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The rehabilitation of patient function and esthetics is essential from a social and psychological point of view. After a maxillary resection, the supporting structures that help provide retention or stability to a removable prosthesis are lacking. An effective, functional, straightforward, comfortable, and esthetic prosthetic rehabilitation of a patient with a resected maxilla using a digital workflow is presented. The rehabilitation was done using a computer-aided design and computer-aided manufactured bar and clip-supported overdenture prosthesis over quad zygomatic implants., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Introduction:  Interim restorations are essential in restorative dentistry, serving as temporary solutions until permanent restorations can be placed. Polymethyl methacrylate (PMMA) is a promising solution for customizing teeth for removable dentures to match the exact requirements of patients. The color stability of these restorations is critical for patient satisfaction. PMMA is a widely used material for interim restorations due to its favorable properties. The study compares the color stability of PMMA interim restorations polished using traditional pumice versus Algishine, a novel polishing agent derived from pulverized old alginate impressions., Materials and Methods:  The 3-D design software Geomagic Design X (3D Systems, Rock Hill, CA) created a standard tessellation language file of 2-cm radius circles. Sixty PMMA samples were milled and divided into two groups of 30 each. Group A samples were polished using pumice, while group B samples were polished with Algishine. Baseline color measurements were taken using a spectrophotometer (VITA Easyshade V, VITA Zahnfabrik, Bad Säckingen, Germany). The samples were then subjected to staining with coffee, tea, and red wine solutions for 30 days, simulating oral conditions. Post-staining color measurements were taken, and color changes (ΔE) were calculated at the seven-day (t1) and one-month (t2) mark. The Shapiro-Wilk test assessed normality, followed by a two-way ANOVA test to compare color change values at different time points., Results:  At t1 (seven days), there were no significant differences between groups A and B in the coffee and tea staining groups. However, significant differences were observed in red wine staining, with group B exhibiting lower ΔE values (0.14 ± 0.067) compared to group A (0.38 ± 0.076) (p < 0.01). At t2 (30 days), significant differences were noted in all staining groups. Group B consistently showed lower ΔE values: coffee (0.125 ± 0.084 vs. 0.236 ± 0.015, p < 0.01), tea (0.254 ± 0.087 vs. 0.391 ± 0.015, p < 0.01), and red wine (1.174 ± 0.045 vs. 1.309 ± 0.074, p < 0.01), indicating superior resistance to staining compared to group A., Discussion:  The results suggest that Algishine is more effective than pumice in maintaining the color stability of PMMA interim restorations. The novel polishing agent derived from old alginate impressions enhances esthetic longevity and provides an eco-friendly solution for recycling dental material waste., Conclusion:  Algishine performs superiorly in preserving the color of PMMA interim restorations against common staining agents. Its application can potentially improve patient satisfaction and contribute to sustainable dental practices., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Koppaka et al.)

