The association of telomere length and religiosity: A systematic review.

Objective: Religiosity is a complex construct comprised observance, intrinsic beliefs, meditative practice, and communal elements. Religiosity has been associated with reduced mortality and improved overall health, but understanding the underlying biological associations is evolving. As increased telomere length has been associated with increased longevity, this project presents a systematic review of studies investigating the relationship between religiosity and telomere length.

Audit and feedback is an effective implementation strategy to increase fidelity to a multi-component labor induction protocol designed to reduce obstetric inequities.

Background: Studies have demonstrated that standardizing labor induction (IOL), often with the use of protocols, may reduce racial inequities in obstetrics. IOL protocols are complex, multi-component interventions. To target identified implementation barriers, audit and feedback (A&F) was selected as an implementation strategy.

Explainable Machine Learning to Predict Treatment Response in Advanced Non-Small Cell Lung Cancer.

Purpose: Immune checkpoint inhibitors (ICIs) have demonstrated promise in the treatment of various cancers. Single-drug ICI therapy (immuno-oncology [IO] monotherapy) that targets PD-L1 is the standard of care in patients with advanced non-small cell lung cancer (NSCLC) with PD-L1 expression ≥50%. We sought to find out if a machine learning (ML) algorithm can perform better as a predictive biomarker than PD-L1 alone.

Racial, Socioeconomic, and Geographic Disparities in Preamputation Vascular Care for Patients With Chronic Limb-Threatening Ischemia.

Background: Black patients, those with low socioeconomic status (SES), and those living in rural areas have elevated rates of major lower extremity amputation, which may be related to a lack of subspecialty chronic limb-threatening ischemia care. We evaluated the association between race, rurality, SES, and preamputation vascular care.

Methods: Among patients aged 66 to 86 years with fee-for-service Medicare who underwent major lower extremity amputation for chronic limb-threatening ischemia from July 2010 to December 2019, we compared the proportion who received vascular care in the 12 months before amputation by race (Black versus White), rurality, and SES (dual eligibility for Medicaid versus no dual eligibility) using multivariable logistic regression adjusting for clinical and demographic covariates.

Outcomes of Importance to Patients Living With Cutaneous Chronic Graft-vs-Host Disease.

Importance: Cutaneous chronic graft-vs-host disease (GVHD) is independently associated with morbidity and mortality after allogeneic hematopoietic cell transplant. However, the health-related quality-of-life (HRQOL) domains that are most important to patients are poorly understood.

Objective: To perform a concept elicitation study to define HRQOL in cutaneous chronic GVHD from the patient perspective and to compare experiences of patients with epidermal vs sclerotic disease.

Paving the way for Alzheimer's disease blood-based biomarkers in primary care.

Blood-based biomarkers (BBBMs) for Alzheimer's disease (AD) have the potential to revolutionize the detection and management of cognitive impairment. AD BBBMs are not currently recommended for use in primary care but may soon be as research demonstrates their clinical utility for differential diagnosis and patient management. To prepare for the incorporation of AD BBBMs into primary care, several practical challenges must be addressed.

Standardized protocol for labor induction: a type I hybrid effectiveness-implementation trial.

Background: Cesarean delivery remains the most common obstetrical procedure with more than 250,000 patients in the US undergoing cesarean following labor induction annually. Here, we evaluated the impact of prospectively implementing a standardized labor induction protocol on cesarean delivery rates.

Methods: This multi-site type I hybrid effectiveness-implementation study compared 2 years before (PRE) and 2 years after (POST) implementation of a standardized labor induction protocol at two hospitals within the University of Pennsylvania Health System (2018-2022).

Pre-Implementation Strategies to Support Adaptation of Thrive: A Care Transitions Model for Economically Disadvantaged Patients with Serious Mental Illness.

Background: Economically disadvantaged patients diagnosed with serious mental illness (SMI) experience post-hospitalizations disparities due to fragmented care transitions.

Purpose: To describe the pre-implementation strategies used to adapt and implement a nurse-led transitional care intervention (Thrive) to meet the needs of economically disadvantaged patients diagnosed with an SMI.

Methods: Two pre-implementation strategies, Evidence Based Quality Improvement (EBQI) meetings and Formative Evaluation (FE) research, were used to adapt intervention components.

Assessing the benefit-risk profile of newer glucose-lowering drugs: A systematic review and network meta-analysis of randomized outcome trials.

Aim: To comprehensively evaluate the benefits and risks of glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl peptidase 4 inhibitors (DPP4i), and sodium-glucose cotransporter 2 inhibitors (SGLT2i).

Materials And Methods: A systematic search of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to November 2023 to identify randomized cardiovascular and kidney outcome trials that enrolled adults with type 2 diabetes, heart failure, or chronic kidney disease and compared DPP4i, GLP-1RAs, or SGLT2i to placebo. Twenty-one outcomes (e.

