Rhode Island Research Articles

Babesiosis: Analysis of the Evidence for Infections in the United Kingdom.

Human babesiosis is caused when erythrocytes are invaded by Babesia. Infection can occur from the bite of an infected tick, blood transfusion or congenitally. Issues related to the infecting species, symptomology and testing technology are discussed and the implications of accurate incidence and prevalence of the disease discussed. Human babesiosis is considered to be relatively rare in the UK. With a considerable number of non-specific symptoms and diagnostic testing limitations, it is probable that true positives are being missed. Based on co-infection data for Borrelia and Babesia from Rhode Island and Connecticut, and on Borrelia seropositivity data from northeastern France, the prevalence of babesiosis in those aged under 35 years, 35 to 44 years, 45 to 54 years and 55 years and over would be expected to be 0.6%, 1.8%, 2.8% and 3.5%, respectively. Based on the prevalence of infections in ticks and canines and a disease model previously published, it is estimated that the UK incidence of human babesiosis is likely to be approximately 18,500 cases per year.

Quality of life and interpersonal support among adult patients with cancer undergoing chemotherapy at an academic cancer institute.

370 Background: The National Cancer Institute (NCI) defines quality of life (QOL) as “overall enjoyment of life.” Increasingly, cancer treatments like chemotherapy are focused on not only increasing survival time but on maintaining and/or improving QOL. Interpersonal support has been shown to have an impact on QOL. Assessment of both can help focus efforts to improve quality of care for cancer patients. Methods: This study enrolled patients from the Lifespan Cancer Institute at The Miriam Hospital (TMH) in Rhode Island who were adults 18+ and on chemotherapy infusion treatment with an active cancer diagnosis. Patients were randomly selected for an in-person interview during scheduled chemotherapy infusion appointments from February 9 to April 26, 2024. We collected patient demographics and study staff administered the 16-item Quality of Life Scale (QOLS) and 12-item Interpersonal Support Evaluation List (ISEL). Results: Of 432 total eligible cancer patients at TMH, 96 (22%) completed the prospective survey. The average (SD) age was 68.4 years old (10.3). The majority of patients were male (51%), Caucasian (80%), married (65%), on Medicare (62%), diagnosed in 2023 or 2024 (59%), and the most common cancers were gastrointestinal (30%), genitourinary (24%), and breast (17%). Overall, patients demonstrate mostly high satisfaction in certain QOL and interpersonal support domains with variation across others. Over 80% of patients are “delighted” or “pleased” with their material comforts, close family and friends, entertainment, and independence. However, approximately 50% of patients report a mixed or worse level of satisfaction with their health, participation in organizations/public affairs, and active recreation and varying levels of satisfaction with other QOL domains. Over 60% of patients report the highest level of perceived interpersonal support across all domains (appraisal, belonging, tangible) with indication of stronger appraisal support compared to belonging and tangible. Conclusions: Our results indicate a strong satisfaction among patients with their close interpersonal networks rather than external affairs or activities. Satisfaction with health and active recreation among chemotherapy patients is much more variable. These findings suggest possible benefits of wellness and health maintenance programs during treatment. Lowest areas of interpersonal support indicate a need to build more comprehensive support resources for tangible tasks like moving, assisting with chores, or other physical activities and building support groups to increase belonging. Opportunities to build community among chemotherapy patients or utilize clinical social workers will likely improve satisfaction in many of the more low and variable QOL and interpersonal support domains, particularly for patients navigating a new or first-ever cancer diagnosis.

