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•Quantitative CT lung strain can diagnose early BOS before decline in percent predicted forced expiratory volume in 1 second.•Quantitative CT lung strain can distinguish types of BOS.

Background: Silicone oil (SO) is a long-term tamponade for repair of complex retinal pathology but has limitations including late redetachment. This study describes our experience with SO tamponade for repair of retinal detachment with proliferative vitreoretinopathy (PVR), with attention to anatomic and functional outcomes. Methods: Retrospective consecutive case series of eyes with retinal detachment (RD) complicated by proliferative vitreoretinopathy (PVR) receiving SO tamponade at the University of Wisconsin between 2013 and 2019. Group 1 defined as primary SO placement; Group 2 had SO placed after failing prior retinal detachment repair. Results: Inclusion criteria of SO placement for repair of RD with PVR was met for 117 eyes. The final reattachment rate was 84% for all eyes, with no difference between Groups 1 and 2. Vision improvement was 2.1 lines for Group 1 (p= 0.06 from baseline) and 4.6 lines for Group 2 (p< 0.0001). The mean number of silicone oil placements was 1.4. Less improvement in vision was noted with repeat SO placement, though overall functional vision of 5/200 or better was achieved in 63.2% of patients. Conclusions: SO tamponade allows long-term anatomical stabilisation and substantial vision recovery in eyes with retinal detachment complicated by PVR. Rates of anatomic and functional success have improved significantly when compared to prior studies using oil tamponade for repair of PVR.

•Among 6995 HCT recipients, 81 (1%) developed DAH at a median of 54 days post-HCT.•DAH is rare but associated with mortality exceeding 70% by 1 year after diagnosis.•Risk increases with nonmalignant hematologic disease, CNI + MMF therapy, and acute GVHD.•Associated ICU comorbidities included hypertension, pericarditis, and renal failure.

Dietary restriction (DR) and hypoxia (low oxygen) extend lifespan in Caenorhabditis elegansthrough the induction of a convergent downstream longevity gene, fmo-2. Flavin-containing monooxygenases (FMOs) are highly conserved xenobiotic-metabolizing enzymes with a clear role in promoting longevity in nematodes and a plausible similar role in mammals. This makes them an attractive potential target of small molecule drugs to stimulate the health-promoting effects of longevity pathways. Here, we utilize an fmo-2fluorescent transcriptional reporter in C. elegansto screen a set of 80 compounds previously shown to improve stress resistance in mouse fibroblasts. Our data show that 19 compounds significantly induce fmo-2, and 10 of the compounds induce fmo-2more than twofold. Interestingly, 9 of the 10 high fmo-2inducers also extend lifespan in C. elegans. Two of these drugs, mitochondrial respiration chain complex inhibitors, interact with the hypoxia pathway to induce fmo-2, whereas two dopamine receptor type 2 (DRD2) antagonists interact with the DR pathway to induce fmo-2, indicating that dopamine signaling is involved in DR-mediated fmo-2induction. Together, our data identify nine drugs that each (1) increase stress resistance in mouse fibroblasts, (2) induce fmo-2in C. elegans, and (3) extend nematode lifespan, some through known longevity pathways. These results define fmo-2induction as a viable approach to identifying and understanding mechanisms of putative longevity compounds.

Flow diverter devices are small stents used to divert blood flow away from aneurysms in the brain, stagnating flow and inducing intra-aneurysmal thrombosis which in time will prevent aneurysm rupture. Current devices are formed from thin (∼25 μm) wires which will remain in place long after the aneurysm has been mitigated. As their continued presence could lead to secondary complications, an absorbable flow diverter which dissolves into the body after aneurysm occlusion is desirable. The absorbable metals investigated to date struggle to achieve the necessary combination of strength, elasticity, corrosion rate, fragmentation resistance, radiopacity, and biocompatibility. This work proposes and investigates a new composite wire concept combining absorbable iron alloy (FeMnN) shells with one or more pure molybdenum (Mo) cores. Various wire configurations are produced and drawn to 25–250 μm wires. Tensile testing revealed high and tunable mechanical properties on par with existing flow diverter materials. In vitro degradation testing of 100 μm wire in DMEM to 7 days indicated progressive corrosion and cracking of the FeMnN shell but not of the Mo, confirming the cathodic protection of the Mo by the FeMnN and thus mitigation of premature fragmentation risk. In vivo implantation and subsequent μCT of the same wires in mouse aortas to 6 months showed meaningful corrosion had begun in the FeMnN shell but not yet in the Mo filament cores. In total, these results indicate that these composites may offer an ideal combination of properties for absorbable flow diverters.

