Digital Commons Network^™

Orthopass: Long-Term Outcomes Following Implementation Of An Orthopaedic Patient Handoff Template., Harry Lightsey, Caleb Yeung, Laura Rossi, Antonia Chen, Mitchel Harris, Derek Stenquist

Rothman Institute Papers

Standardized handoff tools improve communication and patient care; however, their widespread use in surgical fields is lacking. OrthoPass, an orthopaedic adaptation of I-PASS, was developed in 2019 to address handoff concerns and demonstrated sustained improvements across multiple handoff domains over an 18-month period. We sought to characterize the longitudinal effect and sustainability of OrthoPass within a single large residency program 3.5 years after its implementation. This mixed methods study involved electronic handoff review for quality domains in addition to survey distribution and evaluation. We conducted comparative analyses of handoff adherence and survey questions as well as a thematic analysis of …

Breaking The Loop: Strategies For Fighting Climate Change On U.S. Farms, Ashley Barry

Honors Capstones

Climate change is an increasingly urgent area of research due to the hardships it causes for lands and communities across the globe. Specifically in regard to the United States (U.S.), climate change has many concerning implications on our agricultural system. Increased weather hazards, decreased crop production, and drought are just a few of the hardships American farmers are facing in their fight to keep their farms alive and feed their communities, despite a rapidly changing climate. This study investigates how farmers can fight and prevent climate change through the use of specific mitigation and adaptation strategies on their farms. Semi- …

Innovation Process And Industrial System Of Us Food And Drug Administration-Approved Software As A Medical Device: Review And Content Analysis, Jiakan Yu, Jiajie Zhang, Shintaro Sengoku

Faculty, Staff and Student Publications

BACKGROUND: There has been a surge in academic and business interest in software as a medical device (SaMD). SaMD enables medical professionals to streamline existing medical practices and make innovative medical processes such as digital therapeutics a reality. Furthermore, SaMD is a billion-dollar market. However, SaMD is not clearly understood as a technological change and emerging industry.

OBJECTIVE: This study aims to review the landscape of SaMD in response to increasing interest in SaMD within health systems and regulation. The objectives of the study are to (1) clarify the innovation process of SaMD, (2) identify the prevailing typology of such …

Pediatric Hiv+ Kaposi Sarcoma Exhibits Clinical, Virological, And Molecular Features Different From The Adult Disease, Carolina Caro-Vegas, Alice Peng, Angelica Juarez, Allison Silverstein, William Kamiyango, Jimmy Villiera, Casey L Mcatee, Rizine Mzikamanda, Tamiwe Tomoka, Erin C Peckham-Gregory, Razia Moorad, Carrie L Kovarik, Liane R Campbell, Parth S Mehta, Peter N Kazembe, Carl E Allen, Michael E Scheurer, Nmazuo W Ozuah, Dirk P Dittmer, Nader Kim El-Mallawany

Center for Medical Ethics and Health Policy Staff Publications

BACKGROUND

Kaposi sarcoma (KS) is among the most common childhood cancers in Eastern and Central Africa. Pediatric KS has a distinctive clinical presentation compared with adult KS, which includes a tendency for primary lymph node involvement, a considerable proportion of patients lacking cutaneous lesions, and a potential for fulminant disease. The molecular mechanisms or correlates for these disease features are unknown.

METHODS

This was a cross-sectional study. All cases were confirmed by IHC for KS-associated herpesvirus (KSHV) LANA protein. Baseline blood samples were profiled for HIV and KSHV genome copy numbers by qPCR and secreted cytokines by ELISA. Biopsies were …

The 2022 American College Of Cardiology Expert Consensus On The Role Of Nonstatin Therapies: An Expert-Guided Tour, Mini G Varughese, Christie M Ballantyne

The Texas Heart Institute Journal

No abstract provided.

