Serum Galectin-9 and Decorin in relation to brain aging and the green-Mediterranean diet: A secondary analysis of the DIRECT PLUS randomized trial.

Background And Aims: We explored whether changes in serum proteomic profiles differed between participants with distinct brain aging trajectories, and whether these changes were influenced by dietary intervention.

Methods: In this secondary analysis of the 18-month DIRECT PLUS trial, 294 participants were randomized to one of three arms: 1) Healthy dietary guidelines (HDG); 2) Mediterranean (MED) diet (+440 mg/day polyphenols from walnuts); or 3) low red/processed meat green-MED diet (+1240 mg/day polyphenols from walnuts, Mankai plant, and green tea). We measured 87 serum proteins (Olink-CVDII).

Opportunities for employers to address the opioid epidemic: results from a national survey.

Introduction: Employers play a critical role in addressing the opioid crisis in the United States, so the federal government created the Recovery-Ready Workplace (RRW) framework, which suggests employer action in 4 areas: prevention and risk reduction, education, employment, and treatment.

Methods: This study examines employees' views of RRW-related actions taken by their employers to address opioid misuse, using a national survey of 1010 U.S.

Biomarkers of Atrial Fibrillation-Related Pathways and Left Atrial Structure and Function in an Overweight and Obese Population.

Background Exploring longitudinal associations of blood biomarkers with left atrial (LA) structure and function can enhance our understanding of atrial fibrillation (AF) etiopathogenesis. Methods We studied 532 participants of the PREDIMED-Plus trial, a multicenter randomized trial in overweight and obese adults with metabolic syndrome. At baseline, 3 and 5 years after randomization, participants underwent transthoracic echocardiography and provided blood for serum biomarker measurements (propeptide of procollagen type I (PICP), high-sensitivity (hs) troponin T (hsTnT), hs C-reactive protein (hsCRP), 3-nitrotyrosine (3-NT), and N-terminal propeptide of B-type natriuretic peptide (NT-proBNP)).

The COVID-19 global pandemic and allostatic load among a cohort of Black and Latina transgender women living with HIV.

This exploratory study investigated the impact of the COVID-19 pandemic on stress biomarkers and allostatic load for Black and Latina transgender women living with HIV (BLTWLH), as well as COVID-19 infection, hospitalization, and vaccination status. LITE Plus is a longitudinal cohort study of BLTWLH designed to identify pathways linking biopsychosocial stress to HIV co-morbidities. Participants were enrolled between October 2019-June 2022.

A Call for a Unified Database to Address Exposure Disparities in the United States.

United States (US) drinking water quality is federally regulated under the Safe Drinking Water Act (SDWA) with the goal of ensuring clean, safe drinking water for the entire population. However, siting of pollution point sources in historically redlined communities with lower socioeconomic status and higher proportions of people of color adversely affects drinking water quality. Prior studies show higher concentrations of a suite of contaminants in small PWS, PWS in rural areas, and PWS serving greater proportions of people of color.

-specific antibodies in plasma and saliva in cholera patients during a severe outbreak in Zambia: an antibody profiling approach.

Background: Cholera is a public health threat in resource-limited settings and is responsible for causing over 3 million cases globally. Mucosal immune responses play an important role in protecting against infection, a non-invasive mucosal pathogen, yet traditional plasma-based assays are invasive and logistically challenging, particularly during outbreaks in low- and middle-income countries (LMICs). Saliva offers a unique window into mucosal immunity and may serve as a non-invasive alternative for seroprevalence and vaccine immunogenicity studies.

Effect of smoking on drug-resistant tuberculosis treatment outcomes and exploring potential pathways: A multicountry cohort study.

People who smoke are at increased risk of unfavorable tuberculosis (TB) treatment outcomes compared with those who do not, but the pathways explaining this effect are unclear. We estimated the effect of smoking on a successful end-of-treatment outcome for multidrug-resistant and rifampicin-resistant (MDR/RR) TB and examined if intervening on loss to follow-up mitigates this effect. The endTB Observational Study was a prospective cohort of people with MDR/RR-TB who were treated with longer regimens containing bedaquiline and/or delamanid.

