Re-evaluation of the methodology for estimating the US specialty physician workforce.

Increasing pursuit of subspecialized training has quietly revolutionized physician training, but the potential impact on physician workforce estimates has not previously been recognized. The Physicians Specialty Data Reports of the Association of American Medical Colleges, derived from specialty designations in the American Medical Association (AMA) Physician Professional Data (PPD), are the reference source for US physician workforce estimates; by 2020, the report for pathologists was an undercount of 39% when compared with the PPD. Most of the difference was due to the omission of pathology subspecialty designations.

Gabapentin Use During Pregnancy and Lactation With and Without Concurrent Opioid Exposure: Considerations and Future Directions.

Gabapentin is a γ-aminobutyric acid analog formally indicated for the treatment of epilepsy and neuropathic pain that is gaining increased popularity. Gabapentin has been historically considered a safe medication, including during pregnancy and lactation, with low reported concerns for misuse and use disorders. However, new empirical efforts are revealing concerns regarding the safety of widespread gabapentin use, particularly in pregnancy and for individuals with a propensity toward substance misuse.

Prevention of musculoskeletal disorders among animal research technicians: Understanding difficulties and their determinants through a work activity analysis.

This study aimed at understanding animal research technicians (ART) work activity to identify difficulties encountered by workers and their determinants which may increase musculoskeletal disorders (MSD) risks. The methods for the work activity analysis combined interviews, observations, events and operations chronicles as well as inclinometry. From the work activity analysis of the three main tasks (changing mouse cages, preparation of water bottles and unloading dirty material), difficulties such as awkward postures, heavy load handling, repetitiveness, high workload, supplementary tasks, interruptions and difficult social interactions emerged.

Serving Rural Veterans with Disabilities: A National Survey of Centers for Independent Living.

This study comprises a systematic national examination of how Centers for Independent Living can and do support Veteran consumers, especially those living in rural communities. This research provides contextualized understanding of rural Veteran needs for community-based services and resources available through Centers for Independent Living. A survey was administered to the leadership of 383 Centers for Independent Living throughout the United States, the majority of which have rural catchment areas and serve rural Veterans through both main and satellite offices.

Being accompanied to liver discharge clinic: An easy measure to identify potential liver transplant candidates among those previously considered ineligible.

Background: Patients with cirrhosis deemed ineligible for liver transplantation are usually followed in general hepatology or gastroenterology clinics, with the hope of re-evaluation once they meet the appropriate criteria. Specific strategies to achieve liver transplant eligibility for these patients have not been studied.

Aim: To assess clinical and sociodemographic factors associated with future liver transplant eligibility among patients initially considered ineligible.

Feasibility of quantifying the physical exposure of materials handlers in the workplace with magnetic and inertial measurement units.

Handling tasks can expose workers to risk factors. The objective was to describe the feasibility of using magnetic and inertial measurement units (MIMUs) to quantify the physical exposure of materials handlers in the workplace. Full-body kinematics were obtained with MIMUs on 10 handlers gathering products ordered by retailers with a pallet truck.

Clinical utility of genomic analysis in adults with idiopathic liver disease.

Background & Aims: Adult patients suffering from liver disease of unknown cause represent an understudied and underserved population. The use of whole-exome sequencing (WES) for the assessment of a broader spectrum of non-oncological diseases, among adults, remains poorly studied. We assessed the utility of WES in the diagnosis and management of adults with unexplained liver disease despite comprehensive evaluation by a hepatologist and with no history of alcohol overuse.

Advance Care Planning for Patients with Cirrhosis in a Structured Inpatient/Outpatient Hepatology Program.

Patients with end-stage liver disease (ESLD) have high mortality, but low utilization of palliative care. A transitional care liver clinic (TCLC), bridging inpatient hepatology care to outpatient clinics, should offer the ideal setting for advance care planning (ACP). To examine ACP and related outcomes for TCLC patients who died within one year of the initial TCLC visit.

Assessing food security using household consumption expenditure surveys (HCES): a scoping literature review.

