bluuebunny/crossref_metadata_2025 huggingface dataset:
Diffraction modelling of a 2023 March 5 stellar occultation by subkilometer-sized asteroid (98943) 2001 CC21
Authors: Arimatsu Ko , Yoshida Fumi , Hayamizu Tsutomu , Ida Miyoshi , Hashimoto George L , Abe Takashi , Akitaya Hiroshi , Aratani Akari , Fukuda Hidekazu , Fujita Yasuhide , Fujiwara Takao , Horikawa Toshihiro , Iihoshi Tamio , Imamura Kazuyoshi , Imazawa Ryo , Kasebe Hisashi , Kawasaki Ryosuke , Kishimoto Hiroshi , Mishima Kazuhisa , Miyachi Machiko , Mizutani Masanori , Nakajima Maya , Nakatani Hiroyoshi , Okamura Kazuhiko , Okanobu Misaki , Okuda Masataka , Suzuki Yuji , Tatsumi Naoto , Uno Masafumi , Yamamura Hidehito , Yasue Mikoto , Yoshihara Hideki , Hirabayashi Masatoshi , Yoshikawa Makoto
Published: July 2024

We present an analysis of a stellar occultation event caused by a near-Earth asteroid (98943) 2001 CC21, an upcoming flyby target in the Hayabusa2 extended mission, on 2023 March 5. To determine the asteroid’s shape from diffraction-affected light curves accurately, we developed a novel data-reduction technique named the Diffracted Occultation’s United Simulator for Highly Informative Transient Explorations (DOUSHITE). Using DOUSHITE-generated synthetic models, we derived constraints on (98943) 2001 CC21’s shadow shape from the single-chord occultation data. Our results suggest a significant elongation of the shadow with an axis ratio of $b/a = 0.37\pm 0.09$. This shape could be crucial for planning Hayabusa2’s high-speed flyby to optimise the limited imaging opportunities.
Labor unions, work contexts, and workers’ access to work–family policies
Authors: Paek Eunjeong
Published: July 2024

Unions serve as primary labor market institutions that improve employees’ working conditions, yet existing literature offers mixed results of their influence on workers’ access to work–family policies. This may be partially due to the extant literature having not considered possible variation across work contexts. In this study, I ask whether union coverage can increase workers’ access to work–family policies and examine how family-friendly work contexts—public sector organizations and female-dominated occupations—can modify these union effects in the United States. Using the National Longitudinal Survey of Youth 97 (2000–2017) and individual-fixed effect models, I analyze the impact of transitioning from a nonunion worker to a union-represented worker on the worker’s access to three work–family policies: paid parental leave, schedule control, and paid sick/vacation days. Results show that changing from a nonunion position to a union-represented one increases workers’ access to paid parental leave and paid sick/vacation days but decreases access to schedule control. The findings also show that workers in public sector organizations and female-dominated occupations tend to experience outsized benefits of union coverage on access to longer paid sick/vacation days. These findings suggest that the advantages of union coverage in workers’ access to work–family policies may be influenced by gendered work contexts.
Preventive medicine in obstructive sleep apnea—a systematic review and a call to action
Authors: Correa Eduardo J , Conti Diego M , Gozal David , O’Connor-Reina Carlos
Published: July 2024

Study Objectives

The purpose of this systematic review is to evaluate the modifiable risk factors associated with obstructive sleep apnea (OSA) and analyze extant publications solely focused on prevention of the disease.

Methods

Studies focused on prevention strategies for OSA and modifiable risk factors were eligible for inclusion. A detailed individual search strategy for each of the following bibliographic databases was developed: Cochrane, EMBASE, MEDLINE, PubMed, and LILACS. The references cited in these articles were also crosschecked and a partial gray literature search was undertaken using Google Scholar. The methodology of selected studies was evaluated using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies.

Results

Search resulted in 720 publications examining risk factors and prevention of OSA, as well as lifestyle modifications. Of these, a thorough assessment of the abstracts and content of each of these manuscripts led to the rejection of all but four papers, the latter being included in this systematic review. In contrast, a search regarding “Therapeutics” showed that 23 674 articles on OSA were published, clearly illustrating the imbalance between the efforts in prevention and those focused on therapeutics.

Conclusions

Notwithstanding the importance and benefits of technological advances in medicine, consideration of the needs of people with OSA and its consequences prompts advocacy for the prevention of the disease. Thus, despite the economic interests that focus only on diagnosis and treatment, strategies preferentially aimed at overall avoidance of OSA emerge as a major priority. Thus, public and healthcare provider education, multidimensional prevention, and early diagnosis of OSA should be encouraged worldwide.
Longer-term effect of physical activity intervention on sleep quality: a secondary analysis of cluster randomized controlled trial
Authors: Li Xianlan , Ye Qin , Liu Qianqian , Peng Jie , Li Nanyan , Deng Qian , Hu Julinling , Yong Chan , Li Shiyi , Wang Yufei , Zhu Jingjie , Zhao Xing , Zhou Junmin
Published: July 2024

Abstracts

Study Objectives

To examine the longer-term effect of physical activity (PA) intervention on sleep quality and whether the effect was heterogeneous between daytime nappers and non-nappers.

Methods

This study was a secondary analysis of a cluster randomized controlled trial in China. Eight villages were randomized 1:1 to intervention or control group. The intervention group received an 8-week PA intervention, while the control group did not. The primary outcome of this study was the change in the Pittsburgh Sleep Quality Index (PSQI) global score at 24 months.

