Program Register Research Articles

Exceeding expectations increases satisfaction among Louisiana waterfowl hunters

AbstractLouisiana surveys waterfowl hunters every 5 years to assess hunter effort, harvest success, demographics, and preferences for proposed regulations and management practices. The 2020 Survey of Louisiana Waterfowl Hunters addressed hunter satisfaction patterns, hunter perceptions on waterfowl migration, associations of field experiences to satisfaction, associations among distribution waves, the efficacy of sample coverage by an email survey, and allowed comparison with hunter satisfaction with surveys in 2005, 2010, and 2015. We distributed a 31‐question survey by email to 73,554 Louisiana waterfowl hunters following the 2019–2020 season. We received 13,483 total responses, of which 8,218 were usable (licensed respondents actively hunting waterfowl during the 2019–2020 season), resulting in a qualified response rate of 12.0%. We compared qualified respondents to the overall population of Harvest Information Program registrants (169,891) and found no significant differences for age class, geographic distribution, and license type. Our results indicated that surveys should be distributed in 3 waves, as the number of days hunted would be overestimated by 7% (mean of 15 days [95% confidence interval = 14.7–15.7] compared to a mean of 14 days [95% confidence interval = 13.7–14.4]) by a single survey. Hunters' satisfaction was independent of which geographic zone they hunted, whether they were members of conservation organizations, or how many waterfowl were seen. Our results also indicated that the probability of greater hunter satisfaction was increased by 98% as the number of waterfowl harvested surpassed 57, by 68% for respondents reporting that their actual harvest exceeded expected harvest by at least one bird, and by 61% for respondents reporting that their actual days hunted exceeded expected days hunted by at least one day.

Prevalence of Hypertension in Type 2 Diabetes Mellitus in the Working Area of Jatibaru Community Health Center in 2023

The World Health Organization (WHO) predicts an increase in the number of diabetes mellitus sufferers in Indonesia from 8.4 million people in 2000 to around 21.3 million people in 2030. The prevalence of type 2 diabetes increases with age and changes in unhealthy lifestyles. Several studies show that the incidence of hyperglycemia in diabetes is closely related to hypertension. According to the American Diabetes Association (ADA) 2017, two out of three people with diabetes have high blood pressure. At the Jatibaru Community Health Center, based on 2023 data, it is known that hypertension and diabetes are always included in the data on the 10 most common diseases every month. Based on this background and related to the incidence of Hypertension and type 2 diabetes mellitus is still relatively high, so researchers are interested to knowing the picture hypertension in type 2 diabetes mellitus in the Jatibaru. This research is a descriptive study with a cross-sectional approach using secondary data taken from Non-Communicable Disease data. The population in this study were all adult and elderly respondents registered in the non-communicable disease program register, who based on anamnesis, physical and laboratory examination, were diagnosed with type 2 diabetes mellitus and hypertension. The sample was taken by purposive sampling. In this research, it was found that people with hypertension and diabetes mellitus were found in all adult and elderly age categories. The distribution of hypertension and type 2 diabetes mellitus patients continues to increase with increasing age, the prevalence of sufferers being more female than male. As many as 65% of the total type 2 diabetes mellitus sufferers also experience hypertension.

Strengthening the Chain: A Continuing Medical Education Program for Test Results Follow-up.

The Canadian Medical Protective Association (CMPA)'s Commitment to Change in Test-Results Follow-Up (CTC-TRFU) program aims to provide physicians with resources to enhance their test results follow-up systems for improved patient safety. Framed around the Transtheoretical Model, the program involves a 6-month multimodal educational intervention involving individual and group coaching sessions, action planning, and reflection surveys. This study evaluates the CTC-TRFU program's impact by analyzing survey responses and course documents, focusing on three main outcomes: physicians' perceived barriers and challenges, changes in their confidence and commitment, and implemented practice changes with perceived impact on patient safety. Participants were Canadian physicians who enrolled through the CMPA's open-access registration, with a particular emphasis on those facing challenges in test result follow-up. One hundred two physicians have enrolled in the program. Of these physicians, 34 (33.3%) have successfully completed the program and 28 (27.5%) are actively enrolled. Among the 34 physicians who successfully completed the program, an overwhelming majority of 97.1% (n = 33) expressed their belief that the improvements made to their test follow-up system significantly enhance patient safety within their practice. We observed a significant increase in confidence in the robustness of the physician's follow-up system from program registration to completion (P < .001). Physicians reported catching specific missed test results (55.9%, n = 19), including various laboratory reports and diagnostic imaging like abnormal mammograms or missing MRI/CT results. Physicians who participated in the CTC-TRFU program reported meaningful practice changes, which we believe underscores the value of comprehensive, longitudinal continuing patient safety CPD initiatives. These findings indicate the potential for future studies to explore the long-term impact of similar programs and their scalability.

