Spinal cord injury (SCI) is a permanent condition affecting every aspect of life including health, daily activities, and participation and quality of life. Persons with SCI are at high risk of pressure injury (PrI) throughout their lives due to loss of sensation, nerve damage and immobility. PrIs are local areas of damage to the skin and underlying soft tissue caused by pressure and shear commonly located over bony prominences. While most PrIs are hospital- or nursing home-acquired, in people with SCI, PrIs typically develop in the community. Community-acquired pressure injuries (CAPrIs) are common, devastating, and costly. This grant proposal will assess how well a decision support tool, called the Community Acquired Pressure Injury Prevention Field Implementation Tool (CAPP-FIT), is used in the clinic and how well it prevents CAPrIs. The CAPP-FIT will be implemented at seven sites across the country in a staggered fashion. The CAPP-FIT includes: 1) an automated Veteran survey to identify risks, actions, and resources needed to prevent CAPrIs and 2) a companion Provider Report immediately available in the electronic health record listing Veteran responses to survey items with recommended evidence-based provider actions. The Veteran survey can be completed via a secured email on the computer or phone. There are three aims in the proposal: Aim 1 is implementing the CAPP-FIT at the seven geographically diverse VA SCI clinics. After CAPP-FIT implementation, each site will determine how the CAPP-FIT will be maintained in clinical practice to support sustainability. Aim 2 assesses how well the CAPP-FIT prevents CAPrIs and CAPrI-associated hospitalizations and assesses provider and Veteran satisfaction. Aim 3 assesses how well the CAPP-FIT is implemented in the SCI clinic.

开始日期2024-11-01

申办/合作机构

VA Office of Research and Development

[+7]

NCT05493943

/ Not yet recruitingN/A

P.E.M.F. Therapy of Chronic Wounds

To measure the effectiveness of pulsed electromagnetic fields (PEMF) as an adjunct wound care therapy.

开始日期2024-05-01

申办/合作机构

PEMF Systems, Inc.

[+2]

NCT05514184

/ Enrolling by invitationN/AIIT

Plant-Focused Nutrition in Patients With Diabetes and Chronic Kidney Disease (PLAFOND Study): A Pilot/Feasibility Study

In this pilot clinical trial, the investigators will recruit and randomize 120 patients with diabetes mellitus and chronic kidney disease (CKD/DM) stages 3 to 5 to a patient-centered and flexible Plant-Focused Nutrition in Diabetes (PLAFOND) diet with >2/3 plant-based sources, which will be compared with a standard-of-care CKD diet, which is usually a low-potassium and low-salt diet, over a 6-month period. Through this study, the investigators will determine whether the plant-focused diet intervention is feasible for patient adherence, whether this diet is safe by avoiding malnutrition, frailty, and high potassium or glucose blood levels, and whether patient reported outcomes are favorably impacted.

开始日期2023-10-01

申办/合作机构

University of California, Irvine

[+1]

100 项与 VA Long Beach Healthcare System 相关的临床结果

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0 项与 VA Long Beach Healthcare System 相关的专利（医药）

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387

项与 VA Long Beach Healthcare System 相关的文献（医药）

2025-05-01·Journal of Biological Chemistry

Spectroscopy and crystallography define carotenoid oxygenases as a new subclass of mononuclear non-heme FeII enzymes

Article

作者: Daruwalla, Anahita ; Solomon, Edward I ; Babicz, Jeffrey T ; Kiser, Philip D ; DeWeese, Dory E ; Everett, Michael P

Carotenoid cleavage dioxygenases (CCDs) are non-heme Fe^II enzymes that catalyze the oxidative cleavage of alkene bonds in carotenoids, stilbenoids, and related compounds. How these enzymes control the reaction of dioxygen (O₂) with their alkene substrates is unclear. Here, we apply spectroscopy in conjunction with X-ray crystallography to define the iron coordination geometry of a model CCD, CAO1 (Neurospora crassa carotenoid oxygenase 1), in its resting state and following substrate binding and coordination sphere substitutions. Resting CAO1 exhibits a five-coordinate (5C), square pyramidal Fe^II center that undergoes steric distortion toward a trigonal bipyramidal geometry in the presence of piceatannol. Titrations with the O₂-analog, nitric oxide, show a >100-fold increase in iron-nitric oxide affinity upon substrate binding, defining a crucial role for the substrate in activating the Fe^II site for O₂ reactivity. The importance of the 5C Fe^II structure for reactivity was probed through mutagenesis of the second-sphere Thr151 residue of CAO1, which occludes ligand binding at the sixth coordination position. A T151G substitution resulted in the conversion of the iron center to a six-coordinate state and a 135-fold reduction in apparent catalytic efficiency toward piceatannol compared with the wildtype enzyme. Substrate complexation resulted in partial six-coordinate to 5C conversion, indicating solvent dissociation from the iron center. Additional substitutions at this site demonstrated a general functional importance of the occluding residue within the CCD superfamily. Taken together, these data suggest an ordered mechanism of CCD catalysis occurring via substrate-promoted solvent replacement by O₂. CCDs thus represent a new class of mononuclear non-heme Fe^II enzymes.

