Initial Days Research Articles

Does Concomitant Psychostimulants Mitigate Second-Generation Antipsychotics-Associated Weight Gain? An Observational Study Based on Electronic Medical Records Data.

Objective: Weight loss is a well-documented adverse effect of psychostimulants. Given their frequent coprescription with second-generation antipsychotics (SGA) in pediatric patients, this study aims to examine whether concomitant use of psychostimulants mitigates SGA-associated weight gain in children and adolescents. Method: This study utilized the IQVIA Ambulatory electronic medical record-U.S. database (2016-2021) to identify patients aged 6-17 years who initiated an SGA. Those who started psychostimulants within 7 days of SGA initiation and maintained ≥90 days of use were classified as concomitant users, while those who initiated psychostimulants later with ≥90 days of overlap were add-on users. Patients never prescribed psychostimulants were SGA-only users. After adjusting for the baseline covariates using propensity scores, 6- and 12-month body mass index (BMI) z-score trends following psychostimulant initiation were compared between (1) concomitant and SGA-only users and (2) add-on and SGA-only users, using a linear mixed-effects regression model. Results: The results of linear mixed effect regression models indicate that concomitant users experienced a 0.0143 less monthly BMI z-score increase (p = 0.0063) compared with the SGA-only users over the 6 months following psychostimulant initiation. Similarly, add-on users had a significantly lower rate of weight gain compared with SGA-only users (β = -0.0463, p < 0.0001). When the follow-up period was extended to 12 months, the sensitivity analyses for both concomitant and add-on users were consistent with their primary analyses. Conclusions: Concomitant and add-on psychostimulants appear to mitigate SGA-associated weight gain in children and adolescents. Further investigation is needed to understand their effectiveness and safety relative to other interventions for antipsychotic-associated weight gain.

Impact of Relationship Quality and Recovery Attitudes on Medication for Opioid Use Disorder Among Young Adults

Extended-release medications for opioid use disorder (XR-MOUD) with young adults have shown promise to increase treatment adherence, though dropout remains high. Recovery capital factors like relationship quality and recovery attitudes may influence treatment outcomes in young adults with OUD. This study examined the relationship between initial opioid use, recovery capital, and treatment outcomes among 52 young adults (11.5% female) receiving MOUD in a novel treatment program. Recovery capital factors were self-reported pre- and post-treatment, and treatment outcomes (opioid use days and MOUD dosages) were assessed via self-report and urinary screens. Recovery attitudes buffered the association between baseline opioid use and days used during the study and were found to change non-uniformly longitudinally. Moreover, more frequent negative relationship events buffered the association between initial opioid use severity and days used. This study adds novel information to the literature regarding recovery attitudes and factors involved in young adult opioid use treatment.

Understanding undocumented migration from Bangladesh to Italy: the role of transnational networks

ABSTRACT Bangladesh has increasingly become a notable source of undocumented migrants, ranking among the largest groups attempting to reach Europe, primarily through the perilous journey across the Mediterranean Sea and various land borders. Drawing on multi-sited qualitative research conducted in Italy and Bangladesh, this article analyses the narratives of Bangladeshi migrants to understand how transnational social networks facilitate and sustain undocumented migration from Bangladesh to Italy. It argues that in today’s interconnected societies, many migrants maintain transnational social fields that foster migration aspirations among non-migrants. These findings contribute to the existing body of literature on undocumented migration by illuminating the role of social networks across three phases: the pre-migration phase, which informs migration decisions and preparatory measures; the migration phase, which facilitates border crossings; and the post-migration phase, which supports the process of acclimatisation during the initial days in Italy.

A Versatile Immune Protective Armor to Enhance the Regenerative Potential of Exogenous Stem Cells.

