World Report Research Articles

Examining Gender Representation in US News and World Report Top 25 Urology Departments: Female Faculty Hold Lower Professorial Levels and Publication Rates Than Male Counterparts.

To examine female representation in US News and World Report (USNWR) top 25 US Urology departments and identify trends of female representation in institutional roles. Using the 2022 USNWR, we collected data from each institution's websites along with a compared geographically local cohort to evaluate the presence of female residents, female attendings, and professorial levels. First or last author faculty publications numbers were found using PubMed and Scopus in fiscal year 2022. The top 25 institutions averaged ~32.3% female residents and 18.7% female attendings, which wasnot significantly different from the comparison cohort. Of the total publications of fiscal year 2022, female attendings contributed ~14% (p < 0.001), also not significantly different from the comparison cohort. Only 20.4% of listed female attendings in top 25 programs are full Professors, compared to 41.1% of the listed men (p < 0.05). The most common level of female professorship is Assistant Professor (53.4%). Level of female professorship between cohort was significantly different, with female urologists more likely to hold a title of full Professor in the top 25 cohort compared to the nontop 25 cohort regardless of similar publication output (p < 0.05). Female faculty in Urology continue to be underrepresented in the top Urology departments, with significant difference in equitable female professorship appointments between top 25 and nontop 25 departments. Future directions include examining the impact of early mentorship and sponsorship on representation over time.

A contrastive analysis of reports on US Military withdrawing from Afghanistan: China Daily and U.S. News &amp; World Report

This article studies new reports released by the U.S. and China press from 30 August to 2 September 2021 on the United States’ troops withdrawing from Afghanistan, aiming at investigating the difference of ideologies towards the evacuation. Comparing how China Daily and U.S. News &amp; World Report reported the withdrawal, the study finds out that invidious terminology isn’t presented in the U.S. reports but repugnant terms are presented in China reports in the headlines. Moreover, the chaotic withdrawal is just Biden’s failure and there is no mention of the death of Afghans at all in the U.S. press, while the withdrawal is the U.S. failure but also their so-called “war on terror” is pointless from the beginning, moreover the “America First” policy is implied in China reports. Taoist philosophy (Tao Te Ching) has been reflected in China reports.

Abstract 4136705: Complexity and Inconsistency of Echocardiogram Prices at Top-Rated Hospitals in the United States

Background: Recent U.S. policies require hospitals and health insurers to post payer-specific negotiated prices for services. Few studies, if any, have thoroughly investigated the accuracy of these payer-specific prices for individual hospitals. Hypothesis: Top-rated medical centers charge consistent prices for echocardiograms, which are reflected in price transparency files. Aim: To evaluate the concordance of prices of echocardiograms using three datasets: 1) hospital price transparency, 2) payer price transparency data, and 3) Electronic Remittance Advice (ERA) claims data, reflecting actual payments. Methods: We extracted prices for transthoracic echocardiograms (CPT 93306) at 22 top-rated hospitals by US News&amp;World Report from 1/1/2022 to 12/31/2022. We used price transparency data aggregated by Turquoise Health and compared with ERA claims data. This analysis included 9,171 insurance claims, matched to either payer or hospital-reported prices. For each claim, concordance between datasets was determined by evaluating whether each claim payment fell within a $10 margin of a publicly reported payer-specific price. Findings: In the payer and hospital price transparency files, reported prices ranged from $1.3 to $34,424. In the ERA claims data, the median payment for the professional fee was $203 (Q1 = $116, Q3 = $245), and the median payment for the facility fee was $2682 (Q1 = 1829, Q3 = $4531). There was a ten-fold difference in median price between the cheapest and most expensive facility. Only 27.4% of claim payments had a concordant price in the payer price transparency dataset, and 11.9% in the hospital dataset. Conclusion: Deriving accurate price estimates for patients requires precise matching of the insurance plan, place of service, and fee type. This process highlights the complexity of insurance contracting, and it is not surprising that there is some disagreement in prices. Regardless, we are hopeful that highlighting variation and complexity in prices is a step towards a better system of healthcare payments in the United States.