Results

The 511 participants had a mean age of 70.94 years (SD 5.73) and 55.6% were female. The intervention showed improvements in the PSQI global score at 8 weeks (adjusted mean difference −1.05; p = .002), and the effect diminished at 24 months (−0.64; p = .06). There were statistically significant improvements in the PSQI global score for daytime nappers, but not for non-nappers at 8 weeks (adjusted mean difference −0.98; p = .01 vs. −1.27; p = .05), 12 months (−0.86; p = .03 vs. −0.84; p = .21), and 24 months (−0.80; p = .04 vs. −0.14; p = .84), although these improvements were below the minimum detectible level of the PSQI which is 1 point.

Conclusions

The 8-week PA intervention was effective in improving sleep quality, while the effect was diminished and below the minimum detectible level of the PSQI which is 1 point after 24 months. The effect of PA intervention on sleep quality was more pronounced in daytime nappers. Additional interventions (e.g. focusing on multiple behavioral interventions such as PA and a healthy diet) are needed to maintain the beneficial effect of PA on sleep quality in the general older populations. Further research is required to confirm the mechanisms of the effect of napping and develop tailored interventions.

Trial Registration

Conceptualizing a physical activity intervention model among rural older adults in China: a socio-ecological model-based approach, https://www.chictr.org.cn/showprojEN.html?proj=123704, registered at Chinese Clinical Trial Registry on April 20, 2021 (identifier: ChiCTR2100045653).
A Comparative Study of the Indian Penal Code and the Bharatiya Nyaya Sanhita’s Gender-related Provisions
Authors: Shrivastava Himanshu , Akhter Sabeeh
Published: July 2024

The Bharatiya Nyaya Sanhita (BNS) of 2023 replaces the existing Indian Penal Code (IPC) of 1860 as the primary penal law of India. The new BNS offers a potential pathway for the reformation of the legal landscape concerning gender-based offences in India. This paper analyzes all such changes introduced in the BNS (relating to provisions of gender-related offenses such as adultery, assault, cruelty, domestic violence, rape, sex trafficking, etc.) by comparing them to the previous Indian Penal Code (IPC, 1860). This paper explores the new bill’s potential to address long-standing gender inequalities in the existing code. It also assesses its limitations and suggests areas for improvement. In doing so, it also emphasizes the importance of recognizing and protecting LGBTQIA+ rights within the legal framework.
Preserving isohydricity: vertical environmental variability explains Amazon forest water-use strategies
Authors: Penha Deliane , Brum Mauro , Alves Luciana F , Domingues Tomas F , Meneses Anderson , Branches Rardiles , Restrepo-Coupe Natalia , Oliveira Rafael S , Moura José Mauro S , Pequeno Pedro A C L Aurélio , Prohaska Neill , Saleska Scott R
Published: July 2024

Increases in hydrological extremes, including drought, are expected for Amazon forests. A fundamental challenge for predicting forest responses lies in identifying ecological strategies which underlie such responses. Characterization of species-specific hydraulic strategies for regulating water-use, thought to be arrayed along an ‘isohydric–anisohydric’ spectrum, is a widely used approach. However, recent studies have questioned the usefulness of this classification scheme, because its metrics are strongly influenced by environments, and hence can lead to divergent classifications even within the same species. Here, we propose an alternative approach positing that individual hydraulic regulation strategies emerge from the interaction of environments with traits. Specifically, we hypothesize that the vertical forest profile represents a key gradient in drought-related environments (atmospheric vapor pressure deficit, soil water availability) that drives divergent tree water-use strategies for coordinated regulation of stomatal conductance (gs) and leaf water potentials (ΨL) with tree rooting depth, a proxy for water availability. Testing this hypothesis in a seasonal eastern Amazon forest in Brazil, we found that hydraulic strategies indeed depend on height-associated environments. Upper canopy trees, experiencing high vapor pressure deficit (VPD), but stable soil water access through deep rooting, exhibited isohydric strategies, defined by little seasonal change in the diurnal pattern of gs and steady seasonal minimum ΨL. In contrast, understory trees, exposed to less variable VPD but highly variable soil water availability, exhibited anisohydric strategies, with fluctuations in diurnal gs that increased in the dry season along with increasing variation in ΨL. Our finding that canopy height structures the coordination between drought-related environmental stressors and hydraulic traits provides a basis for preserving the applicability of the isohydric-to-anisohydric spectrum, which we show here may consistently emerge from environmental context. Our work highlights the importance of understanding how environmental heterogeneity structures forest responses to climate change, providing a mechanistic basis for improving models of tropical ecosystems.
Cytoskeleton‐associated gelsolin responds to the midgut distention process in saline meal‐fed Aedes aegypti and affects arbovirus dissemination from the midgut
Authors: Cui Yingjun , Megawati Dewi , Lin Jingyi , Rehard David G. , Grant DeAna G. , Liu Pei , Jurkevich Alexander , Reid William R. , Mooney Brian P. , Franz Alexander W. E.
Published: July 2024

