Depression affects over 280 million people worldwide. Long-chain omega-3 fatty acids may relate to depression, but observational evidence is inconsistent.

To examine the association between dietary long-chain omega-3 intake and depression severity in US adults.

Cross-sectional analysis of NHANES 2021–2023. Participants: Adults ≥18 years with complete dietary, PHQ-9, and covariate data (n=3,608). Main outcome: PHQ-9 severity categories (0–4 to 20–27). Exposure: Total omega-3 (ALA, EPA, DPA, DHA) from 24-hour recalls (FNDDS 2021–2023); supplements excluded. Supplement use was a binary covariate.

Survey-weighted ordinal logistic regression (svyolr); all continuous variables centred/scaled (ORs per 1 SD). Covariates: age, sex, race/ethnicity (collapsed for sparse cells), income-to-poverty ratio, BMI, smoking, alcohol, physical activity, omega-3 supplement use. Results: Higher total omega-3 intake was inversely associated with depression severity (OR 0.865 per 1 SD, 95% CI 0.761–0.983, p=0.026). EPA showed a significant inverse association (OR 0.907, 95% CI 0.824–0.998, p=0.045); ALA, DPA, and DHA were not significant. No interaction by sex (p=0.656) or race/ethnicity (p=0.155). Sensitivity analyses: excluding supplement users (n=3,093) OR 0.872 (95% CI 0.773–0.984, p=0.026); two recalls only (n=3,229) OR 0.847 (95% CI 0.751–0.955, p=0.007).

Dietary omega-3 intake, particularly EPA, was modestly and inversely associated with depression severity. Residual confounding and reverse causation remain possible; longitudinal studies with biomarkers are needed.

Describe the first healthcare-associated outbreak of Candida auris in Maricopa County, Arizona. Also, outline the Maricopa County Department of Public Health (MCDPH) response activities to halt transmission and identify affected healthcare facilities (HCFs) and contacts colonized with C. auris.

At HCFs with confirmed C. auris cases (i.e., exposed HCFs), MCDPH provided virtual infection control assessment and response activities, including contact investigations among hospitalized patients and point prevalence surveys (PPSs) to identify ongoing transmission. Confirmed C. auris cases included C. auris detected by cultures or polymerase chain reaction (PCR) in a hospitalized patient. Clinical cases had C. auris from cultures obtained during routine care in a hospitalized patient. Colonized cases included C. auris detected by PCR obtained from hospitalized patients for screening purposes.

On April 21, 2022, the first clinical case was identified, resulting in an outbreak with C. auris screening at 28 exposed HCFs. In total, 39 clinical C. auris cases were reported. Among 1,994 contacts identified, 899 (45.0%) were screened, 8 (0.4%) declined screening, and 1,087 (54.5%) were ineligible for screening (i.e., no longer hospitalized in Maricopa County). Among screened patients, 158 (17.6%) were colonized with C. auris; 15 (9.5%) colonized contacts later acquired clinical infections. This outbreak concluded on February 23, 2023, after 2 consecutive PPSs yielded no C. auris detection at exposed HCFs.

The first C. auris outbreak in Maricopa County highlights the coordinated efforts between HCFs, laboratories, and public health to identify exposed HCFs, screen contacts, and halt C. auris transmission.

Community engagement that emphasizes shared leadership is essential in clinical and translational science, and language, naming, and framing have the potential to shape power dynamics. This study explored how renaming and restructuring a Community Advisory Board (CAB) into a Community Leadership Board (CLB) could strengthen a trauma-informed network of care (TINoC) by elevating community power, cultural responsiveness, and equitable participation.

Guided by the Trauma and Resilience Informed Research Principles and Practice(TRIRPP) framework, we established a paid CLB in Yolo County, California, composed of six individuals who identified as members of groups underrepresented in science. We reviewed timesheets and TINoC products and conducted an inductive thematic analysis of meeting minutes to determine the CLB’s main areas of influence.

The CLB met 25 times over two years, provided iterative feedback on more than a dozen educational materials, clinical workflows, trauma-informed trainings, and communication strategies, and co-presented at community meetings. Eight recurring areas of influence were identified: trauma-informed ACE screening, accessibility, workflow feasibility, community- and patient-centered feedback, health communication, participant compensation, engagement, and post-screening navigation. CLB members highlighted gaps not identified by the academic and community members of the TINoC, including translation accuracy, time allowed for ACE screening, and ensuring voluntary patient participation.

Renaming the CLB as a “leadership” body signaled a shift in accountability, deepened engagement, and underscored how naming practices can drive more equitable translational research. Virtual-only meetings potentially limited the representativeness of the CLB; however, results suggest naming is a critical component of trauma-informed community-engaged research(CEnR).

