Rank US Research Articles

P-1927. Utilization of Patient Characteristics and the Area Deprivation Index (ADI) To Evaluate Referral Patterns for Long COVID at a Tertiary-Care Veterans Affairs (VA) Medical Center

Abstract Background The COVID-19 pandemic disproportionally affected socioeconomically disadvantaged communities, with corollary expectation of increased impact of post-acute sequelae in this population. We established a subspecialty Long COVID Clinic (LCC) at VA Northeast Ohio to care for patients with post-acute sequelae of COVID-19 in 2023. The LCC was advertised system-wide to providers via email and videoconference presentations, and to patients via the facility website. After the first 1/2 year of implementation, an analysis of patients and of referral adequacy in meeting the needs of the catchment area was undertaken. Methods The Area Deprivation Index (ADI) uses census data to rank US neighborhoods by socioeconomic disadvantage and can be a tool in refining delivery of services or healthcare. Neighborhoods are ranked nationally and within-state (state deciles 1-10, with 10 indicating greatest disadvantage). In addition to other health factors, national and state ADI indices were obtained for each patient seen in our LCC between March 2023 and April 2024. Results 70 unique patients (mean age 63) were seen via referral in the 1st 8 months of the LCC (Fig 1). These were 13 (19%) women, 55 (79%) men, 2 (1%) transgender, 10 (14%) Black and 54 (77%) White. The most common comorbidities were psychiatric (57%), hypertension (44%) and cardiac (40%) (Fig 1). The most common presenting complaints were fatigue (73%), exercise intolerance (72%), and dyspnea (52%) (Fig 2). ∼1/4 of LCC patients had experienced severe COVID-19 (Fig 3). The average in-state ADI decile was 5 (range, 1-10). Conclusion Disclosures All Authors: No reported disclosures

2020 rankings for US PharmD programs, research, and overall quality

BackgroundUS News and World Report (USNWR) publishes well-known rankings of graduate health programs. Medicine and nursing are ranked with weighted metrics using multiple criteria, and medical schools are ranked separately according to their focus (research or primary care). USNWR pharmacy school rankings are based on a single-question peer perception survey. ObjectiveThe objective of this study was to develop a simple, transparent framework to rank US colleges and schools of pharmacy in overall quality and separately based on program quality and research quality, using data that are readily available to the academy. MethodsData for three education quality and four research quality metrics were obtained for 2020. Each metric was standardized and ranked, and then each set was summed to determine separate ranks for education and research. Education and research scores were combined using equal weights to provide a single rank for overall quality. A sensitivity analysis was performed to determine the effect of assigning higher proportionate value to education, similar to USNWR medical school rankings. ResultsDistinct ranks were produced for education, research, overall (education: research) 50:50, and overall 60:40. Sensitivity analysis suggests the more disproportionately the education and research factors are weighted, the more ranks change. Mid-ranked schools were most impacted when weightings changed due to relative strength in one factor and relative weakness in the other. When weighted 60:40, nine (7%) mid-ranked programs improved in rank, while 11 (11%) worsened in rank compared to the 50:50 model. ConclusionSeparately ranking education and research can highlight the diverse strengths of pharmacy schools. The proposed model is based on easily obtainable data and is easily reproducible, allowing for annual rankings. These rankings may be used by PharmD and PhD applicants when selecting schools and by pharmacy schools to benchmark true and aspirational peers.

Social Media Engagement as a Metric for Ranking US Olympic Athletes as Brand Endorsers

Athletes often use social media to help build their personal brand, communicate with stakeholders, and promote endorsements. Research suggests that athletes who elicit greater engagement on social media are more valuable to endorse brands than those who simply have a large number of followers. From a regulatory perspective, it is important for athlete endorsers to disclose the commercial nature of sponsored posts. Therefore, based on social influence theory (SIT), the purpose of this study was to examine Olympic athletes’ follower engagement on social media with a focus on brand mentions and disclosures of the relationships. Utilizing a content analysis of 190 US Olympic athletes’ tweets during the 2018 PyeongChang Games, findings revealed statistically significant differences in follower engagement based on the athlete’s gender. Non-brand-related posts received statistically significant greater engagement than brand-related posts, and only 12.90% of the posts that mentioned a brand disclosed a brand relationship. Implications and future research also are discussed.

