTHOR]

Self-regulated learning (SRL) and metacognitive processes are important in education because they contribute to effective learning and improved academic performance. Metacognitive SRL may be facilitated by the implementation of computer technology. This qualitative study examined the presence and use of metacognitive SLR processes among elementary school students as they completed computer-and paper-based reading assignments. Students in two after-school programs were recruited from a public school district in a southeastern region of the United States (U.S.). The participants consisted of 52 elementary students in Grades 2-5. Students participated in two, counterbalanced, conditions that involved computer- and paper-based reading assignments. Observations and semi-structured interviews were conducted. The results indicated that students were more likely to apply metacognitive SRL skills when reading on paper than reading on a computer. Overall, students showed signs of planning more in the paper than in the computer condition but student behaviors and responses differed between grades. Monitoring practices appeared in both the computer- and the paper-based reading assignment, with monitoring connected with background knowledge in Grades 2 and 3 but reading content in Grades 4 and 5. Control processes such as retrying and representing graphically were more common in the computer- than in the paper-based reading across all grades. Students used their score in a reading assignment as an evaluation tool to assess performance in the computer- and paper-based reading condition. These findings suggest that the utilization of prior information, integration of multimedia and verbal signals, and comfort level with the reading medium all influenced students' SRL decision-making. [ABSTRACT FROM AUTHOR]

Internal medicine physicians are increasingly interacting with systems that implement artificial intelligence (AI) and machine learning (ML) technologies. Some physicians and health care systems are even developing their own AI models, both within and outside of electronic health record (EHR) systems. These technologies have various applications throughout the provision of health care, such as clinical documentation, diagnostic image processing, and clinical decision support. With the growing availability of vast amounts of patient data and unprecedented levels of clinician burnout, the proliferation of these technologies is cautiously welcomed by some physicians. Others think it presents challenges to the patient-physician relationship and the professional integrity of physicians. These dispositions are understandable, given the "black box" nature of some AI models, for which specifications and development methods can be closely guarded or proprietary, along with the relative lagging or absence of appropriate regulatory scrutiny and validation. This American College of Physicians (ACP) position paper describes the College's foundational positions and recommendations regarding the use of AI- and ML-enabled tools and systems in the provision of health care. Many of the College's positions and recommendations, such as those related to patient-centeredness, privacy, and transparency, are founded on principles in the ACP Ethics Manual. They are also derived from considerations for the clinical safety and effectiveness of the tools as well as their potential consequences regarding health disparities. The College calls for more research on the clinical and ethical implications of these technologies and their effects on patient health and well-being., Competing Interests: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M24-0146.