A Multicenter Retrospective Cohort Study To Characterize Patients Hospitalized With Multisystem Inflammatory Syndrome In Adults And Coronavirus Disease 2019 In The United States, 2020-2021, Michael Melgar, Joseph Y Abrams, Shana Godfred-Cato, Ami B Shah, Amit Garg, Andrew Strunk, Mangala Narasimhan, Jonathan Koptyev, Alexandra Norden, David Musheyev, Fahmida Rashid, Rachel Tannenbaum, Rosa M Estrada-Y-Martin, Bela Patel, Siddharth Karanth, Chad J Achenbach, Gavin T Hall, Sara M Hockney, Matthew Caputo, Lilian M Abbo, Laura Beauchamps, Stephen Morris, Renzo O Cifuentes, Annabelle De St Maurice, Douglas S Bell, Kavitha K Prabaker, Fernando J Sanz Vidorreta, Evan Bryant, David K Cohen, Rohith Mohan, Christopher P Libby, Spencer Soohoo, Tristel J Domingo, Angela P Campbell, Ermias D Belay

Faculty, Staff and Student Publications

Background: The diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated multisystem inflammatory syndrome in adults (MIS-A) requires distinguishing it from acute coronavirus disease 2019 (COVID-19) and may affect clinical management.

Methods: In this retrospective cohort study, we applied the US Centers for Disease Control and Prevention case definition to identify adults hospitalized with MIS-A at 6 academic medical centers from 1 March 2020 to 31 December 2021. Patients MIS-A were matched by age group, sex, site, and admission date at a 1:2 ratio to patients hospitalized with acute symptomatic COVID-19. Conditional logistic regression was used to compare demographic characteristics, …

Fdic Board Of Directors Issues A Final Rule On Special Assessment Pursuant To Systemic Risk Determination, Federal Deposit Insurance Corporation (Fdic)

Documents

No abstract provided.

Concussion Exposure And Suicidal Ideation, Planning, And Attempts Among Us High School Students, Jacob J. Kay, Colt A. Coffman, Adam Harrison, Abbas S. Tavakoli Drph, Mph, Me, Toni Torres-Mcgehee Phd, Lat, Atc, Steven P. Broglio, Robert Davis Moore Ms, Ph.D.

Publications

CONTEXT: Interest is growing in the association between repetitive concussions and mental health. However, studies on the relationship between concussion frequency and adverse mental health outcomes among female and male youth are lacking. OBJECTIVES: To examine the association between self-reported concussion frequency and nonfatal suicidal behaviors among youth and to explore the possible interaction of biological sex. DESIGN: Retrospective cross-sectional survey. SETTING: National Youth Risk Behavior Surveillance System. PATIENTS OR OTHER PARTICIPANTS: United States secondary school students (N = 28 442). MAIN OUTCOME MEASURE(S): Exposure variables were the frequency of self-reported sport- or recreation-related concussion in the previous 12 months …

Tazemetostat For Tumors Harboring Smarcb1/Smarca4 Or Ezh2 Alterations: Results From Nci-Cog Pediatric Match Apec1621c, Susan N Chi, Joanna S Yi, P Mickey Williams, Sinchita Roy-Chowdhuri, David R Patton, Brent D Coffey, Joel M Reid, Jin Piao, Lauren Saguilig, Todd A Alonzo, Stacey L Berg, Nilsa C Ramirez, Alok Jaju, Joyce C Mhlanga, Elizabeth Fox, Douglas S Hawkins, Margaret M Mooney, Naoko Takebe, James V Tricoli, Katherine A Janeway, Nita L Seibel, D Williams Parsons

Center for Medical Ethics and Health Policy Staff Publications

Background: National Cancer Institute-Children's Oncology Group Pediatric Molecular Analysis for Therapy Choice assigns patients aged 1-21 years with refractory solid tumors, brain tumors, lymphomas, and histiocytic disorders to phase II trials of molecularly targeted therapies based on detection of predefined genetic alterations. Patients whose tumors harbored EZH2 mutations or loss of SMARCB1 or SMARCA4 by immunohistochemistry were treated with EZH2 inhibitor tazemetostat.

Methods: Patients received tazemetostat for 28-day cycles until disease progression or intolerable toxicity (max 26 cycles). The primary endpoint was objective response rate; secondary endpoints included progression-free survival and tolerability of tazemetostat.