The mosquito, Aedes aegypti, is the principal vector for several arboviruses. The mosquito midgut is the initial tissue that gets infected with an arbovirus acquired along with a blood meal from a vertebrate host. Blood meal ingestion leads to midgut tissue distention thereby increasing the pore size of the surrounding basal lamina. This allows newly synthesized virions to exit the midgut by traversing the distended basal lamina to infect secondary tissues of the mosquito. We conducted a quantitative label‐free proteomic time course analysis with saline meal‐fed Ae. aegypti females to identify host factors involved in midgut tissue distention. Around 2000 proteins were detected during each of the seven sampling time points and 164 of those were uniquely expressed. Forty‐five of 97 differentially expressed proteins were upregulated during the 96‐h time course and most of those were involved in cytoskeleton modulation, metabolic activity, and vesicle/vacuole formation. The F‐actin‐modulating Ae. aegypti (Aa)‐gelsolin was selected for further functional studies. Stable knockout of Aa‐gelsolin resulted in a mosquito line, which showed distorted actin filaments in midgut‐associated tissues likely due to diminished F‐actin processing by gelsolin. Zika virus dissemination from the midgut of these mosquitoes was diminished and delayed. The loss of Aa‐gelsolin function was associated with an increased induction of apoptosis in midgut tissue indicating an involvement of Aa‐gelsolin in apoptotic signaling in mosquitoes. Here, we used proteomics to discover a novel host factor, Aa‐gelsolin, which affects the midgut escape barrier for arboviruses in mosquitoes and apoptotic signaling in the midgut.
Self, Physician, and Specialty: A Qualitative Exploration of Medical Students’ Specialty Identity Formation During Undergraduate Medical Training
Authors: Schrepel Caitlin , Amick Ashley E. , Bann Maralyssa , Watsjold Bjorn , Ilgen Jonathan S. , Jauregui Joshua
Published: July 2024

Purpose

A physician’s specialty is an integral part of their professional identity formation (PIF), not only determining the role they play in patient care but also shaping group interactions in the workplace. Prior work on PIF in medical students has focused on the development of a physician identity. However, little is known about how medical students might begin to develop divergent specialty-specific identities during medical school. Consequently, the authors aimed to explore how the process of specialty selection shapes PIF during undergraduate medical training and to develop a construct of specialty identity formation (SIF) as an important aspect of PIF.

Method

The authors used a constructivist grounded theory approach to explore SIF in senior medical students at the University of Washington between August 2022 and January 2023. The author team consisted of 6 attending physicians. Two investigators conducted hour-long, semistructured interviews, which were audio recorded, transcribed, and deidentified. After analysis, member checking was completed with 2 participants.

Results

The authors interviewed 14 students and categorized the data into 3 phases: nascent understanding, experiential grounding, and projecting forward. Participants reflected on considering their personal values, while simultaneously exploring the values and defining features of various specialty groups. Early impressions were formed based on ideas influenced by peers and mentors and later integrated with experiences on clinical rotations. Finally, participants noted engaging in a process projecting forward as they attempted to envision their potential futures as both physicians and members of a specialty group.

Conclusions

As students explore their specialty identity, they use self-anchoring and self-stereotyping to integrate components of their evolving specialty identity into their professional identity. However, uncertainty regarding their fit with a specialty persists for many. Many sociocultural aspects of the learning environment affect SIF, including threats to psychological and identity safety.
Unveiling the Invisible: Challenges Faced by Arab Women International Medical Graduates in U.S. Academia
Authors: Alkhatib Maram , Hasan Inaya , Ali Ayra , Zaidi Zareen
Published: July 2024

Purpose

The Arab experience is understudied because until 2024 Arabs were categorized as White on the U.S. Census, leading to diminished documentation of their personal experiences. There is also little understanding of the Arab experience and its intersectionality with gender, being an international medical graduate (IMG), and working in academia. The authors studied the experience of Arab women IMGs working in the U.S. academic system.

Method

This qualitative study used interpretative phenomenological analysis to analyze in-depth interview data from 20 first-generation U.S. immigrant Arab women who were IMGs. Interpretative phenomenologicalanalysis involved data familiarization, immersion, and coding. Codes were grouped into potential themes on the participants’ experience. The authors explored connections between the themes and engaged in reflexive practice through memo writing and team meetings. The study was performed from November 2022–May 2023.

Results

The experiences of the 20 first-generation U.S. immigrant Arab women IMGs were as diverse as the Arab identity itself but congruent with some documented IMG experiences. Political turmoil, desire for new opportunities, and career goals were all reasons that led them to emigrate, but cultural differences, isolation from their home countries, and missing family were central to their experiences. Muslim women wearing the hijab or those with heavy accents faced more microaggressions and xenophobia in academic clinical settings. Those in environments that embraced their differences and supported them described less discrimination. They all felt, nonetheless, that they benefited from training in the United States. However, they noted room for improving cultural humility in residencies and the need for a more inclusive workplace.

Conclusions

This study highlights the visible and invisible challenges that affect Arab women IMGs’ experience in the United States. Program directors and department leaders should try to learn about the backgrounds of IMGs and current geopolitical events that might affect IMGs and extend support.
“Making Space for More People, More Perspectives, and More Ideas”: How Medical Education Journal Editors View Their Role in Capacity Building
Authors: Cheung Jeffrey J.H. , Balmer Dorene F. , Bierer S. Beth , Cianciolo Anna T.
Published: July 2024

Purpose

Medical education journal editors work to improve scholarly rigor and expand access to scholarship. How editors conceptualize these dual roles is unknown and holds implications for the kinds of scholarship that are valued and made visible through publication. The authors applied the concept of capacity building to examine how medical education journal editors conceptualize and operationalize capacity building and to identify the contextual factors that support or constrain these efforts.

