Development and Implementation of a Multicenter Registry for Resuscitation-Focused Transesophageal Echocardiography.

Study Objective: To evaluate the clinical effect, safety, and clinical outcomes of focused transesophageal echocardiography (TEE) in the evaluation of critically ill patients in the emergency department (ED) and ICUs.

Methods: We established a prospective, multicenter, observational registry involving adult critically ill patients in whom focused TEE was performed for evaluation of out-of-hospital cardiac arrest (OHCA), inhospital cardiac arrest, evaluation of undifferentiated shock, hemodynamic monitoring, and/or procedural guidance in the ED, ICU, or operating room setting. The primary objective of the current investigation was to evaluate the clinical influence and safety of focused, point-of-care TEE in critically ill patients.

Efficacy of Behavioral Intervention, Text Messaging, and Extended Intervention to Address Alcohol Misuse in Sexual Minority Men with HIV: A Factorial Randomized Clinical Trial.

This clinical trial examined the individual and combined effects of three different approaches to reducing alcohol misuse among a sample of sexual minority men (SMM) with HIV. Specifically, we used a 2 × 2 × 2 randomized factorial design to compare: (a) behavioral intervention based in motivational interviewing (MI) vs. brief intervention (BI), (b) interactive text messaging (ITM) for alcohol use vs.

The effects of regular home delivery of HIV self-testing and follow-up counselling on HIV testing and prevention outcomes in men who have sex with men who test infrequently in the United States: a pragmatic, virtual randomized controlled trial.

Introduction: Past research shows that HIV self-testing (HIVST) can increase testing and facilitate more HIV diagnoses relative to clinic testing. However, in the United States, the use of HIVSTs is limited due to concerns that those who use HIVST could be less likely to be linked to care.

Methods: From January 2019 to April 2022, we recruited 811 men who have sex with men (MSM) in the United States who tested infrequently using an online marketing campaign and randomized them 1:1:1 to receive one of the following every 3 months for a year: (1) text message reminders to get tested at a local clinic (control); (2) mailed HIVST kits with access to a free helpline (standard HIVST); and (3) mailed HIVST kits with counselling provided within 24 hours of opening a kit (eTest).

Black social media influencers engage higher percentages of Black gay and bisexual men in online outreach for HIV prevention research relative to paid ads.

Background: Influencer-based social media marketing campaigns are a popular strategy to engage customers in many non-research industries (e.g., retail), but have been increasingly used in public health campaigns to reach and engage specific populations.

Challenges in implementing cultural adaptations of digital health interventions.

Differences in the access and use of digital health interventions are driven by culture, in addition to economic and physical factors. To avoid the systematic exclusion of traditionally underserved cultural groups, creating inclusive digital health interventions is essential. One way to achieve this is through cultural adaptations, defined as the systematic modification of an existing intervention that aligns with a target audience's cultural norms, beliefs, and values.

Using web analytics data to identify platforms and content that best engage high-priority HIV populations in online and social media marketing advertisements.

Background: Online advertisements on social media platforms are an important tool for engaging relevant populations in public health research. However, little is known about what platforms and ad characteristics are most effective in engaging high-priority HIV populations, including racial/ethnic and sexual minority individuals.

Methods: Data from this study were drawn from advertising campaigns conducted on popular websites and social media platforms that recruited for several nationwide randomized controlled trials of various HIV prevention and testing strategies among sexual minority men (SMM) from December 2019 until March 2022.

Pilot Randomized Controlled Trial of Game Plan for PrEP: A Brief, Web and Text Message Intervention to Help Sexual Minority Men Adhere to PrEP and Reduce Their Alcohol Use.

Suboptimal adherence to oral PrEP medications, particularly among younger sexual minority men (SMM), continues to be a key barrier to achieving more substantial declines in new HIV infections. Although variety of interventions, including web and text-message-based applications, have successfully addressed PrEP adherence, very few have addressed the potential influence of alcohol. This pilot study explored whether the Game Plan for PrEP, a brief, web-based and text messaging intervention, helped promote PrEP persistence and adherence and reduced condomless sex and alcohol use.

Patient Perceptions of In Vivo Versus Virtual Reality Exposures for the Treatment of Anxiety Disorders: Cross-Sectional Survey Study.

Background: Psychotherapy, and particularly exposure therapy, has been proven to be an effective treatment for many anxiety disorders, including social and specific phobias, as well as posttraumatic stress disorders. Currently, exposures are underused and mostly delivered in vivo. Virtual reality exposure therapy (VRET) offers a more flexible delivery mechanism that has the potential to address some of the implementation barriers of in vivo exposures while retaining effectiveness.

Virtual reality (VR) treatments for anxiety disorders are unambiguously successful, so why are so few therapists using it? Barriers to adoption and potential solutions.

Anxiety disorders are a significant cause of disability globally, yet only one in ten sufferers receives adequate quality treatment. Exposure-based therapies are effective in reducing symptoms associated with a number of anxiety disorders. However, few therapists use exposure techniques to treat these conditions, even when they are adequately trained in them, often because of concerns about provoking distress, drop out, logistical barriers, and other concerns.

Addressing key issues in HIV self-test program implementation for Black and Latino sexual minority men in the Southern United States: a multiphase study protocol.

Background: Black and Latino sexual minority men in the Southern United States have the highest HIV infection rates in the country. Increased HIV testing can help decrease onward HIV transmission through detecting previously undiagnosed infections. HIV self-testing is an evidence-based strategy to increase HIV testing among sexual minority men, but the implementation of this intervention in the Southern United States is limited.