Abstract: Residency recruitment practices have undergone significant changes in the last several years. Interviews are now conducted fully virtually leading to both positive and negative downstream effects, including decreased cost to applicants and programs, decreased time away from clinical activities, flexibility in scheduling, and increased applications for applicants and program directors. In response to these changes, the Association of Academic Physiatrists Residency and Fellowship Program Directors Council convened a workgroup consisting of program directors, program coordinators, residents, and medical students who reviewed the available literature to provide an evidence-based set of best practices for program leaders and applicants. Available data from the Association of American Medical Colleges and its relevance to future recruitment cycles are also discussed., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Although psychologists are trained to conduct research as well as clinical work, it can be challenging for psychologists outside of traditional academia to find the time or capacity to engage in research. Providing opportunities for practicing psychologists to conduct research may enhance the generalizability of psychological research, as well as provide benefits to psychologists in terms of collaboration, promotion, and engagement. Yet, several barriers exist, including competing demands on time, lack of institutional support, and limited research confidence. This article describes "Paper in a Day" (PiaD), a novel approach to research engagement that is well-suited for busy practitioners. PiaD considers many of the aforementioned factors and provides a method to navigate the often-daunting prospect of research involvement for the practicing clinician. Through PiaD, two Department of Veterans Affairs (VA) Medical Centers engaged clinicians and trainees in collaborating in a time-limited way to write and publish peer-reviewed articles. The current article outlines the process by which clinicians at these two sites structured research engagement utilizing PiaD, and it was also written utilizing the PiaD model. The authors have now led or participated in the PiaD process five times, with 13 teams of clinicians producing nine peer-reviewed articles and five conference presentations. A brief survey indicated that participants felt engaged in the process and would participate again if given the opportunity. This article outlines barriers and facilitators of the PiaD process, with the hope of encouraging other settings to consider using such a method to enhance research productivity and engagement for psychologists. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Despite incredible growth in systems of care and rapidly expanding therapeutic options for people with inflammatory bowel disease, there are significant barriers that prevent patients from benefiting from these advances. These barriers include restrictions in the form of prior authorization, step therapy, and prescription drug coverage. Furthermore, inadequate use of multidisciplinary care and inflammatory bowel disease specialists limits patient access to high-quality care, particularly for medically vulnerable populations. However, there are opportunities to improve access to high-quality, patient-centered care. This position statement outlines the policy and advocacy goals that the American Gastroenterological Association will prioritize for collaborative efforts with patients, providers, and payors., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: Incisional hernia (IH) is one of the most common complications after abdominal surgeries and may bring great suffering to patients. This study aims to evaluate the global trends in IH research from 2003 to 2023 and visualize the frontiers using bibliometric analysis., Methods: The literature search was conducted on the Web of Science for IH studies published from 2003 to 2023 and sorted by citation frequency. The top 100 most-cited articles were analyzed by the annual publication number, prolific countries and institutions, influential author and journal, and the number of citations through descriptive statistics and visualization., Results: The top paper was cited 1075 times and the median number of citations was 146. All studies were published between 2003 and 2019 and the most prolific year was 2003 with 14 articles. Jeekel J and Rosen M were regarded as the most productive authors with ten articles each and acquired 2738 and 2391 citations, respectively. The top three institutions with the most productive articles were Erasmus Mc, Carolinas Med Ctr, and Univ Utah, while the top three countries were the United States, Netherlands and Germany. The most frequent keyword was "incisional hernia" with 55 occurrences, followed by "mesh repair", "randomized controlled trial", and "polypropylene"., Conclusion: The 100 most-cited papers related to IH were published predominantly by USA and European countries, with randomized controlled trial (RCT) and observational study designs, addressing topics related to risk factors, complications, mesh repair, and mesh components., (© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Purpose: As part of efforts to modernize the Youth Risk Behavior Surveillance System, the national Youth Risk Behavior Survey (YRBS) is moving from paper-and-pencil instrument (PAPI) administration to electronic administration using tablets. This study aimed to examine differences in demographic characteristics and the reporting of health behaviors and experiences between the PAPI- and tablet-administered 2021 national YRBS questionnaire., Methods: High school students (grades 9-12) in classrooms from 57 schools participating in the 2021 national YRBS were assigned randomly to complete the survey using PAPI (n = 4,684 students) or using tablets (n = 3,645 students). Eighty-nine behavior and experience items were examined to compare the missingness in reporting and the prevalence estimation (i.e., proportions) by administration mode., Results: Demographic characteristics (sex, race/ethnicity, grade, and sexual identity) did not differ by mode (PAPI vs. tablet). For the majority (93.2%, 83 out of 89) of YRBS behavior and experience items, mode was not significantly associated with the reported proportions, adjusting for sex, race/ethnicity, grade, and sexual identity. However, 30 out of 89 (33.7%) items showed significant variation in missingness by mode; 10 items had higher missingness with PAPI administration while 20 had higher missingness with tablet administration., Discussion: Survey administration mode was not significantly associated with behavior and experience reporting among high school students. More research is needed to understand differential patterns of missingness by mode. Aligning with Centers for Disease Control and Prevention's Public Health Data Modernization Initiative, findings from this study provide evidence to support electronic survey administration for the national YRBS, particularly using tablet data collection., (Published by Elsevier Inc.)

