Flu-Phobia: Influenza Vaccine Hesitancy in a Rural Primary Care Setting.

The sentiments expressed by individuals, such as "I do not trust vaccines," "I do not believe in vaccines," and "I do not want a shot," are commonly encountered by physicians during the annual influenza season. This study investigates vaccine hesitancy regarding the influenza vaccine within a rural primary care setting in New York State. Observations of subjective comments from community members prompted an inquiry into whether the contentious discourse surrounding the COVID-19 vaccine has influenced patients' decisions about the influenza vaccination.

A Comparison of Surgical Subspecialty Match Rates in 2022 in the United States.

This paper examines the 2022 surgical subspecialty results within the Match hosted yearly by the National Resident Matching Program (NRMP) in the United States. It exists to place medical graduates with post-graduate training programs via an algorithm based on ranked lists provided by both residency programs and individual applicants around the world. This paper compares the match rates between allopathic medical graduates (MDs) and osteopathic medical graduates (DOs).

COVID-19 Vaccine Hesitancy in a Rural Primary Care Setting.

As the United States clamors with anti-vax protests, researchers seek to understand what social and behavioral values are keeping patients from electing to vaccinate themselves against the coronavirus disease 2019 (COVID-19) virus. Over the past year, the race to vaccinate has become less about developing working vaccines and more about finding ways to encourage vaccine uptake. This paper examines the question of vaccine hesitancy in rural Chemung County, NY.

Core-shell microneedle patch for six-month controlled-release contraceptive delivery.

There is a tremendous need for simple-to-administer, long-acting contraception, which can increase access to improved family planning. Microneedle (MN) patches enable simple self-administration and have previously been formulated for 1-2 months' controlled release of contraceptive hormone using monolithic polymer/drug MN designs having first-order release kinetics. To achieve zero-order release, we developed a novel core-shell MN patch where the shell acts as a rate-controlling membrane to delay release of a contraceptive hormone, levonorgestrel (LNG), for 6 months.

Benefits of developing graduate medical education programs in community health systems.

The creation of new CMS-funded Graduate Medical Education (GME) cap positions by the Consolidated Appropriations Act 2021 offers a unique opportunity for systems in community and rural settings to develop and expand their training programs. This article provides a review of the evidence behind the value proposition for system administrators to foster the growth of GME in community health systems. The infrastructure needed to accredit GME programs may reduce the cost of care for both the patients and the system through improved patient outcomes and facilitation of system efforts to recognize and mitigate social determinants of health.

Development and Field Validation of Lidocaine-Loaded Castration Bands for Bovine Pain Mitigation.

Castration is among the most common management procedures performed in the dairy and beef cattle industries and is mainly performed by surgery or elastic banding. Despite the various benefits of castration, all methods produce pain and distress. Castration by banding is simple, inexpensive, produces fewer complications, and can be performed in a high-throughput manner.

Recognizing postoperative nutritional complications of bariatric surgery in the primary care patient: a narrative review.

Bariatric surgery is an effective treatment for patients with morbid obesity. However, as safe and common as bariatric procedures have become, multiple complications can still result. These complications vary depending on the type of procedure performed (malabsorptive or restrictive) and are often nutritional derangements from the altered malabsorptive surface of the gastrointestinal tract and decreased capacity of the stomach.

Spatial Sequencing: A Perspective.

Fluorescent spatial sequencing brings next-generation sequencing into a new realm capable of identifying nucleic acids in the cell's natural environment. For the first time, scientists are able to multiplex the assignment of specific locations to hundreds of transcriptional targets and lay the foundation for understanding how genetic changes control the fate of each cell within the tissue microenvironment. In this perspective, we discuss the capabilities of fluorescent spatial sequencing in the context of other spatial imaging technologies and describe how these new technologies offer a data-rich, multiomic solution to many research applications.

Long-acting reversible contraception by effervescent microneedle patch.

To increase access to long-acting contraception, we developed a reversible contraceptive microneedle patch that is simple-to-administer, slowly releases contraceptive hormone (levonorgestrel) for >1 month, and generates no biohazardous sharps waste. After manually pressing the patch to skin for 1 min, microneedles rapidly separate from the patch within the skin due to effervescence triggered by contact with skin's interstitial fluid, as demonstrated in rats and human participants. Long-acting contraception is achieved by formulating microneedles with a biodegradable polymer [poly(lactic--glycolic) acid] that slowly releases levonorgestrel for ~1 month in vitro.

Rapidly separable microneedle patch for the sustained release of a contraceptive.

Women often have limited access to contraception, and barrier methods have low acceptance and a high failure rate, mostly due to incorrect use, which can result in unplanned pregnancies. Sustained-release formulations of contraceptive hormones are available, yet typically require their administration by trained personnel. Here, we report the design of a microneedle patch with rapidly separable biodegradable polylactic acid and polylactic-co-glycolic acid needles, and its application for the continuous release of levonorgestrel-a contraceptive hormone.

