Research examining the relationship between a neighborhood\'s built-environment and resident health or health-related outcomes has largely either focused on static characteristics using a cross-sectional research design or focuses on the neighborhood in its entirety. Such an approach makes it difficult to understand how specific dynamic neighborhood characteristics are associated with individual well-being. In this analysis, we use longitudinal data from the Pittsburgh Research on Neighborhood Change and Health (PHRESH) studies to assess the relationship between publicly funded neighborhood investments occurring across seven years (2011-2018) on five health-related outcomes: food insecurity, stress, perceived neighborhood safety, neighborhood satisfaction, and dietary quality. We additionally utilize this dataset to determine whether the distance between an individual\'s place of residence and the investment, as measured at the neighborhood, 1 mile, and ½ mile level, effects the magnitude of associations. Using individual and year fixed effects models, we find that when measured at the neighborhood level, a one standard deviation increase in investments (about $130 million dollars) is associated with decreased food insecurity (-0.294 sd), increased safety (0.231 sd), and increased neighborhood satisfaction (0.201 sd) among adults who remain in the study for at least two waves of data collection. We also analyze specific investment types and find that commercial investments are largely driving the changes in food insecurity, safety, and neighborhood satisfaction, while business investments are correlated with the decrease in stress. We find no relationship between investments and dietary quality.

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Nurses are the largest group in the health care system. The current care shortage remains a global challenge in the healthcare system.The accelerated second-degree nursing (ABSN) program was first proposed by the University of St.Louis in 1971 and then vigorously developed in the United States. Its purpose is to train more nursing talents to solve the medical needs of the poor in the United States. In the past few decades, this project has been carried out by many countries around the world to solve their domestic nursing problems.As a strategy to address severe care shortages, ABSN is continuing to increase rapidly.China as the world\'s second most populous country, coupled with aging year by year, the demand for nursing talents, and the ABSN project just gave China effective inspiration.Therefore, this article introduces the basic design of the bachelor\'s degree in nursing at the University of Washington, summarizes the characteristics of the training model, and draws on experience from the basic situation, training objectives, courses and evaluation methods. It is urgent to provide guidance and reference for the acceleration of nursing education in China.

BACKGROUND: This study aims to study the disparity in Cigna and Medicaid insurance holders, to secure an appointment for a patient with a headache for two days unrelieved by over-the-counter medication.
METHODS: This is a cross-sectional \"secret shopper\" type study, assessing the three most populated cities in seven states with the lowest Medicaid coverage and Internal Medicine specialists within a 10-mile radius, with a minimum rating of 3 stars and a willingness to accept new patients.
RESULTS: There was a statistically significant difference in the average waiting period for those with Medicaid and Cigna in the states of Missouri, Nebraska, and Utah, as well as the total average for all seven states. Moreover, there were more healthcare providers who accepted Medicaid rather than Cigna in New Hampshire; whereas in Wyoming, the numbers for Medicaid and Cigna were almost equal.
CONCLUSIONS: The significant Medicaid-Cigna acceptance rate disparities should be corrected to ensure higher healthcare access.

The genus Rhamphempisgen. nov. (Diptera: Empididae: Empidinae: Empidini) is described and includes the following five new species from French Guiana and the USA: Rhamphempis concavasp. nov. (France: French Guiana, Roura); R. distinctasp. nov. (France: French Guiana, Roura); R. mirificasp. nov. (France: French Guiana, Régina); R. montreuilisp. nov. (Type species, France: French Guiana, Mitaraka, Roura, St-Georges-de-l\'Oyapock); and R. septentrionalissp. nov. (USA: Maryland, College Park). The genus differs from other empidine genera by the following combination of characters: scape and postpedicel lengthened, proboscis long, strongly sclerotised with labella as long as prementum bearing annulations, wing with R2+3 somewhat shortened, more or less recurved at pterostigma, R4+5 unforked, base of abdomen yellowish in male, brownish to blackish in female, male pregenital segments strongly modified and postabdomen more or less downcurved, presence of large surstylus, very fine and long phallus. The genus is fully illustrated and keyed along with a discussion of its peculiar disjunct geographic distribution and its phylogenetic relationship within the tribe Empidini.

