Digital Commons Network^™

Racial Differences In Treatment And Survival Among Older Patients With Multiple Myeloma, Rong Wang, Natalia Neparidze, Xiaomei Ma, Graham A Colditz, Su-Hsin Chang, Shi-Yi Wang

2020-Current year OA Pubs

BACKGROUND: Treatments for multiple myeloma (MM) have evolved over time and improved MM survival. While racial differences in MM treatment and prognosis between non-Hispanic African American (NHAA) and non-Hispanic White (NHW) patients are well-established, it is unclear whether they have persisted after the introduction of novel agents.

METHODS: Using the Surveillance, Epidemiology, and End Results-Medicare linked database, our study investigated racial difference in the receipt of treatment within 1 year following diagnosis and assessed survival outcomes among Medicare beneficiaries (≥66 years) diagnosed with MM from 2007 to 2017. We applied multivariable Cox proportional hazards models to estimate the association between …

Strategies For Secondary Use Of Real-World Clinical And Administrative Data For Outcome Ascertainment In Pragmatic Clinical Trials, Cynthia Hau, Patricia A Woods, Amanda S Guski, Srihari I Raju, Liang Zhu, Patrick R Alba, William C Cushman, Peter A Glassman, Areef Ishani, Addison A Taylor, Ryan E Ferguson, Sarah M Leatherman

Faculty, Staff and Students Publications

Background: Pragmatic trials are gaining popularity as a cost-effective way to examine treatment effectiveness and generate timely comparative evidence. Incorporating supplementary real-world data is recommended for robust outcome monitoring. However, detailed operational guidelines are needed to inform effective use and integration of heterogeneous databases.

Objective: Lessons learned from the Veterans Affairs (VA) Diuretic Comparison Project (DCP) are reviewed, providing adaptable recommendations to capture clinical outcomes from real-world data.

Methods: Non-cancer deaths and major cardiovascular (CV) outcomes were determined using VA, Medicare, and National Death Index (NDI) data. Multiple ascertainment strategies were applied, including claims-based algorithms, natural language processing, and systematic …

Improving Veteran Engagement With Virtual Care Technologies: A Veterans Health Administration State Of The Art Conference Research Agenda, Taona P Haderlein, Jenice Guzman-Clark, Navid S Dardashti, Nicholas Mcmahon, Elizabeth L Duran, Jolie N Haun, Stephanie A Robinson, Amanda C Blok, Sarah L Cutrona, Jan A Lindsay, Christina M Armstrong, Kim M Nazi, Stephanie L Shimada, Nancy R Wilck, Erin Reilly, Eric Kuhn, Timothy P Hogan

Faculty, Staff and Students Publications

Although the availability of virtual care technologies in the Veterans Health Administration (VHA) continues to expand, ensuring engagement with these technologies among Veterans remains a challenge. VHA Health Services Research & Development convened a Virtual Care State of The Art (SOTA) conference in May 2022 to create a research agenda for improving virtual care access, engagement, and outcomes. This article reports findings from the Virtual Care SOTA engagement workgroup, which comprised fourteen VHA subject matter experts representing VHA clinical care, research, administration, and operations. Workgroup members reviewed current evidence on factors and strategies that may affect Veteran engagement with virtual …

Stability And Crisis Response: Comparing The U.S. And Canadian Banking Systems, Sarah E. Boslaugh

Undergraduate Research Symposium

In 2007-08, the United States experienced a banking crisis, as 5 of the 6 other G-7 countries. The exception? Canada, which experienced only a mild recession, with no bank failures or government bank bailouts. Further research reveals that while banking crises have been commonplace in the United States (8 occurred in the 19th century alone), they are essentially nonexistent in Canadian history. I find that the primary reasons for these differences in national experience lie not in the strictness of government regulation or the qualifications demanded of borrowers in the two countries, but in the differing structures of the banking …

The 1904 World’S Fair: Intended Impact Of The U.S. Government Building Versus Visitor Experience, Dalton King

