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Article ; Online: Notes from the Field: Emergency Department Visits for Unsupervised Pediatric Melatonin Ingestion - United States, 2019-2022.

Freeman, Devin I / Lind, Jennifer N / Weidle, Nina J / Geller, Andrew I / Stone, Nimalie D / Lovegrove, Maribeth C

MMWR. Morbidity and mortality weekly report

2024 Volume 73, Issue 9, Page(s) 215–217

MeSH term(s)	Child ; Humans ; United States/epidemiology ; Melatonin ; Emergency Room Visits ; Emergency Service, Hospital ; Hospitalization ; Eating ; Retrospective Studies
Chemical Substances	Melatonin (JL5DK93RCL)
Language	English
Publishing date	2024-03-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	412775-4
ISSN	1545-861X ; 0149-2195
ISSN (online)	1545-861X
ISSN	0149-2195
DOI	10.15585/mmwr.mm7309a5
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Zs.B 1827: Show issues

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Article ; Online: Advocating for Policy Change: Examples Emerging From a Medical-Legal Partnership in Primary Care.

Shah, Nishwa / Radford, Kim / Durant, Steve / Shoucri, Rami / Stone, Jennifer / Persaud, Navindra / Pinto, Andrew D

Journal of health care for the poor and underserved

2024 Volume 35, Issue 1, Page(s) 8–17

Abstract: Medical-legal partnerships bring legal services directly into clinical settings. Policy advocacy is often opportunistic and varies across partnerships. Our objective was to study policy advocacy that emerged from a medical-legal partnership in Toronto ... ...

Abstract	Medical-legal partnerships bring legal services directly into clinical settings. Policy advocacy is often opportunistic and varies across partnerships. Our objective was to study policy advocacy that emerged from a medical-legal partnership in Toronto over a four-year period. This study consisted of a document review and thematic analysis, triangulated with data from interviews with legal team members and health providers. We defined policy advocacy as actions associated with attempts to change policy or legislation. The medical-legal partnership engaged in seven distinct cases of policy advocacy: disability support form requirements, changing workplace review, challenging barriers to citizenship, housing, publicly funded medication program (pharma care), safe injection sites, and the need for increased social assistance. Actions taken included presentations at conferences and submissions of briefs to government. We found that a medical-legal partnership resulted in policy advocacy with issues arising from both the health and the legal team with impacts likely greater than if each group had acted alone.
MeSH term(s)	Humans ; Primary Health Care/organization & administration ; Health Policy ; Ontario
Language	English
Publishing date	2024-04-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	1142637-8
ISSN	1548-6869 ; 1049-2089
ISSN (online)	1548-6869
ISSN	1049-2089
DOI	10.1353/hpu.2024.a919804
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Zs.A 3605: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 493: Show issues

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Article ; Online: The link between adolescent girls' interpersonal emotion regulation with parents and peers and depressive symptoms: A real-time investigation.

Do, Quyen B / McKone, Kirsten M P / Hamilton, Jessica L / Stone, Lindsey B / Ladouceur, Cecile D / Silk, Jennifer S

Development and psychopathology

2023 , Page(s) 1–15

Abstract: Adolescents often experience heightened socioemotional sensitivity warranting their use of regulatory strategies. Yet, little is known about how key socializing agents help regulate teens' negative emotions in daily life and implications for long-term ... ...

Abstract	Adolescents often experience heightened socioemotional sensitivity warranting their use of regulatory strategies. Yet, little is known about how key socializing agents help regulate teens' negative emotions in daily life and implications for long-term adjustment. We examined adolescent girls' interpersonal emotion regulation (IER) with parents and peers in response to negative social interactions, defined as parent and peer involvement in the teen's enactment of emotion regulation strategies. We also tested associations between rates of daily parental and peer IER and depressive symptoms, concurrently and one year later. Adolescent girls (
Language	English
Publishing date	2023-11-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1036173-x
ISSN	1469-2198 ; 0954-5794
ISSN (online)	1469-2198
ISSN	0954-5794
DOI	10.1017/S0954579423001359
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Zs.A 2601: Show issues

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Article ; Online: Decision aids for patients with carotid stenosis.

