Associations between maternal fish intake and polyunsaturated fatty acid status with childhood asthma in a high fish-eating population.

Background: Studies investigating associations between prenatal polyunsaturated fatty acid status (PUFAs), in particular the anti-inflammatory n-3 PUFAs, and the development of childhood asthma have yielded conflicting results.

Objective: To determine the associations between maternal fish intake (a rich source of the n-3 PUFAs), maternal or cord PUFAs with the prevalence of childhood asthma in a high fish-eating population.

Methods: We examined these associations between fish intake and PUFA concentrations with childhood asthma prevalence in the Seychelles Child Development Study Nutrition Cohort 2, a large observational study in a high fish-eating population.

Structural and antigenic characterization of novel and diverse glycoproteins.

(HNVs), a genus within the family, includes the highly virulent Nipah and Hendra viruses that cause yearly reoccurring outbreaks of deadly disease. Recent discoveries of several new species, including the zoonotic Langya virus, have revealed much higher antigenic diversity than currently characterized. Here, to explore the limits of structural and antigenic variation in HNVs, we construct an expanded, antigenically diverse panel of HNV fusion (F) and attachment (G) glycoproteins from 56 unique HNV strains that better reflects global HNV diversity.

Anti-HIV-1 B cell antigen receptor signaling and structure.

Unlabelled: The B cell antigen receptor (BCR) complex, comprised of antigen recognition and signaling components, functions in initiating B cell activation. While structural studies have described BCR domain organization, gaps remain in our understanding of its antigen binding domain (Fab, fragment antigen-binding) disposition, and how antigen binding is sensed to initiate signaling. Here, we report antigen affinity and signaling of the immunoglobulin (Ig) class IgM and IgG BCRs and define conformational states of full-length BCRs of two human broadly neutralizing antibodies, the glycan-specific, heavy chain domain-swapped, I-shaped 2G12, and a canonical Y-shaped antibody, CH31, that recognizes the CD4-binding site on the HIV-1 Envelope protein (Env).

Caregiver Accompaniment in Pediatric Critical Care Transport: A Systematic Scoping Review.

Context: Family-centered care is a critical component of critical care interfacility and medical retrieval transport (MRT) services. These services provide a critical bridge for a physiologically and psychologically unique population often best served in specialized, tertiary centers. Caregivers often wish to accompany patients during MRT.

Isolation and characterization of IgG3 glycan-targeting antibodies with exceptional cross-reactivity for diverse viral families.

Broadly reactive antibodies that target sequence-diverse antigens are of interest for vaccine design and monoclonal antibody therapeutic development because they can protect against multiple strains of a virus and provide a barrier to evolution of escape mutants. Using LIBRA-seq (linking B cell receptor to antigen specificity through sequencing) data for the B cell repertoire of an individual chronically infected with human immunodeficiency virus type 1 (HIV-1), we identified a lineage of IgG3 antibodies predicted to bind to HIV-1 Envelope (Env) and influenza A Hemagglutinin (HA). Two lineage members, antibodies 2526 and 546, were confirmed to bind to a large panel of diverse antigens, including several strains of HIV-1 Env, influenza HA, coronavirus (CoV) spike, hepatitis C virus (HCV) E protein, Nipah virus (NiV) F protein, and Langya virus (LayV) F protein.

How does online postal self-sampling (OPSS) shape access to testing for sexually transmitted infections (STIs)? A qualitative study of service users.

Background: Sexually transmitted infections (STIs) are a serious public health issue in many countries. Online postal self-sampling (OPSS) is increasingly used to test for STIs, a trend accelerated by the COVID-19 pandemic. There remains limited understanding of how service users experience OPSS and what leads them to access it over clinic-based services, or vice versa.

SARS-CoV-2 Omicron XBB lineage spike structures, conformations, antigenicity, and receptor recognition.

A recombinant lineage of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant, named XBB, appeared in late 2022 and evolved descendants that successively swept local and global populations. XBB lineage members were noted for their improved immune evasion and transmissibility. Here, we determine cryoelectron microscopy (cryo-EM) structures of XBB.

Azithromycin for Pediatric Critical Asthma: A Multicenter Retrospective Cohort Study.

Objectives: To characterize the prescribing trends and clinical outcomes related to azithromycin (AZI) among children hospitalized for critical asthma (CA).

