Roy Sabo's research while affiliated with Virginia Commonwealth University and other places
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Publications (176)
Introduction:
Clinical preventive services can reduce mortality and morbidity, but Americans receive only half of the recommended care. Although wellness visits protect time for clinicians to review needs and discuss care with patients, studies have not shown that having a wellness visit improves health outcomes. This study seeks to understand the...
Objective
To determine whether cascade reporting is associated with a change in meropenem and fluoroquinolone consumption.
Design
A quasi-experimental study was conducted using an interrupted time series to compare antimicrobial consumption before and after the implementation of cascade reporting.
Setting
A 399-bed, tertiary-care, Veterans’ Affai...
Background
Patients with type 2 diabetes require recommendations for self-management education and support.
Objective
In this study, we aim to design the Diabetes Engagement and Activation Platform (DEAP)—an automated patient education tool integrated into primary care workflow—and examine its implementation and effectiveness.
Methods
We invited...
Response‐adaptive (RA) allocation designs can skew the allocation of incoming subjects toward the better performing treatment group based on the previously accrued responses. While unstable estimators and increased variability can adversely affect adaptation in early trial stages, Bayesian methods can be implemented with decreasingly informative pr...
Introduction:
In December 2013, cholesterol treatment guidelines changed the approach to statin therapy by recommending fixed doses of low-, medium-, or high-intensity statins based on cardiovascular risk. We sought to evaluate the guideline's adoption in a diverse group of practices.
Methods:
Using a mixed-methods approach, we analyzed electron...
Background
Cascade reporting (CR) is a strategy of reporting antimicrobial susceptibility test results in which secondary agents are only reported if an organism is resistant to primary, narrow spectrum agents within a drug class. A multidisciplinary team developed CR algorithms for Gram-negative bacteria based on the local antibiogram and infectio...
UNSTRUCTURED
Aims: To help patients with type 2 diabetes receive recommended self-management education and support (DSMES), we designed the Diabetes Engagement and Activation Platform (DEAP) – an automated patient education tool integrated into primary care workflow – and examined its implementation and effectiveness. Methods: We invited patients a...
Objective
Prenatal care (PNC) and well child visit (WCV) attendance are associated with improved health outcomes. We aimed to determine if the factors affecting maternal and child attendance are similar or different.
Methods
We conducted a retrospective case control study at Virginia Commonwealth University Health System. We used the Adequacy of P...
Objective
Excluded from reporting to CMS's Percentage of long-stay residents who got an antipsychotic medication quality-measure are antipsychotics prescribed to nursing home patients with schizophrenia, Tourette's, or Huntington's. Over the 4 years following its 2012 debut, the quality-measure calculated a 27% reduction in inappropriate antipsycho...
Introduction: Indolent B-Cell Non-Hodgkin's Lymphomas (NHL) represent a heterogeneous group of lymphoproliferative malignancies, that remain largely incurable. Marginal zone lymphomas (MZL) are the second most common subtype of indolent NHL, and lack a unique cytogenetic identifying abnormality. The B-cell receptor signaling pathway is activated in...
The standard of care for patients with newly diagnosed multiple myeloma who are transplant eligible is induction therapy followed by conditioning with high dose melphalan and autologous hematopoietic cell transplant (HCT). While the value of a single HCT (S-HCT) is established in standard-risk myeloma (SRM), there is controversy about whether tande...
Intravenous (IV) ascorbic acid (AA) improves organ function and reduces inflammation in sepsis, an inflammatory state similar to the post-hematopoietic cell transplant (HCT) milieu. This salutary effect is mediated by antioxidant activity as well transcriptional modulation by AA. HCT recipients are deficient in AA, therefore we evaluated the safety...
Scientists in biomedical and psychosocial research need to deal with skewed data all the time. In the case of comparing means from two groups, the log transformation is commonly used as a traditional technique to normalize skewed data before utilizing the two-group t-test. An alternative method that does not assume normality is the generalized line...
Background:
Previous research demonstrated that registries are effective for improving clinical guideline adherence for the care of patients with type 2 diabetes. However, registry implementation has typically relied on intensive support (such as practice facilitators) for practice change and care improvement.
Objective:
To determine whether a r...
Introduction:
Screening for colorectal cancer is beneficial. Yet, screening remains suboptimal, and underserved populations are at greater risk for not being appropriately screened. Although many barriers to screening are understood, less is known about how the decision-making process on whether to receive colonoscopy or stool testing influences s...