Barriers and facilitators to caregiver comfort with health-related social needs data collection in the pediatric clinical setting.

Objective: To identify barriers and facilitators to family-level comfort with health-related social needs (HRSN) data collection and documentation in the pediatric clinical setting.

Study Setting And Design: This qualitative study was nested within a pragmatic randomized controlled trial on social care integration in the pediatric clinical setting. We used a hybrid random-purposive strategy to sample 60 caregivers of pediatric patients ages 0-25 presenting at two primary care clinics and one emergency department affiliated with a large pediatric healthcare system between September 2022 and 2023.

Real-world effectiveness and causal mediation study of BNT162b2 on long COVID risks in children and adolescents.

Background: The impact of pre-infection vaccination on the risk of long COVID remains unclear in the pediatric population. We aim to assess the effectiveness of BNT162b2 on long COVID risks with various strains of the SARS-CoV-2 virus in children and adolescents, using comparative effectiveness methods. We further explore if such pre-infection vaccination can mitigate the risk of long COVID beyond its established protective benefits against SARS-CoV-2 infection using causal mediation analysis.

Organization of primary care and early MOUD discontinuation.

Unlabelled: Primary care clinic structures and operations may influence early MOUD discontinuation. Flexible scheduling can improve early MOUD retention but must be balanced with clinic efficiency. Multidisciplinary teams can improve retention but require additional resources.

Using Electronic Health Records to Identify the Daily Primary Provider During Hospitalization.

Objectives: Providers vary in their impact on clinical outcomes, but this is rarely accounted for in healthcare research. By failing to identify the provider responsible for a patient's care, investigators miss an opportunity to account for nonrandom variation in outcomes. Prior methods of identifying responsible providers have relied on manual chart review, which is time-consuming and expensive, or analysis of claims data, which has been demonstrated to be inaccurate.

Association Between Delayed/Forgone Medical Care and Resource Utilization Among Women with Breast Cancer in the United States.

Background: Although high treatment costs of breast cancer care are well documented, the relationship between delayed/forgone (D/F) care and resource utilization among patients with breast cancer is unknown. This study sought to investigate the relationship between D/F care, resource use, and healthcare expenditures among patients with breast cancer.

Methods: Data on adult female patients with breast cancer were obtained from the Medical Expenditure Panel Survey to assess resource utilization and expenditures in the United States from 2007 to 2017.

Preferred Language and Race Impact Code Status in Critically Ill Children.

Importance: Few studies have assessed the relationships between language, race, and code status in a PICU.

Objectives: We aimed to identify whether non-English language preference (NELP) or race was associated with code status in a PICU.

Design, Setting, And Participants: This was a single-center retrospective cohort study of 45,143 patients admitted to the PICU between January 2013 and December 2022, excluding those with pre-PICU do not resuscitate (DNR) orders.

Lessons for local oversight of AI in medicine from the regulation of clinical laboratory testing.

Current regulatory frameworks for artificial intelligence-based clinical decision support (AICDS) are insufficient to ensure safety, effectiveness, and equity at the bedside. The oversight of clinical laboratory testing, which requires federal- and hospital-level involvement, offers many instructive lessons for how to balance safety and innovation and warnings regarding the fragility of this balance. We propose an AICDS oversight framework, modeled after clinical laboratory regulation, that is deliberative, inclusive, and collaborative.

Volumetric Breast Density Estimation From Three-Dimensional Reconstructed Digital Breast Tomosynthesis Images Using Deep Learning.

Purpose: Breast density is a widely established independent breast cancer risk factor. With the increasing utilization of digital breast tomosynthesis (DBT) in breast cancer screening, there is an opportunity to estimate volumetric breast density (VBD) routinely. However, current available methods extrapolate VBD from two-dimensional (2D) images acquired using DBT and/or depend on the existence of raw DBT data, which is rarely archived by clinical centers because of storage constraints.

Adolescents' Self-Reported Exposure to Advertisements for Flavored Tobacco Products After Implementation of a Statewide Ban on Flavored Tobacco Product Sales and Advertising in Massachusetts.

Objectives: Massachusetts signed into law An Act Modernizing Tobacco Control (hereinafter, the Act) in 2019, which restricted retail sales of flavored tobacco products, including menthol cigarettes. This study assessed differences in advertising exposure to flavored tobacco products among adolescents in Massachusetts compared with adolescents in 4 neighboring states after passage of the Act.

Methods: We collected monthly cross-sectional survey data from April 2021 through August 2022 among a convenience sample of adolescents (aged 13-17 y) in Massachusetts and 4 control states: Connecticut, New Hampshire, Rhode Island, and Vermont.