Host immune rejection has long been recognized as a major contributor to the poor survival rates of exogenous stem cells (ESCs). In this study, we present a simple and versatile strategy to protect ESCs from host immune system insults by developing a protective "armor." This armor was designed using tannic acid (TA), leveraging its strong affinity for biomacromolecules and its anti-inflammatory properties. Prior to implantation, the armor can be readily applied to the surface of individual ESCs, cell aggregates, cell sheets, or cell-laden hydrogel systems by simply immersing them in a TA solution for several seconds, without additional processing steps. The TA-based armor effectively modulates the acute inflammatory response during the initial days postimplantation by scavenging reactive oxygen species (ROS), thereby creating an ESCs-friendly immune microenvironment. This was evidenced by reduction in the infiltration of pro-inflammatory immune cells and the secretion of pro-inflammatory cytokines. Consequently, the survival of engrafted ESCs was significantly enhanced, with preserved stemness and immunomodulatory functions. The regenerative potential of ESCs was further demonstrated in a rat periodontal defect model. These findings provide a novel approach for enhancing the regenerative performance of ESCs and offer a straightforward and versatile strategy to shield ESCs from host immune rejection.

INFLUENCE OF SOCIAL AND MEDICAL FACTORS ON THE DURATION OF EXCLUSIVE BREASTFEEDING

The rates of exclusive breastfeeding (EBF) remain low worldwide, with only 36% of children under six months receiving EBF. Recent research indicates that parents are influenced by numerous social and medical factors that affect their decisions regarding infant feeding. Aim of the study. To analyze the impact of social and medical factors on the success and duration of breastfeeding. Materials and methods. A survey was conducted among 96 breastfeeding women with varying feeding practices using a Google form. The questionnaire included 24 items covering the woman’s age, social status, adherence to breastfeeding support strategies at different stages of medical care, difficulties with breastfeeding, knowledge of the benefits of breastfeeding, the influence of healthcare professionals on feeding decisions, and more. In carrying out scientific work, the basic principles of biomedical research are preserved. Statistical analysis was performed using methods of variation statistics, calculating the mean (M) and standard error of the mean (m). Correlation analysis was conducted to determine the relationship between variables and to assess its strength and direction. The significance of differences between means was evaluated using Student’s t-test. Results. According to the survey, 66.7% of children were exclusively breastfed for up to six months, which aligns with statistical reports from healthcare facilities in Chernivtsi (69.3%, p &gt; 0.05). The longest duration of breastfeeding was observed among office workers (18.00 ± 2.27 months) and women without permanent employment (15.00 ± 5.09 months), while the shortest duration was among entrepreneurs (11.14 ± 3.83 months). Among age groups, women aged 31–35 years had the longest breastfeeding duration, while women aged 21–30 years had the shortest. Strong positive correlations were found between breastfeeding duration and participation in breastfeeding education sessions (r = 0.69; p &lt; 0.005) as well as the woman’s social group (r = 0.73; p &gt; 0.005). Strong negative correlations were observed between breastfeeding duration and the use of infant formula in the first days (r = -0.62; p &lt; 0.005) as well as difficulties with breastfeeding (r = -0.70; p &lt; 0.005). Conclusion. A breastfeeding support strategy requires training for healthcare professionals and women during pregnancy, the initial days in maternity hospitals, and subsequent stages of medical care to prevent difficulties and avoid the discontinuation of breastfeeding.

Temporal Patterns of Patient Falls in an Inpatient Rehabilitation Facility: A Retrospective Analysis.

Falls are a significant safety concern in inpatient rehabilitation facilities, where patients often face increased risk due to functional impairments. This retrospective study examined fall trends across days post-admission and daily 2-hour intervals within a single rehabilitation hospital. Linear regression analysis revealed a significant decline in fall rates over time, suggesting a decrease in fall risk as patients acclimate and improve physically. However, two peak periods for falls were identified during early morning and evening hours, aligning with heightened patient activity and staff shift changes. These findings emphasize the need for targeted fall prevention strategies during the initial days post-admission and specific high-risk times of the day. Implementing tailored interventions for these critical periods may reduce fall incidents and enhance patient safety in rehabilitation settings.

The influence of IMPDH activity on ciliogenesis and adipogenesis of 3T3-L1 cells while undergoing differentiation.

The influence of IMPDH activity on ciliogenesis and adipogenesis of 3T3-L1 cells while undergoing differentiation.

Early fungal colonization and infection as an independent predictor of in-hospital mortality in mechanically ventilated COVID-19 patients: A nationwide target trial emulation study in Taiwan.

