Despite widespread availability of curative therapy, tuberculosis treatment outcomes remain suboptimal. Clinical prediction models can inform treatment strategies to improve outcomes. Using baseline clinical data, we developed a prediction model for unsuccessful TB treatment outcome and evaluated the incremental value of HIV-related severity and isoniazid acetylator status. Data originated from the Regional Prospective Observational Research for Tuberculosis Brazil cohort, which enrolled newly-diagnosed tuberculosis patients in Brazil from 2015-2019. This analysis included participants with culture-confirmed, drug-susceptible pulmonary tuberculosis who started first-line anti-tuberculosis therapy and had ≥12 months of follow-up. The endpoint was unsuccessful tuberculosis treatment composite of death, treatment failure, regimen switch, incomplete treatment, or not evaluated. Missing predictors were imputed. Predictors were chosen via bootstrapped backward selection. Discrimination and calibration were evaleadily available at treatment initiation, performed well in this population. The findings may guide future work to allocate resources or inform targeted interventions for high-risk patients. Patients diagnosed with isolated rapid eye movement (REM) sleep behavior disorder (iRBD) and Parkinson's disease (PD) have altered sleep stability reflecting neurodegeneration in brainstem structures. We hypothesize that neurodegeneration alters the expression of cortical arousals in sleep. We analyzed polysomnography data recorded from 88 healthy controls (HC), 22 iRBD patients, 82 de novo PD patients without RBD and 32 with RBD (PD+RBD). These patients were also investigated at a 2-year follow-up. Arousals were analyzed using a previously validated automatic system, which used a central EEG lead, electrooculography, and chin electromyography. Multiple linear regression models were fitted to compare group differences at baseline and change to follow-up for arousal index (ArI), shifts in electroencephalographic signals associated with arousals, and arousal chin muscle tone. The regression models were adjusted for known covariates affecting the nature of arousal. In comparison to HC, patients with iRBD and PD+RBD showed increased ArI during REM sleep and their arousals showed a significantly lower shift in α-band power at arousals and a higher muscle tone during arousals. In comparison to HC, the PD patients were characterized by a decreased ArI in NREM sleep at baseline. ArI during NREM sleep decreased further at the 2-year follow-up, although not significantly. Patients with PD and iRBD present with abnormal arousal characteristics as scored by an automated method. These abnormalities are likely to be caused by neurodegeneration of the reticular activation system due to alpha-synuclein aggregation.Patients with PD and iRBD present with abnormal arousal characteristics as scored by an automated method. These abnormalities are likely to be caused by neurodegeneration of the reticular activation system due to alpha-synuclein aggregation. Although researchers have linked intergenerational emotional cohesion (IEC) to psychological well-being (PWB) among older adults, the mechanisms and conditions under which IEC is related to PWB-particularly in rural areas-are less well understood. Raf inhibitor This study analyzed data from rural China to examine whether loneliness mediated the relation between IEC and PWB, and whether friendship ties moderated the strength of the direct and indirect relationships between IEC and PWB. Mediation and moderated mediation models were tested using a sample of rural adults age 60 and older (N = 958) from the Longitudinal Study of Older Adults in Anhui Province, China. Measures included IEC, friendship ties, loneliness, and two PWB indicators-depressive symptoms and life satisfaction. The results revealed that IEC was negatively related to loneliness, which in turn was associated with depressive symptoms and life satisfaction. Further, this indirect pathway linking IEC and depressive symptoms (but not life satisfaction) was positively conditioned on the size of friendship ties. This study advances our understanding of the mechanism through which IEC influences PWB in older adults. Alleviating loneliness could help boost PWB. Other implications for practice and future research are discussed.This study advances our understanding of the mechanism through which IEC influences PWB in older adults. Alleviating loneliness could help boost PWB. Other implications for practice and future research are discussed. Cytomegalovirus (CMV) viremia is common in HIV infection, and is associated with worse long-term outcomes. To date, no studies have assessed CMV viremia in children diagnosed with HIV in hospital. We studied CMV viremia and clinical outcomes in 163 Kenyan children aged 2 months-12 years, diagnosed with HIV in hospital. CMV DNA levels in plasma were measured using quantitative PCR. Regression models were used to assess associations between CMV viremia >1000 IU/mL and the risk of continued hospitalization or death at 15 days, duration of hospitalization, and 6-month mortality. At enrollment, 62/114 (54%) children had CMV viremia, and 20 (32%) were >1000 IU/mL. Eleven CMV reactivations were observed after admission. The prevalence and level of CMV viremia were highest in children <2 years and lowest in children >5 years old. CMV viremia >1000 IU/mL was independently associated with age < 2 years (p=0.03), higher log10 HIV RNA level (p=0.01), and height-for-age z score <-2 (p=0.02). Adjusting for age and log10 HIV RNA, the relative risk of death or continued hospitalization at 15 days was 1.74 (95%CI=1.04, 2.90), and the hazard ratio of 6-month mortality was 1.97 (95%CI=0.57, 5.07) for children with CMV DNA ≥1000 IU/ml compared to lower-level or undetectable CMV DNA. Children with CMV DNA ≥1000 IU/ml were hospitalized a median ~5 days longer than children with lower-level or undetectable CMV DNA (p=0.002). In this nested observational study, CMV viremia was common in hospitalized children with HIV, and levels ≥1000 IU/mL were associated with increased risk of mortality and longer hospitalization.In this nested observational study, CMV viremia was common in hospitalized children with HIV, and levels ≥1000 IU/mL were associated with increased risk of mortality and longer hospitalization.

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