Increased intervals in enzyme replacement therapy for stable type 1 Gaucher disease: A non‐inferiority sequential trial emulation

Abstract Objective To compare the efficacy and safety of extended interval (Q3–4W) enzyme replacement therapy (ERT) versus standard biweekly (Q2W) ERT in clinically stable type 1 Gaucher disease (GD) patients. Methods We emulated a target trial with a sequential trial design, using data from the French Gaucher Disease Registry. Eligible patients were treated for ≥2 years biweekly without clinical events. Every 3 months, switchers to Q3–4W were matched to Q2W patients by age, sex, referral center follow‐up, disease history (bone events, anemia, thrombocytopenia, splenectomy, and hepatosplenomegaly), and dose of ERT. The primary outcome was a composite of GD‐related events (bone events, anemia, and thrombocytopenia). A 10% non‐inferiority margin was prespecified. Secondary outcomes were biomarker changes and economic analyses. Results Among 280 eligible GD patients, 63 switched to Q3–4W and were matched to a total of 215 Q2W patients, followed for an average of 6.3 years. No significant difference in the risk of clinical events was observed between groups (hazard ratio: 0.98 [95% confidence intervals (CI): 0.54–1.51]). During follow‐up, absolute risk difference remained below the 10% non‐inferiority threshold at all timepoints. Biomarkers remained stable or slightly decreased in the Q3–4W group. The dosing interval extension led to an average reduction of 55 infusions per patient, corresponding to approximately €450,000 saved per patient over 6 years. Conclusion In stable GD1 patients, extending ERT administration to every 3–4 weeks was non‐inferior to the standard biweekly regimen, supporting personalized spacing strategies that may improve quality of life and reduce healthcare costs.

Childhood Sexual Abuse and Cognitive, Affective, and Behavioral Responses to Partner Touch

ABSTRACT Objective This dyadic study examined how childhood sexual abuse is associated with cognitive, affective, and behavioral responses anticipated in reaction to different types of hypothetical partner touch. Background Trauma theories contend that childhood sexual abuse is associated with long‐term relational challenges, including difficulties with intimacy and physical touch. Touch plays a central role in fostering connection and well‐being in couples, but individuals with a history of childhood sexual abuse and their partner may react differently to touch from a romantic partner. Method A convenience sample of 363 couples ( n  = 695 participants) mostly living in Canada completed self‐report measures assessing perceptions of sexual intent, anticipated negative affect, and behavioral avoidance in response to hypothetical scenarios depicting affectionate, sexual, or no‐touch. Actor‐partner interdependence models examined the associations between a person's childhood sexual abuse and both partners' responses to touch. Results Individuals with higher childhood sexual abuse frequency anticipated greater negative affect and behavioral avoidance in response to hypothetical sexual touch, but lower avoidance in response to hypothetical affectionate touch. In the hypothetical no‐touch condition, individuals with higher CSA frequency anticipated higher negative affect and men perceived greater sexual intent. Moreover, partners of individuals with higher CSA frequency reported expecting greater negative affect and perceived greater sexual intent. Conclusion Childhood sexual abuse may shape how partners interpret touch, suggesting that while sexual touch may be distressing, affectionate touch could play a role in rebuilding intimacy via lower avoidance.

Effects of a Virtual Nutrition Intervention on Montessori Teachers' Nutrition Role Modeling Abilities and Classroom Practices

