Association of Fontan Pathophysiology With Plasma Bile Acids.

Background: Patients with Fontan circulation are frail and experience multisystem dysfunction including impaired exercise capacity, low resting and exercise-augmented cardiac output, and progressive liver fibrosis. However, common underlying biochemical abnormalities or disease-specific biomarkers have not been well-described.

Objectives: We wish to investigate Fontan and their matched healthy subjects using a nontargeted, followed by targeted metabolomic analysis.

Enhancing prediction and inference of daily in-stream nutrient and sediment concentrations using an extreme gradient boosting based water quality estimation tool - XGBest.

Estimating constituent loads in streams and rivers is a crucial but challenging task due to low-frequency sampling in most watersheds. While predictive modeling can augment sparsely sampled water quality data, it can be challenging due to the complex and multifaceted interactions between several sub-watershed eco-hydrological processes. Traditional water quality prediction models, typically calibrated for individual sites, struggle to fully capture these interactions.

Real-World Treatment Patterns Among US Patients With Type 2 Diabetes Mellitus Initiating Treatment With Once Weekly Semaglutide for Diabetes.

Purpose: Injectable once weekly semaglutide for diabetes (OW sema) is a medication approved in 2017 for the treatment of patients with type 2 diabetes (T2DM). In clinical trials, OW sema has been shown to be effective at helping patients achieve glycemic targets. However, more data are needed to understand how patients who initiate treatment with OW sema are treated in the real world and to aid prescribers in making treatment decisions.

Merits of the social return on investment methodology for assessing the value of palliative care programmes.

Despite the widely accepted benefits of palliative care for individuals with serious illnesses and their families, the utilisation of this approach remains low. Although an increased use of palliative care services can increase the value of health-care spending by providing comprehensive wraparound services to support care, the economic evidence required to implement, promote, and engage in palliative care models on a wide scale eludes the affected individuals, health-care providers, payers, and policy makers. This gap in evidence is partly owing to the methodological limitations of standard value-assessment frameworks, which do not capture important societal dimensions of the value generated by palliative care.

Definitions and use of tumour bulk in phase 3 lymphoma trials: a comprehensive literature review.

Tumour 'bulk' has historically been considered an important prognostic marker and clinical tool to guide treatment in patients with lymphoma. However, its use and definitions in trial designs varies significantly and it is unclear how this has influenced the relevance of bulk in contemporary practice. This comprehensive literature review evaluated the definitions, applications and prognostic impact of bulk in phase 3 randomised trials in four major lymphoma subtypes.

Prepartum supplementation of Ascophyllum nodosum meal or ethylenediamine dihydroiodide: Effects on colostrum yield and growth and health of dairy calves.

We aimed to evaluate the effects of prepartum supplementation of different I sources (Ascophyllum nodosum [ASCO] meal and ethylenediamine dihydroiodide [EDDI]) on colostrum yield of cows, and blood concentrations of glucose, BHB, and thyroid hormones and growth of dairy calves. Forty multiparous Holstein cows were blocked by lactation number and expected calving date and assigned to 1 of 4 treatments 28 d before parturition: (1) EDDI supplemented (11 mg/d) to a basal diet to meet the NRC (2001) I concentration of 0.5 mg of I/kg of DMI (control = CON [0 g/d of ASCO meal]; actual I concentration = 0.

Effectiveness of behavioural and psychological interventions for managing obesity in children and adolescents: A systematic review and meta-analysis framed using minimal important difference estimates based on GRADE guidance to inform a clinical practice guideline.

Objective: Conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) of behavioural and psychological interventions for managing paediatric obesity.

Methods: Eligible studies, published between 1985 and 2022, included 0 to 18 year olds with outcomes reported ≥3 months post-baseline, including patient-reported outcome measures (PROMs), cardiometabolic and anthropometric outcomes, and adverse events (AEs). We pooled data using a random effects model and assessed certainty of evidence (CoE) related to minimally important difference estimates for outcomes using GRADE.

An Observational Study to Determine the Prevalence of COVID-19 Among Hospitalized Patients With Multidrug-Resistant Enterobacterales Infections and Clinical Outcomes, 10 US Sites, 2020--2022.

Background: We investigated hospitalized carbapenem-resistant Enterobacterales (CRE) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) cases with and without COVID-19, as identified through Emerging Infections Program surveillance in 10 sites from 2020 to 2022.

Methods: We defined a CRE case as the first isolation of , complex, , , , or resistant to any carbapenem. We defined an ESBL-E case as the first isolation of , , or resistant to any third-generation cephalosporin and nonresistant to all carbapenems tested.

Safety, Tolerability, and Pharmacokinetics of Long-Acting Broadly Neutralizing HIV-1 Monoclonal Antibody VRC07523LS in Newborn Infants Exposed to HIV-1.

Background: Vertical HIV-1 transmission despite antiretroviral therapy may be mitigated by use of long-acting, broadly neutralizing, monoclonal antibodies (bNAb) such as VRC07523LS. The present study was designed to determine the safety and pharmacokinetics of VRC07523LS.

Methods: VRC07523LS, 80 mg/dose, was administered subcutaneously after birth to non-breastfed (Cohort 1; N=11, enrolled in USA) and breastfed (Cohort 2; N=11, enrolled in South Africa and Zimbabwe) infants exposed to HIV-1.

Genotyped cluster investigations versus standard contact tracing: comparative impact on latent tuberculosis infection cascade of care in a low-incidence region.

