Pediatric T cell and B cell responses to SARS-CoV-2 infection.

Background: Understanding age-associated differences in acute and memory adaptive immunity to SARS-CoV-2 and how this contributes to more favorable outcomes in children is critically important.

Methods: We evaluated SARS-CoV-2-specific T cell, B cell, and antibody responses in 329 peripheral blood samples collected from non-hospitalized children, adolescents, and adults at three timepoints, including acute and memory timepoints.

Results: Most children produced robust CD4+ T cell responses during infection and developed memory CD4+ T cells; however, young children <4 years old often had undetectable CD4+ T cell responses compared to older children and adults.

"He said he could take his own advice:" Stigmatizing language in notes documenting discharges against medical advice.

Background: Against medical advice (AMA) discharges are associated with adverse clinical outcomes and can be stigmatizing to patients. Most prior work has described patient characteristics associated with AMA discharges, with little attention to interpersonal clinician-patient dynamics that culminate in a discharge being designated AMA.

Objective: To describe clinical documentation about patients whose hospitalizations ended in an AMA discharge, attending to both what was written and how it was written.

Survivorship and Cause-Specific Revision Risk Following Primary Total Knee Arthroplasty Using a Newer versus Older Generation Implant System From the Same Manufacturer.

Background: New implant systems have design modifications seeking to improve total knee arthroplasty (TKA) patient satisfaction and survivorship. We sought to determine whether there was a difference in overall and cause-specific aseptic revision risk between two successive modern TKA designs, both overall and when stratified by constraint type: posterior stabilized (PS), ultra-congruent (UC), and cruciate retaining (CR).

Methods: Adult patients who underwent primary fully cemented TKA for osteoarthritis between 2009 and 2022 were identified using our institutional total joint arthroplasty registry.

Access to water, sanitation, and hygiene (WASH) facilities and key influencing factors in coastal households, Bangladesh.

This study assessed the accessibility and determinants of water, sanitation, and hygiene (WASH) facilities in Bangladesh's climate-sensitive coastal region, which is highly vulnerable to sea-level rise, salinity intrusion and extreme weather events. A cross-sectional survey was conducted from March to July 2023, involving 471 households across nine subdistricts within three coastal zones using a three-stage cluster sampling technique. Multivariable logistic regression was performed to identify the associated factors, considering WASH indicators (as defined by the WHO/UNICEF Joint Monitoring Program) as outcomes and sociodemographic characteristics as exposure variables.

Alterations of the upper respiratory microbiome among children living with HIV infection in Botswana.

Children living with HIV (CLWH) are at high risk of colonization and infection by respiratory pathogens, though this risk can be reduced by other microbes in the upper respiratory microbiome. The impact of HIV infection on the pediatric upper respiratory microbiome is poorly understood, and we sought to address this knowledge gap by identifying associations between HIV infection and the nasopharyngeal microbiomes of Batswana children. We enrolled Batswana CLWH (<5 years) and age- and sex-matched HIV-exposed, uninfected (HEU) and HIV-unexposed, uninfected (HUU) children in a cross-sectional study.

Defining double burden of malnutrition across individual, household and population level: A narrative review.

Aims: This study aims to evaluate the existing definitions of double burden of malnutrition and to synthesise and propose operational definitions at different levels, with the goal of improving consistency in measurement and policy development.

Methods: We conducted a narrative review that used structured search and narrative synthesis to review and summarise how double burden of malnutrition has been defined at different levels. We performed a structured search across PubMed, Web of Science and Scopus, focusing on peer-reviewed articles published between January 2010 and December 2024.

Real-World Outcomes of Infections Following Tisagenlecleucel in Patients with B-Cell ALL: A CIBMTR Analysis.

Tisagenlecleucel (tisa-cel) is a CD19-directed chimeric antigen receptor T-cell therapy for relapsed/refractory precursor B-cell acute lymphoblastic leukemia (R/R B-ALL). We report infectious complications through 100 days (D100) following tisa-cel therapy in 471 pediatric and young adults (median age 13.8 years) with R/R B-ALL reported from September 2017 to June 2022.

Newer versus Older Implant Systems from a Single Manufacturer and Cause-Specific Revision Risk following Primary Total Knee Arthroplasty.

Novel implant systems have design modifications that seek to improve total knee arthroplasty (TKA) survivorship. We evaluated overall and cause-specific revision risk for a newer generation implant system compared with its predecessor from the same manufacturer. We conducted a cohort study using data from the United States-based Kaiser Permanente Total Joint Replacement Registry.

