Interim Estimates of 2024-2025 Seasonal Influenza Vaccine Effectiveness - Four Vaccine Effectiveness Networks, United States, October 2024-February 2025

Annual influenza vaccination is recommended for all persons aged ≥6 months in the United States. Interim influenza vaccine effectiveness (VE) was calculated among patients with acute respiratory illness-associated outpatient visits and hospitalizations from four VE networks during the 2024-25 influenza season (October 2024-February 2025). Among children and adolescents aged \u3c18 years, VE against any influenza was 32%, 59%, and 60% in the outpatient setting in three networks, and against influenza-associated hospitalization was 63% and 78% in two networks. Among adults aged ≥18 years, VE in the outpatient setting was 36% and 54% in two networks and was 41% and 55% against hospitalization in two networks. Preliminary estimates indicate that receipt of the 2024-2025 influenza vaccine reduced the likelihood of medically attended influenza and influenza-associated hospitalization. CDC recommends annual receipt of an age-appropriate influenza vaccine by all eligible persons aged ≥6 months as long as influenza viruses continue to circulate locally

Navigating professional growth for women in radiology: A practical guide for mentorship, sponsorship, and coaching

Historically, women in radiology are underrepresented in radiology and face disproportionate barriers to career advancement related to work-life integration, gender bias, and relative lack of female role models. Given these challenges, women must be proactive and seek out mentorship and sponsorship to help navigate career obstacles and to guide career direction. At times of inflection, coaching can play a role in helping to clarify next steps through self-discovery of one\u27s strengths, limitations, and desired goals. In this manuscript, we provide practical tips for women on how to successfully navigate mentorship, sponsorship and coaching during a career in radiology. Keywords: Career advancement; Coaching; Mentorship; Professional growth; Sponsorship; Women in radiology

Healthy at Home for COPD: An Integrated Digital Monitoring, Treatment, and Pulmonary Rehabilitation Intervention

Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the United States. Frequent exacerbations result in higher use of emergency services and hospitalizations, leading to poor patient outcomes and high costs. The objective of this study is to demonstrate the feasibility of a multimodal, community-based intervention in treating acute COPD exacerbations. Results: Over 18 months, 1,333 patients were approached and 100 (7.5%) were enrolled (mean age 66, 52% female). Ninety-six participants (96%) remained in the study for the full enrollment period. Fifty-five (55%) participated in tele-pulmonary-rehabilitation. Participants wore the smartwatch for a median of 114 days (IQR 30-210) and 18.9 hours/day (IQR16-20) resulting in a median of 1034 minutes/day (IQR 939-1133). The rate at which participants completed scheduled survey instruments ranged from 78-93%. Nearly all participants (85%) performed COPD ecological momentary assessment at least once with a median of 4.85 recordings during study participation. On average, a 2.48-point improvement (p=0.03) in COPD Assessment Test Score was observed from baseline to study completion. The adherence and symptom improvement metrics were not associated with baseline patient activation measures. Conclusions: A multimodal intervention combining preventative care, symptom and biometric monitoring, and MIH services was feasible in adults living with COPD. Participants demonstrated high protocol fidelity and engagement and reported improved quality of life. Keywords: Chronic Obstructive Pulmonary Disease; Community Health; Community Paramedicine; Decentralized Trial; Digital Health; Mobile Integrated Health; Remote Monitoring

Comparative outcomes of culprit-only versus complete revascularisation in cardiogenic shock complicating acute myocardial infarction: insights from the Gulf-Cardiogenic Shock registry

Objectives: To compare in-hospital and long-term outcomes between culprit-only percutaneous coronary intervention (PCI) and multivessel PCI in patients with acute myocardial infarction complicated by cardiogenic shock and multivessel coronary artery disease. Design: Retrospective subgroup analysis of the multicentre Gulf-Cardiogenic Shock registry. Setting: 13 tertiary care centres across six Gulf countries (Saudi Arabia, Qatar, Oman, UAE, Kuwait and Bahrain) between January 2020 and December 2022. Participants: 961 patients with angiographically confirmed multivessel coronary artery disease who underwent PCI were included from the Gulf-Cardiogenic Shock registry. Patients were divided into culprit-only PCI group (n=792, 82.4%) and multivessel PCI group (n=169, 17.6%). Patients with single-vessel disease were excluded. Interventions: Patients underwent either culprit-only PCI (intervention limited to the culprit artery) or multivessel PCI (immediate intervention to both culprit and non-culprit arteries during the same procedure). Primary and secondary outcome measures: The primary outcome was in-hospital all-cause mortality. Secondary outcomes included reinfarction, cerebrovascular accident, major and minor bleeding events, target lesion revascularisation, target vessel revascularisation, hospital stay duration and freedom from major adverse cardiac and cerebrovascular events (MACCEs) at 6 and 12 months. Results: Hospital mortality was comparable between multivessel PCI and culprit-only PCI groups (43.2% vs 46.1%; p=0.493). Freedom from MACCE rates at 6 and 12 months were 62% and 46% for multivessel PCI versus 70% and 49% for culprit-only PCI, respectively (log-rank p=0.711). Subgroup analysis revealed that culprit-only PCI was associated with increased hospital mortality in patients older than 70 years (OR 1.55, 95% CI: 1.01 to 2.39). Multivariable analysis of the interaction between revascularisation strategy and the subgroups revealed that culprit vessel revascularisation was associated with increased mortality in patients with left main disease (OR: 1.99 (95% CI: 1.22 to 3.27), p=0.006) and left anterior descending lesions (OR: 1.54 (95% CI: 1.06 to 2.25), p=0.025). Conclusions: No statistically significant differences in hospital mortality or long-term MACCE-free survival were observed between culprit-only PCI and multivessel PCI strategies in patients with cardiogenic shock complicating acute myocardial infarction. However, patients older than 70 years may benefit from a multivessel PCI approach. These findings support current guideline recommendations favouring culprit-only PCI due to reduced procedural complexity while highlighting the need for individualised treatment strategies based on patient age and clinical factors. Further prospective randomised studies are needed to validate these age-specific findings and identify optimal patient selection criteria for each revascularisation strategy. Keywords: Coronary intervention; Myocardial infarction; Observational Study