Amidate-based ligands (N-(tert-butyl)isobutyramide, ITA) bind κ2to form homoleptic, 8-coordinate complexes with tetravalent 237Np (Np(ITA)4, 1-Np) and 242Pu (Pu(ITA)4, 1-Pu). These compounds complete an isostructural series from Th, U–Pu and allow for the direct comparison between many of the early actinides with stable tetravalent oxidation states by nuclear magnetic resonance (NMR) spectroscopy and single crystal X-ray diffraction (SCXRD). The molecular precursors are subjected to controlled thermolysis under mild conditions with the exclusion of exogenous air and moisture, facilitating the removal of the volatile organic ligands and ligand byproducts. The preformed metal–oxygen bond in the precursor, as well as the metal oxidation state, are maintained through the decomposition, forming fully stoichiometric, oxidation-state pure NpO2and PuO2. Powder X-ray diffraction (PXRD), scanning transmission electron microscopy (STEM), and energy dispersive X-ray spectroscopy (EDS) elemental mapping supported the evaluation of these high-purity materials. This chemistry is applicable to a wide range of metals, including actinides, with accessible tetravalent oxidation states, and provides a consistent route to analytical standards of importance to the field of nuclear nonproliferation, forensics, and fundamental studies.

The metal–organic frameworks (MOFs) CALF-20 and ZIF-8 were combined into single bead-like structures through phase inversion of poly(styrene-block-ethylene-co-butylene-block-styrene) to make engineered particles for protection against sulfur dioxide (SO2) at a broad range of relative humidity (RH) conditions. CALF-20 provided good protection under dry conditions, while ZIF-8 provided good protection under humid conditions. An optimal ratio of a 50:50 mixture was found to perform approximately twice as good as a broad spectrum activated, impregnated carbon, with SO2capacities of 0.9 and 2.6 mol/kg under dry and humid conditions, respectively. The mixed-MOF beads also provided good uptake of 2-chloroethyl ethyl sulfide, a chemical warfare agent simulant, under both dry and humid conditions, with the 50:50 mix having loadings of 4.1 and 3.0 mol/kg, respectively, further expanding the potential usefulness of these materials.

New interspecific hybrid hazelnut crosses between American (Corylus americana) and European (Corylus avellana) hazelnuts are being developed to support a commercial industry in the Midwest region of the United States. In this study, volatile compounds that impact consumer aroma liking of roasted hybrid hazelnuts (C. americana× C. avellana) were investigated by targeted and nontargeted GC/MS flavoromics. Chemical profiles from 10 roasted hybrid hazelnut samples were modeled with consumer aroma liking scores by orthogonal partial least-squares with good fit and predictive performance (R2≥ 0.92, Q2≥ 0.82, RMSECV= 0.2). Top ranked predictors positively correlated with liking included 12 aroma compounds and 4 profiled volatiles for the targeted and nontargeted methods, respectively. Sensory recombination testing of hazelnut samples with addition of the 12 predictive odorants was preferred by consumers (p< 0.001, Δ aroma liking = 2.2 on 9-point scale) and perceived as more roasty, nutty, and sweet compared to the control (p< 0.05). Addition of the 4 predictive volatiles at subthreshold levels also was preferred (p= 0.02) and perceived as less earthy and mushroom like than the control (p< 0.05).

American-European hybrid hazelnuts (Corylus americana× Corylus avellana) are an emerging crop in the Upper Midwest of the United States that have been reported to have unique sensory characteristics compared to traditionally grown European hazelnuts. In this study, key odor-active compounds in a roasted hybrid hazelnut variety (C. americana× C. avellana) were identified and profiled across different hybrid hazelnut varietals to understand sensory differences. Gas chromatography/mass spectrometry/olfactometry analysis identified 33 odorants with high flavor dilution factors (FD ≥ 16) in the roasted hybrid hazelnut, including 2-acetylpyrazine and 2-aminoacetophenone as first reported hazelnut odorants. Descriptive sensory analysis profiles of the roasted hazelnut and an aroma recombination model consisting of 27 odorants quantified above their odor detection thresholds were not significantly different for the six evaluated attributes, confirming the aroma contribution of the identified odorants. Variation in all 33 aroma-active compounds across 12 hybrid and two European hazelnut varieties was visualized through principal component analysis and related to aroma profiles previously characterized by consumers.

•Patients with limited (<5 disease sites) pre-CART B-cell NHL are at high risk of local relapse/progression.•BRT before CART for patients with R/R NHL and limited disease (<5 involved sites) improves outcomes without causing significant toxicities.

