Major medical organizations form a coalition to stem the rising tide of firearm violence using a comprehensive public health approach

The increase in firearm-related violence since the COVID-19 pandemic requires urgent and comprehensive action to address the problem

Peer-Reviewed Publication

AMERICAN COLLEGE OF SURGEONS

Key Takeaways

• A new coalition to address firearm violence: A new group — the Healthcare Coalition for Firearm Injury Prevention — is being established to advance firearm injury prevention using a public health approach.
• Violence prevention starts in the community: Community engagement programs at the local level have been effective in preventing repeat offenders and improving attitudes toward reducing violence.
• Firearm owners must be part of the solution: Engaging firearm owners as part of the solution allows for broad-level engagement from everyone dedicated to reducing firearm injury and is critical to the implementation of firearm safety initiatives.

CHICAGO (March 6, 2023): Leading medical and public health professional organizations across the United States are coming together to form the Healthcare Coalition for Firearm Injury Prevention to push for a comprehensive public health approach to advance firearm injury prevention efforts through education, advocacy, and community-centered approaches to address this growing problem.  

Representatives from 46 organizations convened for the second Medical Summit on Firearm Injury Prevention in September 2022, one of the largest gatherings of medical and injury prevention professionals on this issue. This Summit featured a review of community violence initiatives, strategies to support healthcare-centered communication, and a review of the evidence informing public policy for firearm injury prevention. The objectives of the Summit focused on identifying consensus-based, non-partisan strategies that can be effective in reducing the burden of firearm injury in communities across the United States. The proceedings from the Summit are published today in the Journal of the American College of Surgeons (JACS).

Healthcare professionals see the impact of firearm violence in their communities every day. This perspective, and the direct contact they have to those at risk of firearm violence, allow medical professionals to propose real, workable solutions to reduce firearm-related injury, death, and disability.

The scope of the problem

The inaugural Medical Summit on Firearm Injury Prevention took place in 2019. Since then, levels of violence have continued to increase in the U.S.—firearm-related deaths increased 28.4% during the first year of the COVID-19 pandemic and non-fatal firearm injuries increased 34.2% during the same period.1 Further, firearm-related injury has now eclipsed motor vehicle fatalities as the leading cause of death in the U.S. for children and adolescents, age 1-19 years.2

To renew efforts to address this ongoing public health crisis, leaders of the American College of Surgeons (ACS), American College of Physicians (ACP), American College of Emergency Physicians (ACEP), American Academy of Pediatrics (AAP), and the Council of Medical Specialty Societies (CMSS) cohosted the second Medical Summit on Firearm Injury Prevention. Forty-six organizations attended the Summit, during which sessions were held on public policy initiatives, addressing community violence, and effective healthcare-centered communication on firearm injury prevention.

Community-level firearm injury prevention efforts

“All clinicians who care for patients have the opportunity to identify those at risk of firearm injury and provide counseling to mitigate these risks,” the authors wrote in the article. They provided specific examples of what these clinical opportunities include:

• Education on secure firearm storage
• Lethal means safety counseling, where healthcare providers work with patients who are at-risk of injury or death and their families to reduce access to firearms
• Family support in the implementation of extreme risk protection programs (to temporarily remove firearms from the homes of those at risk for suicide or domestic violence)
• Hospital and community-centered violence intervention programs
• Mentoring programs for at risk youth
• Integration of social care into the delivery of health care

These community engagement programs are rooted in the understanding of social determinants of health and the principles of Trauma Informed Care, which is an approach that addresses implicit bias and creates an environment for patients that promotes equity, sensitivity of broader needs, and empowerment.

Engaging firearm owners as part of the solution

Summit attendees noted the importance of broad community engagement to address firearm violence, which requires engagement from everyone dedicated to reducing firearm injury.

“All too often the community of firearm owners in the U.S. are approached as part of the firearm injury problem, and less commonly as part of the solution,” the authors wrote.

An example of this engagement is a strategy pursued by the ACS Committee on Trauma (COT) that acknowledges both the constitutional right to keep and bear arms and the critical and significant problem of intentional firearm violence in the U.S. The ACS has established a Firearm Strategy Team (FAST) of firearm owning surgeons to inform and advise on firearm safety initiatives.

The authors also noted that there have been successful partnerships between health professionals and firearm retailers, instructors, and advocates. Firearm owners and experts are seen as “trusted messengers” and have effectively delivered firearm safety messages in their communities.

Summit attendees called for further engagement with firearm owners through the new Healthcare Coalition for Firearm Injury Prevention.

