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The Healthy Change Program aimed to improve the accuracy of maternal perceptions of children's weight (MPCW), maternal feeding style (MFS) and feeding practices. Using a randomized control trial design, the intervention group received 4-weekly group sessions focusing on MPCW, MFS and healthy behaviors. The control group received the same dose of attention-control sessions on food hygiene. Data were collected at the baseline and at the end of the program via self-administered questionnaires and anthropometric measurements. Participants included 294 mother-child dyads with 149 in the intervention group and 145 in the control group. The accuracy of MPCW significantly increased at the study end point in the intervention group (57.0-67.1%, P < 0.05) but not in the control group (67.6-69.7%, P > 0.05), with no between-group difference in pre- and post-change (P > 0.05). At the study end point, more mothers of overweight and obese children in the intervention group had accurate MPCW than their control counterparts (31.4% versus 11.1%, P < 0.01). The intervention group had a shift toward an authoritative style at the study end point (17.4% versus 26.2%, P < 0.001) and favorable changes in feeding practices. The Healthy Change Program contributed to improving the accuracy of MPCW and shifts toward favorable MFS and feeding practices.

Circulating tumor DNA (ctDNA) can be utilized to identify the presence of cancer as well as minimal residual disease (MRD). Quantification of ctDNA can be a useful cancer management tool to assess prognosis. Here we evaluate the feasibility of using a tumor-naïve genome-wide methylome enrichment platform to quantify ctDNA in plasma and predict recurrence in early-stage non-small cell lung cancer (NSCLC). In a retrospective evaluation of banked, pre-treatment samples from newly diagnosed Stage I and II NSCLC patients (collected from 2009 to 2013, Princess Margaret Cancer Centre), samples were analyzed with a bisulfite-free, non-degradative genome-wide DNA methylation enrichment platform using 5-10 ng of cell-free DNA isolated from plasma. ctDNA was quantified from average normalized counts across informative regions. Events were defined as cancer recurrence or death due to any cause, whichever occurred earlier. A ctDNA quantity threshold was set where all samples from patients without an event fell below the threshold (i.e., 100% specificity). Time to recurrence or death was compared for samples with ctDNA quantities above the threshold to those below the threshold. Recurrence-free survival was estimated using Kaplan-Meier method, and the difference was assessed by the log-rank test. Multivariable Cox regression analysis was used to adjust for known prognostic covariates. Samples from 41 patients were included. The table describes clinico-demographic information. With a median follow-up time of 56.4 months, there were 27 events. Samples with ctDNA above the threshold showed significantly worse recurrence-free survival [hazard ratio (HR) 2.70 (95% CI 1.26, 5.78), log-rank P=0.008], even after accounting for histology (selected using univariate analysis) [HR 2.79 (95% CI 1.30, 6.02), P=0.009]. Our data shows that this blood-based genome-wide methylome enrichment platform can be used for ctDNA quantification and prognostication in early-stage NSCLC. Initial feasibility was evaluated here using treatment-naïve plasma samples. Applications for cancer management will be further evaluated in future studies utilizing post-treatment and longitudinal samples. [ABSTRACT FROM AUTHOR]

Background: Outcomes for patients with locally advanced head and neck cancer (HNC) treated with curative intent remain disappointing, with 5-year survival rates at 50%. Most recurrences occur within the first 2 years after treatment, providing a window of opportunity to identify patients with molecular residual disease (MRD). A tissue-agnostic test for MRD detection in patients with human papillomavirus (HPV) positive and negative HNC, where tissue is often scarce, is needed., Patients and Methods: Patients with stage I-IVB HNC, including patients positive and negative for HPV, were enrolled and peripheral blood plasma was collected longitudinally at diagnosis and ∼3, 12, and 24 months after curative intent treatment. The full cohort includes 325 patients with 1155 samples. Samples were split into distinct sets to train and validate a classifier capable of identifying MRD using a tissue-agnostic genome-wide methylome enrichment platform. The primary endpoint was recurrence-free survival (RFS)., Results: With a median follow-up of 60 months, patients in the blinded validation set with MRD positivity experienced significantly worse RFS with a hazard ratio (HR) of 35.7 [95% confidence interval (CI) 10.8-117.8; P < 0.0001]. For patients with HPV negativity, HR was 42.3 (95% CI 9.8-182.3; P < 0.0001); for patients with HPV-positive oropharyngeal cancer, HR was 24.1 (95% CI 3.0-196.8; P < 0.0001). Moreover, the lead time between MRD positivity and clinical recurrence was up to 14.9 months, with a mean lead time of 4.1 months. Surveillance sensitivity was 91% (95% CI 77% to 97%) and specificity was 88% (95% CI 80% to 93%)., Conclusions: Here we validate the clinical performance characteristics of a tissue-agnostic genome-wide methylome enrichment assay for MRD detection in patients with HNC. The MRD detection test showed high sensitivity for identifying recurrence at high specificity across different anatomical sites, HPV status, and treatment regimens, highlighting the broad applicability for MRD detection in patients with HNC., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Collision sellar tumors are rare disease entities. Less than 30 cases have been reported in the literature in the last 20 years. We present the case of one patient diagnosed with a collision sellar tumor and describe the use of Enhanced Contact Endoscopy for pituitary gland and tumoral identification not previously described in the literature., Case Description: The patient is a 57-year-old man who presented with visual field deficits and intense frontal headache accompanied by a slight hypothyroidism. Magnetic resonance imaging shows two different lesions in the sellar area, with a pendular effect of the pituitary stalk displaced to the side of the pituitary adenoma. The patient was operated on with an endoscopic endonasal subsellar approach, aiding with an enhanced contact endoscopy to demarcate the pituitary gland from the tumor adequately. Pathology diagnosis was compatible with pituitary adenoma (First lesion) and papillary craniopharyngioma (Second lesion). A short surgical video was added to complement the learning of the technique for enhanced contact endoscopy for a description of the microvasculature pattern., Conclusion: Collision sellar tumors are a rare pathology in the sellar region and could benefit from a variety of combined treatments for optimal outcomes. Enhanced contact endoscopy for pituitary surgery could be useful for distinguishing the normal pituitary gland from the tumor., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Surgical Neurology International.)

