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Assessing Consumer Preferences for Seafood Products in a North Carolinian Community-Supported Fishery
No full textIn recent years, Community Supported Fisheries (CSFs) have gained prominence in the North American seafood industry, with Walking Fish CSF in North Carolina being one of the pioneering efforts. However, due to the relatively recent introduction of CSFs, little is known about consumer preferences for seafood products within this sector. This project aims to investigate and compare the preferences of Walking Fish members and the general public for seafood products within the North Carolinian context. The findings reveal that Walking Fish members exhibit a stronger preference for wild-caught seafood products over farmed products compared to the general public, with the exception of bivalves (oysters and clams) and blue crabs. Moreover, Walking Fish customers attach greater importance to specific attributes such as taste, environmental benefits, and freshness when it comes to wild-caught products in comparison to the general public. The study concludes with a discussion on the implications of consumer preferences for the future development of CSFs, such as Walking Fish
Multi-faceted strategies improve collection compliance and sample acceptance rate for carbapenem-resistant Enterobacteriaceae (CRE) active surveillance testing.
No full textBackgroundActive surveillance testing (AST) is one element of a comprehensive Carbapenem-resistant Enterobacteriaceae (CRE) prevention strategy. However, the utility of AST may be impacted by compliance with sample collection and the quality of specimens. Here, we describe strategies used to optimize a CRE AST program at a large academic medical center.MethodsTests ordered, collected, rejected, and processed were tracked weekly for each participating unit. Sample collection compliance and acceptance rates were calculated and tracked weekly. Strategies were implemented to improve collection compliance and sample acceptance rates, including computerized provider order entry, printed educational materials, and audit and feedback. Weekly dedicated Infection Preventionist (IP) time was estimated.ResultsOver 35 months, mean collection compliance increased from 82.7% to 91.2%, and then decreased to 86.2%. Over 27 months, sample acceptance rate increased from 57.7% to 83.6%, and then remained stable at 83.4%. Over 39 months, dedicated weekly IP time decreased 92%.DiscussionUse of evidence-based quality improvement strategies optimized our CRE AST program. Optimizing the AST process aids in early CRE detection, leading to timely isolation and preventing the spread of CRE to other patients. Other hospitals may benefit from these lessons and enhance local AST programs
eHealth Use and Disease Control During COVID-19 among Diabetes Patients in China and the Philippines
No full textBackground: According to the WHO 2020 NCD report, the COVID-19 pandemic disrupted diabetes care in 49% of countries. eHealth emerged as a solution to disease management challenges during the unprecedented outbreak. Due to the rapidly expanding nature of eHealth use during the pandemic, this study aimed to determine 1) the sociodemographic factors associated with eHealth during COVID-19 and 2) whether eHealth was associated with diabetes management and clinical outcomes. Methods: Using quantitative data from cross-sectional surveys from Kunshan and Taicang, China (n=309) and Manila, Philippines (n=150) (data sets uncombined), we performed Chi-squared and Fisher’s exact tests and univariate logistic regressions to determine the relationship of eHealth use and sociodemographic characteristics. We then performed logistic and linear regression to determine the association of eHealth use with diabetes disease outcomes. Results: In China, younger age (p=0.02), higher education level (p=0.001), married marital status (p=0.03), suburban residence type (p=0.001), and higher household monthly income during COVID-19 (p=0.004) were associated with using eHealth. In the Philippines, younger age (p= 0.009) and higher education level (p=0.01) were associated with eHealth use. eHealth use was associated with undergoing FBS testing in the last three months (OR = 2.19, 95%CI = 1.00, 4.78), undergoing HbA1c testing in the last three months (OR = 3.64, 95%CI = 1.01, 13.15), and reporting disease control per their last HbA1c test (OR = 9.98, 95%CI = 3.41, 29.18) in the Philippines, adjusting for various demographic characteristics. Conclusions: Our data indicated eHealth use could positively affect diabetes clinical and management outcomes for people with diabetes in China and the Philippines. We posit more research is needed for the impacts of eHealth on clinical outcomes as well as the methods for eHealth implementation and integration in LMIC.</p
The Hidden Costs of Securing Innovation: The Manifold Impacts of Compulsory Invention Secrecy
No full text One of the most commanding powers of the U.S. Patent and Trademark Office (USPTO) is to compel inventions into secrecy, withholding patent rights and prohibiting disclosure, to prevent technology from leaking to foreign competitors. This paper studies the impacts of compulsory secrecy on firm invention and the wider innovation system. In World War II, USPTO issued secrecy orders to more than 11,000 patent applications, which it rescinded en masse at the end of the war. Compulsory secrecy caused implicated firms to shift their patenting away from treated classes, with effects persisting through at least 1960. It also restricted commercialization and impeded follow-on innovation. Yet it appears it was effective at keeping sensitive technology out of public view. The results provide insight into the effectiveness of compulsory secrecy as a regulatory strategy and into the roles, and impacts, of formal intellectual property in the innovation system. This paper was accepted by Toby Stuart, entrepreneurship and innovation. </jats:p
