Publications by authors named "Kern L"

Host-microbiome-dietary interactions play crucial roles in regulating human health, yet their direct functional assessment remains challenging. We adopted metagenome-informed metaproteomics (MIM), in mice and humans, to non-invasively explore species-level microbiome-host interactions during commensal and pathogen colonization, nutritional modification, and antibiotic-induced perturbation. Simultaneously, fecal MIM accurately characterized the nutritional exposure landscape in multiple clinical and dietary contexts.

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In Switzerland, additional vaccinations against influenza, COVID-19, Streptococcus pneumoniae and varicella zoster virus (VZV), are recommended for patients with chronic lung diseases such as COPD, asthma or interstitial lung disease, since infectious diseases often lead to exacerbation of lung diseases resulting in increased disease burden and mortality. In this review we give an overview on recommended vaccinations for patients with chronic lung diseases, also including vaccinations against pertussis and RSV, which are recommended in international guidelines. While continuous development of vaccines against S.

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The patch-clamp technique allows us to eavesdrop the gating behavior of individual ion channels with unprecedented temporal resolution. The signals arise from conformational changes of the channel protein as it makes rapid transitions between conducting and non-conducting states. However, unambiguous analysis of single-channel datasets is challenging given the inadvertently low signal-to-noise ratio as well as signal distortions caused by low-pass filtering.

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Background And Objectives: Receiving care at patient-centred medical homes (PCMH) is associated with reduced emergency department (ED) visits among children. Adverse social determinants of health (SDoH), such as lower socioeconomic status and household poverty, are associated with increased ED visits in children. The objective of this study is to use machine learning techniques to understand the relative importance of each PCMH component among different populations with adverse SDoH on the outcome of ED visits.

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Background: Rhabdomyosarcoma (RMS) is a rare malignant soft tissue sarcoma (STS), accounting for almost 50% of pediatric STSs. Due to its heterogeneity, RMS presents challenges in diagnosis and treatment, with prognosis varying depending on multiple factors. Tumors localized in the other site (OTH)-including the paraspinal, perianal, thoracic, abdominal, pelvic, and perineal regions-are generally classified as unfavorable.

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Article Synopsis
  • The study focuses on improving care transitions for heart failure patients by implementing an intervention called I-TRANSFER-HF, which combines early home health care (HHC) nurse visits with outpatient medical follow-up to reduce hospital readmissions.
  • It employs a Hybrid Type 1, stepped wedge randomized trial design, involving multiple hospital and home health agency (HHA) pairs across the US, to measure the effectiveness of the intervention on readmission rates and patient outcomes.
  • Additionally, the study aims to understand the factors affecting the implementation of I-TRANSFER-HF through qualitative interviews with key stakeholders, using the Consolidated Framework for Implementation Research 2.0 to guide the analysis.
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  • Recent research indicates that the gut microbiome can influence brain development and age-related changes, suggesting a strong connection between gut health and neurological processes.
  • Dysbiotic configurations of the microbiome are linked to various neurological disorders, but understanding the causal relationships is still limited.
  • The mechanisms behind these effects often depend on metabolites produced by gut bacteria, which can affect the central nervous system by crossing the blood-brain barrier or by signaling to peripheral nerves and influencing immune responses.
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Background: Fragmentation of care (that is, the use of multiple ambulatory providers without a dominant provider) may increase the risk of gaps in communication among providers. However, it is unclear whether people with fragmented care (as measured in claims) perceive more gaps in communication among their providers. It is also unclear whether people who perceive gaps in communication experience them as clinically significant (that is, whether they experience adverse events that they attribute to poor coordination).

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  • The study looked at how untreated depression affects people's visits to doctors and specialists.
  • They found that older adults with untreated depression didn't visit specialists as much and were less likely to see a psychiatrist compared to those who were treated.
  • The results show that these patients aren't getting enough help for their depression, and they may not be seeking out more care than needed.
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Objectives: This study examines the perspectives of key stakeholders in home health toward Medicare's Home Health Value Based Purchasing (HHVBP) program, piloted among home health agencies (HHAs) in 9 states from 2016 to 2021, and based on initial performance, was expanded to the remaining 41 (nonpilot) states in January 2023.

Design: We conducted semistructured interviews wherein we inquired participants' views toward and experiences with HHVBP. We used convenience and purposive sampling to obtain diversity in HHA size, geography, and quality.

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Background: One-third of people living with dementia (PLWD) have highly fragmented care (i.e., care spread across many ambulatory providers without a dominant provider).