Purpose: The purpose of the study was to explore Hispanic adults' experiences participating in the Building a Healthy Temple diabetes self-management education and support (DSMES) cluster randomized trial and collect their insights on intervention approach, delivery, content, impact, and suggested improvements for future DSMES programs delivered at church., Methods: Focus groups were conducted with participants from both intervention arms, that is, faith-based (FB) group and faith-placed group. Participating churches were predominantly Hispanic and located in San Antonio, Texas. Focus groups were audiotaped and transcribed verbatim. Inductive content analysis was performed with the assistance of NVivo software to code and categorize emerging themes., Results: A total of 138 adult participants took part in the current study. Participants in both groups highly valued the church setting for its convenient location and support system and reported positive changes in diabetes-related beliefs, knowledge, skills, behaviors, and health outcomes. FB participants appreciated the incorporation of spiritual teachings and facilitation by lay leaders, which created a sense of empowerment and improved outlook on living with diabetes., Conclusions: Church holds promise as a setting for DSMES program delivery in Hispanic communities. Church-based DSMES programs using a FB approach may further facilitate program adoption and sustainability., Competing Interests: Declaration of Conflicting InterestsThe authors declare that there are no conflicts of interest.

Competing Interests: Declaration of competing interest RAN is a paid consultant for ModernaTX and BioNTech. SJP is a consultant for Next Gen Diagnostics. GGR is scientific advisor of Resitell (Muttenz, Switzerland), a start-up implicated in nanomotion-based measure of antimicrobial resistance. DH is managing director and shareholder of the company Ridom GmbH that develops the SeqSphere + tool. AE is scientific advisor of Sefunda (Muttenz, Switzerland).

Objective: Describe the demographic profile of US participants in Amgen clinical trials over a 10-year period and variations across therapeutic areas, indications, and geographies., Methods: Cross-sectional retrospective study including participants enrolled (2005-2020) in phase 1-3 trials completed between January 1, 2012 and June 30, 2021., Results: Among 31,619 participants enrolled across 258 trials, one-fifth represented racial minority populations (Asian, 3%; Black or African American, 17%; American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, multiracial, each < 1%); fewer than one-fifth (16%) represented an ethnic minority population (Hispanic or Latino). Compared with census data, representation of racial and ethnic groups varied across US states. Across most therapeutic areas (bone, cardiovascular, hematology/oncology, inflammation, metabolic disorders, neuroscience) except nephrology, participants were predominantly White (72-81%). A similar proportion of males and females were enrolled between 2005 and 2016; male representation was disproportionately higher than female between 2016 and 2020. Across most medical indications, the majority of participants were 18-65 years of age., Conclusions and Relevance: While the clinical research community is striving to achieve diversity and proportional representation across clinical trials, certain populations remain underrepresented. Our data provide a baseline assessment of the diversity and representation of US participants in Amgen-sponsored clinical trials and add to a growing body of evidence on the importance of diversity in clinical research. These data provide a foundation for strategies aimed at supporting more equitable and representative research, and a baseline from which to assess the impact of future strategies to advance health equity., (© 2023. The Author(s).)

Background: Rosai-Dorfman disease (RDD) is a rare type of histiocytosis that can manifest with diverse symptoms. It usually presents with systemic involvement, and only a few cases have been reported at the level of the skull base. RDD typically follows a benign course during the progression of the disease. In this particular case reported, after the skull base invasion, the disease started to infiltrate the brain parenchyma. Our objective for this case report was to present this particular progression pattern and the nuances of its surgical treatment. In addition, a revision of the current literature was performed about skull base RDD with intracranial invasion and brain parenchyma infiltration not previously described., Case Description: We are presenting the case study of a 57-year-old male patient who was experiencing severe headaches and an increase in volume in the right fronto-orbital region. On clinical examination, no neurologic clinical symptoms were observed. Contrast computed tomography and magnetic resonance imaging showed a tumor mass that affected the right orbit, frontal paranasal sinus, greater sphenoid wing, and right frontal lobe with moderate adjacent brain edema. The patient underwent surgery using an extended pterional approach with intracranial, orbital decompression, and frontal sinus cranialization, accompanied by frontal lobe tumor resection. Neuropathologic diagnosis revealed a Rosai-Dorfman histiocytosis disease., Conclusion: The etiopathogenesis of RDD is still not completely understood. The current literature considers this disease to have a predominantly benign course. Nevertheless, as we have shown in this case, it may, in some cases, present direct parenchymal invasion. We consider that prompt surgical treatment should be ideal to avoid the local and systemic progression of the disease., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Surgical Neurology International.)

