Addressing Racial and Socioeconomic Disparities Through Patient Education and Increasing Healthcare Professionals’ Cultural Competency to Reduce Maternal Mortality in the United States

Pregnancy-related deaths in the United States continue to increase with a notable disparity for women of color and/or low socioeconomic status. Hundreds of women die each year due to pregnancy or delivery complications as researchers and healthcare providers remain unclear on the solution. The mortality rate is the result of pregnancy complications, the aggravation of preexisting comorbidities, methods of intervention, or events precipitated by the pregnancy.https://openworks.mdanderson.org/rmps/1002/thumbnail.jp

Low Rates of Breakthrough COVID-19 Infection After SARS-CoV-2 Vaccination in Patients With Inflammatory Bowel Disease

We demonstrate low rates of breakthrough coronavirus disease 2019 (COVID-19) infection and mild course of illness following severe acute respiratory syndrome coronavirus 2 vaccination in a large cohort of inflammatory bowel disease patients. Residence in southern United States and lower median anti-receptor binding antibody level were associated with development of COVID-19

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Longitudinal Studies on the Etiology of Cannabis Use Disorder: A Review

Purpose of reviewThis review summarizes the literature to date that has capitalized on the longitudinal research study framework in order to elucidate the etiology of cannabis use disorders (CUDs).Recent findingsThe studies are mixed with respect to reliable predictors of CUD development. Of the studies outlined, the most consistently indicated risk factors for CUD development include: male sex, past cannabis and other substance use (especially tobacco), and the presence of pre/comorbid psychopathology (especially mood disorders). Social motives and peer involvement may also play a role in this transition. Many of these CUD risk factors appear to be distinct from other factors linked with overall cannabis use.SummaryCUD development is likely the product of interactions between biological, psychological, social, and environmental factors. However, many more well-planned and developmentally sensitive prospective studies are needed to identify specific and reliable risk factors for CUD development

Strategic plan to improve the competitiveness of the industrial agricultural society CCD SAS "termales los volcanes" (municipality of Macheta)

Este proyecto de pasantías tiene como finalidad brindar un plan estratégico para mejorar la competitividad de sociedad Agrícola industrial CCD SAS, ubicada en el km 13 vía Sisga-Macheta, asi definir sus oportunidades y amenazas para poder aumentar sus ventajas competitivas frente a su entorno.This internship project aims to provide a strategic plan to improve the competitiveness of the CCD SAS Industrial Agricultural Society, located at km 13 via Sisga-Macheta, thus defining its opportunities and threats in order to increase its competitive advantages vis-à-vis its environment.Sociedad agricola industrial CCD SAS “termales los volcanes

Neurocognitive Correlates of Adolescent Cannabis Use: An Overview of Neural Activation Patterns in Task-Based Functional MRI Studies.

Adolescence is dynamic and comprises physiological, psychological, and neurocognitive changes. Notably, many developmentally associated neurobiological changes (e.g., synaptic pruning, myelination) coincide with peak substances use prevalence rates, particularly for cannabis use. Cannabis remains the most commonly used illicit drug among adolescents with 23.9% reporting cannabis use in the last year (Johnston et al., 2019). Adolescents who engage in cannabis use often show poorer neurocognitive performance and alterations in structural and functional brain development as compared to their non-using peers (Jacobus & Tapert, 2014). Over the past several decades, the cognitive domains most consistently associated with cannabis use among adolescents are learning and memory and several facets of executive functioning (e.g., inhibitory control, decision-making). Functional magnetic resonance imaging (fMRI) is a non-invasive method for probing the neural substrates underlying possible cannabis-related changes in cognition. This brief review aims to synthesize recent findings on the relationship between adolescent (≤25 years old) cannabis use and neural response during task-based functional magnetic resonance imaging (fMRI). Findings thus far suggest aberrant, often hyperactive, response to task-based stimuli in youth cannabis users. When considering the future directions of fMRI research with cannabis-using youth, review of existing studies also highlights the need for more prospective research with diverse samples

Neurocognitive Correlates of Adolescent Cannabis Use: An Overview of Neural Activation Patterns in Task-Based Functional MRI Studies.

