Digital Commons Network^™

Allocation Of Special Drawing Rights For The Eleventh Basic Period: Draft Executive Board Decision And Managing Director Report To The Board Of Governors, International Monetary Fund (Imf), International Monetary Fund (Imf): Monetary And Financial Systems Department

Documents

No abstract provided.

Discrepancies In Stroke Distribution And Dataset Origin In Machine Learning For Stroke., Lohit Velagapudi, Nikolaos Mouchtouris, Michael P Baldassari, David Nauheim, Omaditya Khanna, Fadi Al Saiegh, Nabeel Herial, M Reid Gooch, Stavropoula Tjoumakaris, Robert H Rosenwasser, Pascal Jabbour

Department of Neurosurgery Faculty Papers

BACKGROUND: Machine learning algorithms depend on accurate and representative datasets for training in order to become valuable clinical tools that are widely generalizable to a varied population. We aim to conduct a review of machine learning uses in stroke literature to assess the geographic distribution of datasets and patient cohorts used to train these models and compare them to stroke distribution to evaluate for disparities.

AIMS: 582 studies were identified on initial searching of the PubMed database. Of these studies, 106 full texts were assessed after title and abstract screening which resulted in 489 papers excluded. Of these 106 studies, …

Trends In Race/Ethnicity Of Pediatric Residents And Fellows: 2007-2019, Kimberly Montez, Emma A Omoruyi, Kenya Mcneal-Trice, Wendy J Mack, Lahia Yemane, Alissa R Darden, Christopher J Russell

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVES: A diverse pediatric workforce reflecting the racial/ethnic representation of the US population is an important factor in eliminating health inequities. Studies reveal minimal improvements over time in the proportions of underrepresented in medicine (URiM) physicians; however, studies assessing trends in pediatric URiM trainee representation are limited. Our objective was to evaluate longitudinal trends in racial/ethnic representation among a cross-section of US pediatric trainees and to compare it to the US population.

METHODS: Repeated cross-sectional study of graduate medical education census data on self-reported race/ethnicity of pediatric residents and subspecialty fellows from 2007 to 2019. To evaluate trends …

Cardiovascular Outcomes In Patients With Mitochondrial Disease In The United States: A Propensity Score Analysis, Tran Nguyen, Talal Alzahrani, Joseph Krepp, Gurusher Panjrath

The Texas Heart Institute Journal

Mitochondrial disease comprises a wide range of genetic disorders caused by mitochondrial dysfunction. Its rarity, however, has limited the ability to assess its effects on clinical outcomes. To evaluate this relationship, we collected data from the 2016 National Inpatient Sample, which includes data from >7 million hospital stays. We identified 705 patients (mean age, 22 ± 20.7 yr; 54.2% female; 67.4% white) whose records included the ICD-10-CM code E88.4. We also identified a propensity-matched cohort of 705 patients without mitochondrial disease to examine the effect of mitochondrial disease on major adverse cardiovascular events, including all-cause in-hospital death, cardiac arrest, and …

Sustained Use Of The Impella 50 Heart Pump Enables Bridge To Clinical Decisions In 34 Patients, Daniel W Nelson, Sakthi Sundararajan, Evan Klein, Lyle D Joyce, Lucian A Durham, David L Joyce, Asim A Mohammed

The Texas Heart Institute Journal

We studied whether sustained hemodynamic support (>7 d) with the Impella 5.0 heart pump can be used as a bridge to clinical decisions in patients who present with cardiogenic shock, and whether such support can improve their outcomes. We retrospectively reviewed cases of patients who had Impella 5.0 support at our hospital from August 2017 through May 2019. Thirty-four patients (23 with cardiogenic shock and 11 with severely decompensated heart failure) underwent sustained support for a mean duration of 11.7 ± 9.3 days (range, ≤48 d). Of 29 patients (85.3%) who survived to next therapy, 15 were weaned from …

Sex-Related Disparities In Cardiovascular Health Care Among Patients With Premature Atherosclerotic Cardiovascular Disease, Michelle T Lee, Dhruv Mahtta, David J Ramsey, Jing Liu, Arunima Misra, Khurram Nasir, Zainab Samad, Dipti Itchhaporia, Safi U Khan, Richard S Schofield, Christie M Ballantyne, Laura A Petersen, Salim S Virani

Faculty, Staff and Students Publications

IMPORTANCE: There is a paucity of data regarding secondary prevention care disparities in women with premature and extremely premature atherosclerotic cardiovascular disease (ASCVD), defined as an ASCVD event at 55 years or younger and 40 years or younger, respectively.

