United States

Background: Within New York City (NYC), certain communities have experienced greater rates of adverse COVID-19 outcomes. Current literature has evaluated the effectiveness of public health interventions during COVID-19 but fails to stratify across boroughs with varying demographic makeups. Understanding the effect of COVID-19 on different NYC communities may allow for the development of more efficacious public health policies that address populational disparities. Therefore, we compared trends in COVID-19 cases, hospitalizations, and deaths between the five NYC boroughs before and after the start of vaccine administration, using an interrupted time series analysis.

Methods: Data was collected from the Department of Health and Mental Hygiene’s dataset on daily COVID-19 cases, hospitalizations, and deaths. Our interrupted time series began on June 8th, 2020 and analyzed data through July 3rd, 2021. The intervention in our analysis was the availability of vaccinations to New Yorkers aged 16 years or older, beginning April 6th, 2021. Changes between pre- and post-intervention outcome trends were compared across each of the boroughs.

Results: In NYC as a whole, there was a significant decrease in the trend of cases, hospitalizations, and deaths following vaccinations. The greatest decreases in case trends were seen in the Bronx, Brooklyn, and Queens. Staten Island had a significantly greater decrease in hospitalizations, yet had the smallest change in deaths per unit time. In contrast, Brooklyn had a significantly greater decrease in death trends compared to all other boroughs.

Conclusion: We demonstrate a significant decrease in the trends of cases, hospitalizations, and deaths in NYC following vaccinations, illustrating its effectiveness in mitigating the spread of the pandemic. However, such decreases varied between boroughs, potentially owing to demographic and population-based disparities. Variations in post-intervention death trends may be attributed to Brooklyn’s larger population and a higher percentage of unmet medical care. Furthermore, boroughs with the highest proportion of Black/Hispanic inhabitants and unemployment experienced the greatest rise in pre-intervention death trends. This may indicate a need to target such populations in future public health crises. Nevertheless, boroughs with the highest minority populations showed the greatest decrease in case and death trends, suggesting the vaccine’s effectiveness among underserved populations. 


AMA Research Challenge 2022

Differences in the Effectiveness of COVID-19 Vaccine Administration Between the Five New York City Boroughs: An Interrupted Time Series Analysis

The 9th Brazilian Conference on Intelligent Systems (BRACIS), the 16h Encontro Nacional de Inteligência Artificial e Computacional (ENIAC), and the 12th Concurso de Teses e Dissertações em Inteligência Artificial e Computacional (CTDIAC) was held from 20 to 23 October, 2020.

BRACIS originated from the combination of the two most important scientific events in Brazil in Artificial Intelligence (AI) and Computational Intelligence (CI): the Brazilian Symposium on Artificial Intelligence - SBIA (22 editions), and the Brazilian Symposium on Neural Networks - SBRN (13 editions). ENIAC is a national forum for researchers, practitioners, educators and students to present and discuss innovations, trends, experiences, developments and work in progress in the fields of Artificial and Computational Intelligence. CTDIAC is a satellite event whose goals are to disseminate and award the best dissertations and theses (MSc and PhDs concluded in Brazilian universities from June 2018 to May 2020) in Artificial and Computational Intelligence areas.

In this year, the Symposium on Knowledge Discovery, Mining and Learning (KDMiLe) will be held in conjunction with BRACIS 2020. This sysposium aims at integrating researchers, practitioners, developers, students and users to present their research results, to discuss ideas, and to exchange techniques, tools, and practical experiences – related to the Data Mining and Machine Learning areas.

BRACIS 2020

poster

Welcome to the largest national, multi-specialty research event **featuring research from 750 medical students, residents and fellows, and international medical graduates.**


#### Event Details
The 2022 American Medical Association Research Challenge includes a poster symposium hall and a semifinals hall with the top scored research. Log in at any time throughout the event to:
* **View posters and presentations** on a variety of topics and specialties
* **Score posters in the semifinals** to help decide the top five finalists (AMA member exclusive opportunity)
* **Connect with participants** and provide feedback to help advance their research

At the conclusion of this event, the AMA will announce the top five finalists who will advance to the AMA Research Challenge finals, present their research to an elite panel of judges and compete to win a $10,000 grand prize sponsored by Laurel Road.
 

