Medicaid billing for community health worker services growing, but remains low, 2016-2020.

Despite the recognized value of Community Health Workers (CHWs) in improving health outcomes, the integration of CHWs into Medicaid continues to be a challenge. This study examines the trends in CHW billing for Medicaid services across states from 2016 to 2020. We conducted an exploratory descriptive analysis of the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) 2016-2020 to identify trends in direct billing for CHW services, including beneficiaries served, total services rendered, payment type, place of service, and procedure codes used for services billed by CHWs.

Loss of glucose-stimulated β-cell Nr4a1 expression impairs insulin secretion and glucose homeostasis.

A central aspect of type 2 diabetes is decreased functional β-cell mass. The orphan nuclear receptor Nr4a1 is critical for fuel utilization, but little is known regarding its regulation and function in the β-cell. Nr4a1 expression is decreased in type 2 diabetes rodent β-cells and type 2 diabetes patient islets.

CBD oil by-product (): Evaluation for nutritional composition, heavy metals and functionality as a food ingredient.

Background: The recent interest among consumers in industrial hemp due to health and wellness benefits has led to several products from industrial hemp, including cannabidiol (CBD) oil. CBD oil extraction from hemp buds and flowers generates by-product biomass (), often posing disposal challenges and with little or no applications. We hypothesized that hemp flakes possess residual compounds with nutritional and health value that could be used to improve utilization.

Assessing the Racial and Ethnic Diversity of Physician Assistant/Associate Program Graduates from 2010 to 2012 and 2019 to 2021.

Introduction: To assess the racial/ethnic diversity of graduates of US Physician Assistant/Associate (PA) programs compared with the diversity of the populations from which they draw students and to assess diversity changes over time among PA graduates.

Methods: We calculated proportion of Black or Hispanic PA graduates nationally and by school between 2010 to 2012 and 2019 to 2021 using the Integrated Postsecondary Education Data System (IPEDS) and compared it with the diversity of the 20 to 35-year-old population using the American Community Survey. We created benchmark populations for each school based on whether the school was public or private, with in-state/out-of-state proportions provided by the Physician Assistant Education Association.

Outcomes for nighttime bracing in adolescent idiopathic scoliosis based on brace wear adherence.

Background: This study determined brace wear adherence for patients treated with nighttime braces and evaluated the effect of brace adherence on curve progression.

Methods: One hundred twenty-two patients with AIS ages 10-16 years, Risser stages 0-2, major curves 20°-40° treated with Providence nighttime braces prescribed to be worn at least 8 h per night were prospectively enrolled and followed until skeletal maturity or surgery. Brace adherence was measured using iButton temperature sensors after 3 months of brace initiation and at brace discharge.

CEBPA Overexpression Enhances β-Cell Proliferation and Survival.

A commonality between type 1 and type 2 diabetes is the decline in functional β-cell mass. The transcription factor Nkx6.1 regulates β-cell development and is integral for proper β-cell function.

A holistic approach to fragile X syndrome integrated guidance for person-centred care.

Background: The Fragile X community has expressed a desire for centralised, national guidelines in the form of integrated guidance for Fragile X Syndrome (FXS).

Methods: This article draws on existing literature reviews, primary research and clinical trials on FXS, a Fragile X Society conference workshop and first-hand experience of clinicians who have worked with those living with FXS over many years.

Results: The article scopes proposed integrated guidance over the life course, including appendices of symptoms, comorbidities and referral options for FXS and Fragile X Premutation Associated Conditions.

Black and Hispanic Representation Declined After Increased Degree Requirements for Physician Assistants.

Introduction: The physician assistant (PA) profession is one of the least racially and ethnically diverse health professions requiring advanced education. New PA graduates are even less diverse than the current PA workforce and less diverse than professions requiring doctoral degrees. Between 1995 and 2020, the percent of all PA graduates that were Black individuals fell from 7% to 3.

Positive childhood experiences serve as protective factors for mental health in pandemic-era youth with adverse childhood experiences.

Background: While adverse childhood experiences (ACEs) predict poorer mental health across the life course, positive childhood experiences (PCEs) predict better mental health. It is unclear whether PCEs protect against poor mental health outcomes and promote mental well-being in pandemic-era adolescents with ACEs.

Methods: We examined the individual and joint contributions of ACEs and PCEs to mental health and well-being (MHW) in eleventh-grade British Columbian adolescents (N = 8864) during the fifth wave of COVID-19.

Association of genetic variation in with adolescent idiopathic scoliosis.

Adolescent idiopathic scoliosis (AIS) is a common and progressive spinal deformity in children that exhibits striking sexual dimorphism, with girls at more than fivefold greater risk of severe disease compared to boys. Despite its medical impact, the molecular mechanisms that drive AIS are largely unknown. We previously defined a female-specific AIS genetic risk locus in an enhancer near the gene.

Naming and Describing Disability in Law and Medicine.

