Are opioid use disorder assessments in the emergency department biased? An examination across sex, race, and employment status using item response theory.

Background: In acute care settings such as the emergency department (ED), the absence of test bias is essential for any assessment. Unbiased assessments of the DSM-5 criteria for opioid use disorder (OUD) are crucial to ensure valid comparison of OUD severity, though focused tests of potential bias are lacking.

Method: This study used item response theory (IRT) to examine potential test bias across patient characteristics (i.

Opioid use disorder risk alleles in self-reported assigned African American/Afro-Caribbean and European biogeographical genetic ancestry groups and in males and females.

The influence of genetic variants related to opioid use disorder (OUD) was evaluated using multiple logistic regression analysis in self-reported assigned African American/Afro-Caribbean and European biogeographical ancestry groups (BGAGs) and by sex. From a sample size of 1301 adult patients (>18 years of age) seen in emergency departments of three medical centers in Ohio, six variants were found to be associated with OUD. Two of the variants, rs2740574 (CYP3A4) and rs324029 (DRD3), were included in the analysis having met criteria of at least five subjects for each BGAG, variant carrier status, and OUD status combinations.

Microhabitat selection by the Oscura Mountains Colorado Chipmunk (): an old-growth pinyon-juniper woodland specialist.

Habitat specialists have been largely overlooked in old-growth pinyon-juniper woodlands, despite specialists exhibiting heightened sensitivity to anthropogenic habitat loss. Furthermore, small mammal relationships within pinyon-juniper woodlands have most commonly been investigated via species abundance or habitat use, rather than habitat selection, thereby providing limited management metrics. We used the Oscura Mountains Colorado Chipmunk () as a model organism to evaluate whether old-growth conditions drive resource selection by small mammals associated with pinyon-juniper woodlands.

Association between maternal prenatal depressive symptoms and offspring epigenetic aging at 3-5 weeks.

Epigenetic clocks are emerging as tools for assessing acceleration and deceleration of biological age during childhood. Maternal depression during pregnancy may affect the biological aging of offspring and related development. In a low-income cohort of mother-child dyads, we investigated the relationship between prenatal maternal depressive symptoms and infant epigenetic age residuals, which represent the deviation (acceleration or deceleration) that exists between predicted biological age and chronological age.

Screening for problematic opioid use in the emergency department: Comparison of two screening measures.

Study Objective: Earlier intervention for opioid use disorder (OUD) may reduce long-term health implications. Emergency departments (EDs) in the United States treat millions with OUD annually who may not seek care elsewhere. Our objectives were (1) to compare two screening measures for OUD characterization in the ED and (2) to determine the proportion of ED patients screening positive for OUD and those who endorse other substance use to guide future screening programs.

Infant Obesity Prevention Programs for Underrepresented Mothers in a Home Visiting Program: A Qualitative and Community-Engaged Needs Assessment.

A qualitative, community-engaged assessment was conducted to identify needs and priorities for infant obesity prevention programs among mothers participating in home visiting programs. Thirty-two stakeholders (i.e.

A First-Class Simulation: In-Situ In-Flight Medical Emergencies Curriculum for Emergency Medicine Residents Aboard a Commercial Airliner.

Introduction: In-flight medical emergencies occur in an estimated one out of 604 flights. Responding in this environment poses a unique set of challenges unfamiliar to most emergency medicine (EM) providers, including physical space and resource limitations. We developed a novel high-fidelity in-situ training curriculum focused on frequent or high-risk in-flight medical scenarios while replicating this austere environment.

Performance of a Standardized Clinical Assay for Urinary C-C Motif Chemokine Ligand 14 (CCL14) for Persistent Severe Acute Kidney Injury.

Background: Clinical use of biomarkers requires the development of standardized assays and establishment of cutoffs. Urinary C-C motif chemokine ligand 14 (CCL14) has been validated to predict persistent severe AKI in critically ill patients with established AKI. We now report on the performance of standardized cutoffs using a clinical assay.

COVID-19 Booster Uptake among First Responders and Their Household Members May Be Lower than Anticipated.

(1) Background: COVID-19 vaccination status varies widely among law enforcement and emergency medical services professionals. Though at high risk of exposure, these first responders have demonstrated significant vaccine hesitancy, with only 70% reportedly vaccinated. We sought to understand whether similar vaccine hesitancy exists for first responders and their household contacts around COVID-19 boosters.

Barriers and Facilitators to Peer Support Services for Patients With Opioid Use Disorder in the Emergency Department.

There is a high prevalence of opioid use disorder in the United States, and emergency departments (EDs) play multiple vital roles in providing care to help these patients with achieving sobriety, one of which is the application of peer recovery services. This technical report discusses the utilization of peer recovery supporters in the ED and associated barriers. They include but are not limited to the difficult hiring process, referral process challenges for certain populations, difficulty with follow-up data collection, retention of peer recovery supporters, and a lack of ED provider awareness.

A case for multiscale habitat selection studies of small mammals.