Asuhan Kebidanan Komprehensif Pada Ny. M Umur 44 Tahun G4P2A1 Faktor Resiko Umur Ibu Lebih Dari 35 Tahun Dan Pre-Eklamsia Di Wilayah Kerja Puskesmas Paguyangan Tahun 2023

The Program Registration at the Ministry of Health in 2020 shows a figure of 5,125 deaths. AKI is caused by bleeding, pre-eclampsia/eclampsia, infection, late arrival of the mother to a health facility and mothers with positive PCR/Antigen. The aim of this research is to be able to implement comprehensive midwifery care for Mrs. M, 44 years oldhe maternal mortality rate in Indonesia compiled from the Family Health. This research method used quantitative descriptive with a case study approach. The case study carried out was in the form of Comprehensive Midwifery Care which examined women during pregnancy, childbirth, newborns, postpartum and family planning with Varney's seven-step midwifery management and SOAP. Comprehensive Midwifery Care for Mrs. M, namely during pregnancy, pre-eclampsia was discovered. Delivery by Sectio Caesarea and the baby was born normally. During the postnatal period, no problems were found in the baby. During the postpartum period, no problems were found. Mother uses MOW birth control. Based on the care, it is concluded that the care has been implemented according to Midwifery Service standards.

HPR86 The Impact of Mandated Prescription Drug Monitoring Program Registration on Prescription Opioid-Related Mortality in California

HPR86 The Impact of Mandated Prescription Drug Monitoring Program Registration on Prescription Opioid-Related Mortality in California

The Influence of Electronic Word of Mouth (eWOM) in Enhancing the Program Registration Applicants of a Youth Organization

The study explores the impact of electronic word-of-mouth (e-WOM) on the decisionmaking process of registering for the AIESEC 2021 program. Conducted using a quantitative survey method, the research applies marketing communication theory to understand the influence of e-WOM on consumer behavior. Surveying 75 registrants from the UPN "Veteran" Yogyakarta class of 2021, the findings reveal a significant and robust positive correlation (0.797) between e-WOM and registration decisions, as confirmed by the Product Moment Correlation Test. Additionally, the statistical significance of this relationship is supported by the t Test (p &lt; 0.05), with the F Test indicating that eWOM contributes significantly to decisionmaking, accounting for 62.9% of the variance. However, 37.1% of decisionmaking factors remain unexplored. These results highlight the pivotal role of e-WOM in shaping consumer decisions, particularly in the context of registering for programs such as JOIN AIESEC 2021. Understanding and leveraging e-WOM can thus be crucial for organizations seeking to enhance their marketing strategies and attract participants to their programs

Risk of Cervical Abnormalities for Women With Multiple Sclerosis Treated With Moderate-Efficacy and High-Efficacy Disease-Modifying Therapies.

