The purpose of this study was to document the development of a Community Advisory Board (CAB) to enhance equitable dissemination of research findings within an implementation mapping study to enhance equitable impact of Universal School Meals (USM) through the Designing for Dissemination and Sustainability (D4DS) process.

The D4DS process comprises 7 key elements to facilitate meaningful dissemination. To accomplish Step 1: Identify Partners, the research team conducted snowball recruitment methods within the local Philadelphia community and with existing connections. To Empathize and Outline the Problem (Step 2) and Understand the Context (Step 3), an interest meeting was held followed by monthly meetings. Our team Confirmed and Co-designed the Product (Step 4) and Developed the Dissemination Plan (Step 5) through collaborative brainstorming sessions. Finally, we started the Iterative Evaluation (Step 6) and Plan for Sustainability (Step 7) by administering a baseline and follow-up survey measuring CAB members’ perceived utility, effectiveness, and sustainability of the board.

The final CAB included 8 members. The co-created dissemination products and plan comprised a 2-page infographic, social media toolkits, and a webinar slide deck, which were disseminated locally by the research team via presentations, websites, and email communication, in spring 2024. Initial findings from baseline and follow-up surveys indicated that CAB members benefited from skill development, compensation, writing credit, and autonomy in dissemination designing.

Sharing power and decision-making enhanced the capacity for local-level dissemination, which is much needed to advance the science of community partnerships.

To analyze the impact of a fully remote tele-antimicrobial stewardship program (TASP) at two small community hospitals in partnership with an academic medical center.

Retrospective survey from August 1, 2020, to July 31, 2022.

A TASP, co-led by an infectious diseases (ID) physician and ID pharmacist, was implemented at M Health Fairview (MHF) Northland, a 21-bed hospital, and at MHF Lakes, a 49-bed hospital. The ID physician and ID pharmacist are located at the University of Minnesota Medical Center.

Antimicrobial stewardship interventions were tracked monthly. Restricted antimicrobial days of therapy per 1000 patient days (DOT/1000 PD) were also tracked monthly and two years pre and postimplementation data were compared. All annual antimicrobial expenditures were followed.

For the first two TASP years, a total of 789 antimicrobial interventions were made with 85.6% being accepted. Restricted antimicrobial use trended down from 142.93 to 113.97 DOT/1000 PD at MHF Northland. A smaller decrease from 106.31 to 103.12 DOT/1000 PD was seen at MHF Lakes. Annual antimicrobial costs per total patient days decreased. MHF Northland hospital’s annual antimicrobial expenditures per total patient days fell from $18.89 in 2019 (preimplementation) to $6.64. MHF Lakes followed a similar trend, decreasing from $11.20 to $5.36.

A fully remote TASP in partnership with an academic medical center for two small community hospitals resulted in high rates of accepted interventions sustained over two years. Restricted antimicrobial use and antimicrobial costs trended down.

Leveraging the National COVID-19 Cohort Collaborative (N3C), a nationally sampled electronic health records repository, we explored associations between individual-level social determinants of health (SDoH) and COVID-19-related hospitalizations among racialized minority people with human immunodeficiency virus (HIV) (PWH), who have been historically adversely affected by SDoH.

We retrospectively studied PWH and people without HIV (PWoH) using N3C data from January 2020 to November 2023. We evaluated SDoH variables across three domains in the Healthy People 2030 framework: (1) healthcare access, (2) economic stability, and (3) social cohesion with our primary outcome, COVID-19-related hospitalization. We conducted hierarchically nested additive and adjusted mixed-effects logistic regression models, stratifying by HIV status and race/ethnicity groups, accounting for age, sex, comorbidities, and data partners.

Our analytic sample included 280,441 individuals from 24 data partner sites, where 3,291 (1.17%) were PWH, with racialized minority PWH having higher proportions of adverse SDoH exposures than racialized minority PWoH. COVID-19-related hospitalizations occurred in 11.23% of all individuals (9.17% among PWH, 11.26% among PWoH). In our initial additive modeling, we observed that all three SDoH domains were significantly associated with hospitalizations, even with progressive adjustments (adjusted odds ratios [aOR] range 1.36–1.97). Subsequently, our HIV-stratified analyses indicated economic instability was associated with hospitalization in both PWH and PWoH (aOR range 1.35–1.48). Lastly, our fully adjusted, race/ethnicity-stratified analysis, indicated access to healthcare issues was associated with hospitalization across various racialized groups (aOR range 1.36–2.00).