A Qualitative Scoping Review of Community Firearm Violence in Low-Income Settings.

Firearm violence is a public health crisis in the United States that disproportionately impacts community members in low-income areas who witness and experience violence and violent victimization at elevated rates compared to other socioeconomic groups, often as result of community disinvestment and systemic racism (Smith et al., Soc Sci Med 246:112587, 2020). While quantitative reviews of firearm violence and related factors exist, a review of qualitative methods and findings regarding exposure to firearm violence has not yet been conducted. This scoping review sought to address a gap in the literature by summarizing the findings of qualitative studies on community firearm violence in low-income settings in the U.S. EBSCO databases, Criminal Justice Abstracts, National Criminal Justice Reference Service Abstracts, ProQuest, and PsycINFO were searched for studies that described the firearm related experiences of individuals and families in low-income communities. Thirty studies met the criteria for review. Findings were situated within the Centers for Disease Control and Prevention's (CDC) Social-Ecological Model as a framework for prevention (CDC, The social-ecological model: a framework for prevention, https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html , 2018; Dahlberg and Krug, World Report on violence and health, World Health Organization, Geneva, 2002). A critique of the literature, as well as implications and future directions of findings, are discussed. This study may inform future research questions and programs that center the voices of those most impacted by firearm violence.

Relativity, Rank, and the US News Health's Cardiology, Heart, and Vascular Surgery Best Hospitals.

Virtually anything can be ranked; the US News and World Report (USNWR or US News) ranks the top 50 hospitals specializing in cardiology, heart, and vascular surgery. Here the authors propose validating the effectiveness of rankings by comparing differences among the USNWR metrics across the top 50 hospitals. The ranking system for the top 50 hospitals specializing in cardiology, heart, and vascular surgery was derived from 16 variant scores. Each hospital's scores were collected from the USNWR. Hospitals were categorized into quintiles consisting of 10 institutions (1-10, 11-20, etc). An analysis of variance/χ2 comprehensive statistical analysis was run alongside a Wilcoxon/Kruskal-Wallis test to compare statistical outcomes. A significant threshold was deemed to be P < 0.05. Significant differences were noted between quintiles for advanced technologies (P = 0.05), US News specialty score (P < 0.001), number of patient referrals (P = 0.004), and expert opinion (P < 0.001). Non-statistically significant differences were found among patient experience, public transparency, Society of Thoracic Surgery transparency, American College of Cardiology transparency, recognition as a magnet hospital, and nursing staffing. Interestingly, a large variance was noted in the average number of referrals between the first quintile (13,371) and the last (6690). Expert opinion plays a critical role in the reputation of the USNWR's top 10 hospitals in cardiology, heart, and vascular surgery. Although many have argued about the merits of USNWR hospital rankings, taken together, rankings fill a strong customer demand and are sticky.

Leadership Practices, Organization Structure, and Other Factors Associated with Higher 2022-2023 US News and World Report Ranking.

U.S. News and World Report 2022-2023 hospital rankings were used to investigate the leadership practices and organizational structure of ranked healthcare institutions. Institutional variables including physician leadership status, executive board size, number of physician board members, type of physician practice, health system size, and for-profit status were collected. US News and World Report scores were used to create a comprehensive institutional rank order list. Strength of association was evaluated between these variables and the organization's US News and World Report rank. Our analysis included 546 institutions representing 1676 hospitals. Leadership under a physician CEO (OR 1.59 (95% CI 1.27, 2.00) P < 0.001), group practice (OR 1.25 (95% CI 1.01, 1.59) P = 0.042), and bed count of the institution's highest-ranking hospital (OR 1.001 (95% CI 1.0009, 1.0014) P < 0.001) were associated with higher US News and World Report ranking. For-profit status was negatively associated with institution ranking (OR 0.44 (95% CI 0.24, 0.78) P = 0.005). No significant association was demonstrated between number of physician executive board members, health system bed count, executive board size, or the number of hospitals in a health system and the institutional ranking. Physician leadership, organizational structure, size of the institution's flagship hospital, and tax status are significantly associated with an organization's US News and World Report rank.