Methods: We performed a multicenter, retrospective cohort study using the Pediatric Health Information Systems registry of children 3 to 17 years of age hospitalized in a PICU for CA from January 2011 to December 2022. We excluded for alternative indications for AZI (eg, atypical pneumonia, B.

SARS-CoV-2 Omicron XBB lineage spike structures, conformations, antigenicity, and receptor recognition.

A recombinant lineage of the SARS-CoV-2 Omicron variant, named XBB, appeared in late 2022 and evolved descendants that successively swept local and global populations. XBB lineage members were noted for their improved immune evasion and transmissibility. Here, we determine cryo-EM structures of XBB.

Designing and maintaining a rescue extracorporeal life support program: A holistic simulation approach.

Rescue Extracorporeal Life Support Programs based at non-cardiac surgery centers have unique needs to be able to ensure successful outcomes despite low patient volumes. In this paper we describe the important role simulation had in each stage of development, implementation, and maintenance of our pediatric Rescue ECLS Program. Systems-focused simulations were used to develop robust workflows, processes, and bundles.

Conjugation of HIV-1 envelope to hepatitis B surface antigen alters vaccine responses in rhesus macaques.

An effective HIV-1 vaccine remains a critical unmet need for ending the AIDS epidemic. Vaccine trials conducted to date have suggested the need to increase the durability and functionality of vaccine-elicited antibodies to improve efficacy. We hypothesized that a conjugate vaccine based on the learned response to immunization with hepatitis B virus could be utilized to expand T cell help and improve antibody production against HIV-1.

Copy Number Analysis in Cancer Diagnostic Testing.

Accurate detection of copy number alterations (CNAs) has become increasingly important in clinical oncology for the purpose of diagnosis, prognostication, and disease management. Cytogenetic approaches for the detection of CNAs, including karyotype, fluorescence in situ hybridization (FISH), and chromosomal microarray, remain mainstays in clinical laboratories. Yet, with rapidly decreasing costs and improved accuracy of CNA detection using emerging technologies such as next-generation sequencing and optical genome mapping, we are approaching a new era of cytogenomics and molecular oncology.

Setting up a Rescue Extracorporeal Life Support Program.

Extracorporeal life support (ECLS) is a high-risk, lifesaving medical treatment that is typically limited to centers that can support a comprehensive ECLS program. Rescue programs can bridge the gap in care between ECLS centers and other tertiary pediatric centers without cardiac surgical and comprehensive ECLS support. We describe how our pediatric center without cardiac surgery successfully partnered with an established ECLS center to develop a Rescue ECLS Cannulation Program.

Key Considerations in Establishing a Pediatric Rescue Extracorporeal Life Support Program: A Multi Methods Review.

Extracorporeal life support (ECLS) is generally limited to centers with cardiac surgery. However, pediatric centers without cardiac surgery can still provide potentially lifesaving ECLS through a Rescue Program, allowing a local team to cannulate and stabilize patients before they are transported to a center with cardiac surgery support for ongoing care. This multimethod study provides an exploration of pediatric ECLS team insights regarding program implementation and offers recommendations for other centers wishing to develop a similar program.

Pediatric Extracorporeal Life Support Transport in Western Canada: Experience over 14 years.

This retrospective cohort study describes all children transported on extracorporeal life support (ECLS) by the Stollery Children's Hospital Pediatric Transport team (SCH-PTT) between 2004 and 2018. We compared outcomes and complications between primary (SCH-PTT performed ECLS cannulation) vs. secondary (cannulation performed by referring facility) transports, as well as secondary transports from referring centers with and without an established ECLS cannulation program.

"Suction Tube Uterine Tamponade" for treatment of refractory postpartum hemorrhage: Internal feasibility and acceptability pilot of a randomized clinical trial.

Objective: To assess feasibility and acceptability of a novel, low-cost "Suction Tube Uterine Tamponade" (STUT) treatment for refractory postpartum hemorrhage (PPH).

Methods: We allocated patients with refractory PPH by randomly ordered envelopes to STUT or routine uterine balloon tamponade (UBT, Ellavi free-flow system) in 10 hospitals in South Africa. In the STUT group, a 24FG Levin stomach tube was inserted into the uterine cavity and vacuum created with a vacuum pump or manual vacuum aspiration syringe.