Random allocation models used in clinical trials aid researchers in determining which of a particular treatment provides the best results by reducing bias between groups. Often however, this determination leaves researchers battling ethical issues of providing patients with unfavorable treatments. Many methods such as Play the Winner and Randomized...
Objectives
Lung cancer remains the leading cause of cancer-related deaths in the United States. In 2013, the US Preventive Services Task Force recommended annual screening for lung cancer with low-dose computed tomography in adults meeting certain criteria. This study seeks to assess lung cancer screening uptake in three health systems.
Setting
Th...
Background:
Many patients with poorly controlled multiple chronic conditions (MCC) also have unhealthy behaviors, mental health challenges, and unmet social needs. Medical management of MCC may have limited benefit if patients are struggling to address their basic life needs. Health systems and communities increasingly recognize the need to addres...
Introduction: Indolent B-cell non-Hodgkin’s lymphomas (NHL) represent a heterogeneous group of lymphoproliferative malignancies that remain largely incurable. Marginal zone lymphomas (MZL) are the second most common subtype of indolent NHL and lack a unique cytogenetic identifying abnormality. The B-cell receptor signaling pathway is activated in B...
Background:
Unhealthy alcohol use is the third leading cause of preventable death in the United States. Evidence demonstrates that screening for unhealthy alcohol use and providing persons engaged in risky drinking with brief behavioral and counseling interventions improves health outcomes, collectively termed screening and brief interventions. Me...
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a variable clinical presentation that ranges from asymptomatic, to severe disease with cytokine storm. The mortality rates also differ across the globe, ranging from 0.5-13%. This variation is likely due to both pathogen and host factors. Host factors may include genetic differences i...
Killer immunoglobulin-like receptor (KIR) and KIR-ligand (KIRL) interactions play an important role in natural killer (NK) cell mediated graft versus leukemia (GVL) effect following hematopoietic cell transplantation (HCT). However, there is considerable heterogeneity in the KIR gene and KIRL content in individuals, making it difficult to estimate...
Introduction
Current guidelines recommend monitoring and preemptive therapy for cytomegalovirus (CMV) reactivation in patients receiving allogeneic hematopoietic cell transplantation (HCT). Treatment options are limited by side effects such as myelosuppression and renal toxicity. Effective CMV prophylaxis may avoid these complications. At our insti...
Intravenous (IV) ascorbic acid (AA) improves organ function and reduces inflammation in sepsis, an inflammatory state similar to post-hematopoietic cell transplant (HCT) milieu. This salutary effect is mediated by antioxidant activity as well transcriptional modulation by AA. We evaluated the safety and efficacy of IV AA in ameliorating the inflamm...
The medical school admissions process seeks to assess a core set of cognitive and non-cognitive competencies that reflect professional readiness and institutional mission alignment. The standardized format of multiple mini-interviews (MMIs) can enhance assessments, and thus many medical schools have switched to this for candidate interviews. Howeve...
The linear spline growth model (LSGM) is a popular tool for examining nonlinear change patterns over time. It approximates complex patterns by attaching at least two linear trajectories. Besides examining within-person changes and between-person differences of trajectories simultaneously, it poses interesting statistical challenges, such as estimat...
The linear spline growth mixture model (LSGMM), which extends the linear spline growth model (LSGM) to the growth mixture model framework, is an appropriate tool for analyzing longitudinal data sets that come from a mixture of at least two latent classes and the underlying growth trajectories within each class are nonlinear. For each latent class,...
Background
Chronic lymphocytic leukemia (CLL) is the most common form of adult leukemia, and remains largely incurable with current therapies. The anti-apoptotic protein Bcl-2 is overexpressed in CLL patients, where it mediates survival and resistance to chemotherapy and targeted therapies. Venetoclax is the first-in-class BH3 mimetic to specifical...
Killer immunoglobulin-like receptor (KIR) and KIR-ligand (KIRL) interactions play an important role in natural killer (NK) cell mediated graft versus leukemia effect following hematopoietic cell transplantation (HCT). However, there is considerable heterogeneity in the KIR gene and KIRL content in individuals, making it difficult to estimate the fu...
Background:
Adult opioid use and neonatal abstinence syndrome (NAS) are growing public health problems in the United States (U.S.). Our objective was to determine how opioid use disorder treatment access impacts the relationship between adult opioid use and NAS.
