Effectiveness of an Online Medical Spanish Course in Improving Medical Students' Spanish Proficiency.

Introduction: A growing need exists for language-concordant healthcare for Spanish speakers in the United States. More than three-quarters of American medical schools provide Spanish language instruction, but little data exists on best practices. The purpose of this retrospective study was to examine whether an online medical Spanish course is effective at improving medical students' Spanish proficiency.

Benchmarks for retrospective automated driving system crash rate analysis using police-reported crash data.

Objectives: With fully automated driving systems (ADS; SAE level 4) ride-hailing services expanding in the U.S., we are now approaching an inflection point in the history of vehicle safety assessment.

Comparison of Waymo rider-only crash data to human benchmarks at 7.1 million miles.

Objectives: This article examines the safety performance of the Waymo Driver, an SAE level 4 automated driving system (ADS) used in a rider-only (RO) ride-hailing application without a human driver, either in the vehicle or remotely.

Methods: ADS crash data were derived from NHTSA's Standing General Order (SGO) reporting over 7.14 million RO miles through the end of October 2023 in Phoenix, Arizona, San Francisco, California, and Los Angeles, California, and compared to human benchmarks from the literature.

Bridging the gap: Mechanistic-based cyclist injury risk curves using two decades of crash data.

Objective: Injury risk curves are vital in quantifying the relative safety consequences of real-world collisions. Previous injury risk curves for bicycle-passenger vehicle crashes have predominantly focused on frontal impacts. This creates a gap in cyclist injury risk assessment for other geometric crash configurations.

A sampling strategy for longitudinal and cross-sectional analyses using a large national claims database.

Importance: The United States (US) Medicare claims files are valuable sources of national healthcare utilization data with over 45 million beneficiaries each year. Due to their massive sizes and costs involved in obtaining the data, a method of randomly drawing a representative sample for retrospective cohort studies with multi-year follow-up is not well-documented.

Objective: To present a method to construct longitudinal patient samples from Medicare claims files that are representative of Medicare populations each year.

National Hospitalization Rates and In-Hospital Mortality Rates of HIV-Related Opportunistic Infections in the United States, 2011-2018.

Background: Human immunodeficiency virus (HIV)-related opportunistic infections (OIs) cause substantial morbidity and mortality among people with HIV (PWH). US hospitalization and in-hospital mortality rates associated with OIs have not been published using data from the past decade.

Methods: We analyzed the National Inpatient Sample for the years 2011 through 2018.

QSAR and Chemical Read-Across Analysis of 370 Potential MGMT Inactivators to Identify the Structural Features Influencing Inactivation Potency.

-methylguanine-DNA methyltransferase (MGMT) constitutes an important cellular mechanism for repairing potentially cytotoxic DNA damage induced by guanine -alkylating agents and can render cells highly resistant to certain cancer chemotherapeutic drugs. A wide variety of potential MGMT inactivators have been designed and synthesized for the purpose of overcoming MGMT-mediated tumor resistance. We determined the inactivation potency of these compounds against human recombinant MGMT using [H]-methylated-DNA-based MGMT inactivation assays and calculated the IC values.

Passenger and heavy vehicle collisions with pedestrians: Assessment of injury mechanisms and risk.

Objective: Automated Driving System (ADS) fleets are currently being deployed in several dense-urban operational design domains within the United States. In these dense-urban areas, pedestrians have historically comprised a significant portion, and sometimes the majority, of injury and fatal collisions. An expanded understanding of the injury risk in collision events involving pedestrians and human-driven vehicles can inform continued ADS development and safety benefits evaluation.

Approach to Quantify Eye Movements to Augment Stroke Diagnosis With a Non-Calibrated Eye-Tracker.

Unlabelled: Automated eye-tracking technology could enhance diagnosis for many neurological diseases, including stroke. Current literature focuses on gaze estimation through a form of calibration. However, patients with neuro-ocular abnormalities may have difficulty completing a calibration procedure due to inattention or other neurological deficits.

Spinal injury rates and specific causation in motor vehicle collisions.

Motor vehicle collisions (MVCs) are a leading cause of acute spinal injuries. Chronic spinal pathologies are common in the population. Thus, determining the incidence of different types of spinal injuries due to MVCs and understanding biomechanical mechanism of these injuries is important for distinguishing acute injuries from chronic degenerative disease.

Airway driving pressure is associated with postoperative pulmonary complications after major abdominal surgery: a multicentre retrospective observational cohort study.

Background: High airway driving pressure is associated with adverse outcomes in critically ill patients receiving mechanical ventilation, but large multicentre studies investigating airway driving pressure during major surgery are lacking. We hypothesised that increased driving pressure is associated with postoperative pulmonary complications in patients undergoing major abdominal surgery.

Methods: In this preregistered multicentre retrospective observational cohort study, the authors reviewed major abdominal surgical procedures in 11 hospitals from 2004 to 2018.

Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network.

Introduction: Diarrhoea remains a leading cause of child morbidity and mortality. Systematically collected and analysed data on the aetiology of hospitalised diarrhoea in low-income and middle-income countries are needed to prioritise interventions.

Methods: We established the Global Pediatric Diarrhea Surveillance network, in which children under 5 years hospitalised with diarrhoea were enrolled at 33 sentinel surveillance hospitals in 28 low-income and middle-income countries.

