COVID-19 reinfection in pregnancy: assessment of Severity and pregnancy outcomes in England.

Background: Disease severity and pregnancy outcomes following SARS-CoV-2 reinfections in pregnancy are not well understood.

Methods: We linked women aged 18 to 50 years testing positive in the community for COVID-19 between April 2021 and March 2022 to hospital, vaccine and maternal services databases. We compared hospital and intensive care unit (ICU) admission rates following infection and reinfection in pregnant and non-pregnant women, and low birthweight, prematurity and stillbirth in women infected and reinfected during pregnancy.

Improving outcomes for very preterm babies in England: does place of birth matter? Findings from OPTI-PREM, a national cohort study.

Objective: Babies born between 27 and 31 weeks of gestation contribute substantially towards infant mortality and morbidity. In England, their care is delivered in maternity services colocated with highly specialised neonatal intensive care units (NICU) or less specialised local neonatal units (LNU). We investigated whether birth setting offered survival and/or morbidity advantages to inform National Health Service delivery.

Revision Pulley Reconstruction in a Rock Climber for Phalanx Bone Resorption With Extensor Retinaculum Slip: A Case Report and Technique Review.

We report this case of a rock climber who sustained a right ring-finger grade-III A2 pulley rupture. After failed nonoperative management, the patient underwent pulley reconstruction with ipsilateral palmaris longus autograft using a double-loop technique. The immediate postoperative course was uncomplicated, and the patient returned to painless rock climbing six months after the index procedure.

Real-world experience of paediatric acute promyelocytic leukaemia in the United Kingdom and Ireland.

Acute promyelocytic leukaemia (APL), defined by the t(15;17)(q24;q21) translocation, accounts for 5%-10% of paediatric acute myeloid leukaemia cases. All-trans retinoic acid (ATRA) and arsenic trioxide (ATO) are key treatments, though ATO access varies. We evaluated treatment, complications and survival in 50 UK paediatric APL patients diagnosed between 2014 and 2021.

Association between sick child facility readiness and quality of care at the individual and facility level in five low- and middle-income countries.

Background: Raising the quality of health services is key to continued progress in improving child health, however, data on service quality are limited and difficult to interpret. The relationship between facility readiness and the quality of care is complex.

Methods: Using publicly available data sets from five low- and middle-income countries (LMICs), we assessed the relationship between structural factors and the clinical quality of care for managing sick children.

Cooling down is as important as warming up for a large-bodied tropical reptile.

An ectotherm's performance and physiological function are strongly tied to environmental temperature, and many ectotherms thermoregulate behaviourally to reach optimum body temperatures. Tropical ectotherms are already living in environments matching their thermal tolerance range and may be expected to conform to environmental temperatures. We tracked the body temperatures () of 163 estuarine crocodiles across 13 years and compared of 39 crocodiles to water temperature gathered using fish-borne sensors () across 3 years (2015-2018).

Global Meningococcal Initiative: Insights on antibiotic resistance, control strategies and advocacy efforts in Western Europe.

In Western Europe, many countries have robust and well-established surveillance systems and case reporting mechanisms. IMD incidence across Western Europe is low with a predominance of meningococcal serogroup B (MenB). Case confirmation and antimicrobial susceptibility testing is often standardised in this region, with many countries also having robust vaccination programmes in place.

Improving the Surgical Education Experience: 9-month Outcomes of an Education Time-Out Pilot Study.

Objective: We aimed to: 1) create a Surgical Education Time-Out Tool (SET-OuT) checklist training module for faculty utilizing a highly-realistic simulation and 2) assess faculty and resident perioperative educational experiences pre- and post-SET-OuT intervention.

Design, Setting, And Participants: We recruited gynecologic surgical faculty and PGY1 to PGY3 obstetrics and gynecology (OBGYN) residents from the University of Utah. Each enrolled participant completed a baseline and 9-month survey about their educational experiences and SET-OuT satisfaction.

Correction: A Clinical Course of Repeated Supratherapeutic Ingestion of Acetaminophen.

[This corrects the article DOI: 10.7759/cureus.59883.