A consensus-based, comprehensive public health approach

Just as motor vehicle deaths have sharply declined over the years due to public health-based injury prevention strategies, a comprehensive public health and medical approach is necessary to reduce firearm injury, death, and disability.

To achieve the goals outlined at the Summit, the sponsoring organizations agreed to establish the Healthcare Coalition for Firearm Injury Prevention. This Coalition will include the following workgroups: Health Professional Education, Advocacy and Policy Initiatives, Healthcare Professional Engagement for Firearm Safety, Communications, and Community-Centered Approach for Violence Prevention.

“Establishing this coalition provides a venue to continue ongoing multidisciplinary collaboration and leverage the resources of the entire public health and healthcare community,” the authors concluded. “The opportunity is before us, and the time is now to address this critically important American public health problem.”

The following comments were issued by article authors and leaders from the five organizations that co-hosted the Summit:

“Preventing firearm violence requires a multifaceted approach, one that includes not only common-sense firearm legislation, but also addressing the underlying social and economic factors that contribute to it,” said Joseph V. Sakran, MD, MPH, MPA, FACS, survivor and trauma surgeon at Johns Hopkins Medicine. “We have come together as a medical community to create a society where every person feels safe and valued, and where the senseless loss of life due to firearm violence becomes a thing of the past.”

“Effective healthcare is not just about treating the wounds of firearm violence, but also preventing them in the first place. By addressing the root causes of violence and providing education and support, healthcare professionals can play a crucial role in preventing firearm violence and promoting a safer, healthier society,” said Eileen M. Bulger, MD, FACS, Medical Director, ACS Trauma Programs. “This renewed effort to create a Healthcare Coalition for Firearm Injury Prevention leverages the talents of major medical organizations across America as we guide the nation in tackling this public health crisis.”

“The crisis of firearm violence continues to afflict communities across this country, day after day. The American College of Surgeons and our coalition partners have come together because the medical community is well positioned to help address this vexing issue,” said Patricia L. Turner, MD, MBA, FACS, ACS Executive Director & CEO. “By taking an approach that we know works for other public health issues, and by engaging all stakeholders, including those who own firearms, we can create actionable solutions to reduce death and save lives.”

“Firearms-related deaths and injuries are a public health crisis that need immediate action. We need to employ commonsense strategies that will help to keep our patients and our communities safe. For nearly 30 years, the American College of Physicians has called attention to this issue and believes that as trusted resources for our patients, physicians should be part of informing our patients about what they can do to keep themselves and their families safer,” said Sue S. Bornstein, MD, MACP, chair, ACP Board of Regents.

“Firearm violence indelibly affects emergency department patients and their families as well as those of us who care for them,” said Christopher S. Kang, MD, FACEP, president of ACEP. “Efforts to curb firearm violence and promote safety and injury prevention are a public health imperative. Emergency physicians are a vital partner in these collaborative efforts by the healthcare community to improve treatments, save lives, and prevent more tragedies from occurring.”

“As firearms are now the leading cause of death for U.S. children and youth, the American Academy of Pediatrics was proud to be one of the organizing members of the Medical Summit on Firearm Injury Prevention,” said Lois K. Lee, MD, MPH, FAAP, chair of the AAP Council on Injury, Violence and Poison Prevention. “We understand the lifelong consequences firearm injuries and deaths have to children, their families, and communities, and we must do better for our children. By using a multi-pronged approach, we can start to address this serious public health crisis.”

“The complex topic of firearm injury prevention requires a coordinated and concerted effort on the part of the entire medical community. As an organization of 50 specialty societies, we recognize the enormous potential of working together in this new coalition to prevent firearm injuries,” said Helen Burstin, MD, MPH, chief executive officer of the Council of Medical Specialty Societies. “By jointly addressing key levers that prevent firearm injury, including health professions education, community engagement, and advocacy, we can ensure that our collective efforts will be greater than the sum of individual organizational efforts.”

Article authors are Joseph V. Sakran, MD, MPH, MPA, FACS; Sue S. Bornstein, MD, MACP; Rochelle Dicker, MD, FACS; Frederick P. Rivara, MD, MPH, FAAP; Brendan T. Campbell, MD, MPH, FACS, FAAP; Rebecca M. Cunningham, MD, FACEP; Marian Betz, MD, MPH; Stephen Hargarten, MD, MPH; Ashley Williams, MD, FACS; Joshua M. Horwitz, JD; Deepika Nehra, MD, FACS; Helen Burstin, MD, MPH, MACP; Karen Sheehan, MD, MPH; Fatimah L. Dreier; Thea James, MD, FACEP; Chethan Sathya, MD, MSCE; John H. Armstrong, MD, FACS; Ali Rowhani-Rahbar, MD, MPH, PhD; Scott Charles, MAPP; Amy Goldberg MD, FACS; Lois K. Lee, MD, MPH, FAAP, FACEP; Ronald M. Stewart, MD, FACS; Jeffrey D. Kerby, MD, PhD, FACS; Patricia L. Turner, MD, MBA, FACS; and Eileen M. Bulger, MD, FACS.