A Pan-Canadian Validation Study for the Detection of T790M Mutation Using Circulating Tumor DNA From Peripheral Blood.

Introduction: Genotyping circulating tumor DNA (ctDNA) is a promising noninvasive clinical tool to identify the T790M resistance mutation in patients with advanced NSCLC with resistance to EGFR inhibitors. To facilitate standardization and clinical adoption of ctDNA testing across Canada, we developed a 2-phase multicenter study to standardize T790M mutation detection using plasma ctDNA testing.

Methods: In phase 1, commercial reference standards were distributed to participating clinical laboratories, to use their existing platforms for mutation detection.

Very Low Vitamin D in a Patient With a Novel Pathogenic Variant in the Gene That Encodes Vitamin D-Binding Protein.

Circulating plasma vitamin D metabolites are highly bound to vitamin D-binding protein (DBP), also known as roup-specific omponent or Gc-globulin. DBP, encoded by the gene, is a member of the albumin family of globular serum transport proteins. We previously described a homozygous gene deletion in a patient with apparent severe vitamin D deficiency, fragility fractures, and ankylosing spondylitis.

Serum cytokines are associated with n-3 polyunsaturated fatty acids and not with methylmercury measured in infant cord blood in the Seychelles child development study.

Background: Maternal fish consumption increases infant methylmercury (MeHg) exposure and polyunsaturated fatty acid (PUFA) concentrations. The n-3 PUFA are regulators of inflammation while MeHg may impact the cord cytokine profile and, subsequently, contribute to immune mediated outcomes. This study aimed to investigate associations between infant MeHg exposure and cord cytokine concentrations while adjusting for cord PUFA.

Telemedicine-guided thoracentesis of tension pneumothorax in a term newborn.

We describe a case of a term female infant born in a rural community hospital and who developed a left-sided spontaneous tension pneumothorax shortly after birth. We used telemedicine to guide the family physician and healthcare team at the referring hospital to perform a life-saving thoracentesis using an intravenous cannula. The cannula was kept in place to drain the persistent pneumothorax during transportation to the pediatric intensive care unit at the tertiary hospital.

Maternal Serum Cytokine Concentrations in Healthy Pregnancy and Preeclampsia.

The maternal immune response is essential for successful pregnancy, promoting immune tolerance to the fetus while maintaining innate and adaptive immunity. Uncontrolled, increased proinflammatory responses are a contributing factor to the pathogenesis of preeclampsia. The Th1/Th2 cytokine shift theory, characterised by bias production of Th2 anti-inflammatory cytokine midgestation, was frequently used to reflect the maternal immune response in pregnancy.

Maternal and child fatty acid desaturase genotype as determinants of cord blood long-chain PUFA (LCPUFA) concentrations in the Seychelles Child Development Study.

Optimal maternal long-chain PUFA (LCPUFA) status is essential for the developing fetus. The fatty acid desaturase (FADS) genes are involved in the endogenous synthesis of LCPUFA. The minor allele of various FADS SNP have been associated with increased maternal concentrations of the precursors linoleic acid (LA) and α-linolenic acid (ALA), and lower concentrations of arachidonic acid (AA) and DHA.

Balancing Support for Staff and Patient Centeredness Through the Design of Immediate and Relational Space: A Case Study of Ambulatory Care Center Layouts.

Purpose: This descriptive case study of ambulatory care center typologies builds a layout-based approach to patient-centered care and care team work using theory and methods from space syntax and a recently developed approach to floorplan analysis focused on visibility.

Background: Calibrating support for care team work and patient centeredness is a persistent dilemma in ambulatory care settings.

Method: A review of literature and floorplan layout analysis are used.

The influence of fish consumption on serum n-3 polyunsaturated fatty acid (PUFA) concentrations in women of childbearing age: a randomised controlled trial (the iFish Study).

Purpose: Long-chain polyunsaturated fatty acids (LCPUFA) can be synthesised endogenously from linoleic acid (LA) and α-linolenic acid (ALA) in a pathway involving the fatty acid desaturase (FADS) genes. Endogenous synthesis is inefficient; therefore, dietary intake of preformed LCPUFA from their richest source of fish is preferred. This study investigated the effect of fish consumption on PUFA concentrations in women of childbearing age while stratifying by FADS genotype.