#### Attend Live Forums
**Oct. 20, 6 — 7 p.m. Central**
 **How to plan a career in academic medicine** 
 Learn how to plan a career in academic medicine and get your questions answered. [Access Here](https://underline.io/events/363/lounge)
 
 **Speakers**
![](https://assets.underline.io/uploads/markdown_image/1/image/d5adb133dfc58eb0a6d469e9cedcd5d4.jpg)
Ricardo Correa, MD, EdD
![](https://assets.underline.io/uploads/markdown_image/1/image/5f9437ab87861538bf02b9ca7c0d926e.jpg)
Stuart M. Greenstein, MD
![](https://assets.underline.io/uploads/markdown_image/1/image/05b1b637c99286d558c371f8e8b185ce.jpg)
Stephanie Strohbeen, MD
 
 **Oct. 22, 11 a.m. — Noon Central**
 **How to get published**
 Learn tips to get your research published and get your questions answered. [Access Here](https://underline.io/events/363/lounge)
 
 **Speakers**
![](https://assets.underline.io/uploads/markdown_image/1/image/8ce6235e957d31cb5e6f9097cc6f6972.jpg)
Jessica Li, MD/PhD Candidate
![](https://assets.underline.io/uploads/markdown_image/1/image/9950ef2e0237f54cb3d8280334d42491.jpg)
Charles Lopresto, DO

### Sponsor
AMA would like to thank Laurel Road for sponsoring a $10,000 grand prize for the winner of the AMA Research Challenge. Laurel Road is not involved in the judging or scoring process to select the winner. The winner will be announced on Dec. 7 during the AMA Research Challenge finals. Payment of the grand prize will be directly from Laurel Road. See the AMA Research Challenge Official Rules for terms and conditions.

![](https://assets.underline.io/uploads/markdown_image/1/image/611e331d4a0eba0920f240cfc04b4d77.png)

**There is no registration fee for this event! **

Register to explore research in a variety of topics. AMA members get exclusive access to score posters in the semifinals.

**Please use the link below to register for free if you have not already done so:**

https://www.ama-assn.org/about/events/ama-research-challenge

Registration Is Required

Welcome to the largest national, multi-specialty research event featuring research from 750 medical students, residents and fellows, and international medical graduates.


Background
Asthma is a chronic respiratory condition affecting around 300 million people worldwide. In North America, the prevalence of asthma in children and young adults is about 11%. Multiple studies have shown that the burden of asthma was higher in the inner-city when compared to non-inner-city areas. In the United States, African and Hispanic Americans have a higher burden for asthma compared to White Americans. The goal of this study was to differentiate the burden of asthma between US-born and foreign-born Black New York City (NYC) residents. 
Methods
This is a secondary data analysis of the 2014 NYC Health and Nutrition Examination Survey (NYC HANES). The covariates of interest are age, sex, education, income, health insurance, and smoking status. We test for differences in asthma among Black residents of NYC by nativity using a multivariable Cox proportional hazard model with robust estimates by using a constant time for cross-sectional studies. We use domain analysis to maintain the complex survey structure of the data. Standard errors were estimated using Taylor’s Series Linearization, accounting for the complex survey nature of the data collection. We conducted all analyses in SAS OnDemand for Academics®. We set the threshold for significance at 5%.
Results
The final analytic sample represented a weighted proportion of 24.16% (SE = 1.40). The proportion of US-born Black residents was 61.1% and the proportion of foreign-born Black residents was 38.9%. Univariate analysis indicated that 29.2% of US-born Black NYC residents reported an asthma diagnosis compared to 10.7% of foreign-born Black residents of NYC (p-value < 0.001). The result of the covariate-adjusted model indicated that foreign-born Black NYC residents had a significantly lower prevalence of asthma compared to US-born (PR = 0.40, 95% CI = 0.21-0.76). Additionally, those who are 65 years and older had a lower asthma risk compared to those 20-34 years old.
Conclusion
This study shows that asthma is found in higher rates amongst US-born Black NYC residents as opposed to foreign-born. Further studies should investigate this result in a national sample. Also, studies should investigate association of acculturation to asthma outcome in foreign-born population.

Disparities in asthma rates amongst Black residents of New York City

Donation Trend from the American College of Physicians and American Academy of Family Physicians Politcal Action Committees: A 2006-2020 Analysis of Partisan Contributions

Abstract Title: Exploration of Exercise Referrals to Personal Fitness Trainers by Primary Care Physicians to Increase Adherence to Exercise Recommendations in African American Women.

Background: The endless health benefits of physical activity are common knowledge, yet physical inactivity is still a public health crisis in the U.S. Increased intervention is necessary to improve adherence to recommendations on physical activity. Adjacent to this crisis, is an increase in patients with obesity. African American women are among those most impacted by obesity and have been found to be the least physically active group in the country. Exercise referrals by primary care physicians to other health care professionals, specifically personal fitness trainers, is one intervention that may increase physical activity. While exercise referrals to personal fitness trainers is an underutilized, understudied intervention in addressing physical inactivity, studies suggest that exercise referrals to personal fitness trainers may have some benefit to African American female women. This study explores how African American women might benefit from exercise referral programs from their primary care physician to personal fitness trainers.