OBJECTIVE: To evaluate sex-based differences in antiplatelet agents, any statin, high-intensity statin (HIS) therapy, and statin adherence in patients with premature and extremely premature ASCVD.

DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional, multicenter, nationwide VA health care system-based study with patients enrolled in the Veterans With Premature Atherosclerosis (VITAL) registry. The study assessed patients who had at least 1 primary …

The New (Version 9) American Joint Committee On Cancer Tumor, Node, Metastasis Staging For Cervical Cancer, Alexander B Olawaiye, Thomas P Baker, M Kay Washington, David G Mutch

2020-Current year OA Pubs

The American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) staging for all cancer sites has been periodically updated as a published manual for many years. The last update, the eighth edition AJCC Cancer Staging Manual went into use on January 1, 2018. The AJCC has since restructured and updated its processes, and all AJCC staging-related data are now housed on its new application programming interface. Consequently, the next AJCC TNM staging update, AJCC version 9 TNM staging, will be published electronically and will be released chapter by chapter. The first chapter of version 9 AJCC TNM staging is …

The Option Value Of Municipal Liquidity: Evidence From Federal Lending Cutoffs During Covid-19, Andrew Haughwout, Benjamin J. Hyman, Or Shachar

Documents

No abstract provided.

Responding To The Call: Building A Training Program To Diversify The Academy In Alzheimer's Disease Research, Lucy Annang Ingram Phd, Mph, Marvella E. Ford, Christiana L. Johnson, Brianna Ashford-Carroll, Quentun Mccollum, Daniela B. Friedman Ph.D., Sue Ellen Levkoff

Faculty and Staff Publications

Alzheimer's disease and related dementias (ADRD) are at the forefront of the United States (US) public health agenda due to their tremendous human and financial burden. Further, disproportionately high ADRD rates among racial/ethnic minorities require incorporating the unique perspectives of racially and ethnically diverse scientists, which will necessitate diversifying the scientific workforce that investigates disparities in aging. The purpose of this paper is to describe the training and mentorship initiatives of the National Institute on Aging (NIA)-funded Carolina Center on Alzheimer's Disease and Minority Research, emphasizing lessons learned from our engagement with underrepresented minority and minoritized (URM) Scientists. We highlight …

Resistance Exercise, Alone And In Combination With Aerobic Exercise, And Obesity In Dallas, Texas, Us: A Prospective Cohort Study, Angelique G. Brellenthin, Duck-Chul Lee, Jason A. Bennie, Xuemei (Mei) Sui M.D., M.P.H., Ph.D., Steven N. Blair

Faculty Publications

Background

Obesity is a significant and growing public health problem in high-income countries. Little is known about the relationship between resistance exercise (RE), alone and in combination with aerobic exercise (AE), and the risk of developing obesity. The purpose of this prospective cohort study was to examine the associations between different amounts and frequencies of RE, independent of AE, and incident obesity.

Methods and findings

Participants were 11,938 healthy adults ages 18–89 years with a BMI < 30 kg/m2 at baseline who completed at least 2 clinical examinations during 1987–2005 as part of the Aerobics Center Longitudinal Study. Self-reported RE participation in minutes/week and days/week was collected from a standardized questionnaire. Incident obesity was defined as a BMI ≥ 30 kg/m2 at follow-up. Incident obesity was also defined by waist circumference (WC) > 102/88 cm for men/women and percent body fat (PBF) ≥ 25%/30% for men/women at follow-up in participants who were not obese by WC (n …

The Federal Reserve's Response To The Coronavirus Pandemic, Jerome Powell

Documents

No abstract provided.

Resident Opinions Of Diabetes Management In Training: A Survey., Amber M Healy, Jarrod L Uhrig, Jay H Shubrook, Nay Linn Aung, Archana R Sadhu

Medical Education Articles

CONTEXT: Primary care physicians need a strong foundation in diabetes management, as they are the first line of care for patients with this complex disease, which is increasing in frequency in the United States. This foundational training begins in medical school, but its applications become more important during residency.