Background: Microvascular decompression (MVD) using Teflon or Ivalon is the surgeon's preference for treating trigeminal neuralgia (Tn). Still, sometimes the prosthetic material is unavailable, or there is some recurrence of pain during the follow-up. In this case series, we report the outcome analysis for MVD using the expanded polytetrafluoroethylene (ePTFE) sleeve technique in classic Tn., Methods: We conducted a retrospective analysis of patients with Tn from January 2017 to March 2022. Classic or primary Tn was considered a direct compression by a cerebrovascular structure in the posterior fossa, detected by magnetic resonance imaging or direct surgical visualization. Pre- and postoperative Barrow Neurological Institute Pain Intensity Scale (BNI-SI) and Barrow Neurological Institute Hypoesthesia Scale (BNI-HS) were used for the clinical results assessment of the ePTFE sleeve circumferential technique., Results: There were nine patients approached with the 3/4 circumferential ePTFE sleeve technique with BNISI IV ( n : 11, 58%) and BNI-SI V ( n : 8, 42%). In all patients, there was a clinical improvement after the surgical treatment ( P < 0.001). All patients obtained BNI-SI ≤ IIIa in an average follow-up of 11.89 (±14.137), with a slight improvement in BNI-HS ( P : 0.157). In our revision, this technique has not previously been described for Tn., Conclusion: The circumferential ePTFE sleeve technique is a good option for MVD in Tn. For classic Tn, MVD could remain the first option, and this technique could be applied for multi-vessel compression., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Surgical Neurology International.)

Introduction: Cellulite, also known as edematous fibrosclerotic panniculopathy (EFP), affects up to 90% of women and has a significant aesthetic impact. EFP is a multifactorial condition characterized by local circulatory changes, increased adipose tissue thickness, and a fibrotic response involving thick collagen bundles and septa, driven by local hypoxia. Although numerous treatments exist, their effects are typically temporary. This study evaluates the outcomes of four patients with EFP treated using a combined recombinant enzymatic therapy consisting of a lyase, lipase, and collagenase., Methods: A standardized protocol involving injections of a combined enzyme solution (pbserum Medium™) was administered to the lower limbs in three separate sessions. Pre- and post-treatment photographs were collected for comparative analysis., Results: All four patients showed improvements in skin appearance and fibrosis, with no systemic or local adverse events reported., Conclusions: We propose that a treatment strategy targeting the edematous, adipose, and fibrotic components of EFP may offer an economical and pathogenic-based approach for managing this condition in affected women.

Leishmaniasis, a vector-borne disease, is caused by the infection of Leishmania spp., obligate intracellular protozoan parasites. Presently, human vaccines are unavailable, and the primary treatment relies heavily on systemic drugs, often presenting with suboptimal formulations and substantial toxicity, making new drugs a high priority for LMIC countries burdened by the disease, but a low priority in the agenda of most pharmaceutical companies due to unattractive profit margins. New ways to accelerate the discovery of new, or the repositioning of existing drugs, are needed. To address this challenge, our study aimed to identify potential protein targets shared among clinically-relevant Leishmania species. We employed a subtractive proteomics and comparative genomics approach, integrating high-throughput multi-omics data to classify these targets based on different druggability metrics. This effort resulted in the ranking of 6502 ortholog groups of protein targets across 14 pathogenic Leishmania species. Among the top 20 highly ranked groups, metabolic processes known to be attractive drug targets, including the ubiquitination pathway, aminoacyl-tRNA synthetases, and purine synthesis, were rediscovered. Additionally, we unveiled novel promising targets such as the nicotinate phosphoribosyltransferase enzyme and dihydrolipoamide succinyltransferases. These groups exhibited appealing druggability features, including less than 40% sequence identity to the human host proteome, predicted essentiality, structural classification as highly druggable or druggable, and expression levels above the 50th percentile in the amastigote form. The resources presented in this work also represent a comprehensive collection of integrated data regarding trypanosomatid biology., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest to disclose. This research was conducted in an impartial and unbiased manner, and no external influences or competing interests have affected the design, execution, or reporting of this study., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background/objectives: Neck circumference (NC) has been proposed as a simple measurement to identify patients with overweight and obesity. It has been found that adipose tissue at the cervical level is associated with the presence of metabolic alterations. The aim of this study was to estimate the association between NC and indicators of Metabolic Syndrome (MS) to subsequently estimate its capacity to identify the risk of MS compared to waist circumference (WC) and Body Mass Index (BMI)., Methods: A cross-sectional study was carried out with a sample of 286 children 6-9 years old who attended six public primary schools in Jalisco, Mexico. Pearson's correlation coefficients along with sensitivity and specificity tests were performed to analyze the relationship between NC and MS indicators. Odds ratio (OR) and concordance analyses were performed considering the Kappa index., Results: NC showed statistically significant correlations with all MS indicators except for LDL cholesterol and total cholesterol. The cut-off points of NC to identify MS according to sex was >27.4 cm for girls and >29.8 cm for boys. The association of NC with values above the cutoff point and the presence of MS was OR: 21.6 (CI: 7.11-65.74)., Conclusions: NC represents a simple and cost-effective alternative to identify children at risk of MS when compared to BMI and WC.

