Epidemiology, trends, and disparities in maternal mortality: A framework for obstetric anesthesiologists.

Since 2015, reductions in maternal mortality have stalled globally. In some parts of the world, severe maternal morbidity and mortality have increased, and most cases are thought to be from preventable causes. This is further exacerbated by significant racial, ethnic, and geographic disparities in maternal health outcomes, particularly among countries with diverse populations.

Association of Medicaid Accountable Care Organizations and postpartum mental health care utilization.

Objective: To examine the association of Massachusetts Medicaid Accountable Care Organization (ACO) implementation with changes in mental health care utilization in the postpartum period.

Study Setting And Design: We examine care for people with a birth covered by Medicaid or private insurance. We used a difference-in-differences design to compare differences before and after Medicaid ACO implementation for those with Medicaid versus those with private insurance.

Refinement of a Published Gene-Physical Activity Interaction Impacting HDL-Cholesterol: Role of Sex and Lipoprotein Subfractions.

Large-scale gene-environment interaction (GxE) discovery efforts often involve analytical compromises for the sake of data harmonization and statistical power. Refinement of exposures, covariates, outcomes, and population subsets may be helpful to establish often-elusive replication and evaluate potential clinical utility. Here, we used additional datasets, an expanded set of statistical models, and interrogation of lipoprotein metabolism via nuclear magnetic resonance (NMR)-based lipoprotein subfractions to refine a previously discovered GxE modifying the relationship between physical activity (PA) and HDL-cholesterol (HDL-C).

High prevalence of reverse transcriptase inhibitors associated resistance mutations among people living with HIV on dolutegravir-based antiretroviral therapy in Francistown, Botswana.

Objectives: We assessed HIV-1 drug resistance profiles among people living with HIV (PLWH) with detectable viral load (VL) and on dolutegravir-based antiretroviral therapy (ART) in Botswana.

Methods: The study utilised available 100 residual HIV-1 VL samples from unique PLWH in Francistown who had viraemia at-least 6 months after initiating ART in Botswana's national ART program from November 2023 to January 2024. Viraemia was categorized as low-level viraemia (LLV) (VL: 200-999 copies/mL) or virologic failure (VF) (VL ≥1000 copies/mL).

Detection of neurologic changes in critically ill infants using deep learning on video data: a retrospective single center cohort study.

Background: Infant alertness and neurologic changes can reflect life-threatening pathology but are assessed by physical exam, which can be intermittent and subjective. Reliable, continuous methods are needed. We hypothesized that our computer vision method to track movement, pose artificial intelligence (AI), could predict neurologic changes in the neonatal intensive care unit (NICU).

Dissemination of Decision Aids about Hip and Knee Osteoarthritis to Spanish-Speaking Adults through Social Media.

Background: Older adults and Hispanic individuals are increasingly turning to social media platforms to access health-related information. The purpose of this project was to evaluate a social media campaign to disseminate information from decision aids (DAs) on hip and knee osteoarthritis to Spanish-speaking adults.

Methods: A social media marketing team helped create an 8-mo campaign posted across 3 social media platforms to promote visits to a Web site offering free multilingual DAs for treatment of hip or knee osteoarthritis.

Diagnostic challenges of long COVID in children: a survey of pediatric health care providers' preferences and practices.

Introduction: Given the challenges in diagnosing children with long COVID, we sought to explore diagnostic practices and preferences among clinicians.

Methods: A ten-question survey assessed pediatric providers' clinical decision making for identifying and evaluating long COVID in children. Of the 120 survey respondents, 84 (70%) were physicians, 31 (26%) nurse practitioners, and 5 (4%) physician assistants.

Inner engineering is associated with perceived improvements in relationship quality, interpersonal connections, and interpersonal compassion.

Objectives: Interpersonal relationships are a cornerstone of wellbeing. Mindfulness-based practices have been shown to improve relationship quality and reduce perceived stress. Inner Engineering (IE) is a transformative program that includes meditative and yogic practices associated with improvements in mindfulness and wellbeing.