The impact of immunomodulatory therapies on the risk of cervical pre-cancer and invasive cancer development is important for the health and safety of women with multiple sclerosis (wwMS). We investigate the risk of cervical abnormalities in wwMS treated with disease-modifying therapies (DMTs). This is a multicenter cohort study with data collected from 1998 to 2019 in Victoria, Australia. Data linkage was performed using matching records from the MSBase Registry, the National Human Papillomavirus (HPV) Vaccination Program Register, and the Victorian Cervical Cytology Register. The primary outcome was the detection of any type of cervical abnormality as determined by cytology or histology. Survival methods were used to assess the time to cervical abnormality detection on cervical screening tests (CSTs). Crude and adjusted Cox proportional hazards models were used to determine time to and magnitude of association of DMTs with the risk of cervical abnormality. In a sensitivity analysis, we constructed standardized survival curves averaged over the same set of covariates to determine the commensurate population-average (marginal) causal effects. We included 248 wwMS. The incidence of abnormal CSTs was lower (p < 0.001) for women not exposed to moderate-high-efficacy therapy (10.2 per 1,000 patient-years [95% confidence interval (CI) 5.5-14.9]), compared with those exposed (36.6 per 1,000 patient-years [95% CI 21.7-51.6]). Exposure to higher efficacy treatment was associated with a 3.79-fold increased hazard (95% CI 2.02-7.08, p < 0.001) of developing a cervical abnormality relative to those not exposed. When adjusted for vaccination status, smoking, hormonal contraceptive use, and socioeconomic status, the risk remained elevated at 3.79 (95% CI 1.99-7.21, p < 0.001). Marginal hazard ratios declined over time, ranging from 3.90 (95% CI 2.09-7.27) at 20 years of age to 2.06 (95% CI 1.14-3.73) at 70 years of age. A greater than three-and-a-half-fold increased risk of cervical abnormalities was found after exposure to moderate-high-efficacy DMTs. This risk persisted despite adjusting for HPV vaccination status, hormonal contraception use, smoking, and socioeconomic status. If confirmed in future studies, we would advocate for wwMS exposed to moderate-high-efficacy DMTs to be treated in line with immune-deficient paradigm in cervical screening and HPV vaccination programs. This study provides Class III evidence that highly active MS therapy compared with less active therapy increases the risk of developing cervical abnormalities among women with MS.

Participants' perspectives of "NeuroSask: Active and Connect"-a virtual chronic disease management program for individuals with a neurological condition.

Neurological conditions account from more than half of Canadians requiring chronic care. Both physical activity and the development of a self-management skillset are critical components supporting individuals with chronic health conditions. "NeuroSask: Active and Connected" is a virtual chronic disease management program offering twice weekly neuro-physiotherapist directed "active" exercise sessions, followed by weekly knowledge-exchange "connect" sessions with invited guest experts. NeuroSask was launched April 2020 in response to the restricted services and supports for people with neurological conditions. The program aimed to provide seated physical activity, social interaction, and access to expertise in neurological conditions and neurorehabilitation. A program evaluation of NeuroSask was conducted to gain participants' perspectives. All participants registered for the NeuroSask program were invited to complete optional online surveys (SurveyMonkey) circulated by email at 3 occasions post-program launch: 10 weeks, 1 year, and 2 years. Participants could complete any one or all of the surveys, at their discretion. The number of potential respondents changed dependent on the total number of participants registered for NeuroSask at the time the survey was circulated. Questions were co-designed by multi-stakeholder team members. Descriptive statistics were used for closed-ended questions and a reflexive thematic analysis was completed with coding conducted in NVivo 12 Plus for open-ended text. Response rates (participants/registrants) were as follows: 10-week survey 260/793, one year survey 326/1224, and 2-year survey 434/1989. 90% of participants reported being in either the age categories of 40-59 years or above 60 years. 75% of both survey respondents and program registrants were female. 70% of both survey respondents and program registrants reported a diagnosis of multiple sclerosis and 30% reported other neurological conditions. Survey respondents were from all ten Canadian provinces, with 45% reporting living outside of large cities. Respondents reported preferring online vs. in person format for this type of programming. Three main themes, and eight corresponding subthemes were identified highlighting the perceived impact and key components of the NeuroSask program: Theme 1 "together in a positive and encouraging environment" (subthemes 1a: connection, 1b: empowerment); Theme 2 "access to enthusiastic qualified leaders from home" (subthemes 2a: leader characteristics, 2b: accessibility, 2c: program logistics); Theme 3 "being able to enjoy everyday life" (subthemes 3a: symptom benefits and beyond, 3b: carry-over, 3c: keep going, please do not cancel). NeuroSask is an example of an accessible and meaningful virtual approach to providing ongoing support for some individuals with neurological conditions. It was perceived as beneficial for fostering community and connection in a positive environment with perceived benefits extending beyond symptom management to participant reported improvements in function, daily life, and disease experience.