Habitat information for small mammals typically consists of anecdotal descriptions or infrequent analyses of habitat use, which often are reported erroneously as signifying habitat preference, requirements, or quality. Habitat preferences can be determined only by analysis of habitat selection, a behavioral process that results in the disproportionate use of one resource over other available resources and occurs in a hierarchical manner across different environmental scales. North American chipmunks ( and ) are a prime example of the lack of studies on habitat selection for small mammal species.

Emergency department disposition of non-neutropenic febrile patients with cancer.

Objectives: National data reveal that 60% of the 4.5 million annual emergency department (ED) visits by patients with cancer result in admission. Many of these visits are due to a febrile illness.

Linking camera-trap data to taxonomy: Identifying photographs of morphologically similar chipmunks.

Remote cameras are a common method for surveying wildlife and recently have been promoted for implementing large-scale regional biodiversity monitoring programs. The use of camera-trap data depends on the correct identification of animals captured in the photographs, yet misidentification rates can be high, especially when morphologically similar species co-occur, and this can lead to faulty inferences and hinder conservation efforts. Correct identification is dependent on diagnosable taxonomic characters, photograph quality, and the experience and training of the observer.

A qualitative study exploring older smokers' attitudes and motivation toward quitting during the COVID-19 pandemic.

Older individuals who smoke are at increased risk of having severe outcomes from COVID-19, due to their long-term smoking and underlying health conditions. In this qualitative study, we explored the impact of COVID-19 on attitudes toward smoking and motivation to quit. Participants (N = 30) were enrolled in a larger ongoing randomized controlled smoking cessation trial conducted in the lung cancer screening setting.

Cultivating emergency physician behavioral empathy to improve emergency department care for pain and prescription opioid misuse.

Clinical empathy is the ability to understand the patient's experience, communicate that understanding, and act on it. There is evidence that patient and physician benefits are associated with more empathic communications. These include higher patient and physician satisfaction, improved quality of life, and decreased professional burnout for physicians, as well as increased patient compliance with care plans.

Agitated Psychiatric Patient.

Audience: This scenario was developed to educate emergency medicine residents about the diagnosis and management of the agitated psychiatric patient.

Introduction: The prevalence of agitation among patients in the emergency department is increasing, with an estimated 1.7 million events occurring annually in the United States.

Predicting the distribution of a rare chipmunk (): comparing MaxEnt and occupancy models.

Species distribution models (SDMs) use presence records to determine the relationship between species occurrence and various environmental variables to create predictive maps describing the species' distribution. The Oscura Mountains Colorado chipmunk () occurs in central New Mexico and is of conservation concern due to its relict distribution and threats to habitat. We previously created an occupancy model for this taxon, but were concerned that the model may not have adequately captured the ecological factors influencing the chipmunk's distribution because of the data hungry nature of occupancy modeling.

Deletion rescue resulting in segmental homozygosity: A mechanism underlying discordant NIPT results.

With the increasing capabilities of non-invasive prenatal testing (NIPT), detection of sub-chromosomal deletions and duplications are possible. This case series of deletion rescues resulting in segmental homozygosity helps provide a biological explanation for NIPT discrepancies and adds to the dearth of existing literature surrounding segmental UPD cases and their underlying mechanisms. In the three cases presented here, NIPT reported a sub-chromosomal deletion (in isolation or as part of a complex finding).

Effects of a naturalistic intervention on the speech outcomes of young children with cleft palate.

: The purpose of this study was to investigate the extent to which a naturalistic communication intervention, Enhanced Milieu Teaching with Phonological Emphasis (EMT + PE) improved the speech outcomes of toddlers with cleft palate with or without cleft lip (CP ± L): This study was a stratified randomised controlled trial.Setting: Treatment was delivered in a university clinic by a trained speech-language pathologist.Thirty children aged between 15 and 36 months ( = 25) with nonsyndromic CP ± CL and typical cognitive development were randomly assigned to a treatment (EMT + PE) or business as usual comparison condition.

Early Speech and Language Development in Children With Nonsyndromic Cleft Lip and/or Palate: A Meta-Analysis.

Objective The aim of the study was to conduct a meta-analysis of research examining the early speech and language functioning of young children, birth to age 8;11 (years;months), with nonsyndromic cleft lip and/or palate (NSCL/P) compared to their peers without NSCL/P. Method We conducted a random-effects metaregression using 241 effect sizes from 31 studies comparing 955 young children with NSCL/P to 938 typically developing peers on measures of speech and language functioning. Moderators were sample characteristics (i.

Triage Performance of School Personnel Using the SALT System.

Introduction: The aim of this study was to determine if school personnel can understand and apply the Sort, Assess, Life-saving interventions, Treat/Transport (SALT) triage methods after a brief training. The investigators predicted that subjects can learn to triage with accuracy similar to that of medically trained personnel, and that subjects can pass an objective-structured clinical exam (OSCE) evaluating hemorrhage control.

Methods: School personnel were eligible to participate in this prospective observational study.