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Objective: Prior studies and have shown that gaps in care coordination (CC) increase the risk of emergency department (ED) visits among children with special healthcare needs. This study aims to determine if gaps in CC are associated with an increased risk of ED visits among children without special needs (non-CSHCN).

Study Design: We conducted a cross-sectional study using the National Survey of Children's Health (2018-2019), representing children up to age 17.

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Objectives: To develop a statistical approach that provides a quantitative index measuring the magnitude of the irregularity of the breathing response to exercise for the diagnosis of dysfunctional breathing.

Design: Cross-sectional, retrospective, real-world study.

Setting: Single-centre study.

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Psychiatric disorders are common and can cause psychological disabilities. While the creation of day hospitals (DHs) was intended to direct psychiatric care towards community settings, they may have paradoxically contributed to a form of chronicity. Furthermore, the heterogeneity and lack of evaluation of care within DHs prevent the availability needed to collect objective data on users outcomes.

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GFRAL-expressing neurons actuate aversion and nausea, are targets for obesity treatment, and may mediate metformin effects by long-term GDF15-GFRAL agonism. Whether GFRAL neurons acutely regulate glucose and energy homeostasis is, however, underexplored. Here, we report that cell-specific activation of GFRAL neurons using a variety of techniques causes a torpor-like state, including hypothermia, the release of stress hormones, a shift from glucose to lipid oxidation, and impaired insulin sensitivity, glucose tolerance, and skeletal muscle glucose uptake but augmented glucose uptake in visceral fat.

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Objective: This study compared mental health treatment engagement among people with serious mental illness after release from jails that had either a for-profit (N=3 jails) or a nonprofit mental health provider (N=7 jails).

Methods: Across the 10 jails, data were collected in 2019 for 1,238 individuals with serious mental illness. Data included demographic characteristics (age, race-ethnicity, gender, geography, and jail type) and behavioral health variables (previous mental health treatment, psychotropic medication use, substance use, and receipt of jail-based mental health services).

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Background: The magnitude of the relationship between ambulatory care fragmentation and subsequent total health care costs is unclear.

Objective: To determine the association between ambulatory care fragmentation and total health care costs.

Research Design: Longitudinal analysis of 15 years of data (2004-2018) from the national Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, linked to Medicare fee-for-service claims.

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Background: Social restrictions and their possible impact on lifestyle make people with multimorbidity (≥2 co-existing chronic conditions) more vulnerable to poor perceived mental health and health behaviours modifications during the COVID-19 pandemic.

Objective: To understand the mental health status and health behaviour modifications among individuals with multimorbidity during different levels of COVID-19 social restrictions.

Methods: Longitudinal multinational cohort study consisting of two online questionnaires with its first wave taken place while social restrictions were imposed (May 2020), and its second wave with less social restrictions in place (November 2020).

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Article Synopsis
  • The study investigates exercise dependence, referred to as problematic physical activity (PPA), highlighting challenges in its theoretical and methodological frameworks.
  • Using confirmatory factor analysis (CFA) and a bifactor model, researchers analyzed the French version of the Exercise Dependence Scale-Revised (EDS-R) among 435 selected students to determine its dimensional structure.
  • Findings suggest that most items on the EDS-R are better indicators of a general exercise dependence factor, with withdrawal being identified as a distinct sub-dimension, contributing to ongoing discussions around behavioral addiction and how to conceptualize exercise dependence.
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Gaps in care coordination (CC) can have detrimental impacts on children's health. It is unclear how much adverse social determinants of health (SDoH) may affect CC gaps. We determined whether exposure to adverse SDoH is associated with experiencing more gaps in CC using a representative national sample of children.

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Background: The role of autoreactive T cells on the course of Coronavirus disease-19 (COVID-19) remains elusive. Type II pneumocytes represent the main target cells of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Autoimmune responses against antigens highly expressed in type II pneumocytes may influence the severity of COVID-19 disease.

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  • Asthma affects over 300 million people globally, with 5-10% experiencing severe asthma and contributing significantly to healthcare costs.
  • This study focused on characterizing 278 severe asthma patients in Switzerland through the Swiss Severe Asthma Registry, evaluating various health factors and asthma control statistics.
  • Results showed that biologic treatments are linked to better asthma control, while factors like higher BMI and use of oral steroids negatively impact management, highlighting the need for further research in this area.
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Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung disorder with a complex clinical picture. The diagnosis may be difficult at times, as COPD may develop insidiously and remain unnoticed for a long time. Therefore, general practitioners play a central role in early detection of disease.

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