Early fungal colonization and infection as an independent predictor of in-hospital mortality in mechanically ventilated COVID-19 patients: A nationwide target trial emulation study in Taiwan.

Impact of Initial Postweaning Feed Intake on Weanling Piglet Metabolism, Gut Health, and Immunity.

Low feed intake in weanling pigs can be hypothesized as both cause and consequence to intestinal disturbances and metabolic stress. We explored the associations between individual daily feed intake (FI) patterns, metabolic status and intestinal physiology. Female pigs (n = 24) were selected based on high or low cumulative FI between d1 and d3 relative to weaning (d0) from 12 pens equipped with electronic feeding stations at 1-week after weaning for dissection and sampling. Four classes of pigs were created with pigs which started with a high or low FI (d1 to d3) and continued with a high or low FI (d4 to d6) (HH, HL, LH and LL, respectively; n = 6) for data analysis. In plasma, HL pigs showed higher plasma glutamate dehydrogenase than LL pigs (P < 0.05). A low FI d1 to d3 increased plasma creatinine and lactate dehydrogenase, and reduced insulin-like growth factor (IGF-I), gastrointestinal organ weights, and jejunal villus surface area at one week after weaning (P < 0.05). However, low FI d4 to d6 increased plasma haptoglobin, PigMAP, bile acids and bilirubin levels and reduced jejunal villus length (P < 0.05). In jejunum tissue, HH pigs had the highest jejunal upregulated IGF-I receptor and a reduced local inflammatory gene expression when compared to HL pigs (MyD88), and similarly, when compared to all classes (FAXDC2). For the main effects, pigs classified as high FI d1 to d3 had upregulated immune system including IL6, TGFB1, TLR2, and TLR4 genes compared to low FI d1 to d3 pigs (P < 0.05). In a multivariate model, variance in ADG (R2 = 0.82) was mostly explained by positive correlations with FI d1 to d3, jejunal morphometrics, and plasma IGF-I, while negatively explained by histamine in digesta, and creatinine, PigMAP, triglycerides, and haptoglobin in plasma. In conclusion, pigs transitioning from high to a low feed intake showed distinct metabolic alterations and a subtle local inflammation masked by the vigorous local immune response in pigs with initial (d1 to d3) high FI. Pigs with an initial low FI had a fasting-like metabolic state, indicated by hepatic alterations pointing at shifting protein metabolism into energy production. Altogether, feed intake during the initial days postweaning significantly impacts pig growth, immunity, and metabolism, with sustained low intake (i.e. up to 6 days) triggering a systemic inflammatory response.

The impact of various stress factors on lactation in goats

Background and Aim. The study of milk formation and secretion physiology is essential for addressing various biomedical issues related to the biological significance of lactation and milk in supporting offspring immunity and metabolism, as well as for the production of high-quality dairy products. The occurrence and duration of hypogalactia are determined by the quantitative balance between lactogenic and stress hormones. The aim of the study was to assess the levels of stress hormones and their impact on milk secretion in lactating goats under normal conditions and various stress factors. Materials and Methods. The study was conducted on goats, biochemical analyses of blood and milk were carried out. The levels of adrenaline and noradrenaline were measured using the fluorimetric method, considering different stress conditions and lactation stages. Results. The levels of key lactogenic hormones were found to be highest during the early stages of lactogenesis. For the first time, it was established that stress hormone levels in goats vary depending on the lactation period and the influence of stress factors. The highest concentrations of adrenaline and noradrenaline were observed in the initial days of lactogenesis, followed by a decline during subsequent stages of lactopoiesis. Conclusion. The results of the study showed that low milk yield is associated with increased levels of adrenaline and noradrenaline in the bloodstream. Under such conditions, milk production decreases, and a reduction in fat, protein and lactose content is observed, leading to a shorter lactation period.