Creation of a telehealth addiction consultation service at a rural hospital: a case study

Background: Rural communities face significant barriers to accessing substance use disorder (SUD) treatment, resulting in gaps in care and increased rates of opioid-related overdose deaths. Hospital-based Addiction Consult Services (ACS) improve outcomes for patients with SUD, but rural hospitals often lack these services. Case presentation: The Community Addiction Consult (CAC) service was established at a rural hospital in western Massachusetts to address this gap. CAC was designed by a community coalition comprised of a diverse cross-section of the community in which the hospital is based, using opioid-overdose data from the region to inform their decisions. Using a telehealth model, the CAC provided evidence-based treatments to support hospital staff treating patients with opioid use disorder (OUD) or requiring addiction-related care. From April 2023 through December 2023, the CAC provided 36 consults, facilitating increased access to medications for opioid use disorder (MOUD), and enhancing provider confidence in treating people who use drugs (PWUD) and initiating MOUD. An average of 22 patients received MOUD as inpatients monthly, and 11 emergency department patients received MOUD monthly. The CAC team also implemented training sessions, and an anti-stigma campaign to familiarize hospital staff with harm reduction principles and person-centered care strategies to foster a more supportive treatment environment for PWUD. Conclusions: The Community Addiction Consult service demonstrates the feasibility and efficacy of a telehealth Addiction Consult Service model. Paired with staff trainings, such a model can bridge the gaps in rural addiction care. By leveraging local expertise and data-driven approaches, this model offers a scalable, equitable solution to improving access to substance use disorder treatment in rural settings. Keywords: Addiction consult service; Medications for opioid use disorder; Opioid; Overdose; Rural

Analysis of the 2024 Breast Surgical Oncology Fellowship Match: Survey of Applicants\u27 and Program Directors\u27 Preferences Regarding In-Person Versus Virtual Interviews

Background: In 2020, in response to the coronavirus disease 2019 (COVID-19) pandemic, Breast Surgical Oncology (BSO) fellowship programs transitioned to virtual interviews; however, for the 2024 cycle, programs selected either virtual or in-person interviews with applicants participating in potentially both formats. Following the match, a survey was performed to evaluate experiences among applicants and program directors (PDs). Methods: Surveys were developed within the BSO Fellowship Program Directors Committee and distributed via email to matched applicants and PDs from 18 July 2024 to 9 August 2024. Descriptive statistics were conducted. Results: Of the 89 matched applicants, 60 completed the survey (response rate 67.4%). Most applicants (76.7%, n = 46) preferred in-person over virtual interviews. The top reason for preferring in-person was \u27to see the program in person\u27 (56.7%, n = 34). Nearly half of applicants (48.3%, n = 29) estimated spending ≥$5000 on interviews, and 78.3% (n = 47) indicated the cost was \u27worth it\u27. Over half of applicants (51.7%, n = 31) reported interview style had an impact on their match. Of the 64 PDs, 38 completed the survey (response rate 59.4%). Virtual interviews were the most common format (65.8%, n = 25). The most important factor reported by most programs regarding the interview approach was cost to applicants (42.1%, n = 16). Over half of PDs (52.6%, n = 20) felt the interview approach influenced the match. Conclusions: The majority of 2024 BSO fellowship matched applicants preferred in-person interviews, noting the importance of location, faculty, and culture to their decision making. This data may assist PDs in choosing the interview approach best suited for their programs and guide training programs more broadly. Keywords: Breast fellowship; Fellowship interviews; Match; Program directors

