Jacobs Institute of Women's Health
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Snapchat Artificial Intelligence as an Information Source on Delta-8 THC
No full textPURPOSE: Snapchat is a prominent social media site among youth. In April 2023, Snapchat released an artificial intelligence (AI)-powered chatbot that was automatically implemented on all accounts. Given the apparent ease in communicating with this feature, youth may use it as an information source. METHODS: While Snapchat purports to block results for drug keywords, it is unclear the extent to which this type of content is blocked. In August 2024-January 2025, we asked Snapchat AI questions related to delta-8, a derived intoxicating cannabis product that has been rapidly rising in popularity in the United States and has limited regulations. Qualitative responses were independently coded into thematic categories. RESULTS: The AI prompted individuals to ask follow-up questions, which largely drove the themes. Themes included general information (similarity to delta-9 THC, but with a purported lower potency; relaxing/euphoric effects; legality), use motives (pain relief, anti-nausea, appetite stimulation, anxiety reduction), potential consequences (dry mouth, red eyes, increased heart rate, drowsiness, contaminated products, inaccurate labeling), retail availability, and product recommendations. Responses did not provide supporting citations. While the AI did not block results related to delta-8, it did block results pertaining to weed and THC. DISCUSSION: Snapchat AI is a plausible information source about delta-8 THC among youth. No citations were provided to support claims made by the AI, which portrayed delta-8 THC use favorably, as having benefits and low risks from use. Findings have policy implications, including restricting or regulating this type of content-particularly relating to claims without supporting scientific evidence
Commentary: Second Cardiopulmonary Bypass Run After Complete Atrioventricular Septal Defect Repair: To Perform or Not to Perform?
No full textTransforming neonatal care through informatics: A review of artificial intelligence, data, and implementation considerations
No full textSignificant strides have been made in utilizing data, information, and knowledge to enhance neonatal outcomes. This review examines how data informatics, encompassing electronic health records (EHRs), data standards, and artificial intelligence (AI), has facilitated advancements in neonatal care and research. Vast amounts of data, structured and unstructured, have been produced from clinical care. In turn AI stands to improve patient care, safety, and quality improvement initiatives. Facilitated by AI, clinicians\u27 interaction with neonatal informatic tools is transitioning from reactive to real-time, proactive care. Historically, necrotizing enterocolitis, sepsis, medical imaging, and neonatal mortality have been the targets of AI-integrated neonatal care. While much progress has been made in developing state-of-the-art AI tools, their development and implementation must consider optimization of patient care, clinical workflows, and aim to decrease clinician burnout. Employing a sociotechnical framework to assess both technical and human factors is key to effectively evaluating clinical utility, promoting adoption, and facilitating successful deployment. Beyond technical concerns, ethical considerations such as trust in AI, data security, and model transparency are critical to the responsible deployment of informatics tools. Ongoing advancements in neonatal care coupled with informatics, multi-omics, AI, and federated learning expands the possibilities of personalized care for neonates
Community-Based Provider Concerns About Pediatric Hospice and Palliative Care
No full textCONTEXT: Children and families often rely on community-based hospice and palliative care organizations for care services. OBJECTIVES: The purpose of this study was to explore pediatric-specific concerns of field-based hospice and palliative care clinicians in the United States. METHODS: The study analyzed responses from a free-text question distributed within an electronic organizational membership survey sent to National Alliance for Care at Home (the Alliance) members. Semantic content analysis was applied. RESULTS: Out of 295 survey respondents, 92 (31%) answered the optional free-text final question: What keeps you up at night regarding pediatric palliative and hospice care? . Over half of responders (53%; n=49) worry most about unmet needs . Additional practical concerns included: resources; staff shortages and lack of succession plans; training and education gaps; emotional toll; policy confusion; regulatory fears including concerns about the future of concurrent care; community awareness/stigma; referral patterns; lack of leadership support. Concerns were described as being in tension with the philosophy of hospice and palliative care. Responses depicted philosophical fears about the current or future risk of not upholding the field\u27s core values such as equity, fairness, quality, sustainability, viability, non-abandonment due to pragmatic and practical realities. CONCLUSION: Further coordinated research and engagement are warranted to prevent current evening concerns from devolving into daytime realities
Neurosurgery as a Catalyst for Global Health and Surgery Targets: Road to 2030 Highlights from WHO\u27s 78th World Health Assembly
No full textThe 78th World Health Assembly (WHA78) marked a decade since three pivotal milestones in global surgery: the 2015 Lancet Commission on Global Surgery (LCoGS) report, the adoption of WHA Resolution 68.15 recognizing surgery and anesthesia as integral to Universal Health Coverage (UHC), and the launch of the United Nations Sustainable Development Goals (SDGs). Together, these set 2030 as the shared target year for strengthening surgical systems worldwide. This review highlights WHA78\u27s role as a critical checkpoint, emphasizing how neurosurgery can serve as both a specialty and a strategic catalyst for achieving global health and surgery targets
How maternal morbidities impact women\u27s quality of life during pregnancy and postpartum in sub-Saharan Africa and South Asia: A qualitative study