Krafcik, Brianna M / Jarmel, Isabel A / Beach, Jocelyn M / Suckow, Bjoern D / Stableford, Jennifer A / Stone, David H / Goodney, Philip P / Columbo, Jesse A

Journal of vascular surgery

2023 Volume 79, Issue 3, Page(s) 704–707

Abstract: Background: Shared decision-making tools have been underused by clinicians in real-world practice. Changes to the National Coverage Determination by Medicare for carotid stenting greatly expand the coverage for patients, but simultaneously require a ... ...

Abstract	Background: Shared decision-making tools have been underused by clinicians in real-world practice. Changes to the National Coverage Determination by Medicare for carotid stenting greatly expand the coverage for patients, but simultaneously require a shared decision-making interaction that involves the use of a validated tool. Accordingly, our objective was to evaluate the currently available decision aids for carotid stenosis. Methods: We conducted a review of the literature for published work on decision aids for the treatment of carotid disease. Results: Four publications met inclusion criteria. We found the format of the decision aid impacted patient comprehension and decision making, although patient characteristics also played a role in the therapeutic decisions made. Notably, none of the available decision aids included the widely adopted transcarotid artery revascularization as an option. Conclusions: Further work is needed in the development of a widespread validated decision aid instrument for patients with carotid stenosis.
MeSH term(s)	Humans ; Carotid Stenosis/diagnostic imaging ; Carotid Stenosis/surgery ; Decision Support Techniques ; Medicare ; Stents ; Treatment Outcome ; United States ; Vascular Surgical Procedures
Language	English
Publishing date	2023-11-03
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2023.10.050
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Zs.A 1933: Show issues

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Article ; Online: Readmission After Lower Extremity Bypass Following Discharge to a Rehabilitation or Nursing Facility.

Krafcik, Brianna M / Jarmel, Isabel A / Beach, Jocelyn M / Suckow, Bjoern D / Stableford, Jennifer A / Stone, David H / Goodney, Philip P / Columbo, Jesse A

The Journal of surgical research

2023 Volume 292, Page(s) 167–175

Abstract: ... discharge location. The primary outcome was 30-d hospital readmission.: Results: We included 6076 ... patients across 147 centers. The overall 30-d readmission rate was 18%. Readmission occurred among 15 ... association between discharge location and 30-d readmission (rehabilitation versus home odds ratio: 1.06, 95 ...

Abstract	Introduction: Hospital readmission after lower extremity arterial bypass (LEB) is common. Patients are often discharged to a facility after LEB as a bridge to home. Our objective was to define the association between discharge to a facility and readmission after LEB. Methods: We used the Vascular Quality Initiative to study patients who underwent LEB from 2017 to 2022. The primary exposure was discharge location. The primary outcome was 30-d hospital readmission. Results: We included 6076 patients across 147 centers. The overall 30-d readmission rate was 18%. Readmission occurred among 15% of patients discharged home, 22% of patients discharged to a rehabilitation facility, and 25% of patients discharged to a nursing home. After controlling for patient and procedural factors, there was no significant association between discharge location and 30-d readmission (rehabilitation versus home odds ratio: 1.06, 95% confidence interval: 0.87-1.29; nursing facility versus home odds ratio: 1.21, 95% confidence interval: 0.99-1.47). Female sex, end-stage renal disease, diabetes, heart failure, pulmonary disease, smoking, preoperative functional impairment, tibial bypass target, critical limb threatening or acute ischemia, and postoperative complications including surgical site infection, change in renal function and graft thrombosis were associated with an increased likelihood of readmission. Conclusions: Patients discharged home after LEB experienced a similar likelihood of readmission as those discharged to a facility. While discharge to a facility may aid in care transitions, it did not appear to lead to reduced 30-d readmissions. The recommended discharge location should be predicated on patient care needs and not as a perceived mechanism to reduce readmissions.
Language	English
Publishing date	2023-08-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2023.07.042
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Zs.A 178: Show issues

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Article ; Online: The distribution of breast density in women aged 18 years and older.

Perera, Dilukshi / Pirikahu, Sarah / Walter, Jane / Cadby, Gemma / Darcey, Ellie / Lloyd, Rachel / Hickey, Martha / Saunders, Christobel / Hackmann, Michael / Sampson, David D / Shepherd, John / Lilge, Lothar / Stone, Jennifer

Breast cancer research and treatment

2024

Abstract: Purpose: Age and body mass index (BMI) are critical considerations when assessing individual breast cancer risk, particularly for women with dense breasts. However, age- and BMI-standardized estimates of breast density are not available for screen-aged ... ...

