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COVID Watch is a remote patient monitoring program implemented during the pandemic to support home dwelling patients with COVID-19. The program conferred a large survival advantage. We conducted semi-structured interviews of 85 patients and clinicians using COVID Watch to understand how to design such programs even better. Patients and clinicians found COVID Watch to be comforting and beneficial, but both groups desired more clarity about the purpose and timing of enrollment and alternatives to text-messages to adapt to patients’ preferences as these may have limited engagement and enrollment among marginalized patient populations. Because inclusiveness and equity are important elements of programmatic success, future programs will need flexible and multi-channel human-to-human communication pathways for complex clinical interactions or patients who do not desire tech-first approaches.

Although a history of incarceration is associated with poor long-term health status, the experience of seeking health care access during reentry is complex. Semistructured open-ended interviews were conducted among individuals with a recent history of incarceration (

ImportanceEmergency department (ED)–based initiation of buprenorphine has been shown to increase engagement in outpatient treatment and reduce the risk of subsequent opioid overdose; however, rates of buprenorphine treatment in the ED and follow-up care for opioid use disorder (OUD) remain low in the US. The Opioid Hospital Quality Improvement Program (O-HQIP), a statewide financial incentive program designed to increase engagement in OUD treatment for Medicaid-enrolled patients who have ED encounters, has the potential to increase ED-initiated buprenorphine treatment.ObjectiveTo evaluate the association between hospitals attesting to an ED buprenorphine treatment O-HQIP pathway and patients’ subsequent initiation of buprenorphine treatment.Design, Setting, and ParticipantsThis cohort study included Pennsylvania patients aged 18 to 64 years with continuous Medicaid enrollment 6 months before their OUD ED encounter and at least 30 days after discharge between January 1, 2016, and December 31, 2020. Patients with a claim for medication for OUD 6 months before their index encounter were excluded.ExposuresHospital implementation of an ED buprenorphine treatment O-HQIP pathway.Main Outcomes and MeasuresThe main outcome was patients’ receipt of buprenorphine within 30 days of their index OUD ED visit. Between August 2021 and January 2023, data were analyzed using a difference-in-differences method to evaluate the association between hospitals’ O-HQIP attestation status and patients’ treatment with buprenorphine after ED discharge.ResultsThe analysis included 17 428 Medicaid-enrolled patients (female, 43.4%; male, 56.6%; mean [SD] age, 37.4 [10.8] years; Black, 17.5%; Hispanic, 7.9%; White, 71.6%; other race or ethnicity, 3.0%) with OUD seen at O-HQIP–attesting or non–O-HQIP–attesting hospital EDs. The rate of prescription fills for buprenorphine within 30 days of an OUD ED discharge in the O-HQIP attestation hospitals before the O-HQIP intervention was 5%. The O-HQIP attestation was associated with a statistically significant increase (2.6 percentage points) in prescription fills for buprenorphine within 30 days of an OUD ED discharge (β, 0.026; 95% CI, 0.005-0.047).Conclusions and RelevanceIn this cohort study, the O-HQIP was associated with an increased initiation of buprenorphine in patients with OUD presenting to the ED. These findings suggest that statewide incentive programs may effectively improve outcomes for patients with OUD.

Porphyry deposits are an important source of copper and their value may be upgraded by minor contents of precious metals, if they are extractable. The mechanisms for enrichment of precious and base metals in these systems are not well understood. This study investigates the deportment of trace metals in the Ann-Mason porphyry deposit, including gold, silver, palladium, mercury, lead and bismuth. Petrographic and geochemical data are integrated to characterise the size and habit of minerals, the host mineral assemblages, and their association with alteration assemblages. Ann-Mason is one of several ore deposits hosted by the Yerington batholith in Nevada, and is being assessed for copper extraction from bornite and chalcopyrite ore assemblages, associated with potassic alteration. Mineralisation assemblages at Ann-Mason have been categorised as chalcopyrite-bornite, chalcopyrite-pyrite and pyrite > chalcopyrite zones. Limited two-metre assay data indicates that gold is most closely associated with bornite, although it is found in all three mineralisation zones. Analysis by SEM-EDS shows that trace elements are mostly present as microparticles hosted by sulfide minerals. Of the 438 grains measured, 89% are hosted by a sulfide mineral, with 68% hosted by bornite. Silver is most commonly present as hessite and gold as electrum, hosted by bornite and associated with potassic alteration. Palladium, mercury and bismuth are most commonly observed as telluride and selenide minerals. Palladium minerals are associated with potassic alteration, while mercury and bismuth minerals are mostly found with sericitic alteration. High fineness native gold is observed as three round blebs hosted by pyrite or silicates. Observations suggest that the trace metals in the chalcopyrite-bornite zone may have been incorporated by bornite and chalcopyrite, and exsolved upon cooling. In the chalcopyrite-pyrite and pyrite > chalcopyrite zones, the trace metals may have been deposited directly from a mineralising hydrothermal fluid and incorporated into the growing sulphide minerals. These findings have implications for the paragenesis of porphyry deposits, as well as for the milling processes that would be needed to extract precious metals at the Ann-Mason porphyry deposit.