Incidence, prevalence, and mortality of type 1 diabetes in children and youth in Burkina Faso 2013-2022

AimThere are no data on type 1 diabetes (T1D) incidence and prevalence in Burkina Faso. We aimed to determine these in persons aged <25 years (y) since the implementation of Life for a Child (LFAC) program in 2013. Patients and methodsData were collected from the prospective program register. Diagnosis of T1D was clinical, based on presentation, abrupt onset of symptomatic hyperglycemia, need for insulin replacement therapy from diagnosis, and no suggestion of other diabetes types. ResultsWe diagnosed 312 cases of T1D <25y in 2013–2022. Male-to-female ratio was 1:1. T1D incidence <25y per 100,000 population/year increased from 0.08 (CI 95% 0.07-0.60) in 2013 to 0.34 (CI 95% 0.26-0.45) in 2022 (p=0.002). Incidence <15y/y rose from 0.04 (CI 95% 0.01-0.10) to 0.27 (CI 95% 0.18-0.38) per 100,000/year in 2013 and 2022, respectively (p < 0.002). Prevalence per 100,000 population <25y was 0.27 (CI 95% 0.19-0.37) in 2013 and rose to 1.76 (CI 95% 1.546-1.99) in 2022 (p<0.0001). Mortality rate was 20 (CI 95% 13-29.6) per 1,000-person y. ConclusionsThere is a low but sharply rising T1D incidence and prevalence rates in children and youth in Burkina Faso since LFAC program implementation. It is very likely this is partly due to improved case detection. Mortality remains substantial.

Public Perception Toward the Malaysian National COVID-19 Immunisation Programme (PICK) in the State of Sabah, Malaysia: A Cross-Sectional Survey.

The Malaysian Government has initiated the National COVID-19 Immunisation Programme, known as PICK, to be a national strategy for addressing the spread of the coronavirus disease (COVID-19) pandemic across the country. Although the government intensified public awareness to increase program registration, the total number that registered in the state of Sabah, located in East Malaysia, was relatively low during August 2021, accounting for only 42.9% as compared to that of Peninsular Malaysia. Therefore, this paper examines the public perception toward the PICK program in Sabah based on 4 main components: safety, communication, psychology, and milieu. This study is based on the empirical findings drawn from 1024 respondents across Sabah using online Google Form surveys. This study adopts 5 methodologies for data analysis by using K-means clustering, mean score, Mann-Whitney U test, spatial analysis, and frequency analysis. It has been revealed that the percentage of respondents (categorized as Cluster 1) who have a negative perception toward the vaccination program is higher (55.9%) than those who have a positive perception (44.1%). This study further discovered that Cluster 1 has shown high skepticism regarding the vaccination program, which can be explained through the communication component (M = 3.33, SD = 0.588), especially Co2, Co3, Co1, and Co4. Following the communication factor, a chain of negative perceptions also affects other components such as safety, psychology, and milieu among Cluster 1, all of which contribute to poor participation in the PICK program. The study outcomes are extremely useful for informing local authorities to establish policies related to public interests, primarily in the areas of public health. Understanding the community's perspectives and their obstacles in participating in such programs may assist local authorities in developing or implementing public policies and campaigns that ensure such related public programs can be conducted more effectively in the future.