Clinical Adjudication of Outpatient Complications Reported in the U.S. News and World Report’s Urology Rankings

ObjectivesTo assess whether the US News and World Report (USNWR) Urology specialty ranking methodology accurately captures and classifies complications following elective outpatient urology procedures. MethodsWe conducted electronic health record chart review of n=80 elective, outpatient urology procedures with complications from 2019-2023 across four hospitals in our integrated US health system. We used the Solventum AM-PPC software and USNWR methodology to determine eligibility and measure complications. For each complication identified by the software, we assessed: 1.) Whether the procedure was performed by a urologist; 2.) Whether the adjudicator agreed with the complication type; and 3.) Whether the complication was a clinically-related sequelae of the index procedure. We reported Clavien-Dindo severity of each complication. Results: Our adjudication agreed on complication type in 62/80 (78%) complications, and 64/80 (80%) complications were clinically related to the index urology procedure. Combined, 57/80 (71%) complications were concordant on both complication type and clinical relatedness. However, 38/80 (48%) index procedures were conducted by interventional radiologists, not urologists. Furthermore, 11/80 (13.8%) complications were false positive urinary tract infections (UTIs). ConclusionsThe USNWR methodology for elective outpatient urology procedural complications showed reasonable clinical validity but detected several false positive UTIs. Further, USNWR should clarify the extent to which procedures performed by interventional radiologists belong in urology rankings.

Кадрове забезпечення медичної допомоги дітям в Україні в умовах війни та пандемії COVID-19

Most countries around the world report risks to children's health care due to a growing shortage of paediatricians. Аim - to analyse the staffing of paediatric health care in Ukraine in the context of the ongoing war and the COVID-19 pandemic. Materials and methods. The methods used were a systematic approach and comparative analysis of data from the state institution "Centre for Public Health of the Ministry of Health of Ukraine" for 2020-2023. Results. During the years of the pandemic and full-scale aggression of the Russian Federation, the number of paediatricians in Ukraine decreased by 1006 people, which led to a corresponding decrease in the paediatric care coverage rate by 12.5% to 1.19 per 1000 children, which may affect the quality and accessibility of medical care for children, especially newborns. The largest staff losses during the pandemic and war have been in paediatric pathology, pulmonology, phthisiology, infectious diseases, immunology, dentistry, dermatology, neurology, gynaecology, gastroenterology and neonatology, which has already led to problems in the availability of specialised paediatric care for children and newborns, especially in the frontline and de-occupied areas. In such difficult conditions, pediatric doctors and the system of providing medical care to Ukrainian children in general have proven their viability and are still able to withstand the double pressure of war and the COVID-19 pandemic, preventing a significant increase in child morbidity and infant mortality. Conclusions. In order to eliminate the shortage of personnel, it is urgent to increase the number of doctors trained at higher medical educational institutions in specialty 228 «Paediatrics» to 1,000 per year, to adjust the state order and admission conditions accordingly, and to introduce paediatric residencies in the most popular specialties. No conflict of interests was declared by the authors.

Clinical Outcomes, Costs, and Value of Surgery Among Older Patients with Colon Cancer at US News and World Report Ranked Versus Unranked Hospitals