OBJECTIVES: To quantify osteopathic and allopathic family medicine residents' amount of exposure to diabetes in residency training, investigate referral patterns related to diabetes management, and assess comfort levels with various diabetes treatment modalities.

METHODS: An 18-item cross sectional survey was sent via email using Qualtrics to program directors and chief residents …

Designing The Main Street Lending Program: Challenges And Options, William "Bill" English, Nellie Liang

Documents

No abstract provided.

Dietary Fiber Intake, The Gut Microbiome, And Chronic Systemic Inflammation In A Cohort Of Adult Men, Wenjie Ma, Yin Cao, Et Al.

2020-Current year OA Pubs

BACKGROUND: A higher intake of dietary fiber is associated with a decreased risk of chronic inflammatory diseases such as cardiovascular disease and inflammatory bowel disease. This may function in part due to abrogation of chronic systemic inflammation induced by factors such as dysbiotic gut communities. Data regarding the detailed influences of long-term and recent intake of differing dietary fiber sources on the human gut microbiome are lacking.

METHODS: In a cohort of 307 generally healthy men, we examined gut microbiomes, profiled by shotgun metagenomic and metatranscriptomic sequencing, and long-term and recent dietary fiber intake in relation to plasma levels of …

The Aric (Atherosclerosis Risk In Communities) Study: Jacc Focus Seminar 3/8, Jacqueline D Wright, Aaron R Folsom, Josef Coresh, A Richey Sharrett, David Couper, Lynne E Wagenknecht, Thomas H Mosley, Christie M Ballantyne, Eric A Boerwinkle, Wayne D Rosamond, Gerardo Heiss

Faculty, Staff and Student Publications

ARIC (Atherosclerosis Risk In Communities) initiated community-based surveillance in 1987 for myocardial infarction and coronary heart disease (CHD) incidence and mortality and created a prospective cohort of 15,792 Black and White adults ages 45 to 64 years. The primary aims were to improve understanding of the decline in CHD mortality and identify determinants of subclinical atherosclerosis and CHD in Black and White middle-age adults. ARIC has examined areas including health disparities, genomics, heart failure, and prevention, producing more than 2,300 publications. Results have had strong clinical impact and demonstrate the importance of population-based research in the spectrum of biomedical research …

Temporal Trends In Suicidal Ideation And Attempts Among Us Adolescents By Sex And Race/Ethnicity, 1991-2019, Yunyu Xiao, Julie Cerel, J. John Mann

Social Work Faculty Publications

Importance: Disparities by sex and racial/ethnic group in suicide death rates are present in US adolescents. Whether disparities in suicide death extend to groups targeted for suicide prevention efforts, namely, those with suicidal ideation or nonfatal suicide attempts, is unknown.

Objective: To examine differences in temporal trends between suicidal ideation and suicide attempts in US adolescents from 1991 through 2019 by sex and race/ethnicity subgroups.

Design, Setting, and Participants: A cross-sectional analysis of the national Youth Risk Behavior Survey, weighted to represent US adolescents from 1991 to 2019, included 183 563 US high-school students in grades 9 to 12. Data …

Integrated Omics Endotyping Of Infants With Respiratory Syncytial Virus Bronchiolitis And Risk Of Childhood Asthma., Yoshihiko Raita, Marcos Pérez-Losada, Robert J. Freishtat, Brennan Harmon, Jonathan M Mansbach, Pedro A Piedra, Zhaozhong Zhu, Carlos A Camargo, Kohei Hasegawa

Pediatrics Faculty Publications

Respiratory syncytial virus (RSV) bronchiolitis is not only the leading cause of hospitalization in U.S. infants, but also a major risk factor for asthma development. While emerging evidence suggests clinical heterogeneity within RSV bronchiolitis, little is known about its biologically-distinct endotypes. Here, we integrated clinical, virus, airway microbiome (species-level), transcriptome, and metabolome data of 221 infants hospitalized with RSV bronchiolitis in a multicentre prospective cohort study. We identified four biologically- and clinically-meaningful endotypes: A) clinical

Covid-19 Treatment Combinations And Associations With Mortality In A Large Multi-Site Healthcare System., Dagan Coppock, Michael Baram, Anna Marie Chang, Patricia Henwood, Alan Kubey, Ross Summer, John Zurlo, Michael Li, Bryan Hess