The article authors have no relevant disclosures to report.

This article is published as an article in press on the JACS website.

Citation: Sakran JV, Bornstein SS, Dicker R, et al. Proceedings from the Second Medical Summit on Firearm Injury Prevention, 2022: Creating a Sustainable Healthcare Coalition to Advance a Multidisciplinary Public Health Approach. Journal of American College of Surgeons. DOI: 10.1097/XCS.0000000000000662

Further information on ACS firearm injury prevention activities, including resources for journalists, is available on the ACS website.

________________

1Sun S, Cao W, Ge Y, Siegel M, Wellenius GA. Analysis of Firearm Violence During the COVID-19 Pandemic in the US. JAMA Netw Open. 2022 Apr 1;5(4):e229393.

2JE Goldstick, RM Cunningham, P Carter Current Causes of Death in Children and Adolescents in the United States. N Engl J Med, 386 (2022), pp. 1955-1956.

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About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 84,000 members and is the largest organization of surgeons in the world. "FACS" designates that a surgeon is a Fellow of the American College of Surgeons. For further information, contact pressinquiry@facs.org.

About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 160,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter, Facebook, and Instagram.

About the American College of Emergency Physicians
The American College of Emergency Physicians (ACEP) is the national medical society representing emergency medicine. Through continuing education, research, public education, and advocacy, ACEP advances emergency care on behalf of its 40,000 emergency physician members, and the more than 150 million people they treat on an annual basis. For more information, visit www.acep.org and www.emergencyphysicians.org. 
Contact: Steve Arnoff | sarnoff@acep.org | Twitter @EmergencyDocs

About the American Academy of Pediatrics
The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds.

About the Council of Medical Specialty Societies
The Council of Medical Specialty Societies (CMSS) is a coalition of specialty societies representing more than 800,000 physicians across the house of medicine. CMSS works to catalyze improvement across specialties through convening, collaborating, and collective action. For more information, visit www.cmss.org. 

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JOURNAL

Journal of the American College of Surgeons

DOI

10.1097/XCS.0000000000000662 

ARTICLE TITLE

Proceedings from the Second Medical Summit on Firearm Injury Prevention, 2022: Creating a Sustainable Healthcare Coalition to Advance a Multidisciplinary Public Health Approach

ARTICLE PUBLICATION DATE

6-Mar-2023

'Greed is good' for likes and retweets if you're a U.S. senator

Peer-Reviewed Publication

UNIVERSITY OF BRITISH COLUMBIA

Tweet about greed.

That's what U.S. politicians ought to do if they want to gain likes and retweets on Twitter, according to new University of British Columbia research.

Analyzing nine years of tweets from U.S. senators

The researchers from UBC's department of psychology analyzed every tweet posted by U.S. senators from early 2013 to late 2021—a total of 861,104 tweets from 140 senators. The researchers were looking specifically for communication about greed, so they could see if it correlates with more likes and retweets.

As it turns out, it does.

Tweets about greed perform best for Democrats

Both Democratic and Republican senators got more support and traction for their tweets when tweeting about greed. The effect was stronger for Democrats, though, and stronger still if those tweets also happened to mention their political opponents.

Senators from both parties tweet negatively about greed

Regardless of party, senators were more likely to tweet in negative terms about greed than positive. Even if some politicians act as though "greed is good," they generally don't tweet like it.

In the U.S.'s highly partisan political system, social media matters. Politicians can boost their chances in tightly contested elections by reaching like-minded partisans and motivating them to act, the researchers note.

The tweets in this study began in 2013 on the opening day of the 113th session of Congress—the first time all U.S. senators had Twitter accounts.

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JOURNAL

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2218680120 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Greed communication predicts the approval and reach of US senators' tweets

ARTICLE PUBLICATION DATE

6-Mar-2023

New research: Hotter and drier conditions limit forest recovery from wildfires

Ecological forest management can help

Peer-Reviewed Publication

THE NATURE CONSERVANCY, ARIZONA

March 6, 2023 —Warmer and drier climate conditions in western U.S. forests are making it less likely that trees can regenerate after wildfires, according to new research published in the Proceedings of the National Academy of Sciences.