Optimal Delay Time to Initiate Anticoagulation After Ischemic Stroke in Atrial Fibrillation

Clinical practice guidelines recommend initiation of anticoagulation within 2 weeks after stroke with atrial fibrillation. It is unknown whether there is an optimal starting day within the 14-day period that balances the risks of recurrent embolic events against serious hemorrhagic events. To determine if there is an optimal delay time to initiate treatment with a direct oral anticoagulant after atrial fibrillation-related stroke that minimizes the risk of a composite outcome of ischemic or hemorrhagic events. This phase 2, pragmatic, response-adaptive randomized clinical trial was conducted between June 2017 and June 2023 at acute care hospitals in Texas and included patients who had a mild to moderate ischemic stroke (minimum lesion diameter of 1.5 cm) with atrial fibrillation and were prescribed a direct oral anticoagulant within 2 weeks from stroke onset. Within 3 to 4 days after atrial fibrillation-associated ischemic stroke, patients were randomized to a group for treatment start date (group 1 was day 3 or 4 after stoke onset; group 2 was day 6; group 3 was day 10; and group 4 was day 14) with a direct oral anticoagulant for secondary stroke prevention. The composite primary outcome was an ischemic (stroke or systemic embolism) or hemorrhagic (symptomatic intracranial hemorrhage or major systemic hemorrhage) event observed within 30 days from the index stroke time of onset. Posterior probabilities were used to estimate which timing groups were optimal for treatment initiation and were recalculated at predefined intervals. The randomization allocations were adjusted to favor the groups with higher probabilities. The trial enrolled and randomized 200 patients (50% were female; the median age was 75 years [IQR, 65-81 years]; 17.5% were Asian, Black, or >1 race; 16.5% were Hispanic; the median National Institutes of Health Stroke Scale score was 6.5 [IQR, 4-14]; and the median lesion diameter was 3.1 cm [IQR, 2.0-4.4 cm]). No ischemic events were observed for group 1, 3 events were observed for group 2, 2 events were observed for group 3, and 2 events were observed for group 4. One hemorrhagic event was observed for group 1, 1 event was observed for group 2, 1 event was observed for group 3, and 0 events were observed for group 4. Group 1 had a posterior probability of 0.41 for being the optimal day for treatment initiation and it was 0.26 for group 2, 0.17 for group 3, and 0.15 for group 4. The use of response-adaptive randomization was feasible and favored groups with earlier initiation times for use of a direct oral anticoagulant. A clearly superior day to initiate use of a direct oral anticoagulant for secondary stroke prevention in patients with atrial fibrillation was not identified, but the evidence suggests that initiating use of a direct oral anticoagulant earlier is better than at later times within the first 2 weeks after stroke onset. ClinicalTrials.gov Identifier: NCT03021928.

Effect of melatonin and melatonin plus progestagen protocols on some reproductive performance and blood parameters at the beginning of the breeding season in Hasmer ewes

The aim of this study was to investigate the effect of exogenous melatonin administered by different methods at the beginning of the breeding season on estrus onset, fertility, plasma progesterone and malondialdehyde (MDA) concentrations in Hasmer ewes. To this end, the ewes were divided into three groups: Group I (MEL): This group received subcutaneously 18 mg melatonin implant (RegulinTM, Ceva– Turkiye) Group II (MELPRO): This group received subcutaneously 18 mg of melatonin implant (RegulinTM, Ceva–Turkiye), followed by the intravaginal administration of a sponge containing 20 mg of flugestone acetate (Choronogest CRTM–France) for a period of 9 day. This was followed by the intramuscular injection of 250 µg of cloprostenol (SenkrodinTM– Vetas–Turkiye) as soon as the sponge was removed. Group III designated as the control group (CON), received 1 mL of saline was administered subcutaneously for placebo effect. Estrus was detected using teaser rams starting 24 h after the melatonin (Group MEL), PGF2α (Group MELPRO) and physiological saline (Group CON) applications twice a day (06:00 and 17:00). Ewes in oestrus were moved to separate compartments and mated with fertile rams. Blood samples were collected from the vena jugularis on the day of treatment initiation, on the day of mating, and on day 17 of gestation. Pregnancy examinations were performed between 25 and 30 days after mating, and heartbeats were monitored using a 5–8 MHz linear trans–rectal probe in the groups (DP 50 VETTM, Mindray Ltd. China). There was no statistical difference in the onset of first oestrus between the groups (P&gt;0.05). A noteworthy finding was the increase in progesterone concentration on the 17th day of pregnancy in the group treated with melatonin alone, compared to other groups, at the beginning of the breeding season (P&lt;0.05).

