Initial outcomes in a sickle cell disease transition clinic.

Background: Transition in sickle cell disease (SCD) is associated with an alarming increase in acute care utilization, cost, and risk of early mortality. Effective transition preparation is crucial to address these issues. We established a multidisciplinary transition clinic at our urban SCD center in the fall of 2021.

Associations of early life per- and polyfluoroalkyl substances (PFAS) exposure with body mass index and risk of overweight or obesity at age 2-18 years: Mixture analysis in the prospective Boston Birth Cohort.

Background: Per- and polyfluoroalkyl substances (PFAS) are a class of widespread persistent chemicals, which may have obesogenic effects during the fetal period. This study investigated the long-term association of maternal plasma PFAS concentrations at delivery and their mixture with child body mass index (BMI) and the risk of Overweight or Obesity (OWO) at the age of 2-18 years.

Methods: The study included 1189 mother-child dyads from the prospective Boston Birth Cohort.

Antenatal Steroids Enhance Long-Term Neonatal Lung Outcomes and are Associated with Placental Alterations in Experimental Chorioamnionitis.

Intrauterine inflammation from chorioamnionitis (CA) is associated with placental dysfunction and increased risk of bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity. Antenatal steroid (ANS) treatment improves early respiratory outcomes for premature infants. However, it remains unclear whether ANS improve long-term respiratory outcomes, and whether these effects are mediated through improvement of placental dysfunction and/or direct impact on the fetal lung.

Thyroid hormone and the Liver.

It is known that thyroid hormone can regulate hepatic metabolic pathways including cholesterol, de novo lipogenesis, fatty acid oxidation, lipophagy, and carbohydrate metabolism. Thyroid hormone action is mediated by the thyroid hormone receptor (THR) isoforms and their coregulators, and THRβ is the main isoform expressed in the liver. Dysregulation of thyroid hormone levels, as seen in hypothyroidism, has been associated with dyslipidemia and metabolic dysfunction-associated fatty liver disease.

Pediatrics leading the way: co-enrollment as the next step in health-related social needs screening and referral.

Purpose Of Review: To contextualize how pediatrics led the field in developing and implementing tools to screen for social determinants of health in clinical care as well as in creating innovative interventions to mitigate them, and to summarize where the evidence points as the next frontier.

Recent Findings: The evidence showed that health-related social needs (HRSN), like food insecurity, energy insecurity, and housing instability, continue to drive poor health outcomes across the lifespan; patients and healthcare providers are open to discussing HRSN in clinical settings, though some providers feel ill-equipped to do so; to mitigate HRSN, healthcare plays a unique role in ensuring patients' HRSN are understood, referring to effective resources through building strong, lasting relationships with community partners, embedding services in the healthcare setting across all departments, and empowering patient families to participate in programs and services; and administrative burden hinders families from getting all the benefits to which they are entitled, which streamlined co-enrollment processes can address.

Summary: Pediatric providers can add a unique and credible voice to seeking changes to the safety-net, including co-enrollment, that could reduce administrative burden, address patients' HRSN, and improve health starting in the prenatal period through later adulthood.

Defining the transition from new to normal: a qualitative investigation of the clinical change process.

Background: Understanding how and when a new evidence-based clinical intervention becomes standard practice is crucial to ensure that healthcare is delivered in alignment with the most up-to-date knowledge. However, rigorous methods are needed to determine when a new clinical practice becomes normalized to the standard of care. To address this gap, this study qualitatively explores how, when, and why a clinical practice change becomes normalized within healthcare organizations.

Increasing diversity in the nutrition, obesity, and diabetes biomedical workforce: the BRIDGES consortium.

Scientists from diverse backgrounds are underrepresented (UR) in academia. This lack of diversity impedes scientific discovery and innovation. UR scientists tend to conduct research on issues relevant to UR populations, including chronic disease prevention and management, and health disparities.

Surgical Trends in Use of Lumbar Disk Arthroplasty Versus Lumbar Fusion From 2010 to 2021.

Introduction: Lumbar disk arthroplasty (LDA) is a relatively novel procedure with limited indications and use in the United States, especially relative to lumbar fusion (LF). This study aimed to determine surgical trends between LDA versus LF over the past 10 years to quantify absolute/relative surgical volume over time and compare baseline patient demographics, readmission, 2-year revision rates, and costs-of-care.

Methods: A total of 714,268 patients were identified from a nationwide database who underwent LF (n = 710,527) or LDA (n = 3,741) from 2010 to 2021.

Curation and validation of electronic medical record-based dementia diagnoses in the VA Million Veteran Program.

Background: The age distribution and diversity of the VA Million Veteran Program (MVP) cohort make it a valuable resource for studying the genetics of Alzheimer's disease (AD) and related dementias (ADRD).

Objective: We present and evaluate the performance of several International Classification of Diseases (ICD) code-based classification algorithms for AD, ADRD, and dementia for use in MVP genetic studies and other studies using VA electronic medical record (EMR) data. These were benchmarked relative to existing ICD algorithms and AD-medication-identified cases.

Protecting historically marginalized groups or targeted marketing? A computational analysis of individuals engaging with public and protected cigar-branded tweets.

