The Bronx Defenders

The South Bronx in New York City is an economically disempowered community that is overburdened by environmental injustice, including traffic-related air pollution. Through a partnership between South Bronx Unite, a local nonprofit organization 1 , the Laboratory School of Finance and Technology (X223), and Columbia University, a STEM initiative was launched. Together the team developed a curriculum in which high school students used the Arduino open electronics platform to build air monitors. The students then engaged in grass-roots efforts to launch the installation of the monitors to create a locally managed air monitoring network in the South Bronx. Here we describe the development of a curriculum as an educational air monitoring tool and explore the increased capacity of youth to address environmental health concerns.

Introduction: In low- and middle-income countries (LMICs), Pediatric Critical Care Medicine (PCCM) training often lacks structured skill-based education. Airway management errors can result in significant morbidity. We hypothesized that a structured simulation bootcamp could enhance knowledge, confidence, and behavioral skills in pediatric trainees. Methods: We conducted a 1-day hybrid simulation bootcamp at Aga Khan University in collaboration with PediSTARS India. Eighteen participants (4 fellows, 8 residents, 6 nurses) completed four high-fidelity airway simulations, including intubation, tracheostomy dislodgment, upper airway obstruction, and mediastinal mass. Faculty underwent two months of training. Pre- and post-bootcamp assessments measured knowledge, confidence, and satisfaction. Evaluation followed Kirkpatrick’s levels 1–3: reaction, learning, and behavior. Results: Participants’ knowledge scores increased by 45% (pre: 30.2%, post: 75.2%, p<.001). Confidence scores improved by 38%. The most reported skills gained were bag-mask ventilation, endotracheal intubation, and rapid sequence intubation. Satisfaction and confidence ratings were 4.8 and 4.6 out of 5, respectively. Behavioral improvements included faster equipment preparation and oxygen delivery. Eighty-one percent valued Crisis Resource Management, and 94% cited improved teamwork and communication. Conclusions: The first hybrid PCCM simulation bootcamp in Pakistan led to significant gains in knowledge, confidence, and team behavior. The Kirkpatrick model proved useful in evaluating outcomes. Our findings support the feasibility and effectiveness of simulation-based training in LMICs and encourage further adoption and longitudinal assessment.

The XIST RNA is known for its critical roles in X Chromosome inactivation (XCI). It is thought to be expressed exclusively from one copy of the X Chromosome and silence it by recruiting various chromatin factors in female cells. In this study, we find XIST expression in male peripheral glia after integrated analyses of single-cell RNA-seq data from multiple human tissues and organs. Single-cell epigenomic data further indicate that the expression is likely driven by an alternative promoter at the end of the first exon, resulting in at least one shorter transcript (referred to as sXIST) that is active in Schwann cells and, moreover, at a higher level in nonmyelinating Schwann cells. This promoter exhibits similar activity in female glia. Multiple lines of evidence from bulk transcriptomic and epigenomic data from peripheral nerve tissues further support these findings. Genes coexpressed positively and strongly with sXIST in male glia show functional enrichment in axon assembly and cilia signaling, with many of them sharing putative miRNA binding sites with sXIST, whereas the negatively correlated genes are enriched for processes important for neuromuscular junctions. This suggests possible functions of sXIST in modulating glia–neuron interactions, perhaps via competitive miRNA binding. This idea is also supported by overexpression analysis of a partial sXIST sequence and the finding of significant XIST expression changes in human cardiomyopathy and polyneuropathy. In summary, the current study suggests a novel, non-XCI role of XIST in peripheral Schwann cells that is mediated by a newly recognized transcript.

Abstract The Veterans Health Administration’s (VHA) commitment to veteran-centered care prioritizes the unique needs of veterans, offering Home Health Aid (HHA) services purchased from community providers essential for those, especially, with higher needs. Trust in the patient-provider relationship, recognition of veteran autonomy, and respect for veterans’ care choices are crucial for HHA service uptake and engagement in care. To better understand how veteran-centered approaches affect use of HHA, our team conducted 60 semi-structured interviews with VA primary care providers (MD, RN, NP, Social Workers) and home health agency staff at 5 geographically diverse sites (15-20/site). Interviews were recorded, transcribed, and analyzed using inductive thematic analysis. Findings across these 5 sites highlighted how trust and autonomy impacts multiple touch points of care when connecting veterans to HHA, including 1) initial assessment (ex. encouraging disclosure of ADL needs) 2) referral and acceptance of services (ex. veterans’ preferences for care and their concern for the loss of independence) 3) ongoing engagement with services (ex. veterans’ voicing concerns about care quality). Additionally, VHA and agencies’ strategies to build trust, such as providing information and education about available HHA services, involving family and caregivers in discussions and care, and fostering collaborative care were identified as key factors that directly influence informed clinical decision-making. Building trust at every stage of the HHA service process requires coordinated efforts across both VHA and contracted agencies, ensuring that veterans, providers, and caregivers establish strong relationships and work together to ensure high-quality care.

