Within-Hospital Concordance of Opioid Exposure Diagnosis Coding in Mothers and Newborns.

Background And Objectives: We measured within-hospital concordance of mothers with opioid use disorder (OUD) and newborns with neonatal abstinence syndrome (NAS) or opioid exposure (OE). Secondarily, we described the demographics of mothers and newborns with and without opioid-related diagnoses.

Methods: We used hospital discharge abstracts from California, Florida, New Jersey, and Pennsylvania in 2016.

Substitution of a Surface-Exposed Residue Involved in an Allosteric Network Enhances Tryptophan Synthase Function in Cells.

Networks of noncovalent amino acid interactions propagate allosteric signals throughout proteins. Tryptophan synthase (TS) is an allosterically controlled bienzyme in which the indole product of the alpha subunit (αTS) is transferred through a 25 Å hydrophobic tunnel to the active site of the beta subunit (βTS). Previous nuclear magnetic resonance and molecular dynamics simulations identified allosteric networks in αTS important for its function.

The effect of opioids on the cognitive function of older adults: results from the Personality and Total Health through life study.

Background: chronic pain, a common complaint among older adults, affects physical and mental well-being. While opioid use for pain management has increased over the years, pain management in older adults remains challenging, due to potential severe adverse effects of opioids in this population.

Objective: we examined the association between opioid use, and changes in cognitive function of older adults.

Newborns With Neonatal Abstinence Syndrome Are Concentrated in Poorer-Quality Hospitals.

Objectives: To determine the extent to which newborns with neonatal abstinence syndrome (NAS) are concentrated in some hospitals as compared with newborns without NAS and whether care quality and safety differed among these hospitals. We hypothesized that newborns with NAS would be cared for in poorer-quality hospitals.

Methods: Secondary analysis of 3 2016 data sets: (1) the panel study of effects of changes in nursing on patient outcomes-US survey of hospital registered nurses regarding work conditions and safety, (2) inpatient discharge abstracts, and (3) the American Hospital Association annual survey.

Trends in anticholinergic and opioid dispensing in older adults from 2004 to 2015: Results from the Personality and Total Health (PATH) Through Life Study.

Objective: Due to potential adverse effects, guidelines recommend that anticholinergics and opioids be avoided in older adults unless necessary. This study examines the dispensing trends of these medications among older Australians.

Methods: Data of 2222 PATH study (60+ cohort) participants were analysed.

Distinct conformational dynamics and allosteric networks in alpha tryptophan synthase during active catalysis.

Experimental observations of enzymes under active turnover conditions have brought new insight into the role of protein motions and allosteric networks in catalysis. Many of these studies characterize enzymes under dynamic chemical equilibrium conditions, in which the enzyme is actively catalyzing both the forward and reverse reactions during data acquisition. We have previously analyzed conformational dynamics and allosteric networks of the alpha subunit of tryptophan synthase under such conditions using NMR.

Sleep duration patterns from adolescence to young adulthood and the risk of asthma.

Purpose: This study examined the association between sleep duration trajectories from adolescence to young adulthood and the risk of asthma into young adulthood.

Methods: Using data from 10,362 participants in the National Longitudinal Study of Adolescent to Adult Health (Add Health) free of asthma at baseline, we constructed trajectories of sleep duration from adolescence (age 13-18 years) to young adulthood (age 24-32 years) and used them to examine the association between sleep duration patterns and the risk of new-onset asthma using a log-binomial regression model after adjusting for potential confounders.

Results: The results revealed that 14.

The Effect of Cumulative Anticholinergic Use on the Cognitive Function of Older Adults: Results from the Personality and Total Health (PATH) Through Life Study.

Background: Multiple comorbidities are common in older adults, resulting in polypharmacy that often includes medications with anticholinergic properties. These medications have multiple side effects, which are more pronounced in the older population. This study examined the association between the use of anticholinergics and changes in the cognitive function of older adults.

Linking the work environment to missed nursing care in labour and delivery.

Aim: To measure the association between the nurse work environment (NWE) and missed nursing care on labour and delivery (L&D) units.

Background: L&D units provide a sizable fraction of acute hospital services to a unique population that is a national and global priority. L&D nurses are the frontline providers during labour.

Young adult US-born Latina women's thoughts, feelings and beliefs about unintended pregnancy.

Current measures of unintended pregnancy underestimate the co-occurring, complex set of social, cultural, economic and structural factors that influence how women interpret unintended pregnancy. The purpose of this study was to prospectively explore young adult US-born Latinas' thoughts, feelings and beliefs about pregnancy, specifically unintended pregnancies and the sociocultural factors identified as contributors to those beliefs. In-depth interviews ( = 20) were conducted with US-born, English-speaking Latinas aged 18-25 years in south Florida.

Relationship Between Depression and/or Anxiety and Hospital Readmission Among Women After Childbirth.

Objective: To examine the relationship between depression and/or anxiety and any psychiatric diagnosis and readmission after childbirth.

Design: Cross-sectional analysis of administrative data from patient discharge records.

Setting: Urban academic medical center in the northeastern United States.

Maternal exposure to ambient cadmium levels, maternal smoking during pregnancy, and congenital diaphragmatic hernia.

Background: Congenital diaphragmatic hernia (CDH) is a rare musculoskeletal birth defect with a prevalence of 2.61 per 10,000 in the United States. There is limited evidence for ambient air pollutants in the etiology of CDH in humans.

