Sharing Overdose Data Across State Agencies to Inform Public Health Strategies: A Case Study.

Data sharing and analysis are important components of coordinated and cost-effective public health strategies. However, legal and policy barriers have made data from different agencies difficult to share and analyze for policy development. To address a rise in overdose deaths, Maryland used an innovative and focused approach to bring together data on overdose decedents across multiple agencies. The effort was focused on developing discrete intervention points based on information yielded on decedents' lives, such as vulnerability upon release from incarceration. Key aspects of this approach included gubernatorial leadership, a unified commitment to data sharing across agencies with memoranda of understanding, and designation of a data management team. Preliminary results have yielded valuable insights and have helped inform policy. This process of navigating legal and privacy concerns in data sharing across multiple agencies may be applied to a variety of public health problems challenging health departments across the country.

Block copolymers for the rational design of self-forming postsurgical adhesion barriers.

Post-surgical adhesions, abnormal fibrous linkages between adjacent tissue surfaces, represent one of the most common and significant complications facing surgical recovery today. Physical barriers and gels have been the most successful at limiting their formation, yet are not effective in cases where the pro-adhesive site is either unknown or difficult to reach (e.g. during laparoscopic surgery). In this work, poly(methacrylic acid-co-t-butylmethacrylate)-b-poly(ethylene glycol (M(N) = 1000) methacrylate) diblock and statistical copolymers were synthesized as a platform for designing self-forming adhesion barriers, which can attach to exposed pro-adhesive sites through binding with the positively charged extracellular matrix, basement membrane proteins and deposited fibrin. An experimental model based upon a quartz crystal microbalance with dissipation was developed to test the diblock copolymers ability (i) to adsorb to an amine-terminated self-assembled monolayer, and (ii) to inhibit subsequent protein adsorption. These results were also confirmed using an in vitro cell attachment model. As the mole fraction of methacrylic acid content increased, polymer adsorption increased. All synthesized diblock copolymers investigated provided high resistance to protein adsorption, with blockade ranging from 55% to 81%. Except for the uncharged control polymers, the ability of these materials to resist cellular attachment showed similar trends, with the suppression of attachment approaching 75%. Energy dissipation analysis and variable-angle spectroscopic ellipsometry revealed two competing adsorption mechanisms depending on the molecular properties of the polymer.