Health information exchange and 42 CFR part two: Incorporating the voice of people with histories of substance use disorder

IntroductionWe set out to understand patient attitudes and concerns about sharing information about substance use disorder (SUD) history through a Health Information Exchange (HIE), in the context of 42 CFR Part 2. MethodsThe study conducted semi-structured qualitative interviews of people with SUD history, recruited through an association of recovery communities in Rhode Island. Interviews were recorded and transcribed. Two Research Assistants coded the interviews using Atlas.ti™ in consultation with the principal investigator. Each first coded a sample of interviews independently. The team then discussed the coding and agreed on broad coding categories. The team met regularly to discuss emerging constructs and agree on a detailed coding schema. We came to consensus on broad themes and selected illustrative quotations. Interpretation was pragmatic, focusing on the nature and consequences of participants' experiences, and their wishes and intentions with respect to information sharing. ResultsOf 27 respondents, all but three reported negative experiences with health care providers because of current or former SUD, ranging from judgmental to neglectful or inappropriate treatment, to disparagement and abuse. With few exceptions, they would not consider sharing their SUD history through an HIE without specific, revocable control over which individual providers could receive the information. ConclusionsRespondents' requirements are consistent with the legal requirements of 42 CFR Part 2. Implementing Part 2 compliant HIE will require overcoming substantial technical and procedural challenges.

Comprehensive Dynamic 3-Dimensional Analysis of Tricuspid Valve in Functional Tricuspid Regurgitation: Implications for Prophylactic Tricuspid Valve Intervention

ObjectivesUnderstanding of changes in tricuspid annulus (TA) during secondary or functional tricuspid regurgitation (TR) is currently limited and its surgical management relies on limited 2-dimensional (2D) imaging. The aims of the study were to: 1) track and measure changes in TA using 3-dimensional (3D) echocardiography during complete cardiac cycle in patients with functional TR when compared to no TR, and 2) compare TAPSE derived from 2D and 3D coordinates as a measure of RV function when compared to standard method of fractional area change (FAC). DesignIntraoperative 3D echocardiography data was collected prospectively followed by post processing software analysis to track and reconstruct changes throughout the cardiac cycle. SettingData was collected from 108 patients undergoing left sided heart surgery at two large academic centers – Beth Israel Deaconess Medical Center in Boston, MA and Rhode Island Hospital, Providence, RI between from November 2018 to April 2020. ParticipantsFinal dataset (n=92) included two groups: no significant functional tricuspid regurgitation (NTR) group (n=74), defined as ≤ mild tricuspid regurgitation (TR) and TA < 35 mm, and a significant functional TR (FTR) group (n=18), defined as ≥ moderate TR. Interventions3D TEE datasets were analyzed, and the motion of TA coordinates was tracked during complete cardiac cycle in 2D and 3D planes using post-processing and software analysis. Computational modeling of TA motion was performed using computer-aided design. In further analysis, reconstructed and 3D printed models of TV were developed for the two groups. Measurements and Main ResultsPatients in FTR group had larger TA size during the cardiac cycle with less overall excursion and reduced annular dynamism. 3D motion of TA for lateral (L), anterolateral (AL) and posterolateral (PL) coordinates was lower in FTR group compared to NTR group [(18±6.8 vs 13.6±8.5, p=0.02), (15.2±5.5 vs 11.3±6.0, p=0.009) and (17.6±6.6 vs 12.3±5.2, p=0.002) respectively]. TAPSE derived from 3D planes was more accurate for RV function assessment (AUC 0.704, p = 0.011) than 2D TAPSE (AUC 0.625, p = 0.129). Finally, in the FTR group, the anteroseptal-posterolateral (AS-PL) diameter was consistently larger during all phases of cardiac cycle, in comparison with septo-lateral (S-L) diameter. Conclusion3D echocardiographic assessment of TA helps better understand its geometry and dynamism in functional TR, and is more accurate than 2D measurements for RV function assessment.