Method

Using a reflexive thematic approach, the authors interviewed 13 editors of 11 medical education journals between February 2022 and March 2023. Data collection and analyses were performed iteratively. Interview transcripts were coded by 2 authors to generate initial codes, which were then refined by the research team until final themes were created.

Results

Editors viewed capacity building “making space” for people and perspectives. Making space for people included efforts to support editors and reviewers, offer feedback to authors, and engage with readers. Making space for perspectives included efforts to promote discussion on diversity and inclusion and to introduce ideas perceived to advance the field. How editors made space was shaped by a journal’s ecosystem, including local features unique to each journal (e.g., aims, scope, readership) and system-level factors that influenced all journals (e.g., English as the language of science, academic promotion and tenure).

Conclusions

Although medical education journal editors’ capacity-building work will inevitably guide future scholars and scholarship, their work should be considered in the context of a larger ecosystem, including such features as institutional academies for scholarship and promotion and tenure policies. Improving rigor and expanding access will require clarifying how editors’ approach and understand capacity building to advance as a field. Future work should clarify how individual journals’ capacity-building efforts can be facilitated and how journals can collectively reimagine spaces for knowledge-building conversations.
Age-related Psychometric Dimensionality Using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Opioid Use Disorder Diagnostic Criteria
Authors: Falise Alyssa M. , Li Ziying , Huggins-Manley Anne Corinne , Lopez-Quintero Catalina , Cottler Linda B. , Striley Catherine W.
Published: July 2024

Objectives

Age-related psychometric differences in Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) opioid use disorder (OUD) diagnostic criteria have been hypothesized, but not been tested. This study investigated DSM-5 OUD diagnostic criteria for age-related measurement noninvariance among younger adults (YAs) and middle/older adults (MOAs) with past 12-month nonmedical use of prescription opioids.

Methods

People who participated in the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions III and reported past 12-month nonmedical use of prescription opioids were included. YAs were 18–49 years old, and MOAs were 50+ years old. Item response theory, differential item functioning (DIF), and differential test functioning were used to assess for age-related measurement noninvariance.

Results

One in 5 people met the DSM-5 OUD diagnostic criteria for OUD within the past 12 months, with the most endorsed criteria being tolerance (17.96%). DIF was identified for 3 criteria, including (1) taking opioids for longer or in larger doses than intended, (2) long periods spent obtaining/using/recovering from use, and (3) withdrawal. DIF was associated with the latent OUD severity needed to correctly endorse the criteria, with criteria being correctly endorsed at less severe levels of latent OUD for MOAs when compared with YAs. Differential test functioning analyses showed collectively the criteria had improved detection in MOAs when compared with YAs (P < 0.01).

Conclusions

These findings suggest that there may be age-related variations in the DSM-5 OUD diagnostic criteria’s ability to detect latent OUD. Future research should identify contributing factors and the influence it has on the accuracy of age-specific surveillance estimations.
Wound Care Capacity of the Addiction Workforce in the Setting of Xylazine
Authors: Jawa Raagini , Blakemore Samantha , Murray Stephen , Ventura Alicia S. , Hristova Tavita , Wilder Alexa , Shang Margaret , Johnson Tehya , LaBelle Colleen
Published: July 2024

Objectives

As xylazine increasingly adulterates the unregulated opioid supply, people who use drugs (PWUD) are more likely to experience sequalae from xylazine. Given xylazine exposure is consistently associated with development of wounds which can heal with medically directed wound care, we sought to understand the level of preparedness and ability of front-line addiction professionals who interact with PWUD to provide wound care treatment.

Methods

We administered a 26-item online survey assessing participant and organizational characteristics, level of wound care training, ability to test for xylazine and treat xylazine-associated wounds, and funding and billing characteristics to a national sample of addiction professionals using a listserv of over 11,000 individuals.

Results

We had a response rate of 12.8% in which 1,280 met eligibility criteria and completed the survey, with the majority (23.7%) being nurses. While nearly all participants had cared for patients who had experienced any xylazine-associated harms, less than half (43.6%) had cared for patients with xylazine wounds and 43.4% had any training or certification in wound care, including 26.9% of physicians. Although 75.9% of participants had access to wound care supplies, just 19.5% provided wound care services onsite.

Conclusions

Most addiction professionals, especially physicians, lack wound care training and do not provide onsite treatment for drug-associated wounds at the organizational level. There is a critical need to bridge this gap in knowledge and build capacity to provide evidence-based wound care services to PWUD in areas impacted by xylazine adulteration.
Interspinous Motion Measurement Could Serve as a Quantitative Method for Assessing Bony Fusion After Anterior Cervical Corpectomy and Fusion
Authors: Wang Haoxiang , Xia Tian , Qu Ruomu , Sun Yu , Zhang Fengshan , Pan Shengfa , Chen Xin , Zhao Yanbin , Jiang Liang , Zhou Feifei
Published: July 2024

Study Design.

A retrospective diagnostic test study.

Objective.

To establish quantitative fusion criteria for ACCF.

Summary of Background Data.