Tacrolimus to belatacept conversion in proteinuric kidney transplant recipients.

Background: Proteinuria is associated with worse allograft outcomes in kidney transplant recipients (KTRs) and treatment strategies are limited. We examined the outcomes of calcineurin inhibitor (CNI) to belatacept conversion in proteinuric KTRs.

Methods: In a pilot phase II single-arm multicenter prospective trial, we recruited adult KTRs >6 months post-kidney transplantation with an estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.

Association between somatic microsatellite instability, hypermutation status, and specific T cell subsets in colorectal cancer tumors.

Background: Microsatellite instability-high (MSI-high) tumors comprise ~15% of sporadic colorectal cancers (CRC) and are associated with elevated T cell infiltration. However, the universality of this response across T cell subtypes with distinct functions is unknown.

Methods: Including 1,236 CRC tumors from three observational studies, we conducted T cell profiling using a customized 9-plex (CD3, CD4, CD8, CD45RA, CD45RO, FOXP3, KRT, MKI67, and DAPI) multispectral immunofluorescence assay.

Designing for medication adherence in inflammatory bowel disease: multi-disciplinary approaches for self-administrable biotherapeutics.

Biotherapeutics are among the therapeutics that have revolutionized standard inflammatory bowel disease (IBD) treatment, which was previously limited to mesalamine, 5-aminosalicylic acid, corticosteroids, and classical immunosuppressants. Self-administrable biotherapeutics for IBD would enable home-based treatment and reduce the burden on medical infrastructure. Self-administration is made possible through subcutaneous injectable, oral, and rectal dosage forms.

Long-term prescription opioid use following surgery in the US (2017-2022): a population-based study.

Background: Over the last decade, numerous efforts have been made to combat the opioid crisis globally. The impact of these strategies has not been adequately measured and may differ across populations depending on baseline risk. We compared changes in long-term prescription opioid use following surgery within a national US cohort, between 2017 and 2022.

The response of health systems to the needs of migrants and refugees in the COVID-19 pandemic: a comparative case study between Mexico, Colombia and Peru.

Background: Protecting the health of migrants and refugees during the pandemic was a significant challenge in the Latin American region. We aimed to describe and contrast the response of the health systems of Mexico, Colombia and Perú to migrants' and refugees' health needs during the COVID-19 pandemic, and to situate the response in the context of the migration and health policies of each country.

Methods: We conducted case studies of the three countries.

Isoform-selective and non-selective rho-kinase inhibitors do not affect collagenase-induced intracerebral hemorrhage outcomes in mice: Influence of sex and circadian cycle.

Rho-associated protein kinase (ROCK) inhibitors are therapeutic candidates in ischemic stroke and subarachnoid hemorrhage. However, their efficacy in intracerebral hemorrhage (ICH) is unknown. Here, we tested the efficacy of fasudil (10 mg/kg), an isoform-nonselective ROCK inhibitor, and NRL-1049 (10 mg/kg), a novel inhibitor with 43-fold higher selectivity for ROCK2 isoform compared with ROCK1, in a collagenase-induced ICH model in mice.

The relative cerebral blood volume (rCBV) < 42% is independently associated with hemorrhagic transformation in anterior circulation large vessel occlusion.

Background: Pretreatment CT perfusion (CTP) marker relative cerebral blood volume (rCBV) < 42% lesion volume has recently shown to predict poor collateral status and poor 90-day functional outcome. However, there is a paucity of studies assessing its association with hemorrhagic transformation (HT). Here, we aim to assess the relationship between rCBV < 42% lesion volume with HT.

Glucagon-like peptide-1 receptor agonists and upper endoscopy: a real-world experience.

Objective: Increased use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) has raised safety concerns during endoscopy due to their mechanism of delaying gastric emptying. This study aims to evaluate the impact of GLP-1RAs on technical success and safety of esophagogastroduodenoscopy (EGD).