Stimulating soil health within Nebraska's Natural Resources Districts

I mproving soil health is increasingly recognized by farmers, researchers, policymakers, and agribusiness as a solution to a number of challenges facing agriculture, including rising soil degradation, growing climate change risks, and declining water quality (FAO 2011; Webb et al. 2017; Zimnicki et al. 2020). As a result of this additional focus on soil health, a number of new policy initiatives are being developed to support increased funding and capacity for soil health–related practices. This includes federal policies, through mechanisms such as the farm bill, which designate funding for national conservation programs to address natural resource concerns, of which soil health is one of many (Harrigan and Charney 2019). At present, these programs represent greater than US$6 billion spent annually and are organized into various initiatives such as working lands programs, land retirement, easements, partnerships, and grants (CRS 2019). These dollars are distributed at the state level based on local resource needs and other technical considerations, through the USDA Natural Resources Conservation Service (NRCS) and/or their partner organizations (USDA ERS 2019; USDA NRCS 2020). In addition to federal support for soil health, there are a growing number of statewide initiatives; for example, the Nebraska legislature recently passed a bill to support the creation of a “Healthy Soils Task Force,” a group of agricultural leaders in the state who are developing a roadmap for future soil health–related work in the state (NDA 2019). It is important to more closely consider the implementation of soil health–related programs, particularly at a local level, given increasing interest and investments. Nebraska is the fourth ranking US …

Cardiovascular Disease Risk Prediction in the HIV Outpatient Study.

Cardiovascular disease (CVD) risk prediction tools are often applied to populations beyond those in which they were designed when validated tools for specific subpopulations are unavailable. Using data from 2283 human immunodeficiency virus (HIV)-infected adults aged ≥18 years, who were active in the HIV Outpatient Study (HOPS), we assessed performance of 3 commonly used CVD prediction models developed for general populations: Framingham general cardiovascular Risk Score (FRS), American College of Cardiology/American Heart Association Pooled Cohort equations (PCEs), and Systematic COronary Risk Evaluation (SCORE) high-risk equation, and 1 model developed in HIV-infected persons: the Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) study equation. C-statistics assessed model discrimination and the ratio of expected to observed events (E/O) and Hosmer-Lemeshow χ2 P value assessed calibration. From January 2002 through September 2013, 195 (8.5%) HOPS participants experienced an incident CVD event in 15 056 person-years. The FRS demonstrated moderate discrimination and was well calibrated (C-statistic: 0.66, E/O: 1.01, P = .89). The PCE and D:A:D risk equations demonstrated good discrimination but were less well calibrated (C-statistics: 0.71 and 0.72 and E/O: 0.88 and 0.80, respectively; P < .001 for both), whereas SCORE performed poorly (C-statistic: 0.59, E/O: 1.72; P = .48). Only the FRS accurately estimated risk of CVD events, while PCE and D:A:D underestimated risk. Although these models could potentially be used to rank US HIV-infected individuals at higher or lower risk for CVD, the models may fail to identify substantial numbers of HIV-infected persons with elevated CVD risk who could potentially benefit from additional medical treatment.

Bounding obesity rates in the presence of self-reporting errors

We examine what, if anything, we can learn about obesity rates using self-reported BMI once we allow for possible measurement error. We use self-reported obesity rates, along with estimates of misclassification rates, to derive upper and lower bounds for the true population obesity rate. These bounds are then used as the basis for obesity rankings. Our results show, that once measurement error is taken into account, it is difficult to obtain meaningful rankings across European countries. However, our analysis shows that it is still possible to rank US states by obesity status using only minimal assumptions on the nature of the error process. As a result, cross-state variation in self-reported BMI, when used in conjunction with our bounds, may still provide a useful source of information for understanding the causes and consequences of obesity in the USA.