Undergraduate Research Symposium

The 1904 Saint Louis World’s Fair, known as the Louisiana Purchase Exposition, has long been known for its significant impact on America and the world. This research explores the intended purpose of the 1904 World’s Fair’s United States Government Building and its exhibits of the War and Navy Departments. Furthermore, this analysis investigates the visitor experience of the Government Building’s characteristics and exhibits. During the Progressive Era, American society was undergoing a significant paradigm shift through countless evolutions in industry, technology, and culture, and this research contextualizes historical study of the time. Though the recent body of literature revolves around …

Cardiovascular Health Assessment In Routine Cancer Follow-Up In Community Settings: Survivor Risk Awareness And Perspectives, Kathryn E Weaver, Emily V Dressler, Sydney Smith, Chandylen L Nightingale, Heidi D Klepin, Simon Craddock Lee, Brian J Wells, W Gregory Hundley, Joseph A Demari, Sarah N Price, Randi E Foraker

2020-Current year OA Pubs

BACKGROUND: Guidelines recommend cardiovascular risk assessment and counseling for cancer survivors. For effective implementation, it is critical to understand survivor cardiovascular health (CVH) profiles and perspectives in community settings. We aimed to (1) Assess survivor CVH profiles, (2) compare self-reported and EHR-based categorization of CVH factors, and (3) describe perceptions regarding addressing CVH during oncology encounters.

METHODS: This cross-sectional analysis utilized data from an ongoing NCI Community Oncology Research Program trial of an EHR heart health tool for cancer survivors (WF-1804CD). Survivors presenting for routine care after potentially curative treatment recruited from 8 oncology practices completed a pre-visit survey, including …

Investment Company Act Of 1940 - 270.22e-3 Exemption For Liquidation Of Money Market Funds., United States: Securities And Exchange Commission (Sec)

Documents

No abstract provided.

“It’S Not That We Care Less”: Insights Into Health Care Utilization For Comorbid Diabetes And Depression Among Latinos, Sharon Borja, Miriam G. Valdovinos, Kenia M. Rivera, Natalia Giraldo-Santiago, Robin Gearing, Luis R. Torres-Hostos

School of Social Work Faculty Publications

Despite robust knowledge regarding the socio-economic and cultural factors affecting Latino* access to healthcare, limited research has explored service utilization in the context of comorbid conditions like diabetes and depression. This qualitative study, embedded in a larger mixed-methods project, aimed to investigate perceptions held by Latinos and their social support systems (i.e., family members) regarding comorbid diabetes and depression and to identify barriers and facilitators to their help-seeking behaviors and treatment engagement. Bilingual and bicultural researchers conducted eight focus groups with 94 participants in a large U.S. metropolitan area and were primarily conducted in Spanish. The participants either had a …

It's Not That We Care Less: Insights Into Health Care Utilization For Comorbid Diabetes And Depression Among Latinos, Sharon Borja, Miriam G Valdovinos, Kenia M Rivera, Natalia Giraldo-Santiago, Robin E Gearing, Luis R Torres

Faculty, Staff and Student Publications

Despite robust knowledge regarding the socio-economic and cultural factors affecting Latino* access to healthcare, limited research has explored service utilization in the context of comorbid conditions like diabetes and depression. This qualitative study, embedded in a larger mixed-methods project, aimed to investigate perceptions held by Latinos and their social support systems (i.e., family members) regarding comorbid diabetes and depression and to identify barriers and facilitators to their help-seeking behaviors and treatment engagement. Bilingual and bicultural researchers conducted eight focus groups with 94 participants in a large U.S. metropolitan area and were primarily conducted in Spanish. The participants either had a …

Longitudinal Varying Coefficient Single-Index Model With Censored Covariates, Shikun Wang, Jing Ning, Ying Xu, Ya-Chen Tina Shih, Yu Shen, Liang Li