Introduction Small compounds like L-leucine can boost bone regrowth by blocking certain effects, sparking cell reactions through signaling sequences. This research explored how combining L-leucine with hyaluronic acid on the developed novel graft material affects the bone's ability to conduct bone-building processes. Material and methods This study was designed as an in-vitro experiment, where a novel bone graft was formulated by integrating L-leucine with hyaluronic acid and incorporated into a hydroxyapatite-based ovine bone graft material. The sintering procedure was modified to include the amino acid L-arginine. Comprehensive examinations were executed using methodologies such as scanning electron microscopy, X-ray diffractometry, Fourier-transform infrared spectroscopy (FTIR), MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, and bone formation assay. These analyses were juxtaposed with the characteristics of the commercially accessible unaltered Bio-Oss, focusing on their physicochemical properties. The properties were compared with a commercially available bone graft material. Results The sintered hydroxyapatite/L-leucine graft displayed an interconnected pore structure, indicating that higher sintering and consolidation affected hydroxyapatite, as observed through scanning electron microscopy. X-ray diffraction (XRD) analysis confirmed hydroxyapatite in the sintered ovine bone samples, affirming their suitability for various biomedical applications. In the bone formation assay, optical density (OD) values were 61% for the hydroxyapatite/L-arginine graft, 58% for the Bio-Oss group, and 51% for the control group. The MTT assay, which assesses cell viability and metabolic activity, demonstrated biocompatibility and cell growth for all samples at 24 hours. Conclusion The research noted beneficial outcomes by incorporating L-leucine into the novel bone graft material with hyaluronic acid for bone grafting, demonstrating enhanced compatibility with existing bone tissue. However, the specific advantages of this combined approach are not fully known. It is essential to conduct more studies to uncover how this synergy works, assess its prolonged impacts, carry out clinical tests, and enhance the effectiveness of this blend for practical applications in bone graft surgeries., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: Scientific Review Board - (SRB/SDC/PROSTHO-20/22/TH-126) Samples were, however, obtained from the cortical hind limb femur goat bones collected from the local slaughterhouse located in Chennai, Tamil Nadu. Issued protocol number SRB/SDC/PROSTHO-20/22/TH-126. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Koppaka et al.)

Introduction Zygomatic implants (ZIs) have emerged as a promising option for rehabilitating completely edentulous patients with severe maxillary atrophy. These implants anchor into the zygomatic bone, bypassing the need for extensive grafting procedures. Success rates in dental and craniofacial implant surgeries can be influenced by several surgical factors, including suture techniques, flap design, and treatment planning. The research aimed to present the clinical outcomes and complications in individuals with severely resorbed maxillae who underwent prosthodontic rehabilitation using the Quad Zygoma Protocol (QZP) and the Anatomy-Guided Approach (AGA), focusing on long-term assessment. Material and methods Data for this retrospective study were extracted from the institution's patient database, involving a meticulous review of patient records. This comprehensive examination encompassed demographic data, preoperative assessments, details of surgical procedures, postoperative complications, and subsequent follow-up evaluations. Patients with severe maxillary bone deficiencies resulting in complete edentulism, due to inadequate bone quality and quantity in both anterior and posterior regions, were selected for inclusion. Exclusion criteria were applied to individuals with incomplete records or insufficient follow-up data, as well as those who underwent alternative treatment modalities or presented with comorbidities potentially impacting implant outcomes. The selected patients underwent treatment utilizing the QZP, with each participant subjected to a minimum three-year follow-up period. The implant survival rate, prosthetic success, complications, and Oral Health-Related Quality of Life using the OHIP-14 questionnaire were assessed. Results At the end of the follow-up period involving 12 patients (eight men, four women) with 43 ZIs - 37 from Neodent, four from Nobel Biocare, and two from Norris - with a mean duration of 4.3 years (range: 1.2-5.4), the overall success rate stood at 99.08%, with only 1 out of 42 implants failing. All patients received immediate loading with an acrylic prosthesis, proving effective in 98.2% of cases. The most common issues observed were localized soft tissue inflammation (35.7%) and sinus inflammation (12.5%), occurring after mean follow-up periods of 1.2 and 3.5 years, respectively. In 12 patients, the mean score of the OHIP-14 questionnaire was 1.6 ± 2.6, with a follow-up period of 5 ± 0.6 years. Conclusion The QZP has consistently demonstrated excellent long-term success in restoring severely reduced maxillary structures. An immediate loading approach could aid in stabilizing ZIs through cross-arch support., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Scientific Review Board of Saveetha Dental College issued approval SRB/SDC/PROSTHO-2103/23/143. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Koppaka et al.)

