Peak Oxygen Consumption Scaled to Body Composition Is Associated With Mortality and Morbidity in People With a Fontan Circulation.

Background: Peak oxygen consumption (peak O) is traditionally scaled by body mass, but it is most appropriately scaled by fat-free mass. However, it is unknown whether peak O scaled by fat-free mass is associated with mortality and morbidity in people with a Fontan circulation. The aim of this study was to assess the associations between different expressions of peak O with mortality and morbidity in people with a Fontan circulation.

Enhanced oxygen availability and preserved aggregative function in platelet concentrates stored at reduced platelet concentration.

Background: Storage of platelets as platelet concentrates for transfusion is limited to 7 days in the United Kingdom due to deleterious effects on platelet quality and function that occur over time. Oxygen (O) availability and sufficient gaseous exchange are known to be essential in maintaining the viability and function of platelets stored for transfusion. Despite this, there is a paucity of studies undertaking direct measures of O and optimization of conditions throughout storage.

Aromatic amino acid metabolism and active transport regulation are implicated in microbial persistence in fractured shale reservoirs.

Hydraulic fracturing has unlocked vast amounts of hydrocarbons trapped within unconventional shale formations. This large-scale engineering approach inadvertently introduces microorganisms into the hydrocarbon reservoir, allowing them to inhabit a new physical space and thrive in the unique biogeochemical resources present in the environment. Advancing our fundamental understanding of microbial growth and physiology in this extreme subsurface environment is critical to improving biofouling control efficacy and maximizing opportunities for beneficial natural resource exploitation.

Nurse practitioner program enrollment trends and predictions.

Background: As the fastest growing segment of the healthcare workforce, understanding NP enrollment is vital.

Purpose: This work aimed to guide healthcare workforce forethought, academic planning, and policy initiatives.

Method: This secondary data analysis investigated nurse practitioner (NP) program enrollment trends from 2013 to 2022, including sub-analyses of master's versus doctoral enrollment, clinical tracks (acute care, primary care, psychiatric mental health), and enrollment status (part-time vs.

Exposure to child sexual abuse materials among law enforcement investigative personnel: Exploring trauma and resilience profiles.

Objective: This study aimed to identify distinct profiles of investigators based on their exposure to child sexual abuse material (CSAM) and associated mental health symptomatology. Specifically, the study seeks to differentiate resilient profiles from those exhibiting psychopathologies. Additionally, this research explores resilience as a transdiagnostic and distal factor, examining individual- and agency-level coping and resiliency factors.

Post-licensure Safety Surveillance of 20-Valent Pneumococcal Conjugate Vaccine (PCV20) Among US Adults in the Vaccine Adverse Event Reporting System (VAERS).

Background: On June 8, 2021, a new 20-valent pneumococcal conjugate vaccine (PCV20, PREVNAR 20, Pfizer, Inc.) was licensed for use in adults aged ≥ 18 years by the US Food and Drug Administration (FDA).

Objective: To describe reports to the Vaccine Adverse Event Reporting System (VAERS) after administration of the 20-valent pneumococcal conjugate vaccine in adults.

Assessment of adherence to American Diabetes Association guidelines and evaluation of social determinants of health and interventions in patients with type 2 diabetes mellitus in a nurse practitioner-owned clinic.

Background: This was an ongoing quality-improvement (QI) project that aimed to assess the quality of nurse practitioner (NP)-driven diabetes care based on the 2023 American Diabetes Association (ADA) Standards of Care (SOC) at a NP-owned primary care practice. In addition, a more recent focus was the assessment of and intervention on social determinants of health (SDOH). Nationally, 47.

1-Year Real-World Outcomes of TAVR With the Fifth-Generation Balloon-Expandable Valve in the United States.

Background: Longer term outcomes of transcatheter aortic valve replacement (TAVR) with the SAPIEN 3 Ultra RESILIA (S3UR) valve over its predecessors have not been reported in a national registry.

Objectives: The aim of this study was to compare the 1-year clinical and echocardiographic outcomes of the S3UR with those of the SAPIEN 3 (S3) and SAPIEN 3 Ultra (S3U) in the Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry.

Methods: From September 2022 to March 2023, patients who underwent native TAVR with the S3UR or the S3 or S3U valve were propensity matched and compared.

Active Monitoring With or Without Endocrine Therapy for Low-Risk Ductal Carcinoma In Situ: The COMET Randomized Clinical Trial.

Importance: Active monitoring for low-risk ductal carcinoma in situ (DCIS) of the breast has been proposed as an alternative to guideline-concordant care, but the safety of this approach is unknown.

Objective: To compare rates of invasive cancer in patients with low-risk DCIS receiving active monitoring vs guideline-concordant care.

Design, Setting, And Participants: Prospective, randomized noninferiority trial enrolling 995 women aged 40 years or older with a new diagnosis of hormone receptor-positive grade 1 or grade 2 DCIS without invasive cancer at 100 US Alliance Cancer Cooperative Group clinical trial sites from 2017 to 2023.

Co-mast: Harmonized seed production data for woody plants across US long-term research sites.

Plants display a range of temporal patterns of inter-annual reproduction, from relatively constant seed production to "mast seeding," the synchronized and highly variable interannual seed production of plants within a population. Previous efforts have compiled global records of seed production in long-lived plants to gain insight into seed production, forest and animal population dynamics, and the effects of global change on masting. Existing datasets focus on seed production dynamics at the population scale but are limited in their ability to examine community-level mast seeding dynamics across different plant species at the continental scale.

Effect of Rurality on Type of Clinicians Delivering Psychotherapy and Prescribing Antidepressants to Veterans.

Objective: Mental health care is delivered by teams that include social workers, psychologists, nonphysician prescribing clinicians (NPPCs), and physicians. The objective of this study was to determine whether patient rurality has an effect on the types of U.S.