Exploring Barriers and Enablers to Peru’s COVID-19 Pandemic Response, and the Local, Regional, and Global Implications
No full textBackground: Peru had more COVID-related deaths per capita than any other country. Given its relative wealth as an Upper Middle Income Country, Peru did not receive many COVID vaccine donations through COVAX, and challenges directly negotiating for vaccines with pharmaceutical companies delayed Peru’s initial response. However, once vaccines were procured, Peru successfully initiated wide-spread vaccination campaigns. This study was done to understand Peru’s unique COVID challenges and successes and aims to explore barriers and enablers of Peru’s pandemic response to offer lessons for the scale-up of vaccinations, health innovations, and pandemic response capacity in Peru, Latin America, and globally. Methods: 31 semi-structured in- depth interviews were conducted in Lima, Peru with 35 individuals from public, private, academia, healthcare, and civil society sectors that worked in diverse geographies across Peru. Participants were recruited through purposeful and snowball sampling via WhatsApp, based on the inclusion criteria of being involved in Peru’s COVID-19 pandemic response and preparedness (i.e., with vaccine procurement and distribution, emergency health innovations, and community responses). Ethics approval was received from the Duke University Campus Institutional Review Board. Written and verbal consent was obtained from participants before each interview. A qualitative content analysis is currently being done on the interview transcripts. Afterwards a force field analysis will be applied to understand which factors most negatively and positively impacted Peru’s pandemic response capacity. Results: Preliminary findings from the 31 interviews indicate political instability, cross-sector competition, a fragmented health system, and limited medical resource manufacturing and regulations limited Peru’s pandemic response. However, previous experience with vaccination campaigns, community-based support, and cross-sector collaboration influenced effective COVID vaccine distribution and vaccination levels. Conclusion: Peru experienced some small-scale effective COVID response measures, but these were overshadowed by large-scale systemic and political issues, hindering Peru’s pandemic response. This study explores economic, cultural, political, and social factors that impacted Peru’s COVID response, and includes diverse perspectives from various sectors and geographies, increasing the validity and generalizability of findings. However, future studies should include equal representation of sectors and geographies, as most participants represent the public sector and worked in Lima.</p
ERα PvuII and XbaI polymorphisms in postmenopausal women with posterior tibial tendon dysfunction: a case control study.
No full textBackgroundPosterior tibial tendon (PTT) insufficiency is considered as the main cause of adult acquired flat foot and is three times more frequent in females. High estrogen levels exert a positive effect on the overall collagen synthesis in tendons. We have previously demonstrated the association between some genetic single-nucleotide polymorphism (SNP) and tendinopathy. In the present study, we investigated the association of PvuII c454-397T>C (NCBI ID: rs2234693) and XbaI c454-351A>G (NCBI ID: rs9340799) SNPs in estrogen receptor alfa (ER-α) gene with PPT dysfunction.MethodsA total of 92 female subjects with PTT dysfunction, with histopathological examination of the tendon and magnetic resonance image (MRI) evidence of tendinopathy, were compared to 92 asymptomatic females who presented an intact PPT at MRI for PvuII and XbaI SNPs in the ER-α gene. Genomic DNA was extracted from saliva and genotypes were obtained by polymerase chain reaction restriction fragment length polymorphism.ResultsThe analysis of PvuII SNPs showed no significant differences in the frequency of alleles and genotypes between control and PTT dysfunction groups. The XbaI SNPs in the ER-α gene showed significant differences in the frequency of genotypes between control and test groups (p = 0.01; OR 95% 1.14 (0.55-2.33).ConclusionsThe XbaI SNP in the ERα gene may contribute to tendinopathy, and the A/A genotype could be a risk factor for PTT tendinopathy in this population. The PvuII SNP studied was not associated with PTT tendinopathy
Biomechanical comparison of plantar-to-dorsal and dorsal-to-plantar screw fixation strength for subtalar arthrodesis.
No full textOBJECTIVE:To compare screw fixation strength for subtalar arthrodesis. METHODS:Eight matched pairs of cadaver feet underwent subtalar joint arthrodesis with two 7.3mm cannulated screws. Randomization was used to assign screw orientation, such that one foot in each pair was assigned dorsal to plantar screw orientation (DP Group), and the other foot, plantar to dorsal orientation (PD Group). Standard surgical technique with fluoroscopy was used for each approach. Following fixation, each specimen was loaded to failure with a Bionix ® 858 MTS device, applying a downward axial force at a distance to create torque. Torque to failure was compared between DP and PD Groups using Student's t test, with p=0.05 used to determine statistical significance. RESULTS:Statistical analysis demonstrated that the mean torque to failure slightly favored the DP Group (37.3Nm) to the PD Group (32.2Nm). However, the difference between the two groups was not statistically significant (p=0.55). CONCLUSION:In subtalar arthrodesis, there is no significant difference in construct strength between dorsal-to-plantar and plantar-to-dorsal screw orientation. The approach chosen by the surgeon should be based on factors other than the biomechanical strength of the screw orientation
Predicting the combined occurrence of poor clinical and radiographic outcomes following cervical deformity corrective surgery.