This study aimed to investigate leptin (LEP) (G-2548A) and leptin receptor (LEPR) (668A>G) gene polymorphisms in SCZ patients with and without suicide attempts, compared to controls

The study included 120 patients with SCZ and 130 healthy volunteers. Sociodemographic characteristics, suicidal behavior, and symptom severity were assessed using data collection forms. Gene polymorphisms were analyzed from DNA samples using the polymerase chain reaction–restriction fragment length polymorphism.

The LEP genotype distribution in SCZ patients differed significantly from controls, with the heterozygous GA genotype more frequent in controls (p = .026). Within SCZ, LEPR genotype distribution differed by suicide attempt history; the heterozygous AG genotype was more frequent in non-attempters (p = .048). Logistic regression showed that the LEPR polymorphism (p = .023), number of hospitalizations (p = .036), and PANSS-psychopathology score (p = .023) predict suicide attempt history in SCZ.

Our findings suggest that LEP polymorphism may contribute to SCZ susceptibility, while LEPR polymorphism may be linked to suicide attempts in SCZ.

Parental adverse childhood experiences have been associated with poorer health outcomes for children in the general population. This single-centre study examined the prevalence of parental adverse childhood experiences in a sample of young children with single ventricle CHD, the associations between parental adverse childhood experiences and child health outcomes, and the moderating effects of parental stress and social support on the relationship between parental adverse childhood experiences and child health outcomes.

Parents (N = 72) responded to questionnaires assessing demographic characteristics, parental adverse childhood experiences, social support, and stress. Child health outcomes (hospital admissions, length of stay, missed appointments) were assessed via parent-report and medical record review.

Half of parents (52.8%) endorsed exposure to at least one adverse childhood experience. In univariate analyses, children whose parents had a history of adverse childhood experiences were 1.78 times as likely to have more parent-reported hospital admissions (p = 0.002) and 2.22 times as likely to have more missed visits (p = 0.03) compared to children of parents without a history of adverse childhood experiences. Parental social support significantly moderated the relationship between parental adverse childhood experiences and total hospital length of stay (p = 0.03). Specifically, for each unit increase in parents’ social support total score, parents with a history of adverse childhood experiences were likely to have an 83% reduction in their child’s length of stay.

Parental adverse childhood experiences may be associated with poorer single ventricle CHD outcomes. Strengthening parental social support may improve health outcomes for children with single ventricle CHD in the setting of pre-existing psychosocial risk.

Multidrug-resistant organisms (MDROs) such as carbapenem-resistant Enterobacterales (CRE) are a significant public health threat. Patients colonized with MDROs are at higher risk of severe outcomes and can serve as a source of spread to others. The public health impact of a hypothetical agent that reduces MDRO load (i.e., pathogen reduction), including in the gastrointestinal tract, has not been described.

Compartmental models of CRE transmission in healthcare facilities were used to estimate the impact of a hypothetical pathogen reduction agent on CRE bloodstream infections (BSIs) and deaths.

The agent was assumed to reduce the time to pathogen clearance with effectiveness varying from 25–100% across simulations. Interventions were modeled in acute care hospitals (ACHs), critical access hospitals, long-term acute care hospitals (LTACHs), skilled nursing facilities, and ventilator-capable skilled nursing facilities (vSNFs). Direct effects (among patients who received the agent) and indirect effects (among patients who did not receive the agent) were estimated at the national healthcare network level.

At baseline without intervention, an estimated 2,086 CRE BSIs and 622 associated deaths occurred annually nationwide. Use of a pathogen reduction agent in LTACHs and vSNFs averted 69–75% of CRE BSIs nationally, with greater reductions when expanded to all facility types. Approximately 90% of averted CRE BSIs would have occurred in patients who were not administered the agent.

An effective pathogen reduction agent might substantially reduce MDRO infections and deaths among patients in U.S. healthcare facilities. New and expanded efforts are needed to accelerate the development of such products.

Decentralized trial designs can improve accessibility and continuity of research participation by enabling remote data collection. This manuscript describes our team’s experiences with remote data collection to identify acute asthma exacerbations in a clinical study as well as practical insights that support the continued optimization of remote methodologies.

In this 12-month observational study, adolescents aged 12–21 years with persistent asthma and ≥1 exacerbation in the prior 24 months completed an initial in-person visit followed by monthly virtual visits. Participants used home spirometry, app-based symptom tracking, smart inhalers to monitor lung function and short-acting beta agonist (SABA) use, and self-collection of nasal epithelial lining fluid (NELF) samples. Exacerbations were defined a priori by symptom/SABA thresholds or ≥20% FEV1 decline.

