Oral Health Screening by MassHealth Accountable Care Organizations: An opportunity for equity-focused interventions.

Establishing reliable access to dental services for publicly insured patients is an important part of achieving equitable oral health care. In 2023, an oral health screening requirement was added to the MassHealth Accountable Care Organization contract, which has the capacity to affect over 1.3 million members enrolled in MassHealth Accountable Care Organizations throughout the state.

Advancing Oral Health Equity through Medical-Dental Integration: Dental hygienists as catalysts for change in an evolving health care system.

This report explores the changing landscape of oral health care delivery in the United States, highlighting the evolving role of dental hygienists. The 2021 National Institutes of Health report "Oral Health in America: Advances and Challenges" has become a key milestone in addressing oral health inequities, acknowledging the important role that dental hygienists could play in expanding innovative care models, and promoting medical-dental integration (MDI). The Rainbow Model of Integrated Care offers a framework to examine facilitators of MDI care models, revealing supportive policies, interprofessional collaborative practice, incremental change, and local leadership as some of the crucial components needed for success.

Developing Parametric and Nonparametric Models for Model-Informed Precision Dosing: A Quality Improvement Effort in Vancomycin for Patients With Obesity.

Background: Both parametric and nonparametric methods have been proposed to support model-informed precision dosing (MIPD). However, which approach leads to better models remains uncertain. Using open-source software, these 2 statistical approaches for model development were compared using the pharmacokinetics of vancomycin in a challenging subpopulation of class 3 obesity.

Critical shear stress of sunken, No. 6 heavy fuel oil in fresh water.

A series of flume- and laboratory-based experiments defined and quantified the thresholds of sunken oil transport using No.6 heavy fuel oil mixed with kaolinite clay. When the sunken oil became mobile, the current-induced bed shear stress exceeded a threshold value specific to the oil, known as critical shear stress (CSS).

An Evaluation of STFM's National Addiction Curriculum.

Background And Objectives: Family physicians are well positioned to treat patients with substance use disorders (SUDs), expand access to care, destigmatize addiction, and provide a biopsychosocial treatment approach. There is a great need to train residents and faculty to competency in SUD treatment. Through the Society of Teachers of Family Medicine (STFM) Addiction Collaborative, we created and evaluated the first national family medicine (FM) addiction curriculum using evidence-based content and teaching principles.

Establishing Antibiotic Stewardship Programs in Rural Hospitals to Decrease Fluoroquinolone Prescribing: The Vermont Experience.

Critical access and rural community hospitals struggle to develop effective antimicrobial stewardship programs (ASPs). We assisted six Vermont hospitals in developing their antimicrobial stewardship programs to meet the Centers for Disease Control and Prevention's core elements of antibiotic stewardship. We show that rural hospitals in Vermont can (1) extract antimicrobial use data from their electronic medical record; (2) develop interventions to decrease high use antimicrobial agents, such as fluoroquinolones; and (3) successfully develop sustained ASPs meeting the CDC core elements in less than 2 years.

Association between maternal periodontal disease and adverse pregnancy outcomes: an analysis of claims data.

Background: While a number of studies have explored the link between periodontal disease and adverse pregnancy outcomes, both epidemiological studies and intervention trials have reached contradictory results with relatively small sample sizes. Utilizing large-scale claims data, we aim to investigate the association between maternal periodontal disease and adverse pregnancy outcomes.

Objective: Utilizing large-scale claims data, we aim to investigate the association between maternal periodontal disease and adverse pregnancy outcomes.

Variation in dental services by rurality among privately insured adults in the United States.

Objectives: Rurality is associated with reduced dental access and worse oral health outcomes. It is unknown whether there is variation in dental services received by rural adults who visit a dentist.

Methods: This was a retrospective analysis of claims data from a large private insurer.

The integration of oral health-related best practice recommendations in the management of patients with diabetes: a cross-sectional survey of primary care physicians.

Objective: To determine whether best practice recommendations are being followed by primary care physicians (PCPs) by examining the integration of oral health-related practices in their management of patients with diabetes.

Methods: A cross-sectional study design was used to examine PCPs' knowledge of the bidirectional link between diabetes and periodontal disease (PD), their adherence to international best practice recommendations, and their experience of interprofessional collaboration with dentists via an online survey.

Results: In total, 79 of 173 PCPs completed the online survey.

The detection of oral cancer and potentially malignant disorders in Ireland: An observational study of 100 cases.