Our study underscores the importance of assessing individual-level SDoH variables to unravel the complex interplay of these factors for racialized minority groups.

To determine whether poorer performance on the Boston Naming Test (BNT) in individuals with transactive response DNA-binding protein 43 pathology (TDP-43+) is due to greater loss of word knowledge compared to retrieval-based deficits.

Retrospective clinical-pathologic study of 282 participants with Alzheimer’s disease neuropathologic changes (ADNC) and known TDP-43 status. We evaluated item-level performance on the 60-item BNT for first and last available assessment. We fit cross-sectional negative binomial count models that assessed total number of incorrect items, number correct of responses with phonemic cue (reflecting retrieval difficulties), and number of “I don’t know” (IDK) responses (suggestive of loss of word knowledge) at both assessments. Models included TDP-43 status and adjusted for sex, age, education, years from test to death, and ADNC severity. Models that evaluated the last assessment adjusted for number of prior BNT exposures.

43% were TDP-43+. The TDP-43+ group had worse performance on BNT total score at first (p = .01) and last assessments (p = .01). At first assessment, TDP-43+ individuals had an estimated 29% (CI: 7%–56%) higher mean number of incorrect items after adjusting for covariates, and a 51% (CI: 15%–98%) higher number of IDK responses compared to TDP-43−. At last assessment, compared to TDP-43−, the TDP-43+ group on average missed 31% (CI: 6%–62%; p = .01) more items and had 33% more IDK responses (CI: 1% fewer to 78% more; p = .06).

An important component of poorer performance on the BNT in participants who are TDP-43+ is having loss of word knowledge versus retrieval difficulties.

Loss of control eating is more likely to occur in the evening and is uniquely associated with distress. No studies have examined the effect of treatment on within-day timing of loss of control eating severity. We examined whether time of day differentially predicted loss of control eating severity at baseline (i.e. pretreatment), end-of-treatment, and 6-month follow-up for individuals with binge-eating disorder (BED), hypothesizing that loss of control eating severity would increase throughout the day pretreatment and that this pattern would be less pronounced following treatment. We explored differential treatment effects of cognitive-behavioral guided self-help (CBTgsh) and Integrative Cognitive-Affective Therapy (ICAT).

Individuals with BED (N = 112) were randomized to receive CBTgsh or ICAT and completed a 1-week ecological momentary assessment protocol at baseline, end-of-treatment, and 6-month follow-up to assess loss of control eating severity. We used multilevel models to assess within-day slope trajectories of loss of control eating severity across assessment periods and treatment type.

Within-day increases in loss of control eating severity were reduced at end-of-treatment and 6-month follow-up relative to baseline. Evening acceleration of loss of control eating severity was greater at 6-month follow-up relative to end-of-treatment. Within-day increases in loss of control severity did not differ between treatments at end-of-treatment; however, evening loss of control severity intensified for individuals who received CBTgsh relative to those who received ICAT at 6-month follow-up.

Findings suggest that treatment reduces evening-shifted loss of control eating severity, and that this effect may be more durable following ICAT relative to CBTgsh.

Cognitive impairment in Parkinson's disease (CIPD) is present in approximately 40% of patients. Language deficits, evidenced by poor word- retrieval, have historically characterized memory weaknesses in PD. That is, the "retrieval deficit hypothesis," suggests successful memory encoding, but poor retrieval subsequent to language and executive dysfunction, another prominent area of CIPD. However, recent studies suggest that memory impairments in PD are instead at the level of learning. At present, several suggested etiologies to explain learning impairments in PD exist that are not related to language, for example that processing speed deficits (another characteristic of CIPD) impact learning; however, other studies present evidence against this theory. Therefore, we hypothesize that deficits in language continue to be a primary component of memory impairment in PD, but at the level of learning rather than retrieval

85 adults (age M = 61.54, SD = 10.00; %female = 26.7; Dementia Rating Scale M = 137.77, SD = 5.63) diagnosed with Parkinson's disease according to the UK Brain Bank criteria for idiopathic PD, completed a neuropsychological test battery when "off" levodopa medication. The battery included the Boston Naming Test (BNT), verbal fluency tests (Controlled Oral Word Association [COWA] and category fluency), the California Verbal Learning Test, 2nd Edition (CVLT-II), and the Oral Symbol Digit Modalities Test (SDMT). Separate linear regression models were used to examine BNT, COWA, category fluency, and SDMT performance as predictors of total learning (sum of trials 1-5), short-delay free recall, long-delay free recall, and recognition discriminability on the CVLT-II. Analyses were adjusted for age, sex, education, and disease severity (MDS-Unified Parkinson's Disease Rating Scale, part 3 score). Follow up analyses adjusted for processing speed (oral SDMT).