Abstract	Purpose: Age and body mass index (BMI) are critical considerations when assessing individual breast cancer risk, particularly for women with dense breasts. However, age- and BMI-standardized estimates of breast density are not available for screen-aged women, and little is known about the distribution of breast density in women aged < 40. This cross-sectional study uses three different modalities: optical breast spectroscopy (OBS), dual-energy X-ray absorptiometry (DXA), and mammography, to describe the distributions of breast density across categories of age and BMI. Methods: Breast density measures were estimated for 1,961 Australian women aged 18-97 years using OBS (%water and %water + %collagen). Of these, 935 women had DXA measures (percent and absolute fibroglandular dense volume, %FGV and FGV, respectively) and 354 had conventional mammographic measures (percent and absolute dense area). The distributions for each breast density measure were described across categories of age and BMI. Results: The mean age was 38 years (standard deviation = 15). Median breast density measures decreased with age and BMI for all three modalities, except for DXA-FGV, which increased with BMI and decreased after age 30. The variation in breast density measures was largest for younger women and decreased with increasing age and BMI. Conclusion: This unique study describes the distribution of breast density measures for women aged 18-97 using alternative and conventional modalities of measurement. While this study is the largest of its kind, larger sample sizes are needed to provide clinically useful age-standardized measures to identify women with high breast density for their age or BMI.
Language	English
Publishing date	2024-03-18
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	604563-7
ISSN	1573-7217 ; 0167-6806
ISSN (online)	1573-7217
ISSN	0167-6806
DOI	10.1007/s10549-024-07269-y
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Zs.A 1655: Show issues

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Article ; Online: Amplicon Sequencing Minimal Information (ASqMI): Quality and Reporting Guidelines for Actionable Calls in Biodefense Applications.

Keenum, Ishi / Player, Robert / Kralj, Jason / Servetas, Stephanie / Sussman, Michael D / Russell, Joseph A / Stone, Jennifer / Chandrapati, Sailaja / Sozhamannan, Shanmuga

Journal of AOAC International

2023 Volume 106, Issue 5, Page(s) 1424–1430

Abstract: Background: Accurate, high-confidence data is critical for assessing potential biothreat incidents. In a biothreat event, false-negative and -positive results have serious consequences. Worst case scenarios can result in unnecessary shutdowns or ... ...

Abstract	Background: Accurate, high-confidence data is critical for assessing potential biothreat incidents. In a biothreat event, false-negative and -positive results have serious consequences. Worst case scenarios can result in unnecessary shutdowns or fatalities at an exorbitant monetary and psychological cost, respectively. Quantitative PCR assays for agents of interest have been successfully used for routine biosurveillance. Recently, there has been increased impetus for adoption of amplicon sequencing (AS) for biosurveillance because it enables discrimination of true positives from near-neighbor false positives, as well as broad, simultaneous detection of many targets in many pathogens in a high-throughput scheme. However, the high sensitivity of AS can lead to false positives. Appropriate controls and workflow reporting can help address these challenges. Objectives: Data reporting standards are critical to data trustworthiness. The standards presented herein aim to provide a framework for method quality assessment in biodetection. Methods: We present a set of standards, Amplicon Sequencing Minimal Information (ASqMI), developed under the auspices of the AOAC INTERNATIONAL Stakeholder Program on Agent Detection Assays for making actionable calls in biosurveillance applications. In addition to the first minimum information guidelines for AS, we provide a controls checklist and scoring scheme to assure AS run quality and assess potential sample contamination. Results: Adoption of the ASqMI guidelines will improve data quality, help track workflow performance, and ultimately provide decision makers confidence to trust the results of this new and powerful technology. Conclusion: AS workflows can provide robust, confident calls for biodetection; however, due diligence in reporting and controls are needed. The ASqMI guideline is the first AS minimum reporting guidance document that also provides the means for end users to evaluate their workflows to improve confidence. Highlights: Standardized reporting guidance for actionable calls is critical to ensuring trustworthy data.
MeSH term(s)	Polymerase Chain Reaction ; Research Design
Language	English
Publishing date	2023-04-17
Publishing country	England
Document type	Journal Article
ZDB-ID	1103149-9
ISSN	1944-7922 ; 1060-3271
ISSN (online)	1944-7922
ISSN	1060-3271
DOI	10.1093/jaoacint/qsad047
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Zs.A 1229: Show issues

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Article ; Online: Epidural analgesia for reduction of postoperative systemic opioid use following selective dorsal rhizotomy in children.