No full textOBJECTIVE:Cervical deformity (CD) correction is clinically challenging. There is a high risk of developing complications with these highly complex procedures. The aim of this study was to use baseline demographic, clinical, and surgical factors to predict a poor outcome following CD surgery. METHODS:The authors performed a retrospective review of a multicenter prospective CD database. CD was defined as at least one of the following: cervical kyphosis (C2-7 Cobb angle > 10°), cervical scoliosis (coronal Cobb angle > 10°), C2-7 sagittal vertical axis (cSVA) > 4 cm, or chin-brow vertical angle (CBVA) > 25°. Patients were categorized based on having an overall poor outcome or not. Health-related quality of life measures consisted of Neck Disability Index (NDI), EQ-5D, and modified Japanese Orthopaedic Association (mJOA) scale scores. A poor outcome was defined as having all 3 of the following categories met: 1) radiographic poor outcome: deterioration or severe radiographic malalignment 1 year postoperatively for cSVA or T1 slope-cervical lordosis mismatch (TS-CL); 2) clinical poor outcome: failing to meet the minimum clinically important difference (MCID) for NDI or having a severe mJOA Ames modifier; and 3) complications/reoperation poor outcome: major complication, death, or reoperation for a complication other than infection. Univariate logistic regression followed by multivariate regression models was performed, and internal validation was performed by calculating the area under the curve (AUC). RESULTS:In total, 89 patients with CD were included (mean age 61.9 years, female sex 65.2%, BMI 29.2 kg/m2). By 1 year postoperatively, 18 (20.2%) patients were characterized as having an overall poor outcome. For radiographic poor outcomes, patients' conditions either deteriorated or remained severe for TS-CL (73% of patients), cSVA (8%), horizontal gaze (34%), and global SVA (28%). For clinical poor outcomes, 80% and 60% of patients did not reach MCID for EQ-5D and NDI, respectively, and 24% of patients had severe symptoms (mJOA score 0-11). For the complications/reoperation poor outcome, 28 patients experienced a major complication, 11 underwent a reoperation, and 1 had a complication-related death. Of patients with a poor clinical outcome, 75% had a poor radiographic outcome; 35% of poor radiographic and 37% of poor clinical outcome patients had a major complication. A poor outcome was predicted by the following combination of factors: osteoporosis, baseline neurological status, use of a transition rod, number of posterior decompressions, baseline pelvic tilt, T2-12 kyphosis, TS-CL, C2-T3 SVA, C2-T1 pelvic angle (C2 slope), global SVA, and number of levels in maximum thoracic kyphosis. The final model predicting a poor outcome (AUC 86%) included the following: osteoporosis (OR 5.9, 95% CI 0.9-39), worse baseline neurological status (OR 11.4, 95% CI 1.8-70.8), baseline pelvic tilt > 20° (OR 0.92, 95% CI 0.85-0.98), > 9 levels in maximum thoracic kyphosis (OR 2.01, 95% CI 1.1-4.1), preoperative C2-T3 SVA > 5.4 cm (OR 1.01, 95% CI 0.9-1.1), and global SVA > 4 cm (OR 3.2, 95% CI 0.09-10.3). CONCLUSIONS:Of all CD patients in this study, 20.2% had a poor overall outcome, defined by deterioration in radiographic and clinical outcomes, and a major complication. Additionally, 75% of patients with a poor clinical outcome also had a poor radiographic outcome. A poor overall outcome was most strongly predicted by severe baseline neurological deficit, global SVA > 4 cm, and including more of the thoracic maximal kyphosis in the construct
LESSONS LEARNED FROM THE 2022 US BABY FORMULA SHORTAGE
No full textThe baby formula shortage was a challenging experience for everyone in the U.S., yet low-income mothers experienced the worst effects of the baby formula shortage. Through conducting virtual interviews of mothers, I built a theory that uncovered three themes and multiple sub-themes that emerged on how low-income mothers coped with the baby formula shortage. These three themes were: (1) Access to and availability of baby formula during the shortage was difficult. (2) Community support in obtaining baby formula played a prominent role in mother's lives. (3) Social services and the healthcare system, specifically doctors, played a significant role in alleviating the baby formula shortage for mothers. Alongside these interviews, a background analysis of the policy and cultural situations was reviewed to provide context on how a baby formula shortage came to be.
The background information provided along with the interviews resulted in the creation of policy implications and recommendations ranging from policymakers changing requirements around WIC to social service officers partnering more with community organizations. These two pieces of information undergird this master's project (MP), which is meant to help guide policymakers and social service officers on how to best support low-income mothers and mothers writ large during their potential baby formula purchasing experience. By learning from their experiences and implementing recommendations that tackle the breadth and depth of the issues that caused the baby formula shortage, we can ensure we are effectively supporting two populations that are extremely important to the current and future success of our communities and the U.S., mothers, and infants