Implications of Positive Effects of Early Childhood Education for Education Policy

Emerging research on the benefits of early childhood education has sparked interest in making preschool education universal to improve children's readiness for school and their subsequent achievement of social, economic, and professional success. The implementation of early childhood education (ECE) programs, which aim to prepare 4-year-old children for school, has resulted in an increase in public funding. This increase can be attributed to the positive effects of the ECE program on children, as demonstrated by the academic skills of the children measured, which fall within the national average. These abilities include the ability to read and write, speak and understand mathematics, and recognize patterns in numbers. "Investing as early as possible, from birth through age five, in disadvantaged families yields the highest rate of return in early childhood development." Thus, the community and local government are required to actively involved in managing preschool structures, enhance the supervision and management of early childhood education. Common challenges encountered recorded nearly half of all teachers acknowledged to having significant levels of stress and burnout over the previous several years, mental health issues, low compensation, etc. Furthermore, NIEER research findings reveals only five states Hawaii, Michigan, Rhode Island, Alabama, and Mississippi meet all ten national program quality standards, which include putting child development guidelines into practice and offering professional development to teachers. Thus, this paper recommends that when formulating schools' improvement strategies, the Department of Education should take into account the enrollment rate in early learning and kindergarten institutions. All early childhood professional development programs aim to improve children's learning in the behavioral, social-emotional, communicative, and cognitive domains over the long run through indirect means.

Fisher activity patterns show potential for behavioral adaptations to human modified landscapes

Animals alter their diel activity in response to physiological constraints and ecological conditions. Fisher (Pekania pennanti) activity is known to vary through the diel cycle and change in response to cold stress and generally through both the climatic and biological seasons. However, less is known whether thermoregulatory effects impact fisher activity in milder climates and in areas of high human disturbance. We focused on two distinct research objectives to understand the 1) physiological constraints, and 2) ecological components of fisher activity in a highly disturbed landscape with a relatively mild climate. We used accelerometer data from 34 individual live-captured fisher in Rhode Island, USA from 2021 to 2023. We found that fisher activity patterns were primarily driven by diel cycle with higher activity levels at night than during the day. We did not observe any physiological influence of ambient temperature on fisher activity; daily minimum temperatures did not constrain fisher activity in the colder months, nor did daily maximum temperatures in warmer months. We did find that female activity levels differed by breeding status with non-pregnant females having higher activity levels than pregnant females. Considering ecological components, we found fisher decreased activity levels in higher road density areas during warmer months that coincide with higher traffic volumes. For fisher living in areas with lower road densities, we saw higher activity in the breeding season and summer than in winter. In contrast, fisher living in areas with high road densities had lower activity in the breeding season and summer than in winter. We conclude that fisher largely do not shift their activity to mitigate thermoregulatory costs in areas where temperatures do not reach extremes for extended periods of time. However, our findings suggest that behavioral shifts in activity are impacted by human disturbance and fisher minimize activity in risky areas.

The state of the ocean in the northeastern Atlantic and adjacent seas

Abstract. In this paper, the Copernicus Ocean State Report offers detailed scientific analysis of the ocean under climate change, ocean variability, and ocean extremes in the northeastern Atlantic and adjacent seas. Major results show that the northeastern Atlantic Ocean and adjacent seas have experienced consistent warming, with sea surface temperatures increasing at a rate of 0.25 ± 0.03 °C per decade since 1982, doubling the global average trend. This warming is most pronounced in the Black Sea, Mediterranean Sea, and Baltic Sea. Sea levels have risen significantly over the past 30 years, particularly in the Baltic and Mediterranean seas. Ocean acidification has also increased, with pH decreasing at a rate of −0.017 ± 0.001 units per decade. Marine heatwaves have intensified and expanded, affecting over 60 % of the region in 2022 and 2023. Over the past 16 years, most extreme wind speeds exceeding 22 m s−1 prevailed in the central and subpolar North Atlantic and northern Mediterranean Sea. The region has also seen significant variability in ocean climate indicators and circulation patterns, including increased Atlantic Water transport to the Arctic Ocean through the Fram Strait and notable variations in the Mediterranean Sea's meridional overturning circulation. No major Baltic inflow occurred in winter 2022/23.