Introduction: Poor communication is a leading root cause of preventable maternal mortality in the United States. Communication challenges are compounded with the presence of biases, including racism. Hospital administrators and clinicians are often aware that communication is a problem, but understanding where to intervene can be difficult to determine. While clinical leadership routinely reviews incident reports and acts on them to improve care, we hypothesized that reviewing incident reports in a systematic way might reveal thematic patterns, providing targeted opportunities to improve communication in direct interaction with patients and within the healthcare team itself. Methods: We abstracted incident reports from the Women's Health service and linked them with patient charts to join patient's race/ethnicity, birth outcome, and presence of maternal morbidity and mortality to the incident report. We conducted a qualitative content analysis of incident reports using an inductive and deductive approach to categorizing communication challenges. We then described the intersection of different types of communication challenges with patient race/ethnicity and morbidity outcomes. Results: The use of incident reports to conduct research on communication was new for the health system. Conversations with health system‐level stakeholders were important to determine the best way to manage data. We developed a thematic codebook based on prior research in healthcare communication. We found that we needed to add codes that were equity focused, as this was missing from the existing codebook. We also found that clinical and contextual expertise was necessary for conducting the analysis—requiring more resources to conduct coding than initially estimated. We shared our findings back with leadership iteratively during the work. Conclusions: Incident reports represent a promising source of health system data for rapid improvement to transform organizational practice around communication. There are barriers to conducting this work in a rapid manner, however, that require further iteration and innovation. [ABSTRACT FROM AUTHOR]

Previous research has evaluated the extent to which cocaine and other drugs were detectable on currency in the USA. The literature was in agreement that the majority of bills exhibited some degree of contamination. With the increase of fentanyl in the illicit drug supply, this study was designed to evaluate the extent that fentanyl, cocaine, methamphetamine and other substances were present on circulating currency in 2022. A quantitative assay using liquid chromatography-triple quadrupole mass spectrometry was developed and validated to detect six analytes: fentanyl, 4-anilino-N-phenethylpiperidine, acetylfentanyl, benzylfentanyl, cocaine and methamphetamine. One-dollar bills were collected from 13 cities across the country. Sample preparation consisted of soaking the bills in methanol followed by liquid-liquid extraction. Chromatographic separation was achieved using a C18 analytical column and gradient elution with ammonium formate in water (5 mM, pH 3) and 0.1% formic acid in acetonitrile. The quantitative working range for this assay was 0.1 μg to 1.0 μg per bill (equivalent to 1 ng/mL to 100 ng/mL of extract). Fentanyl was detected on the majority (63%) of samples, with 61% of samples having ≥0.1 μg of fentanyl and 4% of samples having ≥1.0 μg. Cocaine and methamphetamine were detected on 100% and 98% of bills, respectively, typically in amounts >1.0 μg. The remaining fentanyl-related substances were detected in 15% of samples in amounts no >0.69 μg per bill and exclusively in the presence of fentanyl. Unsurprisingly, areas of the country with higher incidence of fentanyl use yielded higher frequency of contaminated bills and higher concentrations. Human exposure to drugs on currency is unlikely to have any significant impacts toxicologically or pharmacologically; however, our research findings suggest that paper currency could serve as a useful substrate for surveillance of drug trends regionally, nationally and/or internationally., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