Link: https://www.pnas.org/cgi/doi/10.1073/pnas.2208120120

Importantly, the research also finds that ecologically based forest management can partially offset climate-driven declines in tree regeneration by limiting fire-caused tree death, but only if action is taken quickly. This study provides timely information to optimize new state and federal initiatives to increase the pace of ecologically based forest management across millions of acres of Western forests.

The Climate Change Challenge

Forests are adapted to different types of fire across the West, but hotter and drier conditions in recent decades have intensified the way fires burn, resulting in more trees being killed. All of this can result in fewer seeds available for forests to regenerate after wildfires. Even when seeds are available, a warming climate is increasingly limiting the chances that seedlings can establish and grow.

“Climate change increasingly limits tree establishment after wildfires because seedlings can be killed by hot temperatures and dry conditions,” says the study’s lead author, Kim Davis, who completed the study at the University of Montana, now a research ecologist for the Forest Service at the Missoula Fire Sciences Laboratory.

The research examined how the severity of a fire – the number of trees it kills – in combination with the climate conditions after the fire affected the chances of tree seedlings regenerating to establish a new forest. It is the most extensive study to date, assessing regeneration of eight major tree conifer species after 334 wildfires across the West, using information from over 10,000 field plots collected by more than 50 research teams.

Researchers found that warmer, drier conditions over the past four decades have led to a decline in tree regeneration after wildfires and this trend is expected to accelerate in the future. For example, from 1981-2000, 95 percent of the areas studied had climate conditions suitable for tree regeneration after wildfires, but this is projected to decrease to only three-quarters of the West by 2050 under future climate scenarios.

The most vulnerable forests were in drier regions in the Southwest and California, while forests in the wetter and cooler regions of the northern Rocky Mountains and Pacific Northwest are still expected to support conifer regeneration in the near-term future.

“The impacts of climate change and wildfires vary across the West, and the large scope of this study allowed us to highlight where these changes are most concentrated and happening first,” says Philip Higuera, a co-author and professor of fire ecology at the University of Montana.

Ecological Forest Management Can Reduce Risk

The study also found that ecological forest management in vulnerable dry forests could offset climate-driven changes by reducing the number of trees killed in wildfires. Specifically, in almost half of the study region, regeneration after wildfires is projected to be likely only if future fires burn at lower severities because fewer trees that produce seeds needed for forest recovery are killed in these fires.

“We know from prior research that forest thinning and controlled burns in overgrown dry forests effectively reduces fire severity and subsequent tree death” says study co-author Marcos Robles, lead scientist for The Nature Conservancy in Arizona. “Land managers can’t do much about drought and climate change in the short term, but they can reduce the area in which forests are vulnerable to severe wildfires by accelerating ecological based forest management”

Prior research published by The Nature Conservancy demonstrates that ecological forest management in a large restoration initiative in Arizona would not only reduce wildfire-cased tree death, but also provide additional co-benefits, including significant reductions in drought-related tree death, while increasing carbon storage, stream flow and tree growth.

“But the clock is ticking; it’s urgent that we implement these treatments in our forests now, lest we lose them altogether,” says Robles.

Even in cooler high-elevation forests in the Rocky Mountains and Pacific Northwest that experienced large tree-killing wildfires in the past, the researchers also found that climate change is making it less likely for trees to regenerate after wildfire. In these forests, planting trees after wildfire may take on increased urgency, given a shortening window of opportunity for trees to establish in climate conditions that are warmer and drier than in the past.   

The good news is that the federal government allocated around $3 billion to fund ecological forest management and reforestation efforts across 50 million acres in the next 10 years throughout the West. This research provides much needed information that can inform these efforts, particularly given the rapid pace of change our Western forests are experiencing.

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JOURNAL

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2208120120 

METHOD OF RESEARCH

Data/statistical analysis

ARTICLE TITLE

New Research: Hotter and Drier Conditions Limit Forest Recovery from Wildfires

ARTICLE PUBLICATION DATE

6-Mar-2023

JMIR Medical Education launches special issue on the use of ChatGPT in medical education, after new study finds ChatGPT passes the United States Medical Licensing Examination

The study found that ChatGPT reaches the equivalent of a passing score for a third-year medical student

Peer-Reviewed Publication

JMIR PUBLICATIONS

 

IMAGE: AI-GENERATED IMAGE BY DALL-E IN RESPONSE TO THE REQUEST "A FUTURISTIC IMAGE ILLUSTRATING THE IMPACT OF GENERATIVE ARTIFICIAL INTELLIGENCE ON MEDICAL EDUCATION". view more 

CREDIT: SOURCE: HTTPS://LABS.OPENAI.COM/S/GUWECW9HOL7JOTYX02B9SMOW

A study published on February 8, 2023, in JMIR Medical Education, a leading open access journal on digital medical education, evaluated the potential of ChatGPT, a natural language processing model, as a medical education tool. The study found that ChatGPT reaches the equivalent of a passing score for a third-year medical student. Conducted by researchers from Yale University School of Medicine’s Section for Biomedical Informatics and Data Science and University College Dublin, the study aimed to test the performance of ChatGPT and previous-generation large language models on the medical question-answering problem as part of the United States Medical Licensing Examination (USMLE) Step 1 and Step 2 exams.