Introduction Surface roughness (Ra) significantly impacts the aesthetic and functional qualities of dental prosthetics. Traditional polishing involves pumice, a material routinely used in dental practice. This study introduces Algishine as a potential cost-effective eco-friendly alternative. Materials and methods A 3D design software (Geomagic) created a Standard Tesselation Language (STL) file of 10 mm x 10 mm x 2 mm. 30 STL file outputs were generated. The output was milled in wax. This was then flasked and processed. 30 acrylic resin specimens were fabricated and divided into two groups. Group A was polished using traditional pumice, and Group B was polished using Algishine. The Ra of each sample was measured using surface profilometry, with three readings per sample averaged for each group. Results Kruskal-Wallis test was performed to compare the two groups with the pre-testing samples, which showed p<0.05; indicating that there was a significant difference between the two groups. The average Ra value for unpolished acrylic was 7.105, while the specimens polished with pumice showed an Ra value of 2.218; specimens polished with novel material Algishine showed an Ra value of 1.743. This illustrates that Algishine achieves surface smoothness significantly superior to commonly used polishing agent and pumice. Discussion The results of our study demonstrate that Algishine, a novel polishing material derived from recycled alginate, effectively reduces the Ra of acrylic resin. This finding has significant implications, both clinically and environmentally. The primary clinical benefit of a smoother acrylic resin surface is the enhanced aesthetic appearance and increased patient comfort. A polished surface reduces plaque accumulation, thereby decreasing the risk of oral infections and improving the longevity of the dental prosthesis. The results show that Algishine achieves surface smoothness comparable to or better than pumice indicating that it can maintain, if not enhance, these clinical outcomes. Dental professionals can confidently use Algishine, knowing it meets the high standards required for patient care. Conclusion Algishine effectively reduces the Ra of acrylic resin, suggesting it is a viable, eco-friendly alternative to traditional pumice for dental polishing procedures. This indicates potential benefits in maintaining clinical outcomes while promoting environmental sustainability., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Koppaka et al.)

Vaccination disparities are part of a larger system of health inequities among racial and ethnic groups in the United States. To increase vaccine equity of racial and ethnic populations, the Centers for Disease Control and Prevention (CDC) designed the Partnering for Vaccine Equity program in January 2021, which funded and supported national, state, local, and community organizations in 50 states-which include Indian Health Service Tribal Areas; Washington, DC; and Puerto Rico-to implement culturally tailored activities to improve access to, availability of, and confidence in COVID-19 and influenza vaccines. To increase vaccine uptake at the local level, CDC partnered with national organizations such as the National Urban League and Asian & Pacific Islander American Health Forum to engage community-based organizations to take action. Lessons learned from the program include the importance of directly supporting and engaging with the community, providing tailored messages and access to vaccines to reach communities where they are, training messengers who are trusted by those in the community, and providing support to funded partners through trainings on program design and implementation that can be institutionalized and sustained beyond the COVID-19 pandemic. Building on these lessons will ensure CDC and other public health partners can continue to advance vaccine equity, increase vaccine uptake, improve health outcomes, and build trust with communities as part of a comprehensive adult immunization infrastructure., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Inequities in availability and access to adult vaccinations represent significant gaps in the US public health infrastructure. Adults in racial and ethnic minority groups are less likely to receive routinely recommended vaccinations due to systemic barriers, distribution inequities, and lack of trust in vaccines; similar disparities were seen during early COVID-19 vaccination efforts. However, a deliberate focus on reducing disparities can yield progress. National data show narrowing of racial and ethnic adult COVID-19 vaccination coverage disparities over time, highlighting the value of the equity-focused, community-level interventions implemented during the pandemic. This paper describes the Centers for Disease Control and Prevention's efforts during the COVID-19 pandemic to address racial and ethnic disparities in adult immunization, and how lessons learned may be applied post-pandemic. Progress made is likely to be lost without sustained support for adult vaccination at national, state, and community levels., Competing Interests: Conflicts of interest Please see ICMJE form(s) for author conflicts of interest. These have been provided as supplementary materials., (Published by Oxford University Press on behalf of Project HOPE - The People-To-People Health Foundation, Inc. 2023.)