Immunodominant epitope discovery platforms play an important role in identifying novel biomarkers for effective immunotherapies and diagnostics. Methods to analyze the B-cell repertoire have been improved both experimentally and computationally. We developed an enhanced peptide microarray platform to discover and subsequently screen immunodominant epitopes. We utilized SARS-Cov-2 IgG positive and negative samples as a proof-of-concept to demonstrate the power of these improved peptide microarrays. The method identified significantly discriminant epitopes that classify positive and negative samples with good performance both as single peptides and in combination. We provide the assay conditions and parameters that justify the use of peptide microarrays in the selection of high-affinity epitopes, and we directly compare peptide performance against proteins. The results suggest that this platform can be used to confidently identify immunodominant antiviral epitopes while also serving as a useful tool for high-volume screening.

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In the current study, investigators examined the effects of an instructional reading package consisting of shared reading and systematic instruction (e.g., task analysis, system of least prompts, visual supports, and native language support) in a small group setting on percentage of correct consonant-vowel-consonant (CVC) words for three elementary participants with extensive support needs who also were multilingual learners. A multiple probe design across word sets with replication across participants resulted in a functional relation between the percentage of correct CVC words acquired and the instructional package. In addition, there were positive changes in exploratory (secondary) dependent variables that included components of reading (i.e., phonemic awareness, fluency, vocabulary, comprehension, and generalization) as demonstrated through pre-posttest assessments. Social validity measures for parents, students, and paraprofessionals also revealed positive pre-post changes. Limitations and future research are discussed.

For community forest enterprises (CFEs) in central Mexico, ‘scaling up’ can be an effective means of achieving the transition to economically attractive and sustainable forest management, but little is known about the potential and challenges that they face in this regard. We used a qualitative case study to evaluate a set of variables that determine the limitations and opportunities for scaling up CFEs in central Mexico and thereby expanding their commercial capacities, activities and outputs. The framework included concepts related to sustainable forest management, natural resource governance and temperate forest ecology. We interviewed leaders of four communities (n= 30) and 15 external actors (regional industry, and national non-governmental organizations). Communities that had developed long-term plans for forest management that embrace conservation values were also those with the greatest capacity to generate sustainable income streams from diverse sources. The robust legal frameworks and community institutions that set up procedures for responsibly harvesting and selling timber, thereby generating income, offer opportunities to enhance the effectiveness of CFEs. Demand continues to grow for wood products involving skilled crafts in central Mexico, but local production remains low; a lack of access to finance imposes limits on investment in the forests and value-added options for the products and services. Market opportunities and growth are also restricted by substandard physical infrastructure (e.g., roads, electricity) limited access to finance (e.g., credit, private-sector investors), and an absence of business plans. There are no formal networks to facilitate learning among these CFEs. Scaling up for these CFEs will require access to markets, innovations, and finance to create sustainable value chains for wood and non-wood forest products. The Mexican government could be instrumental in this by incorporating the notion of scaling up for CFEs when enacting policy that builds on and supports the country’s proven models of community-based forest management. On the other hand, this approach can be useful for developing more robust theoretical and methodological frameworks that capture these complex dynamics, contribute to the theory and practice of enterprise forestry development, sustainable natural resource management, and effective policy formulation.

Background: Digoxin is a widely prescribed drug for congestive heart failure and atrial fibrillation. Digoxin has a narrow therapeutic index and toxicity can develop quite easily. Digoxin immune fab (DIF) is an effective treatment for toxicity, however there are limited studies characterizing its impact on clinical outcomes in real-world clinical practice. Objectives: The aim of this study was to identify factors and healthcare outcomes associated with digoxin immune fab (DIF) treatment in patients with confirmed/suspected digoxin toxicity. Methods: An IRB-approved retrospective chart review of digoxin toxic patients (2011–2020) presenting at an academic healthcare system was conducted. Demographic and clinical data were collected. Patients were stratified by DIF treatment versus non-DIF treatment. DIF utilization patterns (appropriate, use when not indicated, or underutilized) were determined using pre-defined criteria. Severe digoxin toxicity was defined as having one or more of the following: mental status disturbances, antiarrhythmic therapy, acute renal impairment or dehydration, serum digoxin concentration (SDC) > 4 ng/mL, or serum K+ > 5 mEq/mL. Logistic multivariable regression analysis evaluated factors associated with DIF use. All statistical analyses were performed in R version 4.1. Results: Data from 96 patients (non-DIF treated group = 49; DIF treated group = 47) were analyzed. DIF was used appropriately in 70 patients (73%), underutilized in 19 (20%), and administered to 7 (7%) patients when it was not indicated. Several clinical parameters differentiated the DIF from the non-DIF group (p&lt; 0.05) including higher mean SDC (3.41 ± 1.63 vs 2.87 ± 1.17), higher mean potassium (5.33 ± 1.48 vs 4.55 ± 0.87), more toxicity severity (85% vs 49%), and more likely to require cardiac pacing (26% vs 4%). Digoxin toxicity resolved sooner in the DIF group (coefficient − 0.702, 95% CI − 1.137 to − 0.267) (p&lt; 0.01) and they had shorter intensive care unit lengths of stay (12.4 ± 20.3 vs 24.4 ± 28.7 days; p= 0.018). The all-cause mortality rate in patients appropriately managed with DIF therapy versus those patients where DIF was underutilized was 11% and 21%, respectively. Conclusions: Based on our study population, DIF therapy appears to be beneficial in limiting duration of toxicity and intensive care unit lengths of stay in digoxin toxic patients. Although DIF was appropriately utilized in most cases, there was a relatively high proportion of cases in which DIF treatment was either underutilized or not indicated.

