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Introduction: Peritoneal dialysis (PD)-related peritonitis is one of the leading causes of discontinuation of PD and is considered a critically important outcome for patients on PD. However, there is no universally accepted method of measuring this outcome in clinical trials. Method(s): We convened an online consensus workshop to establish a core outcome measure for PD-related peritonitis in clinical trials. Result(s): A total of 53 participants, including 18 patients and caregivers, from 12 countries engaged in breakout discussions in this workshop. Transcripts were analyzed thematically. We identified the following 3 themes: (i) feasibility and applicability across diverse settings, which reflected the difficulty with implementing laboratory-based measures in resource-limited environments; (ii) ensuring validity, which included minimizing false positives and considering the specificity of symptoms; and (iii) being meaningful and tangible to patients, which meant that the measure should be easy to interpret, reflect the impact that symptoms have on patients, and promote transparency by standardizing the reporting of peritonitis among dialysis units. Conclusion(s): A core outcome measure for PD-related peritonitis should include both symptom-based and laboratory-based criteria. Thus, the International Society for Peritoneal Dialysis (ISPD) definition of peritonitis is acceptable. However, there should be consideration of reporting suspected peritonitis in cases where laboratory confirmation is not possible. The measure should include all infections from the time of catheter insertion and capture both the rate of infection and the number of patients who remain peritonitis free. A core outcome measure with these features would increase the impact of clinical trials on the care and decision-making of patients receiving PD.Copyright © 2022 International Society of Nephrology

OBJECTIVE: To assess pregnancy outcomes following first trimester combined screening for preterm preeclampsia in Australia. METHODS: We compared pregnancy outcomes of women with singleton pregnancies who underwent first trimester combined preeclampsia screening with the Fetal Medicine Foundation algorithm between 2014 and 2017 in Melbourne and Sydney, Australia, with those from women who received standard care. The primary outcomes were preterm preeclampsia and screening performance. Effect estimates were presented as risk ratios with 95% confidence intervals. RESULTS: A total of 29 618 women underwent combined screening and 301 566 women received standard care. Women who had combined screening were less likely to have preeclampsia, preterm birth, small neonates, and low Apgar scores than the general population. Women with high-risk results (≥1 in 100) were more likely to develop preterm preeclampsia (2.1% vs. 0.7%, risk ratio [RR] 3.04, 95% CI 2.46-3.77), while low-risk women (risk <1 in 100) had lower rates of preterm preeclampsia (0.2% vs. 0.7%, RR 0.26, 95% CI 0.19-0.35) and other pregnancy complications. Screening detected 65.2% (95% CI 56.4-73.2%) of all preterm preeclampsia cases, with improved performance after adjustment for treatment effect. CONCLUSIONS: First trimester screening for preeclampsia in clinical practice identified a population at high risk of adverse pregnancy outcomes and low-risk women who may be suitable for less intensive antenatal care.

Sedimentary records of past hurricane activity indicate centennial-scale periods over the past millennium with elevated hurricane activity. The search for the underlying mechanism behind these active hurricane periods is confounded by regional variations in their timing. Here, we present a new high resolution paleohurricane record from The Bahamas with a synthesis of published North Atlantic records over the past millennium. We reconstruct hurricane strikes over the past 1,050 years in sediment cores from a blue hole on Long Island in The Bahamas. Coarse-grained deposits in these cores date to the close passage of seven hurricanes over the historical interval. We find that the intensity and angle of approach of these historical storms plays an important role in inducing storm surge near the site. Our new record indicates four active hurricane periods on Long Island that conflict with published records on neighboring islands (Andros and Abaco Island). We demonstrate these three islands do not sample the same storms despite their proximity, and we compile these reconstructions together to create the first regional compilation of annually resolved paleohurricane records in The Bahamas. Integrating our Bahamian compilation with compiled records from the U.S. coastline indicates basin-wide increased storminess during the Medieval Warm Period. Afterward, the hurricane patterns in our Bahamian compilation match those reconstructed along the U.S. East Coast but not in the northeastern Gulf of Mexico. This disconnect may result from shifts in local environmental conditions in the North Atlantic or shifts in hurricane populations from straight-moving to recurving storms over the past millennium.

