In the comparison between CHRs and HCs, the rank order of effect sizes across the neurocognitive tests was similar for the top two tests of symbol coding and verbal learning. Comparison between CHR-Cs and CHR-NCs revealed that adolescent CHR-Cs performed significantly worse than CHR-NCs on seven of eight neurocognitive tests; however, adult CHR-Cs performed significantly worse than CHR-NCs only in the visuospatial memory test.

The role of neurocognitive dysfunction may have different patterns and weights during the onset of psychosis in adolescent and adult CHRs, implicating the development of specific strategies that could monitor and improve cognitive function in adolescents with CHR.

The role of neurocognitive dysfunction may have different patterns and weights during the onset of psychosis in adolescent and adult CHRs, implicating the development of specific strategies that could monitor and improve cognitive function in adolescents with CHR.

Pericardial adipose tissue (PAT) is associated with adverse cardiovascular outcomes in those with and without established heart failure (HF). However, it is not known whether PAT is associated with adverse outcomes in patients with end-stage HF undergoing left ventricular assist device (LVAD) implantation. This study aimed to evaluate the associations between PAT and LVAD-associated outcomes.

We retrospectively measured computed tomography-derived PAT volumes in 77 consecutive adults who had available chest CT imaging prior to HeartMate 3 LVAD surgery between October 2015 and March 2019 at Duke University Hospital. Study groups were divided into above-median (≥219 cm

) and below-median (<219 cm

) PAT volume. Those with above-median PAT had a higher proportion of atrial fibrillation, chronic kidney disease and ischemic cardiomyopathy. Groups with above-median vs below-median PAT had similar Kaplan-Meier incidence rates over 2 years for (1) composite all-cause mortality, redo-LVAD surgery and cardiac transplantation (35.9 vs 32.2%; log-rank P = 0.65) and (2) composite incident hospitalizations for HF, gastrointestinal bleeding, LVAD-related infection, and stroke (61.5 vs 60.

%; log-rank P = 0.67).

In patients with end-stage HF undergoing LVAD therapy, PAT is not associated with worse 2-year LVAD-related outcomes. The significance of regional adiposity vs obesity in LVAD patients warrants further investigation.

In patients with end-stage HF undergoing LVAD therapy, PAT is not associated with worse 2-year LVAD-related outcomes. The significance of regional adiposity vs obesity in LVAD patients warrants further investigation.

Nonalcoholic steatohepatitis (NASH) affects patients’ health-related quality of life (HRQoL). Patient-reported outcomes (PROs) evaluating HRQoL were assessed in the REGENERATE study, which showed that obeticholic acid (OCA) significantly improved fibrosis in patients with NASH.

Noncirrhotic NASH patients in a phase 3, double-blind, randomized, placebo-controlled, multicenter, international study of OCA. The Chronic Liver Disease Questionnaire-NASH and EuroQol EQ-5D-5L were administered at baseline, 6, 12, and 18 months.

There were 1218 patients (age, 54.1 ± 11.5 y; 57% women; 43% stage F3) in the expanded intent-to-treat population (stages, F1-F3) assigned randomly to 10 mg (N= 407) or 25 mg (N= 404) OCA or placebo (N= 407). NSC697923 manufacturer Baseline measurements were balanced across treatment groups for EuroQol EQ-5D-5L and Chronic Liver Disease Questionnaire-NASH, including Itch score 5.75 ± 1.53 (scale 1-7, with 7 representing no itching). Nineteen (1.6%) patients discontinued therapy (protocol mandated) because of gly after OCA therapy initiation and does not worsen over time. ClinicalTrials.gov NCT02548351.

Individuals with inflammatory bowel disease (IBD) have an increased risk of herpes zoster (HZ) infection. Although the efficacy of recombinant zoster vaccine (RZV) is high among immunocompetent individuals, little is known about its effect among immunosuppressed individuals with IBD.

We conducted a retrospective cohort study among individuals in the national Veterans Affairs Healthcare System diagnosed with IBD on or before January 3, 2018, the earliest date of RZV vaccinations. We collected data on 7008 and 26,292 eligible patients with IBD in the 50- to 60-year and >60-year age groups, respectively. We identified veterans who received RZV and compared the incidence of HZ between vaccinated versus unvaccinated individuals. We performed multivariable Cox regression with time varying analysis to determine the risk of HZ among the vaccinated (full dose and single dose separately) versus unvaccinated cohort, stratified by IBD medications.

The crude HZ incidence rate after full dose vaccination of RZV when compared with the unvaccinated group was lower in both the 50- to 60-year age group (0.00 vs 3.93 per 1000 person-years) and >60-year age group (1.80 vs 4.57 per 1000 person-years). RZV vaccination was associated with a significantly lower risk of HZ among the 50- to 60-year and >60-year age groups, although this was limited by low HZ event rates.

RZV vaccination was associated with decreased risk of HZ infection among both the 50- to 60-year and >60-year age groups. Greater efforts should be made to vaccinate all patients with IBD with RZV.

60-year age groups. Greater efforts should be made to vaccinate all patients with IBD with RZV.Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related death worldwide and one of the few cancers with a rising mortality in the United States. There are opportunities for intervention along the cancer care continuum (CCC), which includes risk assessment, primary prevention, detection (ie, screening initiation and follow-up of screening results), diagnosis, and treatment.1 Each step is prone to failures that are influenced by factors at multiple socioecological levels (ie, patient, provider, health delivery system, community, and policy levels).2 We recently described a conceptual model of the steps and interfaces along the CCC that are required for effective implementation of HCC screening in clinical practice.3 Herein, we present a conceptual model for the implementation and evaluation of interventions at each of the socioecological levels using implementation strategies that promote optimal delivery and uptake. We focus on early steps in the CCC including risk assessment, primary prevention, and early detection (ie, secondary prevention), because these have the greatest potential to reduce HCC mortality.