The Centers for Medicare & Medicaid Services (CMS) introduced the Severe Sepsis/Septic Shock Management Bundle (SEP-1) as a pay-for-reporting measure in 2015 and is now planning to make it a pay-for-performance measure by incorporating it into the Hospital Value-Based Purchasing Program. This joint IDSA/ACEP/PIDS/SHEA/SHM/SIPD position paper highlights concerns with this change. Multiple studies indicate that SEP-1 implementation was associated with increased broad-spectrum antibiotic use, lactate measurements, and aggressive fluid resuscitation for patients with suspected sepsis but not with decreased mortality rates. Increased focus on SEP-1 risks further diverting attention and resources from more effective measures and comprehensive sepsis care. We recommend retiring SEP-1 rather than using it in a payment model and shifting instead to new sepsis metrics that focus on patient outcomes. CMS is developing a community-onset sepsis 30-day mortality electronic clinical quality measure (eCQM) that is an important step in this direction. The eCQM preliminarily identifies sepsis using systemic inflammatory response syndrome (SIRS) criteria, antibiotic administrations or diagnosis codes for infection or sepsis, and clinical indicators of acute organ dysfunction. We support the eCQM but recommend removing SIRS criteria and diagnosis codes to streamline implementation, decrease variability between hospitals, maintain vigilance for patients with sepsis but without SIRS, and avoid promoting antibiotic use in uninfected patients with SIRS. We further advocate for CMS to harmonize the eCQM with the Centers for Disease Control and Prevention's (CDC) Adult Sepsis Event surveillance metric to promote unity in federal measures, decrease reporting burden for hospitals, and facilitate shared prevention initiatives. These steps will result in a more robust measure that will encourage hospitals to pay more attention to the full breadth of sepsis care, stimulate new innovations in diagnosis and treatment, and ultimately bring us closer to our shared goal of improving outcomes for patients., Competing Interests: Potential conflicts of interest. K. C. discloses grants or contracts from the CDC and AHRQ to my institution and serves as the IDSA and PIDS representative to the SCCM Pediatric Sepsis Definitions Taskforce. D. C. C. reports payment for expert testimony. S. E. C. reports grants or contracts from Patient-Centered Outcomes Research Institute (PCORI), National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), Agency for Healthcare Research and Quality (AHRQ); consulting fees from Duke Clinical Research Institute; participation on a Data Safety Monitoring Board or Advisory Board for Debiopharm; roles as a Board Member for National Foundation for Infectious Diseases and for Global Antibiotic Research & Development Partnership North America (GARDP-NA). R. G. reports support for attending meetings and/or travel for his government relations work from Society of Hospital Medicine; participation as an advisor on a Data Safety Monitoring Board or Advisory Board for Honor Technologies, Clinical Language Engineering Workbench (CLEW), Sitka; volunteer position as Sr. Advisor for Government Affairs SHM; stock from Sitka, Honor Technologies, CLEW. E. L. H. reports consulting fees paid to author for peer review of drug monographs from Wolters Kluwer (Lexi-Comp); honoraria for continuing education presentations from Clinical Care Options. A. C. K. reports grants or contracts as Investigator for the National Institutes of Health Adaptive COVID-19 Treatment Trial. M. K. reports grants to institution from CDC and AHRQ; royalties to author from UpToDate; Honorarium for lecture on sepsis metrics, paid to author, from Burns & Trauma Journal. H. M. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Infectious Disease Board Review and International AIDS Society USA; patents planned, issued or pending for Immunofluorescent antibody for pneumocystis; leadership or fiduciary role with Society of Critical Care Medicine, Critical Care Medicine (Senior Editor) and is an IDSA representative to Surviving Sepsis Guideline; and other financial or non-financial interests in Infectious Disease Board Review LLC. C. R. reports grants to institution from CDC and AHRQ; royalties to author from UpToDate; payment to author for consulting related to sepsis diagnostics from Cytovale; leadership or fiduciary role with IDSA as Associate Editor for Clinical Infectious Diseases. D. A. S. reports grants or contracts as investigator for the National Institutes of Health Adaptive COVID-19 Treatment Trial. A. T. reports consulting fees from Vapotherm (no payments made related to this manuscript; Vapotherm is a medical device that can be used to treat sepsis); a role as President-elect for the American College of Emergency Physicians (no direct payment related to this manuscript). D. M. Y. reports grants or contracts to institution from National Heart, Lung, and Blood Institute (NHLBI); royalties or licenses from UpToDate (pneumonia chapter) and Lippincott Inc (EM text editor); payment or honoraria as journal editor for American College of Emergency Physicians; payment for expert testimony from University of Pennsylvania and Pennsylvania State University. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

A significant amount of researcher and practitioner effort has focused on developing new chemical controls for the parasitic Varroa destructor mite in beekeeping. One outcome of that has been the development and testing of "glycerol–oxalic acid" mixtures to place in colonies for extended periods of time, an off-label use of the otherwise legal miticide oxalic acid. The majority of circulated work on this approach was led by practitioners and published in nonacademic journals, highlighting a lack of effective partnership between practitioners and scientists and a possible failure of the extension mandate in beekeeping in the United States. Here, we summarize the practitioner-led studies we could locate and partner with a commercial beekeeper in the Southeast of the United States to test the "shop towel–oxalic acid–glycerol" delivery system developed by those practitioners. Our study, using 129 commercial colonies between honey flows in 2017 split into 4 treatment groups, showed no effectiveness in reducing Varroa parasitism in colonies exposed to oxalic acid–glycerol shop towels. We highlight the discrepancy between our results and those circulated by practitioners, at least for the Southeast, and the failure of extension to support practitioners engaged in research. [ABSTRACT FROM AUTHOR]