Methods: This was a retrospective study of bariatric patients who underwent EGD between January 2022 and December 2023.

Access to healthcare for children with CHDs in middle and low-income countries: a systematic literature review.

CHD includes a wide range of cardiac disorders present at birth. If appropriate care is delivered in time, the prognosis is relatively good. However, in many parts of the world, access to healthcare continues to be a problem for these patients, particularly in low- and middle-income countries.

Prevalence of Disordered Eating Behaviors Among Sexual and Gender Minority Youth Varies at the Intersection of Gender Identity and Race/Ethnicity.

Objective: Prior work has documented inequities in disordered eating behavior (DEB) prevalence across gender identity, race, and ethnicity, yet has often ignored the fact that individuals belong to multiple social groups simultaneously. The present study assessed DEB inequities at the intersection of gender identity and race/ethnicity.

Method: The sample included n = 10,287 adolescents (68% gender-diverse, 33% belonging to marginalized racial/ethnic groups).

Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease For the STORCC Investigators.

Background: Electrocardiograms (EKGs) are routinely performed in pregnant patients with pre-existing cardiovascular disease. However, in pregnant patients with congenital heart disease (CHD), EKG changes during gestation have not been explored.

Methods: We performed a retrospective study of pregnant patients with CHD enrolled in the STORCC initiative.

Promoting Physical Activity in People With Parkinson's Disease Through a Smartphone App: A Pilot Study.

Background And Purpose: Physical activity has beneficial symptomatic effects for people with Parkinson's disease (PD), but increasing-and sustaining-a physically active lifestyle remains challenging. We investigated the feasibility (ability to increase step counts) and usability of a behavioral intervention using a motivational smartphone application to remotely increase physical activity in PD.

Methods: We performed a 4-week, double-blind pilot trial.

Substance use recovery needs among college students seeking recovery services: a thematic qualitative analysis.

Background: College students who are in recovery from substance use disorders face challenges related to abstaining from substance use, finding supportive social networks, and achieving their academic goals. These students may therefore seek out various recovery supports at their institutions to meet their needs and goals.

Methods: This study analyzed previously collected data to explore themes related to students' experiences of recovery, including their recovery needs and challenges while also attending college.

The association between perceived neighborhood social cohesion and intimate partner violence in a refugee camp in Dollo Ado, Ethiopia.

Background: Intimate partner violence (IPV) is the most common form of gender-based violence affecting women and girls worldwide and is exacerbated in humanitarian settings. There is evidence that neighborhood social processes influence IPV. Perceived neighborhood social cohesion (P-NSC)-a measure of community trust, attachment, safety, and reciprocity-may be protective against women's experience of and men's perpetration of IPV and controlling behaviors.

TiMON: a real-time integrated monitor for improving the placement and wear of emergency tourniquets.

Background: The use of emergency tourniquets among military personnel has helped to dramatically reduce battlefield deaths and has recently gained popularity in the civilian sector. Yet, even well-trained individuals can find it difficult to assess proper tourniquet application. Emergency tourniquets are typically deemed sufficiently tightened through cursory visual confirmation or pulse assessment.

Assessment of the functional and health-related needs of patients with metastatic breast cancer prior to initiation of cancer treatment.

Purpose: To identify needs of metastatic breast cancer patients prior to starting a new systemic treatment.

Methods: Fifty patients with newly diagnosed, recurrent, or progressive metastatic breast cancer completed an electronic survey which included patient-reported outcome measures of function (PROMIS Cancer Function Brief 3D profile), quality of life (FACT-G), exercise (Godin Leisure-Time exercise questionnaire), and diet (REAP-S); demographic information; and self-reported use of or referral to specific resources at the cancer center prior to beginning a new systemic oncologic treatment.

Results: Prior to starting a new treatment for metastatic breast cancer, patients reported mild functional impairment (PROMIS Cancer Function Brief 3D profile mean score:42.