Going from theory to practice: Succeeding with OTPs in corrections

With her compassion and knowledge, Linda Hurley, CEO of CODAC Behavioral Healthcare in Rhode Island, is able to convince corrections staff of the benefits of methadone and buprenorphine. But it isn't easy.

“The Ocean is a Part of Me”: The Importance of Coastal Place Attachment to Well-Being and Implications for Coastal Access Management

Public coastal access is a growing issue in coastal management, particularly as both environmental changes and increased coastal development threaten existing public coastal access points around the country. This has implications both economically and on non-economic factors such as individual and community well-being. Through a mixed-methods case study of coastal users in Rhode Island (n = 200 surveys and n = 29 interviews), this study explores the concept of attachment to coasts as a specific type of place attachment by identifying Coastal Place Attachment (CPA) as a concept, developing a quantitative index to measure CPA, and qualitatively describing the value that coastal attachment brings to well-being. Results show that individuals do have a unique attachment to coastal environments that is not transferable to other natural areas, although it may be generalizable to other coastal areas. We also document how this attachment provides important contributions to psychological, physical, and social well-being. Implications for coastal access management are discussed.

Pharmacy School Affordability for Pharmacy Technicians From 2004 to 2022

ObjectiveThis study aimed to evaluate the trends in pharmacy technician wages relative to pharmacy school tuition and fees for the first professional year (P1) from 2004 to 2022, and to assess the affordability of pharmacy education for those currently employed as technicians in a pharmacy. MethodsThis observational cross-sectional study used data from the United States Bureau of Labor Statistics to calculate median disposable incomes for pharmacy technicians and the American Association of Colleges of Pharmacy Tuition Trends Database to calculate cumulative sums of P1 in-state tuition and mandatory fees for pharmacy students. The primary outcome was the national change in the tuition affordability ratio, defined as the comparison of median disposable income with median total tuition and fees for P1. Changes in the tuition affordability ratio for the most affordable programs in each state were analyzed as a secondary outcome. ResultsThe study found that from 2004 to 2022, the median disposable income of pharmacy technicians nationally increased from $20,103 to $33,255, while median P1 tuition and fees rose from $13,223 to $36,183. The median tuition affordability ratio decreased from 1.52 in the 2004–2005 academic year to 0.92 in 2022–2023, indicating a 40% reduction in affordability. State-specific analysis revealed varying affordability ratios, with only Pennsylvania and Rhode Island showing an increase in affordability. ConclusionThe study highlights a significant decline in the affordability of pharmacy education, raising concerns about the economic barriers faced by prospective pharmacy students and calling for a reevaluation of financial strategies within the field.

Split-explicit external mode solver in the finite volume sea ice–ocean model FESOM2

Abstract. A novel split-explicit (SE) external mode solver for the Finite volumE Sea ice–Ocean Model (FESOM2) and its sub-versions is presented. It is compared with the semi-implicit (SI) solver currently used in FESOM2. The split-explicit solver for the external mode utilizes a dissipative asynchronous (forward–backward) time-stepping scheme that does not require additional filtering during the barotropic sub-cycling. Its implementation with arbitrary Lagrangian–Eulerian vertical coordinates like Z star (z*) and Z tilde (z̃) is explored. The comparisons are performed through multiple test cases involving idealized and realistic global simulations. The SE solver demonstrates lower phase errors and dissipation, while maintaining a simulated mean ocean state very similar to the SI solver. The SE solver is also shown to possess better run-time performance and parallel scalability across all workloads tested.

Teletrauma Use in US Emergency Departments.