In their paper titled “How Does ChatGPT Perform on the United States Medical Licensing Examination? The Implications of Large Language Models for Medical Education and Knowledge Assessment,” [1], Aidan Gilson and coauthors tested the models on study aids commonly used by medical students, including multiple-choice questions (with indicators of question difficulty) and the National Board of Medical Examiners (NBME) test sample questions. ChatGPT outperformed previous-generation models and was capable of correctly answering up to over 60% of questions, which is comparable to a passing score for a third-year medical student. Incorrect answers were primary due to logical and information errors, and the performance decreased as question difficulty increased. Impressively, ChatGPT provided logical reasoning and information internal to the question in most of its answer selection. Additionally, ChatGPT’s responses provided external information beyond the question, which was significantly correlated with the performance. ChatGPT can provide a basis for dialogic interaction that is likened to studying with a peer, not only by giving a narrative, coherent answer but also by establishing the information needed to answer the question.

ChatGPT has drawn considerable attention since its prototype was released on November 30, 2022, with users sharing their impressions of the chatbot all across the globe. These researchers describe how the artificial intelligence (AI)–powered chatbot ChatGPT, as the first in a new line of language models, can prove to be an interactive medical education tool given its ability to represent a combination of clinical knowledge and dialogic interaction. 

Conrad W Safranek, one of the medical students involved in the project, describes his use of ChatGPT as a study aid. Upon reflection, he found value in using the tool to unearth context relevant to the question, which supported his ability to recall external information and make logical connections from medical courses as expected by the question. Using this tool to enhance self-directed reflective learning is but one example of the opportunities that ChatGPT brings to enhancing medical education.

The corresponding author, David Chartash, PhD, from Yale University School of Medicine remarked, “JMIR Medical Education has proved time and again to understand the value of the integration of medical informatics in medical education. This study builds upon on the fundamental principles which I have previously written about with colleagues last year [see published work here]: as medical education seeks to develop competencies in clinical informatics for medical students, exposure to the fundamentals of novel technology in pre-clinical years that may shape their practice (such as with dialogic AI) will support their ability to understand the technology-augmented clinical practice they will inherit when they graduate."

The authors of the study believe that their results make a compelling case for the potential use of ChatGPT as an interactive medical education tool, as it provides users with contextually interpretable and narratively coherent translation of medical knowledge along with its answers. This study published by JMIR Publications marks a significant advancement in natural language processing models for medical question answering and could have a profound impact on the future learning environment for medical students.

To further demonstrate the capabilities of this tool, the authors asked ChatGPT to summarize their research findings. Want to know how ChatGPT performed? Read the (second) “Conclusions” of this paper here.

JMIR Medical Education Launches a Theme Issue on ChatGPT, Generative Language Models, and AI in Medical Education

Given the interest this research has generated among medical educators and researchers, JMIR Medical Education has released a call for papers for its upcoming theme issue and e-collection titled “ChatGPT and Generative Language Models in Medical Education” [2]. This special issue aims to explore the potential of emerging technologies like ChatGPT and similar generative language models or AI applications in medical education, including their use in teaching and learning, clinical decision-making, and patient care. JMIR Medical Education welcomes submissions from researchers, educators, and practitioners in medicine, health care, computer science, and related fields. Submissions from a breadth of professionals at all career stages who are engaged in medical education are welcome. We encourage both empirical and theoretical submissions, including original research, systematic reviews, viewpoints, and tutorials. We also encourage submissions that address practical challenges and opportunities related to the use of generative language models and AI in medical education. 

“ChatGPT has changed the world and the potential for ChatGPT to disrupt medical education is significant,” says Gunther Eysenbach, publisher at JMIR Publications. “ChatGPT not only provides new interactive learning opportunities for medical students and health professionals but also raises new interesting questions for medical educators. The special issue will be a useful resource for researchers, medical educators, and trainees alike to get the most out of this fascinating technology that will change how we teach and learn.” In an accompanying editorial, Eysenbach interviews ChatGPT itself, having the machine illustrate some of the opportunities for medical education; however, some striking errors and limitations also became evident [3].