Introduction: Swisher Sweets, a leading brand of little cigars and cigarillos in the United States, switched its Twitter account to protected status, limiting access to its tweets. This study examines how the protected status of Swisher Sweets tweets influences post engagement, aiming to inform regulatory strategies for branded tobacco promotions on social media.

Method: Using natural language processing, we predicted the demographics of individuals replying to Swisher Sweets' public and protected tweets.

Deep learning algorithm enables automated Cobb angle measurements with high accuracy.

Objective: To determine the accuracy of automatic Cobb angle measurements by deep learning (DL) on full spine radiographs.

Materials And Methods: Full spine radiographs of patients aged > 2 years were screened using the radiology reports to identify radiographs for performing Cobb angle measurements. Two senior musculoskeletal radiologists and one senior orthopedic surgeon independently annotated Cobb angles exceeding 7° indicating the angle location as either proximal thoracic (apices between T3 and T5), main thoracic (apices between T6 and T11), or thoraco-lumbar (apices between T12 and L4).

Associations Between Retinal Vascular Occlusions and Dementia.

Background/objectives: Retinal vascular occlusions, such as retinal vein occlusion (RVO) and retinal artery occlusion (RAO), are associated with cognitive impairment, including dementia. Our objective was to examine the odds of dementia among patients with retinal vascular occlusion.

Methods: This cross-sectional study included 474 patients with retinal vascular occlusion and 948 patients without retinal vascular occlusion (comparison group).

Perspectives on Microbiome Therapeutics in Infectious Diseases: A Comprehensive Approach Beyond Immunology and Microbiology.

Although global life expectancy has increased over the past 20 years due to advancements in managing infectious diseases, one-fifth of people still die from infections. In response to this ongoing threat, significant efforts are underway to develop vaccines and antimicrobial agents. However, pathogens evolve resistance mechanisms, complicating their control.

Nutritionally acquired immunodeficiency must be addressed with the same urgency as HIV to end tuberculosis.

Tuberculosis (TB) is the leading infectious killer worldwide, with 10.6 million cases and 1.6 million deaths in 2021 alone.

Change in sexual and reproductive health knowledge among young women using the conversational agent "Nthabi" in Lesotho: a clinical trial.

Background: Young women worldwide face problems like unwanted pregnancy and sexually transmitted infections. Providing sexual and reproductive health education to young women in low- and middle-income countries is a priority. It is unknown if using digital health interventions to deliver health education is effective in resource-constrained settings.

Tai Chi and Wellness Interventions for Veterans with Gulf War Illness: A Randomized Controlled Feasibility Trial.

Background: Gulf War Illness (GWI) is a chronic multi-symptom illness that affects up to one-third of the 700,000 American military personnel deployed to the Persian Gulf region in 1990 and 1991. We conducted a randomized controlled trial to examine feasibility and the relative efficacy of two 12-week in-person group treatments (Tai Chi and Wellness) to address GWI symptoms of chronic pain, fatigue, and changes in mood and cognitive functioning.

Method: Male and female veterans were randomly assigned to Tai Chi (n = 27) or Wellness (n = 26) group interventions and assessed at four time points: baseline, post-treatment, 3-, and 9-month follow-up.

Atrial Fibrillation: A Review.

Importance: In the US, approximately 10.55 million adults have atrial fibrillation (AF). AF is associated with significantly increased risk of stroke, heart failure, myocardial infarction, dementia, chronic kidney disease, and mortality.

Alzheimer's Disease Sequencing Project Release 4 Whole Genome Sequencing Dataset.

The Alzheimer's Disease Sequencing Project (ADSP) is a national initiative to understand the genetic architecture of Alzheimer's Disease and Related Dementias (AD/ADRD) by sequencing whole genomes of affected participants and age-matched cognitive controls from diverse populations. The Genome Center for Alzheimer's Disease (GCAD) processed whole-genome sequencing data from 36,361 ADSP participants, including 35,014 genetically unique participants of which 45% are from non-European ancestry, across 17 cohorts in 14 countries in this fourth release (R4). This sequencing effort identified 387 million bi-allelic variants, 42 million short insertions/deletions, and 2.

Management of thrombosed or failed dialysis access.

Hemodialysis (HD) access for patients with end-stage renal disease is a steadily increasing necessity, and maintaining patency of native or synthetic fistulas can be challenging. The main physiologic changes of an HD access that cause it to fail are inflow or outflow vessel stenosis or access thrombosis. These are propagated by factors intrinsic to end-stage renal disease, altered hemodynamics from a fistula, and typically further exacerbated by associated comorbidities.

Long-Term Safety and Effectiveness of Dimethyl Fumarate in Patients with Multiple Sclerosis Treated in Routine Medical Practice: Final Analysis of the ESTEEM Study.

Introduction: Dimethyl fumarate (DMF) has demonstrated a favorable benefit-risk profile in patients with relapsing-remitting multiple sclerosis (RRMS) in clinical and real-world studies. The ESTEEM study (NCT02047097) was conducted to assess the long-term safety and effectiveness of delayed-release DMF in patients with relapsing forms of MS in routine clinical practice. We report final outcomes from ESTEEM with up to 6.