Results: Twenty patients (median age = …

Counts, Incidence Rates, And Trends Of Pediatric Cancer In The United States, 2003–2019, David A Siegel, Jessica B King, Philip J Lupo, Eric B Durbin, Eric Tai, Kathi Mills, Elizabeth Van Dyne, Natasha Buchanan Lunsford, S Jane Henley, Reda J Wilson

Faculty, Staff and Students Publications

BACKGROUND: Cancer is a leading cause of death by disease among children and adolescents in the United States. This study updates cancer incidence rates and trends using the most recent and comprehensive US cancer registry data available.

METHODS: We used data from US Cancer Statistics to evaluate counts, age-adjusted incidence rates, and trends among children and adolescents younger than 20 years of age diagnosed with malignant tumors between 2003 and 2019. We calculated the average annual percent change (APC) and APC using joinpoint regression. Rates and trends were stratified by demographic and geographic characteristics and by cancer type.

RESULTS: With …

Fhlbank System At 100: Focusing On The Future​​​, Federal Housing Finance Agency

Documents

No abstract provided.

The Gift That Never Stops Giving: A Comparison Of Us Aide And Reconstruction In Afghanistan, Post-War Europe, And Ukraine, John Chadwick Canty Jr.

Washington Semester Program

This research paper seeks to add to the rich historiography of US foreign aid and interventions abroad by examining both the aid given during the war in Afghanistan and the Marshall Plan. Afghanistan saw $2 trillion spent on programs seemingly without clearly defined aims and which collapsed within 11 days in 2021. On the other hand, the Marshall Plan economically resuscitated a Western Europe devastated by the Second World War. Dissecting these two cases will allow the author to understand where the money went, what the aims of the aid were, how it was disbursed, and whether or not the …

Segregated Patterns Of Hospital Care Delivery And Health Outcomes, Sunny C Lin, J. Gmerice Hammond, Michael Esposito, Cassandra Majewski, Randi E Foraker, Karen E Joynt Maddox

2020-Current year OA Pubs

IMPORTANCE: Residential segregation has been shown to be a root cause of racial inequities in health outcomes, yet little is known about current patterns of racial segregation in where patients receive hospital care or whether hospital segregation is associated with health outcomes. Filling this knowledge gap is critical to implementing policies that improve racial equity in health care.

OBJECTIVE: To characterize contemporary patterns of racial segregation in hospital care delivery, identify market-level correlates, and determine the association between hospital segregation and health outcomes.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study of US hospital referral regions (HRRs) used 2018 Medicare claims, …

The Modern And Historical Roots Of Inequality, Lukas Althoff

Dissertation Awards

This dissertation studies inequality in the access to opportunity in America over the past 150 years, including the impact of pivotal policies and institutions.

In Chapter 1, Hugo Reichardt and I study the long-run effects of anti-Black institutions —from slavery to Jim Crow—on Black Americans’ economic outcomes. I trace each family’s records from 1850 to 2000 to measure their exposure to those institutions. I show that Black families whose ancestors were enslaved until the Civil War have considerably lower education, income, and wealth today than families whose ancestors were free earlier. The disparities between the two groups have persisted because …

Meeting Report Of The Annual Workshop On Principles And Techniques For Improving Preclinical To Clinical Translation In Alzheimer's Disease Research., Michael Sasner, Paul R Territo, Stacey J Sukoff Rizzo

Faculty Research 2023

INTRODUCTION: The second annual 5-day workshop on Principles and Techniques for Improving Preclinical to Clinical Translation in Alzheimer's Disease Research was held October 7-11, 2019, at The Jackson Laboratory in Bar Harbor, Maine, USA, and included didactic lectures and hands-on training. Participants represented a broad range of research across the Alzheimer's disease (AD) field, and varied in career stages from trainees and early stage investigators to established faculty, with attendance from the United States, Europe, and Asia.

METHODS: In line with the National Institutes of Health (NIH) initiative on rigor and reproducibility, the workshop aimed to address training gaps in …

Cost And Utilization Of Healthcare Services For Persons With Diabetes., Evan L Reynolds, Kara Mizokami-Stout, Nathaniel M Putnam, Mousumi Banerjee, Dana Albright, Lynn Ang, Joyce Lee, Rodica Pop-Busui, Eva L Feldman, Brian C Callaghan

Health Services and Informatics Research

AIMS: Describe and compare healthcare costs and utilization for insured persons with type 1 diabetes (T1D), type 2 diabetes (T2D), and without diabetes in the United States.