Coordinated Network Changes across the Catalytic Cycle of Alpha Tryptophan Synthase.

Networks of noncovalent interactions are important for protein structural dynamics. We used nuclear magnetic resonance chemical shift covariance analyses on an inactive variant of the alpha subunit of tryptophan synthase to map amino acid interaction networks across its catalytic cycle. Although some network connections were common to every enzyme state, many of the network connections strengthened or weakened over the catalytic cycle; these changes were highly coordinated.

Post-traumatic stress disorder and hypertensive disorders of pregnancy among military women.

Background: Women are more likely to develop post-traumatic stress disorder (PTSD) than men. Limited research exists evaluating the risk of hypertensive disorders of pregnancy (HDP) among military women with PTSD.

Methods: We conducted a retrospective cohort study using US Department of Defense (DoD) data comprised of all active-duty women giving birth to their first, liveborn singleton infant using DoD-sponsored health insurance from 1 January 2004 to 31 December 2008 (n = 34 176).

Millisecond Timescale Motions Connect Amino Acid Interaction Networks in Alpha Tryptophan Synthase.

Tryptophan synthase is a model system for understanding allosteric regulation within enzyme complexes. Amino acid interaction networks were previously delineated in the isolated alpha subunit (αTS) in the absence of the beta subunit (βTS). The amino acid interaction networks were different between the ligand-free enzyme and the enzyme actively catalyzing turnover.

Deployment Among Active-Duty Military Women and Pregnancy-Related Hypertensive Disorders.

Introduction: Today women comprise 15% of the U.S. active-duty military, but are often overlooked in research of the Armed Forces.

Trends, correlates, and survival of infants with congenital diaphragmatic hernia and its subtypes.

Objective: To identify the live-birth prevalence, trends, correlates, and neonatal and 1-year survival rates of congenital diaphragmatic hernia.

Methods: Using a population-based, retrospective cohort study design, we examined 1,025 cases of congenital diaphragmatic hernia from the 1998-2012 Florida Birth Defects Registry. We used Poisson and joinpoint regression models to compute prevalence ratios and temporal trends, respectively.

Assigning methyl resonances for protein solution-state NMR studies.

Solution-state NMR is an important tool for studying protein structure and function. The ability to probe methyl groups has substantially expanded the scope of proteins accessible by NMR spectroscopy, including facilitating study of proteins and complexes greater than 100 kDa in size. While the toolset for studying protein structure and dynamics by NMR continues to grow, a major rate-limiting step in these studies is the initial resonance assignments, especially for larger (>50 kDa) proteins.

Implementation of Fee-Free Maternal Health-Care Policy in Ghana: Perspectives of Users of Antenatal and Delivery Care Services From Public Health-Care Facilities in Accra.

In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users' perspectives regarding the implementation of this policy initiative.

Institution of a Comprehensive Postpartum Hemorrhage Bundle at a Large Academic Center does not Immediately Reduce Maternal Morbidity.

Objective: Obstetric hemorrhage is a leading cause of morbidity and mortality. We sought to assess whether institution of a postpartum hemorrhage (PPH) bundle could improve maternal morbidity in our population.

Study Design: Preintervention data (PRE) was collected on all deliveries at Hospital of the University of Pennsylvania between October 15, 2013 and December 15, 2013.

Engineered control of enzyme structural dynamics and function.

Enzymes undergo a range of internal motions from local, active site fluctuations to large-scale, global conformational changes. These motions are often important for enzyme function, including in ligand binding and dissociation and even preparing the active site for chemical catalysis. Protein engineering efforts have been directed towards manipulating enzyme structural dynamics and conformational changes, including targeting specific amino acid interactions and creation of chimeric enzymes with new regulatory functions.

Improving Staff Communication and Transitions of Care Between Obstetric Triage and Labor and Delivery.

Objective: To improve staff perception of the quality of the patient admission process from obstetric triage to the labor and delivery unit through standardization.

Design: Preassessment and postassessment online surveys.

Setting: A 13-bed labor and delivery unit in a quaternary care, Magnet Recognition Program, academic medical center in Pennsylvania.

Sleep Duration Trajectories and Systemic Inflammation in Young Adults: Results From the National Longitudinal Study of Adolescent to Adult Health (Add Health).

Study Objectives: This study examines the effects of short and long sleep duration patterns in young adults on the levels of C-reactive protein (CRP), as well as the potential effect modification by sex.

Methods: Using data from waves III (age 18-26) and IV (age 24-32) of the National Longitudinal study of adolescent to adult health, we examined the association between sleep trajectories in young adults, and the risk of elevated high sensitivity-CRP (hs-CRP), a marker of systemic inflammation.

Results: Short sleep trajectories were associated with significantly elevated log-transformed hs-CRP (coefficient = 0.

Interdisciplinary Skills Review Program to Improve Team Responses During Postpartum Hemorrhage.

Objective: To develop an interdisciplinary, interactive, skills review program to improve team responses during a postpartum hemorrhage (PPH).

Design: Online didactic modules in combination with an interdisciplinary skills program consisting of seven hemorrhage-related stations.

Setting/local Problem: The project was conducted in the Women's Health Department in a quaternary-care Magnet- and Baby Friendly-designated academic medical center in Philadelphia, Pennsylvania.