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Category: health

Navigating Postacute Care Options for Patients After Hospital Discharge: A Review

Approximately 25% to 40% of hospitalized adults are discharged to receive postacute care either at home through home health or in skilled nursing facilities, inpatient rehabilitation facilities, or long-term acute care hospitals.

This Narrative Review considers postacute care settings to assist hospital-based clinicians in effectively collaborating with patients, caregivers, and interdisciplinary care teams to facilitate transitions to high-quality postacute care.

Clinicians often care for patients who cannot return to their previous level of support in the community due to new functional impairments or complex posthospital care needs. After hospital discharge, these patients may require postacute care (PAC)—broadly defined as medical and rehabilitative services intended to help individuals recuperate and rehabilitate. PAC can be provided at home through home health (HH) or in skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and long-term acute care hospitals (LTACHs). A key criterion for PAC eligibility is the need for skilled nursing and/or rehabilitative services as determined by the treating physician.1-3 Payers require that these health services be reasonable and necessary for the treatment of a specific illness or injury, and that given their complexity (eg, wound care, intravenous infusion), they be provided only by a health professional. Yet, clinicians often play a passive role in PAC planning; many report a lack of knowledge around PAC capabilities, quality, and constraints.4-6

The epidemiology of PAC in the US is best understood for Traditional Medicare (or fee-for-service). Among hospitalized Medicare beneficiaries, approximately 40% were discharged to PAC in 2023: 18% to HH, 17% to SNF, 5% to IRFs, and 1% to LTACHs,7 accounting for approximately $60 billion of Medicare spending annually.7 Up to three-quarters of regional differences in Medicare spending are attributable to PAC, suggesting that discharge decisions are often driven by local practice norms rather than patient need. This underscores the need to improve and standardize PAC best practices.8,9

Hospital-based physicians, nurse practitioners, and physician assistants play an important role in PAC discharge planning due to their in-depth understanding of a patient’s complex medical needs. A better understanding of the qualifications and services provided can help clinicians engage in a more helpful role in the PAC discharge planning process. This Narrative Review provides an overview of PAC settings with the goal of helping clinicians collaborate most effectively with patients, caregivers, and interdisciplinary care teams to promote transition to high-quality PAC. We present a general summary of the most common types of PAC, followed by a comparison of the supporting evidence for each PAC setting. Descriptions of elements of PAC are based on the benefits covered by Traditional Medicare, which generally inform other payers’ coverage policies. Lastly, we review best practices for clinicians to actively discuss PAC options with patients, helping to orchestrate transitions of care to PAC for eligible individuals.

The role of liver sinusoidal endothelial cells in liver diseases: Key players in health and pathology

Liver sinusoidal endothelial cells (LSECs) are specialised endothelial cells that orchestrate hepatic homeostasis within the liver sinusoid. Besides their key role in regulating intrahepatic vascular tone, trafficking and cellular crosstalk, their scavenging and immune-regulatory role makes them central to the development of liver disease. LSEC dysfunction includes loss of fenestrae, inflammatory activation and the gain of vasoconstrictive and prothrombotic functions. Robust evidence has demonstrated how preserving LSECs is crucial in a pathological context, placing LSECs at the centre of novel therapeutic and diagnostic strategies.

Cuffless Devices for the Measurement of Blood Pressure: A Scientific Statement From the American Heart Association

Cuffless BP devices have the potential to increase access and overcome barriers to BP screening, particularly for underresourced communities. Individuals from these communities—including people from rural areas, with low income, or from underrepresented racial or ethnic groups—often have a higher prevalence of hypertension and uncontrolled BP than their counterparts and face barriers to accessing health care services, including regular BP monitoring and confirmation of office BP with ABPM.32–34

One of the primary barriers to BP screening in underresourced communities is a lack of health care facilities and trained physicians.35 Cuffless devices, which are often portable and convenient and can be incorporated into everyday objects (eg, watches, smartphones), can be deployed in homes, in community centers, among lay community health workers, and by individuals themselves.4,5,36 This accessibility eliminates the need for individuals to travel long distances to receive basic health screenings, making it easier for residents of rural areas, or areas with shortages of health care professionals, to monitor their out-of-office BP regularly.