Forty participants enrolled; 73% completed all visits. Median adherence to performance of daily spirometry and symptom surveys was 44% and 38%, respectively. Seventy-eight percent experienced ≥1 exacerbation. Of 132 alerts, 80% represented true exacerbations, primarily due to ≥20% FEV1 decline; erroneous alerts were linked to software errors and poor spirometry technique. Sixty-six NELF sample sets were collected and 50 were analyzed. Cytokine concentrations did not differ significantly between clinic-collected and self-collected samples. Technical challenges included device connectivity issues, erroneous alerts, and shipping delays.

Decentralized study designs with remote data collection requires further study as a means of conducting clinical research in asthma that increases participant accessibility, representation and generalizability of trial results. This approach presents numerous challenges and requires further optimization to address adherence, technical complexity, and staff burden while maintaining scientific rigor.

Increasing survival probabilities among children and young adults with acute lymphoblastic leukemia (ALL) have led to a growing population at risk for long-term neurocognitive sequelae. This study investigated cognitive functioning among individuals treated for ALL under the Nordic Society of Paediatric Haematology and Oncology ALL2008 protocol in Eastern Denmark, including performance across multiple domains and associations with age at diagnosis, sex, time since end of treatment, hematopoietic stem cell transplantation (HSCT), and neurotoxic events during treatment.

Eighty-three survivors of ALL diagnosed before age 25 underwent neurocognitive testing at a median of 7.24 years post-treatment (interquartile range: 4.20–8.78). Performance was measured as age-standardized Z scores derived from normative data. Impairment was defined as Z ≤ −1.3 and severe impairment as Z ≤ −2.0. Multiple linear regression was used to investigate associations between cognitive outcomes and clinical risk factors.

Average performance was generally comparable to norms, but at least 38.6% of participants showed severe impairment in one or more domains, and at least 12% in two or more. Younger age at diagnosis was associated with poorer processing speed, executive functions, and non-verbal reasoning, while HSCT was associated with poorer processing speed and non-verbal reasoning.

Although average performance of the participants was generally comparable to norms, a notable proportion exhibited multi-domain, severe cognitive impairment. Associations with age at diagnosis and HSCT indicate potential for risk-stratified cognitive monitoring and targeted interventions.

To report on the investigation of a pseudo-outbreak of Mycobacterium mucogenicum and examine its clinical and operational impact.

Outbreak investigation, retrospective cohort study.

Academic medical center in Los Angeles, California.

Patients whose bronchoalveolar lavage (BAL) cultures grew M. mucogenicum from 2020–2024.

We performed an institutional outbreak investigation of M. mucogenicum, reviewed electronic medical records of a subset of affected patients (2023–2024), and assessed the operational impact.

The incidence of M. mucogenicum in BAL cultures at Hospital A increased from 6.1% (29/473) in 2020 to 18.6% (29/156) in the first quarter of 2024. Epidemiologic investigation revealed non-sterile ice baths used to cool uncapped sterile syringes during bronchoscopy procedures as the contamination source. Next generation sequencing linked clinical isolates to M. mucogenicum recovered from a perioperative ice machine. Nearly all (157/160) clinical isolates grew from nocardia media rather than acid-fast bacilli media. Among 154 patients, including 51 (33.1%) who were highly immunocompromised, no true infections were identified. Thirty-nine (25.3%) patients were referred to infectious diseases for consultation, seven (4.5%) underwent additional workup, and only one received targeted treatment. The pseudo-outbreak incurred 458 hours of microbiology technologist and infection preventionist time and cost the laboratory $88,426.

A four-year pseudo-outbreak of M. mucogenicum traced to contaminated ice baths used during bronchoscopy resulted in unnecessary infectious disease referrals and substantial operational and financial burden to the institution. Avoidance of non-sterile ice use in procedures prevents costly and burdensome pseudo-outbreaks of environmental mycobacteria in healthcare settings.

A nuclear detonation resulting in radiation exposure to a large population can cause acute radiation syndrome (ARS). Bone marrow colony stimulating factors (CSF), also known as cytokines, are FDA approved to treat hematopoietic-acute radiation syndrome (H-ARS). This review characterizes the use of CSFs (filgrastim, pegfilgrastim, romiplostim, and sargramostim) and stem cell therapies for H-ARS.

Using identified keywords, the literature search was conducted on biomedical databases from January 1996-July 2022 and returned 7452 articles. However, after review based on PICO and exclusion criteria, a total of 39 animal studies were included in this systematic review.

Data synthesis using vote counting demonstrated that 34 of 39 studies reported benefit with CSFs or stem cell therapies based on an increase in percent survival or physiological improvement in the experimental group when compared to the control (87% [95% CI 71.77%-95.18%], P = <0.001).

While studies looking at efficacy of CSFs given after 24 hours were limited, 2 studies included in this review showed that delayed administration of CSFs up to 120 hours may be beneficial compared to no treatment. Lack of standardization in experimental study design (e.g. radiation doses, animal species, interventions) between studies prevented direct comparisons using meta-analytic statistical approach.