Publications by authors named "Kline D"

Specialty palliative care has been associated with cost savings at the end of life, while patient navigators have been independently associated with cost savings due to screening and treatment early in the course of disease. Evidence is limited regarding patient navigators and cost savings at the end of life. To determine the cost-effectiveness of a lay patient navigator intervention in improving palliative care outcomes for Hispanic persons with serious noncancer illness.

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Background: Medications for opioid use disorder are associated with lower risk of drug overdoses at the individual level. However, little is known about whether these effects translate to population-level reductions. We investigated whether county-level efforts to increase access to medication for opioid use disorder in 2012-2014 were associated with opioid overdose deaths in New York State during the first years of the synthetic opioid crisis.

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Background: Abdominal adhesions are networks of fibrotic tissues that form between organs postoperatively. Current prophylactic strategies do not reproducibly prevent adhesive small bowel obstruction across the entire abdomen. Human placental-derived stem cells produce an anti-inflammatory secretome that has been applied to multiple fibrosing diseases.

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  • In recent rural U.S. studies, individuals who use drugs (PWUD) are increasingly combining opioids with stimulants like methamphetamine and cocaine.
  • Among 2,705 PWUD surveyed, 74% reported using both opioids and stimulants, with 76% having undergone hepatitis C virus (HCV) testing.
  • Those who used opioids alone had lower rates of HCV testing, and those using both opioids and stimulants were less likely to have received anti-HCV medication compared to those using other drugs.
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Spatial repellents may protect personnel in delimited areas from incursion of vector or nuisance Diptera, such as mosquitoes and sand flies. We investigated the efficacy of resin diffusers impregnated with transfluthrin in protecting 2 simulated military field scenarios (partially opened tents and open bivouacs lacking shelter) from natural populations of Culex species mosquitoes and Phlebotomus species sand flies. Using a benchmark efficacy of 61% expected reduction from a recent literature survey, we found that transfluthrin protected bivouacs from sand flies (74.

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Background: Developments in natural language processing (NLP) and unsupervised machine learning methodologies (e.g., clustering) have given researchers new tools to analyze both structured and unstructured health data.

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Background: The authors observed an association between cervical spine mobility and arm injury risk in baseball players; however, there is a need to assess the generalizability of cervical measurement data. Assessing the downstream associations of cervical dysfunction on shoulder and elbow injuries can inform clinical interventions to help reduce future arm injuries. The purpose of this study was to assess the generalizability of neck range of motion measures as arm injury prognostic factors in professional baseball pitchers.

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Approaches to population size estimation are of importance across a wide spectrum of disciplines, especially when census and simple random sampling are impractical. The capture-recapture method and the multiplier-benchmark method are two commonly used approaches that use data that partially capture the target population and overlap in a known way. Due to similarities in required data structures, the approaches are often used interchangeably without a critical appraisal of the underlying assumptions, especially in the two-sample case.

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We examined a natural history of opioid overdose deaths from 1999-2021 in the United States to describe state-level spatio-temporal heterogeneity in the waves of the epidemic. We obtained overdose death counts by state from 1999-2021, categorized as involving prescription opioids, heroin, synthetic opioids, or unspecified drugs. We developed a Bayesian multivariate multiple change point model to flexibly estimate the timing and magnitude of state-specific changes in death rates involving each drug type.

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Introduction: High-quality health information handovers are critical to optimal patient care and trainee education. The purposes of this study were to assess the feasibility of implementing an emergency general surgery (EGS) morning handover and to explore its impact upon markers of clinical care.

Methods: This prospective feasibility study was conducted at a single academic tertiary-care medical center following implementation of a novel EGS morning handover process.

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Introduction: Abdominal adhesions represent a chronic postsurgical disease without reliable prophylaxis. Animal modeling has been a cornerstone of novel therapeutic development but has not produced reliable clinical therapies for prevention of adhesive small bowel obstruction. The purpose of this scoping review is to analyze animal models for abdominal adhesion generation by key considerations of external validity (i.

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In the last 2 decades, there has been an increase in the geographic range and frequency of vector-borne diseases. Management of mosquito populations has become challenging due to increasing rates of resistance to existing insecticidal products and formulations. Several alternative tools have emerged to suppress or replace mosquito populations.