Methods:
We conducted a cross-sectional state-level ecologic study using 36 states w...
Background:
Although Web-based questionnaires are an efficient, increasingly popular mode of data collection, their utility is often challenged by high participant dropout. Researchers can gain insight into potential causes of high participant dropout by analyzing the dropout patterns.
Objective:
This study proposed the application of and assess...
Background
Though there is thorough examination of psychosocial issues in SCT, there are few longitudinal studies examining the meaning SCT patients attribute to their treatment.
Objective
The object of this study was to examine change in situational appraisal over time, and to explore potential modifiers of that change.
Methods
A prospective, lo...
Introduction: Indolent B-Cell Non-Hodgkin’s Lymphoma (i-NHL) represents a heterogeneous group of lymphoproliferative malignancies, encompassing 40% of NHL, that remains largely incurable. The B-cell receptor signaling pathway is activated in B-cell malignancy and mediates its activity mainly through the Phosphoinositide 3-kinase (PI3K) pathway. Fur...
A doubly-inflated Poisson distribution is presented to account for count inflation at some positive integer value k in addition to that seen at zero. Maximum likelihood and moment estimators are derived, and their performances are compared using asymptotic relative efficiencies. The doubly-inflated Poisson distribution is also incorporated into the...
Killer immunoglobulin-like receptor (KIR) and KIR-ligand (KIRL) interactions play an important role in natural killer (NK) cell mediated graft versus leukemia effect following hematopoietic cell transplantation (HCT). However, there is considerable heterogeneity in the KIR gene and KIRL content in individuals, making it difficult to estimate the fu...
Objectives:
To investigate the relationship between barometric pressure and the incidence of benign paroxysmal positional vertigo (BPPV).
Methods:
181 patients diagnosed with classic BPPV seen between 2011 and 2016 were identified. Demographic information, data of onset, and date of presentation were recorded. Historical barometric data for each...
A novel antimicrobial consumption metric designed to identify the proportion of carbapenem consumption (PoCC) among broad-spectrum antipseudomonal antimicrobials has been shown to vary significantly by US Census Bureau region. This retrospective surveillance study identified significant total PoCC variability (27%; P = .001) across 8 inpatient unit...
Background:
Primary care clinicians write 45% of all opioid prescriptions in the United States, but little is known about the characteristics of patients who receive them and the clinicians who prescribe opioids in primary care settings. Our study aimed to describe the patient and clinician characteristics and clinicians' perspectives of chronic o...
Stem cell transplant, meaning making, coping, adjustment; situational attribution, illness representations. Longitudinal; prospective.
Loneliness is associated with poor health outcomes, and there is growing attention on loneliness as a social determinant of health. Our study sought to determine the associations between community factors and loneliness. The Three-Item Loneliness Scale and zip codes of residence were collected in primary care practices in Colorado and Virginia. Liv...
Introduction
Patients who receive HLA matched allogeneic hematopoietic cell transplant (HCT) from donors with killer immunoglobulin-like receptor (KIR) haplotype B have improved survival, decreased acute GVHD, and less CMV reactivation when compared with those transplanted with KIR haplotype A donors. However, the effect of NK cell (CD56+) reconsti...
Purpose:
Loneliness has important health consequences. Little is known, however, about loneliness in primary care patient populations. This study describes the prevalence of loneliness in patients presenting for primary care and associations with self-reported demographic factors, health care utilization, and health-related quality of life.
Metho...
Clinical outcomes following hematopoietic cell transplant (HCT) are considered stochastic with different outcomes despite uniformity in characteristics between patients. However, immune reconstitution following SCT has features of a dynamical system, making it likely that clinical outcomes are partially deterministic. We hypothesized that early ces...
Background:
Primary Hepatobiliary Lymphoma (PHBL) is a rare disease. In review of the literature, there are only few retrospective studies. On prior studies, the median age at presentation was 62 years and was associated with a median overall survival of 162 months. In this study, we sought to characterize standard prognostic factors and their effe...
Introduction
There are roughly 75,000 new cases of Non-Hodgkin's Lymphoma every year, representing almost 5% of all new cancer diagnoses. Indolent B-Cell Non-Hodgkin's Lymphoma (i-NHL) represents a heterogeneous group of lymphoproliferative malignancies, encompassing 40% of NHL, that remains largely incurable. Follicular lymphoma and marginal zone...
