Publications by authors named "Carpenter D"

Cough detection is a crucial tool for long-term monitoring of respiratory illnesses. While clinical methods are accurate, they are not available in a home-based setting. In contrast, wearable devices offer a more accessible alternative, but face challenges in ensuring user speech privacy and detecting coughs accurately in real-world settings due to potential poor audio quality and background noise.

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Objective: To examine whether youth with ADHD who received a question prompt list and video intervention and their caregivers were more likely to: (a) be asked about their treatment preferences, (b) have their input included into treatment decisions, (c) rate their providers as using more of a participatory decision-making (PDM) style, and (d) be more satisfied with their visits.

Methods: Youth with ADHD were randomized to a pre-visit question prompt list intervention or usual care. Visits were audio-recorded; youth were interviewed after visits; caregivers completed questionnaires.

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Background: Opioid overdose is an ongoing public health issue in the rural United States and can be countered by increasing access to the opioid antagonist naloxone. Community pharmacists are well-positioned to offer and dispense naloxone to patients at risk of opioid overdose, but still experience a range of communication barriers. Understanding rural patient communication preferences is essential to prepare pharmacists to discuss naloxone in a patient-centered manner.

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Background: Widespread familial hypercholesterolemia screening requires a large upfront economic investment, but the health benefits and cost savings of cardiovascular disease prevention directed by screening occur over many years.

Objective: We evaluated the cost-effectiveness of population genetic screening for familial hypercholesterolemia compared to cascade testing to US payers while accounting for patient insurance switching between commercial and Medicare insurance.

Methods: We developed a hybrid decision-tree Markov model to assess genetic screening in 20-year-old adults over a lifetime horizon in which cohort members transitioned between commercial payers representing three commercial plans and Medicare.

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Introduction: Fentanyl and xylazine test strips (FTS, XTS) are simple point-of-care tests that determine the presence of fentanyl or xylazine in a substance before use. Access to FTS and XTS is limited. For pharmacists who are willing to sell an FTS, there is little guidance about how to implement FTS sales and counseling as no training for community pharmacists regarding FTS and XTS exists.

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Background: Tissue-based genomic classifiers (GCs) have been developed to improve prostate cancer (PCa) risk assessment and treatment recommendations.

Purpose: To summarize the impact of the Decipher, Oncotype DX Genomic Prostate Score (GPS), and Prolaris GCs on risk stratification and patient-clinician decisions on treatment choice among patients with localized PCa considering first-line treatment.

Data Sources: MEDLINE, EMBASE, and Web of Science published from January 2010 to August 2024.

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With the Food and Drug Administration's approval of the first over-the-counter naloxone nasal spray in 2023, it was expected that access to naloxone nasal spray would increase and that its cost would be reduced. However, the writers of this commentary found varying insurance coverage of naloxone during purchase attempts at local pharmacies. Failure to cover naloxone can reduce access and increase risk of overdose death.

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Background: Minimally invasive liver surgery (MILS) is superior to open surgery when considering decreased blood loss, fewer complications, shorter hospital stay, and similar or improved oncologic outcomes. However, operative limitations in laparoscopic hepatectomy have curved its applicability and momentum of complex minimally invasive liver surgery. Transitioning to robotic hepatectomy may bridge this complexity gap.

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Background: Over-the-counter (OTC) naloxone became available for sale at community pharmacies in September 2023. This study examines whether naloxone availability and cost are associated with pharmacy type (independent vs chain), pharmacy rurality, and their interaction.

Methods: Using a cross-sectional secret shopper study design, data were collected by phone from a stratified random sample of 600 community pharmacies in North Carolina from November 2023 to January 2024.

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Article Synopsis
  • Obesity significantly increases the risk of noncommunicable diseases and can shorten life expectancy by up to 20 years, primarily due to factors like disrupted energy balance, genetics, and lifestyle.
  • Endocrine-disrupting chemicals (EDCs), known as obesogens, affect lipid homeostasis by increasing adipocyte size and number, influencing appetite regulation, and altering insulin sensitivity across various organs.
  • Although research on obesogens is growing, the exact mechanisms remain unclear, and more epidemiological studies are essential to better understand human exposure to these harmful substances.
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Article Synopsis
  • The text reviews the impact of Covid-19 on the mental health and well-being of pregnant women during the perinatal period, analyzing 42 empirical studies published between December 2019 and September 2021.
  • It identifies overarching themes such as "Impact" and "Emotional Impact," highlighting various factors like demographic influences, socio-economic status, and the quality of maternity service delivery that affect maternal mental health during the pandemic.
  • While there is evidence of increased risk for perinatal mental illness compared to pre-pandemic levels, many studies didn’t find a significant jump in prevalence, stressing the importance of understanding individual risk and protective factors in their specific contexts.
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Background: There's limited information available about the range of harm reduction (HR) services provided by rural pharmacies.

