Understanding parental choices related to infant sleep practices in the United States using a mixed methods approach.

Background: This study aimed to gather information about parental practices, knowledge, and attitudes regarding infant sleep habits and environments, among families who practice non-recommended sleep practices.

Methods: We conducted one-on-one phone interviews with parents who had practiced non-recommended sleep methods with their infant and had or had not experienced an undesirable sleep event such as a fall. Interviews were recorded and coded with MAXQDA software.

Pregnancy-related acute kidney injury leads to hypertension, reduced kidney function and cognitive impairment in postpartum rats.

Introduction: Women with hypertensive disorders of pregnancy such as HELLP (hemolysis, elevated liver enzyme, low platelet) Syndrome are affected by acute kidney injury during pregnancy (PR-AKI) at higher rates than women without hypertension. Both hypertensive disorders of pregnancy and Acute Kidney Injury (AKI) outside the context of pregnancy have been associated with an increased risk of developing Chronic Kidney Disease (CKD) and cognitive impairment. In our current study, we set out to determine if PR-AKI led to the development of CKD and impaired cognition in the postpartum period and if HELLP syndrome exacerbates the impairments.

Use of mobile applications and mental health services among veterans who received internet-connected tablets.

Objectives: Among Veterans Health Administration (VHA) patients receiving internet-connected tablets, we examined (1) app usage, (2) clusters of commonly used apps and patient characteristics across clusters, and (3) the relationship between app clusters and mental health services.

Materials And Methods: A survey was distributed to a national sample of VHA patients ( = 5449) within 6 months of tablet receipt. Self-reported app use was clustered with agglomerative hierarchical clustering.

mHealth Physical Activity and Patient-Reported Outcomes in Patients With Inflammatory Bowel Diseases: Cluster Analysis.

Background: Regular physical activity is associated with improved quality of life in patients with inflammatory bowel diseases (IBDs), although much of the existing research is based on self-reported data. Wearable devices provide objective data on many rich physical activity dimensions including steps, duration, distance, and intensity. Little is known about how patients with IBDs engage in these varying dimensions of exercise and how it may influence their symptom and disease-specific patient-reported outcomes (PROs).

Recommendations to promote fairness and inclusion in biomedical AI research and clinical use.

Objective: Understanding and quantifying biases when designing and implementing actionable approaches to increase fairness and inclusion is critical for artificial intelligence (AI) in biomedical applications.

Methods: In this Special Communication, we discuss how bias is introduced at different stages of the development and use of AI applications in biomedical sciences and health care. We describe various AI applications and their implications for fairness and inclusion in sections on 1) Bias in Data Source Landscapes, 2) Algorithmic Fairness, 3) Uncertainty in AI Predictions, 4) Explainable AI for Fairness and Equity, and 5) Sociological/Ethnographic Issues in Data and Results Representation.

Maternal immune suppression during pregnancy does not prevent abnormal behavior in offspring.

Background: Offspring of hypertensive disorders of pregnancy are at an increased risk of developing neurodevelopmental and neurobehavioral disorders compared to offspring from non-affected pregnancies. Using rodent models of Preeclampsia (PreE; new onset of hypertension after 20 weeks gestation) and HELLP (hemolysis, elevated liver enzymes, and low platelets), we studied the behavioral outcome of their offspring in adolescence.

Methods: A subset of dams received Orencia, a T-cell activation inhibitor, as T cells have been associated with the induction of hypertension and inflammation during pregnancy.

Relationship Between Patient Portal Tool Use and Medication Adherence and Viral Load Among Patients Living with HIV.

Background: Patient portals play an increasingly critical role in engaging patients in their health care. They have the potential to significantly impact the health of those living with chronic diseases, such as HIV, for whom consistent care engagement is both critical and complex.

Objective: The primary aim was to examine the longitudinal relationships between individual portal tool use and health-related outcomes in patients living with HIV.

A Tool to Identify and Engage Patients on Risky Opioid Regimens.

Background: Concerns around opioid safety for patients living with chronic pain have led to a growing number of collaborative and multimodal pain care initiatives. A major challenge in these efforts has been identifying and engaging patients on high-risk opioid regimens in a timely manner.

Objectives: In this clinical informatics case report, we describe the development and implementation of a web-based tool to support providers as they implement an integrated pain support clinical initiative at primary care clinics across three health care systems.

MV140 sublingual vaccine reduces recurrent urinary tract infection in women Results from the first North American clinical experience study.