A clinical case of an adult horse with invasive, ulcerative, proliferative, pyogranulomatous disease of the skin (tumor) in the shoulder region is presented. The mass had a granulomatous and crater-shaped appearance, with serosanguinous discharge and the presence of fistulas with caseous material. The tumor was removed by surgery and sent to the laboratory for diagnosis. Histopathology was performed using Grocott-Gomori methenamine silver stain. The presence of necrotic material, fibrosis, infiltrated cells, and brown-colored hyphae, characteristic of members of the genus Pythium, were observed. To identify the infecting species, conventional PCRs for the amplification of the ITS-1 was carried out. Histopathological and PCR tests confirmed infection by a Pythium insidiosum strain closely associated with previous records from the US and Central America. Our report represents the first molecularly confirmed case of equine pythiosis in Mexico., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Bacteria are exposed to reactive oxygen and nitrogen species that provoke oxidative and nitrosative stress which can lead to macromolecule damage. Coping with stress conditions involves the adjustment of cellular responses, which helps to address metabolic challenges. In this study, we performed a global transcriptomic analysis of the response of Pseudomonas extremaustralis to nitrosative stress, induced by S-nitrosoglutathione (GSNO), a nitric oxide donor, under microaerobic conditions. The analysis revealed the upregulation of genes associated with inositol catabolism; a compound widely distributed in nature whose metabolism in bacteria has aroused interest. The RNAseq data also showed heightened expression of genes involved in essential cellular processes like transcription, translation, amino acid transport and biosynthesis, as well as in stress resistance including iron-dependent superoxide dismutase, alkyl hydroperoxide reductase, thioredoxin, and glutathione S-transferase in response to GSNO. Furthermore, GSNO exposure differentially affected the expression of genes encoding nitrosylation target proteins, encompassing metalloproteins and proteins with free cysteine and /or tyrosine residues. Notably, genes associated with iron metabolism, such as pyoverdine synthesis and iron transporter genes, showed activation in the presence of GSNO, likely as response to enhanced protein turnover. Physiological assays demonstrated that P. extremaustralis can utilize inositol proficiently under both aerobic and microaerobic conditions, achieving growth comparable to glucose-supplemented cultures. Moreover, supplementing the culture medium with inositol enhances the stress tolerance of P. extremaustralis against combined oxidative-nitrosative stress. Concordant with the heightened expression of pyoverdine genes under nitrosative stress, elevated pyoverdine production was observed when myo-inositol was added to the culture medium. These findings highlight the influence of nitrosative stress on proteins susceptible to nitrosylation and iron metabolism. Furthermore, the activation of myo-inositol catabolism emerges as a protective mechanism against nitrosative stress, shedding light on this pathway in bacterial systems, and holding significance in the adaptation to unfavorable conditions., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Venero et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Information is scarce regarding the economic burden of respiratory syncytial virus (RSV) disease in low-resource settings. This study aimed to estimate the cost per episode of hospital admissions due to RSV severe disease in Argentina., Methods: This is a prospective cohort study that collected information regarding 256 infants under 12 months of age with acute lower respiratory tract infection (ALRTI) due to RSV in two public hospitals of Buenos Aires between 2014 and 2016. Information on healthcare resource use was collected from the patient's report and its associated costs were estimated based on the financial database and account records of the hospitals. We estimated the total cost per hospitalization due to RSV using the health system perspective. The costs were estimated in US dollars as of December 2022 (1 US dollar = 170 Argentine pesos)., Results: The mean costs per RSV hospitalization in infants was US$587.79 (95% confidence interval [CI] $535.24 - $640.33). The mean costs associated with pediatric intensive care unit (PICU) admission more than doubled from those at regular pediatric wards ($1,556.81 [95% CI $512.21 - $2,601.40] versus $556.53 [95% CI $514.59 - $598.48])., Conclusions: This study shows the direct economic impact of acute severe RSV infection on the public health system in Argentina. The estimates obtained from this study could be used to inform cost-effectiveness analyses of new preventive RSV interventions being developed., (© 2024. The Author(s).)