Is remnant preservation in anterior cruciate ligament reconstruction superior to the standard technique? An overview of systematic reviews

BackgroundAnterior cruciate ligament injury is a common knee joint injury. Anterior cruciate ligament reconstruction is a common surgical treatment to treat anterior cruciate ligament injury. It may have certain advantages to retain the ligament stump during the operation, but the results of systematic evaluation on whether to retain the ligament stump are different. The conclusion is still controversial, and the quality needs to be strictly evaluated.ObjectiveTo evaluate the methodological quality, risk of bias, reporting quality and evidence quality of the systematic review of remnant preservation in anterior cruciate ligament reconstruction, and to provide reference for clinical work.MethodsWe systematically searched the system evaluations in 8 electronic databases, the languages were limited to Chinese and English, and the time limit was from the establishment of the database to June 2023. Two reviewers independently screened literature and extracted data. The methodological quality, risk of bias, reporting quality and quality of evidence were evaluated by AMSTAR-2, ROBIS, PRISMA and GRADE tools.ResultsA total of 14 systematic reviews were included. The evaluation of results showed that the methodological quality of the included systematic reviews was relatively low, of which 5 were low quality and 9 were critically low quality. A small number of systematic reviews were low risk of bias. The system evaluation reports are relatively complete, but the lack of program registration is a common problem. A total of 111 pieces of clinical evidence were extracted from the included 14 systematic reviews. The quality of evidence was generally low, with only 7 pieces of high-quality evidence, 45 pieces of medium-quality evidence, and the rest were low and very low-quality evidence. Among the reasons for relegation, imprecision is the most common, followed by inconsistency and indirectness. The existing evidence shows that patients after anterior cruciate ligament reconstruction with remnant preservation have certain advantages in knee joint function, joint stability and proprioception recovery, which may be a more effective surgical method. However, it may also increase the incidence of postoperative complications and adverse reactions.ConclusionCompared with Standard Technique, Remnant Preservation in Anterior Cruciate Ligament Reconstruction has more advantages in restoring joint function and stability and proprioception. But the potential risks should also be considered by surgeons. At present, the quality of evidence is generally low, and the reliability of the conclusion is insufficient. It still needs to be verified and further in-depth research is needed.

ЦИФРОВЫЕ РЕСУРСЫ В ПРЕДИКЦИИ ПРЕЭКЛАМПСИИ И ЗАДЕРЖКИ РОСТА ПЛОДА

Abstact. Introduction. Preeclampsia and fetal growth restriction are pregnancy complications related to Great Obstetrical Syndromes and having a similar pathogenesis. No antipathogenetic therapy methods have been found for both pathologies, but there is a means of prevention: Acetylsalicylic acid. The drug is effective only in high-risk pregnant women; therefore, various models are being developed to predict preeclampsia and fetal growth restriction, including digital models. They aim to help select patients who need that prophylaxis. Aim. This study is aiming to create a digital model for the early prediction of preeclampsia, based on the patient’s electronic medical card. Materials and Methods. The investigation involved 231 pregnant women. An algorithm was developed for the early prediction of preeclampsia and fetal growth restriction, based on detecting a combination of systemic and local hemodynamic markers: High variability of blood pressure between visits (long-term variability) and high resistance of blood flow in uterine arteries. Long-term (intervisit) variability of blood pressure is calculated for each trimester: First, the arithmetic mean is calculated among the values of systolic blood pressure at successive visits; second, the standard deviation is computed based on the result. Uterine arteries are checked using Doppler ultrasound technology at 11-13 weeks of gestation: Resistivity of blood flow (peripheral resistivity) in the right and left uterine arteries is assessed. Results and Discussion. For this new prediction algorithm, a digital model was developed, the ECAPP program (registration certificate No. 2018660666 – Electronic Prenatal Record with assessing the risk of developing preeclampsia based on blood pressure variability and uterine blood flow resistance). Conclusions. The IT resource presented has a potential for the effective early prediction of preeclampsia, as well as for predicting fetal growth restriction. Keywords: preeclampsia, fetal growth restriction, prognosis, digital model.