BackgroundUS News and World Report (USNWR) hospital rankings influence patient choice of hospital, but their association with surgical outcomes remains ill-defined. We sought to characterize clinical outcomes and costs of surgery for colon cancer among USNWR top ranked and unranked hospitals.MethodsUsing Medicare Standard Analytic Files, patients aged ≥65 years undergoing surgery for colon cancer were identified. Hospitals were categorized as ‘ranked’ or ‘unranked’ based on USNWR cancer hospital rankings. One-to-one matching was performed between patients treated at ranked and unranked hospitals, and clinical outcomes and costs of surgery were compared.ResultsAmong 50 ranked and 2522 unranked hospitals, 13,650 patient pairs were compared. Overall, 30-day mortality was 2.13% in ranked hospitals versus 3.68% in unranked hospitals (p < 0.0001), and the overall paired cost difference was $8159 (p < 0.0001). As patient risk increased, 30-day mortality differences became larger, with the ranked hospitals having 30-day mortality of 7.59% versus 11.84% for unranked hospitals among the highest-risk patients (p < 0.0001). Overall paired cost differences also increased with increasing patient risk, with cost of care being $72,229 for ranked hospitals versus $56,512 for unranked hospitals among the highest-risk patients (difference = $14,394; p = 0.02). The difference in cost per 1% reduction in 30-day mortality was $9009 (95% confidence interval [CI] $6422–$11,597) for lowest-risk patients, which dropped to $3387 (95% CI $2656–$4119) for highest-risk patients (p < 0.0001).ConclusionTreatment at USNWR-ranked hospitals, particularly for higher-risk patients, was associated with better outcomes but higher-cost care. The benefit of being treated at highly ranked USNWR hospitals was most pronounced among high-risk patients.

Social Media Use by American Association of Hip and Knee Surgeons Members.

Social media offers physicians marketing opportunities previously unavailable. We sought to evaluate social media use and its correlation with public rankings among Association of Hip and Knee Surgeons members. A list of members and demographics was collected. Social media sites were reviewed for each surgeon, and a score was calculated based on active use. The US News and World Report (NWR) was used to determine rating and number of reviews. The Spearman correlation coefficient and independent samples t-test were used to measure correlation and compare means between the groups, respectively. A total of 2436 members were analyzed. The average social media score was 4.14. The average US NWR score was 4.25. A strong correlation was observed between social media and US NWR scores (r = 0.74, P < 0.01) but not with the number of reviews (r = 0.40, P = 0.17). A strong association with US NWR rating (r = 0.74, P = 0.04) and a weak correlation with the total number of reviews (r = 0.61, P = 0.06) were found. Social media use is correlated with US NWR scores. Association of Hip and Knee Surgeons members may be underutilizing social media for the promotion of their practices. Future studies are needed to evaluate whether it affects patient volume and outcomes.

Exploring the gender gap in neurosurgery: A cross-sectional analysis of preresidency publications among neurosurgery residents.

While the number of female physicians has increased since the 1970s, there continues to be a lack of female surgeons compared to their male counterparts, with the gender gap more prominent in surgical subspecialties such as neurosurgery. While surgical subspecialities have accelerated initiatives to close the gap, potential disparities in research opportunities may position women at a disadvantage, particularly in neurosurgery, where academic publications are an indicator of residency match success. In this paper, we sought to investigate whether gender disparities exist in preresidency neurosurgery publications among current neurosurgery residents. The present study selected residency programs from the top 25 neurology and neurosurgery hospitals in US News & World Report's 2022 Ranking. A database of neurosurgery residents and their publications was created using PubMed, neurosurgery residency program websites, and supplementary search. Articles published between the time of birth and December 31st of the year of graduation (medical degree) were used to determine publications before residency. Our research indicates that 25.7% (n = 135/526) of US neurosurgery residents at top 25 hospitals are women and 74.3% (n = 391/526) are men. Men (n = 391) had a median of 7 (interquartile range [IQR], 3-14.5; range, 0-129) publications before residency, and women (n = 135) had a median of 7 (IQR, 4-11.0; range, 0-74) publications before residency. There were no significant differences in the median number of publications between genders (p = 0.65). In conclusion, our research indicates there is no gender disparity in preresidency publications among neurosurgery residents. To improve women's representation in the field, further study is needed to better understand gender inequality among neurosurgeons, particularly in the earlier stages of medical training.

Implications for neurosurgery of medical schools leaving the United States News and World Report.