Objective: To describe the diagnostic details of a sample of histologically diagnosed malignant and potentially malignant oral lesions from Ireland; to examine how these lesions were first detected, and by whom; and to determine whether factors influenced how these lesions were detected, who detected them, and the type of lesion diagnosed.

Methods: A retrospective review was carried out of the clinical notes relating to oral lesions histologically diagnosed as squamous cell carcinoma (SCC), carcinoma in-situ, or epithelial dysplasia from biopsies performed in hospital-based specialist units and submitted to a diagnostic pathology service based in Dublin, Ireland, between June and December 2015. In addition to sex, age, and smoking status, details were collected relating to the diagnosis, how the lesion was detected, and by whom.

An AUC Target Simulation for Vancomycin in Patients With Class III Obesity.

Objective: The objective of this simulation is to compare 24-hour vancomycin (Vanc) dosage requirements between a target area under the curve (AUC) versus a target trough approach in patients with class III obesity.

Methods: Adult patients were included if they received vancomycin in accordance with the University of Vermont Medical Center's class III obesity dosage protocol from June 2016 through December 2018. Patient-specific pharmacokinetic parameters were calculated for each patient using the Sawchuck-Zaske method.

When are Oral Antibiotics a Safe and Effective Choice for Bacterial Bloodstream Infections? An Evidence-Based Narrative Review.

Bacterial bloodstream infections (BSIs) are a major cause of morbidity and mortality in the United States. Traditionally, BSIs have been managed with intravenous antimicrobials. However, whether intravenous antimicrobials are necessary for the entirety of the treatment course in BSIs, especially for uncomplicated episodes, is a more controversial matter.

Identification of Risk Factors for Elevated Neonatal Gentamicin Trough Concentrations.

Objectives: The objective of this study was to identify neonatal and maternal characteristics that may be associated with elevated neonatal gentamicin trough concentrations despite application of a previously published gentamicin dosage strategy.

Methods: Retrospective cohort study of all neonates admitted to University of Vermont Medical Center (562-bed academic teaching hospital, Burlington, VT) receiving gentamicin between June 1, 2009, and August 31, 2013. A total of 205 neonates were included, with 41 cases and 164 controls.

Identification of Risk Factors for Initial Elevated Vancomyin Trough Concentrations.

Recent literature suggests that elevated vancomycin trough concentrations (>20 µg/mL) may be associated with an increased risk of nephrotoxicity and lead to an increase in mortality and hospital length of stay. The purpose of this study was to identify variables that may be predictive of elevated initial vancomycin trough concentrations. Retrospective case-control study of all adult patients who had an initial vancomycin trough concentration measured between January 1, 2013, and December 31, 2014.

Photophysical properties of {[Ag(CN)2](-)}2 complexes trapped in a supramolecular electron-acceptor organic framework.

The organic acceptor 1,1'-bis-(2,4-dinitrophenyl)-4,4'-bipyridinium (DNP(2+)) reacts with dicyanoargentate to form a supramolecular complex with the general formula: {[Ag(CN)2]2DNP}·2H2O. The photophysical properties of this complex were determined using solid-state luminescence experiments including luminescence lifetime measurements. Luminescence of the dicyanoargentate dimers is observed both by direct excitation of the silver dimers as well as excitation of the DNP(2+) followed by indirect non-radiative energy transfer to the silver dimer units for emission.

Structure and emissive properties of heterobimetallic Ln-Au coordination polymers: role of Tb and Eu in non-aurophilic [nBu4N]2[Ln(NO3)4Au(CN)2] versus aurophilic Ln[Au(CN)2]3·3H2O/3D2O chains.

This investigation is focused on comparing photophysical properties between two series of lanthanide-dicyanoaurate coordination polymers that contain and lack aurophilic interactions, respectively. Luminescence and crystallographic studies have been carried out on five different coordination polymer chain frameworks: the non-aurophilic [(n)Bu4N]2[LnxGd1-x(NO3)4Au(CN)2] (Ln = Eu, Tb; x = 0.01, 0.

Photocatalysis of fenoxycarb over silver-modified zeolites.

Two samples of silver doped into zeolite Y were prepared and characterized. ICP and SEM-EDS analysis indicate that the AgY1 sample contains twice the amount of silver compared to the AgY2 sample. Solid state luminescence spectroscopy shows variations in the emission modes of the site-selective luminescence where various luminophores might be excited upon selecting the proper excitation energy.