Does clinical research account for diversity in deploying digital health technologies?

Digital health technologies (DHTs) should expand access to clinical research to represent the social determinants of health (SDoH) across the population. The frequency of reporting participant SDoH data in clinical publications is low and is not known for studies that utilize DHTs. We evaluated representation of 11 SDoH domains in 126 DHT-enabled clinical research publications and proposed a framework under which these domains could be captured and subsequently reported in future studies. Sex, Race, and Education were most frequently reported (in 94.4%, 27.8%, and 20.6% of publications, respectively). The remaining 8 domains were reported in fewer than 10% of publications. Medical codes were identified that map to each of the proposed SDoH domains and the resulting resource is suggested to highlight that existing infrastructure could be used to capture SDoH data. An opportunity exists to increase reporting on the representation of SDoH among participants to encourage equitable and inclusive research progress through DHT-enabled clinical studies.

Information design to support growth, quality, and equity of the US transplant system.

The Organ Procurement and Transplantation Network, an arm of the Health Resources and Services Administration, has a contract with the United Network for Organ Sharing since 1986 to provide central oversight of organ donation and transplants in the United States. The United Network for Organ Sharing has recently come under scrutiny, prompting a review by the National Academies of Sciences, Engineering, and Medicine as summarized in its recent report and also by the US Senate Finance Committee. The national news services have opined about organ donation ethics, access to transplantation particularly for medically underserved populations, and management of organ transplantation data. These critiques raise important concerns that deserve our best response as a transplant community. Broadly, we suggest that the data management approach of the Organ Procurement and Transplantation Network be replaced with a patient-centric omnichannel network in which all donor and recipient data exist in a single longitudinal record that can be used by all applications. A more comprehensive and standardized approach to donor data collection would drive quality improvement across organ procurement organizations and help address inequities in transplantation. Finally, a substantial increase in organ donation would be prompted by considering organ donors as a public health resource, meriting transparent publicly available data collection with respect to organ donor referral, screening, and management.

A cybersecurity primer for translational research.

Virtually all health care organizations have had at least one data breach since 2012. Most of the largest data breaches and Health Care Information Privacy and Accountability Act fines could have been prevented by the simplest of strategies. Each researcher must clearly understand his or her responsibilities and liability.

Complexation hydrogels for oral protein delivery: an in vitro assessment of the insulin transport-enhancing effects following dissolution in simulated digestive fluids.

The insulin-transport enhancing effects of a pH-sensitive poly((methacrylic acid)-grafted-poly(ethylene glycol)) hydrogel system were studied using Caco-2 monolayers as an in vitro model of intestinal transport. Further, the ability of the hydrogel system to protect entrapped proteins through the upper gastrointestinal tract via digestion in simulated gastric and simulated intestinal fluids with digestive enzymes was confirmed. Caco-2 cell monolayers were exposed to a series of formulations including insulin alone, the polymer in insulin solution, insulin-loaded polymer (ILP) and ILP previously subjected to simulated digestive fluids with enzymes. These studies demonstrated greatly increased insulin transport for the ILP samples when compared with insulin alone and insulin in the presence of polymer, P(app)=12.7 x 10(-8) cm/s and 6.61 x 10(-8) cm/s versus 0.07 x 10(-8) cm/s and 0.06 x 10(-8) cm/s, respectively. While enhanced transport with the ILP was observed, the largest changes in TEER values did not coincide with the highest amounts of insulin transport, this suggests that the paracellular route may not be the sole mechanism of transport. Further, as the Caco-2 cell line has been demonstrated to possess the insulin receptor, active transport or a mixed mechanism cannot be ruled out.