Recent publications
Despite numerous studies linking prenatal vaping to adverse perinatal outcomes, a systematic assessment for critical comparison remains absent. To investigate these associations, we conducted a systematic search of studies assessing perinatal outcomes in mothers and/or neonates exposed to vaping during pregnancy compared to those in women without prenatal vaping exposure through MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, PROSPERO, and Google Scholar until July 5, 2024. We performed inverse-variance random-effects meta- analyses for maternal and neonatal outcomes of 23 studies with a total of 924,376 participants with 7552 reporting vaping-only use during pregnancy. Prenatal vaping was associated with 53% higher odds of an adverse maternal outcome (OR: 1.53; 95% CI: 1.27 to 1.85; I2 = 80%), particularly with decreased breastfeeding (OR: 0.53; 95% CI: 0.38 to 0.72; I2 = 45%) and reduced prevalence of adequate prenatal care (OR: 0.69; 95% CI: 0.56 to 0.86; I2 = 82%). Prenatal vaping was also associated with a similarly 53% higher odds of an adverse neonatal outcome (OR: 1.53; 95% CI: 1.34 to 1.76; I2 = 45%), such as low birth weight (OR: 1.56; 95% CI: 1.28 to 1.93; I2: 15%), preterm birth (OR: 1.49; 95% CI: 1.27 to 1.76; I2: 0%), and small for gestational age (OR: 1.48; 95% CI: 1.16 to 1.89; I2: 70%). This is the first comprehensive systematic review and meta-analysis demonstrating vaping during pregnancy as a risk factor for increased odds of both maternal and neonatal outcomes and underscores the urgency to address awareness and regulations of vaping and its potential harms to both humans and the environment.
- Lan Yao
- John Eikelboom
- Andrew Macnab
- [...]
- Weikuan Gu
The prevailing focus of lifespan health research has predominantly centered on “healthy aging”. This oversight may hinder the understanding of health across the lifespan, as disorders in earlier stages can substantially impact overall health and longevity. Aging, conceptually, begins at gestation. The trajectory of an individual's health is influenced from the earliest stages of life, where adverse conditions can set a foundation for lifelong health challenges. For example, suboptimal conditions during gestation leading to premature birth can predispose individuals to various health issues later in life. Additionally, precocious puberty defined as the onset of sexual maturity before eight years of age or early menopause—occurring before 50 years of age requires medical intervention and is indicative of atypical aging processes. To address these critical gaps in lifespan health research, the expansion of medical lexicons and research categorizations is advocated to include “healthy gestation,” “healthy development,” and “healthy reproduction” alongside “healthy aging.” This broader terminology will enable a more comprehensive investigation of disorders at all life stages. An integrative approach underscores the interconnectedness of all life stages and the continuous nature of aging, advocating for a seamless continuum in health research and interventions from gestation through late adulthood.
- Anna Hofner
- Jordan Bawks
BACKGROUND
Aging is a well-established risk factor for the development and progression of atherosclerosis, but the molecular mechanisms underlying this relationship remain poorly defined, and its role in atherosclerosis regression is unknown. To uncover age-related alterations that may impair atherosclerosis regression, we investigated the response of young and old macrophages to atherogenic lipoproteins in vitro and in vivo.
METHODS
Metabolic and proteomic studies were performed in vitro using macrophages differentiated from the bone marrow of young or old mice. To test the role of immune cell aging in atherosclerosis regression, bone marrow from young and old donors was transplanted into irradiated young recipient mice expressing gain-of-function AAV-PCSK9. Following 14 weeks of Western diet feeding, atherosclerosis regression was induced by switching to a standard laboratory diet for 4 weeks.