Methods: A literature review was conducted on the value of personal fitness trainers for African American women. One hundred African American women, with a BMI over 30 were surveyed on their physical activity habits and exercise recommendations from their primary care physician, including referral to personal fitness trainers. Survey respondents were offered a $5-$10 gift card for survey completion. Responses were uploaded manually and analyzed using comparison analysis.

Results: Results show that while most African American female patients at the Deighton Family Medicine Clinic reported being advised on physical activity, none had been directed to meet with a personal fitness trainer. 

Conclusion: African American female patients between the ages of 18 and 65 years of age significantly report being advised to exercise by their primary care physician but report no referrals to personal fitness trainers. This study may be useful in influencing interventional programs that refer African American women to personal fitness trainers by identifying barriers and highlighting exercise referrals as an effective therapeutic approach that is not common use.






Exploration of Exercise Referrals to Personal Fitness Trainers by Primary Care Physicians to Increase Adherence to Exercise Recommendations in African American Women.

Background:
Helicobacter Pylori is a gram-negative bacterium that induces chronic gastritis resulting in peptic ulcer disease and can also cause non-ulcer dyspepsia, gastric carcinoma and mucosa-associated lymphoma. Macrolide-based regimens were the first-line treatment for H. Pylori eradication;however, their widespread usage has led to increased resistance and subsequently treatment failure. Other factors contributing include poor compliance, smoking, prior antibiotics exposure.
Methods:
We performed retrospective analysis of electronic medical records of patients who were tested for H. pylori infection between January 2021 to December 2021. Data on patient’s sociodemographic factors, presenting symptoms, tests used for H. Pylori detection (stool antigen vs antibodies), prior use of antibiotics, the first line regimen used to treat the infection and follow up to confirm eradication of infection, were collected. Frequencies for all variables were calculated.
Results:
Among cohort of 670 with mean age of 57.9, 58% were females, 23% were of Hispanic ethnicity and 14% were former smokers, majority of cohort got tested in the ambulatory settings (75%) using stool antigen test 93% of which 37% (n= 234) tested positive for H. pylori and among these 53% were using PPI. The most common presenting symptoms were abdominal pain (64%) and GERD (22%), respectively. Standard triple regimen consisting of clarithromycin, amoxicillin, and PPI were prescribed to 76.1% of positive tested individuals with only 50%
completed the therapy and 28% of these had eradication confirmation on repeat stool antigen testing at a median follow-up of 12.7 weeks.
Conclusion:
Macrolide resistance, particularly for clarithromycin, has been observed at varying rates (1-21%) across different geographical regions and is now considered as an important factor in eradication failure. In our study we observed a low eradication rate among patients who were treated with macrolide-based regimen as first line therapy, suggesting that macrolide resistance may have played a role in eradication/treatment failure apart from other factors i.e., cost, duration of
therapy, poor compliance and loss of follow up. Thus, use of bismuth-quadruple or levofloxacin based regimen as first line therapy in high macrolide resistance areas is warranted.

Factors for H. Pylori Eradication Failure and Regimen Conformity withStandard Guidelines.

Introduction: Although the high rates of mental health issues and the unmet healthcare needs among Asian Americans have been recognized in literature, there is a lack of empirical research on the mental health issues of Filipino Americans (FAs). Using data from a mixed method study that integrated a quantitative survey with qualitative interviews, this study explored factors that influence mental health needs and access to care in FAs living in Eastern Virginia.

Methods: A Community Health Resources and Needs Assessment (CHRNA) survey was implemented online using REDCap and distributed to Asian and Pacific Islanders in Eastern Virginia in April-July 2022. Participants (N=1,462) were recruited through in-person events and social media channels using three sampling criteria: 1) persons of Asian and Pacific Islander descent, 2) ages 18-85 years, and 3) residents of Hampton Roads and the Eastern Shore. Data from a subsample of 281 respondents who self-reported as Filipino were analyzed using descriptive statistics and multivariable logistic regression. Key informants (N=25, including 15 females and 10 males) were recruited through snowball sampling and referrals from Filipino community stakeholders. Semi-structured interviews (30-60 minutes) were conducted virtually via Zoom in English by trained researchers. Semantic analysis was guided by the grounded theory and the socio-ecological model.

