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Life expectancy of patients with a durable, continuous-flow left ventricular assist device (CF-LVAD) continues to increase. Despite significant improvements in the delivery of care for patients with these devices, hemocompatability-related adverse events (HRAEs) are still a concern and contribute to significant morbility and mortality when they occur. As such, dissemination of current best evidence and practices is of critical importance. This ISHLT Consensus Statement is a summative assessment of the current literature on prevention and management of HRAEs through optimal management of oral anticoagulant and antiplatelet medications, parenteral anticoagulant medications, management of patients at high risk for HRAEs and those experiencing thrombotic or bleeding events, and device management outside of antithrombotic medications. This document is intended to assist clinicians caring for patients with a CF-LVAD provide the best care possible with respect to prevention and management of these events., (Copyright © 2024 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)

Context: The osteopathic tenets may serve as a useful guideline for an interprofessional program. There is an alignment between the osteopathic tenets and the concept of interprofessional education (IPE). IPE occurs when students from two or more professions work with each other to collaborate or improve healthcare outcomes. Holistic treatment is fundamental in both instances, and the interrelatedness of structure and function requires acknowledgment of all healthcare professionals' roles in treating a patient. IPE allows students to gain a better understanding of their own professional roles and the roles of their fellow healthcare providers in treating patients more effectively., Objectives: The objectives of this analysis are to evaluate the ability of an interprofessional summer workshop/lecture utilizing an osteopathic focus to educate students from different healthcare colleges about the interconnectedness of the systems of the human body and how working with a team-based approach will ultimately benefit their collective patients. A secondary objective was to determine the students' perceptions before and after the lecture/workshop to see if there were any perceived differences among students in different healthcare professions at either time., Methods: This was a retrospective data analysis conducted on pretest/posttest surveys completed by 73 incoming students from six different healthcare colleges participating in the Summer Preparedness and Readiness Course (SPaRC), held annually at Western University of Health Sciences (WUHS) in Pomona, California. Analysis was conducted on responses collected during the SPaRC programs of 2013, 2016, and 2019. Participants were given surveys containing five questions scored on a five-point Likert scale. The surveys were given before and after an integrated lecture/hands-on workshop presented at SPaRC that reviewed multiple studies showing the utility of connecting the healthcare professions to best treat a patient., Results: A total of 73 students responded to both the prelecture and postlecture surveys. When the number of positive scores were totaled from students from all colleges, there was an increase in positive responses from 190 (52.2 %) in prelecture surveys when compared to 336 (92.3 %) in postlecture surveys. A Wilcoxon signed-rank test suggested that the lecture workshop elicited a significant improvement in scores from prelecture to postlecture for all students (Z=-6.976, p=0.000). Median scores improved from 3.60 at baseline to 4.40 after the lecture/workshop. Secondary analysis conducted utilizing Kruskal-Wallis H to examine the differences between the responses of the different colleges prelecture and postlecture showed no significant differences prelecture (H [6]=7.58, p=0.271) and a significant difference between postlecture answers (H [6]=14.04, p=0.029). A series of post hoc independent Kruskal-Wallis H analyses was conducted to identify where differences were, and the only identifiable difference after Bonferroni corrections was between students from the Doctor of Osteopathic Medicine college and the Physician Assistant's college after the lecture/survey (p=0.041)., Conclusions: An interprofessional program with the osteopathic principles of focusing on body unity and relatedness of structure and function may serve as a helpful tool for uniting healthcare professionals in their ultimate goal of better serving their patients., (© 2024 the author(s), published by De Gruyter, Berlin/Boston.)

Context: Anecdotal evidence suggested that osteopathic manipulative treatment (OMT) may have imparted survivability to patients in osteopathic hospitals during the 1918 influenza pandemic. In addition, previous OMT research publications throughout the past century have shown evidence of increased lymphatic movement, resulting in improved immunologic function qualitatively and quantitatively., Objectives: The following is a description of a proposed protocol to evaluate OMT effects on antibody generation in the peripheral circulation in response to a vaccine and its possible use in the augmentation of various vaccines. This protocol will serve as a template for OMT vaccination studies, and by adhering to the gold standard of randomized controlled trials (RCTs), future studies utilizing this outline may contribute to the much-needed advancement of the scientific literature in this field., Methods: This manuscript intends to describe a protocol that will demonstrate increased antibody titers to a vaccine through OMT utilized in previous historical studies. Confirmation data will follow this manuscript validating the protocol. Study participants will be divided into groups with and without OMT with lymphatic pumps. Each group will receive the corresponding vaccine and have antibody titers measured against the specific vaccine pathogen drawn at determined intervals., Results: These results will be statistically evaluated. Our demonstration of a rational scientific OMT vaccine antibody augmentation will serve as the standard for such investigation that will be reported in the future. These vaccines could include COVID-19 mRNA, influenza, shingles, rabies, and various others. The antibody response to vaccines is the resulting conclusion of its administration. Osteopathic manipulative medicine (OMM) lymphatic pumps have, in the past through anecdotal reports and smaller pilot studies, shown effectiveness on peripheral immune augmentation to vaccines., Conclusions: This described protocol will be the template for more extensive scientific studies supporting osteopathic medicine's benefit on vaccine response. The initial vaccine studies will include the COVID-19 mRNA, influenza, shingles, and rabies vaccines., (© 2023 the author(s), published by De Gruyter, Berlin/Boston.)

Purpose: To perform in vivo evaluation of the structural morphology and vascular plexuses of the neurosensory retina and choroid across vertebrate species using swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography (SS-OCTA) imaging., Methods: A custom-built SS-OCT system with an incorporated flexible imaging arm was used to acquire the three-dimensional (3D) retinal OCT and vascular OCTA data of five different vertebrates: a mouse (C57BL/6J), a rat (Long Evans), a gray short-tailed opossum (Monodelphis domestica), a white sturgeon (Acipenser transmontanus), and a great horned owl (Bubo virginianus)., Results: In vivo structural morphology of the retina and choroid, as well as en face OCTA images of retinal and choroidal vasculature of all species were generated. The retinal morphology and vascular plexuses were similar between rat and mouse, whereas distinct choroidal and paired superficial vessels were observed in the opossum retina. The retinal and vascular structure of the sturgeon, as well as the pecten oculi and overlying the avascular and choroidal vasculature in the owl retina are reported in vivo., Conclusions: A high-quality two-dimensional and 3D in vivo visualization of the retinal structures and en face visualization of the retina and choroidal vascular plexus of vertebrates was possible. Our studies affirm that SS-OCT and SS-OCTA are viable methods for evaluating the in vivo retinal and choroidal structure across terrestrial, aquatic, and aerial vertebrates., Translational Relevance: In vivo characterization of retinal morphology and vasculature plexus of multiple species using SS-OCT and SS-OCTA imaging can increase the pool of species available as models of human retinal diseases.