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  • Coccidioidomycosis, or Valley fever, is a rising infectious disease caused by inhaling fungal spores from Coccidioides, whose endemic region is expanding due to climate change.
  • Traditional case data for Valley fever is flawed due to issues like false positives and underreporting, making it unreliable for assessing Coccidioides endemicity.
  • A new Bayesian model was proposed to estimate Coccidioides endemicity in the western U.S., revealing high endemicity in states like California and Arizona, while also addressing detection variability linked to environmental factors like precipitation and agriculture.
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  • The study highlights the unknown long-term effects of hypertension in youth, despite its rising rates and high adult cardiovascular mortality.
  • The Study of the Epidemiology of Pediatric Hypertension (SUPERHERO) aims to address past research limitations by gathering a large, diverse registry of youth with hypertension through standardized electronic health records.
  • SUPERHERO focuses on improving cardiovascular outcomes and developing top-notch biomedical informatics methods for managing youth hypertension, with inclusion criteria for patients under 19 with specific hypertension disorders.
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We previously showed that orexin neurons are activated by hypoxia and facilitate the peripheral chemoreflex (PCR)-mediated hypoxic ventilatory response (HVR), mostly by promoting the respiratory frequency response. Orexin neurons project to the nucleus of the solitary tract (nTS) and the paraventricular nucleus of the hypothalamus (PVN). The PVN contributes significantly to the PCR and contains nTS-projecting corticotropin-releasing hormone (CRH) neurons.

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Chronic intermittent hypoxia (CIH) in rodents mimics the hypoxia-induced elevation of blood pressure seen in individuals experiencing episodic breathing. The brainstem nucleus tractus solitarii (nTS) is the first site of visceral sensory afferent integration, and thus is critical for cardiorespiratory homeostasis and its adaptation during a variety of stressors. In addition, the paraventricular nucleus of the hypothalamus (PVN), in part through its nTS projections that contain oxytocin (OT) and/or corticotropin-releasing hormone (CRH), contributes to cardiorespiratory regulation.

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  • A study developed a new rat model to investigate abdominal adhesions, a common surgical issue, and tested various treatments including human placental stem cells (hPSC).
  • Forty-four male Sprague-Dawley rats were used; the study involved creating adhesions and applying different treatments, including a control group and various experimental therapies over a 14-day period.
  • Results showed that treatments with hPSC and its secretome significantly reduced the severity of abdominal adhesions compared to the control group, indicating potential for new therapeutic approaches.
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House flies are notoriously difficult to control, owing to their tendency to live in close relationships with humans and their livestock, and their rapid development of resistance to chemical controls. With this in mind, we explored an alternative chemical control, a spatial repellent to deter L. from points we wanted to protect (i.

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  • The study presents a capture-recapture analysis of opioid use disorder (OUD) prevalence in Massachusetts from 2014 to 2020, aiming to estimate the size of this population at risk.
  • The findings indicate an overall increase in OUD prevalence, highlighting significant disparities, particularly among Hispanic and Black males and females.
  • This research is crucial for informing public health strategies and targeting resources for affected communities, especially as the global overdose crisis continues to escalate.
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An important challenge to addressing the opioid overdose crisis is the lack of information on the size of the population of people who misuse opioids (PWMO) in local areas. This estimate is needed for better resource allocation, estimation of treatment and overdose outcome rates using appropriate denominators (ie, the population at risk), and proper evaluation of intervention effects. In this study, we used a bayesian hierarchical spatiotemporal integrated abundance model that integrates multiple types of county-level surveillance outcome data, state-level information on opioid misuse, and covariates to estimate the latent (hidden) numbers of PWMO and latent prevalence of opioid misuse across New York State counties (2007-2018).

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Background/purpose: Gait impairments in Parkinson disease (PD) contribute to decreased quality of life. This randomized controlled trial examined immediate- and longer-term effects of a single joint robotic exoskeleton device (EXOD), the Honda Walking Assist device, on gait.

Methods: Participants (n = 45) with PD (Hoehn and Yahr stages 1-3) were randomized to a robotic-assisted gait training (RAGT) group (n = 23) or control (CON) group (n = 22).

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The treatment of peripheral nerve injuries has seen tremendous innovations over the past century. Dr Gotthelf Carl Huber, an American immigrant and early experimental pioneer in the field of peripheral nerve injury, created a foundation of scientific knowledge for these advancements. At the beginning of his career, Huber published novel work in peripheral nerve injury, supporting the concept of Wallerian degeneration and demonstrating the use of nerve grafting for repair.

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Material extrusion Additive Manufacturing (AM), is one of the most widely practiced methods of AM. Fused Filament Fabrication (FFF) is what most associate with AM, as it is relatively inexpensive, and highly accessible, involving feeding plastic filament into a hot-end that melts and extrudes from a nozzle as the toolhead moves along the toolpath. Direct Ink Write (DIW) 3D printing falls into this same category of AM, however is primarily practiced in laboratory settings to construct novel parts from flowable feedstock materials.

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