Ranked lists are a highly praised method of assessment in America. Whether it's a list of the top national sports teams, the best restaurants in New York City, or as in this case, the strongest educational institutions, we look to rankings to scrutinize, evaluate, and compare. Unfortunately, not all rankings offer insightful and valuable information. Many use metrics that fall short of an accurate representation of the desired outcome. The U.S. News & World Report (USNWR), one of the most widely regarded rankings of educational institutions, has recently been under the spotlight as several major medical schools have removed themselves from candidate lists. The current USNWR Medical School's rankings are regarded as having a narrow perspective in that the metrics perpetuate a less diverse medical community and fail to recognize worthy institutions that choose to champion a well-rounded student experience. The authors, along with the many others, fear this may deliver a skewed vision of what the USNWR tries to measure: the excellence of a medical education.

Aptamer and aptasensor technology for diagnosis of infectious diseases: A mini review

BackgroundAptamers are not so new a concept, however, it is scarcely discussed by medical fraternity. Aptamers are potent, new identification molecules set to rope in a new technique in the diagnostic arena. Aptamers have started almost a revolution in diagnostic assays since their discovery in the 90s. (Radu S. Current and previous disease outbreaks around the world, U.S. News & World Report. 2020 Mar 13 [cited 2024 Jun 17]. Available from: https://www.usnews.com/news/best-countries/slideshows/20-pandemic-and-epidemic-diseases-according-to-who) provides an overview of pandemics and epidemics as reported by the WHO. It is interesting to note that several endemic and epidemic diseases viz. Chikungunya, Cholera, Crimean-Congo haemorrhagic fever, Ebola virus disease, Hendra virus infection, Influenza, Lassa fever, Marburg virus disease, Meningitis, MERS-CoV (Middle East Respiratory Syndrome Corona Virus), Monkeypox, Nipah virus infection, Novel coronavirus, Plague, Rift Valley fever, SARS (Severe Acute Respiratory Syndrome), Smallpox, Tularaemia, Yellow fever, and Zika virus disease have been identified by the WHO and are being explored for applicability of aptamer technology in their identification. ObjectivesOne of the most important necessities to control epidemic or pandemic diseases is early diagnosis. However, the majority of the diagnostic tests for these diseases are available only in tertiary care centres. The objective of this review is to discuss the potential of aptamer technology to provide undemanding, simple, specific, sensitive, and cost-effective diagnostic assays that are useable in remote and field conditions. ContentHere, we discuss recent advances and approaches in aptamer and aptamer engineering useful in the diagnosis of infectious and non-infectious conditions. This review also discusses a few sensing discoveries which are a gift of advanced engineering and technology using optical and electrochemical aptasensors. It's still a long way to go, and we need to take into account the technological challenges being faced by aptamer-aptasensor technology.

(160) POST-PANDEMIC AMERICAN UROLOGICAL ASSOCIATION SECTION MEETINGS SUCCESSFULLY FEATURE WOMEN UROLOGISTS IN SEXUAL MEDICINE

Abstract Introduction Sexual medicine is a historically male-dominated urological subspecialty, potentially exacerbating the critical lack of research in female sexual medicine. Rates of invited women speakers, moderators, and panelists can correlate to conference planning committees’ representation efforts. Objective An analysis of women urologists in sexual medicine invited as speakers to the 2021-2023 Main and section meetings of the American Urological Association (AUA) was performed to increase understanding of post-pandemic female representation. Historical records were reviewed to stratify sections based on number of past female presidents for further analysis. Methods Review of programs from the AUA Main and section meetings in 2021, 2022, and 2023 was performed. The gender of sexual medicine plenary speakers, moderators, and panelists along with moderators of poster/podium/video sessions was recorded and confirmed via institutional websites or U.S. News &amp; World Report. The number and gender of section past presidents was similarly recorded and confirmed. AUA Census data from 2021 and 2022 was queried for further analysis. Statistical methods included chi-square and two-proportion Z tests (α = 0.05). Results Across 26 meetings (summarized in Table 1), there were 50 women out of 252 sexual medicine speakers (19.8%). There was a range of 13.8% (South Central) to 34.3% (North Central) female speakers across the 9 conferences. Of interest, only North Central had a statistically significant higher proportion of women sexual medicine speakers relative to their proportion of censused practicing women urologists (p &amp;lt; 0.001). When comparing individual section conferences to the Main conference, only North Central had a statistically significant higher proportion of women sexual medicine speakers (p &amp;lt; 0.001). When comparing sections with past female presidents (Northeastern, New England, Mid-Atlantic, Western) to those without (New York, North Central, Southeastern, South Central), there was no statistically significant difference in the overall proportion of female speakers (p = 0.74), women taking part in plenary sessions (p = 0.46), or peer moderators who were female (p = 0.06). Conclusions In contrast to pre-pandemic literature, this study indicated all contemporary AUA conferences have a representative proportion of women sexual medicine speakers compared to their censused proportion of practicing women urologists. Additionally, no section invites a lower proportion of female speakers than the Main conference. Of interest, sections without a previous female president do not invite fewer women sexual medicine speakers or invite them to less prestigious roles. This data supports the efficacy of current diversity and inclusion efforts across the AUA and encourages continued monitoring of female speakers in all subspecialties. Disclosure No.

