Location of Care Delivery for Pulmonary Arterial Hypertension in the United States.

Rationale: Guidelines recommend patients with pulmonary arterial hypertension (PAH) be referred to pulmonary hypertension (PH) centers, but little is known about where care is actually delivered in the United States (US).

Objectives: To use prescription patterns to estimate the proportion of PAH care delivered at US PH centers and explore factors associated with location of care.

Methods: This retrospective study analyzed claims from the Komodo database in adults who received ≥1 PAH prescription between March 2021 and February 2022.

A gut pathobiont regulates circulating glycine and host metabolism in a twin study comparing vegan and omnivorous diets.

Metabolic diseases such as type 2 diabetes and obesity pose a significant global health burden. Plant-based diets, including vegan diets, are linked to favorable metabolic outcomes, yet the underlying mechanisms remain unclear. In a randomized trial involving 21 pairs of identical twins, we investigated the effects of vegan and omnivorous diets on the host metabolome, immune system, and gut microbiome.

Private, non-profit, and plantation: Oil palm smallholders in management-assistance programs vary in socio-demographics, attitudes, and management practices.

Smallholder farmers produce over 40% of global palm oil, the world's most traded and controversial vegetable oil. Awareness of the effects of palm oil production on ecosystems and human communities has increased drastically in recent years, with ever louder calls for the private and public sector to develop programs to support sustainable cultivation by smallholder farmers. To effectively influence smallholder practices and ensure positive social outcomes, such schemes must consider the variety in perspectives of farmers and align with their priorities.

Ruminant-dense environments increase risk of reported Shiga toxin-producing infections independently of ruminant contact.

Cattle and other domestic ruminants are the primary reservoirs of O157 and non-O157 Shiga toxin-producing (STEC). Living in areas with high ruminant density has been associated with excess risk of infection, which could be due to both direct ruminant contact and residual environmental risk, but the role of each is unclear. We investigated whether there is any meaningful risk to individuals living in ruminant-dense areas if they do not have direct contact with ruminants.