Using a rapid response web-based survey, we identified gaps in public understanding of the Centers for Disease Control and Prevention\'s messaging about the pause in use of the Johnson & Johnson-Janssen COVID-19 vaccine and estimated changes in vaccine hesitancy using counterfactual questions.

UNASSIGNED: To analyze the equity of human resources allocation of the Centers for Disease Control and Prevention (CDCs) and to predict the development in the next five years in China, and to provide a scientific basis for promoting the development of human resources.
UNASSIGNED: The data of the CDCs from 2017 to 2021 were obtained from the \"China Health Statistical Yearbook\", and descriptive analysis, health resource density index (HRDI), Theil index, and health resource agglomeration degree (HRAD) were used to evaluate the equity, and the grey prediction model GM (1, 1) was used to predict the development from 2022 to 2026.
UNASSIGNED: Measured by the HRDI, the shortage of human resources in the western region was relatively obvious, with a shortage of more than 11,656 health technicians, more than 6418 licensed (assistant) physicians, and more than 693 registered nurses. The Theil index of human resources allocation by population was between 0.016 and 0.071, and the Theil index of human resources allocation by geography was between 0.312 and 0.359. The allocation of human resources by geography was more unequal than those allocated by population. In terms of HRAD, human resources are over-allocated equitably by geography in the eastern and central regions, while they are under-allocated equitably by geography in the western region. In terms of the difference between the HRAD and PAD, the eastern region has a shortage of human resources relative to the concentration population, and the western region has an excess of human resources relative to the concentration population.
UNASSIGNED: The human resources allocation of the CDCs in China was uneven. The human resources of the CDCs were allocated more equitably by population than by geography. There was a situation where the equity of human resource allocation of the CDCs was contrary to the actual demand for medical care.

The call to optimize brain health is now a local, regional and global priority. Organizations such as the World Health Organization, Centers for Disease Control and Prevention and Alzheimer\'s Association, American Academy of Neurology, World Federation of Neurology, and others have developed recommendations for the maintenance of brain health. Brain health definitions range from broad to narrow in scope and may focus on cognition or encompass broader core components such as cerebral, mental and social domains. In this manuscript we will explore various definitions of brain health and its core components, the importance of cognitive and functional domains, and briefly introduce the concept of cognitive medicine in the context of brain health.

The postoperative burden remains significant due to the possibility of prolonged hospitalization, escalated healthcare costs, and patient distress caused by postorthopedic surgical site infections (SSIs). Orthopedic surgery is likewise faced with a significant challenge posed by these conditions. A positive association has been observed between the presence of postorthopedic SSIs and heightened susceptibility to adverse health outcomes, along with elevated rates of morbidity and mortality. Systemic antibiotic prophylaxis (SAP) reduces the risk of acquiring an SSI. Closed fractures, open fractures, arthroplasty, and percutaneous fixation each possess distinct attributes that impact the data and antimicrobial therapy. When implementing SAP, it is crucial to strike a delicate equilibrium between maintaining effective antibiotic stewardship protocols and preventing the occurrence of SSIs. This practice effectively prevents both the incidence of negative consequences and the emergence of antibiotic resistance. The objective of this study was to examine the existing literature on the use of surgical antibiotic prophylaxis in orthopedic surgery and explore the potential consequences associated with the inappropriate administration of antibiotics.