Karsten, Madeline B / Staffa, Steven J / McClain, Craig D / Amon, Jennifer / Stone, Scellig S D

Journal of neurosurgery. Pediatrics

2021 Volume 27, Issue 5, Page(s) 594–599

Abstract: Objective: Selective dorsal rhizotomy (SDR) requires significant postoperative pain management, traditionally relying heavily on systemic opioids. Concern for short- and long-term effects of these agents has generated interest in reducing systemic ... ...

Abstract	Objective: Selective dorsal rhizotomy (SDR) requires significant postoperative pain management, traditionally relying heavily on systemic opioids. Concern for short- and long-term effects of these agents has generated interest in reducing systemic opioid administration without sacrificing analgesia. Epidural analgesia has been applied in pediatric patients undergoing SDR; however, whether this reduces systemic opioid use has not been established. In this retrospective cohort study, the authors compared postoperative opioid use and clinical measures between patients treated with SDR who received postoperative epidural analgesia and those who received systemic analgesia only. Methods: All patients who underwent SDR at Boston Children's Hospital between June 2013 and November 2019 were reviewed. Treatment used the same surgical technique. Postoperative systemic opioid dosage (in morphine milligram equivalents per kilogram [MME/kg]), pain scores, need for respiratory support, vomiting, bowel movements, and length of hospital and ICU stay were compared between patients who received postoperative epidural analgesia and those who did not, by using the Wilcoxon rank-sum test or Fisher's exact test. Results: A total of 35 patients were identified, including 18 females (51.4%), with a median age at surgery of 6.1 years. Thirteen patients received postoperative epidural and systemic analgesia and 22 patients received systemic analgesia only. Groups were otherwise similar, with treatment selection based solely on surgeon routine. Patients who received epidural analgesia required less systemic morphine milligram equivalents/kg on postoperative days (PODs) 0-4 (p ≤ 0.042). Patients who did not receive epidural analgesia were more likely to require respiratory support on POD 1 (45% vs 8%; p = 0.027). Reported pain scores did not differ between groups, although patients receiving epidural analgesia trended toward less severe pain on PODs 1 and 2. Groups did not differ with respect to postoperative vomiting or time to first bowel movement, although epidural analgesia use was associated with a longer hospital stay (median 7 vs 5 days; p < 0.001). Conclusions: Patients who received postoperative epidural analgesia required less systemic opioid use and had at least equivalent reported pain scores on PODs 1-4, and they required less respiratory support on POD 1, although they remained in the hospital longer when compared to patients who received systemic analgesia only. A larger prospective study is needed to confirm whether epidural analgesia lowers systemic opioid use in children, contributes to a safer postoperative hospital stay, and results in better pain control following SDR.
MeSH term(s)	Analgesia, Epidural/methods ; Analgesics, Opioid/therapeutic use ; Cerebral Palsy/surgery ; Child ; Child, Preschool ; Cohort Studies ; Female ; Humans ; Male ; Pain Management/methods ; Pain, Postoperative/etiology ; Pain, Postoperative/therapy ; Retrospective Studies ; Rhizotomy/adverse effects
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2021-03-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2403985-8
ISSN	1933-0715 ; 1933-0707
ISSN (online)	1933-0715
ISSN	1933-0707
DOI	10.3171/2020.9.PEDS20501
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Uk I Zs.135 -Pediatrics-: Show issues

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Article ; Online: One year of methadone maintenance treatment in a fentanyl endemic area: Safety, repeated exposure, retention, and remission.

Stone, Andrew C / Carroll, Jennifer J / Rich, Josiah D / Green, Traci C

Journal of substance abuse treatment

2020 Volume 115, Page(s) 108031

Abstract: Introduction: Fentanyl is a potent synthetic opioid that has contributed to increasing overdose deaths in the United States in recent years. Concern over safety and efficacy of agonist treatment for fentanyl use may limit access to treatment. This study ...