Trans-pacific multicenter collaborative study of minimally invasive proximal versus total gastrectomy for proximal gastric and gastroesophageal junction cancers

BackgroundThe current standard operation for proximal gastric and gastroesophageal junction (P/GEJ) cancers with limited esophageal extension is total gastrectomy (TG). TG is associated with impaired appetite and weight loss due to the loss of gastric functions such as production of ghrelin and with anemia due to intrinsic factor loss and vitamin B12 malabsorption. Theoretically, proximal gastrectomy (PG) can mitigate these problems by preserving gastric function. However, PG with direct esophagogastric reconstruction is associated with severe postoperative reflux, delayed gastric emptying, and poor quality of life (QoL). Minimally invasive PG (MIPG) with antireflux techniques has been increasingly performed by experts but is technically demanding owing to its complexity. Moreover, the actual advantages of MIPG over minimally invasive TG (MITG) with regards to postoperative QoL are unknown. Our overall objective of this study is to determine the short-term QoL benefits of MIPG. Our central hypotheses are that MIPG is safe and that patients have improved appetite after MIPG with effective antireflux techniques, which leads to an overall QoL improvement when compared with MITG.MethodsEnrollment of a total of 60 patients in this prospective survey-collection study is expected. Procedures (MITG versus MIPG, antireflux techniques for MIPG [double-tract reconstruction versus the double-flap technique]) will be chosen based on surgeon and/or patient preference. Randomization is not considered feasible because patients often have strong preferences regarding MITG and MIPG. The primary outcome is appetite level (reported on a 0-10 scale) at 3 months after surgery. With an expected 30 patients per cohort (MITG versus MIPG), this study will have 80% power to detect a one-point difference in appetite level. Patient-reported outcomes will be longitudinally collected (including questions about appetite and reflux), and specific QoL items, body weight, body mass index and ghrelin, albumin, and hemoglobin levels will be compared.DiscussionSurgeons from the US, Japan, and South Korea formed this collaboration with the agreement that the surgical approach to P/GEJ cancers is an internationally important but controversial topic that requires immediate action. At the completion of the proposed research, our expected outcome is the establishment of the benefit and safety of MIPG.Trial registrationThis trial was registered with Clinical Trials Reporting Program Registration under the registration number NCI-2022–00267 on January 11, 2022, as well as with ClinicalTrials.gov under the registration number NCT05205343 on January 11, 2022.

The Relationship Between Pre-Koas Program and Clinical Registration Outcomes in Students of The Faculty of Medical YARSI University Class of 2016

Medical education is passed through two stages, namely the academic stage and the clinical clerkship stage. Before entering the professional stage, the university provides debriefing which aims to make students more prepared to carry out their clinical stages which will end with a test that aims to c proceed to the next stage, namely the profession stage. After completing and fulfilling the requirements, graduates get a diploma with a Doctor's degree. In previous studies, it was found that there was a significant correlation between GPA scores and UKMPPD scores. From the results of this study, it was found that there was evidence that the preparatory process for an activity affected the final score of an activity and the purpose of this study was to find out whether the results of pre-coach training affected the results of clinical clerkships. The research method uses Cross Sectional. The research sample was students of the Faculty of Medicine, YARSI University class of 2016. Data collection used a questionnaire. The results of the Pre Koas debriefing scores showed that most of the students got C grades of 19 people (22.4%), CD scores of 17 people (20%), and at least B- and B+ scores of 1 person (1.2%) and results of clinical clerkship scores Most of the students got 65 A- grades (76.5%), 17 AB students (20%) and 3 A's (3.5%). In the results of bivariate analysis, there was no relationship between pre-coach training and clinical clerkship results.

The application of information technologies to control environmental safety in agricultural production

The article considers a new approach to the study of environmental safety of chemical spraying technologies for the purpose of crop protection based on the use of an information and software complex. The possibility of implementing the developed software product into agricultural production to control environment safety is substantiated. Developed and approved by a Certificate of computer program registration, the information and software complex equipped with piezo sensors includes three modules: a collection module, a processing module, and an information analysis module. As a result of the measurements carried out, it is possible to assess the environment safety and the effectiveness of technical machines and spraying means, to form and visualize data based on the study results. This software complex contains modules not only for recording and processing data obtained from fields, but also allows to form a database by year, site, substances used, as well as visualize and transmit information in the form of tables, diagrams, and graphs.