The oral medicine workforce and impact on access to care in the United States

The objective of this study was to characterize the current oral medicine (OM) workforce by examining the distribution of OM diplomates (OMDs) across the Unites States and to determine the need for expanding access to care. The OMD access was calculated based on the OMDs per 10,000 state population from the 2020 US Census data as well as their distance from state capitals and most populated cities. OMD penetrance in hospitals and cancer centers was assessed at National Cancer Care Network (NCCN) cancer centers, and Best Hospitals as reported in the 2022 US News and World Report (USNWR). OMDs are present in 64% of the states with an uneven geographic distribution. Primary workplaces included dental schools (47%), hospitals (30%), and private practices (19%). Of the OMDs in private practice, 57% limited their practice to OM. OMDs were noted at 28% of NCCN cancer centers, 30% of USNWR Best Hospitals for Cancer, and 20% of USNWR Best Hospitals. There is low density and uneven distribution of OMDs with approximately one-third of the population without access to an OMD in their state, thus limiting access to care. This suggests both vast opportunities for growth and expansion of OM, as well as challenges in developing and training the necessary workforce.

Reducing time from presentation to surgical intervention for testicular torsion: implementation of a quality improvement protocol

IntroductionTimely surgical intervention for patients with testicular torsion is a quality benchmark set by the U.S. News and World Report (USNWR) for pediatric urology. In this study, we describe and evaluate a quality improvement initiative to reduce the time to surgical intervention for testicular torsion at a single institution through the implementation of a clinical care pathway called “code torsion.”MethodsData abstraction was performed through retrospective chart review to assess process measures. Patients &amp;lt;21 years old with testicular torsion requiring surgical intervention were included. The clinical protocol “code torsion” was created by a multidisciplinary quality improvement workgroup with the primary goal of reducing the time from emergency department presentation to surgical intervention for testicular torsion. “Code torsion” was implemented in October 2021, which was assessed in addition to subsequent interventions through plan–do–study–act (PDSA) cycles.ResultsA total of 30 patients were identified prior to “code torsion” implementation and 14 thereafter. The mean time from triage to operating room (OR) was 228 min prior to “code torsion” compared with 180 min after protocol implementation (p = 0.047). The proportion of cases that had surgical intervention within the 4-h USNWR metric increased from 63% pre-protocol to 93% post-protocol (p = 0.07). Of the patients, 40% required orchiectomy prior to “code torsion” compared with 29% after implementation (p = 0.5). Patients requiring orchiectomy had a significantly longer time from symptom onset to surgical intervention (87 vs. 9.8 h, p &amp;lt; 0.001).ConclusionImplementation of the protocol “code torsion” was successful in reducing the time from presentation to surgical intervention for testicular torsion. The rates of testicular salvage did not differ after “code torsion” implementation and were instead found to be dependent on the total ischemia time.

