Faculty Bibliography

BACKGROUND/UNASSIGNED:Effective management of alcohol withdrawal syndrome during hospitalization is paramount to patient safety and quality care. NYC Health + Hospitals initiated a quality improvement project to pilot an electronic health record (EHR) integrated, nurse-driven CIWA-Ar symptom-triggered protocol, including recommendations for medications for alcohol use disorder (MAUD), in medical and surgical units at 3 public hospitals. OBJECTIVE/UNASSIGNED:To describe implementation processes and to report related implementation outcomes (appropriateness, feasibility, and adoption) of the updated CIWA-Ar protocol in a safety net hospital setting. METHODS/UNASSIGNED:NYC Health + Hospitals implemented a standardized CIWA-Ar symptom-triggered, nurse-driven EHR protocol on March 15, 2022. The protocol included order sets, practice advisories, task lists, and reminders for assessments and orders. We measured nursing perspectives on feasibility and appropriateness at 6 months via a survey. We measured provider adoption as the proportion of admissions with a CIWA-Ar protocol ordered among admissions that triggered a recommendation, and MAUD use as the proportion of admissions with a MAUD order during hospitalization among all patients with a protocol ordered. RESULTS/UNASSIGNED:= .249). CONCLUSIONS/UNASSIGNED:The CIWA-Ar protocol was appropriate, feasible, and adopted at NYC public hospitals. Quality improvements to ensure protocol fidelity with benzodiazepine dosing and MAUD prescribing are needed.

BACKGROUND:Positive psychology well-being constructs like flourishing are important predictors of health and quality of life. However, few studies have examined the association between flourishing and psychological distress (i.e., depression and anxiety). We investigated the association between flourishing and psychological distress symptoms among higher education students. METHODS:We analyzed cross-sectional survey data from 60,386 students aged 18-34 in the United States (Healthy Minds Study 2022-2023). Flourishing was measured using the Flourishing Scale, while symptoms of depression and anxiety were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scales, respectively. Associations between flourishing and psychological distress were examined using multiple logistic regression models, adjusting for age, gender identity, race/ethnicity, financial stress, and self-reported mental health treatment. RESULTS:Of the 60,386 participants included the mean age was 21.7 (SD = 3.6). Most participants were female (68.3 %) and White (55.6 %). Among individuals with significant symptoms of depression or anxiety, 13.7 % and 17.7 % were classified as flourishing (Flourishing Scale ≥48), respectively. Participants with significant symptoms of depression (OR: 0.23; CI: 0.22-0.25) or anxiety (OR: 0.56; CI: 0.54-0.59) were less likely to be classified as flourishing than those without significant symptoms. CONCLUSION/CONCLUSIONS:Flourishing is possible within psychological distress. These results suggest the importance of assessing both positive psychological well-being and psychological distress to understand student mental health. While reducing symptoms of psychological distress is crucial, enhancing positive psychological well-being should also be prioritized as part of mental health treatment.

INTRODUCTION/UNASSIGNED:This study leverages advertising industry data to quantify social media advertising expenditures and advertising impressions of the food and beverage industry on Facebook, Twitter/X, and Instagram from January 2019 to August 2021. METHODS/UNASSIGNED:=18 months). Primary outcomes were monthly trends expenditures of food/beverage advertising and the number of views and expenditures of food/beverage advertising by platform (e.g., TV, online, mobile, print). Primary outcomes was measured by monthly expenditures by (1) social media company, (2) brand, and (3) before COVID-19 versus the first year of the pandemic. RESULTS/UNASSIGNED:for interaction<0.001). CONCLUSIONS/UNASSIGNED:These data reveal that the food/beverage industry spends at least $2.8 billion on social media advertising, which generate billions of views for their products online. Determining adults' exposure to social media food advertising is critical for understanding the upstream factors that shape the risk for diet-related diseases.

As a contingency standard of care, telemedicine use surged during the COVID-19 pandemic. The Medicare telehealth flexibilities introduced during the COVID-19 pandemic expired in September 2025. Any ongoing sustained pivot to telemedicine warrants purposeful attentiveness to ethical considerations and not just technology use as an end unto itself. Telemedicine has the potential to complement face-to-face care practices and enhance clinical interactions when its use is based on shared values. Values such as access, equity, justice, compassion, autonomy, and dignity warrant thoughtful use of telemedicine. Patients and families need to be able to trust that clinicians and health systems will place patient welfare and shared values above technical convenience. As demonstrated in this case description, upholding values fundamental to the practice of medicine in telemedicine can enhance patient connection and foster trustworthy post-pandemic practices.

INTRODUCTION/UNASSIGNED:Membranous nephropathy (MN) is a common cause of nephrotic syndrome usually diagnosed using kidney biopsy. METHODS/UNASSIGNED:= 132). RESULTS/UNASSIGNED:In BKBC, 2 proteins, testican-2 and alpha-1,6-mannosylglycoprotein 6-beta-N-acetylglucosaminyltransferase (MGT5A), were associated with MN when compared with the reference diagnosis (normal or thin basement membrane [TBM] disease) as well as when compared with all other diagnoses among individuals who had undergone kidney biopsy for the indication of proteinuria or nephrotic syndrome. In NEPTUNE, plasma levels of both proteins, as well as glomerular expression of their cognate genes, were increased in MN compared with minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS). In receiver operating characteristic curve analyses, the addition of plasma testican-2 and MGT5A levels significantly improved discrimination of MN from other diagnoses in BKBC and NEPTUNE compared with models incorporating age, sex, race, estimated glomerular filtration rate (eGFR), and proteinuria. CONCLUSION/UNASSIGNED:Together, these findings motivate interest in testican-2 and MGT5A as markers and potential functional participants in MN. More work is required to understand the biological role of these proteins in the glomerular basement membrane in relation to immune complex deposition as well as to assess their performance as biomarkers alongside circulating autoantibodies in patients with MN.

BACKGROUND/UNASSIGNED:Higher relative risk for cardiovascular disease (CVD) events at lower blood pressure (BP) thresholds in female versus male adults suggest that hypertension thresholds should be sex-specific. METHODS/UNASSIGNED:We used the ARIC study (Atherosclerosis Risk in Communities) visit 1 (1987-1989) to compare the BP distribution, estimated risk (via the 10-year Predicting Risk of Cardiovascular Disease Events score), absolute risk, and relative risk of CVD according to BP thresholds, stratified by sex and hypertension treatment status, in participants without prior CVD. RESULTS/UNASSIGNED:=0.93). CONCLUSIONS/UNASSIGNED:In this middle-aged population, there were no consistent differences in BP distribution, risk factor burden, absolute risk, or relative risk of CVD between male and female adults. These findings do not support a sex-specific threshold for hypertension.