This article explores the effects of naming and describing disability in law and medicine. Instead of focusing on substantive issues like medical treatment or legal rights, it will address questions which arise in relation to the use of language itself. When a label which is attached to a disability is associated with a negative meaning, this can have a profound effect on the individual concerned and can create stigma.

Diversity and conservation of the genome architecture of phages infecting the Alphaproteobacteria.

This study reports the results of the largest analysis of genome sequences from phages that infect the Alphaproteobacteria class of bacterial hosts. We analyzed over 100 whole genome sequences of phages to construct dotplots, categorize them into genetically distinct clusters, generate a bootstrapped phylogenetic tree, compute protein orthologs, and predict packaging strategies. We determined that the phage sequences primarily cluster by the bacterial host family, phage morphotype, and genome size.

Evidence of causality of low body mass index on risk of adolescent idiopathic scoliosis: a Mendelian randomization study.

Introduction: Adolescent idiopathic scoliosis (AIS) is a disorder with a three-dimensional spinal deformity and is a common disease affecting 1-5% of adolescents. AIS is also known as a complex disease involved in environmental and genetic factors. A relation between AIS and body mass index (BMI) has been epidemiologically and genetically suggested.

Skeletal Maturity in Legg-Calve-Perthes Disease: Significant Discrepancy Present Between the Hand and the Hip.

Background: The concept of delayed skeletal maturity in Legg-Calve-Perthes Disease (LCPD) has been well identified with the Greulich and Pyle (GP) atlas showing 1 to 2 years delay. Recently the optimized Oxford hip skeletal age (Optimized Oxford) system has been developed and shown to have similar accuracy as the GP atlas for assessing skeletal maturity. However, this system has not been used to assess skeletal maturity in LCPD.

Jumping vs. running: Effects of exercise modality on aerobic capacity and neuromuscular performance after a six-week high-intensity interval training.

Purpose: High-intensity interval training (HIIT) has proven to be effective in improving endurance capacity and muscle endurance. However, its potential to improve other aspects of physical performance such as strength and power has not been well explored, and most research studies used only running and cycling as exercise modalities. Here, we compared the effects of jumping versus running as exercise modalities during a 6-week HIIT.

Characterization of a Novel Thermostable DNA Lyase Used To Prepare DNA for Next-Generation Sequencing.

Recently, we constructed a hybrid thymine DNA glycosylase (hyTDG) by linking a 29-amino acid sequence from the human thymine DNA glycosylase with the catalytic domain of DNA mismatch glycosylase (MIG) from , increasing the overall activity of the glycosylase. Previously, it was shown that a tyrosine to lysine (Y126K) mutation in the catalytic site of MIG could convert the glycosylase activity to a lyase activity. We made the corresponding mutation to our hyTDG to create a hyTDG-lyase (Y163K).

Pre-natal testing, excessive parenting and care ethics.

This article explores the current parenting culture, particularly the promotion of competitive and excessive parenting, as an important background issue against which the debates around pre-natal testing take place. It offers an alternative vision of parenting, relying on care ethics, which sees parenting as a relationship, rather than a job. A relationship that should change a parent's understanding of what is valuable in life.

A Jackstone Calculus Residing in a Urinary Bladder Diverticulum.

Jackstone calculi are uncommon urinary stones, characterized by a central dense core with a spiculated contour, which resemble the toy from the children's game Jacks. They are usually described in the veterinary literature. When present, they are typically found in the vesical bladder.

Chemical and enzymatic modifications of 5-methylcytosine at the intersection of DNA damage, repair, and epigenetic reprogramming.

The DNA of all living organisms is persistently damaged by endogenous reactions including deamination and oxidation. Such damage, if not repaired correctly, can result in mutations that drive tumor development. In addition to chemical damage, recent studies have established that DNA bases can be enzymatically modified, generating many of the same modified bases.

Cocoa extract exerts sex-specific anti-diabetic effects in an aggressive type-2 diabetes model: A pilot study.

Type 2 diabetes (T2D) is characterized by hyperglycemia and insulin resistance. Cocoa may slow T2D development and progression. This study employed male and female BTBR.

Association between state payment parity policies and telehealth usage at community health centers during COVID-19.

Objective: We study the association between payment parity policies and telehealth utilization at community health centers (CHCs) before, during, and after the onset of the pandemic.

Materials And Methods: We use aggregated, de-identified data from FAIR Health for privately insured patients at CHC sites. Descriptive statistics and time trends are calculated.

A combinatorial system to examine the enzymatic repair of multiply damaged DNA substrates.

DNA damage drives genetic mutations that underlie the development of cancer in humans. Multiple pathways have been described in mammalian cells which can repair this damage. However, most work to date has focused upon single lesions in DNA.

Sharing Vulnerabilities in the Woman Patient/Doctor Encounter.

This article is an examination of the doctor-woman patient encounter through a vulnerability lens. This relationship has been traditionally been critiqued as a paternalistic encounter in which the remedy was to recognize the patient's rights of autonomy. In this article, it is suggested that a more helpful approach is to recognize the vulnerability of both the patient and doctor.