2025-04-23·Military Medicine

Treatment and Survival of U.S. Vietnam Veterans With Concurrent Lymphoid Malignancies

Article

作者: Moldenhauer, Matthew R ; Ma, Helen ; Gupta, Pankaj

ABSTRACTIntroductionIn Vietnam veterans, exposure to military toxicants, such as Agent Orange, may be associated with lymphoid malignancies. Toxicant exposure may increase the likelihood of being diagnosed with concurrent lymphoid malignancies, which can occur as composite, discordant, or transformed lymphomas.Materials and MethodsWe conducted a large, retrospective case-control study using the national VA Central Cancer Registry to identify cases of concurrent lymphoid malignancies compared to controls of single lymphoid malignancies and the association with Agent Orange.ResultsThe occurrence of concurrent lymphoid malignancies was rare (n = 128/32,889, 0.4%). The most common concurrent lymphoid malignancy combinations were chronic lymphocytic leukemia (CLL) and diffuse large B-cell lymphoma, CLL and plasma cell neoplasms, CLL and marginal zone lymphoma, and diffuse large B-cell lymphoma and follicular lymphoma. Agent Orange exposure was not associated with increased odds of being diagnosed with concurrent lymphoid malignancies. Though limited in sample size, patients with concurrent lymphoid malignancies did not appear to have a worse survival compared to patients with single lymphoid malignancies. In our qualitative analysis of treatments for those with concurrent diagnoses, veterans primarily underwent first-line treatment for the more aggressive diagnosis, with few requiring treatments for both diagnoses during their clinical course.ConclusionsIn this Vietnam Era cohort, Agent Orange exposure did not appear to influence the development of concurrent lymphoid malignancies. Having a diagnosis of concurrent lymphoid malignancies did not appear to significantly affect patient survival. This will inform counseling of veterans with Agent Orange exposure and has implications for future policy development.

2025-04-01·Contemporary Clinical Trials Communications

Utilization of a structured research site mentorship model to facilitate site performance in a clinical research network

Article

作者: Tiktin, Margaret ; Sueiro, Melyssa ; Decker, Makaila ; Beck, Danielle ; Newcomb, Jeff ; Kiliveros, Amelia ; Johnson, Marcus R ; Asghar, Aliya

BackgroundResearch site mentorship has a positive impact on study enrollment. The VA Cooperative Studies Program's (CSP) Network of Dedicated Enrollment Sites (NODES) utilized an existing site mentorship model to onboard 13 new expansion sites. We describe the successes, challenges, and lessons learned during the development and implementation of this model in this paper.MethodsNODES established a "Site Mentorship/Expansion Workgroup (SWG)" in October 2020 to plan and guide the consortium on providing mentorship and services to other clinical research networks, non-Node CSP study sites, and NODES expansion sites. In 2021, the SWG developed a 12-month implementation plan to onboard 13 new sites by pairing original Node (mentor) sites with expansion Node (mentee) sites. Mentors offered prompt guidance and solutions to mentees on site-level challenges by working with them closely. Implementation of the plan occurred from February 2022 through September 2023.ResultsData from the implementation of this mentorship plan demonstrated a 32.7 % increase (from 54.8 % in 2022 to 87.5 % in 2023) in the expansion sites' achievement of their Objectives & Key Results (OKRs). From October 2020-September 2021, prior to mentorship assignments, the original sites (mentors) achieved an average of 88 % of their OKRs and attained an average of 86.7 % and 80.9 % of those OKRs in October-September of 2022 and 2023 respectively during the mentorship implementation phase.ConclusionsThe results demonstrate that developing and implementing a research site mentorship model to facilitate onboarding and performance of research sites into an established network was feasible and contributed to the success of those sites.

100 项与 VA Long Beach Healthcare System 相关的药物交易

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100 项与 VA Long Beach Healthcare System 相关的转化医学

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