BACKGROUND: Diabetes is a costly epidemic in the United States associated with both health and economic consequences. These consequences can be mitigated by participation in structured lifestyle change programs such as the National Diabetes Prevention Program (DPP) led by the Centers for Disease Control and Prevention. Mississippi consistently has among the highest rates of diabetes and prediabetes nationally. Implementing the National DPP through large health care systems can increase reach and accessibility for populations at the highest risk for diabetes. Translational research on the National DPP in Mississippi has not been studied.
OBJECTIVE: This study aims to evaluate the implementation and impact of the National DPP delivered using telehealth modalities at the University of Mississippi Medical Center in Jackson, Mississippi.
METHODS: An effectiveness-implementation hybrid type III research design is proposed. The study design is guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework and the Practical, Robust Implementation and Sustainability Model. Participants are being recruited via provider referral, and the DPP is being delivered by trained lifestyle coaches. Study participants include adult (≥18 years) patients eligible for the DPP with at least 1 encounter at 1 of 3 ambulatory clinic specialties (lifestyle medicine, family medicine, and internal medicine) between January 2019 and December 2023. The National DPP eligibility criteria include a BMI ≥25 kg/m2 and hemoglobin A1c between 5.7% and 6.4%. The University of Mississippi Medical Center criteria include Medicare or Medicaid beneficiaries. The University of Mississippi Medical Center\'s a priori implementation plan was developed using the Consolidated Framework for Implementation Research and includes 23 discrete strategies. The primary aim will use an embedded mixed method process analysis to identify and mitigate challenges to implementation. The secondary aim will use a nonrandomized quasi-experimental design to assess the comparative effectiveness of the DPP on health care expenditures. A propensity score matching method will be implemented to compare case subjects to control subjects. The primary outcomes include patient referrals, participant enrollment, retention, engagement, the incidence of diabetes, and health care resource use and costs.
RESULTS: At baseline, of the 26,151 patients across 3 ambulatory clinic specialties, 1010 (3.9%) had prediabetes and were eligible for the National DPP. Of the 1010 patients, more than half (n=562, 55.6%) were aged 65 years or older, 79.5% (n=803) were Medicare beneficiaries, 65.9% (n=666) were female, and 70.8% (n=715) were obese.
CONCLUSIONS: This is the first translational study of the National DPP in Mississippi. The findings will inform implementation strategies impacting the uptake and sustainability of the National DPP delivered in an academic medical setting using distance learning and telehealth modalities.
BACKGROUND: ClinicalTrials.gov NCT04822480; https://clinicaltrials.gov/study/NCT03622580.
UNASSIGNED: DERR1-10.2196/50183.

A continent-wide Africa Task Force for Coronavirus with its six technical working groups was formed to prepare adequately and respond to the novel Coronavirus disease (COVID-19) outbreak in Africa. This research in practice article aimed to describe how the infection prevention and control (IPC) technical working group (TWG) supported Africa Centre for Disease Control and Prevention (Africa CDC) in preparedness and response to COVID-19 on the continent. To effectively address the multifaceted IPC TWG mandate of organizing training and implementing rigorous IPC measures at healthcare service delivery points, the working group was sub-divided into four sub-groups-Guidelines, Training, Research, and Logistics. The action framework was used to describe the experiences of each subgroup. The guidelines subgroup developed 14 guidance documents and two advisories; all of which were published in English. In addition, five of these documents were translated and published in Arabic, while three others were translated and published in French and Portuguese. Challenges faced in the guidelines subgroup included the primary development of the Africa CDC website in English, and the need to revise previously issued guidelines. The training subgroup engaged the Infection Control Africa Network as technical experts to carry out in-person training of IPC focal persons and port health personnel across the African continent. Challenges faced included the difficulty in conducting face-to-face IPC training and onsite technical support due to the lockdown. The research subgroup developed an interactive COVID-19 Research Tracker on the Africa CDC website and conducted a context-based operation and implementation research. The lack of understanding of Africa CDC\'s capacity to lead her own research was the major challenge faced by the research subgroup. The logistics subgroup assisted African Union (AU) member states to identify their IPC supply needs through capacity building for IPC quantification. A notable challenge faced by the logistics subgroup was the initial lack of experts on IPC logistics and quantifications, which was later addressed by the recruitment of professionals. In conclusion, IPC cannot be built overnight nor can it be promoted abruptly during outbreaks of diseases. Thus, the Africa CDC should build strong national IPC programmes and support such programmes with trained and competent professionals.

UNASSIGNED: Evidence indicates that serum Klotho concentration is associated with mortality in patients with chronic kidney disease (CKD). However, evidence on this association among people with hypertension is scarce. Therefore, we aimed to examine the association between serum Klotho concentration and all-cause and cardiovascular mortality in American patients with hypertension.
UNASSIGNED: We included 6,778 participants with hypertension from the National Health and Nutrition Examination Survey (NHANES) 2007-2014. A Cox proportional hazard model was used to compute the hazard ratios (HRs) and 95% confidence intervals (CIs). The correlation between serum Klotho concentration and mortality was determined using restricted cubic spline and piecewise linear regression analyses. During 36,714 person-years of follow-up, 575 deaths were documented. Lower serum Klotho concentration was associated with increased all-cause mortality, but not cardiovascular mortality after multivariate adjustment. According to spline analysis, the correlation between serum Klotho concentration and all-cause mortality was non-linear (P < 0.001), and the threshold value was 574 pg/mL. The HR below the threshold point was 0.79 (95% CI: 0.67-0.93); no significant difference was found above the threshold point.
UNASSIGNED: Higher serum Klotho concentration was associated with lower all-cause mortality, but not cardiovascular mortality in patients with hypertension with or without chronic renal impairment.