Rationale and Design of a Study to Assess the Engagement and Usefulness of the Care4Today Connect Digital Health Application for Disease Management in Coronary Artery Disease and Peripheral Artery Disease (iPACE-CVD Study).

Introduction: Coronary artery disease (CAD) and peripheral artery disease (PAD) increase the risks of cardiovascular events and death. Digital health technologies are rapidly expanding to improve healthcare quality and access. The Care4Today Connect (C4T CAD-PAD) mobile application is designed to help patients with CAD and/or PAD improve medication adherence, learn about their disease, make lifestyle modifications, and enhance healthcare provider (HCP) connection via an HCP-facing portal.

High-velocity nasal insufflation versus noninvasive positive pressure ventilation for moderate acute exacerbation of chronic obstructive pulmonary disease in the emergency department: A randomized clinical trial.

Background: Acute exacerbations of chronic obstructive pulmonary disease (COPD) in the emergency department (ED) involve dyspnea, cough, and chest discomfort; frequent exacerbations are associated with increased mortality and reduced quality of life. Noninvasive positive pressure ventilation (NiPPV) is commonly used to help relieve symptoms but is limited due to patient intolerance. We aimed to determine whether high-velocity nasal insufflation (HVNI) is noninferior to NiPPV in relieving dyspnea within 4 h in ED patients with acute hypercapnic respiratory failure.

Medication reconciliation in the outpatient primary care setting: Barriers and opportunities.

Increased complexity of the health care system has led to challenges of vital communications, such as a current and accurate patient medication list. Medication reconciliation aims to create the most comprehensive and accurate list of a patient's current medications by comparing it with their electronic health record. However, effectively gathering, organizing, and communicating this medication information across different stages of care is often complex and challenging.

Strengths-Based Assessment and Inclusive Language for Patients With Intellectual and Developmental Disabilities.

Pediatric dermatology patients with intellectual and developmental disabilities (IDD) and comorbid cutaneous conditions often face barriers to effective healthcare due to differences in communication preferences and sensitivities to environmental factors. The clinical intake process serves as a potential intervention point to help better understand and meet patients' needs. Strengths-based assessment and considerations around identity-first versus person-first language are tools that can improve the clinical intake process in pediatric dermatology.

Underappreciated layers of antibody-mediated immune synapse architecture and dynamics.

The biologic activities of antibody drugs are dictated by structure-function relationships-emerging from the kind, composition, and degree of interactions with a target antigen and with soluble and cellular antibody receptors of the innate immune system. These activities are canonically understood to be both modular: antigen recognition is driven by the heterodimeric antigen-binding fragment, and innate immune recruitment by the homodimeric constant/crystallizable fragment. The model that treats these domains with a high degree of independence has served the field well but is not without limitations.

Etiology, persistence, and risk factors of subclinical mastitis in a meat-producing sheep flock.

Subclinical mastitis, the asymptomatic inflammation of the udder often caused by bacterial infection, is an important economic and welfare concern in meat-producing flocks. We conducted a longitudinal observational study to: (1) characterize the etiology, prevalence, incidence, and persistence of intramammary infections during the first 8 wk of lactation, and (2) investigate the potential risk factors of lactation stage, parity, and the number of lambs reared. Duplicate milk samples (n = 592) were collected aseptically from each udder half of 37 clinically healthy ewes (9 Hampshire, 22 Polypay, and 6 Targhee) weekly for their first 8 wk of lactation.

Associations Between Oncology Outreach and Patient-Sharing Measures of Care Coordination.

Background: Oncology outreach is a common strategy for addressing cancer workforce shortages, where traveling oncologists commute across clinical settings to extend their services. Despite its known benefits specifically for rural patients, oncology outreach reallocates physician resources to satellite clinics and may negatively impact the coordination of cancer care.

Methods: In this retrospective study, we identified patients with incident breast, colorectal, and lung cancers from 2016-2019 nationwide Medicare claims and linked them to oncologists using Part B.

Organoclay flocculation as a pathway to export carbon from the sea surface.

Marine microorganisms play a critical role in regulating atmospheric CO concentration via the biological carbon pump. Deposition of continental mineral dust on the sea surface increases carbon sequestration but the interaction between minerals and marine microorganisms is not well understood. We discovered that the interaction of clay minerals with dissolved organic matter and a γ-proteobacterium in seawater increases Transparent Exopolymer Particle (TEP) concentration, leading to organoclay floc formation.

Social validity of Research Ethics for All: Social-behavioral research ethics education for community research partners with developmental disabilities.

Background: Training in research ethics supports community research partners with developmental disabilities to take on additional research responsibilities. We worked with an academic-community partnership to develop an accessible research ethics training tailored to the roles of community research partners with developmental disabilities that leads to certification: Research Ethics for All.

Objective: We evaluated the social validity of the educational activities and certification process.

How are pro- and anti-cannabis messaging exposures related to US young adult cannabis use-related factors?

Given the diverse sources of cannabis messaging and potential differential effects, this study examined pro- and anti-cannabis messaging exposure overall and via specific channels in relation to cannabis-related perceptions (social acceptability and harm) and behaviors (use status, intentions and frequency; past-year quit attempts). Multivariable regression analyses of 2023 survey data from 4031 US young adults (Mage = 26.29, 59.

From Code to Clots: Applying Machine Learning to Clinical Aspects of Venous Thromboembolism Prevention, Diagnosis, and Management.

The high incidence of venous thromboembolism (VTE) globally and the morbidity and mortality burden associated with the disease make it a pressing issue. Machine learning (ML) can improve VTE prevention, detection, and treatment. The ability of this novel technology to process large amounts of high-dimensional data can help identify new risk factors and better risk stratify patients for thromboprophylaxis.