Introduction: This is the first North American clinical evidence for MV140, a novel bacterial sublingual vaccine, developed for prevention of recurrent urinary tract infection (UTI) in women.

Methods: Female subjects with ≥3 documented UTIs/year underwent three-month vaccination treatment, nine-month efficacy period, and optional three-month followup (total 15 months). Primary outcome was no clinically diagnosed UTI following vaccination (UTI-free rate).

Overcoming Obstacles: Barriers to Virtual Care Use Among Video-Enabled Tablet Recipients in the Veterans Health Administration.

Introduction: The Veterans Health Administration (VHA) distributes video-enabled tablets to individuals with barriers to accessing care. Data suggests that many tablets are under-used. We surveyed Veterans who received a tablet to identify barriers that are associated with lower use, and evaluated the impact of a telephone-based orientation call on reported barriers and future video use.

Rotavirus capping enzyme VP3 inhibits interferon expression by inducing MAVS degradation during viral replication.

Rotavirus is an enteric RNA virus that causes severe dehydrating gastroenteritis in infants and young children through infection of enterocytes in the small intestine. Timely clearance of the virus demands a robust innate immune response by cells associated with the small intestine, including the expression of interferon (IFN). Previous studies have shown that some rotavirus strains suppress the production of interferon, by inducing the degradation of mitochondrial antiviral signaling (MAVS) protein and interferon regulatory factor-3 (IRF3).

A chatbot for hypertension self-management support: user-centered design, development, and usability testing.

Objectives: Health-related chatbots have demonstrated early promise for improving self-management behaviors but have seldomly been utilized for hypertension. This research focused on the design, development, and usability evaluation of a chatbot for hypertension self-management, called "Medicagent."

Materials And Methods: A user-centered design process was used to iteratively design and develop a text-based chatbot using Google Cloud's Dialogflow natural language understanding platform.

Indoxyl Sulfate Administration during Pregnancy Contributes to Renal Injury and Increased Blood-Brain Barrier Permeability.

Rates of pregnancy-related acute kidney injury (PR-AKI) have increased in the U.S over the past two decades, but how PR-AKI affects the blood-brain barrier (BBB) is understudied. AKI is associated with increased amounts of uremic toxins, like indoxyl sulfate (I.

Toward Community-Based Natural Language Processing (CBNLP): Cocreating With Communities.

Rapid development and adoption of natural language processing (NLP) techniques has led to a multitude of exciting and innovative societal and health care applications. These advancements have also generated concerns around perpetuation of historical injustices and that these tools lack cultural considerations. While traditional health care NLP techniques typically include clinical subject matter experts to extract health information or aid in interpretation, few NLP tools involve community stakeholders with lived experiences.

CardinalKit: open-source standards-based, interoperable mobile development platform to help translate the promise of digital health.

Smartphone devices capable of monitoring users' health, physiology, activity, and environment revolutionize care delivery, medical research, and remote patient monitoring. Such devices, laden with clinical-grade sensors and cloud connectivity, allow clinicians, researchers, and patients to monitor health longitudinally, passively, and persistently, shifting the paradigm of care and research from low-resolution, intermittent, and discrete to one of persistent, continuous, and high resolution. The collection, transmission, and storage of sensitive health data using mobile devices presents unique challenges that serve as significant barriers to entry for care providers and researchers alike.

Quantification of Chlorate and Perchlorate in a Broad Range of Food Commodities, Including Baby Food, Nutritional Formulas, and Ingredients by LC-MS/MS: First Action AOAC 2022.06.

Background: Chlorate is an effective herbicide, but also a byproduct of chlorinating agents used to disinfect water, which is one of the reasons why it is regularly found in food. Perchlorate is a ubiquitous contaminant, which is naturally occurring in the environment but also released from anthropogenic sources such as the industrial use of certain natural fertilizers. Chlorate affects the hematological system, and perchlorate the thyroid.

An LC-MS/MS method for the quantitative determination of 57 per- and polyfluoroalkyl substances at ng/kg levels in different food matrices.

To enable the monitoring of a wide scope of per- and polyfluoroalkyl substances (PFAS) in the ng/kg level in foodstuffs, an LC-MS/MS method comprising 57 analytes was developed and validated in seven different matrices (milk powder, milk-based infant formula, meat-based baby food puree, fish and fish oil, fresh egg, and soluble coffee). The analytical approach was based on an acetonitrile:water extraction followed by solid phase extraction clean-up with subsequent quantification of the extracted analytes either by isotope dilution (55 compounds) or by standard addition (2 compounds) mass spectrometry. The validation criteria followed the guidance document for the analysis of PFAS issued by the European Union Reference Laboratory for Halogenated Persistent Organic Pollutants.