Gingival recession is characterized by exposure of the tooth root owing to displacement of the gingival margin. Although commonly managed by dentists and periodontists, recognition of gingival recession could be expanded to other specialists, including dermatologists. Dermatologists are important because gingival health can be negatively impacted in several dermatologic diseases, such as pemphigus vulgaris and oral lichen planus. This review aims to expand the understanding of treatment options for gingival recession, highlighting their relevance not only to dentists and periodontists, but also to dermatologists, who are uniquely positioned to contribute to multidisciplinary care. This review focuses on non-surgical treatment options, as these are most relevant to dermatologists. Non-surgical management largely involves addressing the underlying etiology, treating symptoms, and improving aesthetics. Dermatologists may contribute to multidisciplinary care by educating patients on aspects of non-surgical management, including improving oral hygiene and treating hypersensitivity.

Introduction and Objective: Hispanic men have a relatively high prevalence of diabetes but relatively low rates of enrollment and engagement in preventive interventions like the NDPP. This qualitative study aimed to comprehensively explore influences unique to Hispanic men with low engagement in the NDPP, compared to those with high engagement, with the goal of informing strategies to improve their engagement in the program. Methods: Participants were self-identified Hispanic men, aged ≥18 years, at risk for diabetes per electronic medical records at an urban outpatient network, and invited to the NDPP. They completed individual audio-recorded interviews in English and Spanish. Using Nvivo, transcripts were analyzed deductively, informed by the Theoretical Domains Framework, to identify influences on engagement in the NDPP. Codes emerging uniquely among those with low engagement (attendance at &amp;lt;4 NDPP sessions) were identified through consensus. Results: Of 32 Hispanic men interviewed, 15 had low engagement in the NDPP. More of those with low engagement had limited English proficiency and did not complete high school. Three major themes delineated their Capacity, Motivations, and Opportunities for engaging with the NDPP. They expressed limited awareness of their prediabetes diagnosis, felt self-sufficient about enacting lifestyle change, and were skeptical about their diabetes risk and the utility of the NDPP. They also mentioned financial barriers and limited access to the program. Conclusion: Addressing the unique barriers faced by Hispanic men in engaging with the NDPP is critical to reducing diabetes-related inequities and may require tackling knowledge gaps, financial barriers, and perceptions of program relevance before, during, and after enrollment. Future research should explore how to tailor recruitment strategies and program content to Hispanic men’s specific identities, motivations, and challenges. Disclosure C.J. Gonzalez: None. C.N. Perez-Mejia: None. N. Hernandez: None. H. Flaxman: None. C. Stephenson-Hunter: None. E.N. Gil: None. T. Formagini: None. E. Chambers: None. J.S. Gonzalez: None. Funding Robert Wood Johnson Foundation (234326-01); UCSF Research in Implementation Science for Equity Subaward (R25HL126146 Subaward No 13969sc); National Heart, Lung, and Blood Institute (T32HL079891); National Institute of Diabetes and Digestive and Kidney Diseases (3R01DK121896); National Institute of Diabetes and Digestive and Kidney Diseases (3P30DK111022)

Introduction and Objective: Continuous glucose monitoring (CGM) improves outcomes but is rarely used in community health centers (CHCs). This study aimed to assess CGM use in CHCs in the context of in-person and remote (e.g., telehealth) delivery. Methods: Participants with T2DM were recruited from two Midwest-based CHC systems that care for underserved communities. CGM users and non-users completed a survey and virtual semi-structured interviews with a trained facilitator. Interviews were recorded and transcribed, and themes were identified among CGM non-users and non-users. Results: Twenty-five participants (18 CGM users, 7 non-users, age 48 +13 yrs) were diverse in racial and gender identity (15 black, 6 white, 4 other, 15 female, 8 male, 1 non-binary, 1 transgender) with primarily public insurance (22 Medicare/Medicaid) and 14 unemployed and/or disabled. They reported using internet and cellphones for health information (88%), had apps on phone (88%), and described varying social needs related to transportation (n=14), food (n=10), and housing (n=3). Most utilized EHR portals (n=17), but fewer (n=12) used telemedicine. For CGM non-users, barriers included insurance coverage and lack of device-specific knowledge. CGM users weighed a variety of factors (e.g., reduced need for fingerstick, pain) before deciding; concerns also stemmed from lack of information or prior experience with CGM. Both users and non-users believed that CGM is helpful for diabetes care. Both groups reported learning about CGM outside the clinic through channels such as social media, including specifically YouTube. Conclusion: Advancements in information sharing and health education, along with understanding of social networks, are needed to improve uptake and utilization of CGM among patients with T2DM at CHCs. Disclosure M.E. Wolter: None. E.L. Lam: None. A.S. Boutsicaris: None. J. Gacki-Smith: None. S.E. DeLacey: None. A. Pack: Consultant; Gilead Sciences, Inc. S. Agarwal: Research Support; Dexcom, Inc. A. Berry: None. M.J. O'Brien: None. A. Wallia: Research Support; UnitedHealth Group. Funding NIH NIDDK (5 P30DK020541-4751) and the Chicago Center for Diabetes Translation Research (P30 DK092949)