International Committee for Monitoring Assisted Reproductive Technology world report: assisted reproductive technology, 2015 and 2016

ObjectiveTo report utilization, effectiveness, and safety of assisted reproductive technologies in 2015 and 2016. DesignRetrospective, cross-sectional survey of 3103 assisted reproductive technology clinics in 74 countries in 2015 and 3249 clinics in 79 countries in 2016 that submitted cycle and pregnancy outcome data through national and regional registries. SubjectsPatients undergoing assisted reproductive technology procedures. ExposureAssisted reproductive technology. Main Outcome MeasuresOutcomes on country, regional, and global levels. ResultsReported for 2015: 2,358,239 cycles with 548,652 babies born; for 2016: 2,807,963 cycles with 647,188 babies born. Estimated in 2015, ≥2,683,677 cycles resulted in >675,134 babies; in 2016, ≥3,100,448 cycles resulted in ≥723,026 babies. Reported cycles represent approximately 80% of global utilization. In 2015 and 2016, 27.6% and 27.8%, respectively, of women undergoing fresh autologous cycles were age ≥40 years. Frozen-thawed embryo transfer cycles accounted for 47.0% and 51.9%, respectively, of all embryo transfers in 2015 and 2016. Oocyte donation cycles accounted for 6.7% and 7.1% of all embryo transfers in 2015 and 2016. Intracytoplasmic sperm injection was performed in 57.7% and 56.4% of autologous aspiration cycles in 2015 and 2016, respectively. The cumulative delivery rate per aspiration cycle for fresh and frozen-thawed embryo transfer was 32.4% in 2015 and 33.1% in 2016, respectively. The average number of transferred embryos was 1.70 in 2015 and 1.69 in 2016. The proportion of single embryo transfers in fresh autologous cycles increased from 42.1% in 2015 to 44.0% in 2016. The twin delivery rate decreased from 16.0% in 2015 to 14.7% in 2016, and the triplet rate decreased from 0.6% in 2015 to 0.4% in 2016. The proportion of single embryo transfers in frozen-thawed embryo transfer autologous cycles was 62.2% in 2015 and 64.2% in 2016, with twin and triplet rates of 10.1% and 0.3% in 2015 and 10.0% and 0.2% in 2016, respectively. ConclusionUtilization of assisted reproductive technology and births per cycle increased from 2015 to 2016 while multiple births were reduced . Increasing proportion of frozen-thawed embryo transfer cycles, continuing wide variation in use of intracytoplasmic sperm injection, and increase in single embryo transfer rates are reported.

More than just a crib: Assessing the prevalence of partnerships between Cribs for Kids and children’s hospitals in the United States

Introduction: Cribs for Kids is a national organization with a mission to reduce sudden infant death syndrome (SIDS) and sudden unexpected infant death (SUID) nationwide through adaptation of best practices in infant safe sleep, community engagement, and increased access to resources in assuring infant safety during time of sleep. One integral partnership that enables Cribs for Kids to cast a wider net in yielding the potential to reach many more infants and their families across the country involves attainment of hospitalwide certification by Cribs for Kids across both academic and community healthcare systems that provide care to infants for up to one year of age. Methods: However to date, the prevalence of these partnerships remains unclear. It follows that the present study sought to uncover this prevalence across the nation. Utilizing the U.S. News and World Report, the researcher acquired a random sample of 110 children’s hospitals. Next utilizing the map locator of hospitals certified at the Gold, Silver and Bronze levels by Cribs for Kids on the organization’s website, prevalence of presence and level of certification was ascertained across this sample of children’s hospitals. Results: Notably, the vast majority of this sample (n=78) had not attained hospitalwide certification with Cribs for Kids. Among the hospitals that had attained certification, there was substantial variation across levels based on a range of health promotion and community engagement practices. Conclusion: Recommendations for harnessing the potential of this collaboration are presented to inform directions in examining these partnerships as a point of intervention for future planning considerations across community engagement and health promotion practices surrounding SIDS reduction.