ABSTRACT Background Early childhood is a critical period for establishing lifelong habits, and the presence of healthy role models can play a pivotal role in shaping children's nutrition‐related behaviors. The Teacher Education and Classroom Habits (T.E.A.C.H.) Study aimed to improve teachers' nutrition knowledge, beliefs, and behaviors. Methods Ninety‐five early childhood Montessori teachers from 45 schools across 24 US states participated in a virtual nutrition intervention with synchronous and asynchronous learning modalities. Hierarchical linear modeling was utilized to evaluate changes in nutrition knowledge (NK), nutrition self‐efficacy (NSE), nutrition teaching self‐efficacy (NTSE), cultural competence (CC), classroom‐eating behaviors (CEB), classroom food practices (CFP), nutrition teaching practices (NTP), and teacher‐parent communication (TPC). Results Significant improvements from baseline (week‐0) to post‐intervention (week‐6) were observed in NK, NSE, NTSE, CC, NTP, and TPC. Aside from NSE, sustained changes at follow‐up (week‐12) were observed in all variables. Implications for School Health Policy, Practice, and Equity Findings suggest that implementing flexible nutrition training as part of teacher professional development may support long‐term improvements in classroom practices and promote equitable access to school‐based health initiatives. Conclusion This study demonstrates that a virtual nutrition intervention for teachers, with combined synchronous and asynchronous learning, can lead to sustained improvements in teachers' nutrition‐related role modeling abilities and classroom nutrition practices.

Cracks in the Foundation: The Association of Physical Condition of School Facilities With Absenteeism and Test Scores in Maryland*

ABSTRACT Background Poor physical conditions of school facilities are linked to poor health, lower test scores, and higher rates of chronic absenteeism. Methods We conducted a cross‐sectional analysis using data on physical conditions of school facilities, absenteeism, and test scores for 1266 K‐12 school facilities representing 1388 schools (which may share school facilities) in Maryland. We analyzed the results by race and ethnicity of students and by the area deprivation index. Results Students in schools in the 10th decile for poor physical conditions experienced significantly higher rates of chronic absenteeism and significantly lower SAT, ACT, and Maryland state test scores. Black and Hispanic students were significantly more likely to attend these schools. The significant association between poor school facility conditions and educational outcomes is limited to communities with high socioeconomic deprivation. Implications for School Health Policy, Practice, and Equity Policymakers should consider investments in school infrastructure in under‐resourced communities to close educational gaps and help every child succeed. Conclusions In Maryland communities with high socioeconomic deprivation, poor school facility conditions are associated with greater absenteeism and lower test scores, disproportionately affecting Black and Hispanic children.

Birth Prevalence and Characteristics of Septo‐Optic Dysplasia in Australia: Results From the Australian Paediatric Surveillance Unit

Picking Up the Phone: Clinical Perspectives on Recontacting Patients and Their Families

ABSTRACT Aims When test results are reanalysed after a patient has been discharged from a service, ‘recontact’ can be necessary to inform them of pertinent new information. This scoping review aims to investigate perspectives of clinical healthcare professionals on this recontact and its associated considerations. Methods We searched Medline and Embase for studies investigating the perspectives of healthcare professionals on patient recontact. Results Of 518 articles identified, 13 articles were included in the review. All 13 articles examined recontact in the setting of genetics. There was a consensus that recontact can be necessary, but there was disagreement about where the responsibility to initiate it lies. Challenges identified included logistical strain and validating patient consent. Conclusion Patient recontact is seen as important, but concerns around workload drive a lack of consensus around where the responsibility to recontact lies. There is scope for more research on the implications of recontact outside the field of genetics, and clarification is needed around reasonable expectations of recontact in different clinical situations.

Beyond Resilience: Resources, Respect and Recognition in Global Universal Mental Health Nursing Reform

Sleep Fragmentation and Sleep Stages 1 and 2 Are Associated With Amyloid‐Beta Burden in Cognitively Normal Older Adults