The high prevalence and costs of urinary incontinence and related pelvic floor disorders in adults highlights the need for competent nurses and advanced practice nurses who can provide high-quality continence and pelvic health care. However, challenges exist in recognizing this as a nursing specialty, preparing new and experienced nurses with specialty knowledge and skills, increasing the number and diversity of the workforce, and promoting individual achievement and professional recognition as a continence and pelvic health nursing specialist. This White Paper provides recommendations based on evidence and expert opinion to support the Society of Urologic Nurses and Associate's efforts in advancing the roles of registered nurses and advanced practice registered nurses in the expanded specialty area of continence and pelvic health nursing. [ABSTRACT FROM AUTHOR]

Purpose: To assess the extent of paper waste generated per year by instructions for use (IFUs) brochures included in intraocular lens (IOL) packaging in Europe and the U.S., Setting: Rothschild Foundation Hospital, Paris, France; Royal Free London NHS Foundation Trust; Center for Sight, London, United Kingdom., Design: Experimental study., Methods: A sample of IOLs were collected and each IFU was weighed. In addition, the cumulative weight of these brochures used in cataract surgeries performed annually in Europe and the U.S. was estimated, and the potential annual paper conservation that could be achieved if all manufacturers adopted electronic IFUs (e-IFUs) in Europe and the U.S. was determined., Results: The mean and standard deviation of the weight for overall IFUs, classic IFUs, and e-IFUs were 17.6 ± 13.8 g, 23.5 ± 13.2 g, and 2.9 ± 1.9 g, respectively. The estimated cumulative weight of paper generated from the IFUs accompanying implants used in European and U.S. cataract surgeries is 153 tons. If all manufacturers transition to e-IFUs, the cumulative weight saved would be 128 tons (-84%), equivalent to 120 tons of carbon dioxide equivalent and the preservation of more than 2000 trees annually., Conclusions: The classic IFUs in IOL packaging result in a significant amount of paper waste annually. Therefore, there is an urgent need for a rapid transition to e-IFU technology. The adoption of e-IFUs has already been authorized in Europe and the U.S., and it is crucial to expedite this process., (Copyright © 2023 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Drawing on Michel de Certeau's conceptualisation of the city space in The Practice of Everyday Life, in conversation with AbdouMaliq Simone's approach to the African city, this article explores the problem of belonging in Ufrieda Ho's Paper Sons and Daughters: Growing Up Chinese in South Africa (2011). The text's navigation of the manifold ascribed and asserted identities of the autobiographical self is made prominent through Ho's tracing of the traversals of both her father and herself across Johannesburg. In particular, the illegal gambling game of fahfee and its operation become emblematic of the imbrication of Chinese immigrants within the urban space, positioning the figures in the text within the broader historical and literary archive of Johannesburg and thereby asserting a rootedness within the (post-)apartheid city. It highlights the complexity of the relationship between the self and the (post-)apartheid city and the formulations of belonging that arise as a result. [ABSTRACT FROM AUTHOR]

Background: Despite notable progress over time, broad insight into the scientific landscape of orthopaedic oncology is lacking. We conducted a bibliometric analysis of the 500 most cited papers in the field., Methods: We searched the Science Citation Index Expanded database of the Web of Science Core Collection to find the 500 most cited articles in the field., Results: Citation count ranged from 81 to 1,808. Articles were published from 1965 to 2018. Over half of all articles were published in the United States (53.6%). The 2000s was the most productive decade with 170 (34%) articles. All articles were written in English and were published across 29 journals. Female participation as first authors significantly increased from the 1960s to the 2010s (0% vs 14.6%, P = 0.0434). Similarly, female involvement as senior authors grew from the 1960s to the 2010s (0% vs 12.2%, P = 0.0607). Primary bone sarcomas were the most cited topic among articles from the 1970s to the 1980s. From studies produced in the 1990s up until the 2010s, reconstruction procedures were the most cited topic., Conclusion: Trends over the years have resulted in an emphasis on a surgical technique. Notable progress has been made regarding gender diversity, yet disparities still exist., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.)