Adjusted linear regression models revealed that both verbal fluencies predicted verbal learning (letter: ß = .37, p < .01; category: ß = .45, p < .01), long-delay free recall (letter: ß = .25, p = .05; category: ß = .34, p = .01), and recognition discriminability (letter: ß = .36, p = .02; category: ß =.33, p = .03) on the CVLT-II. Confrontation naming significantly predicted only long-delay free recall (ß =.31, p = .01). Processing speed predicted verbal learning (ß = .51, p < .01), short-delay free recall (ß = .35, p = .03), and long-delay free recall (ß = .44, p < .01). After adjusting for processing speed, letter fluency significantly predicted learning (ß = .23, p = .05) and discriminability (ß = .33, p = .04). Category fluency significantly predicted learning only (ß = .28, p = .04). Finally, confrontation naming significantly predicted only long-delay free recall (ß= .28, p = .01).

While processing speed was associated with verbal learning and recall, components of language predicted variance in verbal learning in PD that was not accounted for by speed. Additionally, discriminability was related to aspects of language that are more reliant on executive functioning. It is therefore suggested that verbal memory in PD is interpreted within the context of one's language ability. Other potential mechanisms and clinical implications are discussed.

Use of intensive longitudinal methods (e.g. ecological momentary assessment, passive sensing) and machine learning (ML) models to predict risk for depression and suicide has increased in recent years. However, these studies often vary considerably in length, ML methods used, and sources of data. The present study examined predictive accuracy for depression and suicidal ideation (SI) as a function of time, comparing different combinations of ML methods and data sources.

Participants were 2459 first-year training physicians (55.1% female; 52.5% White) who were provided with Fitbit wearable devices and assessed daily for mood. Linear [elastic net regression (ENR)] and non-linear (random forest) ML algorithms were used to predict depression and SI at the first-quarter follow-up assessment, using two sets of variables (daily mood features only, daily mood features + passive-sensing features). To assess accuracy over time, models were estimated iteratively for each of the first 92 days of internship, using data available up to that point in time.

ENRs using only the daily mood features generally had the best accuracy for predicting mental health outcomes, and predictive accuracy within 1 standard error of the full 92 day models was attained by weeks 7–8. Depression at 92 days could be predicted accurately (area under the curve >0.70) after only 14 days of data collection.

Simpler ML methods may outperform more complex methods until passive-sensing features become better specified. For intensive longitudinal studies, there may be limited predictive value in collecting data for more than 2 months.

Maternal depressive symptoms in pregnancy may affect offspring health through prenatal programming of the hypothalamic–pituitary–adrenal (HPA) axis. The biological mechanisms that explain the associations between maternal prenatal depressive symptoms and offspring HPA axis regulation are not yet clear. This pre-registered investigation examines whether patterns of maternal depressive symptoms in pregnancy are associated with infant cortisol reactivity and whether this association is mediated by changes in placental corticotropin-releasing hormone (pCRH).

A sample of 174 pregnant women completed assessments in early, mid, and late pregnancy that included standardized measures of depressive symptoms and blood samples for pCRH. Infant cortisol reactivity was assessed at 1 and 6 months of age.

Greater increases in maternal depressive symptoms in pregnancy were associated with higher cortisol infant cortisol reactivity at 1 and 6 months. Greater increases in maternal depressive symptoms in pregnancy were associated with greater increases in pCRH from early to late pregnancy which in turn were associated with higher infant cortisol reactivity.

Increases in maternal depressive symptoms and pCRH over pregnancy may contribute to higher infant cortisol reactivity. These findings help to elucidate the prenatal biopsychosocial processes contributing to offspring HPA axis regulation early in development.