Native Triple-Valve Endocarditis Caused by Corynebacterium striatum Needing Urgent Surgery.

Background: Triple-valve endocarditis is a very rare entity and even more so in the absence of prosthetic valves.

Case Summary: We describe the doubly unusual occurrence of native triple-valve endocarditis caused by Corynebacterium striatum in an otherwise immunocompetent 72-year-old woman in an urban hospital in New Zealand. She presented with colitis initially and was treated empirically, and a positive blood culture with C striatum was disregarded as being a contaminant.

Decreased Microbiota-Driven Tyrosine Metabolism Is Associated With Symptomatic COVID-19 in Children.

Background: The gut microbiota has been implicated in driving coronavirus disease 2019 (COVID-19) disease severity, but the underlying mechanisms remain unknown. We investigated the relationship between the gut microbiota and development of symptomatic COVID-19 in children.

Methods: We prospectively collected stool and plasma samples from 229 children who were exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including 45 COVID-19 negative, 57 with asymptomatic COVID-19, and 127 with symptomatic COVID-19.

Highly Crosslinked Polyethylene Is Associated With a Lower Revision Risk Out to 20-Year Follow-Up Versus Conventional Polyethylene in Total Knee Arthroplasty.

Background: Evidence of any benefit in the long-term performance of highly crosslinked polyethylene (HXLPE) for total knee arthroplasty (TKA) is lacking. We sought to evaluate revision risk for HXLPE versus conventional polyethylene (CPE).

Methods: Data from a US-based health care system's Total Joint Replacement Registry were used to conduct a cohort study.

Taper-Slip Cemented Femoral Stem Designs Are Associated With Higher Periprosthetic Fracture Risk Compared to Composite-Beam in a United States Health Care System.

Background: Recent total hip arthroplasty (THA) studies have highlighted a benefit of cemented femoral fixation for reducing periprosthetic fractures (PPFs), though historically there was a concern of later aseptic loosening (AL). To date, these studies heavily concentrated on either a specific "taper slip" (TS) or "composite beam" (CB) design, with different fixation mechanisms and different implications for PPF and AL. A registry-based study was undertaken to evaluate the revision risk between these two designs.

sp. nov. isolated from the human upper respiratory tract.

Twelve strains of a novel species were cultured from human respiratory samples collected in the USA and Botswana. Five strains underwent detailed phenotypic and chemotaxonomic characterization, while all 12 strains were included in phylogenomic analyses. Optimal growth was observed on brain heart infusion solid medium and in liquid media, including brain heart infusion and tryptic soy broth when supplemented with Tween 80, a source of the fatty acid oleic acid.

Regulatory T cells attenuate chronic inflammation and cardiac fibrosis in hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is a common, serious, genetic heart muscle disorder. Although the biophysical mechanisms by which gene variants in sarcomeric proteins disrupt cardiomyocyte function are largely understood, the cellular and molecular pathways leading to the complex, variable, and adverse remodeling of the non-myocyte compartment are unexplained. Here, we report that postmortem and explanted human HCM hearts exhibited chronic focal leukocyte infiltration and prominent activation of immune cells.

Primary health care performance measurement at the service delivery level in Indonesia: a scoping review.

Background: Indonesia has endeavoured to strengthen primary health care (PHC), a task requiring comprehensive measurement of PHC performance which remains a challenge. This scoping review aims to describe PHC performance measurement pertaining to service delivery in Indonesia and identify what has not been measured.

Methods: We conducted a scoping review, following the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews guideline.

Community Outbreak of OXA-48-Producing Escherichia coli Linked to Food Premises, New Zealand, 2018-2022.

In New Zealand, OXA-48-producing Escherichia coli is uncommon and typically associated with international travel. We investigated a cluster of 25 patients without recent travel history from Hutt Valley health district, New Zealand, who had multilocus sequence type 131 OXA-48-producing E. coli during August 2018-December 2022.

Short-Coupled Premature Ventricular Contractions in a Young Male with Sudden Cardiac Arrest.

Introduction: Idiopathic ventricular fibrillation secondary to short-coupled premature ventricular contractions (scPVCs) is a rare cause of sudden cardiac arrest and predominantly originates from the His-Purkinje system or right ventricular outflow tract.