Faculty, Staff and Student Publications

It is of interest to health policy research to estimate the population-averaged longitudinal medical cost trajectory from initial cancer diagnosis to death, and understand how the trajectory curve is affected by patient characteristics. This research question leads to a number of statistical challenges because the longitudinal cost data are often non-normally distributed with skewness, zero-inflation, and heteroscedasticity. The trajectory is nonlinear, and its length and shape depend on survival, which are subject to censoring. Modeling the association between multiple patient characteristics and nonlinear cost trajectory curves of varying lengths should take into consideration parsimony, flexibility, and interpretation. We propose a …

Virology-The Path Forward, Angela L Rasmussen, Gigi K Gronvall, Anice C Lowen, Felicia Goodrum, James Alwine, Kristian G Andersen, Simon J Anthony, Joel Baines, Arinjay Banerjee, Andrew J Broadbent, Christopher B Brooke, Samuel K Campos, Patrizia Caposio, Arturo Casadevall, Gary C Chan, Anna R Cliffe, Donna Collins-Mcmillen, Nancy Connell, Blossom Damania, Matthew D Daugherty, Kari Debbink, Terence S Dermody, Daniel Dimaio, W Paul Duprex, Michael Emerman, Denise A Galloway, Robert F Garry, Stephen A Goldstein, Alexander L Greninger, Amy L Hartman, Brenda G Hogue, Stacy M Horner, Peter J Hotez, Jae U Jung, Jeremy P Kamil, Stephanie M Karst, Lou Laimins, Seema S Lakdawala, Igor Landais, Michael Letko, Brett Lindenbach, Shan-Lu Liu, Micah Luftig, Grant Mcfadden, Andrew Mehle, Juliet Morrison, Anne Moscona, Elke Mühlberger, Joshua Munger, Karl Münger, Eain Murphy, Christopher J Neufeldt, Janko Z Nikolich, Christine M O'Connor, Andrew Pekosz, Sallie R Permar, Julie K Pfeiffer, Saskia V Popescu, John G Purdy, Vincent R Racaniello, Charles M Rice, Jonathan A Runstadler, Martin J Sapp, Rona S Scott, Gregory A Smith, Erin M Sorrell, Emily Speranza, Daniel Streblow, Scott A Tibbetts, Zsolt Toth, Koenraad Van Doorslaer, Susan R Weiss, Elizabeth A White, Timothy M White, Christiane E Wobus, Michael Worobey, Satoko Yamaoka, Andrew Yurochko

Faculty, Staff and Students Publications

In the United States (US), biosafety and biosecurity oversight of research on viruses is being reappraised. Safety in virology research is paramount and oversight frameworks should be reviewed periodically. Changes should be made with care, however, to avoid impeding science that is essential for rapidly reducing and responding to pandemic threats as well as addressing more common challenges caused by infectious diseases. Decades of research uniquely positioned the US to be able to respond to the COVID-19 crisis with astounding speed, delivering life-saving vaccines within a year of identifying the virus. We should embolden and empower this strength, which is …

How Fears Of Ai In The Classroom Reflect Anxieties About Choosing Sophistry Over True Knowledge In The American Education System, David Arellano Smith

Critical Humanities

The rise of ChatGPT has educators across the United States of America worried about scholastic integrity like never before. This paper argues, however, that underneath this initial concern lies an even greater one, that the education system in the United States so closely resembles the style of teaching used by the sophists in Ancient Greece that it has ultimately failed to cultivate critical thinking skills in America’s youth, so much so that ChatGPT has become a far greater issue than it ever needed to be. The practice of ‘teaching to the test’ and the commodification of education, which is akin …

The Court System Needs To Change To Meet The Asylum Needs Of Deserving Immigrants, Kallin Kelley

Research on Capitol Hill

Immigrants have always been fundamental to the United States’ success. Mia Love, a former U.S. congresswoman, once stated, “behind closed doors, every legislator will tell you that immigration is a good thing.” Immigration is vital to the success of the country and ensuring that our systems are capable of adequately and fairly managing immigration is vital. Immigration courts, however, are ill-equipped to do so.

Us Prepares Rule Forcing Banks To Tap Fed Discount Window, Katanga Johnson

Documents

No abstract provided.