Metabolomic signatures of hypocaloric dietary interventions associate with breast cancer risk in the Nurses' Health Study II.

Background: An individual's metabolic state plays a critical role in breast cancer (BC) risk, influenced by factors such as obesity and insulin signaling. Hypocaloric diets induce metabolic changes that influence these metabolic factors, thereby potentially influencing BC risk. However, it remains unclear whether metabolic profiles like those induced by such beneficial diets are associated with BC risk.

Liquefied Petroleum Gas or Biomass for Cooking and Effects on Blood Pressure: Results from the Household Air Pollution Intervention Network (HAPIN) Trial.

Background: Exposure to household air pollution from burning coal and biomass for cooking is associated with higher blood pressure and other adverse indicators of cardiovascular disease, the leading cause of death worldwide. Evidence demonstrating that switching from biomass to liquefied petroleum gas (LPG) will reduce blood pressure is limited.

Methods: As part of a larger trial of 3200 households, we conducted a randomized trial of 342 women aged 40 to 79 years who lived in households using biomass for cooking in rural areas of Guatemala, India, Peru, and Rwanda to assess the effects of a free LPG stove and fuel intervention.

WHF Roadmap on Single Pill Combination Therapies.

Cardiovascular diseases (CVDs) are the leading global cause of mortality, with treatment adherence posing a major barrier to effective prevention and control. Single pill combinations (SPCs), also known as fixed-dose combinations, simplify treatment by combining multiple agents into one pill, improving adherence and reducing cardiovascular risk. This World Heart Federation Roadmap synthesizes the latest clinical evidence and identifies key barriers to SPC implementation, including limited manufacturing, affordability, regulatory complexity, and inconsistent guideline inclusion.

Exploring the relationships between Early Childhood Adversity, Social Cognition, and Aggression in a South African Study of People Living with Schizophrenia.

People living with schizophrenia (PLS) are at increased risk of being both victims and perpetrators of violence. Recent research suggests that social cognitive impairments may contribute to heightened aggression in schizophrenia. Childhood trauma, a well-established risk factor for both schizophrenia and aggression, is also linked to more severe cognitive deficits in PLS.

Trends and factors associated with opioid prescribing from 2017 to 2023.

Widespread misuse of prescription opioids has resulted in large numbers of opioid-related overdose deaths. It is critical to have a better understanding of the temporal patterns of opioid prescribing practices and associated clinical scenarios. We examined opioid prescription trends over 7 years in a large medical system using electronic health record data.

Low-dose calcium supplementation during pregnancy in low and middle-income countries: A cost-effectiveness analysis.

Calcium supplementation during pregnancy can reduce the risk of preeclampsia and preterm birth. Few countries have implemented WHO-recommended high-dose calcium supplementation (1500-2000mg/day), due to adherence and cost concerns. However, low-dose calcium supplementation (one 500mg tablet daily) has recently been shown to be similarly efficacious as high-dose supplementation.

Burden of tuberculosis in Eastern Africa region from 1990-2021: A systematic analysis for the Global Burden of Disease 2021 Study.

Background: Tuberculosis (TB), despite being a preventable and curable disease, remains a leading infectious cause of death. In Eastern Africa, TB poses a significant public health challenge. This study examined TB incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021.

Intratumoral Microbiome-related MRI Model for Predicting Breast Cancer Shrinkage Pattern Following Neoadjuvant Therapy.

Background Patients with breast cancer exhibit different tumor shrinkage patterns (TSPs) after neoadjuvant therapy (NAT), making accurate TSP prediction essential for breast-conserving surgery planning. The intratumoral microbiome influences treatment response, and related imaging features may improve TSP prediction. Purpose To develop an intratumoral microbiome-related MRI model that accurately predicts TSP following NAT.