The 17 th Workshop on Recent Issues in Bioanalysis (17 th WRIB) took place in Orlando, FL, USA on June 19-23, 2023. Over 1000 professionals representing pharma/biotech companies, CROs, and multiple regulatory agencies convened to actively discuss the most current topics of interest in bioanalysis. The 17 th WRIB included 3 Main Workshops and 7 Specialized Workshops that together spanned 1 week to allow an exhaustive and thorough coverage of all major issues in bioanalysis of biomarkers, immunogenicity, gene therapy, cell therapy and vaccines.Moreover, in-depth workshops on "EU IVDR 2017/746 Implementation and impact for the Global Biomarker Community: How to Comply with this NEW Regulation" and on "US FDA/OSIS Remote Regulatory Assessments (RRAs)" were the special features of the 17 th edition.As in previous years, WRIB continued to gather a wide diversity of international, industry opinion leaders and regulatory authority experts working on both small and large molecules as well as gene, cell therapies and vaccines to facilitate sharing and discussions focused on improving quality, increasing regulatory compliance, and achieving scientific excellence on bioanalytical issues.This 2023 White Paper encompasses recommendations emerging from the extensive discussions held during the workshop and is aimed to provide the bioanalytical community with key information and practical solutions on topics and issues addressed, in an effort to enable advances in scientific excellence, improved quality and better regulatory compliance. Due to its length, the 2023 edition of this comprehensive White Paper has been divided into three parts for editorial reasons.This publication covers the recommendations on Mass Spectrometry Assays, Regulated Bioanalysis/BMV (Part 1A) and Regulatory Inputs (Part 1B). Part 2 (Biomarkers, IVD/CDx, LBA and Cell-Based Assays) and Part 3 (Gene Therapy, Cell therapy, Vaccines and Biotherapeutics Immunogenicity) are published in volume 16 of Bioanalysis, issues 7 and 8 (2024), respectively.

Team-based care models such as the Patient-Centered Medical Home are associated with improved patient health outcomes, better team coordination and collaboration, and increased well-being among health care professionals. Despite these attributes, hindrances to wider adoption remain. In addition, some health care professionals have sought to practice independent of the physician-led health care team, potentially undermining patient access to physicians who have the skills and training to deliver whole-person, comprehensive, and longitudinal care. In this paper, the American College of Physicians reaffirms the importance of the physician-led health care team and offers policy recommendations on professionalism, payment models, training, licensure, and research to support the expansion of dynamic clinical care teams., Competing Interests: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-2260.

Complex congenital heart disease (CCHD) is a group of heart defects present at birth. Some imaging methods can support the diagnosis of these pathologies, such as echocardiography, computed tomography, and magnetic resonance imaging. This study aimed to perform a bibliometric analysis of the top 100 articles cited on CCHD. Articles from 2013 to 2023 found in Scopus were scanned using 15 CCHD topics titles crossed with echocardiography, computed tomography, and magnetic resonance imaging. Duplicated manuscripts were eliminated using Microsoft Excel software, and the publications were ranked according to their citation count. This study selected and analyzed the top 100 most cited English-language papers. The top 100 most cited publications accumulated 16,563 citations. The manuscript with the most citations obtained 1086, representing 6.55% of the total citations. The year 2014 had the highest number of publications, with 27 papers. The first authors had affiliations from 44 countries; the United States was the country that contributed the most, with 54 manuscripts. Boston Children's Hospital was the institution that provided more articles to the top 100. Finally, the Ebstein anomaly was the topic with the highest number of citations. This study identified the 100 most cited on CCHD, and the results obtained can provide practical guidance to clinicians and researchers to familiarize themselves with the most influential publications in this field., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Permethrin is a pyrethroid pesticide and insect repellent that prevents mosquito-borne infections like dengue and malaria in tropical areas. This work describes a new colorimetric sensor based on metronidazole-stabilized silver nanoparticles (MTZ-AgNPs) for the first rapid, sensitive, and selective permethrin detection. The MTZ-AgNPs-based colorimetric sensor has a limit of detection (LOD) of 0.0104 µM and a limit of quantification (LOQ) of 0.0348 µM, respectively. The sensor is further integrated with smartphone and microfluidic fabrication of paper-based analytical devices (µPADs) for real-time and on-site detection of permethrin. Under optimal settings, no potential environmental contaminants interfere with permethrin detection, confirming its high selectivity. Finally, the practical applicability of sensors is confirmed in real tomato and apple extract samples. The US environmental protection agency's recommended UPLC method validated the detection efficiency of the proposed colorimetric sensor. The % recoveries from UPLC and MTZ-AgNPs suggest that the present sensor can quantitatively analyze permethrin in real samples., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

