Low grip strength predicts postoperative loss of independence in older adults undergoing hepatobiliary-pancreatic surgery.

Prenatal and Early Intimate Partner Psychological Violence and Children's Hospital Health Care Use: The ELFE Cohort.

Unplanned Readmissions After Surgical Repair of Congenital Heart Defects at a Tertiary Care Hospital.

Does $1 matter? Health care demand response to a small copayment

Edge feature enhancement: Generating adversarial edge perturbations for preterm infant movement recognition.

Increasing risk of stroke with increased climate vulnerability: Assessing stroke burden and access to health care according to the climate vulnerability index in the United States.

ESPEN practical guideline on ethical aspects of medical nutrition therapy.

Consumption of ultra-processed foods and increased risks of cardiovascular disease in US adults.

Contralateral Total Knee Arthroplasty More Than One Year Apart: Do Patient-Reported Outcomes and Health Care Utilization Differ After Each Surgery?

Exploring Caregivers' Experiences With Diagnostic Uncertainty During a Hospitalization: A Qualitative Study.

Bi-objective home health care routing and scheduling problem based on caregiver-patient matching and satisfaction

Role of Social Support in the Continuum of Cardiovascular Care.

Older adults represent the majority of patients with acute myeloid leukemia (AML), and an increasing proportion receive allogeneic hematopoietic cell transplantation (alloHCT). Mutations in the FMS-like tyrosine kinase 3 gene (FLT3) confer high relapse risk, and post-transplant maintenance with FLT3 tyrosine kinase inhibitors (FLT3-TKIs) is guideline-recommended. However, real-world utilization, adherence, and tolerability of FLT3-TKIs in older adults remain poorly characterized. Using 100% Medicare claims (Parts A/B/D and Medicare Advantage encounter data), we conducted a retrospective cohort study of beneficiaries ≥65years old with AML who received alloHCT between January 1, 2016 and June 30, 2024, and initiated FLT3-TKI maintenance (gilteritinib, midostaurin, or sorafenib) within 100days post-transplant. Baseline demographics, comorbidities, prior therapy, and health care resource utilization (HCRU) were captured from 2010 through the index date. Adherence was assessed using proportion of days covered (PDC). Dose modification, FLT3-TKI switching, and post-transplant HCRU were evaluated descriptively. Centers for Medicare & Medicaid Services suppression rules were applied throughout. Of 7403 eligible older adults with AML undergoing alloHCT, 150 (2.0%) initiated FLT3-TKI maintenance (gilteritinib: 54.7%, midostaurin: 24.0%, sorafenib: 21.3%). Mean age was 70.5years, and 59.3% had Charlson Comorbidity Index ≥4. Utilization of post-transplant FLT3-TKIs was sustained from 2020 onwards at approximately 20% of eligible patients annually. Overall adherence was modest, with a mean PDC of 47% and very few patients achieving PDC ≥80%. Higher mean PDC was observed in patients ≥70years of age, those with fewer comorbidities, those previously treated with low-intensity chemotherapy, and those who received gilteritinib as maintenance. Among patients treated with gilteritinib, two-thirds had no evidence of dose change, and no patients switched to an alternative FLT3-TKI. Across all patients, post-alloHCT HCRU was predominantly outpatient visits, with low hospitalization rates across FLT3-TKIs. In this first real-world analysis of post-alloHCT FLT3-TKI maintenance in older adults, utilization was low and adherence was modest, although not impaired by age alone. Gilteritinib demonstrated the highest adherence and appeared to have favorable tolerability. Strategies to improve adherence and prospective data in older adults are needed to maximize the benefits of FLT3-TKI maintenance in this population.

Advocacy Pillar Development in a Division of Pediatric Emergency Medicine Using a Strategic Planning Process.

Increasing Privatization of Veteran Health Care: Buyer Beware.

Real-world randomized controlled trials (RCTs) evaluating multifaceted interventions often employ multiple study outcomes to measure treatment effects on a small set of underlying constructs. Motivated by a longitudinal RCT evaluating a behavioural intervention, the Arthritis Health Journal (AHJ), we propose a latent-factor multivariate complier average causal effects (MCACE) model for multidimensional longitudinal outcomes with principal strata of compliance types for parsimonious estimation of intervention effects in RCTs with treatment noncompliance. Within each compliance type, a factor regression model relates multiple outcomes to latent constructs, which follow hierarchical regression models. Under the model, high dimensional outcomes are reduced to low dimensional latent factors. This dimension reduction leads to a parsimonious and efficient test of overall CACEs on multiple outcomes, mitigating the multiple testing issues associated with multidimensional outcomes and weak instrumental variable problems associated with low compliance rates. Simulation studies demonstrate that the latent-factor MCACE model outperforms univariate CACE analysis in terms of both statistical power and Type I error control. The application to the AHJ study selects two underlying factors (self-efficacy and interaction with health care providers). Significant and beneficial treatment effects are detected on both factors. Overall, our analysis directly answers the main scientific questions posed by the RCT and yields novel findings not discovered previously.

