Reasons pregnant people use cannabis to self-treat health conditions during pregnancy: Results from a US population-based survey.

Introduction: Little is known about reasons pregnant people self-treat health conditions and pregnancy-related symptoms with cannabis.

Methods: We administered a cross-sectional survey to 3571 pregnant and recently pregnant people from US population-based panels. Participants who used cannabis at some point during pregnancy were asked which health conditions or symptoms they used cannabis to treat and reasons they used cannabis for self-treatment.

Mandatory Warning Signs for Cannabis: Perspectives and Preferences of Pregnant and Recently Pregnant People Who Use Cannabis.

Background: Five U.S. states where recreational cannabis is legal require Mandatory Warning Signs for cannabis use during pregnancy (MWS-cannabis) to be posted in cannabis dispensaries.

Impact of pharmacist-evaluated clinical decision support system alerts on potentially missing or inappropriately prescribed proton pump inhibitors at hospital discharge: a retrospective cross-sectional study.

Background: Proton pump inhibitors (PPIs) are among the most prescribed drugs. A clinical decision support system (CDSS) could improve their rational use.

Aim: The impact of an electronic algorithm (e-algorithm) implemented in a CDSS on potentially missing or inappropriately prescribed PPIs at hospital discharge, its specificity and sensitivity, and the outcome of the alerts issued were analysed.

Development and validation of a clinical decision support system to prevent anticoagulant duplications.

Background And Objective: Unintended duplicate prescriptions of anticoagulants increase the risk of serious adverse events. Clinical Decision Support Systems (CDSSs) can help prevent such medication errors; however, sophisticated algorithms are needed to avoid alert fatigue. This article describes the steps taken in our hospital to develop a CDSS to prevent anticoagulant duplication (AD).

Evaluation of Triple Whammy Prescriptions After the Implementation of a Drug Safety Algorithm.

Background And Objective: The term triple whammy (TW) refers to the concomitant use of non-steroidal anti-inflammatory drugs, diuretics, and angiotensin system inhibitors; this combination significantly increases the risk of acute kidney injury (AKI). To prevent this serious complication, we developed an electronic algorithm that detects TW prescriptions in patients with additional risk factors such as old age and impaired kidney function. The algorithm alerts a clinical pharmacist who then evaluates and forwards the alert to the prescribing physician.

Association of Pregnancy-Specific Alcohol Policies With Infant Morbidities and Maltreatment.

Importance: Research has found associations of pregnancy-specific alcohol policies with increased low birth weight and preterm birth, but associations with other infant outcomes are unknown.

Objective: To examine the associations of pregnancy-specific alcohol policies with infant morbidities and maltreatment.

Design, Setting, And Participants: This retrospective cohort study used outcome data from Merative MarketScan, a national database of private insurance claims.

Clinician views on reporting pregnant and birthing patients who use alcohol and/or drugs to child welfare.

Background: Multiple health professional associations have expressed concern with policies that require clinician reporting of pregnant people's substance use to child welfare, including that reporting negatively affects patient outcomes and the patient-provider relationship. However, research has shown that clinicians continue to report pregnant and birthing patients at high rates.

Objective: This study aimed to explore clinician views on reporting pregnant and birthing patients who use alcohol or drugs during pregnancy to child welfare and whether there are patterns in the types of decisions that clinicians agree with, disagree with, or feel conflicted about.

Tackling alert fatigue with a semi-automated clinical decision support system: quantitative evaluation and end-user survey.

Study Aims: Clinical decision support systems (CDSS) embedded in hospital electronic health records efficiently reduce medication errors, but there is a risk of low physician adherence due to alert fatigue. At the Cantonal Hospital Aarau, a CDSS is being developed that allows the highly accurate detection and correction of medication errors. The semi-automated CDSS sends its alerts either directly to the physician or to a clinical pharmacist for review first.

7-Ketocholesterol Promotes Retinal Pigment Epithelium Senescence and Fibrosis of Choroidal Neovascularization via IQGAP1 Phosphorylation-Dependent Signaling.