Objective: To meet some of the UN's seventeen Sustainable Development Goals by 2030, there is a need for more effective policy to reduce food insecurity in low-income and lower-middle-income countries (LMIC). Measuring progress towards these goals requires reliable indicators of food security in these countries. Routinely conducted household consumption and expenditure surveys (HCES) provide potentially valuable and nationally representative data sets for this purpose.

Fish, food security and health in Pacific Island countries and territories: a systematic literature review.

Background: Pacific Island countries and territories (PICTs) face a double burden of disease, with a high prevalence of household food insecurity and childhood micronutrient deficiencies, accompanied by a burgeoning increase in adult obesity, diabetes and heart disease.

Methods: A systematic literature review was undertaken to assess whether increased availability of, and access to, fish improves a) household food security and b) individual nutritional status.

Results: A total of 29 studies were reviewed.

Chronic exposure to hexachlorobenzene results in down-regulation of connexin43 in the breast.

Decreased expression of connexins has been associated with cancer, but the underlying mechanisms are poorly understood. We have previously shown that a 5 day exposure to hexachlorobenzene (HCB) resulted in decreased connexins expression in hepatocytes 45 days later, and that this down-regulation was linked to activation of Akt through the ILK pathway. Because HCB promotes cancer in both the liver and breast, the present study aimed to determine if the mechanisms are similar in both tissues.

Influence of musculoskeletal pain on workers' ergonomic risk-factor assessments.

This study compares the ergonomic risk-factor assessments of workers with and without musculoskeletal pain. A questionnaire on the musculoskeletal pain experienced in various body regions during the 12 months and seven days preceding the data collection was administered to 473 workers from three industrial sectors. The Ergonomic Workplace Analysis method, developed by the Finnish Institute of Occupational Health (FIOH), was then used by the workers and an ergonomics expert to assess the workstations.

Covariates of alcohol consumption among career firefighters.

Background: Little is known about rates of alcohol consumption in career firefighters.

Aims: To assess the quantity and frequency of alcohol consumption among career firefighters and the covariates that influence consumption levels.

Methods: A convenience sample of career firefighters completed an online, self-administered, health assessment survey.

Sex differences in lifting strategies during a repetitive palletizing task.

Forty-five manual material handlers (15 females, 15 expert males and 15 novice males) performed series of box transfers under conditions similar to those of large distribution centers. The objective of the study was to verify whether sex differences in joint motions and in back loading variables (L5/S1 moments) exist during multiple box transfers. The task consisted in transferring 24 15-kg boxes from one pallet to another (4 layers of boxes; 6 boxes/layer: 3 in the front row, 3 in the back) at a self-determined pace and then at an imposed pace of 9 lifts/min.

Validation of a cardiorespiratory fitness assessment for firefighters.

Currently, a submaximal protocol is used to measure cardiorespiratory fitness in firefighters by estimating their true aerobic capacity (V[Combining Dot Above]O2max); however, this submaximal test has not been cross-validated among firefighters. Thirty firefighters (85% male, 15% female), completed the submaximal protocol and the maximal (Bruce) treadmill protocol on separate occasions. Pearson's correlation analyses between the submaximal and Bruce protocol revealed a significant moderate positive correlation (r = 0.

Beyond the clinic: improving child health through evidence-based community development.

Background: Promoting child wellbeing necessarily goes beyond the clinic as risks to child health and development are embedded in the social and physical environmental conditions in which children live. Pediatricians play a vital role in promoting the health of children in the communities they serve and can maximize their impact by advocating for and supporting efficacious, evidence-based strategies in their communities.

Methods: To provide a succinct guide for community pediatric efforts to advance the wellbeing of all children and particularly disadvantaged children in a community, we conducted a theory-driven and structured narrative review to synthesize published systematic and meta-analytic reviews of policy-relevant, local-level strategies addressing potent and malleable influences on child health and development.

Methods for fostering a community academic partnership in a firefighter community.

Objectives: To describe how a community academic partnership (CAP) created a cardiovascular disease (CVD) prevention program for firefighters.