Exploring the potential cost-effectiveness of a new computerised decision support tool for identifying fetal compromise during monitored term labours: an early health economic model.

Background: Around 60% of term labours in the UK are continuously monitored using cardiotocography (CTG) to guide clinical labour management. Interpreting the CTG trace is challenging, leading to some babies suffering adverse outcomes and others unnecessary expedited deliveries. A new data driven computerised tool combining multiple clinical risk factors with CTG data (attentive CTG) was developed to help identify term babies at risk of severe compromise during labour.

Discussion on "LEAP: the latent exchangeability prior for borrowing information from historical data" by Ethan M. Alt, Xiuya Chang, Xun Jiang, Qing Liu, May Mo, H. Amy Xia, and Joseph G. Ibrahim.

We commend Alt et al.'s innovative approach for analysis with a hybrid control arm while offering insights into two key considerations: the necessity for extrapolation and the potential benefits of curating historical control data before analysis.

COVID-19 Vaccine Safety in Pregnancy, A Nested Case-Control Study in Births From April 2021 to March 2022, England.

Objective: Assessment of COVID-19 vaccine safety in pregnancy using population-based data.

Design: Matched case-control study nested in a retrospective cohort.

Setting: April 2021-March 2022, England.

Pan American climate resilient health systems: a training course for health professionals.

Objectives: To describe the development, implementation, and results of a training course designed to equip health professionals from the Pan American Health Organization region with the knowledge and tools needed to adapt health systems to current climate realities.

Methods: The course was a 9-week live-virtual course in March-April 2023, which was delivered through Zoom and offered in English, Spanish, and French. All lectures were delivered by local and regional climate and health experts.

Climate change and its impact on health: a global collaborative learning model.

To address the health effects of climate change, leaders in healthcare have called for action to integrate climate adaptation and mitigation into training programs for health professionals. However, current educators may not possess sufficient climate literacy and the expertise to effectively include such content in their respective healthcare curricula. We, an international and interprofessional partnership, collaborated with experts to develop and deploy curriculum to increase health educators' and graduate health profession students' knowledge and competencies on climate change.

Active crocodiles are less sociable.

How animals move and associate with conspecifics is rarely random, with a population's spatial structure forming the foundation on which the social behaviours of individuals form. Studies examining the spatial-social interface typically measure averaged behavioural differences between individuals; however, this neglects the inherent variation present within individuals and how it may impact the spatial-social interface. Here, we investigated differences in among-individual (co)variance in sociability, activity and site fidelity in a population of wild estuarine crocodiles, across a 10-year period.

Anxiety sensitivity is associated with heightened intolerance of uncertainty in individuals with alcohol use disorder.

Alcohol use disorder (AUD) is a highly prevalent, yet heterogenous condition linked to anxiety, reward sensitivity, and cognitive biases. Understanding cognitive mechanisms of specific AUD symptoms is crucial for developing tailored, effective interventions. This pilot study sought to assess whether two potential cognitive correlates of AUD-intolerance of uncertainty and delay discounting-differentially influence the relationship between AUD, anxiety sensitivity, and drinking motives.

Accelerated competency-based education in primary care (ACE-PC): a 3-year UC Davis and Kaiser permanente partnership to meet California's primary care physician workforce needs.

Problem: Our nation faces an urgent need for more primary care (PC) physicians, yet interest in PC careers is dwindling. Students from underrepresented in medicine (UIM) backgrounds are more likely to choose PC and practice in underserved areas yet their representation has declined. Accelerated PC programs have the potential to address workforce needs, lower educational debt, and diversify the physician workforce to advance health equity.

A phenome-wide association and factorial Mendelian randomization study on the repurposing of uric acid-lowering drugs for cardiovascular outcomes.

Uric acid has been linked to various disease outcomes. However, it remains unclear whether uric acid-lowering therapy could be repurposed as a treatment for conditions other than gout. We first performed both observational phenome-wide association study (Obs-PheWAS) and polygenic risk score PheWAS (PRS-PheWAS) to identify associations of uric acid levels with a wide range of disease outcomes.