BACKGROUND
Although Web-based questionnaires are an efficient, increasingly popular mode of data collection, their utility is often challenged by high participant dropout. Researchers can gain insight into potential causes of high dropout by analyzing dropout patterns.
OBJECTIVE
To propose and investigate user-specified and existing hypothesis tes...
Background and objectives:
It is unclear which specific well-child visits (WCVs) are most frequently missed and whether age-specific patterns of attendance differ by race or insurance type.
Methods:
We conducted a retrospective cohort study of children 0 to 6 years old between 2011 and 2016 within 2 health networks spanning 20 states. WCVs were...
Outcome- or response-adaptive allocation methods are used to adjust randomization probabilities in clinical trials based on observations from previously accrued patients. These methods aim to achieve one of several allocation goals, which have included maximizing statistical power, balancing for covariates, and maximizing treatment benefit. In the...
Purpose:
Little is known about incorporating community data into clinical care. This study sought to understand the clinical associations of cold spots (census tracts with worse income, education, and composite deprivation).
Methods:
Across 12 practices, we assessed the relationship between cold spots and clinical outcomes (obesity, uncontrolled...
Purpose:
The shift from infusion to oral oncolytic therapy presents challenges to oncology practitioners. The purpose of this study was to describe how a statewide quality-improvement collaborative can enhance quality of care for patients receiving oral oncolytic therapy.
Methods:
The Michigan Oncology Quality Consortium hosted a series of learn...
Allogeneic hematopoietic cell transplantation (HCT) is a curative option for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), but carries a high risk of relapse. This retrospective review evaluates the effectiveness of maintenance azacitidine in high-risk AML and MDS patients to reduce the probability of relapse. Twent...
Lymphoid recovery following myeloablative stem cell transplantation (SCT) displays a logistic pattern of exponential growth followed by a plateau. Within this logistic framework, lymphoid recovery is characterized by the parameters R (slope of ascent), a (time of maximal rate of ascent) and K (plateau), the 'steady-state' lymphocyte count. A retros...
In this study, we used a rapid, highly-sensitive, single-cell biomass measurement method, Live Cell Interferometry (LCI), to measure biomass in populations of CD3+ T-cells isolated from hematopoietic stem cell transplant (SCT) patients at various times pre- and post-transplant (days 0-100). CD3+ T-cell ‘mass spectra’ were obtained from five autolog...
A metric was developed to identify hospital proportion of carbapenem consumption (PoCC) among antipseudomonal antibiotics. The PoCC varied significantly among academic medical centers by Census Bureau geographic division after adjusting for patient mix. This metric may be useful in identifying disproportionate carbapenem use and potential carbapene...
Patient characteristics, excluding haploidentical DRP.
(TIFF)
Clonal frequency distribution for colon responding T cells in patient 2.
(TIFF)
Simulation Program 1 (Allo).
(DOCX)
Simulation Program 2 (T dist).
(DOCX)
Simulated T cell counts by organ in patients with and without GVHD (presented in 1,000s of cells).
(TIFF)
Introduction:
Engaging patients to make informed choices is paramount but difficult in busy practices. This study sought to engage patients outside the clinical setting to better understand how they approach cancer screening decisions, including their primary concerns and their preferences for finalizing their decision.
Methods:
Twelve primary c...
Quantitative relationship between the magnitude of variation in minor histocompatibility antigens (mHA) and graft versus host disease (GVHD) pathophysiology in stem cell transplant (SCT) donor-recipient pairs (DRP) is not established. In order to elucidate this relationship, whole exome sequencing (WES) was performed on 27 HLA matched related (MRD)...
Hypothetical T cell clonal frequency distribution showing interaction of TCR-mHA affinity (IC50 varying from 0.1 to 100 nM) and mHA-HLAx affinity (constant IC50 1 nM).
For TCR affinity of 1 nM, the K varies as mHA-HLA complex affinity varies.
(TIFF)
Transition/Transversion ratio for the WES data from all the patients.
(TIFF)
An example of input data for the simulations.
Selected peptide sequences, HLA binding affinity and tissue expression levels. Variant amino acid given in red.
(TIFF)
Balanced Eq 3 (Units).
(TIFF)
Patient example ANNOVAR-GTEx output.
(XLSX)
Purpose:
To accurately measure external auditory canal (EAC) dimensions by high resolution computed tomography (CT), and compare results with a traditional method of EAC measurement.