Division of Infectious Diseases and Environmental Medicine Faculty Papers

INTRODUCTION: During the early months of the COVID-19 pandemic, mortality associated with the disease declined in the United States. The standard of care for pharmacological interventions evolved during this period as new and repurposed treatments were used alone and in combination. Though these medications have been studied individually, data are limited regarding the relative impact of different medication combinations. The objectives of this study were to evaluate the association of COVID-19-related mortality and observed medication combinations and to determine whether changes in medication-related practice patterns and measured patient characteristics, alone, explain the decline in mortality seen early in the COVID-19 …

Challenges For Higher Education In Times Of Covid-19: How Three Countries Have Responded, Robert L. Funk

Higher Learning Research Communications

The COVID-19 pandemic brings to the fore strengths and weaknesses in many public policies, including higher education. There are at least three separate but related areas where institutions of higher learning have been stressed by COVID-19: financing, issues related to the logistics of learning, and inequality. These problems are especially pronounced in countries that suffer from high levels of inequality, such as Chile. This editorial offers a review of some of these challenges and their implication for long-term education policy, touching on the cases of Chile, Canada, and the United States.

Trends In Venous Thromboembolism Anticoagulation In Patients Hospitalized With Covid-19, Valerie M. Vaughn, Monica Yost, Chelsea Abshire, Scott A. Flanders, David Paje, Paul Grant, Scott Kaatz, Tae Kim, Geoffrey D. Barnes

Hospital Medicine Articles

Importance: Venous thromboembolism (VTE) is a common complication of COVID-19. It is not well understood how hospitals have managed VTE prevention and the effect of prevention strategies on mortality.

Objective: To characterize frequency, variation across hospitals, and change over time in VTE prophylaxis and treatment-dose anticoagulation in patients hospitalized for COVID-19, as well as the association of anticoagulation strategies with in-hospital and 60-day mortality.

Design, Setting, and Participants: This cohort study of adults hospitalized with COVID-19 used a pseudorandom sample from 30 US hospitals in the state of Michigan participating in a collaborative quality initiative. Data analyzed were from patients …

The Local Accountability Journalism Tracker, Sandy Mui

Dissertations, Theses, and Capstone Projects

The Local Accountability Journalism Tracker curates local news stories in the United States that resulted in substantial accountability or change. Published on a Tumblr website, each local news story includes a blurb detailing what the story was about as well as the accountability or change that followed the story’s publication. News stories must meet the following criteria for inclusion:

1. Be published by a news outlet in the United States;
2. Cover a social issue or criminal activity at the local level;[1]
3. Lead to heightened awareness (whether local, national, or international) in the general public about the social issue or criminal …

From Poor Campesinos To Tortilla Kings: Mexican Migrant Elites, Yesenia Ruiz

Dissertations, Theses, and Capstone Projects

This dissertation analyzes a recent transnational Mexican migrant elite—a new social and economic group that emerged not from established elites or from privileged backgrounds, but from poor campesino families. Members of this group migrated to the U.S. from Mexico during the 1980s. The majority of these (male) entrepreneur migrants crossed the border as mojados without passports or money. Over a period of thirty years, these migrants have accumulated an unprecedented amount of wealth and, thereby, gain prestige and status within their communities. Successful in both the US and Mexico, these entrepreneurs are distinct from other transnational migrant groups. They have …

Outcomes And Risk Factors Associated With Sars-Cov-2 Infection In A North American Registry Of Patients With Multiple Sclerosis, Amber Salter, Robert J Fox, Scott D Newsome, June Halper, David K B Li, Pamela Kanellis, Kathleen Costello, Bruce Bebo, Kottil Rammohan, Gary R Cutter, Anne H Cross

2020-Current year OA Pubs

Importance: Emergence of SARS-CoV-2 causing COVID-19 prompted the need to gather information on clinical outcomes and risk factors associated with morbidity and mortality in patients with multiple sclerosis (MS) and concomitant SARS-CoV-2 infections.

Objective: To examine outcomes and risk factors associated with COVID-19 clinical severity in a large, diverse cohort of North American patients with MS.