BACKGROUND: Neuromuscular blockade (NMB) agents are a critical component of balanced anesthesia. NMB reversal methods can include spontaneous reversal, sugammadex, or neostigmine and the choice of reversal strategy can depend on various factors. Unanticipated changes to clinical practice emerged due to the COVID-19 pandemic, and a better understanding of how NMB reversal trends were affected by the pandemic may help provide insight into how providers view the tradeoffs in the choice of NMB reversal agents.
OBJECTIVE: We aim to analyze NMB reversal agent use patterns for US adult inpatient surgeries before and after the COVID-19 outbreak to determine whether pandemic-related practice changes affected use trends.
METHODS: A retrospective longitudinal analysis of a large all-payer national electronic US health care database (PINC AI Healthcare Database) was conducted to identify the use patterns of NMB reversal during early, middle, and late COVID-19 (EC, MC, and LC, respectively) time periods. Factors associated with NMB reversal choices in inpatient surgeries were assessed before and after the COVID-19 pandemic reached the United States. Multivariate logistic regression assessed the impact of the pandemic on NMB reversal, accounting for patient, clinical, procedural, and site characteristics. A counterfactual framework was used to understand if patient characteristics affected how COVID-19-era patients would have been treated before the pandemic.
RESULTS: More than 3.2 million inpatients experiencing over 3.6 million surgical procedures across 931 sites that met all inclusion criteria were identified between March 1, 2017, and December 31, 2021. NMB reversal trends showed a steady increase in reversal with sugammadex over time, with the trend from January 2018 onwards being linear with time (R2>0.99). Multivariate analysis showed that the post-COVID-19 time periods had a small but statistically significant effect on the trend, as measured by the interaction terms of the COVID-19 time periods and the time trend in NMB reversal. A slight increase in the likelihood of sugammadex reversal was observed during EC relative to the pre-COVID-19 trend (odds ratio [OR] 1.008, 95% CI 1.003-1.014; P=.003), followed by negation of that increase during MC (OR 0.992, 95% CI 0.987-0.997; P<.001), and no significant interaction identified during LC (OR 1.001, 95% CI 0.996-1.005; P=.81). Conversely, active reversal (using either sugammadex or neostigmine) did not show a significant association relative to spontaneous reversal, or a change in trend, during EC or MC (P>.05), though a slight decrease in the active reversal trend was observed during LC (OR 0.987, 95% CI 0.983-0.992; P<.001).
CONCLUSIONS: We observed a steady increase in NMB active reversal overall, and specifically with sugammadex compared to neostigmine, during periods before and after the COVID-19 outbreak. Small, transitory alterations in the NMB reversal trends were observed during the height of the COVID-19 pandemic, though these alterations were independent of the underlying NMB reversal time trends.

UNASSIGNED: To describe and compare the research and development (R&D) pipeline of cancer new drugs and newly approved drugs in China and the USA in 2020, thus to provide decision-making evidence for related stakeholders.
UNASSIGNED: Clinical trials and tested cancer new drugs information in China and the USA were respectively acquired from Information Disclosure Platform for Drug Clinical Studies and Trialtrove database. Drug approval was tracked from the official release. Subgroup comparison in terms of initiated trials and drugs were conducted between the two countries.
UNASSIGNED: In 2020, 577 trials on 335 cancer new drugs were registered in China, accounting for 22.6% of all clinical drug trials, while in the USA, 916 trials on 678 cancer new drug trials were captured, accounting for 19.9% of the total. Relatively, a lower proportion of earlier phase (76.9% vs 87.4%), global (17.7% vs 39.0%), and top 20 pharmaceutics contribution (15.8% vs 43.2%) were found for cancer drug trials initiated in China. The fight against solid tumor took top billing in both countries, and the different distribution of cancer indications associated with cancer spectrum was also observed. Compared with the USA, more targeted agents (87.5% vs 77.0%, P < 0.001) and less immune agents (30.7% vs 41.6%, P < 0.001) were tested in China. In addition, 16 and 18 anticancer new drugs were approved in China and the USA, with 6 (37.5%) and 17 (94.4%) drugs being firstly approved worldwide, respectively. Among them, 32 drugs were granted by at least one expedited program, and 31 drugs were approved based on evidence from surrogate endpoints. A total of 17 cancer types were covered, and only one drug was targeted on digestive cancers, including gastric, liver, and esophageal cancers.
UNASSIGNED: R&D of anticancer new drugs is substantial, and great progress has been made in both China and the USA in 2020. The difference and gap between China and the USA highlight that more efforts should be paid to anticancer drug R&D on innovative agents and cancers unique to Chinese populations, as well as to facilitate global synchronous R&D in China.