Real-World Type 2 Diabetes Second-Line Treatment Allocation Among Patients.

This study aimed to evaluate the impact of socioeconomic disparities on the allocation of second-line treatments among patients with type 2 diabetes (T2D). We conducted an observational study using real-world data from over 9 million patients across five University of California Health centers. The study included patients who initiated a second-line T2D medication after metformin, with hemoglobin A1c (HbA1c) measurements within ±7 days of treatment initiation from 2012 through September 2024. Multinomial regression models assessed the association between socioeconomic status and second-line treatment choices. Additionally, we used the GPT-4 large language model with a zero-shot learning approach to analyze 270 clinical notes from 105 UCSF patients. GPT-4 identified adverse social determinants of health (SDOH) across six domains: transportation, housing, relationships, patients with children, support, and employment. Among 15,090 patients (56.7% male, 43.3% female; mean age 59.3 years; mean HbA1c 8.91%), second-line treatments included sulfonylureas (SUs; n = 6,732), DPP4 inhibitors (n = 2,918), GLP-1 receptor agonists (n = 2,736), and SGLT2 inhibitors (n = 2,704). Patients from lower socioeconomic neighborhoods were more likely to receive SUs over other medications: DPP4i (OR = 0.96, [95% CI, 0.95-0.98]), GLP-1RA (OR = 0.94, [95% CI, 0.92-0.96]), SGLT2i (OR = 0.95, [95% CI, 0.93-0.97]). In UCSF clinical notes, we identified adverse SDOH including housing (n=8), transportation (n=1), relationships (n=22), employment (n=12), support (n=1), and patients with children (n=25). Socioeconomic factors influence second-line T2D treatment choices. Addressing these disparities is essential to ensuring equitable access to advanced T2D therapies.

Long term use of lokivetmab (Cytopoint®) in atopic dogs

Lokivetmab (Cytopoint®, Zoetis) has been shown to be effective for the short-term treatment of dogs with allergic and atopic dermatitis but there are no studies at US label dosing (at least 2 mg/kg every 4–8 weeks as necessary) which evaluate long-term usage. The objective of this study was to follow a cohort of dogs receiving lokivetmab to treat their canine atopic dermatitis (CAD) over 12 months. The initial phase of this interventional cohort study evaluated a dog’s pruritus following monthly injections (up to 3 injections) of lokivetmab. Dogs who achieved pruritus < 36 mm using a Pet Owner Pruritus Visual Analogue Scale (PVAS) scoring system during the initial phase, were included in this study. Dogs received lokivetmab injections per the US label every 4–8 weeks and returned on days 180 and 365 (± 7 days) after their initial Day 0 for examination by investigators. Pet owners were asked to complete an electronic PVAS assessment every 2 weeks. At each visit, investigators completed a Canine Atopic Dermatitis Extent and Severity Index (CADESI-4) score and VetVAS to measure skin lesion scores. There were 87% (64/75) of dogs who maintained a PVAS below their baseline PVAS on Day 0. Over the course of the study, 88% (65/75) of dogs obtained a mean PVAS below 36 mm. Of those dogs, 31% (23/75) achieved a biweekly PVAS that was below 36 for the entirety of the study with 11% (8/75) having a biweekly PVAS score that stayed below 20 (considered normal dog level of pruritus) for the entire study. Most owners (93%; 64/49) were satisfied with lokivetmab with 88% planning to continue lokivetmab usage. The majority (80%; 55/69) of pet owners reported they were able to reduce the use of other products while their dog was using lokivetmab, and 87% (60/69) of owners found caring for their dog’s atopic dermatitis was easier with lokivetmab compared to prior treatments.

Osmoregulatory contributions of the corticotropin-releasing factor system in the intestine of Atlantic salmon.