METHODS: Using a nationally representative healthcare claims database, we identified matched persons with T1D, T2D, and without diabetes using a propensity score quasi-randomization technique. In each year between 2009 and 2018, we report costs (total and out-of-pocket) and utilization for all healthcare services and those specific to medications, diabetes-related supplies, visits to providers, hospitalizations, and emergency department visits.

RESULTS: In 2018, we found out-of-pocket costs and total costs were highest for persons with …

Collateral Valuation, Federal Reserve System: Discount Window

Documents

No abstract provided.

Real-World Utilization Of An Intrauterine, Vacuum-Induced, Hemorrhage-Control Device., Dena Goffman, Kara M Rood, Angela Bianco, Joseph R Biggio, Paul Dietz, Kelly Drake, Erica Heilman, Maeve Hopkins, Monique De Four Jones, Tyler Katz, Courtney Martin, Mona Prasad, Marcela C Smid, Kathryn D Wine, Robert Ryan, Candice Yong, Patricia I Carney, Hyagriv N Simhan

Women’s Health Articles

OBJECTIVE: To assess the real-world effectiveness and safety of a U.S. Food and Drug Administration (FDA)-cleared intrauterine vacuum-induced-hemorrhage control device for postpartum hemorrhage (PPH) management.

METHODS: Sixteen centers in the United States participated in this observational, postmarket registry medical record review (October 2020 through March 2022). The primary effectiveness outcome was treatment success , defined as bleeding control after insertion with no treatment escalation or bleeding recurrence. Additional outcomes included blood loss, time to device insertion, indwelling time, bleeding recurrence, and time to bleeding control. Treatment success and severe maternal morbidity measures (transfusion of 4 or more units of red …

Screening For Lung Cancer: 2023 Guideline Update From The American Cancer Society, Andrew M. D. Wolf, Kevin C. Oeffinger, Tina Ya-Chen Shih, Louise C. Walter, Timothy R. Church, Elizabeth T. H. Fontham, Elena B. Elkin, Ruth D. Etzioni, Carmen E. Guerra, Rebecca B. Perkins, Karli K. Kondo, Tyler B. Kratzer, Deanna Manassaram-Baptiste, William L. Dahut, Robert A. Smith

School of Public Health Faculty Publications

Lung cancer is the leading cause of mortality and person-years of life lost from cancer among US men and women. Early detection has been shown to be associated with reduced lung cancer mortality. Our objective was to update the American Cancer Society (ACS) 2013 lung cancer screening (LCS) guideline for adults at high risk for lung cancer. The guideline is intended to provide guidance for screening to health care providers and their patients who are at high risk for lung cancer due to a history of smoking. The ACS Guideline Development Group (GDG) utilized a systematic review of the LCS …

Differences In The Circulating Proteome In Individuals With Versus Without Sickle Cell Trait, Yanwei Cai, Nora Franceschini, Aditya Surapaneni, Melanie E Garrett, Usman A Tahir, Li Hsu, Marilyn J Telen, Bing Yu, Hua Tang, Yun Li, Simin Liu, Robert E Gerszten, Josef Coresh, Joann E Manson, Genevieve L Wojcik, Charles Kooperberg, Paul L Auer, Matthew W Foster, Morgan E Grams, Allison E Ashley-Koch, Laura M Raffield, Alex P Reiner

Faculty, Staff and Student Publications

BACKGROUND: Sickle cell trait affects approximately 8% of Black individuals in the United States, along with many other individuals with ancestry from malaria-endemic regions worldwide. While traditionally considered a benign condition, recent evidence suggests that sickle cell trait is associated with lower eGFR and higher risk of kidney diseases, including kidney failure. The mechanisms underlying these associations remain poorly understood. We used proteomic profiling to gain insight into the pathobiology of sickle cell trait.

METHODS: We measured proteomics ( N =1285 proteins assayed by Olink Explore) using baseline plasma samples from 592 Black participants with sickle cell trait and 1:1 …

Appropriateness Of Antibiotic Prescribing Varies By Clinical Services At United States Children's Hospitals., Devin T. Diggs, Alison C. Tribble, Rebecca G. Same, Jason G. Newland, Brian R. Lee, Sharing Antimicrobial Reports For Pediatric Stewardship (Sharps) Collaborative

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To describe patterns of inappropriate antibiotic prescribing at US children's hospitals and how these patterns vary by clinical service.

