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.

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.

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.

Elucidating the Mechanism of Recognition and Binding of Heparin to Amyloid Fibrils of Serum Amyloid A.

Amyloid diseases feature pathologic deposition of normally soluble proteins and peptides as insoluble fibrils in vital organs. Amyloid fibrils co-deposit with various nonfibrillar components including heparan sulfate (HS), a glycosaminoglycan that promotes amyloid formation in vitro for many unrelated proteins. HS-amyloid interactions have been proposed as a therapeutic target for inflammation-linked amyloidosis wherein N-terminal fragments of serum amyloid A (SAA) protein deposit in the kidney and liver.

Transcriptional Cofactors for Thyroid Hormone Receptors.

Thyroid hormone (TH) is essential throughout life. It's actions are mediated primarily by the thyroid hormone receptor (THR), which is a nuclear receptor. Classically, the THRs act as inducible transcription factors.

Protocol for a randomized controlled trial of strength at home in Israel: A trauma informed intervention for intimate partner violence based on a social-information processing model.

Background: The social information processing (SIP) model of trauma and intimate partner violence (IPV), which emphasizes the impact of trauma on one's ability to accurately process social information and subsequent failure to generate and enact nonaggressive responses, has gained attention in the United States. Recent clinical trial evidence suggests that the Strength at Home (SAH) intervention, a 12-session program that is based on this model, is efficacious in reducing and ending abusive behavior among U.S.

Genetic counselors' perspectives on genomic screening of apparently healthy newborns in the United States.

Purpose: There is growing international interest in using genomic sequencing to screen newborns and children for treatable genomic conditions. Although recent research has demonstrated increasing support for using genomic sequencing to screen newborns and children for treatable genomic conditions among various stakeholders, little is known about the perspectives of genetic counselors (GCs) in the United States, who are frequently engaged in the disclosure of positive newborn screening results and coordination of follow-up testing and management.

Methods: This study utilized a cross-sectional 3-section survey to explore GCs' perspectives on the benefits, limitations, and ethical and practical considerations of genomic sequencing in newborns as an adjunct screen to standard newborn screening (NBS).

Associations of plasma extracellular microRNAs with new-onset breast cancer in the Framingham heart study.

Breast cancer is the second leading cause of cancer deaths among women. Multiple microRNAs (miRNAs) have been reported to be associated with breast cancer progression or metastasis. The purpose of the current study was to identify plasma extracellular miRNAs associated with incident breast cancer.

Chlorthalidone vs Hydrochlorothiazide and Kidney Outcomes in Patients With Hypertension: A Secondary Analysis of a Randomized Clinical Trial.

Importance: Hypertension is a risk factor for the development and progression of chronic kidney disease (CKD). It is unclear whether different thiazide diuretics have a differential impact on kidney outcomes.

Objective: To compare kidney outcomes in patients with hypertension taking chlorthalidone and hydrochlorothiazide.

The State of Medical Education on Criminal Justice Health: A Systematic Review.

Background: The justice-involved population faces significant health disparities yet is often overlooked in medical education, resulting in medical providers having limited preparation to serve this community. The objective of this study is to understand the scope and context of medical education in correctional healthcare.

Methods: Literature was systematically reviewed for curriculum on correctional healthcare aimed at undergraduate or graduate medical learners in U.

Factors Associated with Loss to Follow-Up in Pediatric Concussion Patients after Initial Visit: A Retrospective Study at a Concussion Clinic.

Objective: The objective of this retrospective study is to identify factors associated with loss to follow-up for postconcussion clearance in pediatric patients by comparing loss to follow-up and full clearance patients.

Study Design: This retrospective single-center cohort study analyzed 140 consecutive patients at a pediatric concussion clinic of a safety-net hospital for loss to follow-up, defined as not achieving clearance at last appointment. Univariate and multivariate regression models were fit on variables of interest, including demographic, mechanism and severity of concussion, and characteristics of the first evaluation postconcussion and follow-up management.

Obfuscation via pitch-shifting for balancing privacy and diagnostic utility in voice-based cognitive assessment.

Introduction: Digital voice analysis is gaining traction as a tool to differentiate cognitively normal from impaired individuals. However, voice data poses privacy risks due to the potential identification of speakers by automated systems.

Methods: We developed a framework that uses weighted linear interpolation of privacy and utility metrics to balance speaker obfuscation and cognitive integrity in cognitive assessments.

Association of T-Cell Phenotypes With Peri-Coronary Inflammation in People With and Without HIV and Without Cardiovascular Disease.

Background: Persistent immune activation is linked to elevated cardiovascular diseases in people with HIV on antiretroviral therapy. The fat attenuation index (FAI) is a measure of peri-coronary inflammation that independently predicts cardiovascular disease risk in people without HIV. Whether FAI is associated with immune activation is unknown.

Advanced WIfI Stage is Associated with Poor Outcomes in the BEST-CLI Trial.

Objective: Wound, ischemia, and foot infection (WIfI) staging was established to provide objective classification in patients with chronic limb threatening ischemia (CLTI) and to predict 1-year major amputation risk. Our goal was to validate WIfI staging using data from the Best Endovascular versus Best Surgical Therapy in Patients with CLTI (BEST-CLI) trial.

Methods: Data from the BEST-CLI Trial, a prospective randomized trial comparing surgical (OPEN) and endovascular (ENDO) revascularization, were used to assess the association of WIfI stage on long-term outcomes in an intention to treat analysis.

Losartan attenuates sex-dependent hypertension, neuroinflammation, and cognitive impairment in the aging male sprague-dawley rat.

The prevalence of hypertension increases with age and is the leading modifiable risk factor for cognitive impairment and dementia. At present, the neural mechanisms promoting hypertension across the lifespan are incompletely understood. Using the Sprague-Dawley (SD) rat as a model of normal aging, we hypothesized (1) blood brain barrier (BBB) disruption and neuroinflammation in the paraventricular nucleus (PVN) of the hypothalamus enhances sympathetic tone and contributes to age-dependent hypertension, (2) age-dependent hypertension is associated with cognitive impairment, and (3) lowering blood pressure in aged rats with established hypertension improves cognitive function.

The Dlk1-Dio3 noncoding RNA cluster coordinately regulates mitochondrial respiration and chromatin structure to establish proper cell state for muscle differentiation.

The coordinate regulation of metabolism and epigenetics to establish cell state-specific gene expression patterns during lineage progression is a central aspect of cell differentiation, but the factors that regulate this elaborate interplay are not well-defined. The imprinted Dlk1-Dio3 noncoding RNA (ncRNA) cluster has been associated with metabolism in various progenitor cells, suggesting it functions as a regulator of metabolism and cell state. Here, we directly demonstrate that the Dlk1-Dio3 ncRNA cluster coordinates mitochondrial respiration and chromatin structure to maintain proper cell state.