Retinal ganglion cells (RGCs) are the sole output neurons conveying visual stimuli from the retina to the brain, and dysfunction or loss of RGCs is the primary determinant of visual loss in traumatic and degenerative ocular conditions. Currently, there is a lack of RGC-specific Cre mouse lines that serve as invaluable tools for manipulating genes in RGCs and studying the genetic basis of RGC diseases. The RNA-binding protein with multiple splicing (RBPMS) is identified as the specific marker of all RGCs. Here, we report the generation and characterization of a knock-in mouse line in which a P2A-CreER T2 coding sequence is fused in-frame to the C-terminus of endogenous RBPMS, allowing for the co-expression of RBPMS and CreER T2 . The inducible Rbpms -CreER T2 mice exhibited a high recombination efficiency in activating the expression of the tdTomato reporter gene in nearly all adult RGCs as well as in differentiated RGCs starting at E13.5. Additionally, both heterozygous and homozygous Rbpms -CreER T2 knock-in mice showed no detectable defect in the retinal structure, visual function, and transcriptome. Together, these results demonstrated that the Rbpms -CreER T2 knock-in mouse can serve as a powerful and highly desired genetic tool for lineage tracing, genetic manipulation, retinal physiology study, and ocular disease modeling in RGCs.

Some racial and ethnic minority groups have experienced disproportionately higher rates of COVID-19-related illness and mortality (1,2). Vaccination is highly effective in preventing severe COVID-19 illness and death (3), and equitable vaccination can reduce COVID-19-related disparities. CDC analyzed data from the National Immunization Survey Adult COVID Module (NIS-ACM), a random-digit-dialed cellular telephone survey of adults aged ≥18 years, to assess disparities in COVID-19 vaccination coverage by race and ethnicity among U.S. adults during December 2020-November 2021. Asian and non-Hispanic White (White) adults had the highest ≥1-dose COVID-19 vaccination coverage by the end of April 2021 (69.6% and 59.0%, respectively); ≥1-dose coverage was lower among Hispanic (47.3%), non-Hispanic Black or African American (Black) (46.3%), Native Hawaiian or other Pacific Islander (NH/OPI) (45.9%), multiple or other race (42.6%), and American Indian or Alaska Native (AI/AN) (38.7%) adults. By the end of November 2021, national ≥1-dose COVID-19 vaccination coverage was similar for Black (78.2%), Hispanic (81.3%), NH/OPI (75.7%), and White adults (78.7%); however, coverage remained lower for AI/AN (61.8%) and multiple or other race (68.0%) adults. Booster doses of COVID-19 vaccine are now recommended for all adults (4), but disparities in booster dose coverage among the fully vaccinated have become apparent (5). Tailored efforts including community partnerships and trusted sources of information could be used to increase vaccination coverage among the groups with identified persistent disparities and can help achieve vaccination equity and prevent new disparities by race and ethnicity in booster dose coverage., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Background: Seasonal influenza causes substantial morbidity and mortality among older U.S. adults and those with comorbid health conditions., Objective: To describe seasonal influenza vaccine uptake and identify factors associated with missed opportunities for influenza vaccination., Design: Retrospective cohort study., Setting: Medicare fee-for-service claims., Participants: 31.6 million U.S. adults continuously enrolled under Medicare Parts A and B during the 2018 to 2019 influenza season., Measurements: Influenza vaccine uptake and missed opportunities by patient demographic characteristics, high-risk status (that is, ≥1 condition increasing influenza complication risk), Medicare-Medicaid dual-eligibility status, and health care provider visits (that is, vaccination opportunities)., Results: Overall, 50.5% of beneficiaries aged 19 years or older had Medicare claims for influenza vaccination: 31.6% among people aged 19 to 64 years and 54% among people aged 65 years or older. More White beneficiaries were vaccinated (52.9%) than Black (34.9%) or Hispanic (30.4%) beneficiaries. Uptake was higher (56.1%) for beneficiaries with high-risk conditions than for those without (27.6%). Among unvaccinated beneficiaries overall, 77.4% visited a provider during influenza season; among unvaccinated beneficiaries with and without high-risk conditions, 91% and 43%, respectively, had seen a provider at least once. The proportion of beneficiaries with missed opportunities for influenza vaccination was 44.2% and was higher for beneficiaries in the non-high-risk group (59.1%) than those in the high-risk group (42.2%). Uptake was lower and proportions of missed opportunities were higher among beneficiaries in younger age groups, of Black and Hispanic race/ethnicity, without high-risk conditions, or with Medicare-Medicaid dual eligibility., Limitations: Influenza vaccinations without claims could not be captured. Data on reasons for nonvaccination were unavailable., Conclusion: Influenza vaccination coverage for Medicare beneficiaries continues to be suboptimal, with missed opportunities despite availability of influenza vaccination with no copayment. Disparities persist in vaccination uptake by race/ethnicity., Primary Funding Source: None.