Sedimentary records of past hurricane activity indicate centennial-scale periods over the past millennium with elevated hurricane activity. The search for the underlying mechanism behind these active hurricane periods is confounded by regional variations in their timing. Here, we present a new high resolution paleohurricane record from The Bahamas with a synthesis of published North Atlantic records over the past millennium. We reconstruct hurricane strikes over the past 1,050 years in sediment cores from a blue hole on Long Island in The Bahamas. Coarse-grained deposits in these cores date to the close passage of seven hurricanes over the historical interval. We find that the intensity and angle of approach of these historical storms plays an important role in inducing storm surge near the site. Our new record indicates four active hurricane periods on Long Island that conflict with published records on neighboring islands (Andros and Abaco Island). We demonstrate these three islands do not sample the same storms despite their proximity, and we compile these reconstructions together to create the first regional compilation of annually resolved paleohurricane records in The Bahamas. Integrating our Bahamian compilation with compiled records from the U.S. coastline indicates basin-wide increased storminess during the Medieval Warm Period. Afterward, the hurricane patterns in our Bahamian compilation match those reconstructed along the U.S. East Coast but not in the northeastern Gulf of Mexico. This disconnect may result from shifts in local environmental conditions in the North Atlantic or shifts in hurricane populations from straight-moving to recurving storms over the past millennium.

Purpose: the purpose of this NIH-funded protocol is to adapt (Aim 1) and pilot test (Aim 2) an mHealth intervention to improve maternal and child health in Cameroon. We will adapt the 24/7 University of Alabama at Birmingham Medical Information Service via Telephone (MIST) provider support system to mMIST (mobile MIST) for peripheral providers who provide healthcare to pregnant and postpartum women and newborns in Cameroon. Methods: in Aim 1, we apply qualitative and participatory methods (in-depth interviews and focus groups with key stakeholders) to inform the adaptation of mMIST for use in Cameroon. We use the sequential phases of the ADAPT-ITT framework to iteratively adapt mMIST incorporating qualitative findings and tailoring for local contexts. In Aim 2, we test the adapted intervention for feasibility and acceptability in Ndop, Cameroon. Results: this study is ongoing at the time that this protocol is published. Conclusion: the adaptation, refinement, and pilot testing of mMIST will be used to inform a larger-scale stepped wedged cluster randomized controlled effectiveness trial. If successful, this mHealth intervention could be a powerful tool enabling providers in low-resource settings to deliver improved pregnancy care, thereby reducing maternal and fetal deaths., Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); National Institutes of Health (NIH); Fogarty International Center (FIC); National Institute of Mental Health (NIMH)

This paper quantifies the impact of different policy options on the economic viability of sustainable aviation fuel (SAF) production technologies. The pathways considered include isobutanol to jet from corn grain, hydroprocessed esters and fatty acids (HEFA) from inedible fats and oils, HEFA from palm fatty acid distillate, synthesized iso-paraffins from sugarcane, Fischer-Tropsch (FT) gasification and synthesis from municipal solid waste, and micro FT from wood residues. The policies considered include feedstock subsidies, capital grants, output based incentives, and two policies intended to reduce project risk. Stochastic techno-economic analysis models are used to quantify the policies’ impact on project net present value and minimum selling price of the middle distillate fuel products. None of the technology pathways studied are found to be financially viable without policy aid. The median total policy costs required for economic viability range from 35 to 337 million USD per production facility, or 0.07–0.71 USD/liter. Our results indicate that the cumulative impact of multiple policies, similar in magnitude to analogous real-world fuel policies, could result in economically viable SAF production.