Cost is a major barrier hindering access to health care and traditional BP monitoring methods for individuals from underresourced populations, many of whom may be uninsured or underinsured. Cuffless BP devices could theoretically reduce costs, particularly when integrated into wearable or mobile devices that consumers purchase for multiple uses.36 However, because of the limitations of cuffless devices, including the need for calibration with additional purchased devices and insufficient accuracy, cost-effectiveness remains speculative.

Degenerating Tanycytes Disrupt Tau Removal, Shaping Alzheimer’s Progression

“Tanycytes, whose cell bodies line the walls and floor of the third ventricle and extend long, slim processes that terminate in ‘endfeet’ that contact these fenestrated capillaries,” act as a shuttle between the CSF and the blood, the authors wrote. The new study suggests they also act as a kind of molecular “exit ramp,” moving tau out of the CSF and into the bloodstream for disposal. When these cells become fragmented, that clearance system falters. Tau, which should be ferried away, instead lingers—much like traffic backing up when a major off‑ramp closes—allowing toxic protein species to accumulate.

“Our findings reveal a previously underappreciated, disease‑relevant role for tanycytes in neurodegeneration,” said corresponding author Vincent Prévot, PhD, of INSERM. “Focusing on tanycyte health could be a way to improve tau clearance and limit disease progression.”

Using rodent and cellular models, the researchers showed that tanycytes take up tau from the CSF and release it into pituitary portal capillaries, enabling its entry into the systemic circulation, according to the authors. When the team blocked vesicular transport in tanycytes, tau clearance from CSF to blood slowed dramatically, and tau pathology intensified. As the authors wrote, “Blocking tanycytic vesicular transport blunts CSF‑to‑blood tau efflux and potentiates tau pathology.”

RAB3GAP2 is a regulator of skeletal muscle endothelial cell proliferation and associated with capillary-to-fiber ratio

Ström et al. identify the rs115660502 variant in RAB3GAP2 associated with increased skeletal muscle capillary-to-fiber ratio and enriched in endurance athletes. This variant reduces RAB3GAP2 expression, enhancing endothelial proliferation, tube formation, and TNC secretion, thereby promoting exercise-like angiogenesis and microvascular remodeling in skeletal muscle.

How Multi-Cancer Early Detection Is Reshaping Oncology — Dr. Tomasz Beer, MD — Exact Sciences

With Dr. Tomasz (Tom) Beer MD – Chief Medical Officer for MCED at Exact Sciences

From precision oncology pioneer to leading the shift toward population-scale early detection via blood-based tech. The future of cancer care: intercepting it before it’s too late.

Dr. Tomasz Beer, MD is a nationally recognized medical oncologist and clinical research leader who serves as Chief Medical Officer for Multi-Cancer Early Detection at ‪@ExactSciences‬ Corporation (https://www.exactsciences.com/), a molecular diagnostics company focused on the eradication of cancer by preventing it, detecting it earlier, and guiding personalized treatment.

Before joining Exact Sciences, Dr. Beer spent decades at the forefront of academic oncology, including serving as Deputy Director of the Oregon Health & Science University (OHSU) Knight Cancer Institute, where he helped build one of the country’s leading precision cancer programs.

A prostate cancer specialist by training, Dr. Beer has led numerous clinical trials, authored hundreds of peer-reviewed publications, and been a driving force in advancing biomarker-guided cancer therapy. His career has spanned the evolution of oncology—from empiric chemotherapy to precision medicine and now toward population-scale cancer detection.

Continue reading “How Multi-Cancer Early Detection Is Reshaping Oncology — Dr. Tomasz Beer, MD — Exact Sciences” | >

Listening to the body’s quietest, yet most dynamic movements with a wearable sensor

The human body continuously generates a rich spectrum of vibrations—often without us ever noticing. Everyday unconscious activities such as breathing, speaking, and swallowing all produce subtle yet distinct mechanical signals. Although these faint vibrations carry valuable information about physiological state, they have long been difficult to capture accurately using conventional wearable devices.