Objective: This study's objectives are to describe the types of HR services offered by rural pharmacies and examine pharmacists' attitudes and willingness to offer those services.

Methods: A cross-sectional online survey was sent to pharmacists who are members of a practice-based research network for rural community pharmacies.

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Context: Vaccine hesitancy is associated with political and institutional distrust, but there is little research on how people's trust responds to political events. We revisit the fall of 2020 when evaluation of new COVID-19 vaccines collided with an impending national election. Drawing on a political Bayesian perspective, we assess abrupt changes in attention to political events and test hypotheses on subpopulation response: (1) partisan, (2) educational, and (3) ethnic and racial.

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While it is commonly accepted that ecosystem dynamics are nonlinear, what is often not acknowledged is that nonlinearity implies scale-dependence. With the increasing availability of high-resolution ecological time series, there is a growing need to understand how scale and resolution in the data affect the construction and interpretation of causal networks-specifically, networks mapping how changes in one variable drive changes in others as part of a shared dynamic system ("dynamic causation"). We use Convergent Cross Mapping (CCM), a method specifically designed to measure dynamic causation, to study the effects of varying temporal and taxonomic/functional resolution in data when constructing ecological causal networks.

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Medical students, like many health professional students, are at risk for burnout and other negative well-being outcomes. Research suggests that building resilience may help to mitigate these risks. A multi-disciplinary team developed, delivered, and evaluated a training on building resilience for medical students entitled, "Resilience for Health Providers - Strengthening You to Strengthen Them.

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Biliary intraepithelial neoplasm (BilIN) and intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) are recognized as the two main precursors to biliary carcinoma. Surgical resection is the mainstay of treatment, with pancreaticoduodenectomy for extrahepatic biliary duct disease involving the pancreatic or distal portion of the bile duct, and bile duct and liver resection for perihilar and intrahepatic bile duct involvement. For diffuse IPMN-B with involvement of the entirety of the biliary epithelium of both intrahepatic and extrahepatic biliary systems, there is no well-documented consensus on treatment due to its rarity.

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Electronic waste (e-waste) poses significant environmental and health risks in Thailand due to both domestic production and international imports. A notable portion of this waste is processed in small-scale, community-based workshops, often located in poorer regions, where safety regulations are improperly enforced or entirely ignored. This study focuses on the Kalasin province in Northern Thailand, a region with numerous such workshops, where no comprehensive analysis of exposure to polybrominated diphenyl ethers (PBDEs) and dechlorane plus (DP) has been conducted.

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Background: From 2018 to 2022, mass shooting incidents in the United States increased by 67.7%. Health care-associated shootings also increased.

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Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is common in children. We hypothesized environmental toxins could drive progression to metabolic dysfunction-associated steatohepatitis (MASH), and assayed serum toxins and metabolites in children with histologically characterized MASLD/MASH.

Methods: Environmental chemicals, common in household items, perfluoroalkyl substances (PFAS), polybrominated flame retardants (polybrominated diphenyl ethers [PBDEs]), and metabolic profiles were assayed in children enrolled in the multicenter NASH Clinical Research Network Pediatric Database 2.

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Article Synopsis
  • The chronic toxicity of perfluoroalkyl sulfonic acids (PFSAs), particularly PFBS and PFHxS, is becoming a concern as their presence in the environment increases, but their effects are largely unexplored.
  • Researchers exposed northern leopard frog tadpoles to various concentrations of PFBS and PFHxS and monitored their growth, development, stress levels, and immune responses, finding that high concentrations (1000 μg/L) significantly impacted liver health and altered fatty acid profiles.
  • Notably, exposure to PFHxS at lower environmentally relevant levels (0.1 μg/L) increased the likelihood of tadpoles developing as females, indicating potential endocrine disruption during early development.
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Background And Aims: The course of adults with ZZ alpha-1-antitrypsin deficiency (AATD) liver disease is unpredictable. The utility of markers, including liver biopsy, is undefined.

Methods: A prospective cohort, including protocol liver biopsies, was enrolled to address these questions.

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Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is common in people with HIV (PWH). The morphological spectrum of MASLD compared to matched controls and of the correlation between the NAFLD activity score (NAS) and fibrosis stage in PWH remains unknown.

Methods: Overall, 107 liver biopsies from PWH with MASLD (MASLD-PWH) were matched to 107 biopsies from individuals with MASLD and without HIV (MASLD controls) on age at biopsy, race/ethnicity, sex, type 2 diabetes, body mass index (BMI) and alanine aminotransferase (ALT) level.

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