AbstractObjectiveObesity as assessed by body mass index (BMI) is associated with increased risk of chronic disease. Health fatalism, defined as the belief that health outcomes are outside of one’s control, is also associated with chronic disease risk. The purpose of this cross-sectional study was to understand the relationship between health fatalism and BMI in healthy adults. Secondary outcomes assessed the relationships between health fatalism and diet quality and health fatalism and physical activity.MethodHealthy individuals aged 18 to 65 years were recruited via ResearchMatch, electronic mailing lists, and social media. Participants completed online questionnaires on demographic characteristics, diet quality, physical activity, and degree of health fatalism. Regression models were used to assess the primary and secondary outcomes. For the primary outcome, the model of health fatalism (predictor) and BMI (outcome) was also adjusted for diet quality, physical activity, and demographic characteristics.ResultsParticipants (n = 496) were 38.7 ± 14.3 years old and primarily female (76%) and White (81%), with a BMI of 25.1 ± 5.2 kg/m2. Most participants had a college or post-college education (74%), stated that they always had sufficient income to live comfortably (90%), and were moderately to highly active (91%). There was no relationship between health fatalism and BMI (p > 0.05) or health fatalism and physical activity (p > 0.05); however, there was a significant relationship between health fatalism and diet quality (beta coefficient: −0.046; 95% confidence interval, −0.086 to −0.0058; p = 0.025), such that a higher degree of fatalism predicted a slight decrease in diet quality.ConclusionsAlthough health fatalism did not predict BMI in this population, fatalistic beliefs were associated with poorer diet quality.

Fish mercury concentrations result in fish consumption advisories. However, selenium : mercury molar ratios >1 are protective to wildlife and humans. Therefore, we sampled total selenium (TSe) and total mercury (THg) concentrations and molar ratios in sport fish from 50 Idaho (ID) lakes >20 ha and 67 northeastern USA (NE) lakes >1 ha. Sample lakes were selected at random, to obtain unbiased estimates of mean fish tissue levels, with known confidence limits, for target populations of 95 ID lakes >20 ha in surface area and 12,557 NE lakes >1 ha. Bass and salmonids presented the greatest potential mercury toxicity risk to consumers based on their higher mercury content, desirability as game fish, and widespread distributions. Fish tissue THg exceeded safe consumption criteria in an estimated 20–80% of the lakes in the two regions and TSe exceeded safe consumption thresholds in an estimated 0–20% of the lakes in the two regions. However, the Se : Hg molar ratio was >1 in an estimated 90–97% of fish tested from NE and ID lakes. Therefore, we concluded that Se levels in these systems are usually sufficient to limit disruption of selenoprotein activities by Hg, and that fish consumption advisories based on Hg alone are unnecessarily restrictive.