Social Media Network Analysis of Academic Urologists’ Interaction Within Twitter Microblogging Environment

ObjectiveTo characterize academic urology Twitter presence and interaction by subspecialty designation.MethodsUsing Twitter application programming interface of available data, 94000 specific tweets were extracted for the analysis through the Twitter Developer Program. Academic urologists were defined based on American Urological Association (AUA) residency program registration of 143 residency programs, with a total of 2377 faculty. Two of 3-factor verification (name, location, specialty) of faculty Twitter account was used. Additional faculty information including sex, program location, and subspecialty were manually recorded. All elements of microblogging were captured through Anaconda Navigator. Analyzed tweets were further evaluated using natural language processing for sentiment association, mentions, and quote tweeted and retweeted. Network analysis based on interactions of academic urologist within specialty for given topic were analyzed using D3 in JavaScript. Analysis was performed in Python and R.ResultsWe identified 143 residency programs with a total of 2377 faculty (1975 men and 402 women). Among all faculty, 945 (39.7%) had registered Twitter accounts, with the majority being men (759 [80.40%] versus 185 [19.60%]). Although there were more male academic urologists across programs, women within academic urology were more likely to have a registered Twitter account overall (46% versus 38.5%) compared with men. When assessing registered accounts by sex, there was a peak for male faculty in 2014 (10.05% of all accounts registered) and peak for female faculty in 2015 (2.65%). There was no notable change in faculty account registration during COVID-19 (2019–2020). In 2022, oncology represented the highest total number of registered Twitter users (225), with the highest number of total tweets (24622), followers (138541), and tweets per user per day (0.32). However, andrology (50%) and reconstruction (51.3%) were 2 of the highest proportionally represented subspecialties within academic urology. Within the context of conversation surrounding a specified topic (#aua21), female pelvic medicine and reconstructive surgery (FPMRS) and endourology demonstrated the total highest number of intersubspecialty conversations.ConclusionsThere is a steady increase in Twitter representation among academic urologists, largely unaffected by COVID-19. While urologic oncology represents the largest group, andrology and reconstructive urology represent the highest proportion of their respective subspecialties. Interaction analysis highlights the variant interaction among subspecialties based on topic, with strong direct ties between endourology, FPMRS, and oncology.

Does access to free medication reduce health system costs? An evaluation of the Dispensary of Hope program.

BACKGROUND: Cost-related medication nonadherence-when patients fail to take medication as prescribed because of the cost of the medication-has numerous consequences: more hospitalizations, avoidable deaths, and greater health care expenditures. Dispensary of Hope is a charitable medication access program that collects and distributes pharmaceuticals to pharmacies to dispense free of charge to patients with no insurance, low incomes, and chronic conditions. OBJECTIVE: To estimate the differences in medical costs and utilization of hospital patients enrolled in the Dispensary of Hope program relative to those who were not enrolled. METHODS: We used administrative claims data from 2 health systems participating in Dispensary of Hope to identify those in the program and a comparison group, respectively. Claims data included emergency department (ED) encounters, inpatient encounters, costs, and prescriptions. Health system 1 (HS1) data began July 1, 2016, and ended December 31, 2019; health system 2 (HS2) data ran from March 10, 2014, to December 31, 2019. Program enrollment dates (index dates) were identified via program registration or prescription fills. We propensity score weighted a comparison population from HS1 and HS2, respectively, to match program patient demographic and comorbidity characteristics. We estimated changes in costs, ED visits, inpatient stays, and primary care sensitive ED visits over time between the 2 groups (difference-indifference) over 18 months preenrollment and postenrollment. RESULTS: HS1 comparison (n = 6,714) and Dispensary of Hope (n = 880) groups were balanced on age, sex, race and ethnicity, and comorbidities; both populations were approximately 46 years old, 43% female, 64% White, with an average of 3.0 comorbidities. The HS2 samples were almost 50 years old and a majority female (56%) and Black (55%). Per-person annual costs at HS1 decreased by $3,161 (P < 0.05) more in the Dispensary of Hope group than in the comparison group from the preenrollment to the postenrollment period. Inpatient stays decreased by 200 stays per 1,000 patients per year (P = 0.02) and ED visits increased by 0.32 (P < 0.01) on a yearly basis relative to the comparison group. Primary care sensitive ED visits increased over the period. No results were statistically significant in HS2. CONCLUSIONS: We found substantial reductions in costs and inpatient stays for Dispensary of Hope HS1 participants, and we did not find significant results at HS2. Differences between the health systems or patient populations could explain these varying results. Our study represents a rigorous, multistate evaluation that highlights the impact of a charitable medication access program on hospital utilization for the medically underserved population. DISCLOSURES: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: this work was funded and supported by Dispensary of Hope.

