Off-label use of antipsychotics, often at low doses, is increasing. Exploring the link between individual antipsychotic treatment patterns, including low-dose continuous use, and cardiometabolic health is crucial to prevent long-term morbidity and mortality. The current retrospective study examined the prevalence of cardiometabolic medicine use among antipsychotic-users, and its association with their past antipsychotic treatment patterns.

Using a 10% sample of the Australian national medicine dispensing claims data from 2022, we identified individuals aged 15–64 years with ≥2 antipsychotic dispensings (antipsychotic-users) and non-users. We extracted their past 5-year antipsychotic treatment patterns (dose, duration and use of multiple agents). Using Poisson regression and accounting for age and sex, we calculated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for cardiometabolic medicine use (anti-diabetics, antihypertensives, lipid modifiers, anti-thrombotics) among antipsychotic-users versus non-users. We applied unsupervised hierarchical clustering analysis to identify common antipsychotic-cardiometabolic co-dispensing.

Use of any cardiometabolic medicine was more prevalent among antipsychotic-users (35.8%, n = 28,345) than non-users (26%, n = 1,106,610) yielding an aPR of 1.30 (CI 1.28–1.33). aPRs for the use of anti-diabetics, lipid modifiers and antihypertensives were the highest among the younger age groups between 20 and 49 years and among women. Clustering analysis revealed increased co-dispensing of antipsychotics and anti-diabetics including sulfonylureas, statins, platelet aggregation inhibitors and beta blockers. The prevalence of cardiometabolic medicine use was associated with higher antipsychotic doses (23–54%), treatment duration (12–37%) and use of multiple agents (51%) compared with non-users. However, the prevalence of cardiometabolic medicine use for continuous (≥1 year) low-dose use of aripiprazole, asenapine, brexpiprazole, chlorpromazine, lurasidone, olanzapine, periciazine and quetiapine was also elevated (13–43%).

Use of cardiometabolic medicines is increased among people on long-term antipsychotic treatment. These results highlight the need for active monitoring for cardiometabolic adverse effects, with antipsychotic cessation where possible, or timely interventions to limit morbidity.

The study objective was to compile and rate expert-informed recommendations to enhance US Military Health System (MHS) pandemic preparedness, with implications for large civilian health systems and national preparedness.

A Modified Delphi process was used to assess the importance and feasibility of pandemic preparedness recommendations from Department of Defense (DoD) after-action reports and inspector general reviews. The process consisted of a pre-work phase and 4 rounds of panelist engagement. Panelists rated each recommendation on both importance and feasibility using a Likert scale.

Thirty panelists participated in the interview round, 21 completed the first round of asynchronous rating, 15 participated in the second round of consensus rating, and 14 attended the final consensus conference. The Delphi process began with 102 recommendations; at completion, 25 recommendations were rated high importance and high feasibility. Recommendations addressed key domains including support to civil authorities, public health emergency management, personnel, and policy.

The 25 highest-rated recommendations highlight key areas for enhancing MHS planning for future pandemic preparedness, such as civilian-military coordination, telehealth expansion, and supply chain resilience. While tailored to the MHS, the findings highlight critical areas relevant to civilian health systems and national preparedness, including public health measures, interagency coordination, and resource management.

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.