A large proportion of Americans have at least one disability and yet people with disabilities face inequities in health and health care access. Factors associated with underlying disability and health, how they perceive and interact with the world, and where they live, or work may increase the risk people with disabilities face for illness or severe outcomes from seasonal influenza. Given the need to reduce the burden of respiratory illness on a healthcare system already overwhelmed by the COVID-19 pandemic, maximizing seasonal influenza vaccination coverage is particularly important in 2020-2021. It is critical this season to ensure equitable access to influenza vaccination for people with disabilities. Providing influenza vaccination services in the unique places where people with disabilities are living, working, or receiving care during the COVID-19 pandemic is crucial, as well as communicating effectively to people with different types of disabilities., (Published by Elsevier Inc.)

CDC, the Food and Drug Administration (FDA), state and local health departments, and public health and clinical stakeholders are investigating a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) (1). CDC has published recommendations for health care providers regarding EVALI (2-4). Recently, researchers from Utah and New York published proposed diagnosis and treatment algorithms for EVALI (5,6). EVALI remains a diagnosis of exclusion because, at present, no specific test or marker exists for its diagnosis, and evaluation should be guided by clinical judgment. Because patients with EVALI can experience symptoms similar to those associated with influenza or other respiratory infections (e.g., fever, cough, headache, myalgias, or fatigue), it might be difficult to differentiate EVALI from influenza or community-acquired pneumonia on initial assessment; EVALI might also co-occur with respiratory infections. This report summarizes recommendations for health care providers managing patients with suspected or known EVALI when respiratory infections such as influenza are more prevalent in the community than they have been in recent months (7). Recommendations include 1) asking patients with respiratory, gastrointestinal, or constitutional symptoms about the use of e-cigarette, or vaping, products; 2) evaluating those suspected to have EVALI with pulse oximetry and obtaining chest imaging, as clinically indicated; 3) considering outpatient management for clinically stable EVALI patients who meet certain criteria; 4) testing patients for influenza, particularly during influenza season, and administering antimicrobials, including antivirals, in accordance with established guidelines; 5) using caution when considering prescribing corticosteroids for outpatients, because this treatment modality has not been well studied among outpatients, and corticosteroids could worsen respiratory infections; 6) recommending evidence-based treatment strategies, including behavioral counseling, to help patients discontinue using e-cigarette, or vaping, products; and 7) emphasizing the importance of annual influenza vaccination for all persons aged ≥6 months, including patients who use e-cigarette, or vaping products., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