Abstract	Introduction: Fentanyl is a potent synthetic opioid that has contributed to increasing overdose deaths in the United States in recent years. Concern over safety and efficacy of agonist treatment for fentanyl use may limit access to treatment. This study sought to address these potential concerns in a naturalistic setting. Objectives: Measure 12-month treatment outcomes for methadone maintenance treatment (MMT) in a fentanyl endemic area. Outcomes: Primary: 1) Treatment retention; 2) sustained remission (defined as 3 consecutive negative screens); 3) return to use; 4) methadone dosage required; and 5) number of days to achieve remission. Secondary: Mortality. Methods: A naturalistic follow-up study and retrospective review of consecutive patients newly admitted to a single methadone maintenance treatment program in Rhode Island. Results: We observed 154 unique intake events (representing 151 patients). Eighty percent (n = 121) tested positive for fentanyl at intake. Seventy-five percent of patients achieved remission within the 12-month study period. One-year retention was 53% for fentanyl-exposed individuals and 47% for those not exposed. The majority (99%) of patients who remained in treatment at 12 months achieved remission. We saw prolonged, sustained remission in 44% of patients exposed to fentanyl at intake and 47% of those who were not. Dose and time to remission were similar. Unfortunately, 4 patients died after leaving MMT prematurely. Conclusions: This study suggests MMT is safe despite repeated exposure to fentanyl while taking methadone. Remission is achievable, and MMT is protective against death among fentanyl-exposed patients while in treatment.
MeSH term(s)	Analgesics, Opioid/adverse effects ; Fentanyl/adverse effects ; Follow-Up Studies ; Humans ; Methadone/adverse effects ; Opiate Substitution Treatment ; Opioid-Related Disorders/drug therapy ; Retrospective Studies ; Rhode Island ; United States
Chemical Substances	Analgesics, Opioid ; Methadone (UC6VBE7V1Z) ; Fentanyl (UF599785JZ)
Language	English
Publishing date	2020-05-11
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	605923-5
ISSN	1873-6483 ; 0740-5472
ISSN (online)	1873-6483
ISSN	0740-5472
DOI	10.1016/j.jsat.2020.108031
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Zs.A 2017: Show issues

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Article ; Online: The financial implications of cardiac stress testing prior to abdominal aortic aneurysm repair.

Ponukumati, Aravind S / Columbo, Jesse A / Suckow, Bjoern D / Stableford, Jennifer A / Henkin, Stanislav / Beach, Jocelyn M / Goodney, Philip P / Stone, David H

Vascular medicine (London, England)

2022 Volume 27, Issue 5, Page(s) 469–475

Abstract: Background: The utilization and cost-effectiveness of stress testing before abdominal aortic aneurysm (AAA) repair remains insufficiently studied. We examined the variation and financial implications of stress testing, and their association with major ... ...

Abstract	Background: The utilization and cost-effectiveness of stress testing before abdominal aortic aneurysm (AAA) repair remains insufficiently studied. We examined the variation and financial implications of stress testing, and their association with major adverse cardiovascular events (MACE). Methods: We studied patients who underwent elective endovascular (EVAR) or open AAA repair (OAR) at Vascular Quality Initiative centers from 2015 to 2019. We grouped centers into quintiles of preoperative stress testing frequency. We calculated the risk of postoperative MACE, a composite of in-hospital myocardial infarction, heart failure, or death, for each center-quintile. We obtained charges for stress tests locally and applied these to the cohort to estimate charges per 1000 patients. Results: We studied 32,459 patients (EVAR: 27,978; OAR: 4481; 283 centers). Stress test utilization varied across quintiles from 13.0% to 68.6% (median: 36.8%) before EVAR and 15.9% to 85.0% (median: 59.4%) before OAR. The risk of MACE was 1.4% after EVAR and 10.2% after OAR. There was a trend towards more common MACE after EVAR among centers with higher utilization of stress testing: 0.9% among centers in the lowest quintile, versus 1.7% in the highest quintile ( Conclusion: Stress test use before AAA repair is highly variable and associated with substantial cost, with an unclear association with postoperative MACE. This highlights the need for improved stress testing paradigms prior to surgery.
MeSH term(s)	Aortic Aneurysm, Abdominal/complications ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/surgery ; Blood Vessel Prosthesis Implantation/adverse effects ; Endovascular Procedures/adverse effects ; Exercise Test ; Humans ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Treatment Outcome
Language	English
Publishing date	2022-08-29
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1311628-9
ISSN	1477-0377 ; 1358-863X
ISSN (online)	1477-0377
ISSN	1358-863X
DOI	10.1177/1358863X221112180
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Zs.A 4409: Show issues

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