Using 5-Year Survival Model Does Not Change LAS Estimate of Transplant Benefit

Purpose The Lung Allocation Score (LAS) has been used since 2005 to rank US lung transplant candidates for access to transplant. A revised LAS (LAS-R) system that will better predict outcomes for the current cohort of transplant patients has been approved and is awaiting implementation. Both the current LAS and LAS-R calculate a candidate’s wait-list mortality risk in the year post-listing and survival likelihood during first year posttransplant. We examined the impact of modifying LAS-R to use a long-term 5-year posttransplant survival model (LAS-R5). Methods and Materials SRTR standard analysis files were used to estimate posttransplant survival for lung recipients, 5/4/05-9/30/11. We calculated the LAS for all lung-only candidates aged ≥ 12 years on the waiting list 4/1/2011 using three models: current LAS, LAS-R, and LAS-R5. Using the same variables and parameter estimates for the LAS-R 5-year and 1-year models, we compared C statistics and Hosmer-Lemeshow tests to assess model fit. Results Boxplots show increased LAS-R for diagnosis group B compared with LAS, but LAS-R5 is similar to LAS-R. [ figure 1 ] C statistics for all models are comparable (LAS = 0.59, LAS-R = 0.61, LAS-R5 = 0.58), suggesting similar survival predictive power. However, the Hosmer-Lemeshow test (P = 0.0214) for the LAS-R5 indicates that observed mortality rates do not match expected event rates in subgroups of the model. Conclusions Using long-term 5-year survival with the LAS-R covariates does not improve LAS prediction of posttransplant survival likelihood. Possibly, because wait-list mortality risk is given twice the weight of posttransplant survival in LAS calculation, changes in posttransplant covariates do not significantly impact the LAS.

II. THE ARREST AND IMPENDING TRIAL OF RADOVAN KARADŽIĆ

On 21 July 2008, Radovan Karadzic, the former president of the separatist Bosnian Serb entity, the Republika Srpska, and one of the most sought-after fugitives from international criminal justice, was arrested by Serbian authorities in the Serbian capital, Belgrade. He was surrendered to the custody of the International Criminal Tribunal for the former Yugoslavia (ICTY) several days later, where he will be tried for genocide, crimes against humanity and war crimes committed by Bosnian Serb forces during the 1992-1995 conflict in Bosnia-Herzegovina. This short note will briefly explore some of the basic legal questions arising from the arrest of Karadzic and his impending trial. It will first examine the indictment against Karadzic, including the genocide charge and the consequences of a possible genocide conviction. The note will then turn to the alleged immunity deal that Karadzic claims was agreed between him and Richard Holbrooke, a ranking US diplomat. The note will finally examine the issue of self-representation and the potentially adverse effects that it might have on what is certainly a trial of great symbolic importance.

Sex Differences in Hospital Risk-Adjusted Mortality Rates for Medicare Beneficiaries Undergoing CABG Surgery

The primary purpose of this study was to rank US hospitals performing coronary artery bypass graft (CABG) surgery on Medicare beneficiaries into 4 performance tiers and determine if there were overall and sex-specific differences in the risk-adjusted mortality rates across performance tiers. A retrospective analysis was done using a Medicare Provider Analysis and Review (MEDPAR) file of all Medicare beneficiaries who underwent CABG surgery without valve repair or replacement during fiscal years 2003 and 2004. Logistic regression models controlling for demographic characteristics, comorbidities, and cardiac risk factors were used to predict the probability of in-hospital mortality. Hospitals performing at least 52 CABG surgeries during a fiscal year (at least 17 female patients) were ranked into 4 tiers. Rankings were based on the number of lives saved, calculated as the expected number of risk-adjusted deaths minus the actual number of deaths in the hospital during each fiscal year. Average risk-adjusted mortality rate was stable and declining over the 2 years: 3.68% in 2003 and 3.61% in 2004. In 2004, the average risk-adjusted mortality rate ranged from 1.39% in tier 1 hospitals to 6.40% in tier 4 hospitals. The sex-specific mortality rate was consistently higher for women in all tiers, with the differential smallest (0.68%) in tier 1 hospitals and greatest (2.67%) in tier 4 hospitals. The sex differential increases from top- to bottom-tier hospitals, suggesting female beneficiaries could benefit from having CABG performed at tier 1 hospitals.