RESULTS
Compared with young macrophages, old macrophages accumulated more lipid droplets upon lipid loading with the pro-atherogenic lipoprotein aggregated LDL (low-density lipoprotein), accompanied by a failure to proportionally induce autophagy and cholesterol efflux. Proteomic analysis of bone marrow–derived macrophages revealed that pathways related to endocytosis, engulfment, and phagocytosis were downregulated in old lipid-loaded macrophages. Functional studies confirmed a reduction in efferocytic capacity in old macrophages. In recipient mice transplanted with old bone marrow, atherosclerosis regression was impaired, as evidenced by inefficient resolution of circulating inflammatory cell levels, reduced activation of plaque autophagy and apoptotic cell clearance, and persistent plaque CD45 ⁺ and CD68 ⁺ content.
CONCLUSIONS
Aging impairs macrophage function through reduced efferocytosis and autophagy activation, limiting atherosclerosis regression. These results highlight the need to better define the mechanisms linking aging to atherosclerosis to develop targeted therapies for the aging population.
Purpose of review
Improved perioperative patient monitoring is a crucial step toward better predicting postoperative outcomes. Wearable devices capable of measuring various health-related metrics represent a novel tool that can assist healthcare providers. However, the literature surrounding wearables is wide-ranging, preventing clinicians from drawing definitive conclusions regarding their utility. This review intends to consolidate the recent literature on perioperative wearables and summarize the most salient information.
Recent findings
Wearable devices measuring cardiac output and colonic motility have recently been piloted with mixed results. Novel measurement techniques for established metrics have also been studied, including photoplethysmography devices for heart rate and blood pressure along with resistance thermometers for temperature. Nuanced methods of synthesizing data have been piloted, including machine-learning algorithms for predicting adverse events and trajectory curves for step count progression. Wearable devices are generally well accepted, although adjuvant support systems have improved patient satisfaction.
Summary
Perioperative wearables are valuable tools for tracking postoperative health metrics, predicting adverse events, and improving patient satisfaction. Future research on removing barriers such as technological illiteracy, artifact generation, and false-positive alarms would enable better integration of wearables into the hospital setting.
Co-occurring autism and attention-deficit/hyperactivity disorder (ADHD) have been associated with poorer social skills. Most studies examining the association of ADHD symptoms and social skills in autism employ categorical and cross-sectional designs, which provide a narrow view of the development of ADHD symptoms. Using group-based trajectory modeling, we identified five trajectories of caregiver-reported attention problems in an inception cohort of autistic children ( N = 393) followed from age 2–5 years (T1) to age 10.5–11 years (T8): Low-Stable (LS; 15.5% of participants), Low-Decreasing (LD; 25.2%), Low-Increasing (LI; 19.2%), Moderate-Decreasing (MD; 32.9%), and High-Stable (HS; 7.2%). Child FSIQ and caregiver age at baseline were lower and caregiver depression at baseline was higher for participants in the MD group than the LS group. Psychotropic medication use was associated with higher attention problems. The MD and HS groups had similar mean Vineland Adaptive Behavior Scales, Second Edition (VABS-II) Socialization standard scores at T8, which were lower than other groups. The LI group had lower Socialization scores than the LS group. Results support that a decline in caregiver-reported attention problems is common but not universal in autistic children and that even moderate/subclinical attention problems may relate to social skills outcomes in autism.
This paper investigates the large-time behavior of a buoyancy-driven fluid without thermal diffusion under Navier-slip boundary conditions in a bounded domain with Lipschitz-continuous second derivatives. After establishing improved regularity for classical solutions, we analyze their large-time asymptotics. Specifically, we show that the solutions converge to a state where as , , and hydrostatic balance is achieved in the weak topology of . Furthermore, we identify the necessary conditions under which stable stratification and hydrostatic balance can be achieved in the strong topology as time approaches infinity. We then analyze a particular steady state, the hydrostatic equilibrium, characterized by , and . In a periodic strip, we establish the linear stability of this state for , indicating that the temperature is vertically stably stratified. This work builds upon the results in Doering et al. (Phys D Nonlinear Phenom 376–377:144-159, 2018), which focus on free-slip boundary conditions, as well as recent studies (Aydın and Jayanti in Fractional regularity, global persistence and asymptotic properties of the Boussinesq equations on bounded domains, https://arxiv.org/abs/2403.12509, 2024; Aydın et al. in On asymptotic properties of the Boussinesq equations, https://arxiv.org/abs/2304.00481, 2023) that address no-slip boundary conditions. Notably, the novelty of this study lies in the ability to directly bound the pressure term, made possible by the Navier-slip boundary conditions.