Safety and outcomes of pulsed field ablation in the management of supraventricular arrhythmia: A systematic review

Introduction: Pulsed field ablation (PFA) is an emerging non-thermal ablative technology that induces irreversible electroporation to selectively target cardiac tissue while minimizing damage to adjacent structures. While widely studied for atrial fibrillation, its role in managing supraventricular tachycardia (SVT) remains unclear. This systematic review aims to consolidate existing data on the safety and efficacy of PFA for SVT ablation. Methods: A comprehensive literature search was conducted to identify studies reporting PFA outcomes in SVT. Inclusion criteria encompassed studies involving AVNRT, AVRT, and atrial tachycardia (AT). Data on procedural success, complications, and recurrence rates were extracted and analyzed. The review included 10 studies, comprising 3 case reports and 7 prospective studies, involving a total of 312 patients. Results: PFA demonstrated a high acute procedural success rate of 97.6 %. Success rates varied by SVT type: AVNRT (99.8 %), AVRT (98.7 %), and AT (96.1 %). Transient atrioventricular (AV) block, primarily during slow pathway ablation for AVNRT, occurred in 19.3 % of cases, with most resolving within 24 h. No permanent AV block or major procedural complications were reported. Recurrence rates were 9.6 % overall after six months, with AT exhibiting a higher recurrence rate of 21.4 %. Challenges with lesion durability, particularly in linear ablations, were noted, sometimes requiring adjunctive radiofrequency catheter ablation (RFCA). PFA\u27s tissue selectivity proved beneficial in complex SVT cases near critical structures like the phrenic nerve and right atrial appendage, where RFCA posed higher complication risks. Conclusions: PFA shows promise as an effective and safe alternative to RFCA for SVT, particularly in challenging anatomical locations. Despite its high acute success rates and favorable safety profile, concerns about lesion durability and recurrence-especially in AT-necessitate further investigation. Larger, multicenter studies with standardized protocols are essential to optimize outcomes and clarify PFA\u27s role in SVT ablation. Keywords: Catheter ablation; Outcomes; Pulsed filed ablation; Supraventricular tachycardia

Cell Phone Activity and Trauma Patient Volume in New England Through the COVID-19 Pandemic: A Research Consortium of New England Centers for Trauma (ReCONECT) Study

Background: We sought to understand whether cellular telephone activity in commercial spaces as a marker for population mobility would be associated with trauma admission volumes, taking advantage of cellular telephone data made available during the COVID-19 pandemic and large swings in population activity. Study design: Trauma registry data from six level I trauma centers (TC) in New England were used to identify the number of daily trauma admissions (TA) from January 20th 2020 to July 31st 2021. The Device Exposure Index (DEX) is a standardized measure of daily cellular telephone interactions with other cellular telephones within a county. Spearman\u27s rank correlation was calculated for the first wave of COVID-19 from March 2020 to May 2020 and for the entire study period. Center-specific Poisson models were created to control for seasonality. Results: During the study period, daily mean TA was 42.8 (SD 10.7) and daily mean DEX was 60.6 (SD 26.8) overlapping device visits to venues per day. The daily DEX index was moderately correlated with TA from March to May of 2020 for five centers serving unique catchment areas, with Spearman\u27s rho ranging from 0.22 to 0.47 (p\u3c 0.05). The sixth center where the catchment area overlaps with those of multiple level I centers had much lower correlation r = 0.06 (p=0.59). After controlling for seasonality, DEX vs. TA relationships remained significant among the six centers. Conclusion: County-level daily DEX scores correlated significantly with TC-specific numbers of daily TA at 5 of 6 TC during the first three months of the study period. Additional research is needed; however, use of cellular telephone activity and interactions may be a valuable adjunct for trauma system planning

Validity and Reliability of the New Innovation Culture Scale© for Use in Healthcare Settings

Objective: To assess the psychometric properties of the new 10-item Innovation Culture Scale©. Background: American healthcare is expensive with poor health outcomes as the norm. Nurses can disrupt this paradigm through innovation; however, innovation cannot flourish without a supportive organizational culture. There is a lack of scales to measure innovation culture within healthcare settings, thus supporting improvements in quality of care. Methods: A Northeastern health system provided a convenience sample of 5658 nurses, physicians, and allied health professionals. Scale responses were obtained digitally. Item correlations, scree plot, and confirmatory factory analysis examined the scale\u27s internal structure and assessed model fit. Results: Two hundred sixteen participants completed the scale. Item correlations were positive and significant (P \u3c 0.001). Scree plot confirmed a single factor structure. Several indices supported an acceptable model fit (comparative fit index = 0.935, Tucker-Lewis index = 0.916, standardized root mean square residual = 0.05), although root mean square error of approximation (0.119) was poor. Cronbach\u27s α was 0.94. Conclusion: The Innovation Culture Scale is a valid and reliable measure to assess innovation culture in healthcare settings