Adolescence is dynamic and comprises physiological, psychological, and neurocognitive changes. Notably, many developmentally associated neurobiological changes (e.g., synaptic pruning, myelination) coincide with peak substances use prevalence rates, particularly for cannabis use. Cannabis remains the most commonly used illicit drug among adolescents with 23.9% reporting cannabis use in the last year (Johnston et al., 2019). Adolescents who engage in cannabis use often show poorer neurocognitive performance and alterations in structural and functional brain development as compared to their non-using peers (Jacobus & Tapert, 2014). Over the past several decades, the cognitive domains most consistently associated with cannabis use among adolescents are learning and memory and several facets of executive functioning (e.g., inhibitory control, decision-making). Functional magnetic resonance imaging (fMRI) is a non-invasive method for probing the neural substrates underlying possible cannabis-related changes in cognition. This brief review aims to synthesize recent findings on the relationship between adolescent (≤25 years old) cannabis use and neural response during task-based functional magnetic resonance imaging (fMRI). Findings thus far suggest aberrant, often hyperactive, response to task-based stimuli in youth cannabis users. When considering the future directions of fMRI research with cannabis-using youth, review of existing studies also highlights the need for more prospective research with diverse samples

Project DIS-IMPACT: Drug information in English and Spanish to improve patient preparation before colonoscopy

© 2015, American Pharmacists Association. All rights reserved. Objective: To create culturally appropriate colonoscopy education services and handouts for the Hispanic population undergoing a colonoscopy procedure to ensure correct bowel preparation. Setting: Project DIS-IMPACT was conducted at a federally qualified, nonprofit community health center along the United States-Mexico border. Practice description: Patients identified in the study included those who were at least 50 years of age and had not received a colonoscopy between July 1, 2012, and February 28, 2013. Participants included uninsured Hispanics, able to speak English or Spanish, registered with the clinic, and referred by a provider working at the health center. Practice innovation: The process of evaluating and developing colonoscopy screening education included creating a standing order, developing medication education handouts in both English and Spanish, and documenting areas of improvement at monthly pharmacy staff meetings. Main outcome measures: Outcomes of the program included a descriptive statistics analysis of the served population and culturally appropriate counseling recommendations used in the medication (polyethylene glycol electrolyte solution) education handouts. Results: A total of 143 participants received colonoscopy, including 49 men and 94 women. As the classes were conducted, the patient information handouts were adapted accordingly based on culturally appropriate recommendations from participants and providers. Conclusion: Pharmacists played a unique role in providing culturally appropriate precolonoscopy education material to assist in successful colonoscopy preparation

Parental Family History of Alcohol Use Disorder and Neural Correlates of Response Inhibition in Children From the Adolescent Brain Cognitive Development (ABCD) Study.

BackgroundYouth whose parents have alcohol use disorder (AUD) are at higher risk for earlier initiation and greater magnitude of alcohol use, and have a higher likelihood of developing an AUD than their peers without parental history of AUD. This increased risk may be partly attributable to altered development of inhibitory control and related neural circuitry. This study examined neural activation during a motor response inhibition Stop Signal Task (SST) in substance-naïve youth aged 9 to 10 years with and without parental family history of AUD.MethodsBaseline cross-sectional survey and functional magnetic resonance imaging (fMRI) data were drawn from 6,898 youth in the US-based Adolescent Brain Cognitive Development Study. Generalized additive mixed models were conducted to examine the association between maternal, paternal, and parental (both mother and father) family history of AUD with neural activation during successful and failed response inhibition. Family history interactions with sex and stratification by ethnicity were explored.ResultsOf 6,898 participants, 951 (14%) were family history positive for any parental AUD. Paternal history of AUD was associated with greater activation for successful inhibition in the right medial orbital frontal gyrus, compared to youth with no family history. Maternal history of AUD was associated with greater activation for failed response inhibition among females in the cerebellum, compared to females with no such history. Parental history (both mother and father) of AUD was associated with greater activation during successful inhibition in the left paracentral gyri and left superior parietal lobule. Maternal history and parental history of AUD findings were accounted for by a family history of substance use disorder in general. All effect sizes were relatively small.ConclusionsSubstance-naïve children with a parental family history of AUD exhibit greater neural activation in some regions of the fronto-basal ganglia and cerebellar networks when they successfully or unsuccessfully inhibit a response as compared to children with no such family history. This unique neural response pattern could reflect a compensatory response and may represent an inherent neurobiological vulnerability to risk-related behaviors in these youth which will be examined in future longitudinal analyses of this cohort