- Rodrick Lim
- Riyad B Abu-Laban
- Rafiq Andani
- [...]
- Douglas Sinclair
- L Malec
- C Königs
- B Nolan
- [...]
- K Fijnvandraat
- Katarina Glise Sandblad
- Annika Rosengren
- Sam Schulman
- [...]
- Mazdak Tavoly
Background
The risk of major bleeding from anticoagulant treatment is influenced by both the treatment and the patient's baseline risk, which is often disregarded.
Objectives
To determine the excess bleeding risk in venous thromboembolism (VTE) cases during initial (0 to 6 months) and extended (6 months to 5 years) treatment compared to matched population controls without VTE or anticoagulant treatment, overall, and stratified by sex and age.
Methods
Cancer‐free patients with VTE treated with direct oral anticoagulants from 2014 to 2020, along with propensity score–matched controls, were identified from nationwide Swedish registers. Excess risk of major bleeding was assessed using the incidence rate difference (IRD) calculated by subtracting the control bleeding rate from the case bleeding rate.
Results
The matched cohort comprised 36,115 VTE cases and 36,115 controls. During initial treatment, 388 VTE cases (1.07%) and 103 controls (0.29%) experienced bleeding, IRD: 2.19 (95% confidence interval 1.89–2.49) per 100 person‐years. Following rematching at 6 months, 139 cases (0.70%) and 214 controls (1.08%) experienced bleeding, IRD: 0.70 (0.52–0.89). During initial treatment, females had a higher excess bleeding risk than males, with male IRD: 1.73 (1.34–2.12) and female IRD: 2.69 (2.23–3.15). Excess bleeding risk was highest in the oldest patient population. In extended treatment, excess bleeding was not dependent on sex—male IRD: 0.60 (0.35–0.85), female IRD: 0.81 (0.54–1.08)—and did not increase with age.
Conclusion
The excess bleeding risk from anticoagulant treatment was high during initial treatment, particularly among females and the elderly, but lower and not influenced by sex or age during extended treatment.
High-throughput multi-analyte point-of-care detection is often constrained by the limited number of analytes that can be effectively monitored. This study introduces bio-inspired microfluidic designs optimized for multi-analyte detection using 38–42...
Objectives
Pancreatitis is common following endoscopic retrograde cholangiopancreatography (ERCP). Despite increased vigilance of post-ERCP pancreatitis (PEP), both its incidence and associated mortality are rising. Risk prediction models may provide more accurate stratification of patient risk and proactive mitigation of PEP incidence and/or severe associated outcomes.
Methods
We conducted an electronic search of MEDLINE, PubMEd, Cochrane, and CINAHL from inception through April 9, 2024 for studies evaluating the details and performances of available PEP prediction models. Studies were eligible if they used statistical measures to quantify their model’s predictive ability. Risk of bias was determined using the PROBAST tool.
Results
Nineteen studies met eligibility criteria and were included. Logistic regression models were used in 15 studies, with machine learning models representing the second most commonly employed approach. Ten studies reported the performance of their risk prediction models using derivation data, with areas under the receiver operating curve (AUC) ranging from 0.68 to 0.86. Fifteen studies reported the performance of their risk prediction models on internally validated data, with AUCs ranging from 0.66 to 0.97. Eight studies reported on the performance of their risk prediction models on external validation data, with AUCs ranging from 0.67 to 0.98.
Discussion
Numerous PEP clinical prediction models exist with variable performances. The use of PEP prediction tools can support the management of patients following ERCP. Implementation studies assessing the optimal usability of these tools, followed by prospective evaluations, are needed to evaluate their potential impacts on reducing PEP in real-world practice.
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