Infectious sporadic abortions in cattle are mainly caused by opportunistic bacteria and fungi usually present in environmental or gastrointestinal and reproductive microbiota of healthy animals. A retrospective analysis was carried out to evaluate the main opportunistic microorganisms involved in bovine abortions recorded at INTA Balcarce (Argentina) from 1997 to 2023, accounting for 2.2% of the total diagnosed etiologies of bovine abortion. The opportunistic agents identified as the cause of abortion in 29 fetuses were bacteria (90%) and fungi (10%). Escherichia coli (n = 8), Trueperella pyogenes (n = 5), and Histophilus somni (n = 4) were the bacterial species most often identified as causing infectious abortions, whereas Aspergillus spp. (n = 3) was implicated in all fungal abortions identified. Pure culture of bacteria or fungus was achieved from abomasal content and/or lung essential. Main microscopic findings were bronchopneumonia, myo- and epicarditis, meningitis, and portal hepatitis. Herein, we highlight the importance of detecting potential infectious bacteria in cultures to improve etiological diagnosis of bovine abortions associated with compatible microscopic findings to confirm the etiology., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose: We conducted qualitative interviews with patients with cancer and providers to identify gaps in clinical care and highlight care delivery solutions for the return of secondary germline findings., Methods: Twelve patients and 19 cancer providers from the United States were interviewed between January 2019 and May 2021. Interviews elicited feedback about patient information needs, emotional responses to secondary findings, and recommendations for improving pre-test education., Results: Patients' responses ranged from gratitude to regret, depending on how much pre-test counseling they received before tumor testing. Providers cited insufficient clinic time as a major barrier to pretest education, favoring online support tools and standardized pre-test education models. Providers had differing perspectives on how pre-test education should be integrated into clinical workflows but agreed that it should include the differences between somatic and germline testing, the likelihood of medically actionable findings, and the possibility of being referred to a genetics provider., Conclusion: The spectrum of participants' responses to their secondary findings underscores the importance of adequate pre-test discussions before somatic sequencing. Although educational interventions could address patients' information needs and augment traditional pre-test counseling, health care systems, labs, and genetic providers may be called on to play greater roles in pre-test education., Competing Interests: Conflict of Interest Dr Sam Wing declares employment by Intuitive Surgical. Sam Wing: Employed by Intuitive Surgical. Drs Janine LoBello and Szabolcs Szelinger: Employed by Exact Sciences., (Copyright © 2023 American College of Medical Genetics and Genomics. Published by Elsevier Inc. All rights reserved.)

We generated and characterized a rhesus macaque induced pluripotent stem cell (iPSC) line using induced reprogramming of fibroblasts isolated from a rhesus macaque fetus. The fibroblasts were expanded and then reprogrammed using non-integrating Sendai virus technology. This line is available as riPSC05. The authenticity of riPSC05 was confirmed through the expression of pluripotent and self-renewal markers, in vitro-directed differentiation towards three germ layers (ectoderm, mesoderm, and endoderm), karyotyping, and STR analysis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Three-dimensional (3D) stem cell models of the ovary have the potential to benefit women's reproductive health research. One such model, the reconstituted ovary (rOvary) self-assembles with pluripotent stem cell-derived germ cells creating a 3D ovarian mimic competent to support the differentiation of functional oocytes inside follicles. In this study, we evaluated the cellular composition of the rOvary revealing the capacity to generate multiple follicles surrounded by NR2F2+ stroma cells. However, the rOvary does not develop a surface epithelium, the source of second-wave pre-granulosa cells, or steroidogenic theca. Therefore, the rOvary models represent the self-assembly of activated follicles in a pre-pubertal ovary poised but not yet competent for hormone production., Competing Interests: Declaration of interests A.T.C. is an office holder of the ISSCR., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Introduction: Exercise intolerance is common in chronic airway diseases (CAD), but its mechanisms are still poorly understood. The aim of this study was to evaluate exercise capacity and its association with lung function, ventilatory limitation, and ventilatory efficiency in children and adolescents with cystic fibrosis (CF) and asthma when compared to healthy controls., Methods: Cross-sectional study including patients with mild-to-moderate asthma, CF and healthy children and adolescents. Anthropometric data, lung function (spirometry) and exercise capacity (cardiopulmonary exercise testing) were evaluated. Primary outcomes were peak oxygen consumption (VO 2 peak), forced expiratory volume in 1 s (FEV 1 ), breathing reserve (BR), ventilatory equivalent for oxygen consumption (V E /VO 2 ) and for carbon dioxide production (V E /VCO 2 ), both at the ventilatory threshold (VT 1 ) and peak exercise., Results: Mean age of 147 patients included was 11.8 ± 3.0 years. There were differences between asthmatics and CF children when compared to their healthy peers for anthropometric and lung function measurements. Asthmatics showed lower VO 2 peak when compared to both healthy and CF subjects, although no differences were found between healthy and CF patients. A lower BR was found when CF patients were compared to both healthy and asthmatic. Both CF and asthmatic patients presented higher values for V E /VO 2 and V E /VCO 2 at VT 1 when compared to healthy individuals. For both V E /VO 2 and V E /VCO 2 at peak exercise CF patients presented higher values when compared to their healthy peers., Conclusion: Patients with CF achieved good exercise capacity despite low ventilatory efficiency, low BR, and reduced lung function. However, asthmatics reported reduced cardiorespiratory capacity and normal ventilatory efficiency at peak exercise. These results demonstrate differences in the mechanisms of ventilatory limitation to maximum exercise testing in children and adolescents with CAD., (© 2023 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.)