Currently, the criteria of fusion after ACCF remains controversial. Evaluation techniques such as observation of continuous bony trabeculae across the fusion site were qualitative and conducted by naked eyes, limiting its accuracy. Dynamic fusion indicators such as interspinous motion (ISM) have been successfully utilized in anterior cervical discectomy and fusion (ACDF) for evaluating fusion and detecting pseudarthrosis. However, the accuracy of ISM in ACCF is unclear.

Methods.

Patients who underwent ACCF in our hospital were reviewed. Imaging data including dynamic radiographs and computed tomography (CT) scans were collected. The distance and angle form of ISM (ISM-dis and ISM-ang) were measured on dynamic radiograph, with CT as the gold standard for fusion. The correlation between ISM methods was analyzed using Spearmann correlation. Receiver operating characteristic (ROC) curves were used to evaluate the accuracy and generate optimal cutoff values. Three observers independently measured the data twice to determine interobserver and intraobserver reliability.

Results.

Our study included 178 imaging datasets. ISM-dis showed positive correlation with ISM-ang (r=0.914). The area under ROC (AUC) for ISM-dis and ISM-ang was 0.926 and 0.893. Applying a cutoff value of 1.50 mm to ISM-dis yielded a sensitivity of 87.8% and specificity of 92.3% for detecting pseudarthrosis. For ISM-ang, a cutoff value of 1.75° resulted in a sensitivity of 79.1% and specificity of 92.3%. Intraobserver reliabilities for ISM-dis (0.986, 0.984, and 0.972) were higher than for ISM-ang (0.935, 0.963, and 0.935), as was interobserver reliability (0.985 for ISM-dis and 0.956 for ISM-ang). Fusion rates calculated using ISM-dis and ISM-ang were 52.4% and 61.9%.

Conclusions.

ISM can serve as an alternative to CT for assessing fusion, with ISM-dis at a 1.50-mm cutoff and ISM-ang at 1.75°, demonstrating high diagnostic accuracy.
Reducing language barriers, promoting information absorption, and communication using fanyi
Authors: Wang Difei , Chen Guannan , Li Lin , Wen Shaodi , Xie Zijing , Luo Xiao , Zhan Li , Xu Shuangbin , Li Junrui , Wang Rui , Wang Qianwen , Yu Guangchuang
Published: July 2024

Interpreting genes of interest is essential for identifying molecular mechanisms, but acquiring such information typically involves tedious manual retrieval. To streamline this process, the fanyi package offers tools to retrieve gene information from sources like National Center for Biotechnology Information (NCBI), significantly enhancing accessibility. Additionally, understanding the latest research advancements and sharing achievements are crucial for junior researchers. However, language barriers often restrict knowledge absorption and career development. To address these challenges, we developed the fanyi package, which leverages artificial intelligence (AI)-driven online translation services to accurately translate among multiple languages. This dual functionality allows researchers to quickly capture and comprehend information, promotes a multilingual environment, and fosters innovation in academic community. Meanwhile, the translation functions are versatile and applicable beyond biomedicine research to other domains as well. The fanyi package is freely available at https://github.com/YuLab-SMU/fanyi.
Chinese expert consensus on transfemoral transcatheter aortic valve replacement for pure aortic regurgitation (2023)
Authors:   Structural Heart Disease Group of Chinese College of Cardiovascular Physician, China Heart House
Published: July 2024

Transcatheter aortic valve replacement (TAVR) was initially used to treat aortic stenosis (AS), and gradually expanded into aortic regurgitation (AR) treatment. Scholars worldwide have explored the use of marketed transfemoral TAVR (TF-TAVR) valves for AR patients, offering another option for high-risk surgical patients. However, AR presents distinct challenges compared to AS, including anatomical differences, valve selection, procedural nuances, and complication profiles. Overall, TF-TAVR for AR is more complex with lower success rate than for AS. In order to promote the safe and standardized TF-TAVR for AR in China, the Structural Heart Disease Group of Chinese College of Cardiovascular Physician drafted this consensus. The writing expert team focused on key clinical challenges in TF-TAVR for AR patients, combining evidence from literature up to September 1, 2023, to formulate nine core viewpoints. These encompass indications, valve selection, preoperative evaluation, intraoperative techniques, complication prevention and management, postoperative care, and other aspects.
Complementary and Alternative Medicine Among Adult Cancer Patients
Authors: Emami Seyed Amir Hossein , Khajeh-Mehrizi Ahmad , Safaee-Nodehi Seyed Reza , Dabiri Mohammad Reza , Emami Seyed Amir Mahdi
Published: July 2024

Although there is limited information on efficacy and safety of complementary and alternative medicine (CAM), they are increasingly used by patients with cancer. We aimed to determine the prevalence and predictors of CAM use among a sample of Iranian cancer patients. In this cross-sectional study, conducted in an outpatient cancer clinic, patients with solid tumors or hematologic malignancies in different stages were asked to complete a questionnaire to measure CAM usage. A total of 131 patients with a median age of 58 years (18–86 years) participated in this study. CAM use was reported by 51.9% (n = 68) of the patients. Female gender and higher education level were significantly associated with the use of CAM (OR = 2.47, P value = .01 and OR = 2.55, P value = .02, respectively). Vitamins and minerals were the most frequently used CAM (n = 37, 54.4%). The main reasons for CAM use were to improve immune system and fight cancer (n = 48, 70.6%) followed by relieve side-effects from conventional cancer treatments (n = 26, 38.2%). Although three (4.4%) patients reported side-effects, most patients (n = 53, 77.9%) were satisfied with their CAM use. Among CAM users, 55 (80.9%) patients had reported their CAM use to physician. The CAM use is highly prevalent among adult cancer patients. Health care providers need to raise their awareness on probable disadvantages or benefits of CAMs and discuss these issues with patients.
Exploring the Protective Role of Aspirin Use in Mitigating Colorectal Cancer (CRC) Metastasis
Authors: Paladiya Ruchir , Khoury Neil , Shah Mihir , Moond Vishali , Patel Nishit , Bahirwani Janak , Garg Ayushi , Sohal Aalam , Vaziri Haleh
Published: July 2024