ABSTRACT Insomnia increases the risk of Alzheimer's disease and is associated with increased amyloid‐β (Aβ) levels, but assessments using rigorous objective measures are lacking. The purpose of this cross‐sectional study was to determine the association between sleep characteristics and Aβ burden using polysomnography and positron emission tomography (PET). Cognitively normal older adults (ages 60–85) with symptoms of insomnia underwent PET and overnight polysomnography. Pearson correlations determined the association between sleep variables and the standard uptake values ratio (SUVR) within global cerebral cortex, precuneus, posterior cingulate cortex (PCC), and the medial prefrontal cortex (mPFC). Multivariable stepwise regression was performed for each region of interest with apolipoprotein‐ε (APOE) genotype and age as potential covariates. Sleep parameters between those who were Aβ elevated vs. non‐elevated were compared using t ‐tests. Forty‐three adults (69.3 ± 5.5 years old; 32.6% Aβ elevated; mostly non‐Hispanic white and female) were included in analyses. Longer stage 1 was related to greater cortical and mPFC SUVR, greater wake after sleep onset was related to greater cortical, mPFC, and precuneus SUVR, and shorter stage 2 was associated with greater PCC SUVR. Compared to those who were Aβ non‐elevated, those who were Aβ elevated had longer stage 1 and shorter stage 2 sleep. Greater sleep fragmentation, longer stage 1 sleep, and shorter stage 2 sleep were associated with greater Aβ burden in various regions of the brain in cognitively normal older adults. The results support poor sleep as an early risk factor for Aβ accumulation and possible target for Alzheimer's prevention. Trial Registration: The study was registered on clinicaltrials.gov (NCT03954210).

Predicting Sleep and Sleep Stage in Children Using Actigraphy and Heartrate via a Long Short‐Term Memory Deep Learning Algorithm: A Performance Evaluation

ABSTRACT Children's ambulatory sleep is commonly measured via actigraphy. However, traditional actigraphy measured sleep (e.g., Sadeh algorithm) struggles to predict wake (i.e., specificity, values typically < 70) and cannot predict sleep stages. Long short‐term memory (LSTM) is a machine learning algorithm that may address these deficiencies. This study evaluated the agreement of LSTM sleep estimates from actigraphy and heartrate (HR) data with polysomnography (PSG). Children ( N  = 238, 5–12 years, 52.8% male, 50% Black 31.9% White) participated in an overnight laboratory polysomnography. Participants were referred because of suspected sleep disruptions. Children wore an ActiGraph GT9X accelerometer and two of three consumer wearables (i.e., Apple Watch Series 7, Fitbit Sense, Garmin Vivoactive 4) on their non‐dominant wrist during the polysomnogram. LSTM estimated sleep versus wake and sleep stage (wake, not‐REM, REM) using raw actigraphy and HR data for each 30‐s epoch. Logistic regression and random forest were also estimated as a benchmark for performance with which to compare the LSTM results. A 10‐fold cross‐validation technique was employed, and confusion matrices were constructed. Sensitivity and specificity were calculated to assess the agreement between research‐grade and consumer wearables with the criterion polysomnography. For sleep versus wake classification, LSTM outperformed logistic regression and random forest with accuracy ranging from 94.1 to 95.1, sensitivity ranging from 94.9 to 95.9 across different devices, and specificity ranging from 84.5 to 89.6. The addition of HR improved the prediction of sleep stages but not binary sleep versus wake. LSTM is promising for predicting sleep and sleep staging from actigraphy data, and HR may improve sleep stage prediction.

Move, Rove, Love: Color Cues Help Learning Novel English Words When Pronunciation Is Not Predictable From Spelling

Abstract Seeing written forms of novel words during learning can help memorize vocabulary, but it may alter pronunciation, especially when orthography is opaque like in English. This study investigated whether a color‐code helps participants learn novel words with unpredictable pronunciation. Sixty Spanish speakers learned 16 English‐like pseudowords in one of three training conditions. Audio group learned training items with the auditory word form only. Two other groups learned items with auditory and written forms, with a color‐code ( ColorCode group) or with random colors ( RandColor group). Elicited speech samples from each group were assessed for recall and pronunciation accuracy. ColorCode group outperformed other groups on pronunciation in posttest tasks including reading training items in black text, and reading color‐coded untrained items. Color‐code benefits even strengthened one week later. These findings indicate that a color‐code can support pronunciation learning in languages with opaque orthography and should be more systematically implemented in learning resources.