Nearly 30 million predominantly rural US residents lack timely access to trauma care expertise available at level I or II trauma centers. Telehealth is an established approach to improve access to health care expertise using remote consultation; however, the prevalence of use of telehealth in trauma (teletrauma) across the US is not known. To examine the prevalence of, trends in, and factors associated with teletrauma use and adoption among US emergency departments (EDs). This survey study included data from the National Emergency Department Inventory (NEDI)-USA survey from January 1, 2016, to December 31, 2020. Each year, a 1-page survey was sent to the directors of nonfederal, nonspecialty EDs by mail and email up to 3 times; nonresponders were further contacted via telephone to complete the survey. Data were analyzed from January to March 2023. The primary outcome was self-reported ED use of teletrauma for each year studied. Additional measures included data regarding self-reported use of any other telehealth service and ED characteristics. Multivariable logistic regression analyses were performed to assess ED characteristics associated with teletrauma use in 2020 and teletrauma adoption between 2017 and 2020. Of 5586 EDs in the US in 2020, 4512 had available teletrauma survey data (80.8% response rate); 379 (8.4%) of these EDs reported teletrauma use. In contrast, 2726 (60.4%) reported use of any other telehealth service. Teletrauma use (among EDs with any telehealth use) ranged between 0% in Alabama; Connecticut; Washington, DC; Indiana; New Jersey; Nevada; Oklahoma; Oregon; Rhode Island; and South Carolina to more than 60% in Arkansas (39 of 64 [60.9%]), South Dakota (31 of 41 [75.6%]), and North Dakota (30 of 35 [85.7%]). Factors associated with teletrauma use included rural location (odds ratio [OR], 2.44; 95% CI, 1.77-3.36), critical access hospital (OR, 2.67; 95% CI, 1.83-3.88), and basic stroke hospital vs nonstroke hospital (OR, 1.74; 95% CI, 1.32-2.30) designations. Factors associated with adoption of teletrauma by 2020 included critical access hospital (OR, 1.98; 95% CI, 1.35-2.90) and basic stroke hospital vs nonstroke hospital (OR, 1.42; 95% CI, 1.04-1.94) designation. This survey study found that teletrauma use lagged significantly behind use of other telehealth services in US EDs in 2020. While most EDs using teletrauma were located in rural areas, there was significant state-level variation in teletrauma use. Future research is needed on how teletrauma is being used and to identify barriers to its wider implementation.

Medicaid Expansion and Mortality Among Persons Who Were Formerly Incarcerated

Since 2014, Medicaid expansion has been implemented in many states across the US, increasing health care access among vulnerable populations, including formerly incarcerated people who experience higher mortality rates than the general population. To examine population-level association of Medicaid expansion with postrelease mortality from all causes, unintentional drug overdoses, opioid overdoses, polydrug overdoses, suicides, and homicides among formerly incarcerated people in Rhode Island (RI), which expanded Medicaid, compared with North Carolina (NC), which did not expand Medicaid during the study period. A cohort study was conducted using incarceration release data from January 1, 2009, to December 31, 2018, linked to death records from January 1, 2009, to December 31, 2019, on individuals released from incarceration in RI and NC. Data analysis was performed from August 20, 2022, to February 15, 2024. Participants included those aged 18 years or older who were released from incarceration. Individuals who were temporarily held during ongoing judicial proceedings, died during incarceration, or not released from incarceration during the study period were excluded. Full Medicaid expansion in RI effective January 1, 2014. Mortality from all causes, unintentional drug overdoses, unintentional opioid and polydrug overdoses, suicides, and homicides. Between 2009 and 2018, 17 824 individuals were released from RI prisons (mean [SD] age, 38.39 [10.85] years; 31 512 [89.1%] male) and 160 861 were released from NC prisons (mean [SD] age, 38.28 [10.84] years; 209 021 [87.5%] male). Compared with NC, people who were formerly incarcerated in RI experienced a sustained decrease of 72 per 100 000 person-years (95% CI, -108 to -36 per 100 000 person-years) in all-cause mortality per quarter after Medicaid expansion. Similar decreases were observed in RI in drug overdose deaths (-172 per 100 000 person-years per 6 months; 95% CI, -226 to -117 per 100 000 person-years), including opioid and polydrug overdoses, and homicide deaths (-23 per 100 000 person-years per year; 95% CI, -50 to 4 per 100 000 person-years) after Medicaid expansion. Suicide mortality did not change after Medicaid expansion. After Medicaid expansion in RI, non-Hispanic White individuals experienced 3 times greater sustained decreases in all-cause mortality than all racially minoritized individuals combined, while non-Hispanic Black individuals did not experience any substantial benefits. There was no modification by sex. Individuals aged 30 years or older experienced greater all-cause mortality reduction after Medicaid expansion than those younger than 30 years. Medicaid expansion in RI was associated with a decrease in all-cause, overdose, and homicide mortality among formerly incarcerated people. However, these decreases were most observed among White individuals, while racially minoritized individuals received little to no benefits in the studied outcomes.