Recently, a research team led by Professor Kilwon Cho of the Department of Chemical Engineering at Pohang University of Science and Technology (POSTECH), along with Ph.D. candidate Kang Hyuk Cho and postdoctoral researcher Dr. Jeng-Hun Lee, has developed a wearable vibration sensor capable of precisely detecting these subtle yet highly dynamic signals, without requiring any external power source. This breakthrough opens new possibilities for wearable medical and health care technologies and demonstrates strong potential as a core sensing platform for next-generation smart devices. The work was published in the inaugural issue of Nature Sensors.

Sounds produced by the human body span a wide range of frequencies. Physiological signals such as breathing, swallowing, and speech typically occur at lower frequencies, while sounds such as coughing or groaning emerge at relatively higher frequencies. Accurately capturing these signals requires precise detection of the minute vibrations transmitted to the skin surface across a broad frequency spectrum.

AI-designed diffractive optical processors pave the way for low-power structural health monitoring

A team of researchers at the University of California, Los Angeles (UCLA) has introduced a novel framework for monitoring structural vibrations using diffractive optical processors. This new technology uses artificial intelligence to co-optimize a passive diffractive layer and a shallow neural network, allowing the system to encode time-varying mechanical vibrations into distinct spatiotemporal optical patterns.

Structural Health Monitoring (SHM) systems are vital for assessing the condition of civil infrastructure, such as buildings and bridges, particularly after exposure to natural hazards like earthquakes. Traditional vibration-based methods rely on sensor networks of accelerometers and strain gauges, which demand significant power, generate large datasets requiring complex digital signal processing, and can be expensive to install and maintain.

Furthermore, achieving high spatial resolution for accurate damage localization often requires a costly, dense sensor deployment.

Using tiny ripples at skin level to monitor for possible health problems below

Caltech scientists have developed a method that detects tiny, imperceptible movements at the surface of objects to reveal details about what lies beneath. By analyzing the physics of waves traveling across the surface of an object—whether that be a manufactured product or the human body—the new technique can determine both the stiffness and thickness of the underlying material or tissue. This lays the groundwork for the project’s ultimate goal of enabling inexpensive, at-home health monitoring using little more than a smartphone camera.

“There is information scattered all around us in plain sight that we just haven’t learned to tap into. Our work is trying to leverage that information to recover material properties from inside objects by studying tiny movements on the surface,” says Katie L. Bouman, professor of computing and mathematical sciences, electrical engineering, and astronomy at Caltech and both a Rosenberg Scholar and a Heritage Medical Research Institute (HMRI) Investigator.

Bouman and her colleagues from Caltech presented the technique, called visual surface wave elastography, and its medical applications in a paper presented at the International Conference on Computer Vision in Honolulu last fall. The lead authors are Alexander C. Ogren, Ph.D., and Berthy T. Feng, Ph.D., who completed the work while at Caltech.

Functional photoacoustic microscopy reaches super-resolution by tracking red blood cells

The brain relies on real-time delivery of oxygen and nutrients through its microvasculature, which threads through neural tissue like electrical wires. While modern imaging technologies allow researchers to follow the activity of individual neurons in the brain, they are not yet advanced enough to dissect the microvascular function at a comparable spatial scale. This gap hinders our understanding of cerebral small vessel disease and its contributions to cognitive impairment and dementia.

To address this challenge, a team of researchers at Washington University in St. Louis and Northwestern University, led by Song Hu, professor of biomedical engineering in the McKelvey School of Engineering, have developed super-resolution functional photoacoustic microscopy (SR-fPAM).

By tracking the movement and oxygenation-dependent color change of red blood cells, SR-fPAM allows researchers to image blood flow and oxygenation at single-cell resolution in the mouse brain, which bridges a critical gap in functional microvascular imaging and could provide new insight into microvascular health and disease, such as stroke, vascular dementia and Alzheimer’s disease.

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