On the problem of increasing accuracy of coordinates determination of a machine-tractor unit by information and navigation equipment of a parallel driving system

BACKGROUND: The Federal Scientific and Technical Program for the Development of Agriculture on 20172025 deals with the creation and implementation of competitive domestic technologies based on the scientific achievements. Therefore, the development and investigation of parallel driving systems for a machine-tractor unit with information and navigation equipment in the direction of increasing their accuracy of coordinates determination are relevant.&#x0D; AIMS: Improving the accuracy of coordinates determination of the software and hardware complex for the parallel driving system based on algorithms for correcting and filtering information data of navigation equipment.&#x0D; METHODS: The simulation of the machine-tractor unit (MTU) is carried out in MATLAB/Simulink and contains the models of physical modules of coordinates correction for cases of tilt, geographic coordinates transformation into plane coordinates, orientation and velocity of the machine-tractor unit and the Kalman filter.&#x0D; RESULTS: Using the proposed mathematical model, a simulation of a machine-tractor unit operation with a parallel driving system is carried out. The adequacy of theoretical studies is confirmed by large-scale bench and field tests. The scientific novelty of the study lies in the proposed algorithms for correction of datas obtained from GPS/GLONASS receivers (computer program registration certificate No. 2019617131), the implementation of the 3D visualization of the machine unit on a tablet screen with the Android operating system (computer program registration certificate Nos. 2018613106 and 2020613458).&#x0D; CONCLUSIONS: The practical meaning of the present study lies in usability of the proposed algorithms for corrections and filtration of navigation equipment data under creating modern hardware and software systems for parallel driving of a machine-tractor unit.

Evolving Project ECHO: delivery of pediatric pain core competency learning for interprofessional healthcare providers.

Healthcare providers (HCPs) practicing in community settings are critical to improving access to pain care, yet there are significant gaps in training opportunities designed for interprofessional learners. Project Extension for Community Healthcare Outcomes (Project ECHO®) is an established model for delivering online HCP education through virtual clinics and cultivating a community of practice. However, to our knowledge, the integration of pain core competency education into the ECHO® model has not been previously attempted. This innovation could enhance the ECHO® model while also addressing the growing calls for more accessible interprofessional pain curricula. This paper describes efforts to implement and evaluate core competency curricula within the context of Pediatric Project ECHO for Pain, one of the first pediatric-pain focused ECHO programs in the world. Needs assessments informed curricula development. The first delivered core competency model consisted of synchronous webinar-style sessions while the second model included a mixture of asynchronous (eLearning course) and synchronous (virtual clinical debrief) elements. A convenience sample of HCPs was recruited from ECHO program registrants. Participants completed baseline and follow-up surveys to assess core competency acceptability as well as impact on knowledge and self-efficacy related to managing pediatric pain. Usability of the eLearning platform (model 2 only) was also evaluated. Surveys used 5-point Likert scales to capture outcomes. A priori targets included mean scores ≥4/5 for acceptability and ≥80% of learners reporting knowledge and self-efficacy improvements. The study received local research ethics approval. The core competency was found to be highly acceptable to interprofessional learners (n = 31) across delivery models, surpassing a priori targets. Specifically, it was characterized as a worthwhile and satisfactory experience that was helpful in supporting learning. The core competency was also associated with improvements in knowledge and self-efficacy by 97% and 90% of learners, respectively. The eLearning platform was reported to have high usability with clinically realistic cases (100% of respondents) that were helpful to inform care delivery (94% of respondents). The integration of core competency learning within the Project ECHO® model was a successful approach to deliver pediatric pain education to interprofessional HCPs.

Implementing pathways to anesthesiology: Promoting diversity, equity, inclusion, and success.

Implementing pathways to anesthesiology: Promoting diversity, equity, inclusion, and success.