Legal Briefs

Community college settles suit over human trafficking claims Ohio bill addresses campus safety amid protests Rhode Island reintroduces bill to arm campus police officers

Correlates of fentanyl preference among people who use drugs in Rhode Island

BackgroundFentanyl is increasingly pervasive in the unregulated drug supply and is a driver of drug overdose deaths in the United States. The aims of this study were to characterize and identify correlates of fentanyl preference among people who use drugs (PWUD) in Rhode Island (RI).MethodsUsing bivariate analysis, we examined associations between fentanyl preference and sociodemographic and psychosocial characteristics at baseline among participants enrolled in the RI Prescription Drug and Illicit Drug Study from August 2020-February 2023. Fentanyl preference was operationalized based on responses to a five-point Likert scale: “I prefer using fentanyl or drugs that have fentanyl in them.” Participants who responded that they “strongly disagree,” “disagree,” or were “neutral” with respect to this statement were classified as not preferring fentanyl, whereas participants who responded that they “agree” or “strongly agree” were classified as preferring fentanyl.ResultsAmong 506 PWUD eligible for inclusion in this analysis, 15% expressed a preference for fentanyl or drugs containing fentanyl as their drug of choice. In bivariate analyses, preference for fentanyl was positively associated with younger age, white race, lifetime history of overdose, history of injection drug use, past month enrollment in a substance use treatment program, past month treatment with medications for opioid use disorder, and preferences for heroin and crystal methamphetamine (all p < 0.05). Descriptive data yielded further insight into reasons for fentanyl preference, the predominant having to do with perceived effects of the drug and desire to avoid withdrawal symptoms.ConclusionsOnly a relatively small subset of study participants preferred drugs containing fentanyl. Given the increased prevalence of fentanyl contamination across substances within the unregulated drug market, the result for PWUD is increasingly less agency with respect to choice of drug; for example, people may be forced to use fentanyl due to restricted supply and the need to mitigate withdrawal symptoms, or may be using fentanyl without intending to do so. Novel and more effective interventions for PWUD, including increased access to age-appropriate harm reduction programs such as fentanyl test strips and overdose prevention centers, are needed to mitigate fentanyl-related harms.

Enhanced northward propagation of boreal summer intraseasonal oscillation in the western north Pacific linked to the tropical Indian Ocean warming

While decadal changes in Madden–Julian oscillation (MJO) have received considerable attention, the corresponding changes in Boreal Summer Intraseasonal Oscillation (BSISO) have yet to be well understood. In this study, we show the enhanced northward propagation of BSISO in the Western North Pacific (WNP) during the 2000s compared to the 1980s–1990s. Observational analyses and model experiments suggest this enhancement is partially attributed to the tropical Indian Ocean (TIO) warming. The TIO warming tends to increase the air-sea interaction, enhancing moisture anomalies in the free atmosphere. Consequently, this increase in moisture anomalies strengthens BSISO-scale convection through increased convective anomalies at the north of the BSISO center, thereby enhancing the northward propagation of BSISO. Additionally, vorticity changes resulting from mean-state zonal vertical shear also contribute to the BSISO decadal change. Our findings underscore the importance of considering the interaction between BSISO and changes in the ocean mean state in future assessments.