CDC, the Food and Drug Administration (FDA), state and local health departments, and public health and clinical partners are investigating a multistate outbreak of lung injury associated with the use of electronic cigarette (e-cigarette), or vaping, products. In late August, CDC released recommendations for health care providers regarding e-cigarette, or vaping, product use associated lung injury (EVALI) based on limited data from the first reported cases (1,2). This report summarizes national surveillance data describing clinical features of more recently reported cases and interim recommendations based on these data for U.S. health care providers caring for patients with suspected or known EVALI. It provides interim guidance for 1) initial clinical evaluation; 2) suggested criteria for hospital admission and treatment; 3) patient follow-up; 4) special considerations for groups at high risk; and 5) clinical and public health recommendations. Health care providers evaluating patients suspected to have EVALI should ask about the use of e-cigarette, or vaping, products in a nonjudgmental and thorough manner. Patients suspected to have EVALI should have a chest radiograph (CXR), and hospital admission is recommended for patients who have decreased blood oxygen (O 2 ) saturation (<95%) on room air or who are in respiratory distress. Health care providers should consider empiric use of a combination of antibiotics, antivirals, or steroids based upon clinical context. Evidence-based tobacco product cessation strategies, including behavioral counseling, are recommended to help patients discontinue use of e-cigarette, or vaping, products. To reduce the risk of recurrence, patients who have been treated for EVALI should not use e-cigarette, or vaping, products. CDC recommends that persons should not use e-cigarette, or vaping, products that contain tetrahydrocannabinol (THC). At present, CDC recommends persons consider refraining from using e-cigarette, or vaping, products that contain nicotine. Irrespective of the ongoing investigation, e-cigarette, or vaping, products should never be used by youths, young adults, or women who are pregnant. Persons who do not currently use tobacco products should not start using e-cigarette, or vaping, products., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed. All members of the Lung Injury Response Clinical Working Group have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Carolyn S. Calfee reports a grant from the FDA/NIH (Tobacco Center of Regulatory Science [TCORS]) for a project entitled Impact of Different E-cigarette Characteristics on Acute Lung Injury; a grant from GlaxoSmithKline for an observational study on sepsis and ARDS biomarkers; a grant and personal fees from Bayer for an observational study on pulmonary hypertension in ARDS and for medical consultation; and personal fees from Roche/Genentech for consultation on potential therapies for ARDS, and personal fees from Prometic, CSL Behring, and Quark for serving on medical advisory boards for ARDS. No other potential conflicts of interest were disclosed.

Objective: To identify key competencies and skills that all master of public health (MPH) graduates should have to be prepared to work in a local health department., Methods: In 2011-2012, the New York City Department of Health and Mental Hygiene administered electronic surveys to 2 categories of staff: current staff with an MPH as their highest degree, and current hiring managers., Results: In all, 312 (77%) staff members with an MPH as their highest degree and 170 (57%) hiring managers responded to the survey. Of the respondents with an MPH as their highest degree, 85% stated that their MPH program prepared them for work at the New York City Health Department. Skills for which MPH graduates most often stated they were underprepared included facility in using SAS® statistical software, quantitative data analysis/statistics, personnel management/leadership, and data collection/database management/data cleaning. Among the skills hiring managers identified as required of MPH graduates, the following were most often cited as those for which newly hired MPH graduates were inadequately prepared: quantitative data analysis, researching/conducting literature reviews, scientific writing and publication, management skills, and working with contracts/requests for proposals., Conclusion: These findings suggest that MPH graduates could be better prepared to work in a local health department upon graduation. To be successful, new MPH graduate hires should possess fundamental skills and knowledge related to analysis, communication, management, and leadership. Local health departments and schools of public health must each contribute to the development of the current and future public health workforce through both formal learning opportunities and supplementary employment-based training to reinforce prior coursework and facilitate practical skill development.

Purpose: Capacity to monitor non-communicable diseases (NCDs) at state or local levels is limited. Emerging approaches include using biomeasures and electronic health record (EHR) data. In 2004, New York City (NYC) performed a population-based health study on adult residents using biomeasures (NYC Health and Nutrition Examination Study, or NYC HANES), modeled after NHANES. A second NYC HANES was launched in 2013 to examine change over time, evaluate municipal policies, and validate a proposed EHR-based surveillance system. We describe the rationale and methods of NYC HANES 2013-2014., Methods: NYC HANES was a population-based, cross-sectional survey of NYC adults using three-stage cluster sampling. Between August 2013 and June 2014, selected participants completed a health interview and physical exam (blood pressure, body mass index, and waist circumference). Fasting biomeasures included diabetes, lipid profiles, kidney function, environmental biomarkers, and select infectious diseases., Results: Of the 3065 households approached, 2742 were eligible and 1827 were successfully screened (67%). A total of 1524 of eligible participants completed the survey (54%), for an overall response rate of 36%., Conclusion: Completing a second NYC HANES a decade after the first study affords an opportunity to understand changes in prevalence, awareness and control of NCDs and evaluate municipal efforts to manage them.