Adolescents' perceptions of alcohol portrayals in the media and their impact on cognitions and behaviors.

Objective: Exposure to alcohol in the media is pervasive and may influence adolescents' perceptions and use of alcohol. The purpose of this study was to better understand how adolescents perceive alcohol-related content in both entertainment and social media, with a focus on the valence of portrayals (i.e.

Emotional Reactions to High-Risk Sex among Sexual Minority Men: Exploring Potential Opportunities for Just-In-Time Intervention.

Rates of HIV and other sexually transmitted infections (STIs) are high among sexual minority men (SMM). A large body of research has explored determinants of HIV/STI risk behavior, but few studies have explored emotional consequences of these events. Understanding the valence, timing, and strength of emotional reactions to sexual risk could inform use of specific behavior change techniques in interventions (such as anticipated regret) and identify new opportunities for intervention, including just-in-time interventions.

E-CPR in Cardiac Arrest due to Accidental Hypothermia Using Intensivist Cannulators: A Case Series of Nine Consecutive Patients.

Severe accidental hypothermia (AH) accounts for over 1300 deaths/year in the United States. Early extracorporeal life support (ECLS) is recommended for hypothermic cardiac arrest. We describe the use of a rapid-deployment extracorporeal cardiopulmonary resuscitation (E-CPR) team using intensivist physicians (IPs) as cannulators and report the outcomes of consecutive patients cannulated for ECLS to manage cardiac arrest due to AH.

Feasibility, Appropriateness, and Willingness to Use Virtual Reality as an Adjunct to Counseling among Addictions Counselors.

Introduction: Research suggests that virtual reality (VR) experiences can be helpful as adjunctive tools in psychotherapy for some mental health conditions. VR is a computer-generated experience that produces a feeling of being immersed in a different environment. VR experiences could be useful in the treatment of substance use disorders, and several are currently being tested.

Exploring Whether Addictions Counselors Recommend That Their Patients Use Websites, Smartphone Apps, or Other Digital Health Tools to Help Them in Their Recovery: Web-Based Survey.

Background: Hundreds of smartphone apps or websites claiming to help those with addictions are available, but few have been tested for efficacy in changing clinically relevant addictions outcomes. Although most of these products are designed for self-facilitation by users struggling with addictions, counselors and other addictions treatment providers will likely play a critical role in facilitating adoption by integrating their use into counseling or recommending them to their patients. Yet, few studies have explored the practices of addictions counselors in using or recommending addictions-focused digital health tools in their work.

Using Social Media for Clinical Research: Recommendations and Examples From the Brown-Lifespan Center for Digital Health.

Social media integration into research has increased, and 92% of American social media participants state they would share their data with researchers. Yet, the potential of these data to transform health outcomes has not been fully realized, and the way clinical research is performed has been held back. The use of these technologies in research is dependent on the investigators' awareness of their potential and their ability to innovate within regulatory and institutional guidelines.

Gay, Bisexual, and Other Men Who Have Sex With Men Who Are Not on Oral PrEP may be Less Interested in Available Injectable Products than in Oral PrEP: Examining Individual-Level Determinants of Interest and Barriers Across Products.

Approval of the first injectable PrEP product (cabotegravir) provides an exciting addition to oral PrEP that could encourage those not currently on PrEP to use it. However, few studies have explored interest in injectable cabotegravir among those at increased risk who are not currently on PrEP. We conducted an online survey with 327 gay, bisexual, and other men who have sex with men (GBM) with limited PrEP history to explore their interest and intentions to use oral and injectable PrEP (cabotegravir), and examine barriers and individual-level predictors of both product types.

Game Plan-a Brief Web-Based Intervention to Improve Uptake and Use of HIV Pre-exposure Prophylaxis (PrEP) and Reduce Alcohol Use Among Gay and Bisexual Men: Content Analysis.

Background: HIV pre-exposure prophylaxis (PrEP) has considerable potential for reducing incidence among high-risk groups, such as gay, bisexual, and other men who have sex with men (GBM). However, PrEP's effectiveness is closely linked with consistent use, and a variety of individual-level barriers, including alcohol use, could impede optimal uptake and use. Web-based interventions can encourage medication adherence, HIV prevention behaviors, and responsible drinking and may help support PrEP care, particularly in resource-limited settings.

Game Plan, a Web-Based Intervention to Improve Adherence and Persistence to HIV Pre-exposure Prophylaxis and Reduce Heavy Drinking in Gay, Bisexual, and Other Men Who Have Sex With Men: Usability and User Experience Testing.

Background: Encouraging consistent use of pre-exposure prophylaxis (PrEP) is essential for reducing HIV incidence, particularly among gay, bisexual, and other men who have sex with men (GBM), and especially those who engage in heavy drinking. Although practice guidelines recommend providing adherence counseling to PrEP patients, clinics and providers may not have the resources or expertise to provide it. Internet-facilitated interventions have been shown to improve HIV prevention outcomes, including medication and care adherence.

Transesophageal Echocardiography Performed by Intensivist and Emergency Physicians-A 5-Year, Single-Center Experience.

Data on the use of transesophageal echocardiography (TEE) by intensivist physicians (IP) and emergency physicians (EP) are limited. This study aims to characterize the use of TEE by IPs and EPs in critically ill patients at a single center in the United States. Retrospective chart review of all critical care TEEs performed from January 1, 2016 to January 31, 2021.