UNC System Math Pathways’ Digital Course Enhancement Collaboration to Improve Equity, Instruction, and Access During the COVID-19 Pandemic

This study examines how faculty members and students evaluated, perceived, and used a digital course content collection developed to support high quality remote instruction during the Covid-19 pandemic. The collections were the result of a multi-institutional, collaborative effort within the University of North Carolina System to support its students and faculty. Using surveys from faculty and demographically identified students enrolled in their classes, the authors evaluate the perceived utility and impact of the open educational resource collections. Faculty members rated the collections highly and typically found utility in at least some of the components of the collections. They found activities, videos and assessments to be the most useful tools. Students generally responded positively to the classes using the collections. While students who identified as minority found the materials useful or beneficial, they did not do so in proportional numbers to non-minority students

Evaluation of short-term healing following sustained delivery of osteoinductive agents in a rat femur drill defect model

The bone morphogenetic proteins (BMPs) carry a crucial role in bone formation and bone healing. Previous studies have identified the osteoinductive capabilities of demineralized bone matrix (DBM) and the individual factor osteogenic protein-1 (OP-1), also known as BMP-7. The purpose of this study is to identify the short-term healing effects of targeted drug delivery of demineralized bone matrix and osteogenic protein-1 following bony trauma in terms of mechanical strength and histological changes. Animals in Group 1 acted as the control and Group 2 received a unicortical drill defect and placement of a calcined tricalcium phosphate lysine (TCPL) capsule containing antibiotic (sham). Group 3 and 4 animals had a created drill defect and received a TCPL carrier containing antibiotic along with DBM or OP-1, respectively. After 2 weeks post-implantation, animals in each group were sacrificed before the retrieval of the bone. The femurs were analyzed biomechanically for return of strength and histologically for bone growth. The average rupture strength for the femurs of the control group was shown to be significantly higher than all other groups (p\u3c0.001 compared to sham, DBM, and OP-1). There was no significant difference between the two treatment groups (p=0.984) and there was no significant difference between the sham and DBM or OP-1 treated groups (p=0.908 and p=0.991, respectively). Analysis of the gross specimens showed minimal signs of bone regeneration at the defect site for both DBM and OP-1 treated femurs when compared to the shams. Histological sections did show increased cortical thickness and new bone formation in the DBM and OP-1 groups, with the OP-1 group appearing slightly thicker. Despite the histological changes seen, the results indicate that there is no significant improvement in mechanical strength during the early stages of healing regardless of treatment. Copyright 2007 ISA. All Rights Reserved

Treatment engagement and response to CBT among Latinos with anxiety disorders in primary care.

OBJECTIVE: In the current study, we compare measures of treatment outcome and engagement for Latino and non-Latino White patients receiving a cognitive-behavioral therapy (CBT) program delivered in primary care. METHOD: Participants were 18–65 years old and recruited from 17 clinics at four different sites to participate in a randomized controlled trial for anxiety disorders, which compared the CALM intervention (consisting of CBT, medication, or both) to usual care. Of those participants who were randomized to the intervention arm and selected CBT (either alone or in combination with medication), 85 were Latino and 251 were non-Latino White; the majority of the Latino participants received the CBT intervention in English (n = 77). Blinded assessments of clinical improvement and functioning were administered at baseline, and at 6, 12, and 18 months after baseline. Measures of engagement, including attendance, homework adherence, understanding of CBT principles, and commitment to treatment were assessed weekly during the CBT intervention. RESULTS: Findings from propensity weighted linear and logistic regression models revealed no statistically significant differences between Latinos and non-Latino Whites on symptom measures of clinical improvement and functioning at almost all time points. There were significant differences on two of seven engagement outcomes, namely number of sessions attended and patients’ understanding of CBT principles. CONCLUSIONS: These findings suggest that CBT can be an effective treatment approach for Latinos who are primarily English speaking and likely more acculturated, although continued attention should be directed toward engaging Latinos in such interventions

Treatment Engagement and Response to CBT Among Latinos With Anxiety Disorders in Primary Care

ObjectiveIn the current study, we compared measures of treatment outcome and engagement for Latino and non-Latino White patients receiving a cognitive behavioral therapy (CBT) program delivered in primary care.MethodParticipants were 18-65 years old and recruited from 17 clinics at 4 different sites to participate in a randomized controlled trial for anxiety disorders, which compared the Coordinated Anxiety Learning and Management (CALM) intervention (consisting of CBT, medication, or both) with usual care. Of those participants who were randomized to the intervention arm and selected CBT (either alone or in combination with medication), 85 were Latino and 251 were non-Latino White; the majority of the Latino participants received the CBT intervention in English (n = 77). Blinded assessments of clinical improvement and functioning were administered at baseline and at 6, 12, and 18 months after baseline. Measures of engagement, including attendance, homework adherence, understanding of CBT principles, and commitment to treatment, were assessed weekly during the CBT intervention.ResultsFindings from propensity-weighted linear and logistic regression models revealed no statistically significant differences between Latinos and non-Latino Whites on symptom measures of clinical improvement and functioning at almost all time points. There were significant differences on 2 of 7 engagement outcomes, namely, number of sessions attended and patients' understanding of CBT principles.ConclusionsThese findings suggest that CBT can be an effective treatment approach for Latinos who are primarily English speaking and likely more acculturated, although continued attention should be directed toward engaging Latinos in such interventions

Reproduction and transplantation: report on the AST Consensus Conference on Reproductive Issues and Transplantation.

It has been almost 50 years since the first child was born to a female transplant recipient. Since that time pregnancy has become common after transplantation, but physicians have been left to rely on case reports, small series and data from voluntary registries to guide the care of their patients. Many uncertainties exist including the risks that pregnancy presents to the graft, the patient herself, and the long-term risks to the fetus. It is also unclear how to best modify immunosuppressive agents or treat rejection during pregnancy, especially in light of newer agents available where pregnancy safety has not been established. To begin to address uncertainties and define clinical practice guidelines for the transplant physician and obstetrical caregivers, a consensus conference was held in Bethesda, Md. The conferees summarized both what is known and important gaps in our knowledge. They also identified key areas of agreement, and posed a number of critical questions, the resolution of which is necessary in order to establish evidence-based guidelines. The manuscript summarizes the deliberations and conclusions of the conference as well as specific recommendations based on current knowledge in the field

Implementation of preemptive DNA sequence–based pharmacogenomics testing across a large academic medical center: The Mayo-Baylor RIGHT 10K Study

The Mayo-Baylor RIGHT 10K Study enabled preemptive, sequence-based pharmacogenomics (PGx)-driven drug prescribing practices in routine clinical care within a large cohort. We also generated the tools and resources necessary for clinical PGx implementation and identified challenges that need to be overcome. Furthermore, we measured the frequency of both common genetic variation for which clinical guidelines already exist and rare variation that could be detected by DNA sequencing, rather than genotyping.Targeted oligonucleotide-capture sequencing of 77 pharmacogenes was performed using DNA from 10,077 consented Mayo Clinic Biobank volunteers. The resulting predicted drug response–related phenotypes for 13 genes, including CYP2D6 and HLA, affecting 21 drug–gene pairs, were deposited preemptively in the Mayo electronic health record.For the 13 pharmacogenes of interest, the genomes of 79% of participants carried clinically actionable variants in 3 or more genes, and DNA sequencing identified an average of 3.3 additional conservatively predicted deleterious variants that would not have been evident using genotyping.Implementation of preemptive rather than reactive and sequence-based rather than genotype-based PGx prescribing revealed nearly universal patient applicability and required integrated institution-wide resources to fully realize individualized drug therapy and to show more efficient use of health care resources