Despite advancements in treatment strategies, the mortality from colorectal cancer (CRC) remains high. Evidence suggests that aspirin (ASA) may have a protective effect on CRC incidence and metastasis through various mechanisms. The 2016 to 2020 National Inpatient Sample was used to identify adult patients (age above 18 y) with the principal diagnosis of CRC. Patients were stratified into 2 groups based on ASA use. The outcomes studied were in-hospital mortality and rates of total, gastrointestinal (GI), non-GI, and lymphoid metastasis. A multivariate logistic regression analysis was performed to evaluate the impact of ASA use on outcomes after adjusting for patient demographics, comorbidities, and the Elixhauser Comorbidity Index (ECI). Of the 814,270 patients, 88,620 (10.8%) used ASA, with the majority being aged above 65 years (78%), male (57%), white (77.6%), and had Medicare insurance (74.5%). There was a higher prevalence of Diabetes mellitus, Hypertension, Chronic pulmonary disease, Coronary artery disease, Chronic kidney disease, Chronic heart failure, Obesity, and Smoking among aspirin users than among non-ASA users. Patients who used ASA had a lower prevalence of total (47.3% vs. 32.5%,P<0.001), GI (22.2% vs. 32.4%,P<0.001), non-GI (9.9% vs. 15.3%,P<0.001), and lymphoid (9.3% vs. 10.9%,P<0.001) metastasis compared with those who did not use ASA. After adjusting for confounding factors, patients with ASA use had lower odds of total (aOR: 0.75, 95% CI: 0.72-0.78,P<0.001), GI (aOR: 0.74, 95% CI: 0.71-0.77,P<0.001), non-GI (aOR: 0.72, 95% CI: 0.68-0.77,P<0.1), and statistically insignificant odds of lymphoid (aOR: 0.95, 95% CI: 0.90-1.00,P=0.098) metastasis. The use of ASA is associated with a decrease in the prevalence of metastasis among individuals diagnosed with CRC, but additional studies are required to elucidate the mechanism and duration of therapy needed to be effective.
Engaging Nonphysician Staff in Practice Facilitation-Mediated Quality Improvement to Improve Health Outcomes in Under-Resourced Clinical Practices in New York City
Authors: De Leon Samantha , Tabaei Bahman P. , Glenn Lily , Das Sonali , Fana Ernesto , Pham-Singer Hang
Published: July 2024

In New York City (NYC), hypertension and high cholesterol disproportionately affect residents with low household income and people of color. The NYC Health Department employed practice facilitation (PF) to help nonphysician staff assume added roles aligned with team-based care. The objective was to improve blood pressure (BP) and cholesterol management in 132 small primary care practices serving mostly patients of color. We categorized practices into higher or lower levels of integrated PF, defined as physicians and nonphysician staff collectively participating in PF. Higher integrated PF was associated with improvements in BP (rate ratio [RR] = 1.09, P-value < .05) and cholesterol management (RR = 1.12, P-value < .01). Nonphysician staff in higher integrated PF practices reported skills enhancement and improved teamwork. Involving nonphysician staff in PF-mediated quality improvement efforts can be an effective strategy to improve health outcomes in small clinical practices serving communities with a higher burden of chronic disease and disproportionately impacted by poverty and structural racism.
Current Practices and Attitudes of Community Health Centers Toward the Use of Algorithmic Logic to Identify Patients with Undiagnosed Hypertension
Authors: Barragan Noel C. , Green Gabrielle , Moyer Matt , Cruz Gerardo , Pogosyan Sarine , Kuo Tony
Published: July 2024

Treating patients with uncontrolled hypertension is a powerful intervention for reducing the risk of heart attack and stroke. Leveraging health information technology to identify patients with undiagnosed hypertension using algorithmic logic can be an effective approach for reaching hypertensive patients who may otherwise be overlooked. Despite evidence that this strategy can support favorable cardiovascular health outcomes in the safety-net healthcare setting, little is known about its implementation outside of targeted practice and research environments. In 2021-2022, Community Clinic Association of Los Angeles County and the Los Angeles County Department of Public Health collaborated on a mixed methods, organizational assessment of community health centers to better understand their practices and attitudes toward the use of algorithmic logic to identify patients with undiagnosed hypertension. Results from the assessment suggest that awareness and use of this approach are limited; numerous challenges are associated with its adoption and implementation.
Narrowing Cardiovascular Disease Health Disparities by Advancing the Role of Pharmacists Through a Multisector Consortium
Authors: Barragan Noel C. , Chen Steven , Abraham Jessica , Chu Michelle , Kuo Tony
Published: July 2024