Methods: Principles of community based participatory research (CBPR) were integrated with intervention mapping (IM) to guide the development of a physical activity program.

Results: Key elements of the CAP program include instituting annual CVD screenings; creating a department-wide program and a pilot intervention for high-risk firefighters; training firefighters to become peer health mentors; improving access to physical activity equipment; instituting policy to promote physical activity, and validating instrumentation for assessing cardiorespiratory fitness.

Lifting strategies of expert and novice workers during a repetitive palletizing task.

Thirty manual material handlers (15 experts and 15 novices) were invited to perform series of box transfers under conditions similar to those of large distribution centers. The objective of the present study was to verify whether multiple box transfers leading to fatigue would also lead to differences between expert and novice workers in joint motions and in back loading variables (L5/S1 moments). The task consisted in transferring 24 15-kg boxes from one pallet to another (4 layers of boxes; 6 boxes/layer: 3 in the front row, 3 in the back) at a self-determined pace and then at an imposed pace of 9 lifts/min for a total of 240 lifts.

Immune system phenotyping of radiation and radiation combined injury in outbred mice.

The complexity of a radionuclear event would be immense due to varying levels of radiation exposures and injuries caused by blast-associated trauma. With this scenario in mind, we developed a mouse model to mimic as closely as possible the potential consequences of radiation injury and radiation combined injury (RCI) on survival, immune system phenotype, and immune function. Using a mouse burn injury model and a (137)CsCl source irradiator to induce injuries, we report that the immunological response to radiation combined injury differs significantly from radiation or burn injury alone.

Effect of moderate-intensity exercise training on the cognitive function of young adults with intellectual disabilities.

In addition to cognitive impairment, young adults with intellectual disabilities (IDs) are also more likely to be in poor health. Exercise may help ameliorate both of these deficits. While the health benefits of exercise are well documented and understood, the cognitive benefits of exercise are emerging.

High prevalence of antibiotic-resistant bacterial infections among patients with cirrhosis at a US liver center.

Background & Aims: There are limited data on the prevalence or predictors of antibiotic-resistant bacterial infections (AR-BI) in hospitalized patients with cirrhosis in North America. Exposure to systemic antibiotics is a risk factor for AR-BI; however, little is known about the effects of the increasingly used oral nonabsorbed antibiotics.

Methods: We analyzed data from patients with cirrhosis and bacterial infections hospitalized in a liver unit at a US hospital between July 2009 and November 2010.

Biology and genome sequence of Streptococcus mutans phage M102AD.

M102AD is the new designation for a Streptococcus mutans phage described in 1993 as phage M102. This change was necessitated by the genome analysis of another S. mutans phage named M102, which revealed differences from the genome sequence reported here.

Relative importance of expertise, lifting height and weight lifted on posture and lumbar external loading during a transfer task in manual material handling.

Unlabelled: The objective of this study was to measure the effect size of three important factors in manual material handling, namely expertise, lifting height and weight lifted. The effect of expertise was evaluated by contrasting 15 expert and 15 novice handlers, the effect of the weight lifted with a 15-kg box and a 23-kg box and the effect of lifting height with two different box heights: ground level and a 32 cm height. The task consisted of transferring a series of boxes from a conveyor to a hand trolley.

Physical capacity and functional abilities improve in young adults with intellectual disabilities after functional training.

Individuals with an intellectual disability (ID) have higher rates of obesity, lower rates of physical activity, cardiorespiratory fitness, and muscular endurance than do typically developed individuals (TDI) and are twice as likely to develop chronic disease, living half as long as TDIs do. The purpose of this study was to examine the improvements in physical capacity and functional ability in Special Olympic Athletes (SOAs) aged 19-22 years after participating in a functional training (FT) program and compare these scores with those of the SOAs in a resistance weight training (WT) program. Twenty SOAs (13 men, 7 women with mild to moderate ID) participated in a 1-hour FT program, twice a week, for 10 weeks, compared with 22 same-aged SOAs (14 men, 8 women) participating in a 1-hour WT program (2× week for 8 weeks).