Results: While 7.2% of FAs received diagnoses of depression or other mental health problems from healthcare providers, 27.4% frequently experienced the following: 1) had little interest or pleasure in doing things, 2) felt down, depressed, or hopeless; 3) feeling nervous, anxious or on edge; 4) being unable to stop or control worrying. Higher odds of having mental health issues were found in females, older participants, participants who experienced language barriers, and participants with less economic resources. Religious belief (e.g., Catholicism) and family support served as significant buffers for FAs to cope with stress. Stigma embedded within Filipino culture has been a key mental health barrier in FAs. While the Philippine Cultural Center (PCC) has served as a primary source of community support (particularly for the elderly population), the PCC could be further utilized as a community-based mental health resource, involving licensed mental health practitioners for culturally sensitive interventions in a community setting.

Conclusion: Findings demonstrate that FA mental health is influenced by a complex interplay of macro and micro-level socio-ecological factors. Culturally competent community-based interventions are urgently needed to normalize mental health, to increase awareness and access to care, and to reduce mental health issues and disparities.

Factors Related to the Mental Health of Filipino Americans in Eastern Virginia - Findings from a Mixed Methods Study Conducted in 2022

Though originally designed in the 1960s to provide emergency medical care, emergency medical service (EMS) systems have experienced non-emergency utilization by small groups of frequent EMS users. Frequent EMS use as a public health issue reflects healthcare waste, misused EMS resources, and underserved populations. In turn, municipalities such as San Francisco have developed community paramedicine (CP) programs to improve access to healthcare and social services in non-emergency settings. Prior evaluation has found that EMS-6 — one such CP program operated by the San Francisco Fire Department (SFFD) — is safe and effective at reducing frequent EMS use amongst the most frequent EMS users. That said, frequent EMS users are heterogeneous groups with diverse needs, such as housing assistance, primary care, urgent care, and detoxification. The goal of this in-progress study is to describe the characteristics of frequent EMS users in San Francisco over recent years. By characterizing those frequent EMS users who have not experienced decreases in frequent EMS use, the results may be used to inform adjustments to the CP services provided by EMS-6.

Frequent EMS Users in San Francisco: A Cross-Sectional Study

Healthy East Harlem (HEH): Improving Health Outcomes By Prescribing Fruits and Vegetables

Identifying Top Health Priorities Among Afghan Refugees

Context: 
This study assesses the needs of Afghan refugees receiving services at the Center for Refugee Services (CRS) in San Antonio. Services include assisting refugees with doctors’ appointments, applying for health insurance, and providing translation services. Research has shown that refugees face many health challenges like an increased predominance of chronic disease from the stress of resettlement. 

Objective: 
To identify the health priorities of Afghan refugees who visit the CRS using a needs assessment survey. 

Design: 
Each survey was administered in person with the help of an interpreter, as needed. The survey assesses basic demographics and the respondent’s top health concerns through a combination of open-ended and “check all that apply” questions. 

Setting: 
CRS, San Antonio 

Participants: 
Self-identified Afghan refugees (n=33) aged 18 years and older who reside in San Antonio, Texas, and receive services at the CRS. 

Main and Secondary Outcomes: 
By determining which health concerns are most prevalent among the Afghan refugees, the CRS can target their aid to address the specific needs. 

Results: 
Preliminary results reveal most participants, 84.8%, are male (n=27) with an average age of 30.2. All participants speak Pashto with 75.8% (n=25) being their primary language, 87.9% (n=29) are married and live in households with an average size of 5 people, 45.5% (n=15) completed high school, 30.3% (n=10) are working full time, and 72.7% (n=24) have moved to the US within the past 12 months. 54.5% (n=18) of respondents reported they seek healthcare at the San Antonio Refugee clinic, 48.5% (n=16) seek care at a Doctor’s Office, and 42.4% (n=14) go to a hospital emergency department. The participants’ top three health concerns were teeth problems (n=28), no insurance (n=19), and language (n=12). 

Conclusions: 
This research in progress will help provide care and reduce the negative health consequences that refugees face. 


Identifying Top Health Concerns Among Afghan Refugees

Concern about sex education is primarily focused on prevention of unplanned pregnancy and STI’s. A broader perspective on the relationship of sex education with gender roles and stigma related to sexual behavior has been recognized, although data on these relationships is limited. We sought to address this gap by measuring prevalence of receipt of sex education, focus of sex education, perceived stigma related to sexual behavior, and its distribution amongst gender in undergraduate university students.

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Disparities in asthma rates amongst Black residents of New York City

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