As described in a recently released report of the Forum of International Respiratory Societies, four of the leading causes of death in the world are chronic obstructive pulmonary disease, acute respiratory tract infections, lung cancer, and tuberculosis. A fifth, asthma, causes enormous global morbidity. Not enough progress has been made in introducing new therapies and reducing disease burden for these illnesses in the last few decades, despite generous investments and some notable progress in biomedical research. Four external and modifiable drivers are responsible for a substantial percentage of the disease burden represented by the major lung diseases: tobacco, outdoor air pollution, household air pollution, and occupational exposures to lung toxins. Especially in low- and middle-income countries, but in highly developed economies as well, pressures for economic development and lax regulation are contributing to the continued proliferation of these drivers. Public health approaches to the most common lung diseases could have enormous effects on reducing morbidity and mortality. There must be increased advocacy from and mobilization of civil society to bring attention to the drivers of lung diseases in the world. The World Health Organization should negotiate accords similar to the Framework Convention on Tobacco Control to address air pollution and occupational exposures. Large increases in funding by government agencies and nongovernmental organizations around the world are needed to identify technologies that will reduce health risks while allowing populations to enjoy the benefits of economic development. This paradigm, focused more on public health than on individual medical treatment, has the best chance of substantial reduction in the burden of lung disease around the world in the next several years.

Objectives: In fall 2008, the New York City Department of Health and Mental Hygiene collaborated with Albert Einstein College of Medicine residency program directors to assess the effectiveness of an e-learning course on accurate death certificate completion among resident physicians., Methods: We invited postgraduate year 1 and 2 (PGY1 and PGY2) residents (n = 227) to participate and administered a pretest, e-learning module, posttest, and course evaluation to PGY1 residents; PGY2 residents completed a pretest and survey only., Results: In all, 142 residents (63%) participated. The average pretest scores for PGY2 residents (61%) and PGY1 residents (59%) were not significantly different. The PGY1 residents' average test score increased significantly after taking the e-learning module (59% vs 72%; P < .01). The participants rated course length, delivery method, and utility highly., Conclusions: Results suggest that e-learning can effectively integrate public health-oriented training into clinical residency programs.

Introduction: Poor-quality cause-of-death reporting reduces reliability of mortality statistics used to direct public health efforts. Overreporting of heart disease has been documented in New York City (NYC) and nationwide. Our objective was to evaluate the immediate and longer-term effects of a cause-of-death (COD) educational program that NYC's health department conducted at 8 hospitals on heart disease reporting and on average conditions per certificate, which are indicators of the quality of COD reporting., Methods: From June 2009 through January 2010, we intervened at 8 hospitals that overreported heart disease deaths in 2008. We shared hospital-specific data on COD reporting, held conference calls with key hospital staff, and conducted in-service training. For deaths reported from January 2009 through June 2011, we compared the proportion of heart disease deaths and average number of conditions per death certificate before and after the intervention at both intervention and nonintervention hospitals., Results: At intervention hospitals, the proportion of death certificates that reported heart disease as the cause of death decreased from 68.8% preintervention to 32.4% postintervention (P < .001). Individual hospital proportions ranged from 58.9% to 79.5% preintervention and 25.9% to 45.0% postintervention. At intervention hospitals the average number of conditions per death certificate increased from 2.4 conditions preintervention to 3.4 conditions postintervention (P < .001) and remained at 3.4 conditions a year later. At nonintervention hospitals, these measures remained relatively consistent across the intervention and postintervention period., Conclusion: This NYC health department's hospital-level intervention led to durable changes in COD reporting.