Broken Ties: Black Americans' Diminished Return of Socioeconomic Status on Subjective Well-being.

Minorities' Diminished Return (MDR) theory suggests systematically smaller effects of socioeconomic status (SES) indicators on the health of non-white populations compared to white in the United States (US). We test whether MDR theory holds with regard to subjective well-being (SWB) by investigating racial differences in the association between SES and SWB in the US using data from the Gallup Healthways survey. Our analysis included 126,669 non-Hispanic Black and white US adults.

Leveraging Health Insurance Claims Data to Complement the Centers for Disease Control and Prevention Surveillance System for Birth Defects.

Background: Birth defect surveillance can help identify temporo-spatial clusters and teratogenic signals to inform subsequent investigations or interventions. In the United States, state surveillance systems exist but collect limited information, prompting a complementary use of health insurance claims data to describe national birth defect prevalence trends and investigate signals.

Methods: The Merative MarketScan Commercial Claims and Encounters (MarketScan) database was used to identify liveborn infants from 2016 to 2022, with linkage to maternal health care records during pregnancy.

Statistical learning methods for improving predictive performance in time-dependent survival models.

Background: The COVID-19 pandemic has highlighted the need for survival models to assess risk factors and time-dependent effects in infectious diseases. However, the Cox proportional hazards (PH) model, which assumes constant covariate effects, struggles to capture disease dynamics. This underscores the need for advanced models that incorporate time-dependent coefficients and covariates for improved accuracy.

Deep hierarchical subtyping of multi-organ systemic sclerosis trajectories - a EUSTAR study.

Systemic sclerosis (SSc) is a chronic autoimmune disease with multi-organ involvement. Historically, SSc classification has focused on the type of skin involvement (limited versus diffuse); however, a growing evidence of organ-specific variability suggests the presence of more than two distinct subtypes. We propose a semi-supervised generative deep learning framework leveraging expert-driven definitions of organ-specific involvement and severity.

Heterogeneous Cardiovascular Effects of SGLT2 Inhibitors in Type 2 Diabetes: A Causal Forest and Target Trial Emulation Study.

Aims: Evidence is limited as to who benefit the most from sodium-glucose cotransporter-2 inhibitors (SGLT2i), especially among people without elevated cardiovascular disease (CVD) risk. To address this knowledge gap, we investigated the heterogeneity in the effect of SGLT2i across CVD risk profiles.

Methods: Using a target trial emulation framework, we compared SGLT2i versus dipeptidyl peptidase 4 inhibitors (DPP4i) in a nationwide insurer-based database of working-age Japanese citizens in 2015-2023.

Home-Based Care for Hypertension in Rural South Africa.

Background: Poorly controlled hypertension is a common problem worldwide, particularly in low-resource settings.

Methods: We conducted an open-label, randomized, controlled trial of a home-based model of hypertension care in South Africa. Adults with hypertension were assigned to receive home-based care, which consisted of patient monitoring of blood pressure, home visits from a community health worker (CHW) for data collection and medication delivery, and remote nurse-led decision making supported by a mobile application (CHW group); enhanced home-based care, which consisted of the same intervention but with blood-pressure machines transmitting readings automatically (enhanced CHW group); or standard care with clinic-based management (standard-care group).

How Should Children's Medicaid Eligibility Be Monitored?

Medicaid provides health insurance for nearly 4 in 10 children in the United States, but this coverage can be unstable as a result of annual eligibility redetermination requirements. After the continuous Medicaid coverage mandate during the COVID-19 pandemic ended in March 2023, states were required for the first time to publicly report standardized metrics on terminations and renewals resulting from eligibility redeterminations. Our understanding of redeterminations and their contribution to coverage gaps had been constrained by data limitations, but states' reporting practices offered researchers and policymakers key insights into these processes and associated coverage outcomes.