515 Effects of Bacillus licheniformis HG76 on barrier function and inflammation in the intestinal epithelia cells and gut health of weaned piglets under enterotoxigenic Escherichia coli F4 infection

Abstract Enterotoxigenic Escherichia coli (ETEC) F4 secretes enterotoxins and invades the small intestine, which damages the gut barrier function and stimulates the immune reactions characterized by inflammation. In the current study, the effects of B. licheniformis HG76 on gut health were evaluated with ETEC F4-induced IPEC-J2 cells and weaned piglets. The B. licheniformis HG76 was isolated from cecal contents of Rhode Island Red laying hens raised without using antibiotics. The results from the in vitro study showed that the ETEC F4 infection significantly induced IPEC-J2 cell death, and this effect was significantly attenuated by B. licheniformis HG76 treatment (P &amp;lt; 0.05). The gene expressions of zona occludens (ZO1) and tumor necrosis factor (TNF)-α were significantly increased during ETEC F4 infection with B. licheniformis HG76 treatment (P &amp;lt; 0.05). Meanwhile, the ETEC F4 infection significantly increased the mRNA abundance of toll-like receptors (TLR2, TLR4, and TLR5) (P &amp;lt; 0.05), but the B. licheniformis HG76 treatment alleviated this increase. For the in vivo study, 28 weaned piglets susceptible to ETEC F4 at 28 d of age were individually allotted to four experimental groups: NNC: unchallenged control group; NC: challenged control group; PC: antibiotic group (80 mg·kg-1 of avilamycin); and HG76: Bacillus group (1.0 × 109 CFU kg-1 diet of B. licheniformis HG76). The in vivo results showed during the post-challenge phase, ETEC F4 infection decreased average daily gain (ADG) and increased the severity of diarrhea at 44 h post-inoculum (hpi), respectively, in the NC group compared with the NNC group (P &amp;lt; 0.05). In addition, the infection decreased the villus height (VH) in the duodenum of pigs from the NC, PC and HG76 groups compared with the NNC group. The VH of jejunum and ileum in the pigs from the HG76 group were higher than other groups (P &amp;lt; 0.05). There was an increase (P &amp;lt; 0.05) of crypt depth (CD) in the jejunum and ileum of pigs from the HG76 group compared with those from the NNC group. The pigs in the NNC group had the greatest duodenal VH:CD ratio, but the least ileal VH:CD ratio among all the treatment groups. The Vmax value of sucrase in the HG76 group was greater than the NNC group (P &amp;lt; 0.05). When compared with the NC group, the relative mRNA abundance of interleukin 6 (IL6) was increased in the PC group (P &amp;lt; 0.05). In summary, these results suggest that B. licheniformis HG76 can protect the intestinal cells from ETEC F4 infection by inhibiting inflammation and maintaining barrier integrity, and the supplementation of B. licheniformis HG76 can improve the gut development and increase the digestive enzyme activity of ETEC F4 challenged piglets.

Prevalence and correlates of fentanyl test strip use among people who use drugs in Rhode Island