Organized childcare is an ideal setting to promote gross motor development in young children from low-income minority families. A three-group clustered randomized controlled trial was conducted in Head Start centers serving low-income Latino children to evaluate the impact of an 8-month comprehensive obesity-prevention intervention on children's percentile scores for locomotive skills (LS pctl) and ball skills (BS pctl), and general motor quotient (GMQ). Trained Head Start staff delivered the center-based intervention (CBI) to modify center physical activity and nutrition policies, staff practices, and child behaviors, while the home-based intervention (HBI) offered training and support to parents for obesity prevention at home. Participants were 3-year-old children ( n = 310; 87% Latino; 58% female) enrolled in Head Start centers in South Texas. Twelve centers were randomized (1:1:1 ratio) to receive CBI, CBI and HBI (CBI + HBI), or control treatment. Posttest data were collected from 79.1% of participants. All gross motor development measures improved significantly for children in CBI compared to the control, while children in CBI + HBI only showed improvement for GMQ ( p = 0.09) and LS pctl ( p < 0.001) compared to the control. A comprehensive and culturally competent intervention targeting childcare centers and children's homes was effective at improving children's gross motor development and reducing disparities in child development.

Purpose: It remains unclear why individuals living in disadvantaged neighborhoods have shorter non-small cell lung cancer (NSCLC) survival. It is possible that living in these deprived areas is linked with increased risk of developing aggressive NSCLC biology. Here, we explored the association of somatic KRAS mutations, which are associated with shorter survival in NSCLC patients, and 11 definitions of neighborhood disadvantage spanning socioeconomic and structural environmental elements., Methods: We analyzed data from 429 NSCLC patients treated at a Comprehensive Cancer Center from 2015 to 2018. Data were abstracted from medical records and each patient's home address was used to assign publicly available indices of neighborhood disadvantage. Prevalence Ratios (PRs) for the presence of somatic KRAS mutations were estimated using modified Poisson regression models adjusted for age, sex, smoking status, race/ethnicity, educational attainment, cancer stage, and histology., Results: In the NSCLC cohort, 29% had KRAS mutation-positive tumors. We found that five deprivation indices of socioeconomic disadvantage were associated with KRAS mutation. A one decile increase in several of these socioeconomic disadvantage indices was associated with a 1.06 to 1.14 increased risk of KRAS mutation. Measures of built structural environment were not associated with KRAS mutation status., Conclusion: Socioeconomic disadvantage at the neighborhood level is associated with higher risk of KRAS mutation while disadvantage related to built environmental structural measures was inversely associated. Our results indicate not only that neighborhood disadvantage may contribute to aggressive NSCLC biology, but the pathways linking biology to disadvantage are likely operating through socioeconomic-related stress., (© 2022. The Author(s).)

Pulmonary artery catheterization is a diagnostic procedure in which a catheter is inserted through a central vein and advanced toward the pulmonary artery to measure right atrial, right ventricular, and pulmonary artery pressures, estimate cardiac output, identify intracardiac shunts, and measure pulmonary vascular resistance. Hemodynamic measurements can provide a better understanding of the pathophysiology of heart failure and pulmonary hypertension, but their proper assessment and optimal use can be challenging due to differences in techniques that can lead to differences in conclusions and therapeutic management strategies. In this review, we will discuss right heart catheterization and its role in clinical practice (e.g., shunt evaluation, management of cardiogenic shock) and summarize important concerns related to measurement and interpretation., Competing Interests: None., (AJCD Copyright © 2023.)

This study hypothesized that elevated glycosylated hemoglobin (HbA1c) levels are associated with abnormal right heart catheterization (RHC) hemodynamic parameters in patients with heart failure with reduced ejection fraction (HFrEF) and no prior diagnosis of diabetes., Methods: Retrospective cohort study of adult patients with HFrEF and no prior diagnosis of diabetes who underwent RHC and had HbA1c levels measured 30 days before or after the RHC. This study excluded patients who had received blood transfusions within 90 days prior to HbA1c measurement and patients with known diabetes. Univariate and multivariate regression analyses adjusted for age, sex, and BMI were used to test for an association between RHC hemodynamic parameters and HbA1c levels., Results: A total of 136 patients were included with a mean age of 55 ± 15 years and mean HbA1c was 5.99 ± 0.64%. Unadjusted univariate models showed that HbA1c is significantly associated with cardiac index (CI) by the Fick method and thermodilution, right atrial pressure (RAP), and mean pulmonary arterial pressure (MPAP). After multivariate analysis, for every one unit increase in HbA1c, there was a 0.19 and 0.26 L/min/m 2 decrease in expected CI by thermodilution and by the Fick method ( P = 0.03 and P < 0.01), respectively. For every one unit increase in HbA1c, there was a 2.39 mmHg increase in expected RAP ( P = 0.01)., Conclusion: Elevated HbA1c levels measured within 30 days before or after the index RHC in patients with a left ventricular ejection fraction <40% were associated with congestive hemodynamic parameters., Competing Interests: There are no conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Competing Interests: Conflict of Interest: The authors have no financial conflicts of interest.