IMPORTANCE: Although apolipoprotein B (apoB) is a superior marker of lipid-related risk compared with low-density lipoprotein cholesterol (LDL-C), few data exist to translate the goals and thresholds from LDL-C to their apoB equivalent. In addition, although current American College of Cardiology/American Heart Association guidelines provide a relative indication for apoB measurement among individuals with hypertriglyceridemia, whether discordance is limited to those subgroups is unknown. OBJECTIVES: To assess the variability in apoB level across the spectrum of LDL-C or non–high-density lipoprotein cholesterol (non–HDL-C) levels and evaluate whether discordance between apoB and LDL-C or non–HDL-C is limited to specifiable subgroups. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data from a nationally representative sample of 12 688 adult participants not using statins in the National Health and Nutrition Examination Survey between 2005 and 2016. Statistical analysis was performed from April 2023 to February 2024. MAIN OUTCOMES AND MEASURES: Quantile regression was used to assess the population distribution of apoB across LDL-C or non–HDL-C levels. Discordance between apoB and LDL-C was the difference between measured apoB and median apoB levels for an individual’s LDL-C level. Discordance was evaluated by age, sex, race and ethnicity, obesity, diabetes, triglyceride level, hemoglobin A1c level, body mass index (BMI), statin use, and metabolic health (defined as a BMI between 18.5 and 24.9, triglyceride level &lt;150 mg/dL, and no diabetes). RESULTS: Among the sample of 12 688 participants (median age, 41.0 years [IQR, 29.0-54.0 years]; 52.9% women) for LDL-C values of 55, 70, 100, and 190 mg/dL, the corresponding population median apoB levels were 49, 60, 80, and 140 mg/dL, respectively. For given levels of LDL-C, a range of apoB values was observed. At an LDL-C level of 100 mg/dL, the 95% population distribution of apoB ranged from 66 mg/dL to 99 mg/dL. ApoB variability was highest for LDL-C values estimated using the Friedewald equation, lower when using Sampson or Martin-Hopkins equations, and lowest for non–HDL-C. Although individuals with metabolic risk factors were more likely to have discordantly high apoB levels (ie, had higher median observed apoB levels relative to what was estimated based on LDL-C), significant variability in apoB levels was observed even among metabolically healthy individuals. CONCLUSIONS AND RELEVANCE: This study suggests that even metabolically healthy individuals may have discordantly high apoB levels relative to LDL-C or non–HDL-C levels. The current guideline approach for apoB testing only for those with hypertriglyceridemia appears too narrow. Population percentile data can be used to translate LDL-C goals and thresholds to their apoB equivalent to facilitate clinical adoption.

Little is known regarding differences in cause-specific costs between heart failure (HF) with ejection fraction (EF) ≤40% vs >40%, and potential cost implications of sodium glucose co-transporter 2 inhibitor (SGLT2i) therapy.

Persons diagnosed with schizophrenia (SCZ) or bipolar I disorder (BPI) are at high risk for self-injurious behavior, suicidal ideation, and suicidal behaviors (SB). Characterizing associations between diagnosed health problems, prior pharmacological treatments, and polygenic scores (PGS) has potential to inform risk stratification. We examined self-reported SB and ideation using the Columbia Suicide Severity Rating Scale (C-SSRS) among 3,942 SCZ and 5,414 BPI patients receiving care within the Veterans Health Administration (VHA). These cross-sectional data were integrated with electronic health records (EHRs), and compared across lifetime diagnoses, treatment histories, follow-up screenings, and mortality data. PGS were constructed using available genomic data for related traits. Genome-wide association studies were performed to identify and prioritize specific loci. Only 20% of the veterans who reported SB had a corroborating ICD-9/10 EHR code. Among those without prior SB, more than 20% reported new-onset SB at follow-up. SB were associated with a range of additional clinical diagnoses, and with treatment with specific classes of psychotropic medications (e.g., antidepressants, antipsychotics, etc.). PGS for externalizing behaviors, smoking initiation, suicide attempt, and major depressive disorder were associated with SB. The GWAS for SB yielded no significant loci. Among individuals with a diagnosed mental illness, self-reported SB were strongly associated with clinical variables across several EHR domains. Analyses point to sequelae of substance-related and psychiatric comorbidities as strong correlates of prior and subsequent SB. Nonetheless, past SB was frequently not documented in health records, underscoring the value of regular screening with direct, in-person assessments, especially among high-risk individuals.

System complexity continues to grow, creating many new challenges for engineers and decision makers. To maximize value delivery, “both” systems engineering and decision analysis are essential. The systems engineering profession has had a significant focus on improving systems engineering processes. While process plays an important role, the focus on process was often at the expense of foundational engineering axioms and their contribution to system value. As a consequence, systems engineers were viewed as process developers and managers versus technical leaders with a deep understanding of how system interactions are linked to stakeholder value. With the recent shift toward model‐based systems engineering (MBSE), systems engineering is “getting back to basics,” focusing on value delivery via first principles, using established laws of engineering and science. This paper describes how pattern‐based systems engineering (PBSE), as outlined within INCOSE's model‐based systems engineering (MBSE) initiative, explicates system value through modeling of first principles, re‐uniting systems engineering and decision analysis capabilities.

