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Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery

The increased use of chest computed tomography (CT) has led to an increased detection of pulmonary nodules requiring diagnostic evaluation and/or ...

The science of dissemination and implementation (D&I) is advancing the knowledge base for how best to integrate evidence-based interventions within clinical and community settings and how to recast the nature or conduct of the research itself to make it more relevant and actionable in those settings. While the field is growing, there are only a few training programs for D&I research; this is an important avenue to help build the field's capacity. To improve the United States' capacity for D&I research, the National Institutes of Health and Veterans Health Administration collaborated to develop a five-day training institute for postdoctoral level applicants aspiring to advance this science.

The U.S. training institute for dissemination and implementation research in health.

Proceedings of the 8th Annual Conference on the Science of Dissemination and Implementation : Washington, DC, USA. 14-15 December 2015.

Studies of workers exposed to benzene at average air concentrations below one part per million suggest that benzene, a known hematotoxin, causes hematopoietic damage even at low exposure levels. However, evidence of such effects outside of occupational settings and for other volatile organic compounds (VOCs) is limited.

Associations between blood BTEXS concentrations and hematologic parameters among adult residents of the U.S. Gulf States.

Harnessing the Synergy Between Improvement Science and Implementation Science in Cancer: A Call to Action.

Electromagnetic navigation (EMN) has improved bronchoscopic access to peripheral pulmonary nodules. A novel EMN system utilizing novel tip-tracked instruments for endobronchial [electromagnetic navigation bronchoscopy (ENB)] as well as transthoracic lung biopsy [electromagnetic-guided transthoracic needle aspiration (EMTTNA)] has become available. The system provides real-time feedback as well as the ability to biopsy lesions outside of the airway. These advances have the potential to improve diagnostic yield over previous EMN systems.

Peripheral Lung Nodule Diagnosis and Fiducial Marker Placement Using a Novel Tip-Tracked Electromagnetic Navigation Bronchoscopy System.

Increased use of chest computed tomography and the institution of lung cancer screening have increased the detection of ground-glass and small pulmonary nodules. Intraoperative localization of these lesions via a minimally invasive thoracoscopic approach can be challenging. We present the feasibility of perioperative transthoracic percutaneous nodule localization using a novel electromagnetic navigation platform.

Electromagnetic Transthoracic Nodule Localization for Minimally Invasive Pulmonary Resection.

Efforts to improve cancer care primarily come from two fields: improvement science and implementation science. The two fields have developed independently, yet they have potential for synergy. Leveraging that synergy to enhance alignment could both reduce duplication and, more importantly, enhance the potential of both fields to improve care. To better understand potential for alignment, we examined 20 highly cited cancer-related improvement science and implementation science studies published in the past 5 years, characterizing and comparing their objectives, methods, and approaches to practice change. We categorized studies as improvement science or implementation science based on authors' descriptions when possible; otherwise, we categorized studies as improvement science if they evaluated efforts to improve the quality, value, or safety of care, or implementation science if they evaluated efforts to promote the implementation of evidence-based interventions into practice. All implementation studies (10/10) and most improvement science studies (6/10) sought to improve uptake of evidence-based interventions. Improvement science and implementation science studies employed similar approaches to change practice. For example, training was employed in 8/10 implementation science studies and 4/10 improvement science studies. However, improvement science and implementation science studies used different terminology to describe similar concepts and emphasized different methodological aspects in reporting. Only 4/20 studies (2 from each category) described using a formal theory or conceptual framework to guide program development. Most studies were multi-site (10/10 implementation science and 6/10 improvement science) and a minority (2 from each category) used a randomized design. Based on our review, cancer-related improvement science and implementation science studies use different terminology and emphasize different methodological aspects in reporting but share similarities in purpose, scope, and methods, and are at similar levels of scientific development. The fields are well-positioned for alignment. We propose that next steps include harmonizing language and cross-fertilizing methods of program development and evaluation.

Improvement Science and Implementation Science in Cancer Care: Identifying Areas of Synergy and Opportunities for Further Integration.

Implementation science has focused mainly on the initial uptake and use of evidence-based practices (EBPs), with less attention to sustainment-i.e., continuous use of these practices, as intended, over time in ongoing operations, often involving adaptation to dynamic contexts. Declining EBP use following implementation is well-documented yet poorly understood. Using theories, models, and frameworks (TMFs) to conceptualize sustainment could advance understanding. We consolidated knowledge from published reviews of sustainment studies to identify TMFs with the potential to conceptualize sustainment, evaluate past uses of TMFs in sustainment studies, and assess the TMFs' potential contribution to developing sustainment strategies.

Article	Year
The U.S. training institute for dissemination and implementation research in health. Implementation science : IS\| PubMed ID: 23347882	2013
Proceedings of the 8th Annual Conference on the Science of Dissemination and Implementation : Washington, DC, USA. 14-15 December 2015. Implementation science : IS\| PubMed ID: 27490260	2016
Associations between blood BTEXS concentrations and hematologic parameters among adult residents of the U.S. Gulf States. Environmental research\| PubMed ID: 28448810	2017
Harnessing the Synergy Between Improvement Science and Implementation Science in Cancer: A Call to Action. Journal of oncology practice\| PubMed ID: 29750579	2018
Peripheral Lung Nodule Diagnosis and Fiducial Marker Placement Using a Novel Tip-Tracked Electromagnetic Navigation Bronchoscopy System. Journal of bronchology & interventional pulmonology\| PubMed ID: 30179920	2019
Electromagnetic Transthoracic Nodule Localization for Minimally Invasive Pulmonary Resection. The Annals of thoracic surgery\| PubMed ID: 31233723	2019
Improvement Science and Implementation Science in Cancer Care: Identifying Areas of Synergy and Opportunities for Further Integration. Journal of general internal medicine\| PubMed ID: 32869193	2021
Advancing understanding and identifying strategies for sustaining evidence-based practices: a review of reviews. Implementation science : IS\| PubMed ID: 33036653	2020

David Chambers

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