• Proposes the Burden of Missed Care (BMC) as a novel health planning metric. • BMC quantifies gains from optimal use of all existing effective health care. • Integrates with Global Burden of Disease metrics using YLLs, YLDs, and DALYs. • The GBMC framework ranks interventions by their potential to close health gaps. • Aims to improve resource allocation, policy accountability, and R&D focus.

Artificial intelligence (AI) is rapidly reshaping critical care through predictive analytics, intelligent monitoring and decision-support tools. While these innovations may enhance early detection and workflow efficiency, they also raise professional questions about transparency, explainability, data bias, accountability and the preservation of compassionate, human-centred care. Critical care nurses, positioned at the bedside where AI outputs are interpreted and enacted, experience these tensions directly, yet their lived experiences remain underexplored. To explore critical care nurses' lived experiences of clinical judgement in AI-supported care, focusing on how innovation influences professional integrity, ethical accountability and human-centred practice. A qualitative phenomenological study was conducted at King Faisal University Health Care settings in Saudi Arabia. Semi-structured, in-depth interviews were undertaken with critical care nurses who routinely interacted with AI-supported clinical systems. Data were analysed using reflexive thematic analysis informed by Braun and Clarke's six-phase framework. The study followed the Standards for Reporting Qualitative Research (SRQR). Sixteen nurses participated. Four interconnected themes were identified: (1) Balancing algorithmic input and professional judgement, where AI was valued as a prompt for vigilance but required contextual interpretation rather than automatic compliance; (2) Instinct informed by experience, describing embodied and situational knowing that nurses perceived as essential when AI outputs did not capture patient complexity; (3) Ethical weight and accountability, reflecting heightened responsibility and concern about scrutiny when following or overriding AI recommendations; and (4) Preserving human-centred care, highlighting deliberate efforts to protect relational nursing roles, patient-family communication and professional identity amid technology-dense workflows. Nurses experienced AI as transforming the conditions of clinical judgement rather than replacing it. Innovation was welcomed when it supported early recognition and prioritisation, but nurses emphasised that integrity in AI-supported care depends on maintaining professional discretion, ethical accountability and human-centred values. Implementing AI in critical care should include governance and education that strengthen nurses' critical appraisal of AI outputs, clarify accountability and support transparent, explainable systems. These steps can help ensure AI's impact enhances safety and efficiency without eroding human-centred critical care nursing.

Comparative Outcomes of Transferred vs Nontransferred Cardiogenic Shock Patients Receiving Impella Support.

This bibliometric analysis examines the evolution of research into post-stroke depression (PSD) between 1985 and 2024, evaluating publication trends, key contributions, and thematic shifts in the field. The study analyzed 3146 studies retrieved from the Web of Science Core Collection. Keyword and thematic analyses were conducted using the software tools VOSviewer and CiteSpace. Publications on PSD increased significantly after 2010. China (796 articles) and the United States (615 articles) were the leading countries in research output. Analyses revealed core research themes encompassing depression prevalence, rehabilitation strategies, quality of life, and recovery outcomes. Thematic clusters identified diverse areas of focus, including cognitive impairment, socioeconomic disparities, caregiver roles, alternative therapies, and the influence of culture on PSD management. Emerging trends indicated by citation bursts included "healthcare professionals," "fatigue," and "meta-analysis," pointing to current frontiers in interdisciplinary care, symptom complexity, and evidence synthesis. Highly cited studies emphasized integrating mental health assessments into stroke care and the critical role of rehabilitation in mitigating PSD. The findings illustrate the field's progression from early observational studies to multifaceted investigations addressing the biological, psychological, and social dimensions of PSD. Future research should prioritize multidisciplinary frameworks, culturally sensitive interventions, and innovative therapies. This study underscores the need for holistic rehabilitation models that integrate physical and mental healthcare to improve outcomes for stroke survivors, thereby informing clinical practice, policy, and further research.