This article from Bowlers Journal International offers a chart and reviews of nine bowling balls that are appropriate for the upcoming league season. The chart helps bowlers determine which lane conditions are best suited for each ball based on its hook potential and breakpoint shape. The article provides information about the testing process and the characteristics of each ball, as well as recommendations for different types of players and lane patterns. It is written from a neutral perspective and serves as a helpful resource for library patrons researching bowling equipment. The text provides details about the different bowling balls and their features, including the manufacturer's intent, core specifications, coverstock, and finishes. It also describes how the balls perform on specific lane patterns. For medium oil patterns, the Scorpion Strike and Optimum Idol Pearl are recommended, while the MaxThrill Solid and Pride Liberty are suitable for medium to drier lane conditions. These balls offer varying levels of strength, cleanliness, and angularity, catering to different bowling styles. [Extracted from the article]

Data that are restricted are historically challenging for researchers to find and even more difficult to access. While efforts to support open data have expanded in Canada, the same cannot be said for restricted data. To better understand the landscape of restricted data in Canada, this study aimed to accomplish two primary goals: (1) identify data sources where data were restricted and (2) assess a subset of health sciences data sources to determine how well they make their data discoverable and accessible. Our study identified 137 Canadian data sources, where 48 health sciences sources were evaluated for discoverability/accessibility. Data sources received poor grades with respect to data discovery due to a lack of metadata standards (38/48, 79%), an inability to find datasets through searching and browsing (32/46, 70%), and a lack of data documentation to support reuse (27/48, 56%). The absence of pricing information (31/48, 65%) and opaque dataset restrictions (25/48, 52%) were identified as key barriers to the data access request process. This study highlights significant room for improvement with respect to improving the discovery of and access to restricted data in Canada and makes recommendations for how to better support restricted data sources on a national scale.

Abstract:Music has historically and culturally served as a tool for Black men to express themselves and tell their stories. Further, music is an integral part of Black culture that provides unique insight into Black men’s ideal sexualities, sexual practices, and their conceptualizations of sex. Thus, this content analysis analyzed the lyrics of Black men’s favorite sex songs from a strength-based, sex-positive perspective to better conceptualize Black men’s sexualities and sexual practices. One hundred six men answered the short-form survey question, “What is your favorite sex song?” Analysis of the song content determined Black men’s favorite sex songs were focused on mutual (29%) and their partner’s pleasure (28%). Black men’s favorite sex songs focused on attentiveness and admiration of partner, fulfilling fantasy, lust and yearning, vocal affirmation and reassurance, risky sex, and desire for intimacy. These findings suggest Black men desire reciprocity, intimacy, and vulnerability during sex.

Despite data suggesting that apolipoprotein B (apoB) measurement outperforms low-density lipoprotein cholesterol level measurement in predicting atherosclerotic cardiovascular disease risk, apoB measurement has not become widely adopted into routine clinical practice. One barrier for use of apoB measurement is lack of consistent guidance for clinicians on how to interpret and apply apoB results in clinical context. Whereas guidelines have often provided clear low-density lipoprotein cholesterol targets or triggers to initiate treatment change, consistent targets for apoB are lacking. In this review, we synthesize existing data regarding the epidemiology of apoB by comparing guideline recommendations regarding use of apoB measurement, describing population percentiles of apoB relative to low-density lipoprotein cholesterol levels, summarizing studies of discordance between low-density lipoprotein cholesterol and apoB levels, and evaluating apoB levels in clinical trials of lipid-lowering therapy to guide potential treatment targets. We propose evidence-guided apoB thresholds for use in cholesterol management and clinical care.

Hydrogen peroxide (H2O2) is a highly effective decontaminant against chemical warfare agents (CWAs) when present both in a liquid and as a solid powder. For the latter, this can be in the form of H2O2being complexed to a polymer, such as polyvinylpyrrolidone (PVP). While a H2O2–PVP complex is indeed effective at decontaminating CWAs, it is vulnerable to environmental conditions such as high relative humidities (RH), which can dissociate the H2O2from the complex before it is given the opportunity to react with CWAs. In this paper, we demonstrate that the cross-linked version of PVP forms a highly stable complex with H2O2, which can withstand both high (40 °C) and low (−20 °C) temperatures as well as maintain stability at high RH up to 90% over several days. Collectively, this lays the framework for processing the H2O2–PVP complex in a variety of form factors that can maintain efficacy under a wide range of real-world environmental conditions.