DESIGN: Serial, cross-sectional study using quarterly surveys.

SETTING: Surveys were completed in quarter 1 2019-quarter 3 2020 across 28 children's hospitals in the United States.

PARTICIPANTS: Patients at children's hospitals with ≥1 antibiotic order at 8:00 a.m. on institution-selected quarterly survey days.

METHODS: Antimicrobial stewardship physicians and pharmacists collected data on antibiotic orders and evaluated appropriateness of prescribing. The primary outcome was percentage of inappropriate antibiotics, stratified by clinical service and antibiotic class. Secondary outcomes included reasons for inappropriate use …

Review Of Generic Scenario Environmental Release And Occupational Exposure Models Used In Chemical Risk Assessment, William M Barrett, David E Meyer, Raymond L Smith, Sudhakar Takkellapati, Michael A Gonzalez

Faculty, Staff and Student Publications

Under the Toxic Substances Control Act (TSCA), the United States Environmental Protection Agency (USEPA) is required to determine whether a new chemical substance poses an unreasonable risk to human health or the environment before the chemical is manufactured in or imported into the United States. This manuscript provides a review of the process used to evaluate the risk associated with a chemical based on the scenarios and models used in the evaluation. Specifically, the Generic Scenarios and Emission Scenario Documents developed by the USEPA were reviewed, along with background documentation prepared by USEPA to identify the core elements of the …

Flow-Sizing Critical Care Resources, Joseph L Nates, John M Oropello, Neeraj Badjatia, Gregory Beilman, Craig M Coopersmith, Neil A Halpern, Daniel L Herr, Judith Jacobi, Roozehra Kahn, Sharon Leung, Nitin Puri, Ayan Sen, Stephen M Pastores

Staff and Researcher Publications

Objectives: To describe the factors affecting critical care capacity and how critical care organizations (CCOs) within academic centers in the U.S. flow-size critical care resources under normal operations, strain, and surge conditions.

Data sources: PubMed, federal agency and American Hospital Association reports, and previous CCO survey results were reviewed.

Study selection: Studies and reports of critical care bed capacity and utilization within CCOs and in the United States were selected.

Data extraction: The Academic Leaders in the Critical Care Medicine Task Force established regular conference calls to reach a consensus on the approach of CCOs to "flow-sizing" critical care services. …

Market Competition And Anemia Management In The United States Following Dialysis Payment Reform, Anshul Bhatnagar, Vishnupriyadevi Parvathareddy, Wolfgang C Winkelmayer, Glenn M Chertow, Kevin F Erickson

Faculty, Staff and Students Publications

BACKGROUND: Whether market competition influences health care provider responses to national reimbursement reforms is unknown.

OBJECTIVES: We examined whether changes in anemia management after the expansion of Medicare's dialysis payment bundle varied with market competition.

RESEARCH DESIGN: With data from the US dialysis registry, we used a difference-in-differences (DID) design to estimate the independent associations of market competition with changes in anemia management after dialysis reimbursement reform.

SUBJECTS: A total of 326,150 patients underwent in-center hemodialysis in 2009 and 2012, representing periods before and after reimbursement reform.

MEASURES: Outcomes were erythropoiesis-stimulating agent (ESA) and intravenous iron dosage, the probability of …

Ascertainment Of Minimal Clinically Important Differences In The Diabetes Distress Scale-17: A Secondary Analysis Of A Randomized Clinical Trial, Jack Banks, Amber B Amspoker, Elizabeth M Vaughan, Lechauncy Woodard, Aanand D Naik

Faculty, Staff and Student Publications

IMPORTANCE: The Diabetes Distress Scale-17 (DDS-17) is a common measure of diabetes distress. Despite its popularity, there are no agreed-on minimal clinically important difference (MCID) values for the DDS-17.

OBJECTIVE: to establish a distribution-based metric for MCID in the DDS-17 and its 4 subscale scores (interpersonal distress, physician distress, regimen distress, and emotional distress).

DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis of a randomized clinical trial used baseline and postintervention data from a hybrid (implementation-effectiveness) trial evaluating Empowering Patients in Chronic Care (EPICC) vs an enhanced form of usual care (EUC). Participants included adults with uncontrolled type 2 diabetes (glycated …

The Ethical Data Practices Framework And Its Implications For Data Privacy Relations Between The United States And The European Union, Vasiliki Rahimzadeh

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

Individual- And Neighborhood-Level Characteristics Of Lung Cancer Screening Participants Undergoing Telemedicine Shared Decision Making, Christine S. Shusted, Hee-Soon Juon, Brooke Ruane, Brian M. Till, Charnita Zeigler-Johnson, Russell K. Mcintire, Tyler Grenda, Olugbenga Okusanya, Nathaniel R. Evans, Gregory C. Kane, Julie Barta

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

BACKGROUND: Although lung cancer screening (LCS) for high-risk individuals reduces lung cancer mortality in clinical trial settings, many questions remain about how to implement high-quality LCS in real-world programs. With the increasing use of telemedicine in healthcare, studies examining this approach in the context of LCS are urgently needed. We aimed to identify sociodemographic and other factors associated with screening completion among individuals undergoing telemedicine Shared Decision Making (SDM) for LCS.

METHODS: This retrospective study examined patients who completed Shared Decision Making (SDM) via telemedicine between May 4, 2020 - March 18, 2021 in a centralized LCS program. Individuals were …

Google Search Trends To Assess Public Interest In And Concern About Vuity For Treating Presbyopia, Taku Wakabayashi, Hana A. Mansour, Robert Abishek, Jayanth Sridhar, Michael N. Cohen, David Xu, Jordan Deaner, Yoshihiro Yonekawa, Jason Hsu, Ajay E. Kuriyan

Wills Eye Hospital Papers

PURPOSE: To assess public awareness, interest, and concerns regarding Vuity (1.25% pilocarpine hydrochloride ophthalmic solution), an eye drop for the treatment of presbyopia, based on Google Trends.

METHODS: We used Google Trends that provides a relative search volume for queried terms, to evaluate searches for Vuity from June 30, 2021, to June 30, 2022, in the United States. The data for this study were downloaded on June 30, 2022. Main outcome measures were changes in relative search volumes for the terms "Vuity," "Eye drops for reading," "Eye drops for near vision," "Presbyopia," "Pilocarpine," and related popular search terms, such as …

Comorbidity Clusters And In-Hospital Outcomes In Patients Admitted With Acute Myocardial Infarction In The Usa: A National Population-Based Study, Salwa Zghebi, Martin Rutter, Louise Sun, Waqas Ullah, Muhammad Rashid, Darren Ashcroft, Douglas Steinke, Stephen Weng, Evangelos Kontopantelis, Mamas Mamas

Division of Cardiology Faculty Papers

BACKGROUND: The prevalence of multimorbidity in patients with acute myocardial infarction (AMI) is increasing. It is unclear whether comorbidities cluster into distinct phenogroups and whether are associated with clinical trajectories.

METHODS: Survey-weighted analysis of the United States Nationwide Inpatient Sample (NIS) for patients admitted with a primary diagnosis of AMI in 2018. In-hospital outcomes included mortality, stroke, bleeding, and coronary revascularisation. Latent class analysis of 21 chronic conditions was used to identify comorbidity classes. Multivariable logistic and linear regressions were fitted for associations between comorbidity classes and outcomes.

RESULTS: Among 416,655 AMI admissions included in the analysis, mean (±SD) age …

Expanding The Orbit Of Maya Culture: Creating A Non-Profit In The United States, Apollo Liu, Callie Passwater, Skyler Steckler, Ryan Rowberry

Journal of Maya Heritage

Archaeologists Without Borders of the Maya World (AWBMW) is a Mexican non-profit organization focused on promoting and preserving Mayan history, particularly archaeological sites and tangible culture. To assist its mission, AWBMW wants to be able to solicit donations from U.S. entities to assist in spreading awareness of Maya culture worldwide. Using the U.S. tax code and laws from state of Georgia, this article outlines the legal steps and strategies a foreign non-profit organization must consider when desiring to start a non-profit organization in the United States. Strategies on opening a U.S. branch of an existing foreign non-profit, linking a new …