Methods:
Using an advanced multidimensional open source digital imaging and communications in medicine (DICOM) analysis program (OsiriX, Pixmeo, Geneva, Switzerland...
Simulated T cell counts per donor type by organ (presented in 1,000s of cells).
(TIFF)
Simulation Program 3 (HLA Count).
(DOCX)
Simulation Program 4 (Y Count).
(DOCX)
Patient example colon.
(XLSX)
Introduction:
This study examines how improving curricular content and technical interface issues could make maintenance of certification activities more meaningful to American Board of Family Medicine diplomates completing Maintenance of Certification for Family Physicians (MC-FP) Program self-assessment modules (SAMs).
Methods:
We used a seque...
Objective:
Over the two years following the 2012 introduction of CMS's National Partnership, combined rates of schizophrenia, Tourette's, and Huntington's in US long-stay residents increased 12%. We evaluated trends in reporting of these diagnoses for the subgroup of long-stay residents on antipsychotics.
Methods:
Retrospective analysis of Virgi...
Background and objectives:
Substance use disorder (SUD) is a widespread problem but physicians may feel inadequately prepared to provide addiction care. We sought to assess current addiction medicine curricula in US family medicine residencies (FMRs) and evaluate barriers to improving or implementing addiction medicine curricula.
Methods:
Questi...
The purpose of this study was to examine the performance
and metabolic effects of two weeks of Arm Crank Ergome-
try (ACE) Sprint Interval Training (SIT) in men with Spinal
Cord Injury (SCI). Eight paraplegic males 50.5 + 9.0 yo,
180.8 + 6.7 cm tall, 85.1 + 19.5 kg, and 35.1 + 5.7% body
fat completed three Oral Glucose Tolerance Tests (OGTTs)
at...
Purpose:
Technology could transform routine decision making by anticipating patients' information needs, assessing where patients are with decisions and preferences, personalizing educational experiences, facilitating patient-clinician information exchange, and supporting follow-up. This study evaluated whether patients and clinicians will use suc...
The quantitative relationship between the magnitude of variation in minor histocompatibility antigens (mHA) and graft versus host disease (GVHD) pathophysiology in stem cell transplant (SCT) donor-recipient pairs (DRP) is not established. In order to elucidate this relationship, whole exome sequencing (WES) was performed on 27 HLA matched related (...
Purpose:
The US Food and Drug Administration issued a boxed warning on all products containing a long-acting β-agonist (LABA) in March 2006, after the findings from a trial suggested an increased risk for death in patients treated with salmeterol monotherapy. Almost nothing is known about the impact of this warning on LABA prescribing patterns or...
Objective:
A small body of evidence supports targeting adolescents who are heavy users of cannabis with brief interventions, yet more research is needed to confirm the effectiveness of these studies. We conducted a secondary analysis of our Peer Network Counseling (PNC) study (Mason et al., 2015), focusing on 46 adolescents of the sample of 119 wh...
Increased social stress in the context of peer interactions is associated with multiple negative health outcomes, including substance use. Addressing social stress could provide protective effects for adolescents who are particularly vulnerable to peer-based issues such as loneliness and perceived isolation. Toward this end, we examined the efficac...
Alloreactivity following stem cell transplantation (SCT) is difficult to predict in patients undergoing transplantation from HLA matched donors. In this study we performed whole exome sequencing of SCT donor-recipient pairs (DRP). This allowed determination of entire library of alloreactive peptide sequences which would bind HLA class I molecules i...
Background:
Electronic surveys are convenient, cost effective, and increasingly popular tools for collecting information. While the online platform allows researchers to recruit and enroll more participants, there is an increased risk of participant dropout in Web-based research. Often, these dropout trends are simply reported, adjusted for, or ig...
Previous research has shown that childhood body size is associated with blood pressure in adulthood, and that early and rapid growth rates are correlated with adverse cardiovascular outcomes. Our objectives are to estimate associations between childhood body size growth parameters and adult blood pressure, and to examine the effect of early attainm...
An effective method for improving the communication skills of graduate students in statistics and biostatistics is to provide consultations with non-statistical researchers. Unfortunately, those experiences can be difficult to arrange or occur too infrequently to be reliable. The current study sought to help students develop both written and oral c...
Lymphoid recovery following myeloablative stem cell transplantation (SCT) displays a logistic pattern of exponential growth followed by a plateau. Within this logistic framework, lymphoid recovery is characterized by the parameters R (slope of ascent), a (time of maximal rate of ascent) and K (plateau), the steady state lymphocyte count. A retrospe...