Managed care plans, which contract with states to cover three-quarters of Medicaid enrollees, play a crucial role in addressing the drug epidemic in the United States. However, substance use disorder benefits vary across Medicaid managed care plans, and it is unclear what role states play in regulating their activities. To address this question, we surveyed thirty-three states and Washington, D.C., regarding their substance use disorder treatment coverage and utilization management requirements for Medicaid managed care plans in 2021. Most states mandated coverage of common forms of substance use disorder treatment and prohibited annual maximums and enrollee cost sharing in managed care. Fewer than one-third of states forbade managed care plans from imposing prior authorization for each treatment service. For most treatment medications, fewer than two-thirds of states prohibited prior authorization, drug testing, “fail first,” or psychosocial therapy requirements in managed care. Our findings suggest that many states give managed care plans broad discretion to impose requirements on covered substance use disorder treatments, which may affect access to lifesaving care.

Professional society and expert guidelines recommend the achievement of glycaemic, blood pressure, and cholesterol targets to prevent the microvascular and macrovascular complications of diabetes. The WHO Diabetes Compact recommends that countries meet and monitor these targets for diabetes management. Surveillance—ie, continuous, systematic measurement, analysis, and interpretation of data—is a crucial component of public health. In this Personal View, we use the case of India as an illustration of the challenges and future directions needed for a diabetes surveillance system that documents national progress and persistent gaps. To address the growing burdens of diabetes and cardiometabolic diseases, the Government of India has launched programmes such as the National Programme for Prevention and Control of Non-Communicable Diseases. Different surveys have provided estimates of the diabetes care continuum of awareness, treatment, and control at the national, state, and, very recently, district level. We reviewed the literature to analyse how these surveys have varied in both their data collection methods and the reported estimates of the diabetes care continuum. We propose an integrated surveillance and monitoring framework to augment decentralised decision making, leveraging the complementary strengths of different surveys and electronic health record databases, such as data obtained by the National Programme for Prevention and Control of Non-Communicable Diseases, and building on methodological advances in model-based small-area estimation and data fusion. Such a framework could aid state and district administrators in monitoring the progress of diabetes screening and management initiatives, and benchmarking against national and global standards in all countries.

Neutrophils are rapidly recruited to sites of infection and are critical for pathogen clearance. Therapeutic use of primary neutrophils has been limited, as they have a short lifespan and are not amenable to genetic manipulation. Human induced pluripotent stem cells (iPSCs) can provide a robust source of neutrophils for infusion and are genetically tractable. However, current work has indicated that dampened intracellular signaling limits iPSC-derived neutrophil (iNeutrophil) cellular activation and antimicrobial response. Here, we show that protein tyrosine phosphatase 1B (PTP1B) inhibits intracellular signaling and dampens iNeutrophil effector function. Deletion of the PTP1B phosphatase increased PI3K and ERK signaling and was associated with increased F-actin polymerization, cell migration, and phagocytosis. In contrast, other effector functions like NETosis and reactive oxygen species production were reduced. PTP1B-deficient neutrophils were more responsive to Aspergillus fumigatusand displayed rapid recruitment and control of hyphal growth. Accordingly, depletion of PTP1B increased production of inflammatory factors including the neutrophil chemokine interleukin-8. Taken together, these findings suggest that PTP1B limits iNeutrophil motility and antimicrobial function.Deletion of the phosphatase PTP1B increases induced pluripotent stem cell–derived neutrophil intracellular signaling to improve motility, phagocytosis, and antifungal response.

Background: Peer recovery programs increase recovery support and treatment engagement among individuals with opioid use disorder. Peer recovery specialists (PRS) are critical in the cascade of care of treating addiction and related conditions. Work remains to help identify the benefits of PRS, particularly time spent with a PRS as a clinical indicator associated with referral to substance use treatment services. Gaps in the literature do not consider the nested hierarchical intercorrelations of opioid recovery data within multiple emergency departments.Purpose: The current study examined demographic and clinical correlates with referral to substance use treatment services including prior engagement within an opioid overdose recovery program, mental health diagnosis, the number of naloxone administrations, prior overdoses, and hospital-level variability of PRS time associated with treatment referrals.Method: This study used data collected by providers among patients who engaged in an opioid overdose recovery program. Data were collected between January 2016 and September 2020. Generalized linear mixed effect multilevel regression analyses tested the associations on clinical referral to substance use services.Results: A total of 5655 patients participated in the study (male: 68.91%; age: mean = 37.75 ± 12.43; White non-Hispanic: 62.48%). Significant individual-level associations were identified between demographic and clinical variables and referral to substance use treatment services. At the hospital level, recovery specialist time spent with the patient also showed a positive and significant association with referral to substance use treatment services.Conclusion: The cross-level interaction effect displayed that any period of time spent with PRS played an important role for those patients with a greater number of prior overdoses on referral to treatment. Results provide important information on the role of PRS in the cascade of care, as well as the time spent with those in this role for both individuals with varying number of prior overdoses.