###

Cite as:

1. Gilson A, Safranek CW, Huang T, Socrates V, Chi L, Taylor RA, Chartash D. How Does ChatGPT Perform on the United States Medical Licensing Examination? The Implications of Large Language Models for Medical Education and Knowledge Assessment
   JMIR Med Educ 2023;9:e45312 (Feb 8)
   doi: https://doi.org/10.2196/45312 PMID: 36753318
2. Call for Papers for the ChatGPT Theme Issue for JMIR Medical Education: https://mededu.jmir.org/announcements/365
3. Eysenbach G. The Role of ChatGPT, Generative Language Models and Artificial Intelligence in Medical Education: A Conversation with ChatGPT and a Call for Papers
   JMIR Med Educ 2023;9:e46885
   http://preprints.jmir.org/preprint/46885
   doi: https://doi.org/10.2196/46885

Contact:

Corresponding author: David Chartash, PhD

Institution: Section for Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, CT, US and School of Medicine, University College Dublin, National University of Ireland, Dublin, Dublin, IE

Email: david.chartash@yale.edu

About JMIR Publications

JMIR Publications is a leading, born-digital, open access publisher of 30+ academic journals and other innovative scientific communication products that focus on the intersection of health and technology. Its flagship journal, the Journal of Medical Internet Research, is the leading digital health journal globally in content breadth and visibility, and it is the largest journal in the medical informatics field.

To learn more about JMIR Publications, please visit https://www.JMIRPublications.com or connect with us via:

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The content of this communication is licensed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, published by JMIR Publications, is properly cited.

 

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JOURNAL

JMIR Medical Education

DOI

10.2196/45312 

ARTICLE TITLE

How Does ChatGPT Perform on the United States Medical Licensing Examination? The Implications of Large Language Models for Medical Education and Knowledge Assessment

ARTICLE PUBLICATION DATE

8-Feb-2023

This starchy bioplastic could make soggy paper straws a thing of the past

Peer-Reviewed Publication

AMERICAN CHEMICAL SOCIETY

 

IMAGE: THESE NEW BIOPLASTIC STRAWS MADE USING POTATO STARCH AND LIGNIN ARE STRONG IN WATER BUT STILL BIODEGRADE. view more 

CREDIT: ADAPTED FROM ACS OMEGA, 2023, DOI: 10.1021/ACSOMEGA.2C07797

In the fight against pollution, several regions in the U.S. have banned the use of plastic straws. Alternative materials exist, but most options are either too expensive to scale up, go limp in drinks or taste bad. But now, a team reporting in ACS Omega has developed a new type of bioplastic film from all-natural, degradable materials that can be rolled into a straw that doesn’t get soggy and is stronger than plastic.

As efforts to reduce plastic waste take hold, many researchers and companies have turned to plastic alternatives to fabricate straws that comply with new laws and regulations. But so far, most options either end up breaking down in a drink, like paper straws, or require extra steps and energy to manufacture, like metal or sugarcane straws. But some biopolymers, such as starch and lignin, are readily available as byproducts of other industrial processes and could serve as cheap bioplastic ingredients. Lignin’s natural strength could help overcome starch’s brittleness, especially when combined with a bio-based crosslinker, such as citric acid. So, Dickens Agumba, Duc Hoa Pham and Jaehwan Kim wanted to see if these materials could be combined into a plastic film that was tough, stable in water, yet would still break down when no longer needed.

To create the straws, the researchers blended lignin with either potato starch or polyvinyl alcohol — a more traditional bioplastic material — then added citric acid. They spread the slurry into a thin layer, rolled it into a cylinder and cured it at over 350 F. The bioplastic naturally self-adhered at the seam, but heat treatment set it and made it even stronger. In tests, the cylinders were stronger than those made of polypropylene plastic, yet still flexible. After two months outside, the plastic straws remained unchanged, while the team’s straws degraded significantly. The bioplastic film also offered UV protection, which could be useful for other applications, such as a coating for greenhouse windows. The researchers say that this material could not only reduce the amount of plastic waste in the environment, but also be used to create other, more sustainable bioplastic products from otherwise wasted materials.

The authors acknowledge funding from the National Research Foundation of Korea Creative Research Initiatives Program.

The American Chemical Society (ACS) is a nonprofit organization chartered by the U.S. Congress. ACS’ mission is to advance the broader chemistry enterprise and its practitioners for the benefit of Earth and all its people. The Society is a global leader in promoting excellence in science education and providing access to chemistry-related information and research through its multiple research solutions, peer-reviewed journals, scientific conferences, eBooks and weekly news periodical Chemical & Engineering News. ACS journals are among the most cited, most trusted and most read within the scientific literature; however, ACS itself does not conduct chemical research. As a leader in scientific information solutions, its CAS division partners with global innovators to accelerate breakthroughs by curating, connecting and analyzing the world’s scientific knowledge. ACS’ main offices are in Washington, D.C., and Columbus, Ohio.