Ranking US Army Generals of the 20th Century: A Group Decision-Making Application of the Analytic Hierarchy Process

The pantheon of 20th century US Army generals contains many great wartime commanders. Military historians have written about their leadership qualities but have not ranked the best generals. We asked 10 experts in US military history to evaluate seven generals—Omar Bradley, Dwight Eisenhower, Douglas MacArthur, George Marshall, George Patton, John Pershing, and Matthew Ridgway—using the analytic hierarchy process in a group setting. We developed a ratings hierarchy, and each participant scored each general. We combined individual pairwise comparisons using the geometric-mean method and a new method based on linear programming and obtained a clear, three-tier ranking of generals with George Marshall judged the best US Army general of the 20th century, closely followed by Dwight Eisenhower.

Ranking and selection of motor carrier safety performance by commodity

We use recent safety performance data to rank US motor carrier commodity segments (e.g., Tank segment or Produce segment) in terms of several driver-related, vehicle-related, and crash-related safety measures. Ranking and selection inference techniques are used to determine the best and worst performing commodity segments at the 95% confidence level. The results are mixed, however the Passenger segment is generally best, while the Produce, Intermodal, and Refrigerated segments tend to be worst.

Determining the relative efficiency of MBA programs using DEA

Data envelopment analysis (DEA) is used here to determine the relative efficiency of 24 top ranked US MBA programs. Efficiency scores were determined using three output sets of the MBA programs: output that measured student satisfaction, output that measured recruiter satisfaction and output that measured both. DEA is also used here to determine the relative efficiency of three foreign MBA programs as compared to several top ranking US MBA programs. The publicized ranking of MBA programs by national magazines has a significant impact on corporate recruiters, potential MBA students and on business schools themselves. A new ranking based on DEA will more completely and accurately represent MBA programs. Further, DEA will make it possible to more fairly compare specific programs.

Solvent swelling rates of low rank coals and implications regarding their structure

The rates of solvent swelling of a suite of low rank US coals have been measured in various organic solvents at various temperatures. The equilibrium extents of swelling are independent of temperature within the temperature range studied (25–70°C). The rate of the swelling process was generally relaxation-controlled. The activation energies for the kinetics of swelling are consistent with other recently published values, and support the hypothesis that the activation barrier is associated with the breakage of internal electron donor-acceptor (e.g. hydrogen bonding) interactions. Thermal pretreatment of a lignite at various temperatures up to 395°C decreased the activation energy barrier and the rate of swelling. Swelling rates of the same lignite in different solvents suggest that the activation energy can exceed the value for breaking single hydrogen bonds, possibly because the true barrier involves cleaving more than one of those bonds at a time.

Comparison of Ten Friesian Strains in Poland for Yield Traits from First Three Parities

Milk yield, fat yield, and fat percentage for the first three parities were compared for crosses of Friesian strains from Canada, Denmark, Israel, The Netherlands, New Zealand, Sweden, the United Kingdom, the US, and West Germany with Polish black-and-white cattle. Mixed model multitrait BLUP solutions for milk yield ranked Holstein strains (US, Canada, and Israel) and New Zealand Friesians higher than European Friesian strains for all three parities. Largest difference for milk yield between highest ranking US strain and lowest ranking Polish strain was 1002kg for first lactation. Rankings for fat yield were similar to those for milk yield. For all three parities, the New Zealand strain ranked highest for fat percentage and the US strain lowest. Although rankings were consistent across parities for all yield traits, differences between Holstein and Friesian strains decreased as parity increased. Holstein strains maintained their superiority for milk and fat yields for all three parities despite difficult environmental conditions and a feeding regimen worse than in their country of origin.