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Research demonstrating improved outcomes with third-generation ankle replacement implants has resulted in increasing utilization of total ankle arthroplasty over the past 3 decades. The purpose of this study was to examine the quality and trends of clinical outcomes research being published on third-generation total ankle arthroplasty implants. Two fellowship-trained foot and ankle surgeons reviewed all peer-reviewed, Medline-indexed English-language clinical outcomes studies evaluating total ankle arthroplasty published between 2006 and 2019. Articles were assessed for study design and indicators of study quality. A total of 694 published articles were reviewed and 231 met all inclusion criteria. The majority (78%) of studies were retrospective, most of which were case series (54%) or cohorts (32%). Ten percent (10%) of studies were funded by industry and 28% did not disclose funding sources. Navitoclax molecular weight Thirty-eight percent (38%) of studies reported a conflict of interest and 6% did not disclose whether or not there were conflicts. The average patient follow-up time across studies was 72 months. We found that although the study of outcomes with third-generation total ankle arthroplasty prostheses is steadily increasing, most studies are Level IV, retrospective case series. Some studies have disclosed industry funding and/or a conflict of interest, and a considerable number did not disclose potential funding and/or financial conflicts. Future investigators should strive to design studies with the highest quality methodology possible.

a) To analyze the relationship of known and emerging biomarkers/indicators for early risk identification of cardiometabolic health risk; b) to identify early risk markers to be used in both clinical and nonclinical settings; and c) to propose a definition of early risk identification in terms of pre-metabolic syndrome (PreMetSyn).

Pubmed/Medline, Web of Science, Embase, and Cochrane were searched for Systematic Reviews and Meta-analysis. Selected studies were evaluated, and relevant data were extracted and synthesized.

Serum uric acid is a good predictive biomarker of metabolic syndrome (MetSyn) and has been associated with non-alcoholic liver fat disease (NAFLD) and type 2 diabetes. NAFLD emerges as an early risk indicator of PreMetSyn by itself. Muscle strength should also be included as an early risk marker of cardiometabolic health. High serum triglycerides and waist circumference confirm their predictive value regarding MetSyn. Indicators related to an inflammatory/pro-inflammatory status usually lrum triglycerides and waist circumference confirm their predictive value regarding MetSyn. Indicators related to an inflammatory/pro-inflammatory status usually linked to MetSyn showed limited evidence as robust biomarkers for PreMetSyn. Authors suggest defining PreMetSyn related to cardiometabolic risk. It is also necessary to determine how close people are to the cut-off point of MetSyn components, including emerging indicators proposed by our review. Some biomarkers could be used as indicators of PreMetSyn, before any of the MetSyn components appear, allowing early health interventions to prevent its development. Defining a PreMetSyn status might consider both emerging indicators and those variables already included in the definition of MetSyn. New indicators should be considered to create a new risk score specifically meant for PreMetSyn.

Increasing evidence suggests that major psychiatric disorders, including major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SZ) share biological, neuropsychological and clinical features, despite the criteria for their respective diagnoses being different. Neuroimaging studies have shown disrupted 'static' neural connectivity in these disorders. However, the changes in brain dynamics across the three psychiatric disorders remain unknown.

We aim to examine the connections and divergencies of the dynamic amplitude of low-frequency fluctuation (dALFF) in MDD, BD and SZ. In total, 901 participants [MDD, 229; BD, 146; SZ, 142; and healthy controls (HCs), 384] received resting-state functional magnetic resonance imaging. The dALFF was calculated using sliding-window analysis and compared across three psychiatric disorders.

We found significant increases of dALFF in the right fusiform, right hippocampus, right parahippocampal in participants with MDD, BD and SZ compared to HC. We also found specific increased dALFF changes in caudate and left thalamus for SZ and BD and decreased dALFF changes in calcarine and lingual for SZ and MDD.

Our study found significant intrinsic brain activity changes in the limbic system and primary visual area in MDD, BD, and SZ, which indicates these areas disruptions are core neurobiological features shared among three psychiatric disorders. Meanwhile, our findings also indicate that specific alterations in MDD, BD, and SZ provide neuroimaging evidence for the differential diagnosis of the three mental disorders.

Our study found significant intrinsic brain activity changes in the limbic system and primary visual area in MDD, BD, and SZ, which indicates these areas disruptions are core neurobiological features shared among three psychiatric disorders. Meanwhile, our findings also indicate that specific alterations in MDD, BD, and SZ provide neuroimaging evidence for the differential diagnosis of the three mental disorders.

Unintentional medication discrepancies due to inadequate medication reconciliation pose a threat to patient safety. Skilled nursing facilities (SNFs) are an important care setting where patients are vulnerable to unintentional medication discrepancies due to increased medical complexity and care transitions. This study describes a quality improvement (QI) approach to improve medication reconciliation in an SNF setting as part of the Multi-Center Medication Reconciliation Quality Improvement Study 2 (MARQUIS2).

This study was conducted at a 112-bed US Department of Veterans Affairs SNF. The researchers used several QI methods, including data benchmarking, stakeholder surveys, process mapping, and a Healthcare Failure Mode and Effect Analysis (HFMEA) to complete comprehensive baseline assessments.

Baseline assessments revealed that medication reconciliation processes were error-prone, with high rates of medication discrepancies. Provider surveys and process mapping revealed extremely labor-intensive and highly complex processes lacking standardization.

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