Accumulation of 7-ketocholesterol (7KC) occurs in age-related macular degeneration (AMD) and was found previously to promote fibrosis, an untreatable cause of vision loss, partly through induction of endothelial-mesenchymal transition. To address the hypothesis that 7KC causes mesenchymal transition of retinal pigment epithelial cells (RPE), we exposed human primary RPE (hRPE) to 7KC or a control. 7KC-treated hRPE did not manifest increased mesenchymal markers, but instead maintained RPE-specific proteins and exhibited signs of senescence with increased serine phosphorylation of histone H3, serine/threonine phosphorylation of mammalian target of rapamycin (p-mTOR), p16 and p21, β-galactosidase labeling, and reduced LaminB1, suggesting senescence.

Association of Mandatory Warning Signs for Cannabis Use During Pregnancy With Cannabis Use Beliefs and Behaviors.

Importance: As states have legalized recreational cannabis use, some have enacted policies mandating point-of-sale warning signs with information on harms of using cannabis during pregnancy. While research has found such warning signs are associated with increased adverse birth outcomes, reasons why are unclear.

Objective: To examine whether exposure to cannabis warning signs is associated with cannabis-related beliefs, stigma, and use.

Health care provider reporting practices related to self-managed abortion.

Background: Health care providers reporting patients to government authorities is a main way people attempting self-managed abortion (SMA) become exposed to legal risks. Little is known about health care provider decision-making regarding SMA reporting.

Methods: We conducted semi-structured interviews with 37 clinicians who provided care in hospital-based obstetrics or emergency departments (13 obstetricians/gynecologists, two advance practice registered nurses providing obstetrics care, 12 emergency medicine physicians, and 10 family medicine physicians) throughout the United States.

Impact of Unintentional Air Leaks on Automatic Positive Airway Pressure Device Performance in Simulated Sleep Apnea Events.

Background: Positive airway pressure (PAP) is the accepted standard treatment for obstructive sleep apnea. In the last decades, automatic PAP (APAP) adjustment modes have been increasingly used. Pressure auto adjustment offers better comfort to the patient and represents a valuable help for the clinician to provide optimal treatment.

Health care provider decision-making around prenatal substance use reporting.

Background: Recent research has found that harms related to alcohol and/or drug (AOD) use during pregnancy are not limited to those associated with use itself; harms also result from policies and health care practices adopted in response, including reporting to Child Protective Services (CPS). This study sought to understand factors that influence health care providers' reporting practices.

Methods: We conducted 37 semi-structured interviews with hospital-based obstetricians/gynecologists, family medicine physicians, and emergency department physicians, focused on experiences with reporting pregnant/birthing people with AOD to government authorities.

Computed tomography (CT) and magnetic resonance imaging (MRI) of diffuse liver disease: a multiparametric predictive modelling algorithm can aid categorization of liver parenchyma.

Background: Liver steatosis is common and tracking disease evolution to steatohepatitis and cirrhosis is essential for risk stratification and resultant patient management. Consequently, diagnostic tools allowing categorization of liver parenchyma based on routine imaging are desirable. The study objective was to compare established mono-factorial, dynamic single parameter and iterative multiparametric routine computed tomography (CT) and magnetic resonance imaging (MRI) analyses to distinguish between liver steatosis, steatohepatitis, cirrhosis and normal liver parenchyma.

Reaching Consensus on Politicized Topics: A Convening of Public Health Professionals to Discuss Appropriate Abortion Activities for US Health Departments.

Context: Public health professionals, particularly those in state and local health departments, do not always have clear understandings of their roles related to politically controversial public health topics. A process of consensus development among public health professionals that considers the best available evidence may be able to guide decision making and lay out an appropriate course of action.

Approach: In May 2020, a group of maternal and child health and family planning professionals working in health departments, representatives of schools of public health, and members of affiliated organizations convened to explore values and principles relevant to health departments' engagement in abortion and delineate activities related to abortion that are appropriate for health departments.

Lessons Learned from Implementing a Place-Based, Racial Justice-Centered Approach to Health Equity.

Purpose: As theories about the causes of racial inequities in infant mortality evolve, they are becoming increasingly complex. Interventions to address these inequities must be similarly complex, incorporating both upstream and downstream approaches.

Description: The Best Babies Zone Initiative (BBZ) has been in operation since 2012 with an aim of reducing racial inequities in infant mortality.

Implementation and outcome of an electronic tool for detection of paracetamol overdose in a tertiary care hospital.