Demand for scaling and sustaining clinical services to improve health outcomes while minimizing costs is rising, particularly for patients dealing with major cardiovascular disease and stroke risk factors such as hypertension. Consequently, there is growing national and local interest in engaging pharmacists as part of the solution through the implementation of comprehensive medication management. To capitalize on this momentum, a team from the University of Southern California led the establishment of the California Right Meds Collaborative (CRMC) in 2019. CRMC aims to reduce the burden of uncontrolled chronic disease by advancing the role of pharmacists as team members in the health care system. This case study describes CRMC’s structure and approach to developing value-based payment models and advancing the competency of pharmacists through training, continuous quality improvement, and technical assistance. In addition, this case study provides an overview of a CRMC pilot project wherein a local health plan tested a value-based payment model to deliver comprehensive medication management. The pilot underwent many iterative changes throughout its duration but ultimately was considered a success and adopted as part of standard practice. Lessons learned from this effort can help others leverage the availability of pharmacists to assist vulnerable populations in their communities.
Connecticut Implements a Team-Based Approach to Cardiovascular Disease Prevention Using Community Health Workers and Mobile Medical Devices
Authors: Griffin Amy , Ogazi Chioma , Vozzolo Chelsea , Davis Karin , Baker Robin
Published: July 2024

The Connecticut Department of Public Health’s Early Detection and Prevention Program uses an integrated approach to deliver breast and cervical cancer screening services, cardiovascular disease risk assessment, health coaching, and the identification of social determinants of health to women from economically disadvantaged and minority communities. Statewide contracted providers who represent twenty hospitals and their fee-for-service providers employ community health workers (CHWs) to conduct outreach, screening assessments using mobile medical devices, and risk reduction counseling in community settings to reduce service access barriers, while also engaging eligible women who may not typically frequent clinical services. Mobile medical screening devices enhance healthcare accessibility by enabling screenings to be conducted in a participants preferred setting, whether it is a clinic or within the community, with the added benefit of delivering rapid screening results. Utilizing these results, CHWs provide risk reduction counseling to develop individualized health action plans at the outreach session.
Using Online Surveys for Routine Campylobacter Case Investigations in Colorado, September 2020-December 2021
Authors: Hewitson Ingrid , White Alice E. , Walter Elaine Scallan , Jervis Rachel H.
Published: July 2024

Context:

Routine case investigations are critical for enteric disease control and surveillance. Given limited resources and staffing, public health agencies are exploring more efficient case investigation methods.

Objective:

To identify and describe the advantages and disadvantages of using online surveys to supplement routine enteric disease case investigations.

Design:

We evaluated routine Campylobacter interview data collected via telephone vs online by interviewers with the Colorado Department of Public Health and Environment.

Setting and Participation:

Colorado laboratory-confirmed Campylobacter cases reported from September 1, 2020, through December 31, 2021.

Main Outcome Measures:

We calculated modality preference, response rates, and data quality (missing and unknown answers) and compared demographics (age, gender, and urban vs rural) by modality. Estimated staff time savings and investigation timeliness were compared.

Results:

Modality preference was split among the 966 contacted Campylobacter cases (46% telephone, 50% online, and 4% refusal). Among online respondents, 57% completed the survey for an overall 63% response rate. Females and those 18 to 44 years of age were most likely to select (55%, 60%) and complete (57%, 66%) the online survey, while those under 18 and over 65 years of age were least likely to select (47%, 45%) or complete (53%, 46%). Those who identified as non-Hispanic Black were most likely to select online (62%), whereas those who identified as mixed-race non-Hispanic and non-Hispanic White had the highest completion (78%, 60%). Modality preference was comparable by geography; however, rural residents had higher completion rates (61%). Data quality and completeness were comparable between modalities. Completing the 274 online surveys via telephone would have taken an estimated 78 hours of additional staff time.

Conclusions:

Online surveys can increase public health efficiency and capacity while maintaining data quality. However, use should be limited to high-burden, low-resource pathogens due to reduced response rates. Understanding implementation best practices and conducting regular evaluation are critical for optimization.
Improved Patient Engagement and Cost Savings Through a Novel Medication Review Process
Authors: Winslow Karen R. , Wiggins Patrick
Published: July 2024

Pharmacist-led interventions are pivotal in identifying and resolving potential adverse drug events (pADEs) while enhancing blood pressure control and medication adherence through educational and counseling interventions. This practice brief outlines the outcomes of the Blue Bag Initiative (BBI), which enhanced pharmacist-led comprehensive medication reviews (CMRs) across community pharmacies in Virginia under Center for Disease Control Cooperative Agreement NU58DP006535. BBI yielded a rate of 131.6 pADEs identified per 100 participants and demonstrated cost savings of 1 to 3 million dollars for the health care system. This report underscores the significance of a standardized, pharmacist-led CMR as integral to interdisciplinary team-based care models within physician practices, facilitating medication therapy management implementation. Enhanced CMR can improve cardiovascular health outcomes while reducing health care expenditures by augmenting patient engagement and medication adherence. This study thus highlights the efficacy and potential of pharmacist-led interventions in increasing access to and optimizing patient care.
Reducing Cardiovascular Disparities in Kentucky: The Design, Implementation, and Evaluation of the Cardiovascular Assessment Risk Reduction and Education Self-Measured Blood Pressure (CARE SMBP) Monitoring Program
Authors: Cinnamond Karen E. , Littlefield Natalie , Albuquerque Samantha , Walker Breanna , Boisseau Lonna , Kessinger Emily
Published: July 2024