To automatically receive news releases from the American Chemical Society, contact newsroom@acs.org.

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JOURNAL

ACS Omega

DOI

10.1021/acsomega.2c07797 

ARTICLE TITLE

“Ultrastrong, Hydrostable, and Degradable Straws Derived from Microplastic-Free Thermoset Films for Sustainable Development”

NYU Abu Dhabi researchers develop highly-efficient, non-toxic method to upcycle single-use plastic

Novel approach converts single-use plastic into “carbon dots” that can be used for environmental monitoring, disease diagnosis and treatment, and more

Peer-Reviewed Publication

NEW YORK UNIVERSITY

Abu Dhabi, UAE (March 6, 2023) – A team of researchers at NYU Abu Dhabi have developed a single-step, organic solvent-free, hydrothermal process to convert polyethylene-based plastic bags and polypropylene-based surgical masks into carbon dots.  An estimated 26,000 metric tons of pandemic-related plastic waste – from medical waste to online shopping packaging – have been released into the world’s oceans, making it even more urgent to find efficient methods to upcycle this non-degradable material. One solution is to convert the single-use plastic into so-called carbon dots, carbon nanomaterials that are biocompatible, and have applications in the fields of biological imaging, environmental monitoring, chemical analysis, targeted drug delivery, disease diagnosis and therapy, and anticounterfeiting. Existing methods to upcycle plastic into carbon dots involve multiple, time-consuming steps and utilize toxic chemicals.

In the study titled High-yield, One-pot Upcycling of Polyethylene and Polypropylene Waste into Blue-Emissive Carbon Dots published in the journal Green Chemistry, the researchers present the development of a new synthesis method, which is a simple, cost-effective, and highly scalable approach to upcycling plastic waste. Importantly, this oxidative degradation method can upcycle plastics contaminated with organic waste such as food scraps, which poses a significant challenge to traditional recycling technologies. The senior author is Khalil Ramadi, Assistant Professor of Bioengineering at NYUAD. Mohammed Abdelhameed, a scientist at NYUAD, and Mahmoud Elbeh, an NYUAD undergraduate student, are first authors of the study.

The researchers also estimated the economic feasibility of the synthetic method by comparing the variable costs of this process to existing chemical recycling processes, considering the economic value of the created carbon dots. They found that the global market value of carbon dots is expected to reach USD 6.412 billion by 2025, up from USD 2.496 billion in 2019 – a high commercial value that more than justifies the associated processing costs.

The high volume of single-use plastics used during the pandemic, particularly surgical masks and medical waste, presents an increased need to find a solution for managing non-biodegradable waste. It is also estimated that only 14 percent of the eligible plastic packaging – whose use has surged due to the boom in online shopping – is recycled, with the rest ending up in landfills and oceans, where it does considerable harm. These materials can be consumed by organisms or fragmented into micro- and nano-plastics that can threaten terrestrial, marine, and freshwater ecosystems and, ultimately, human health.

“The new method our team has developed is a cost-effective and safe method that can be easily implemented to significantly reduce the amount of harmful plastic that is released into our ecosystems,” said Ramadi. “In addition to providing a new tool to protect our ecosystems, this approach can efficiently and responsibly produce carbon dots, a versatile nanotechnology whose potential applications are nearly boundless.”

Elbeh stated, “We’re very delighted to further support the UAE’s Circular Economy Policy. Given that we are tackling the plastic waste crisis by creating a valuable product using a relatively easy-to-implement method, we’re looking forward to more collaborations to not only scale up this project but also utilize the produced dots for further development and applications.”

ENDS

About NYU Abu Dhabi

www.nyuad.nyu.edu
NYU Abu Dhabi is the first comprehensive liberal arts and research campus in the Middle East to be operated abroad by a major American research university. NYU Abu Dhabi has integrated a highly selective program with majors in the sciences, engineering, social sciences, arts, and humanities with a world center for advanced research. Its campus enables students to succeed in an increasingly interdependent world, and to advance cooperation and progress on humanity’s shared challenges. NYU Abu Dhabi’s high-achieving students have come from some 120 countries and speak over 115 languages. Together, NYU's campuses in New York, Abu Dhabi, and Shanghai form the backbone of a unique global university, giving faculty and students opportunities to experience varied learning environments and immersion in other cultures at one or more of the numerous study-abroad sites NYU maintains on six continents. 