Using Simulated Patient Avatar and Monitor (SPA©M) to Advance Learner's Knowledge of Pathophysiology and Pharmacology.

A novel method was implemented in the Interprofessional education (IPE) program, which incorporated a Simulated-Avatar© case presentation preceding the virtual breakout segments. Simulated real-time clinical interactions replaced the in-person encounters, leading to the translation of the participants' basic science knowledge of pathophysiology and pharmacology (P&P) into effective treatment of the patient-avatar's condition.

Tablet distribution to veterans: an opportunity to increase patient portal adoption and use.

Objective: Examine whether distribution of tablets to patients with access barriers influences their adoption and use of patient portals.

Materials And Methods: This retrospective cohort study included Veterans Affairs (VA) patients (n = 28 659) who received a VA-issued tablet between November 1, 2020 and April 30, 2021. Tablets included an app for VA's My HealtheVet (MHV) portal.

A guiding framework for creating a comprehensive strategy for mHealth data sharing, privacy, and governance in low- and middle-income countries (LMICs).

With the numerous advances and broad applications of mobile health (mHealth), establishing concrete data sharing, privacy, and governance strategies at national (or regional) levels is essential to protect individual privacy and data usage. This article applies the recent Health Data Governance Principles to provide a guiding framework for low- and middle-income countries (LMICs) to create a comprehensive mHealth data governance strategy. We provide three objectives: (1) establish data rights and ownership to promote equitable benefits from health data, (2) protect people through building trust and addressing patients' concerns, and (3) promote health value by enhancing health systems and services.

Clinical, technical, and implementation characteristics of real-world health applications using FHIR.

Objective: Understanding the current state of real-world Fast Healthcare Interoperability Resources (FHIR) applications (apps) will benefit biomedical research and clinical care and facilitate advancement of the standard. This study aimed to provide a preliminary assessment of these apps' clinical, technical, and implementation characteristics.

Materials And Methods: We searched public repositories for potentially eligible FHIR apps and surveyed app implementers and other stakeholders.

No association between perinatal mood disorders and hypertensive pregnancies.

Mental health disorders such as anxiety and/or depression are the most common mental health disorders seen among reproductive aged women and can increase during pregnancy. Many sociodemographic risk factors have been associated with anxiety and/or depression in pregnancy, which can lead to adverse maternal and infant outcomes including the risk of a hypertensive pregnancy. The current study prospectively examined self-reported anxiety, depression and stress in pregnant women without a history of fetal loss or mood disorders beginning at 20-26 weeks.

Preeclampsia and COVID-19: the Role of Inflammasome Activation.

Purpose Of Review: It is well established that controlled immune activation and balance is critical for women's reproductive health and successful pregnancy outcomes. Research in recent decades in both clinical and animal studies has demonstrated that aberrant immune activation and inflammation play a role in the development and progression of women's reproductive health and pregnancy-related disorders. Inflammasomes are multi-protein cytoplasmic complexes that mediate immune activation.

Evidence of Anxiety, Depression and Learning Impairments following Prenatal Hypertension.

Background: Hypertensive disorders of pregnancy, such as Preeclampsia (PreE) and HELLP (hemolysis, elevated liver enzyme, low platelet) syndrome, affects approximately 5-10% of pregnancies and increases the risk of women developing disorders, such as anxiety or depression, in the postpartum period. Using preclinical rodent models, we set out to determine whether rats with a history of PreE or HELLP had evidence of anxiety, depression or cognitive impairment and whether immune suppression during pregnancy prevented these changes in mood and/or cognition.

Methods: Timed-pregnant rats were infused with sFlt-1 and/or sEng to induce PreE or HELLP beginning on gestational day 12.

Towards a consensus LC-MS/MS method for the determination of acrylamide in food that prevents overestimation due to interferences.

Acrylamide is prone to misquantification, and critical steps in the analytical procedures need to be identified and controlled to ensure a reliable determination. Four methods were considered to illustrate misquantification issues with acrylamide. For two methods varying by the extent of their sample preparations, cases of overestimation in cocoa samples reaching up to a 20-fold factor are shown.