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Objective: To explore the impacts of different types of physical exercise on health outcomes of individuals with hypertensive disorders of pregnancy (HDPs). Methods: Forty individuals with HDPs admitted to a tertiary hospital providing maternal and pediatric care between July 2023 and March 2024 were enrolled in this prospective randomized controlled clinical study and completed a ≥4-week intervention. Data were collected before the intervention and before delivery. Participants were assigned randomly to control (no exercise intervention), aerobic exercise (AE), resistance training (RT), and AE + RT groups. All participants downloaded a mobile health-education app for gestational hypertension developed by our research group. Exercise videos in the app guided participants' performance of different types of exercise. General information; physical activity and sleep quality data; morning blood pressure, lipid profiles, and urinary micro-albumin/creatinine ratios; serum soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF), and advanced oxidation protein product (AOPP) concentrations; and pregnancy outcome data were collected and compared among groups. Results: After the intervention, the physical activity status, sleep quality, morning blood pressure, lipid profiles, urinary micro-albumin/creatinine ratios, and pregnancy outcomes differed significantly among all groups comparing with control (all p <.05). In the three exercise groups, the serum sFlt-1, PlGF, and AOPPs levels improved significantly (all p <.05). All differences were most pronounced in the AE + RT group. Limitations: The study period was relatively short. The further long-term follow-up research is needed. A larger sample size study is also needed. Conclusions: The study results suggest that AE + RT interventions are beneficial for individuals with HDPs in clinical settings, and could be implemented with careful consideration of individuals' specific conditions. [ABSTRACT FROM AUTHOR]

The development of lipid nanoparticles (LNP) holds great promise for vaccine and therapeutic applications. However, ineffective transport of nucleic acid cargo from endosomes to the cytosol, termed "endosomal escape," has remained a bottleneck to achieving greater LNP efficacy. Poor understanding of the mechanisms of endosomal escape and a lack of suitable techniques to assess the efficiency of escape have also impeded progress in this field. To address this gap, a modified SNAPSwitch/SNAP‐tag assay is developed to compare the cytosolic delivery capabilities of various LNP formulations, comparing ionizable lipids used in major commercial LNP products. The results show that all the LNP formulations tested exhibited low (<10%) endosomal escape efficiency. Interestingly, a limited correlation is found between the amount of mRNA delivery to the cytosol and protein expression. While endosomal escape of mRNA LNP cargo is necessary for protein expression, subcellular processes after delivery to the cytosol play a critical role in maximising protein expression. These findings challenge existing paradigms and reveal critical parameters for optimizing nucleic acid delivery and therapeutic effectiveness of next‐generation LNP. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Although preventable, healthcare‐associated infections (HAIs) are commonly observed in post‐acute care settings for at‐risk older adults and are a leading cause of hospital readmissions. However, whether HAIs resulting in avoidable readmissions for preexisting HAIs (the same HAI as at the index admission) are more common for patients discharged to post‐acute care as opposed to home is unknown. We examined the risk of preexisting HAI readmissions according to patient discharge disposition and comorbidity level. DESIGN: We used 2013‐2014 national hospital discharge data to estimate the likelihood of readmissions for preexisting HAIs according to patients' discharge disposition and whether the likelihood varies according to patient comorbidity level, across four common types of HAIs (not including respiratory infections). PARTICIPANTS: A total of 702 304 hospital discharges for Medicare beneficiaries 65 years or older. MEASUREMENTS: Our outcome was a 30‐day preexisting, or "linked," HAI readmission (readmission involving the same HAI diagnosis as at the index admission). Patient discharge disposition was skilled nursing facility (SNF), home health care, and home care without home health care ("home"). RESULTS: Of 702 304 index admissions involving HAI treatment, 353 073 (50%) were discharged to a SNF, 179 490 (26%) to home health care, and 169 872 (24%) to home. Overall, 17 523 (2.5%) of preexisting HAIs resulted in linked HAI readmissions, which were more common for Clostridioides difficile infections (4.0%) and urinary tract infections (2.4%) than surgical site infections (1.1%; P <.001). Being discharged to a SNF compared to home or to home health care was associated with a 1.15 percentage point (95% confidence interval = −1.29 to −1.00), or 38%, lower risk of a linked HAI readmission. This risk difference was observed to increase with greater patient comorbidity. CONCLUSIONS: SNF discharges were associated with fewer avoidable readmissions for preexisting HAIs compared with home discharges. Further research to identify modifiable mechanisms that improve posthospital infection care at home is needed. J Am Geriatr Soc 68:370–378, 2020 [ABSTRACT FROM AUTHOR]

Purpose: Sleep apnea is a recognized risk factor for adverse perioperative outcomes in total joint arthroplasty. Nevertheless, little is known about its impact on shoulder arthroscopy, which is a commonly performed ambulatory procedure. Our primary objective was to determine whether sleep apnea was associated with increases in complications and healthcare utilization in this setting.Methods: We analyzed administrative data collected from 583 U.S. hospitals between 2010-2015 and identified a cohort of 128,932 patients who underwent shoulder arthroscopy. Using a cross-sectional study design, we examined the relationship between sleep apnea and perioperative outcomes including mortality, stroke, myocardial infarction, and pulmonary complications. We also examined a variety of health utilization outcomes.Results: Among patients who underwent shoulder arthroscopy, approximately 6% (7,761 of 128,932) had the diagnosis of sleep apnea. The overall complication rate in these patients was 1.39% (95% confidence interval [CI], 1.33 to 1.45). In a crude analysis, sleep apnea was associated with increases in the majority of systemic complications. In adjusted analyses, sleep apnea was associated with a 4.95 (95% CI, 1.81 to 13.5) times greater odds of acute myocardial infarction and a 4.92 (95% CI, 2.72 to 8.9) times greater odds of pulmonary complications. Sleep apnea was also associated with increased odds of requiring postoperative ventilation, hospital admission, and intensive care unit admission.Conclusion: Sleep apnea is associated with an increased risk of complications and resource utilization in patients undergoing shoulder arthroscopy. [ABSTRACT FROM AUTHOR]