Objective: There is room for improvement in the knowledge of female gout, often noted at risk of gender blindness. This study aims to compare the prevalence of comorbidities in women versus men hospitalised with gout in Spain., Methods: This is an observational, multicentre, cross-sectional study in public and private Spanish hospitals analysing the minimum basic data set from 192 037 hospitalisations in people with gout (International Classification of Diseases, Ninth Revision (ICD-9) coding) from 2005 to 2015. Age and several comorbidities (ICD-9) were compared by sex, with a subsequent stratification of comorbidities by age group. The association between each comorbidity and sex was assessed using multivariable logistic regression. A clinical decision tree algorithm was constructed to predict the sex of patients with gout based on age and comorbidities alone., Results: Women with gout (17.4% of the sample) were significantly older than men (73.9±13.7 years vs 64.0±14.4 years, p<0.001). Obesity, dyslipidaemia, chronic kidney disease, diabetes mellitus, heart failure, dementia, urinary tract infection and concurrent rheumatic disease were more common in women. Female sex was strongly associated with increasing age, heart failure, obesity, urinary tract infection and diabetes mellitus, while male sex was associated with obstructive respiratory diseases, coronary disease and peripheral vascular disease. The decision tree algorithm built showed an accuracy of 74.4%., Conclusions: A nationwide analysis of inpatients with gout in 2005-2015 confirms a different comorbidity profile between men and women. A different approach to female gout is needed to reduce gender blindness., Competing Interests: Competing interests: EDM declares having received speaking fees from AbbVie, Novartis, Pfizer, MSD, BMS, UCB, Roche, Janssen, Sanofi and Lilly; consultancies from Novartis and Janssen; and a research grant from Roche. MA declares having received speaking fees from Menarini and an ongoing research grant from Grunenthal., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Chordin (CHRD) is a secreted protein important in early development, yet a role for CHRD in human disease has not been identified. In this study we investigated CHRD in cancer and normal adult tissues using the wealth of genome-wide data available in public databases. We found that Chordin is amplified in the DNA of specific cancers such as lung squamous cell and others, although copy number variation did not strictly correlate with higher mRNA expression. In some cancers, such as renal and stomach carcinomas, increased CHRD expression significantly correlated with poor survival. In normal adult human tissues, CHRD mRNA was highest in hepatocytes. Crossveinless-2/BMPER, a component of the Chordin morphogenetic pathway expressed at the opposite side in embryos, was expressed in liver stellate cells. This raises the intriguing possibility that a BMP gradient might be established in the extracellular matrix of the space of Disse that surrounds portal sinusoid capillaries., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.)

There is a broad spectrum of pathology in traumatic vascular injury. Arteriovenous fistula (AVF) is an abnormal communication between the high-flow arterial system and the low-flow venous network, directly connecting the afferent artery and nearby draining veins without the regular intervention of the capillary bed. Most of these fistulas occur due to incidental or iatrogenic injury. A retrospective review of procedures performed by an endovascular surgeon in a tertiary center identified 15 cases of vascular injuries that encompassed all these different clinical scenarios, including post-traumatic, iatrogenic, or spontaneous origin. The information collected, including patient age, sex, previous symptoms, and treatment, was gathered from medical records. In addition, information on procedural technique, endovascular devices used, and specific intraprocedural details were collected from procedure notes and angiographic images. A broad spectrum of injuries can present as late trauma complications (over three months); endovascular treatment is a safe and effective approach for intracranial and extracranial injuries. Endovascular treatment can be a sole option or adjuvant to other hybrid therapies and has emerged as essential for treating these lesions as a first option. We have described standard techniques to treat different vascular pathologies, sometimes with limited resources., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Melo-Guzmán et al.)

Background: Single-cell technologies to analyze transcription and chromatin structure have been widely used in many research areas to reveal the functions and molecular properties of cells at single-cell resolution. Sample multiplexing techniques are valuable when performing single-cell analysis, reducing technical variation and permitting cost efficiencies. Several commercially available methods have been used in many scRNA-seq studies. On the other hand, while several methods have been published, multiplexing techniques for single nuclear assay for transposase-accessible chromatin (snATAC)-seq assays remain under development. We developed a simple nucleus hashing method using oligonucleotide-conjugated antibodies recognizing nuclear pore complex proteins, NuHash, to perform snATAC-seq library preparations by multiplexing., Results: We performed multiplexing snATAC-seq analyses on a mixture of human and mouse cell samples (two samples, 2-plex, and four samples, 4-plex) using NuHash. The analyses on nuclei with at least 10,000 read counts showed that the demultiplexing accuracy of NuHash was high, and only ten out of 9144 nuclei (2-plex) and 150 of 12,208 nuclei (4-plex) had discordant classifications between NuHash demultiplexing and discrimination using reference genome alignments. The differential open chromatin region (OCR) analysis between female and male samples revealed that male-specific OCRs were enriched in chromosome Y (four out of nine). We also found that five female-specific OCRs (20 OCRs) were on chromosome X. A comparative analysis between snATAC-seq and deeply sequenced bulk ATAC-seq on the same samples revealed that the bulk ATAC-seq signal intensity was positively correlated with the number of cell clusters detected in snATAC-seq. Moreover, when we categorized snATAC-seq peaks based on the number of cell clusters in which the peak was present, we observed different distributions over different genomic features between the groups. This result suggests that the peak intensities of bulk ATAC-seq can be used to identify different types of functional loci., Conclusions: Our multiplexing method using oligo-conjugated anti-nuclear pore complex proteins, NuHash, permits high-accuracy demultiplexing of samples. The NuHash protocol is straightforward, works on frozen samples, and requires no modifications for snATAC-seq library preparation., (© 2023. The Author(s).)