Case Description: A 36-year-old man with prior episodes of palpitations and a normal Holter monitor evaluation as well as a family history of sudden cardiac death presented following an out-of-hospital ventricular fibrillation cardiac arrest. After exclusion of other etiologies including structural, ischemic, and primary electrical disease, as well as the demonstration of scPVCs with moderator band origin, a diagnosis of scPVCs leading to sudden cardiac arrest was made.

Prevention and Management of Multimorbidity in Southeast Asia: A Narrative Review.

Multimorbidity, the coexistence of two or more chronic conditions, presents a growing global challenge, particularly in low- and middle-income countries such as Southeast Asia. This trend necessitates the development of sustainable integrated care models to prevent and manage multimorbidity effectively. However, progress in this area has been hampered, especially in underdeveloped regions, by various barriers, including the epidemiology of multimorbidity, how to get different specialists and doctors to work together most availably and manage the multiple medication issues and how to develop cost-effective approaches to reduce the health burden of multimorbidity.

Workplace-Based Education Interventions for Managing Metabolic Syndrome in Low- and Middle-Income Countries: A Realist Review.

Background: Sedentary office work and work-related stress increase the risk of metabolic syndrome. Workplace-based education interventions for promoting prevention are gaining popularity due to their positive impact on managing metabolic syndrome. We conducted this realist review to understand the contextual factors and mechanisms that contribute to the effectiveness of these interventions and how they interact to produce outcomes.

Role of the upper airway microbiota in respiratory virus and bacterial pathobiont dynamics in the first year of life.

The mechanisms by which respiratory viruses predispose to secondary bacterial infections remain poorly characterized. Using 2,409 nasopharyngeal swabs from 300 infants enrolled in a prospective cohort study in Botswana, we perform a detailed analysis of factors that influence the dynamics of bacterial pathobiont colonization during infancy. We quantify the extent to which viruses increase the acquisition of Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae.

Alterations of the upper respiratory microbiome among children living with HIV infection in Botswana.

Children living with HIV (CLWH) are at high risk of colonization and infection by bacterial respiratory pathogens, though this risk can be reduced by other microbes in the upper respiratory microbiome. The impact of HIV infection on development of the upper respiratory microbiome during childhood is poorly understood, and we sought to address this knowledge gap by identifying associations between HIV infection and the nasopharyngeal microbiomes of children in Botswana. We enrolled Batswana CLWH (<5 years) and age- and sex-matched HIV-exposed, uninfected (HEU) and HIV-unexposed, uninfected (HUU) children in a cross-sectional study.

Global Assessment of Health Utilities Associated with Pneumococcal Disease in Children-Targeted Literature Reviews.

Background: Pneumococcal disease can significantly impact the quality of life (QoL) of children. Health utilities are used to measure the disease burden and calculate quality-adjusted life year (QALY) estimates. These estimates provide critical inputs in economic evaluations of pneumococcal vaccines in children.

Influence of Maternal Education and Household Wealth on Double Burden of Malnutrition in South and Southeast Asia.

The double burden of malnutrition (DBM), defined by the coexistence of undernutrition and overnutrition within households, poses significant public health challenges in South and Southeast Asia. While previous studies have examined the individual effects of maternal education and household wealth on DBM, findings remain inconsistent, and little is known about how these factors interact across different contexts. To address this gap, we used nationally representative Demographic and Health Survey (DHS) data from Bangladesh (2017-2018), Cambodia (2022), Nepal (2022) and Timor-Leste (2016) to analyse the interaction between maternal education and household wealth in shaping DBM risk.

Genome mining identifies a diversity of natural product biosynthetic capacity in human respiratory strains.

species, integral to the healthy human upper respiratory tract (URT) microbiota, remain underexplored in microbial genomics for their potential to promote respiratory health and exclude pathobionts. This genomic study investigated the diversity and capacity for natural product synthesis within these species, as indicated by their biosynthetic gene clusters (BGCs). We aimed to map and quantify the BGC diversity in a contemporary collection of strains, representative of their prevalence in the respiratory microbiota, and to elucidate intra- and interspecies variation in BGC content.

The spatial analysis of multimorbidity in Thai Cohort Study.

Background: This study used Thai Cohort Study (TCS) data to investigate the spatial and sociodemographic determinants of multimorbidity (two or more chronic conditions coexistence on one person) prevalence in Thailand in 2013.

Methods: Crude and age-adjusted prevalence were calculated for each province. Hotspot analysis was conducted to identify regions with statistically significant hotspots and cold spots, including areas without significant clustering.