Hypertension is a leading risk factor in cardiovascular disease (CVD) with the highest national rates in southeastern and Appalachian counties. To reduce hypertension health disparities and CVD risk, the Kentucky Department for Public Health Heart Disease and Stroke Program (KHDSP) designed, implemented, and continuously evaluated the Cardiovascular Assessment Risk Reduction and Education Self-Measured Blood Pressure (CARE SMBP) program in rural and Appalachian Kentucky. Ten health care systems and two local health departments implemented CARE SMBP. CARE SMBP patients improved their blood pressure and engaged in lifestyle behavior changes that lead to improved long-term health. Health care researchers and potential SMBP implementors can reference the CARE SMBP framework and evaluation results to design their own clinically supported SMBP programs with educational support to reduce CVD risk.
Epidemiology of Mpox Cases, and Tecovirimat and JYNNEOS Utilization, Alameda County, California, June-October 2022
Authors: Ouyang Megan L. , Marusinec Rachel , Bayard Paul J. , Edmunds Magdalen , Johnson Mark , Lai Sunny , Menker Kaeb , Moore Curtis , Moss Nicholas , Nguyen Mychi , Peña April , Rajagopal Sumanth , Shemsu Munira , Sheppard Ieshia , Slome Sally , Tang Michele , Trivedi Kavita K. , Yette Emily , Dunne Eileen F. , Ayala George , Chitnis Amit
Published: July 2024

Context:

The 2022 United States mpox outbreak disproportionately affected racial and ethnic minority gay, bisexual, and other men who have sex with men.

Program:

We utilized surveillance data and vaccination registries to determine whether populations most impacted by mpox in Alameda County received JYNNEOS vaccines and tecovirimat (TPOXX) during June 1-October 31, 2022.

Implementation:

Alameda County Public Health Department responded to the mpox epidemic through partnerships with local health care providers who serve communities disproportionately affected by mpox.

Evaluation:

During June 1-October 31, 2022, a total of 242 mpox cases were identified in Alameda County. Mpox incidence rates per 100 000 were highest among Black/African American (35.7; 95% confidence interval [CI], 26.8-46.5) and Hispanic/Latinx (25.1; CI, 20.1-30.9) residents, compared to Asian (3.8; CI, 2.3-5.9) and White (10.5; CI, 7.7-13.9) residents. Most confirmed cases were identified as gay, lesbian, or same-gender-loving (134, 67.3%) and bisexual (31, 15.6%); 226 (93.8%) cases were male. Sixty-nine (28.5%) mpox patients received TPOXX. There were no statistically significant differences in demographic and clinical characteristics of mpox cases when compared by TPOXX receipt status. JYNNEOS vaccine was received by 8277 Alameda County residents. The largest proportion of vaccinees were White residents (40.2%). Administration rates per 100 000 men who have sex with men were lowest among Asian and Hispanic/Latinx individuals, at 8779 (CI, 8283-9296) and 14 953 (CI, 14 156-15 784), respectively. Black/African American and Hispanic/Latinx males had the lowest vaccination-to-case ratios at 16.7 and 14.8, respectively.

Discussion:

Mpox disproportionately affected Black/African American and Hispanic/Latinx men who have sex with men in Alameda County. Strong partnerships with local health care providers ensured that persons with mpox received TPOXX treatment when indicated. However, higher JYNNEOS vaccine uptake in Black and Latinx communities needs improvement through ongoing and meaningful engagement with Black/African American and Hispanic/Latinx gay, bisexual, and transgender communities.
Estimating the Prevalence of Injection Drug Use Among Acute Hepatitis C Cases From a National Surveillance System: Application of Random Forest-Based Multiple Imputation
Authors: Yin Shaoman , Ly Kathleen N. , Barker Laurie K. , Bixler Danae , Thompson Nicola D. , Gupta Neil
Published: July 2024

Background:

Injection drug use (IDU) is a major contributor to the syndemic of viral hepatitis, human immunodeficiency virus, and drug overdose. However, information on IDU is frequently missing in national viral hepatitis surveillance data, which limits our understanding of the full extent of IDU-associated infections. Multiple imputation by chained equations (MICE) has become a popular approach to address missing data, but its application for IDU imputation is less studied.

Methods:

Using the 2019-2021 National Notifiable Diseases Surveillance System acute hepatitis C case data and publicly available county-level measures, we evaluated listwise deletion (LD) and 3 models imputing missing IDU data through MICE: parametric logistic regression, semi-parametric predictive mean matching (PMM), and nonparametric random forest (RF) (both standard RF [sRF] and fast implementation of RF [fRF]).

Results:

The estimated IDU prevalence among acute hepatitis C cases increased from 63.5% by LD to 65.1% by logistic regression, 66.9% by PMM, 76.0% by sRF, and 85.1% by fRF. Evaluation studies showed that RF-based MICE imputation, especially fRF, has the highest accuracy (as measured by smallest raw bias, percent bias, and root mean square error) and highest efficiency (as measured by smallest 95% confidence interval width) compared to LD and other models. Sensitivity analyses indicated that fRF remained robust when data were missing not at random.

Conclusion:

Our analysis suggested that RF-based MICE imputation, especially fRF, could be a valuable approach for addressing missing IDU data in the context of population-based surveillance systems like National Notifiable Diseases Surveillance System. The inclusion of imputed IDU data may enhance the effectiveness of future surveillance and prevention efforts for the IDU-driven syndemic.