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JOURNAL

Green Chemistry

ARTICLE TITLE

High-yield, one-pot upcycling of polyethylene and polypropylene waste into blue-emissive carbon dots

Risk of thrombotic events should not exclude transgender people from receiving hormone therapy, according to new guidance

Transgender women who develop venous thromboembolism while on feminizing hormone therapy can be safely treated and managed.

Peer-Reviewed Publication

MASSACHUSETTS GENERAL HOSPITAL

BOSTON – The negative mental and physical effects of withholding gender affirming hormone therapy (GAHT) from transgender people may outweigh the risk of GAHT-associated venous thromboembolism (VTE), underscoring the need for a thorough upfront discussion by healthcare provider and patient, according to a study led by investigators from Massachusetts General Hospital, other Mass General Brigham hospitals, and transgender health experts from across the country.

The team’s findings, published in Endocrine Practice, provide the foundation for new guidance for assessing, managing, and treating VTE (potentially serious blood clots that form in deep veins) in transgender patients of all ages receiving feminizing hormone therapy.

“Considerable data have emerged over the past three years showing that not providing GAHT results in poor mental and physical health outcomes and increases the risk of suicidality in transgender patients,” says Robbie Goldstein, MD, PhD, founder and former medical director of the MGH Transgender Health Program.

“Our review found that VTE can be managed in most cases with anticoagulation therapy, and that discontinuing hormone therapy is not always the right answer and, in many cases, may be the wrong answer.”

The new recommendations from a national team of transgender health specialists are the most comprehensive to date in a field of medicine that has undergone enormous change in recent years, driven by an adult transgender population now estimated at 1.4 million people in the U.S.

A challenge for researchers is gathering evidence in an area where little data exist, given the paucity of trial data for transgender patients on hormone therapy undergoing various gender affirming surgical procedures.

Data extrapolated from the cisgender population (i.e., individuals whose sex at birth corresponds to their current gender identify) indicate that the risk of VTE in patients receiving GAHT, specifically estrogen, was slightly elevated—though still minimal—compared to cisgender women not on hormone therapy.

Duration of hormone therapy and route of administration may increase the risk of VTE in the transgender population, especially around the time of procedures such as vaginoplasty, facial feminization, or breast augmentation.

The protocols outlined in the paper specifically address treatment after a thrombotic event. The team of experts recommended that transgender people who develop VTE while on GAHT be treated with the same regimen as cisgender patients, that is, direct oral anticoagulation over vitamin K antagonists or low-molecular-weight heparin to minimize the threat of bleeding.

“Many people diagnosed with VTE are taken off hormone therapy by their healthcare providers and never restarted,” notes co-author Nathan Connell, MD, MPH, chief of Medicine, Brigham and Women’s Faulkner Hospital, and a hematologist at Brigham and Women’s Hospital.

“This practice is based on limited data, however, and we found evidence to suggest that hormone therapy can be continued in patients, even those with a VTE history, as long as full-intensity anticoagulation is also continued.”

As Goldstein points out, it’s crucial for the growing numbers of clinicians who treat transgender patients to become more informed and better prepared in an increasingly specialized field.

“It’s incumbent on the medical community to build trust within the transgender community,” he says, “and we’re hopeful that our guidance will help change practice for many primary care providers, hematologists and endocrinologists, resulting in direct and positive impacts on the mortality and morbidity of transgender patients.”

The authors include Goldstein, instructor in Medicine, Harvard Medical School (HMS) and MGH; Connell, associate professor in Medicine, HMS and Brigham and Women’s Hospital (BWH); Mabel Toribio, MD, assistant professor in Medicine, HMS and MGH; Devin O’Brien-Coon, MD, MS, associate professor in Plastic Surgery, HMS and BWH; Anna Goldman, MD, instructor in Medicine, HMS and BWH; and Frances Grimstad, MD, assistant professor in Obstetrics, Gynecology, and Reproductive Medicine, HMS, BWH, and Boston Children’s Hospital.

The study was funded by a grant from Bristol-Myers Squibb to the North American Thrombosis Forum (NATF), a nonprofit organization dedicated to improving the lives of people affected by blood clots and related diseases.

About the Massachusetts General Hospital

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In August 2021, Mass General was named #5 in the U.S. News & World Report list of "America’s Best Hospitals." MGH is a founding member of the Mass General Brigham healthcare system.

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JOURNAL

Endocrine Practice

DOI

10.1016/j.eprac.2022.12.008 

METHOD OF RESEARCH

Systematic review

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Assessing and Addressing the Risk of Venous Thromboembolism Across the Spectrum of Gender Affirming Care: A Review

ARTICLE PUBLICATION DATE

6-Mar-2023