The increasing prevalence of overweight and obesity in the United States, and disparities by race, ethnicity, and gender, have caused concern among public health practitioners, health care providers, and others, in part because overweight and obesity may be linked to chronic health problems and weight stigma. Researchers have traditionally relied upon body mass index (BMI) as a measure of overweight and obesity, despite its limitations. In this study we apply an intersectional framework and use data from the 2011-2018 waves of the nationally representative National Health and Nutrition Examination Survey (NHANES) to study sex differences in the risk of overweight and obesity among Mexican Americans, triangulating three measures that proxy for overweight and obesity: BMI, high waist circumference, and high percent body fat. We assess heterogeneity across nativity, education, income by parenthood status, food security, time in the United States (for immigrants), and receipt of SNAP/WIC benefits (for the low-income sample). Results from logistic regression models indicate choice of cutoff values and measure are critical to determining whether sex disparities exist. We find no evidence of disparities in BMI but evidence of greater risk for females using traditional cutoff values for high waist circumference and high percent body fat. Adjusted cutoff values provide differing results. Minimal heterogeneity is seen. Results reinforce the importance of considering sex disparities and emphasize the importance of critically examining measures that proxy for overweight and obesity risk, given the high stakes surrounding weight stigma.

Hepatitis B virus (HBV) infection is a vaccine-preventable disease associated with substantial morbidity and mortality. Although safe and effective hepatitis B vaccines are available, an increased number of adults must receive the hepatitis B vaccine in order to reach the goal of the US Department of Health and Human Services for HBV elimination. Previous guidelines from the US Centers for Disease Control and Prevention (CDC) for hepatitis B vaccination among adults utilized a risk-based approach that may have contributed to decreased uptake of the vaccine because the recommendations were difficult to adopt into clinical practice and assumed patients would recognize and disclose their risk factors. Based on review of epidemiologic and cost-effectiveness data, the CDC now recommends that all adults 19 to 59 years old receive the hepatitis B vaccine; however, a risk-based approach to hepatitis B vaccination was retained among adults age 60 years and older because universal vaccination in this age group would not lead to substantial reductions in acute HBV cases and be cost-effective. Implementation of these expanded hepatitis B vaccination recommendations in clinical and public health practice may pose challenges, including ensuring effective HBV screening practices, quality measures to track coverage of the hepatitis B vaccine, utilization of hepatitis B vaccines that have the highest completion rates for the vaccine series in a real-world setting, and sustained efforts to vaccinate high-risk groups such as individuals experiencing incarceration, utilizing sexually transmitted disease clinics, and injecting illicit drugs.

OBJECTIVE: To determine the prevalence of memory problems in individuals with or without a history of DM and cancer and assess possible compounding effects of these diseases on self-reported memory problems (SRMP).
METHODS: We used data from the 2009-2018 National Health and Nutrition Examination Survey. We conducted logistic regression analyses to determine the associations among DM, cancer, and SRMP, adjusting for age, sex, race/ethnicity, education, and poverty level. We examined the interaction effects of comorbid DM and cancer on SRMP. We compared participants with both DM and cancer to those with cancer only and to those with no DM or cancer.
RESULTS: We included 26,842 adults ≥ 20 years old (N = 3374 with DM, N = 23,468 without DM) and 51.87% female. There were 10,434 Whites, 5730 Blacks, 6795 Hispanics, and 3883 other races/multiracial. More individuals with DM reported memory problems than those without DM (p < 0.0001). More individuals with cancer reported memory problems than those without cancer (p < 0.0001). Of those with both DM and cancer, 14.19% reported memory problems. More individuals with DM had cancer than those without DM (p < 0.0001). Of those with both diseases, 55.75% had DM before the cancer diagnosis. DM (odds ratio[OR] = 1.87, 95%CI, 1.55-2.26) and cancer (OR = 1.81, 95%CI, 1.43-2.30) predicted SRMP. The interaction between DM and cancer was significant, and the likelihood of having both diseases compared to having neither DM nor cancer was OR = 2.09, 95%CI, 1.41 - 3.11.
CONCLUSIONS: Strategies to mitigate SRMP in individuals with comorbid DM and cancer history should consider the impact of both diseases.