IMPORTANCE: Kidney health has received increasing focus as part of comprehensive heart failure (HF) treatment efforts. However, the occurrence of clinically relevant kidney outcomes in contemporary populations with HF has not been well studied. OBJECTIVE: To examine rates of incident dialysis and acute kidney injury (AKI) among Medicare beneficiaries after HF hospitalization. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study evaluated adults aged 65 years or older who were hospitalized for HF across 372 sites in the Get With The Guidelines–Heart Failure registry in the US between January 1, 2014, and December 31, 2018. Patients younger than 65 years or requiring dialysis either during or prior to hospitalization were excluded. Data were analyzed from May 4, 2021, to March 8, 2024. MAIN OUTCOMES AND MEASURES: The primary outcome was inpatient dialysis initiation in the year after HF hospitalization and was ascertained via linkage with Medicare claims data. Other all-cause and cause-specific hospitalizations were also evaluated. The covariate-adjusted association between discharge estimated glomerular filtration rate (eGFR) and 1-year postdischarge outcomes was examined using Cox proportional hazards regression models. RESULTS: Overall, among 85 298 patients included in the analysis (mean [SD] age, 80 [9] years; 53% women) mean (SD) left ventricular ejection fraction was 47% (16%) and mean (SD) eGFR was 53 (29) mL/min per 1.73 m2; 54 010 (63%) had an eGFR less than 60 mL/min per 1.73 m2. By 1 year after HF hospitalization, 6% had progressed to dialysis, 7% had progressed to dialysis or end-stage kidney disease, and 7% had been readmitted for AKI. Incident dialysis increased steeply with lower discharge eGFR category: compared with patients with an eGFR of 60 mL/min per 1.73 m2 or more, individuals with an eGFR of 45 to less than 60 and of less than 30 mL/min per 1.73 m2 had higher rates of dialysis readmission (45 to &lt;60: adjusted hazard ratio [AHR], 2.16 [95% CI, 1.86-2.51]; &lt;30: AHR, 28.46 [95% CI, 25.25-32.08]). Lower discharge eGFR (per 10 mL/min per 1.73 m2 decrease) was independently associated with a higher rate of readmission for dialysis (AHR, 2.23; 95% CI, 2.14-2.32), dialysis or end-stage kidney disease (AHR, 2.34; 95% CI, 2.24-2.44), and AKI (AHR, 1.25; 95% CI, 1.23-1.27), with similar findings for all-cause mortality, all-cause readmission, and HF readmission. Baseline left ventricular ejection fraction did not modify the covariate-adjusted association between lower discharge eGFR and kidney outcomes. CONCLUSIONS AND RELEVANCE: In this study, older adults with HF had substantial risk of kidney complications, with an estimated 6% progressing to dialysis in the year after HF hospitalization. These findings emphasize the need for health care approaches prioritizing kidney health in this high-risk population.

Price incentives for reducing fossil fuel related carbon emissions are an important component of effective and efficient climate policy. Current incentives stem from a mixture of energy taxes and carbon pricing (incentivizing less emissions) and diverse support measures for fossil fuels (incentivizing more emissions). We develop a net carbon price indicator that complements existing subsidy and carbon pricing indicators. It can be calculated on different aggregation levels and compared across countries. We calculate the different components and our aggregate indicator for the year 2018 and for eight countries including the worlds’ six largest emitters. Our analysis reveals large differences in net carbon prices across countries and across sectors within countries. We argue that the sectoral differences can inform about adequate national policy reforms while the aggregate national indicator can be useful for international negotiations about comparable national efforts.

This document is a review of different bowling balls and their performance characteristics. It includes a chart that helps bowlers understand which lane conditions are best suited for different bowling balls based on their hook potential and breakpoint shape. The review provides information on seven specific bowling balls, including their hook potential, length ratings, and breakpoint shape. It also includes details about the manufacturer's intent and the core and coverstock specifications of each ball. The review is based on testing by a ball reviewer and input from bowlers and ball company representatives. It provides information about different bowling balls and their performance on various lane patterns, discussing their characteristics and recommending certain balls for different types of bowlers and lane conditions. [Extracted from the article]