The ability of euryhaline fishes to tolerate different environmental salinities depends upon the flexibility of their osmoregulatory organs, including the intestine. Several endocrine pathways contribute to the coordination of osmoregulatory processes in the teleost intestine; however, while the corticotropin-releasing factor (CRF) system has established osmoregulatory actions in the mammalian intestine, it is unclear whether the intestinal CRF system serves similar functions in teleosts. Therefore, we sought to determine whether the CRF system contributes to osmoregulatory processes in the intestine of Atlantic salmon (Salmo salar). We first showed using in vitro sac preparations that activation of CRF receptor type 2 (CRFR2) in the middle and posterior regions of the intestine reduces water, Na+, and Cl- absorption. However, co-activation of CRFR1 and CRFR2 inhibited water and Na+ absorption without affecting net Cl- absorption. We then assessed how the CRF system in the middle and posterior regions of the intestine was transcriptionally regulated during the seasonal acquisition of seawater tolerance (i.e., smoltification) and following changes in environmental salinity. Smolts had higher transcript levels of CRF ligands than parr and this difference persisted following seawater transfer. Additionally, seawater transfer caused transient increases in transcription of urocortin 2 (UCN2) and CRFR2 (posterior intestine only). Similar increases in UCN2 and CRFR2 were observed following seawater to freshwater transfer of post-smolts. Our results indicate that the intestinal CRF system of Atlantic salmon contributes to osmoregulation during the initial days following changes in environmental salinity and that osmoregulatory actions of the intestinal CRF system are conserved across vertebrates.

Favorable correlation between neutrophil percentages obtained using automated hematology analyzers and microscopic examinations in malignant lymphoma patients receiving chemotherapy.

Automated hematology analyzers are routinely used to assess blood cell counts and leukocyte differentials. However, the accuracy of assessing neutrophil percentages with automated hematology analyzers in patients undergoing chemotherapy has not been examined. In this study, the correlation between neutrophil percentages calculated by automated hematology analyzers and those obtained through manual microscopic examinations by laboratory technicians was investigated on the day of chemotherapy initiation in 125 patients receiving CHOP-based chemotherapy for malignant lymphoma. Peripheral blood counts and 5-part leukocyte differential percentages were analyzed using the Sysmex XE-5000 system. An examination of 797 samples from each chemotherapy course showed a favorable correlation between the two methods (Pearson's r = 0.917). However, this correlation significantly diminished in samples when the bone marrow nucleated cell count was ≤ 50 × 109/L or granulocyte colony-stimulating factors were administered in previous chemotherapy courses (r = 0.881 and 0.886, respectively). Furthermore, a tendency towards a weaker correlation was noted when the percentage of immature neutrophils exceeded 3% (r = 0.894). Nevertheless, in all these conditions, the correlations consistently had coefficients of > 0.8, emphasizing the robustness of the correlation. Our study suggests that neutrophil percentages calculated by automated hematology analyzers on the first day of chemotherapy were strongly correlated with those obtained through microscopic examinations. Measuring neutrophil counts with an automated hematology analyzer is sufficient, even in patients receiving chemotherapy.

Floral biology and reproductive phenology of golden apple (Spondias dulcis Frost.) in subtropical terrace soil condition

Knowledge of reproductive biology is the prerequisite for crop improvement through hybridization. So, floral morphology, anthesis, and pollen viability of golden apple were studied to manifest the reproductive biology for utilization as breeding tools. Observations revealed that this deciduous fruit tree gave birth to bright pink panicles accompanying new leaves at apetalous shoot tips during the onset of spring (February), blooming continued for 26 days from the 28th day of panicle initiation (PI), and fruit setting completed within 64 days of PI. Over a three-week-extended flowering cycle, flower opening rose exponentially from 2.0 flowers/panicle on the starting day to a peak of 656 flowers/panicle on day eight, and then decreased gradually to a stop on the 20th day. The racemose type inflorescences had creamy-white hermaphrodite flowers each taking five sepals, five petals, ten anthers and five styles with prominent pinkish ovary. Exhibiting nocturnal anthesis nature, over 91% floral buds bloomed between 6 to 10 pm at night, whereas 6 am to 4 pm daytime period had no blooms. Notably, pollen viability was above 80% till four hours of anthesis (83.34%), then declined drastically to 3.60% in ten hours. Out of 3855 floral buds/panicle, 3577 were bloomed of which 10.34% turned into fruits and 3.13% matured. Floral buds that were protected from outcrossing didn’t set fruits denoting non-synchronous gametic maturity. Therefore, for golden apple improvement, crossing should be performed at night within four hours of anthesis during the second week of blooming in the spring season.