Background: Cluster and contact investigations aim to identify and treat individuals with tuberculosis (TB) and latent TB infection (LTBI). Although genotyped cluster investigations may be superior to contact investigations in generating additional epidemiological links, this may not necessarily translate into reducing infections. Here, we investigated the impact of genotyped cluster investigations compared to standard contact investigations on the LTBI care cascade in a low incidence setting.

Skin disease-associated GJB4 variants differentially influence connexin stability, cell viability and channel function.

Here we characterize seven Cx30.3 gene variants (R22H, S26Y, P61R, C86S, E99K, T130M and M190L) clinically associated with the rare skin disorder erythrokeratodermia variabilis et progressiva (EKVP) in tissue-relevant and differentiation-competent rat epidermal keratinocytes (REKs). We found that all variants, when expressed alone or together with wildtype (WT) Cx30.

Extracellular RNA communication: A decade of NIH common fund support illuminates exRNA biology.

The discovery that extracellular RNAs (exRNA) can act as endocrine signalling molecules established a novel paradigm in intercellular communication. ExRNAs can be transported, both locally and systemically in virtually all body fluids. In association with an array of carrier vehicles of varying complexity, exRNA can alter target cell phenotype.

Cost-utility and cost-benefit analysis of a multi-component intervention (NEXpro) for neck-related symptoms in Swiss office workers.

Background: Neck pain is a significant public health issue, especially among office workers, with a prevalence ranging from 42 to 68%. This study aimed to evaluate the cost-utility and cost-benefit of a multi-component intervention targeting neck pain in the general population of office workers in Switzerland. The 12-week multi-component intervention consisted of neck exercises, health promotion information workshops, and workplace ergonomics sessions.

Exploring the use and usefulness of living guidelines for consumers: international online survey of patients' and carers' views.

Background: Living guidelines contain continually updated, and potentially changing, clinical recommendations. The implications of living guidelines for consumers (e.g.

Similarities and differences in waste composition over time and space determined by multivariate distance analyses.

The composition of solid waste affects technology choices and policy decisions regarding its management. Analyses of waste composition studies are almost always made on a parameter by parameter basis. Multivariate distance techniques can create wholisitic determinations of similarities and differences and were applied here to enhance a series of waste composition comparisons.

Assessing Clinical Improvement of Infants Hospitalized for Respiratory Syncytial Virus-Related Critical Illness.

Background: Pediatric respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (LRTI) commonly requires hospitalization. The Clinical Progression Scale Pediatrics (CPS-Ped) measures level of respiratory support and degree of hypoxia across a range of disease severity, but it has not been applied in infants hospitalized with severe RSV-LRTI.

Methods: We analyzed data from a prospective surveillance registry of infants hospitalized for RSV-related complications across 39 U.

Optimizing automated photo identification for population assessments.

Several legal acts mandate that management agencies regularly assess biological populations. For species with distinct markings, these assessments can be conducted noninvasively via capture-recapture and photographic identification (photo-ID), which involves processing considerable quantities of photographic data. To ease this burden, agencies increasingly rely on automated identification (ID) algorithms.

Specialty palliative care use among cancer patients: A population-based study.

Background: Rigorous population-based assessments of the use of specialty palliative care (SPC) in the US are rare.

Settings/subjects: This study examined SPC use among cancer patients in a mid-sized metropolitan area in Southeast US.

Measurements: In this cancer decedent cohort study, data were acquired and linked from the state-wide cancer registry; state-wide hospital discharge dataset; and local SPC providers.

Six-Month Outcomes in the Long-Term Outcomes After the Multisystem Inflammatory Syndrome in Children Study.

Importance: Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening complication of COVID-19 infection. Data on midterm outcomes are limited.

Objective: To characterize the frequency and time course of cardiac dysfunction (left ventricular ejection fraction [LVEF] <55%), coronary artery aneurysms (z score ≥2.

'Screening should not be based on ability to pay': Australian healthcare providers' and consumers' perspectives on public funding for non-invasive prenatal testing.

Background: Non-invasive prenatal testing (NIPT) does not receive any Medicare rebate. This study investigated the views of Australian healthcare providers and consumers on public funding of NIPT.

Materials And Methods: Two anonymous online, cross-sectional surveys were conducted from September 2022 to January 2023.

From Soil to Salad: Strategies for Reducing Foodborne Illness Outbreaks.

This study addresses the global issue of foodborne illness, specifically focusing on those resulting from the consumption of leafy green vegetables. It explores the rising trend of consuming minimally processed or raw foods and the imperative of maintaining safety standards starting at the preharvest stage to prevent pathogenic bacterial contamination. The study identifies soil and irrigation water as key sources of pathogens and emphasizes the need for strict preventive measures during production and preharvest.

Pacemaker Pocket Erosion: A Critical Issue Requiring Immediate Attention.

Cardiac implantable electronic devices (CIEDs), including pacemakers, implantable cardiac defibrillators (ICD), and cardiac resynchronization therapy (CRT) devices, regulate heart rate and rhythm in patients with cardiac conditions. With an aging population, CIED-related complications, especially pacemaker pocket infections, are rising. Risk factors include frailty, older age, and superficial device fixation, while risk mitigation involves larger pocket sizes, submuscular fixation, and absorbable antibacterial envelopes.

Breaking the Silence on Obesity.

Obesity is a significant global public health concern, and health care providers play a crucial role in addressing it by offering healthy lifestyle counseling and weight management support. Evidence demonstrates that even brief counseling on healthy behaviors can lead to meaningful changes and sustained weight management. However, weight consultations are often underutilized in primary care due to various barriers, including biases against patients with obesity, misconception of physicians with obesity, or concerns about stigmatizing them by initiating discussions about weight.