Widespread use of National Academies consensus reports by the American public.

In seeking to understand how to protect the public information sphere from corruption, researchers understandably focus on dysfunction. However, parts of the public information ecosystem function very well, and understanding this as well will help in protecting and developing existing strengths. Here, we address this gap, focusing on public engagement with high-quality science-based information, consensus reports of the National Academies of Science, Engineering, and Medicine (NASEM). Attending to public use is important to justify public investment in producing and making freely available high-quality, scientifically based reports. We deploy Bidirectional Encoder Representations from Transformers (BERT), a high-performing, supervised machine learning model, to classify 1.6 million comments left by US downloaders of National Academies reports responding to a prompt asking how they intended to use the report. The results provide detailed, nationwide evidence of how the public uses open access scientifically based information. We find half of reported use to be academic-research, teaching, or studying. The other half reveals adults across the country seeking the highest-quality information to improve how they do their job, to help family members, to satisfy their curiosity, and to learn. Our results establish the existence of demand for high-quality information by the public and that such knowledge is widely deployed to improve provision of services. Knowing the importance of such information, policy makers can be encouraged to protect it.

Comparative Performance of Pulmonary Ultrasound, Chest Radiograph, and CT Among Patients With Acute Respiratory Failure.

OBJECTIVES: The study goal was to concurrently evaluate agreement of a 9-point pulmonary ultrasound protocol and portable chest radiograph with chest CT for localization of pathology to the correct lung and also to specific anatomic lobes among a diverse group of intubated patients with acute respiratory failure. DESIGN: Prospective cohort study. SETTING: Medical, surgical, and neurologic ICUs at a 670-bed urban teaching hospital. PATIENTS: Intubated adults with acute respiratory failure having chest CT and portable chest radiograph performed within 24 hours of intubation. INTERVENTIONS: A 9-point pulmonary ultrasound examination performed at the time of intubation. MEASUREMENTS AND MAIN RESULTS: Sixty-seven patients had pulmonary ultrasound, portable chest radiograph, and chest CT performed within 24 hours of intubation. Overall agreement of pulmonary ultrasound and portable chest radiograph findings with correlating lobe ("lobe-specific" agreement) on CT was 87% versus 62% (p < 0.001), respectively. Relaxing the agreement definition to a matching CT finding being present anywhere within the correct lung ("lung-specific" agreement), not necessarily the specific mapped lobe, showed improved agreement for both pulmonary ultrasound and portable chest radiograph respectively (right lung: 92.5% vs 65.7%; p < 0.001 and left lung: 83.6% vs 71.6%; p = 0.097). The highest lobe-specific agreement was for the finding of atelectasis/consolidation for both pulmonary ultrasound and portable chest radiograph (96% and 73%, respectively). The lowest lobe-specific agreement for pulmonary ultrasound was normal lung (79%) and interstitial process for portable chest radiograph (29%). Lobe-specific agreement differed most between pulmonary ultrasound and portable chest radiograph for interstitial findings (86% vs 29%, respectively). Pulmonary ultrasound had the lowest agreement with CT for findings in the left lower lobe (82.1%). Pleural effusion agreement also differed between pulmonary ultrasound and portable chest radiograph (right: 99% vs 87%; p = 0.009 and left: 99% vs 85%; p = 0.004). CONCLUSIONS: A clinical, 9-point pulmonary ultrasound protocol strongly agreed with specific CT findings when analyzed by both lung- and lobe-specific location among a diverse population of mechanically ventilated patients with acute respiratory failure; in this regard, pulmonary ultrasound significantly outperformed portable chest radiograph.

Temporal search persistence, certainty, and source preference in dentistry: Results from the National Dental PBRN.

OBJECTIVES: The primary goal of this paper was to investigate an old question in a new way: what are the search patterns that professionals demonstrate when faced with a specific knowledge gap? METHODS: We examine data from a cascading survey question design that captures details about searching for information to answer a self-nominated clinical question from 1027 dental professionals enrolled in the National Dental Practice Based Research Network. Descriptive and conditional logistical regression analysis techniques were used. RESULTS: 61% of professionals in our sample choose informal sources of information, with only about 11% looking to formal peer reviewed evidence. The numbers of professionals turning to general internet searches is more than twice as high as any other information source other than professional colleagues. Dentists with advanced training and specialists are significantly more likely to consult peer-reviewed sources, and women in the sample were more likely than men to continue searching past a first source. CONCLUSIONS: Speed/availability of information may be just as, or in some cases, more important than credibility for professionals' search behavior. Additionally, our findings suggest that more insights are needed into how various categories of professionals within a profession seek information differently.

Association between predoctoral evidence-based practice training and later use of peer-reviewed journals: National dental PBRN.

OBJECTIVE: We examined whether evidence-based practice (EBP) during dental school was associated with the increased use of peer-reviewed literature during subsequent clinical practice for National Dental Practice-Based Research Network (PBRN) dentists. We also sought to understand whether this association was moderated by being a dental specialist. METHODS: We analyzed cross-sectional data from 1228 dentists participating in the PBRN. We used logistic regression to examine the association between self-reported EBP training during dental school and the use of peer-reviewed journals in clinical practice, controlling for the number of years since dental school graduation and dental practice type. We stratified the data by dental specialists and examined effect modification using the Breslow-Day test for homogeneity of the odds ratio. RESULTS: The prevalence of peer-reviewed journal use by PBRN dentists in clinical practice was 87% (n = 1070) with no statistical evidence of effect modification by dental specialists on the EBP peer-reviewed journal use relationship (p > 0.05). After controlling for years since dental school graduation and dental practice type, dentists who self-reported EBP training during dental school had greater odds of using peer-reviewed journals in clinical practice than dentists who did not self-report EBP training during dental school (OR, 1.47; 95%CI = 1.01, 2.15). CONCLUSION: The use of peer-reviewed published literature by PBRN dentists who had EBP predoctoral training is one important step in the EBP process by which practicing dentists can implement evidence-based findings, interventions, and policies into routine health care and public health settings. These findings add to the body of support for EBP curricula in dental education.

The persistence of high energy burdens: A bibliometric analysis of vulnerability, poverty, and exclusion in the United States.

Using bibliometric methods, we examine the persistently high energy bills borne by low-income households in the U.S. This is a mystifying problem in today's age of abundant and low-priced electricity and fossil fuels. After decades of energy-efficiency programs and targeted policies, the average low-income household still spends a disproportionately large percentage of its income on energy bills. Issues of equity, race and justice are increasingly linked to the problem of persistent energy burdens. In the complex ecosystem of stakeholders that influence energy burden, key gaps still exist in the understanding of causes and solutions. In particular, limited research has examined the role of landlords and property managers in multifamily housing. Over the past decade, research has increasingly illuminated (1) the link between energy burden and health, (2) promising pathways to democratize energy efficiency and rooftop solar, and (3) issues of equity, justice, and African-American populations. Sustainable and affordable household energy is critical today as Covid-19 and climate change introduce new layers of stress that challenge the transition to a clean energy future.

Patient and Care Team Perspectives of Telemedicine in Critical Access Hospitals.

Telemedicine acute care may address issues facing critical access hospitals. This evaluation used web, mail, and telephone surveys to quantitatively and qualitatively assess patient and care team experience with telemedicine in 3 rural critical access hospitals and a large metropolitan tertiary care hospital. Results show that patients, nurses, and clinicians perceived quality of care as high, and they offered feasible recommendations to enhance communication and otherwise improve the experience. Continued work to improve, test, and publish findings on patient and care team experience with telemedicine is critical to providing quality services in often underserved communities.