Background: Widespread establishment of home-based healthy energy balance-related behaviors (EBRBs), like diet, physical activity, sedentary behavior, screen time, and sleep, among low-income preschool-aged children could curb the childhood obesity epidemic. We examined the effect of an 8-month multicomponent intervention on changes in EBRBs among preschool children enrolled in 12 Head Start centers., Methods: The Head Start (HS) centers were randomly assigned to one of three treatment arms: center-based intervention group (CBI), center-based plus home-based intervention group (CBI + HBI), or control. Before and following the intervention, parents of 3-year-olds enrolled in participating HS centers completed questionnaires about their child's at-home EBRBs. Adult-facilitated physical activity (PA) was measured by an index based on questions assessing the child's level of PA participation at home, with or facilitated by an adult. Fruit, vegetable, and added sugar intake were measured via a short food frequency questionnaire, and sleep time and screen time were measured using 7-day logs. A linear mixed effects model examined the intervention's effect on post-intervention changes in PA, intake of fruit, vegetable, and added sugar, sleep time, and screen time from baseline to post-intervention., Results: A total of 325 parents participated in the study (CBI n = 101; CBI + HBI n = 101; and control n = 123). Compared to control children, CBI and CBI + HBI parents reported decreases in children's intake of added sugar from sugar-sweetened beverages. Both CBI and CBI + HBI parents also reported smaller increases in children's average weekday screen time relative to controls. In addition, CBI + HBI parents reported CBI + HBI parents reported increases in children's adult-facilitated PA, fruit and vegetable intake, and daily sleep time during weekdays (excluding weekends) and the total week from baseline to post-intervention, while children in the CBI increased sleep time over the total week compared to the children in the control group., Conclusions: Parent engagement strengthened the improvement in parent-reported EBRBs at home in young children participating in an evidence-based obesity prevention program in a childcare setting. Future studies should investigate equity-related contextual factors that influence the impact of obesity prevention in health-disparity populations., Trial Registration: ClinicalTrials.gov, NCT03590834. Registered July 18, 2018, https://clinicaltrials.gov/ct2/show/NCT03590834., (© 2023. The Author(s).)

Latin America is one of the regions in which the COVID-19 pandemic has a stronger impact, with more than 72 million reported infections and 1.6 million deaths until June 2022. Since this region is ecologically diverse and is affected by enormous social inequalities, efforts to identify genomic patterns of the circulating SARS-CoV-2 genotypes are necessary for the suitable management of the pandemic. To contribute to the genomic surveillance of the SARS-CoV-2 in Latin America, we extended the number of SARS-CoV-2 genomes available from the region by sequencing and analyzing the viral genome from COVID-19 patients from seven countries (Argentina, Brazil, Costa Rica, Colombia, Mexico, Bolivia, and Peru). Subsequently, we analyzed the genomes circulating mainly during 2021 including records from GISAID database from Latin America. A total of 1,534 genome sequences were generated from seven countries, demonstrating the laboratory and bioinformatics capabilities for genomic surveillance of pathogens that have been developed locally. For Latin America, patterns regarding several variants associated with multiple re-introductions, a relatively low percentage of sequenced samples, as well as an increment in the mutation frequency since the beginning of the pandemic, are in line with worldwide data. Besides, some variants of concern (VOC) and variants of interest (VOI) such as Gamma, Mu and Lambda, and at least 83 other lineages have predominated locally with a country-specific enrichments. This work has contributed to the understanding of the dynamics of the pandemic in Latin America as part of the local and international efforts to achieve timely genomic surveillance of SARS-CoV-2., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Molina-Mora, Reales-González, Camacho, Duarte-Martínez, Tsukayama, Soto-Garita, Brenes, Cordero-Laurent, Ribeiro dos Santos, Guedes Salgado, Santos Silva, Santana de Souza, Nunes, Negri, Vidal, Oliveira, Oliveira, Muñoz-Medina, Salas-Lais, Mireles-Rivera, Sosa, Turjanski, Monzani, Carobene, Remes Lenicov, Schottlender, Fernández Do Porto, Kreuze, Sacristán, Guevara-Suarez, Cristancho, Campos-Sánchez and Herrera-Estrella.)