Regional and racial disparities in major amputation rates among medicare beneficiaries with diabetes: a retrospective study in the southeastern USA.

Objective: While rates for non-traumatic lower extremity amputations (LEA) have been declining, concerns exist over disparities. Our objectives are to track major LEA (MLEA) rates over time among Medicare beneficiaries residing in a high diabetes prevalence region in the southeastern USA (the diabetes belt) and surrounding areas.

Methods: We used Medicare claims files for ~900 000 fee-for-service beneficiaries aged ≥65 years in 2006-2015 to track MLEA rates per 1000 patients with diabetes.

Frequency of bystander exposure to antibiotics for enteropathogenic bacteria among young children in low-resource settings.

Children in low-resource settings carry enteric pathogens asymptomatically and are frequently treated with antibiotics, resulting in opportunities for pathogens to be exposed to antibiotics when not the target of treatment (i.e., bystander exposure).

Annual wellness visits are associated with increased use of preventive services in patients with diabetes living in the Diabetes Belt.

Objective: To examine whether Annual Wellness Visits (AWVs) were associated with increased use of preventive services in Medicare patients with diabetes living in the Diabetes Belt.

Methods: We used a case-control design where outcomes were utilization of preventive services recommended for patients with diabetes (foot exam, eye exam, A1c test, and microalbuminuria test) and the exposure was AWVs using data for Medicare patients with diabetes in 2014 - 2015 residing in the Diabetes Belt (N = 412,009).

Results: Only 13.

Errors in Surgery: A Case Control Study.

Objective: While errors can harm patients they remain poorly studied. This study characterized errors in the care of surgical patients and examined the association of errors with morbidity and mortality.

Background: Errors have been reported to cause <10% or >60% of adverse events.

Human vs. Machine Learning Based Detection of Facial Weakness Using Video Analysis.

Background: Current EMS stroke screening tools facilitate early detection and triage, but the tools' accuracy and reliability are limited and highly variable. An automated stroke screening tool could improve stroke outcomes by facilitating more accurate prehospital diagnosis and delivery. We hypothesize that a machine learning algorithm using video analysis can detect common signs of stroke.

Effects of heat strain on cognitive function among a sample of miners.

Heat stress is associated with workplace injuries, likely through a combination of fatigue, reduced cognitive function, and thermal discomfort. The purpose of this study was to evaluate four cognitive tasks for sensitivity to heat stress. Eight participants performed treadmill exercise followed by assessments of serial reaction time (RT), Stroop effect, verbal delayed memory, and continuous performance working memory in an environmental chamber.

Prevention of Alcohol-related Incidents in the U.S. Air Force: Results From a Cluster Randomized Trial.

Background: Alcohol misuse poses significant public health concerns in the U.S. Military.

Evaluating efficiency of counties in providing diabetes preventive care using data envelopment analysis.

For patients with diabetes, annual preventive care is essential to reduce the risk of complications. Local healthcare resources affect the utilization of diabetes preventive care. Our objectives were to evaluate the relative efficiency of counties in providing diabetes preventive care and explore potential to improve efficiencies.

Mediastinal Masses, Anesthetic Interventions, and Airway Compression in Adults: A Prospective Observational Study.

Background: Central airway occlusion is a feared complication of general anesthesia in patients with mediastinal masses. Maintenance of spontaneous ventilation and avoiding neuromuscular blockade are recommended to reduce this risk. Physiologic arguments supporting these recommendations are controversial and direct evidence is lacking.

Development of a concise injury severity prediction model for pediatric patients involved in a motor vehicle collision.

Objective: Transporting severely injured pediatric patients to a trauma center has been shown to decrease mortality. A decision support tool to assist emergency medical services (EMS) providers with trauma triage would be both as parsimonious as possible and highly accurate. The objective of this study was to determine the minimum set of predictors required to accurately predict severe injury in pediatric patients.

How Total Performance Scores of Medicare Value-Based Purchasing Program Hospitals Change Over Time.

Background And Purpose: The Medicare Value-Based Purchasing (VBP) program established performance-based financial incentives for hospitals. We hypothesized that total performance scores (TPS) would vary by hospital type.

Methods: Value-Based Purchasing reports were collected from 2015 to 2017 and merged with the Centers for Medicare and Medicaid Services (CMS) Impact File data.

Etiology and Incidence of Moderate-to-Severe Diarrhea in Young Children in Niger.

Background: High-resolution data on the etiology of childhood diarrhea in countries with the highest burden and mortality remain sparse and are needed to inform burden estimates and prioritize interventions.

Methods: We tested stool specimens collected between October 2014 and December 2017 from children under 2 years of age from the per-protocol population of a placebo-controlled clinical trial of a bovine rotavirus pentavalent vaccine (Rotasiil) in Niger. We tested 1729 episodes of moderate-to-severe diarrhea (Vesikari score ≥ 7) using quantitative PCR and estimated pathogen-specific burdens by age, season, severity, and trial intervention arm.

An omni-directional model of injury risk in planar crashes with application for autonomous vehicles.

Automated driving systems (ADS) are actively being deployed within the driving fleet. ADS are designed to safely navigate roadways, which entails an expectation of encountering varying degrees of potential conflict with other road users. The ADS design and evaluation process benefits from estimating injury severity probabilities for collisions that may occur.