Analysis Of Breast Cancer Mortality In The Us-1975 To 2019, Jennifer L Caswell-Jin, Liyang P Sun, Diego Munoz, Ying Lu, Yisheng Li, Hui Huang, John M Hampton, Juhee Song, Jinani Jayasekera, Clyde Schechter, Oguzhan Alagoz, Natasha K Stout, Amy Trentham-Dietz, Sandra J Lee, Xuelin Huang, Jeanne S Mandelblatt, Donald A Berry, Allison W Kurian, Sylvia K Plevritis

Faculty, Staff and Student Publications

IMPORTANCE: Breast cancer mortality in the US declined between 1975 and 2019. The association of changes in metastatic breast cancer treatment with improved breast cancer mortality is unclear.

OBJECTIVE: To simulate the relative associations of breast cancer screening, treatment of stage I to III breast cancer, and treatment of metastatic breast cancer with improved breast cancer mortality.

DESIGN, SETTING, AND PARTICIPANTS: Using aggregated observational and clinical trial data on the dissemination and effects of screening and treatment, 4 Cancer Intervention and Surveillance Modeling Network (CISNET) models simulated US breast cancer mortality rates. Death due to breast cancer, overall and by …

Chagas Disease Diagnostic Practices At Four Major Hospital Systems In California And Texas, Emily A Kelly, Jose I Echeverri Alegre, Katherine Promer, Jesica Hayon, Roumen Iordanov, Khuzaima Rangwalla, Jerry J Zhang, Zian Fang, Cindy Huang, Cassiana E Bittencourt, Sharon Reed, Rosa M Andrade, Caryn Bern, Eva H Clark, Jeffrey D Whitman

Faculty, Staff and Students Publications

BACKGROUND: Chagas disease (CD) is a parasitic disease that affects ∼300 000 people living in the United States. CD leads to cardiac and/or gastrointestinal disease in up to 30% of untreated people. However, end-organ damage can be prevented with early diagnosis and antiparasitic therapy.

METHODS: We reviewed electronic health records of patients who underwent testing for CD at four hospital systems in California and Texas between 2016 and 2020. Descriptive analyses were performed as a needs assessment for improving CD diagnosis.

RESULTS: In total, 470 patients were tested for CD. Cardiac indications made up more than half (60%) of all …

Regional Variability In The Prevalence Of Food Insecurity And Diet Quality Among United States Children, Jayna M Dave, Tzuan A Chen, Alexandra N Castro, Mamie White, Elizabeth A Onugha, Sloane Zimmerman, Debbe Thompson

Children’s Nutrition Research Center Staff Publications

Understanding the association between food security status (FSS) and diet quality in children is crucial. This study investigated regional variability in FSS, participation in the federal nutrition assistance program (FNAP), and diet quality among US children. National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2016 were analyzed. The association between FSS, FNAP participation, and diet quality (Healthy Eating Index—HEI-2015) was assessed using multiple linear/logistic regression models. The sample included 6403 children (mean age: 7.5 years; 51% male; 33% Hispanic). Within the sample, 13% reported child food insecurity, and 30% reported household food insecurity. Additionally, 90% participated in …

County-Level Trends And Potential Disparities In The Suicide Rates In Virginia, 2020 – 2022, Sharon A. Olowoyo, Oluwatosin M. Oduneye, Glodi B. Bokanya, Ayooluwa G. Olowoyo, Coralie E. Mugenga, Yuhan Yan, Robyn L. Anderson

Montview Journal of Research & Scholarship

Abstract

Objectives

This study aims to investigate the influence of social determinants of health (SDH) on suicide patterns in the state of Virginia.

Methods

A secondary statistical analysis was conducted using publicly accessible data from the County Health Rankings & Roadmaps database for Virginia. Data from 2020 to 2022 were analyzed, focusing on age-adjusted suicide rates and SDH factors, including % rural, mental health provider rate, median household income, high school completion, and unemployment rates. Multiple regression analysis and visualizations were employed for data interpretation.