As the United States' population grows via migration and immigration, with this rise in diverse identities, there has been increasing concern regarding disparities for undocumented immigrants living in the U.S. with limited access to the health system. Given the various constraints involving communication and social structures that undocumented immigrants face, a culture-centered approach is drawn on to investigating how this group goes about navigating a dominant health system given their restricted access. I explore co-constructed themes that emerged through conversations with undocumented immigrants, (people without papers as I call them in this work) living in the United States to gain an understanding as to the structural and cultural limitations faced by this group. By doing qualitative semi-structured interviews with local participants living in the South Florida region, I describe the various features of a complex U.S. health system that undocumented immigrants (people without papers) deemed as important obstacles that limit their willingness to interact with official medical spaces. This work draws on narratives and accounts to shed light on the intersection of disparities this group has to overcome in order to consider entering a medical space to receive the treatment they might need. The findings of this article highlighted the structural violence that certain subaltern groups, such as people without papers experience due to their limited access to foundational systems in their environment.

The relationship of health to rights or human rights is complex. Although many find no right of any kind to health or health care, and others view health care as a right or human right, the American College of Physicians (ACP) instead sees health as a human right . The College, in the ACP Ethics Manual, has long noted the interrelated nature of health and human rights. Health as a human right also has implications for the social and structural determinants of health, including health care. Any rights framework is imperfect, and rights, human rights, and ethical obligations are not synonymous. Individual physicians and the profession have ethical obligations to patients, and these obligations can go beyond matters of rights. Society, too, has responsibilities-the equitable and universal access to appropriate health care is an ethical obligation of a just society. By recognizing health as a human right based in the intrinsic dignity and equality of all patients and supporting the patient-physician relationship and health systems that promote equitable access to appropriate health care, the United States can move closer to respecting, protecting, and fulfilling for all the opportunity for health., Competing Interests: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-1900.

Introduction: Endoscopic biopsy procedures increasingly generate multiple tissue samples from multiple sites, and frequently retrieve concurrent cytologic specimens and small core needle biopsies. There is currently lack of consensus in subspecialized practices as to whether cytopathologists or surgical pathologists should review such samples, and whether the pathology findings should be reported together or separately., Materials and Methods: In December 2021, the American Society of Cytopathology convened the Re-Imagine Cytopathology Task Force to examine various workflows that would facilitate unified pathology reporting of concurrently obtained biopsies and improve clinical care., Results and Conclusions: This position paper summarizes the key points and highlights the advantages, challenges, and resources available to support the implementation of such workflows that result in "one procedure-one report"., (Copyright © 2023 American Society of Cytopathology. Published by Elsevier Inc. All rights reserved.)

Black women in the United States experience a higher maternal mortality rate compared to other racial groups. The maternal mortality rate among non-Hispanic Black women is 3.5 times that of non-Hispanic White women and is higher in the South compared to other regions. The majority of pregnancy-related deaths in Black women are deemed to be preventable. Healthy People 2030 directs healthcare providers to advance health equity through societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and healthcare disparities. The Southern Nursing Research Society has put forward this position paper to provide recommendations to improve maternal health equity among Black women. Recommendations for nurses, multidisciplinary healthcare providers, policymakers, and researchers are discussed., (© 2023 Wiley Periodicals LLC.)