Polymer Coated Urea in Turfgrass Maintains Vigor and Mitigates Nitrogen's Environmental Impacts.

Polymer coated urea (PCU) is a N fertilizer which, when added to moist soil, uses temperature-controlled diffusion to regulate N release in matching plant demand and mitigate environmental losses. Uncoated urea and PCU were compared for their effects on gaseous (N2O and NH3) and aqueous (NO3(-)) N environmental losses in cool season turfgrass over the entire PCU N-release period. Field studies were conducted on established turfgrass sites with mixtures of Kentucky bluegrass (Poa pratensis L.

Nitrous oxide emissions from anhydrous ammonia, urea, and polymer-coated urea in illinois cornfields.

The use of alternative N sources relative to conventional ones could mitigate soil-surface NO emissions. Our objective was to evaluate the effect of anhydrous ammonia (AA), urea, and polymer-coated urea (ESN) on NO emissions for continuous corn ( L.) production.

Fluorescent in situ sequencing (FISSEQ) of RNA for gene expression profiling in intact cells and tissues.

RNA-sequencing (RNA-seq) measures the quantitative change in gene expression over the whole transcriptome, but it lacks spatial context. In contrast, in situ hybridization provides the location of gene expression, but only for a small number of genes. Here we detail a protocol for genome-wide profiling of gene expression in situ in fixed cells and tissues, in which RNA is converted into cross-linked cDNA amplicons and sequenced manually on a confocal microscope.

Forests, fields, and the edge of sustainability at the ancient Maya city of Tikal.

Tikal has long been viewed as one of the leading polities of the ancient Maya realm, yet how the city was able to maintain its substantial population in the midst of a tropical forest environment has been a topic of unresolved debate among researchers for decades. We present ecological, paleoethnobotanical, hydraulic, remote sensing, edaphic, and isotopic evidence that reveals how the Late Classic Maya at Tikal practiced intensive forms of agriculture (including irrigation, terrace construction, arboriculture, household gardens, and short fallow swidden) coupled with carefully controlled agroforestry and a complex system of water retention and redistribution. Empirical evidence is presented to demonstrate that this assiduously managed anthropogenic ecosystem of the Classic period Maya was a landscape optimized in a way that provided sustenance to a relatively large population in a preindustrial, low-density urban community.

Highly multiplexed subcellular RNA sequencing in situ.

Understanding the spatial organization of gene expression with single-nucleotide resolution requires localizing the sequences of expressed RNA transcripts within a cell in situ. Here, we describe fluorescent in situ RNA sequencing (FISSEQ), in which stably cross-linked complementary DNA (cDNA) amplicons are sequenced within a biological sample. Using 30-base reads from 8102 genes in situ, we examined RNA expression and localization in human primary fibroblasts with a simulated wound-healing assay.

Changing the "Peter Principled" culture of health care systems.

The 40-year-old "Peter Principle" still reminds us of the stagnant nature of organizational culture within many health care systems. Consider a prescription to help instill a culture of innovation.

Analysis of AOA/ACGME accredited family medicine residency programs.

Background And Objectives: American Osteopathic Association (AOA) accreditation of Accreditation Council for Graduate Medical Education (ACGME) family medicine residency programs began in the early 1990s to increase the number of Osteopathic Graduate Medical Education (OGME) training positions in family medicine. Despite the rapid expansion of family medicine residencies accredited by both the AOA and the ACGME, little has been published about issues facing these programs.

Methods: We developed an Internet-based survey for osteopathic program directors of dual-accredited family medicine residency programs in 2009.

Incorporating a Mandatory Osteopathic Manipulative Medicine (OMM) curriculum in clinical clerkships: impact on student attitudes toward using OMM.

Context: As the osteopathic medical profession grows and enrollment in osteopathic graduate medical education falls, it is important to ensure that all osteopathic medical students receive adequate training in osteopathic manipulative medicine (OMM).

Objective: To determine if incorporating mandatory exposure to OMM into third- and fourth-year clinical clerkships favorably influences osteopathic medical students' comfort with the use of OMM.

Methods: All participants attended a 1-hour mandatory didactic lecture and a 3-hour practical clinic every week as part of their rotations at Wilson Memorial Medical Center.

The use of standardized patients to evaluate family medicine resident decision making.

Background And Objectives: This study was intended to assess the usefulness of standardized patients (SPs) in the evaluation of family medicine residents' clinical decision-making skills in ambulatory settings.

Methods: A pool of SPs was trained about the symptoms of one of three clinical conditions (depression, headache, or irritable bowel syndrome). These patients were then surreptitiously incorporated into the office hours of 11 residents on one occasion during their second year and once during their third year of training.

Postpartum outcomes in supine delivery by physicians vs nonsupine delivery by midwives.

Context: Clinically preferred maternal position during childbirth has varied between supine and nonsupine over time and from patient to patient. Preferred maternal birthing position is coming under increasing scrutiny.

Objective: To compare postpartum maternal and infant outcomes resulting from supine and nonsupine positions maintained during the second stage of labor.