Notes

Preoperative threat stratification involving lymph node metastasis pertaining to non-functional pancreatic neuroendocrine neoplasm: An international dual-institutional study.
m to date. Intervention refinement and improved teacher training may further improve outcomes. Task-shifting intervention delivery to community providers to scale up interventions is a promising strategy.
Given the rapid expansion of recreational marijuana legalization (RML) polices, it is essential to assess whether such policies are associated with shifts in the use of marijuana and other substances, particularly for adolescents, who are uniquely susceptible to negative repercussions of marijuana use. SAHA This analysis seeks to provide greater generalizability, specificity, and methodological rigor than limited prior evidence.

Youth Risk Behavior Survey data from 47 states from 1999 to 2017 assessed marijuana, alcohol, cigarette, and e-cigarette use among adolescents (14-18+ years; N= 1,077,938). Associations between RML and adolescent past-month substance use were analyzed using quasi-experimental difference-in-differences zero-inflated negative binomial models.

Controlling for other state substance policies, year and state fixed effects, and adolescent demographic characteristics, models found that RML was not associated with a significant shift in the likelihood of marijuana use but predicted a small sipansion of RML policies, ongoing assessment of the consequences for adolescent substance use and related health and behavioral repercussions is essential.
To examine the sleep health of incoming Army trainees and how it is impacted during basic combat training (BCT).

Prospective.

BCT site (Fort Jackson, SC).

A total of 1349 trainees (936=male, 413=female, 20.73 ± 3.67 years).

Participants completed the Pittsburgh Sleep Quality Index (PSQI), the Morningness/Eveningness Questionnaire, and the Epworth Sleepiness Scale at the start of BCT and a modified PSQI at the end of BCT.

At baseline, trainees reported an average sleep duration of 7.65 ± 1.68 hours per night, with 81.8% rating their sleep quality as "Very Good or Fairly Good." The mean reported Morningness/Eveningness Questionnaire score was 50.63 ± 8.11 and the mean Epworth Sleepiness Scale was 8.60 ± 4.02. Reported sleep duration was significantly less during BCT (6.73 ± 0.90 hours) compared to baseline (P< .001). There was no significant difference in the mean PSQI Global score at the end of BCT compared to the start (5.33 ± 3.00 vs. 5.42 ± 2.85, P=.440), however, 6 of the 7 component scores , and performance is warranted.
This study longitudinally compared the sleep of infants in the United States whose mothers were in home confinement to those whose mothers were working as usual throughout the COVID-19 pandemic.

Mothers of 572 infants (46% girls) aged 1-12 months (M=5.9, standard deviation = 2.9) participated. Assessments were conducted on 4 occasions from late March to May 2020. Infant sleep was measured objectively using auto-videosomnography. Mothers reported their sheltering status, demographic characteristics, and infant sleep.

Infants of mothers in home confinement had later sleep offset times and longer nighttime sleep durations, compared to infants of mothers who were working as usual. At the end of March, these infants also had earlier bedtimes, more nighttime awakenings, and more parental nighttime visits, but differences were not apparent during April and May.

Living restrictions issued in the United States may have led to longer sleep durations and temporary delays in sleep consolidation for infants of mothers in home confinement.
Living restrictions issued in the United States may have led to longer sleep durations and temporary delays in sleep consolidation for infants of mothers in home confinement.
Proprotein convertase subtilisin/kexin type-9 inhibitors (PCSK9i) effectively reduce low-density lipoprotein cholesterol (LDL-C), improving cardiovascular outcomes in clinical trials when added to statin therapy.

As real-world evidence is lacking, we aimed to evaluate treatment and adherence patterns using PCSK9i in clinical practice.

We investigated 1600 patients initiating PCSK9i between January 2016 and December 2019 in a large health maintenance organization. Treatment discontinuation was defined as a gap ≥60 days between last days' supply of one prescription and the start of the next. Re-initiation rates as well as proportion of days covered (PDC) over 1-year period and attainment of lipid goals under PCSK9i, were analyzed.

Evolocumab 140mg was initiated by 50.7%, alirocumab 75mg by 29.5% and 150mg by 19.8%. Cumulative discontinuation rates were 28.1% after 6-months and 49.9% after 3-years. Overall, 58% of the patients that discontinued therapy have re-initiated PCSK9i (31% after 3-months from dieatment goals, particularly observed in patients with severe hypercholesterolemia, inadequate drug adherence, and those using PCSK9i as monotherapy.
To investigate whether exposure to antipsychotic medications during pregnancy is associated with gestational diabetes mellitus (GDM) in United Kingdom (UK) and Hong Kong (HK) population cohorts.

Two population-based cohort studies were conducted using data from the UK The Health Improvement Network (THIN) and HK Clinical Data Analysis and Reporting System (CDARS). Nondiabetic women who received any type of antipsychotic medicine before their first pregnancy were included in our cohorts. The exposed group comprised women who continued using antipsychotics from the start of pregnancy to delivery (continuers), while the comparison group included women who were prescribed antipsychotics before the start of pregnancy but stopped during pregnancy (discontinuers). GDM was identified using GDM diagnosis and/or clinicians reported GDM. Odds ratios (ORs) with a 95% confidence interval (CI) were calculated to assess the association between antipsychotic use during pregnancy and GDM. Propensity Score fine-stratification weighting was used to adjust for potential confounding factors.

3114 women with registered first pregnancies (2351 in THIN and 763 in CDARS) were included. 5.49% (2.55% in THIN and 14.55% in CDARS) were diagnosed with GDM. The adjusted OR of GDM in continuers was 0.73 (95% CI 0.43-1.25) in THIN and 1.16 (95% CI 0.78-1.73) in CDARS compared with discontinuers.

Our results do not suggest an increased risk of GDM in women who continued using antipsychotics during pregnancy compared to women who stopped. Based on these results, women should not stop their regular antipsychotics prescriptions in pregnancy due to the fear of GDM.
Our results do not suggest an increased risk of GDM in women who continued using antipsychotics during pregnancy compared to women who stopped. Based on these results, women should not stop their regular antipsychotics prescriptions in pregnancy due to the fear of GDM.
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