Women's health care has evolved significantly since it was first acknowledged as an integral part of internal medicine training more than two decades ago. To update and clarify core competencies in sex- and gender-based women's health for general internists, the Society of General Internal Medicine (SGIM) Women and Medicine Commission prepared the following Position Paper, approved by the SGIM council in 2023. Competencies were developed using several sources, including the 2021 Accreditation Council for Graduate Medical Education Program Requirements for Internal Medicine and the 2023 American Board of Internal Medicine Certification Examination Blueprint. These competencies are relevant to the care of patients who identify as women, as well as gender-diverse individuals to whom these principles apply. They align with pivotal advances in women's health and acknowledge the changing context of patients' lives, reaffirming the role of general internal medicine physicians in providing comprehensive care to women., (© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.)

The rise of fentanyl and fentanyl analogs in the drug supply pose serious threats to public health. Much of these compounds enter the United States through shipping routes. Here we provide a method for fentanyl screening and analysis that utilizes pressure‐sensitive adhesive (PSA) lined paper to recover drug residues from parcel‐related surfaces. The paper used is commercially available repositionable notes (also called post‐it or sticky notes). From this paper, mass spectra were obtained by paper spray‐mass spectrometry (PS‐MS), where PSA paper served as both a sampling and analysis substrate. Seven fentanyl‐related compounds were analyzed: fentanyl, 4‐anilino‐N‐phenethylpiperidine (4‐ANPP), N,1‐diphenethyl‐N‐phenylpiperidin‐4‐amine (phenethyl‐4‐ANPP), valerylfentanyl, 4‐fluoroisobutyrylfentanyl (4‐FIBF), carfentanil, and p‐fluorofentanyl. These compounds were recovered by PSA paper and identified by PS‐MS from packaging tape and plastic at 50 ng and from cardboard and shipping labels at 100 ng. The impact of cutting agents on PS‐MS analysis of fentanyl analogs was explored. No trends of analyte suppression were found at high concentrations of the cutting agents caffeine, diphenhydramine, and lidocaine when recovered from surfaces. A cartridge that required no precise cutting of PSA paper prior to sampling or analysis was evaluated for use in PS‐MS for fentanyl screening. Recovery and detection of fentanyl from plastic sheeting was demonstrated with this cut‐free cartridge. The cut‐free cartridge showed somewhat less consistency and lower analyte signal than the standard cartridge, but performance was suitable for potential screening applications. In combining PSA surface sampling with PS‐MS for drug screening, both sampling and detection of fentanyl‐related compounds is simple, rapid, and low‐cost. [ABSTRACT FROM AUTHOR]

The onset of the COVID-19 pandemic revealed significant gaps in the United States' pandemic and public health emergency response system. In this position paper, the American College of Physicians (ACP) offers several policy recommendations for enhancing federal, state, and local preparedness for future pandemics and public health emergencies. The onset of the COVID-19 pandemic revealed significant gaps in the United States' pandemic and public health emergency response system. At the federal level, government responses were undercut by a lack of centralized coordination, inadequately defined responsibilities, and an under-resourced national stockpile. Contradictory and unclear guidance throughout the early months of the pandemic, along with inconsistent funding to public health agencies, also created notable variance in state and local responses. The lack of a coordinated response added pressure to an already overwhelmed health care system, which was forced to resort to rationing care and personal protective equipment, creating moral distress and trauma for health care workers and their patients. Despite these severe shortcomings, the COVID-19 pandemic also highlighted successful policies and approaches, such as Operation Warp Speed, which led to the fastest development and distribution of a vaccine in history. In this position paper, the American College of Physicians (ACP) offers several policy recommendations for enhancing federal, state, and local preparedness for future pandemic and public health emergencies. This policy paper builds on various statements produced by ACP throughout the COVID-19 pandemic, including on the ethical distribution of vaccinations and resources, conditions to resume economic and social activity, and efforts to protect the health and well-being of medical professionals, among others. [ABSTRACT FROM AUTHOR]