Background Paracetamol is a widely used analgesic and antipyretic drug in hospitals. The development and implementation of an electronic tool with algorithm-based alerts (e-agent) in a clinical information system could reduce the risk of overdose. Objective In this study, the performance of such an e-agent developed to detect paracetamol overdosing was analyzed.

Therapeutic duplication of anticoagulants: a retrospective study of frequency and consequences in a tertiary referral hospital.

Background: Anticoagulants are commonly prescribed in medical practices and could be of significant harm in the case of medication errors. We conducted a retrospective observational study to determine the frequency and consequences of the therapeutic duplication of anticoagulants (TDA). As a secondary objective, we aimed to determine the characteristics of the population in which TDA occurs.

Novel concept to guide systolic heart failure medication by repeated biomarker testing-results from TIME-CHF in context of predictive, preventive, and personalized medicine.

Background: It is uncertain whether repeated measurements of a multi-target biomarker panel may help to personalize medical heart failure (HF) therapy to improve outcome in chronic HF.

Methods: This analysis included 499 patients from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF), aged ≥ 60 years, LVEF ≤ 45%, and NYHA ≥ II, who had repeated clinical visits within 19 months follow-up. The interaction between repeated measurements of biomarkers and treatment effects of loop diuretics, spironolactone, β-blockers, and renin-angiotensin system (RAS) inhibitors on risk of HF hospitalization or death was investigated in a hypothesis-generating analysis.

Dual-comb modelocked laser.

In this paper we present the first semiconductor disk laser (SDL) emitting simultaneously two collinearly overlapping cross-polarized gigahertz modelocked pulse trains with different pulse repetition rates. Using only a simple photo detector and a microwave spectrum analyzer directly down-converts the frequency comb difference from the optical to the microwave frequency domain. With this setup, the relative carrier-envelope-offset (CEO) frequency can be accessed directly without an f-to2f interferometer.

Draft Genome Sequence of the Principal Etiological Agent of Farmer's Lung Disease, Saccharopolyspora rectivirgula.

Saccharopolyspora rectivirgula is the main cause of farmer's lung disease. The development of recombinant antigens to standardize the serodiagnosis of the disease requires knowledge of the S. rectivirgula genome.

Novel extracellular matrix biomarkers as predictors of adverse outcome in chronic heart failure: association between biglycan and response to statin therapy in the CORONA trial.

Background: The extracellular matrix (ECM) plays an important role in left ventricular remodeling and progression of heart failure (HF). Biglycan and mimecan are ECM proteins that are abundantly expressed in cardiac tissue but have not been evaluated as prognostic markers in HF. We investigated their interaction with statin treatment and association with adverse outcome in chronic HF.

Predictive value of endostatin in chronic heart failure patients with poor kidney function.

Objectives: Increased circulating endostatin levels have been demonstrated in progressive cardiovascular (CV) and renal disorders. We investigated the predictive value of endostatin in patients with chronic heart failure (HF) and the association between endostatin and renal function.

Methods: The interaction between serum endostatin, estimated glomerular filtration rate (eGFR) and predefined endpoints, including the primary endpoint (CV death, nonfatal myocardial infarction, nonfatal stroke; n = 397), all-cause mortality (n = 410), CV death (n = 335) or the coronary endpoint (n = 317), was evaluated in 1,390 patients >60 years of age with ischemic systolic HF in the Controlled Rosuvastatin Multinational Trial in HF (CORONA) population, who were randomly assigned to 10 mg rosuvastatin or placebo.

Immunoreactive proteins of Saccharopolyspora rectivirgula for farmer's lung serodiagnosis.

Purpose: Saccharopolyspora rectivirgula is the principal cause of farmer's lung disease (FLD). Serodiagnosis is based on immunoprecipitation techniques or enzyme immunoassays with homemade crude antigens and is not standardized. We aimed to produce specific recombinant antigens for the development of a standardized ELISA.

Gigahertz self-referenceable frequency comb from a semiconductor disk laser.

We present a 1.75-GHz self-referenceable frequency comb from a vertical external-cavity surface-emitting laser (VECSEL) passively modelocked with a semiconductor saturable absorber mirror (SESAM). The VECSEL delivers 231-fs pulses with an average power of 100 mW and is optimized for stable and reliable operation.