O-122 ICMART Preliminary World Report 2020

Abstract Abstract title: International Committee for Monitoring Assisted Reproductive Technologies (ICMART) Preliminary World Report on ART, 2020 Study question In 2020 what was the global utilization, effectiveness and safety of ART? Summary answer Globally, ART utilization and data collection continue to increase but with wide variations in utilization, effectiveness and safety. What is known already ICMART has continuously monitored utilization, effectiveness and safety since 1991, with increasing number of cycles, higher pregnancy rates and lower multiple birth rates, the latter due to the transfer of fewer embryos. Frozen embryo transfer (FET), donor egg cycles and preimplantation genetic testing (PGT) continue to increase. Wide variations in practice and outcomes exist globally. At least 12 million ART babies have been born. ICMART has helped develop registries internationally. A new electronic data collection platform has improved validation. Nevertheless, data collection and quality remain challenging. Study design, size, duration Countries and regions annually collect ART data, some prospectively and others retrospectively. ICMART retrospectively requested data from all known global sources for 2020, reviewed them for missing or incorrect data, and obtained additional information when possible. The corrected dataset was validated and analyzed in partnership with University of New South Wales (UNSW). ICMART finalized the results tables. Standardized definitions and previously developed methods were used. Preliminary results are presented. Participants/Materials, setting, methods The European IVF Monitoring Consortium (EIM), Latin American Network of Assisted Reproduction (REDLARA), Australian/ New Zealand Registry and African Network and Registry for ART (ANARA) submitted regional data, and other countries contributed national data, through standardized formats, to ICMART. A few individual clinics with no registry access also contributed. Data received were reviewed, corrected, and validated to the extent possible, analyzed and summarized by ICMART using descriptive statistics. Main results and the role of chance Data collection and analysis are ongoing, so the presented results are preliminary. The number of ART cycles continues to increase, but utilization remains highly variable among countries and regions. While historically Europe has reported the largest number of cycles, China now reports well over 1 million cycles and Japan almost half a million, with Asia overall reporting approximately half of global cycles. Regional and country differences persist in the age of women treated, number of embryos transferred, live birth rates, rate of multiple births, use of ICSI and cryopreservation, and other factors. Covid reduced ART utilization in many countries. The role of chance is minimal. Data are limited to reporting countries and clinics, representing 90 to 95% of global cycles. However, this is a very large sample size from which imputation of total global results is performed. Limitations, reasons for caution Most, but not all, countries report to ICMART. Some countries have limited data and many countries have limited data validation. ICMART can perform only minimal verification of submitted data. Widespread adherence to consensus definitions provided in the Glossary takes time and requires translation into multiple languages. Standardization of validation and reporting is an ongoing process because of missing data and continuing changes in clinical practice. Wider implications of the findings ICMART World Reports standardize data, track trends, enable comparisons, stimulate questions and improve ART quality. Better understanding of ART increases societal acceptance and support for equitable access and ART research.

Longitudinal changes in Mediterranean diet adherence and perceived benefits and barriers to its consumption in US university students.

The Dietary Guidelines for Americans has recommended consumption of a Mediterranean diet (MD) for overall health and wellbeing, and the US News & World Report has ranked the MD as the top diet overall for the past six consecutive years. However, it is uncertain if university students in the United States (US) have increased their adoption of this dietary approach over these past six years. Longitudinal cross-sectional survey conducted in three cohorts (2018, 2020, 2022) utilizing regression models to assess MD Adherence and other relevant outcomes variables. University in the southern US. Students (n = 761) enrolled in undergraduate introductory nutrition course. Survey respondents were 83% female, 91% white, and 97% ages 18-24. Predictors of MD adherence were older age, female gender, and health-related qualifications. MD adherence was lowest in 2022. The 2022 group perceived less MD health benefits, weight loss, ethical concerns, natural content, and sensory appeal compared to the 2018 group. During the COVID-19 pandemic, changes in eating behavior were examined in the 2020 and 2022 groups. We observed that participants in the 2022 group had a greater frequency of snacking and a lower frequency of eating out compared to 2020 group. MD adherence did not increase over time in US university students. These findings underscore the need for targeted interventions and education to promote healthier eating habits in university students.