No full textMaternal morbidities present a major burden to the health and well-being of childbearing women. However, their impacts on women\u27s functional health are not well understood. This work aims to describe how maternal morbidities affect women\u27s quality of life (QoL) in pregnancy and the postpartum period . This qualitative study involved 118 pregnant and 135 postpartum women at six study sites in Kenya, Ghana, Zambia, Pakistan, and India. Data were collected between December 2023 and June 2024. Participants were selected via purposive sampling, with consideration of age, trimester, and time since delivery. A total of 23 focus group discussions with pregnant and late postpartum (≥6 months) participants and 48 in-depth interviews with early postpartum (≤6 weeks) participants were conducted using semi-structured guides. Data were analyzed using a collaborative, inductive, thematic approach. Four overarching themes were identified and were cross-cutting irrespective of continent or country : (1) physical and emotional challenges pose a barrier to daily activities; (2) lack of social support detracts from women\u27s QoL; (3) receipt of social support mitigates adverse impacts of maternal morbidities on QoL; and (4) economic challenges exacerbate declines in women\u27s QoL during pregnancy and postpartum. Physical and emotional morbidities related to childbearing severely limited women\u27s ability to complete daily tasks and adversely impacted their perceived QoL. Social and financial support from the baby\u27s father, family and/or in-laws, community members, and healthcare providers are important to mitigate the impacts of pregnancy and postpartum challenges on women\u27s health and well-being
Structural and Systemic Drivers of Sugary Drink and Water Consumption in Puerto Rico: A Qualitative Participatory Systems Map
No full textBACKGROUND: Empirical evidence shows that communities experiencing water hardship tend to consume more sugar-sweetened beverages (SSBs); however, the underlying mechanisms are not well understood. OBJECTIVE: This study aimed to integrate the perspectives of multiple stakeholders across different sectors to develop a shared understanding of the drivers of water and SSB consumption in Puerto Rico (PR), where the majority of residents have experienced water hardship. DESIGN: A participatory system dynamics modeling approach (Group Model Building-GMB) was employed to engage stakeholders across multiple sectors in PR to develop a shared understanding of what are the underlying drivers of water and SSB consumption in PR; how these interconnect; and to identify potential leverage points. The GMB workshop was conducted in January 2023 and a parent group discussion in April 2023. PARTICIPANTS: /Setting: Stakeholders in San Juan PR were purposefully recruited from public service (n=7), commercial sector (n=3), civil groups (n=13) and parents (n=5). ANALYSIS: Multiple rounds of feedback and member checking sessions were conducted to synthesize the workshop outputs into an integrated systems map and a set of leverage points. RESULTS: Stakeholders conceptualized water and SSB consumption in PR as outcomes of two interconnected subsystems, both shaped by distrust in government. Fear of contaminants in tap and bottled water discouraged water consumption, and indirectly increased SSB intake. Aggressive marketing reinforced habitual SSB consumption across generations. Stakeholders identified the following leverage points in PR: a) leverage water infrastructure funding; b) provide water quality data in real time; c) coordinate counter-marketing campaigns targeting SSBs paired with drinking water promotion. CONCLUSIONS: This participatory approach brought together stakeholders from diverse sectors, encouraging them to look beyond individual behaviors of interest. Participants agreed that water would not become a viable alternative to SSBs if water insecurity was not addressed first
Cumulative Genetic Risk for Asthma Contributes to Disease Severity in Children with Asthma living in Urban Environments
No full textBACKGROUND: Childhood-onset asthma is highly heritable, with nearly 200 risk loci identified in genome-wide association studies. Aggregated polygenic risk scores can be used to quantify genetic predisposition to asthma, but their power to predict asthma severity in multi-ancestral groups has not been determined. OBJECTIVE: Our aim was to examine the predictive power of biobank-derived asthma polygenic risk scores in children with asthma living in urban environments. METHODS: We generated polygenic risk scores for asthma, derived from a large-scale genome-wide association meta-analysis, in four multi-ancestry asthma study cohorts of children living in urban environments. We assessed genetic predictions across different subphenotypes of asthma and tested for associations between genetic asthma risk and measures of asthma severity. RESULTS: Genetic asthma prediction was significantly stronger for more symptomatic asthma phenotypes (P\u3c0.001). Polygenic risk scores were significantly higher in difficult-to-control vs. easy-to-control asthma (P=0.02). Genetic risk was also significantly associated with more frequent exacerbations (P=0.03), higher blood eosinophil levels (P=0.01), and lower lung function (P\u3c0.001). CONCLUSION: Cumulative genetic risk for asthma is associated with disease severity and exacerbation risk in children with asthma living in urban environments
Real-World Experience of Geographic Atrophy Treatment With Avacincaptad Pegol
No full textTo present the first real-world safety data describing the clinical experience of geographic atrophy (GA) treatment with avacincaptad pegol in a large cohort. A retrospective, observational cohort study was conducted within the PRISM Vision Group by filtering for J codes for avacincaptad pegol from August 3, 2023, to October 10, 2024. The study included 461 eyes of 335 patients with GA who were treated with intravitreal avacincaptad pegol 2 mg (0.1 mL of 20 mg/mL) injections. The mean follow-up time was 120 days. The mean injection interval was 52 days. Fourteen eyes (3%) developed an acute rise in intraocular pressure, and there were no reports of endophthalmitis, intraocular inflammation, or nonarteritic anterior ischemic optic neuropathy. Eight eyes (2.03%) converted to neovascular age-related macular degeneration, with an average of 2 injections before conversion and a predicted annualized rate of conversion of approximately 6.17%. One eye (0.2%) developed a vitreous hemorrhage. This study describes the real-world safety profile of avacincaptad pegol that may aid clinicians in understanding the risk of adverse events associated with this relatively new treatment for GA