Design, Setting, and Participants: This analysis used deidentified, cross-sectional data on patients with MS and SARS-CoV-2 infection reported by health care professionals in North American academic and community practices between April 1, 2020, and December 12, 2020, in the COVID-19 Infections in MS Registry. …

A Helping Hand To Main Street Where And When It Was Needed, Falk Br¤Uning, Josè L. Fillat, Christina J. Wang

Documents

No abstract provided.

United Nations At 75 And The Challenges Facing International Law, Ved Nanda

Pace International Law Review

On September 21, 2020, the Member States celebrated the seventy-fifth anniversary of the founding of the United Nations. In the Declaration marking the occasion, world leaders recounted the achievements of the body, including catalyzing decolonization, promoting and protecting human rights, working to eradicate disease, helping mitigate dozens of conflicts, and saving lives through humanitarian action. They also enumerated challenges the world faces, such as “growing inequality, poverty, hunger, armed conflicts, terrorism, insecurity, climate change, and pandemics.” These challenges, the Declaration said, are interconnected and can only be addressed through reinvigorated multilateralism, which, it emphasized, “is not an option but a …

Covid-19 Pandemic, The World Health Organization, And Global Health Policy, Cosmas Emeziem

Pace International Law Review

The emergence and quick spread of the COVID-19 pandemic has shifted the focus and dynamics of the debates about global health, international law, and policy. This shift has overshadowed many of the other controversies in the international sphere. It has also highlighted the tensions that often exist in international affairs—especially in understanding the place and purpose of international institutions, vis-à-vis states, in the general schema of public international law. Central to the international response to the current pandemic is the World Health Organization (WHO)—a treaty-based organization charged with the overarching mandate of ensuring “the highest possible level of health” for …

Global Journey To Post-Pandemic Normalcy And Revival, Andrzej Sankowski

Journal of Global Awareness

After a year of COVID-19, countries, societies, and individuals are longing for normalcy and beginning to consider what life will be like post-pandemic. Efforts and experiences of countries in the European Union, Asia, Asia-Pacific, Australia, Africa, Latin America, the Caribbean, and the United States are examined as they face challenges to end the pandemic and prepare for the post-pandemic reality. What will be the post-pandemic "new normalcy"? What changes caused by the pandemic are permanent in societies and the world? What are the necessary reforms that have to take place as part of normalcy? Reflections on the impacts of vaccinations, …

Public Discourse On Migration In Germany And The United States Before And After 2015: Racist Media Narratives In The Global Right, Amy Chang

Senior Theses

Within the past decade, migration has become an increasingly controversial subject in Western countries, producing a right-wing and nationalist backlash. In Europe, Germany became the core of the Syrian refugee crisis in 2015 and gained global attention for Chancellor Angela Merkel’s open-door policy towards refugees. This substantial influx of refugees into the country caused a sharp discursive shift regarding migrants and refugees in the German media during and after 2015. At the same time, Donald Trump announced his eventually successful presidential campaign by cultivating a starkly anti-immigrant platform, which generated disproportionate media attention for his campaign and intensified anti-immigrant rhetoric …

Phenotypic And Genomic Profiling Of Staphylococcus Argenteus In Canada And The United States And Recommendations For Clinical Result Reporting, Alireza Eshaghi, Carl Bommersbach, Sandra Zittermann, C A Burnham, Robin Patel, Audrey N Schuetz, Samir N Patel, Julianne V Kus

Open Access Publications

No abstract provided.

Electronic Clinical Decision Support For Children With Minor Head Trauma And Intracranial Injuries: A Sociotechnical Analysis, Jacob K Greenberg, Ayodamola Otun, Azzah Nasraddin, Ross C Brownson, Nathan Kuppermann, David D Limbrick, Po-Yin Yen, Randi E Foraker

2020-Current year OA Pubs

BACKGROUND: Current management of children with minor head trauma (MHT) and intracranial injuries is not evidence-based and may place some children at risk of harm. Evidence-based electronic clinical decision support (CDS) for management of these children may improve patient safety and decrease resource use. To guide these efforts, we evaluated the sociotechnical environment impacting the implementation of electronic CDS, including workflow and communication, institutional culture, and hardware and software infrastructure, among other factors.

METHODS: Between March and May, 2020 semi-structured qualitative focus group interviews were conducted to identify sociotechnical influences on CDS implementation. Physicians from neurosurgery, emergency medicine, critical care, …