Feeding Dynamics in Very Preterm Infants with Delayed Oral Feeding Attainment.

We aimed to characterize features that can accurately identify preterm infants at risk of delay in oral feeding attainment. A prospective observational study of infants born between 250/7 and 326/7 weeks' gestation. Early independent oral feed attainment (EPO) was defined as independent oral feeding within 35 days of initiation and late attainment (LPO) defined at or after 35 days following initiation. Candidate characteristics of comparison included feeding interventions and reasons for feeding discontinuation. Of the 257 infants included, 162 infants achieved EPO. Over the first week of oral feeding, LPO infants received fewer feeding interventions (e.g., side lying position, pacing, and re-alertment) and were fed less frequently (2 vs. 3 times per day; p < 0.001). Compared to infants with EPO, infants with LPO differ in employed feeding strategies. These findings could guide resource allocation and facilitate the provision of individualized care.

Environmental Risk Concern and Short-Term IPO Performance of Green Stocks During the COVID-19 Crisis Period

This study examines the effect of firms’ greenness on IPO underpricing and subsequent short-term performance during the COVID-19 crisis period. Using 173 U.S. IPOs, we find that IPO underpricing is more pronounced for brown firms (i.e., firms have higher carbon footprints or operate in pollution-intensive industries) than for green firms (i.e., firms are engaged in environmentally sustainable practices). However, when we account for the exogenous change in environmental concerns, we find that an increase in environmental concerns causes lower initial day returns for brown firms. Later, we examine the post-IPO 3-month (6-month) holding period returns and find that brown firms earn higher returns than green firms when environmental concerns increase. Additionally, cross-sectional regressions indicate that firm-level characteristics, such as offer price and Hi-Tech, are positively associated, while R&amp;D, leverage, and profitability are negatively associated with IPO.

High-Throughput Screening for Prescribing Cascades Among Real-World Angiotensin-II Receptor Blockers (ARBs) Initiators.

Angiotensin-II Receptor Blockers (ARBs) are commonly prescribed; however, their adverse events may prompt new drug prescription(s), known as prescribing cascades. We aimed to identify potential ARB-induced prescribing cascades using high-throughput sequence symmetry analysis. Using claims data from a national sample of Medicare beneficiaries (2011-2020), we identified new ARB users aged ≥66 years with continuous enrollment ≥360 days before and ≥180 days after ARB initiation. We screened for initiation of 446 other (non-antihypertensive) 'marker' drug classes within ±90 days of ARB initiation, generating sequence ratios (SRs) reflecting proportions of ARB users starting the marker class after versus before ARB initiation. Adjusted SRs (aSRs) accounted for prescribing trends over time, and for significant aSRs, we calculated the naturalistic number needed to harm (NNTH); significant signals were reviewed by clinical experts for plausibility. We identified 320,663 ARB initiators (mean ± SD age 76.0 ± 7.2 years; 62.5% female; 91.5% with hypertension). Of the 446 marker classes evaluated, 17 signals were significant, and three (18%) were classified as potential prescribing cascades after clinical review. The strongest signals ranked by the lowest NNTH included benzodiazepine derivatives (NNTH 2130, 95% CI 1437-4525), adrenergics in combination with anticholinergics, including triple combinations with corticosteroids (NNTH 2656, 95% CI 1585-10074), and other antianemic preparations (NNTH 9416, 95% CI 6606-23784). The strongest signals ranked by highest aSR included other antianemic preparations (aSR 1.7, 95% CI 1.19-2.41), benzodiazepine derivatives (aSR 1.18, 95% CI 1.08-1.3), and adrenergics in combination with anticholinergics, including triple combinations with corticosteroids (aSR 1.12, 95% CI 1.03-1.22). The identified prescribing cascade signals reflected known and possibly under-recognized ARB adverse events in this Medicare cohort. These hypothesis-generating findings require further investigation to determine the extent and impact of these prescribing cascades on patient outcomes.