Results

The analysis revealed that SDH factors significantly predicted suicide rates across the study period. …

Additional Information On Other Credit Extensions, Federal Reserve System

Documents

No abstract provided.

Effect Of Acupuncture Vs Sham Acupuncture On Patients With Poststroke Motor Aphasia: A Randomized Clinical Trial, Boxuan Li, Shizhe Deng, Bifang Zhuo, Bomo Sang, Junjie Chen, Menglong Zhang, Guang Tian, Lili Zhang, Yuzheng Du, Peng Zheng, Gonglei Yue, Zhihong Meng

Faculty, Staff and Student Publications

IMPORTANCE: Motor aphasia is common among patients with stroke. Acupuncture is recommended as an alternative therapy for poststroke aphasia, but its efficacy remains uncertain.

OBJECTIVE: To investigate the effects of acupuncture on language function, neurological function, and quality of life in patients with poststroke motor aphasia.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter, sham-controlled, randomized clinical trial was conducted in 3 tertiary hospitals in China from October 21, 2019, to November 13, 2021. Adult patients with poststroke motor aphasia were enrolled. Data analysis was performed from February to April 2023.

INTERVENTIONS: Eligible participants were randomly allocated (1:1) to manual acupuncture (MA) …

Collateral Effects Of Covid-19 Stay-At-Home Orders On Violence Against Women In The United States, January 2019 To December 2020, Patricia C. Lewis, Yuk F. Cheong, Nadine J. Kaslow, Kathryn M. Yount

Health Science Faculty Publications

Background: The necessary execution of non-pharmaceutical risk-mitigation (NPRM) strategies to reduce the transmission of COVID-19 has created an unprecedented natural experiment to ascertain whether pandemic-induced social-policy interventions may elevate collateral health risks. Here, we assess the efects on violence against women (VAW) of the duration of NPRM measures that were executed through jurisdictional-level orders in the United States. We expect that stay-at-home orders, by reducing mobility and disrupting non-coresident social ties, are associated with higher incident reporting of VAW.

Methods: We used aggregate data from the Murder Accountability Project from January 2019 through December 2020, to estimate count models examining …

Pediatric Medical Subspecialist Use In Outpatient Settings, Christopher B Forrest, Candice P Chen, Eliana M Perrin, Christopher J Stille, Ruth Cooper, Katherine Harris, Qian Luo, Mitchell G Maltenfort, Lauren E Parlett

Faculty, Staff and Student Publications

Importance

A first step toward understanding whether pediatric medical subspecialists are meeting the needs of the nation’s children is describing rates of use and trends over time.

Objectives

To quantify rates of outpatient pediatric medical subspecialty use.

Design, Setting, and Participants

This repeated cross-sectional study of annual subspecialist use examined 3 complementary data sources: electronic health records from PEDSnet (8 large academic medical centers [January 1, 2010, to December 31, 2021]); administrative data from the Healthcare Integrated Research Database (HIRD) (14 commercial health plans [January 1, 2011, to December 31, 2021]); and administrative data from the Transformed Medicaid Statistical Information …

Cost-Effectiveness Of Icosapent Ethyl In Reduce-It Usa: Results From Patients Randomized In The United States, William S Weintraub, Deepak L Bhatt, Zugui Zhang, Sarahfaye Dolman, William E Boden, Adam P Bress, Brandon K Bellows, Catherine G Derington, Sephy Philip, Gabriel Steg, Michael Miller, Eliot A Brinton, Terry A Jacobson, Jean-Claude Tardif, Christie M Ballantyne, Paul Kolm

Faculty, Staff and Students Publications

Background: In 3146 REDUCE-IT USA (Reduction of Cardiovascular Events With Icosapent Ethyl Intervention Trial USA) participants, icosapent ethyl (IPE) reduced first and total cardiovascular events by 31% and 36%, respectively, over 4.9 years of follow-up.