BackgroundIllicitly manufactured fentanyl accounts for a majority of overdose fatalities in the US. Research has demonstrated that fentanyl test strips (FTS) help people who use drugs (PWUD) avoid unintended exposure to fentanyl and overdose. This study assesses characteristics associated with FTS use among PWUD in Rhode Island. Such findings may shed light on whether there are subgroups of PWUD who are less likely to be using FTS and therefore may benefit from their use. MethodsFrom September 2020 - February 2023, participants were recruited to participate in RAPIDS, a clinical trial assessing whether FTS provision can reduce overdose rates. Baseline data were used to assess correlates of lifetime FTS use through bivariable and multivariable analyses. We also examined drug testing patterns relating to FTS use in the past month. ResultsOf 509 people enrolled, 376 (73.9 %) had heard of FTS before enrollment. Among this group, 189 (50.3 %) reported lifetime FTS use and 98 (26.1 %) reported use in the last month. In bivariable analyses, lifetime injection drug use, responding to an overdose, and drug selling were associated with FTS use. Solitary drug use was not associated with FTS uptake. In the multivariable analysis, gender and lifetime naloxone administration were associated with FTS use. Of those who used FTS in the past month, 76.5 % had at least one test that was positive for fentanyl. ConclusionsWe found high uptake of FTS use among PWUD in Rhode Island. Our results also suggest a need for targeted outreach to increase FTS uptake among sub-groups of PWUD. Clinical trial registrationThe Rhode Island Prescription and Illicit Drug Study is a registered clinical trial, NCT043722838

Grand theft ambulance: Media reports of stolen ambulances in the United States, 1980 to 2020

BackgroundAmbulance thefts are frequently reported in the media, particularly over the past decade, with increasing numbers of news stories on these events. Despite these media reports, there is a paucity of peer-reviewed literature describing details and themes of these events. MethodsWe performed a structured review of media reports published between 1980 and 2020 using publicly available databases EMS1.com and Newspaper Source Plus, with keywords “stolen” and “ambulance,” with filters for date range, “1980 to 2020,” and location, “US.” The search was limited to English language articles and duplicate reports were excluded. Results263 unique media reports of stolen ambulances were identified (n = 149 from EMS1.com and n = 114 from Newspaper Source Plus (NSP)). Texas (n = 19) and Pennsylvania (n = 15) had the most media-reported cases of stolen ambulances. Montana, North Dakota, Rhode Island, and Washington, District of Columbia (DC) had the fewest media-reported stolen ambulances. Most cases occurred at a hospital (n = 141), followed by theft on scene (n = 71). Males accounted for approximately two-thirds of alleged perpetrators (68 %, EMS1.com, 66 %, NSP). ConclusionsMedia reports of ambulance thefts in the US have increased in recent years, highlighting the opportunity for improved education, standard policies and procedures, and increased security countermeasures to prevent the potential injuries and economic losses associated with these events.

Comparing the linkage performance of fastLink, Match*Pro and Splink at the Florida Cancer Registry using simulated pseudopeople data

ObjectivesThe objective was to compare the record linkage performance of fastLink, Match*Pro, and Splink using realistic simulated "Rhode Island" data from the Python package pseudopeople. A requirement was no expected wrong matches (false positives, FP) after a limited manual review. ApproachWe incorporated custom noise on (a) Social Security Number (SSN) and (b) address. We first used high-quality data where SSN was available and then low-quality data where SSN was unavailable. Missed matches (false negatives, FN) were acceptable. We used an iterative process of determining the “appropriate” match threshold and the correct matches (true positives, TP). ResultsThe two analysis datasets, df1 and df2, resulted in 660,227 actual matches and 9,987 actual non-matches. The specified match threshold probability was 0.995 for fastLink, 0.999999999 for Splink, and about 0.99 for Match*Pro. When SSN was available, the (rounded) results were: Splink 627,000 TP (4 FP), fastLink 577,000 TP (15 FP), and Match*Pro 436,000 TP (4 FP) in the default frequency-based EpiLink-like option; the EM option crashed. When SSN was unavailable, the results were: Splink 579,000 TP (3 FP), fastLink 582,000 TP (137 FP), and Match*Pro 442,000 TP (3 FP); the EM option had 516,000 TP (442 FP). The fastLink developers are working on adding Active Learning. ConclusionOverall, Splink and fastLink performed better than Match*Pro. A likely explanation is that only Splink and fastLink provide match probability and are open source. Splink (Python) and fastLink (R) require basic user programming skills. The results will be updated once the final report has been approved.