UNASSIGNED: The stage at diagnosis is a major factor in making treatment strategies and cancer control policies. However, the stage distribution for liver cancer in China was not well studied. In this multi-center hospital-based study, we aimed to identify the distribution and factors associated with stage at diagnosis for liver cancer in China.
UNASSIGNED: We included patients diagnosed with primary liver cancer in 13 hospitals of 10 provinces covering various geographic and socioeconomic populations during 2016-2017 in China. The stage distribution overall, and by sex and age at diagnosis were analyzed. We used logistic regression to identify the factors associated with stage III-IV disease. We further compared these estimates with data from the USA.
UNASSIGNED: We included 2,991 patients with known stage at diagnosis in China. The proportion of patients diagnosed with stage I, II, III, and IV was 17.5%, 25.6%, 29.3%, and 27.6%, respectively. The proportion of stage III-IV cases was higher in women [65.1% vs 54.9%, adjusted odds ratio (OR) = 1.5, 95% CI: 1.2, 1.8] and those ≥ 60 years (61.6% vs 52.8%, OR = 1.4, 95% CI: 1.2, 1.6). We found an increased risk of stage III-IV among drinkers and those without a family history of cancer. Compared to the USA, our study population had a substantially higher proportion of stage III-IV cases (56.9% vs 45.6%).
UNASSIGNED: The disparities in liver cancer stage at diagnosis among different populations within China, and between China and the USA, imply the necessity for improving cancer awareness and early detection for liver cancer in China.

HPV is the most prevalent sexually transmitted infection in the U.S., with more than 80% of all Americans contracting it by age 45. Effective vaccines for HPV exist and were recently approved for adults aged 27-45 years, though uptake remains low in all age groups, particularly in Tennessee where 1089 cancers were attributed to HPV in 2020. Between 29 June and 17 August 2023, we conducted a cross-sectional survey to gain insights about the barriers and facilitators of HPV in 2011 adults aged 18 to 45 years in Tennessee. We developed our survey based on previous instruments to understand predictors of HPV vaccination in adults. Using descriptive statistics and bivariate and logistic regression analyses, we found higher vaccination rates in females, participants aged 18-38 years, participants with a high school education or higher, Hispanic or Latine individuals, and participants identifying as moderate or liberal. These insights highlight the need for public health interventions that consider demographic differences to successfully increase vaccination rates and reduce HPV-associated cancer risk.

Background and aims Knowledge about the impact of race on non-variceal upper GI bleeding (NVUGIB) is limited. This study explored the racial differences in the etiology and outcome of NVUGIB. Methods We conducted a study from 2009 to 2014 using the Nationwide Inpatient Sample (NIS) database. NIS is the largest publicly available all-payer inpatient database in the USA with more than seven million hospital stays each year. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for NVUGIB, esophagogastroduodenoscopy (EGD) and demographics were obtained. The outcomes of interest were in-hospital mortality, hospital length of stay (HLOS), total hospital charges, admission to the intensive care unit (ICU), and patient disposition. Analysis was conducted using Chi-square tests and Tukey multiple comparisons between groups. Results Among 1,082,516 patients with NVUGIB, African American and Native Americans had the highest proportions of hemorrhagic gastritis/duodenitis (8.2% and 4.2%, respectively) and Mallory-Weiss bleeding (10.4% and 5.4%, respectively; p<0.01). African Americans were less likely to get an EGD done within 24 hours of admission compared to Whites and Latinxs (45.9% vs 50.1% and 50.4%, respectively; p<0.001). In-hospital mortality was similar among African Americans, Latinxs, and Whites (5.8% vs 5.6% vs 5.9%, respectively; p=0.175). Asian/Pacific Islanders and African Americans were more likely to be admitted to the ICU (9.6% and 9.0%, respectively; p<0.001). Moreover, African Americans had a longer HLOS compared to Latinxs and Whites (7.5 vs 6.5 and 6.4 days, respectively; p<0.001). Conversely, Asian/Pacific Islanders and Latinx incurred the highest hospital total charges compared to African Americans and Whites ($81,821 and $69,267 vs $61,484 and $53,767, respectively; p<0.001). Conclusion African Americans are less likely to receive EGD within 24 hours of admission and are more likely to be admitted to the ICU with prolonged hospital lengths of stay. Latinxs are more likely to be uninsured and incur the highest hospital costs.