We compare posterior and predictive estimators and probabilities in response-adaptive randomization designs for two-and three-group clinical trials with binary outcomes. Adaptation based upon posterior estimates are discussed, as are two predictive probability algorithms: one using the traditional definition, the other using a skeptical distributio...
Citations
... It should be noted that BMI changes rapidly in childhood [16]. Recent evidence has suggested that there are varied BMI changing patterns among children, which may bring different health outcomes [17][18][19]. BMI measurements in the majority of existed epidemiological studies were just be performed at one or limited occasions [20,21], which may be insufficient to explain the risk of hypertension. Traditional regression or growth curve modeling assumes only one mean within the population. ...
... Some is due to patient factors, but there are also clinician factors for not prescribing statins, such as overly complicated or changing guidelines, as noted in this study involving 45 practices across 8 states and the records of 223,289 patients. 12 Non-adherence to medication prevents individuals from maximizing their health and is quite common. Working with focus groups, Tarn et al 13 identify the common thoughts from patients that inform how clinicians could interact with patients in order to increase the likelihood of statin adherence. ...
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... In some studies, retention was defined as number of substance use during the last 30 days or compliance with a treatment plan. Mason et al. [34] assessed retention through self-reported numbers of days a person used substances, such as alcohol, cannabis, during the last month [35]; while in the Ng and Harerimana's study, [36] retention was determined by attendance to scheduled follow-up appointments. Retention was also operationalized as a period representing days on treatment from the first dose to the last dose of methadone or last date of the study period. ...
... However, Korpon et al suggests that the variable with the single strongest correlation between BPPV and seasonal variations is not sunlight or UV index, but rather barometric pressure. 108 Yet, the correlative evidence may be weak because recent evidence suggests such associations to be purely coincidental. 109 Yang et al 110 evaluated the relationship between BMD and Vitamin D with the presence and recurrence of BPPV. ...
... El valor educacional de usar experiencias de consultoría en la educación estadística es bien conocido (Sabo, 2016), la EE intersemestral ¿Cómo aplicar la estadística en proyectos de investigación? no solo planteó un escenario de consultoría, sino que permitió que los estudiantes inscritos adquirieran el conocimiento esencial de la aplicación de la estadística en su disciplina, que aprendieran de otras áreas y se interesaran en temas que no conocían. ...
... Many clinics screen for FI at annual health maintenance exams (HME), even though socioeconomically disadvantaged groups are less likely to attend routine health checks. 2 We performed a retrospective cohort study to evaluate disparities in FI screening and prevalence based on visit type and patient demographics at a community health center serving low-income patients in Southeast Michigan. ...
... Aus Sicht eines Individuums steht einem geringen Nutzen (Senkung der krebsspezifischen Mortalität um schätzungsweise bis zu 1 %) ein sehr geringer Schaden (Risiko für schwerwiegende Komplikationen infolge der Darmspiegelung von schätzungsweise 0,2 %) gegenüber. Dies lässt sich als Nettonutzen interpretieren, ändert aber nichts an der Tatsache, dass Menschenwenn man sie evidenzbasiert informiertunterschiedliche Präferenzen in Bezug auf die Inanspruchnahme des Screenings oder zwischen verschiedenen Screening-Verfahren haben (Woolf et al. 2018). Gleichzeitig gibt es in verschiedenen Ländern teilweise eine erhebliche Überversorgung mit Koloskopien z. ...
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... We could not measure the sound pressure levels of both ears of the participants. Different morphology of the right and left ears was proved by the previous studies (17,18). Thus, it is recommended to further assess the ear canals of both ears at the wider range of SSPL in future studies. ...
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... A recent study of NAS rates and treatment access showed a correlation between NAS rates and opioid prescribing rates in states with greater density of X-waivered physicians. Another explanation for this correlation is that in utero exposure to buprenorphine can lead to NAS. 26 We found a higher prevalence of X-waivered obstetrician-gynecologists in suburban counties and in counties with fewer uninsured residents. This finding aligns with prior evidence that, despite overall uptake in buprenorphine use, 27 access remains uneven based on race, insurance status, and geographic area. ...
... Many facilities have established data repositories to compare AU rate estimates within healthcare systems and collaborative groups to motivate improvements in stewardship [16,43,44]. However, the ability to provide robust, risk-adjusted estimates based on patient case mix is limited. ...