Methods and results: We used participant-level data from REDUCE-IT USA, 2021 US costs, and IPE costs ranging from $4.59 to $11.48 per day, allowing us to examine a range of possible medication costs. The in-trial analysis was participant-level, whereas the lifetime analysis used a Markov model. Both analyses considered value from a US health sector perspective. The incremental cost-effectiveness ratio (incremental costs divided by incremental …

No Balancing For Anti-Constitutional Government Conduct, Bruce Ledewitz

Ledewitz Papers

Published scholarship collected from academic journals, law reviews, newspaper publications & online periodicals

High Suicide Rates Among Young Adults In The United States, Glory Thomas

Ballard Brief

The United States has a much higher suicide rate than other developed countries with an average of 14.5 deaths by suicide per 100,000 people per year. By contrast, the majority of countries across Europe, South America, and Asia report substantially lower rates, typically falling below 10 deaths per 100,000 people each year. Suicide is the second leading cause of death for young adults in the United States. Suicide is a public health crisis and is caused by multiple factors like untreated mental illness, individual attitudes towards suicide, and socio-economic status. Suicide leads to the negative consequence of suicide copycats, or …

The Overconsumption Of Ultra-Processed Foods In The United States, Emily Grover

Ballard Brief

The consumption of ultra-processed foods (UPFs) in America is at an all-time high, with over 50% of daily calories eaten being sourced from UPFs. The increase of consumption of UPFs is due to the growing population, urbanization, and industrialization. UPFs lead to declines in the physical health and mental health of the US population, as those who consume higher amounts of UPFs are more likely to be depressed, overweight, and have a higher all-cause mortality risk. The production of ultra-processed foods also disrupts the health of the climate due to unsustainable farming and livestock practices. The best practices for alleviating …

The Link Between Social Media And Body Image Issues Among Youth In The United States, James Krzymowski

Ballard Brief

Social media has a pervasive impact on body image in the United States, influencing one’s mental, physical, and social health. Body image issues encompass negative feelings and experiences related to one's physical appearance and are characterized by a preoccupation with perceived physical defects. This occurrence is especially common among youth. The harmful effects of constant exposure to idealized images, unrealistic beauty standards, and the influence of social media influencers are wide-ranging and severe. This brief focuses on the United States because of the competitive culture, the high cosmetic surgery rates, and leadership in social media use. Contributing factors such as …

Breaking The Bamboo Ceiling And De-Bunking The Model Minority Myth, Yun Saksena

Journal Articles: College of Dentistry

Leadership roles must incorporate representation from all involved individuals for the resulting decision-making process to reflect the interests and expertise of a diverse organization. Many resources have rightly focused on developing historically underrepresented racial and ethnic (HURE) leaders. Though numbers of Black and Hispanic dental school deans have increased, more work is needed for these and other HURE groups such as American Indians. Asians are not classified as HURE. As an aggregated group they have robust presence in the dental workforce in North America, the United Kingdom and Australia. The assumption is they are fine, so the group is ignored. …

Exploration Of Associations Between Asthma And Depression In Older American Adults: A Pooled Cross-Sectional Analysis Of Medicare Recipients, Brian Ring

Graduate Research Theses & Dissertations

Background

While unclear in older populations within the US, individuals with asthma are disproportionally affected by depression relative to those without asthma. This work explores the associations between asthma, depression, sociodemographic, and disease-related factors in a US population ≥ 65 years of age.

Methods

A pooled cross-sectional analysis of Medicare Current Beneficiary Survey (MCBS) data was utilized to determine the association between asthma and depression from 2018 to 2020. Depression was defined as a score of ≥ 10 from the Patient Health Questionnaire-9 (PHQ-9). Disease-related variables were recorded if the subject met Medicare claims criteria for the calendar year. Multivariable …

Multivariate Evaluation Of Flash Drought Across The United States, J. A. Otkin, Y. Zhong, T. W. Ford, M. C. Anderson, C. Hain, A. Hoell, Mark D. Svoboda, H. Wang

School of Natural Resources: Faculty Publications

No abstract provided.