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SES was a moderator of the association(pINTERACTION = 0·038). HRs for Q1 vs. Q5 were 1·66 (1·22-2·.27) in low, 2·76 (1·86-4·08) in middle and 2·46 (1·53-3·97) in high SES. With population attributable fractions of 14·8%, 40·1% and 37·3%, the expected number of cases/1000 person-years preventable by diet quality improvement was 0·85 in low, 1·28 in middle and 0·90 in high SES. Interpretation Diet quality improvement can potentially prevent one in three cases of type 2 diabetes, but because of a smaller impact in low SES, it will not narrow the socioeconomic health gap in diabetes burden. Funding None. © 2019 Published by Elsevier Ltd.Background An average adult American consumes sulfur amino acids (SAA) at levels far above the Estimated Average Requirement (EAR) and recent preclinical data suggest that higher levels of SAA intake may be associated with a variety of aging-related chronic diseases. However, there are little data regarding the relationship between SAA intake and chronic disease risk in humans. The aim of this study was to examine the associations between consumption of SAA and risk factors for cardiometabolic diseases. Methods The sample included 11,576 adult participants of the Third National Examination and Nutritional Health Survey (NHANES III) Study (1988-1994). The primary outcome was cardiometabolic disease risk score (composite risk factor based on blood cholesterol, triglycerides, HDL, C-reactive protein (CRP), uric acid, glucose, blood urea nitrogen (BUN), glycated hemoglobin, insulin, and eGFR). Group differences in risk score by quintiles of energy-adjusted total SAA, methionine (Met), and cysteine (Cys) intake wet have any funding. © 2019 Published by Elsevier Ltd.Background Sudden infant death syndrome (SIDS) is the leading cause of postneonatal mortality. Although the rate has plateaued, any unexpected death of an infant is a family tragedy thus finding causes and contributors to risk remains a major public health concern. The primary objective of this investigation was to determine patterns of drinking and smoking during pregnancy that increase risk of SIDS. Methods The Safe Passage Study was a prospective, multi-center, observational study with 10,088 women, 11,892 pregnancies, and 12,029 fetuses, followed to 1-year post delivery. Subjects were from two sites in Cape Town, South Africa and five United States sites, including two American Indian Reservations. Group-based trajectory modeling was utilized to categorize patterns of drinking and smoking exposure during pregnancy. Findings One-year outcome was ascertained in 94·2% infants, with 28 SIDS (2·43/1000) and 38 known causes of death (3·30/1000). The increase in relative risk for SIDS, adjusted for key demographtion Disorders. © 2019 Published by Elsevier Ltd.Background UK and European guidelines recommend HIV testing in general practice. We report on the implementation of the Rapid HIV Assessment trial (RHIVA2) promoting HIV screening in general practice into routine care. Methods Interrupted time-series, difference-in-difference analysis and Pearson-correlation on three cohorts comprising 42 general practices in City & Hackney (London, UK); covering three periods pre-trial (2009-2010), trial (2010-2012) and implementation (2012-2014). Cohorts comprised practices receiving "trial intervention" only (n = 19), "implementation intervention" only (n = 13); and neither ("comparator") (n = 10). Primary outcomes were HIV testing and diagnosis rates per 1000 people and CD4 at diagnosis. Findings Overall, 55,443 people were tested (including 38,326 among these cohorts), and 101 people were newly diagnosed HIV positive (including 65 among these cohorts) including 74 (73%) heterosexuals and 69 (68%) people of black African/Caribbean background; with mean CD4 count at diagnoner-city practices with high HIV prevalence increased HIV testing, and may be associated with increased and earlier diagnosis. HIV screening in primary care should be considered a key strategy to reduce undiagnosed infection particularly among high risk persons not attending sexual health services. Funding National Institute for Health Research ARC North Thames, and Barts and The London School of Medicine and Dentistry. © 2019 Published by Elsevier Ltd.Background Determining which babies should receive antibiotics for potential early onset sepsis (EOS) is challenging. We performed a meta-analysis quantifying how many EOS cases might be 'missed' using the Kaiser Permanente electronic calculator, compared with National Institute for Health and Care Excellence (NICE) guidelines. Methods A systematic literature search was carried out for studies citing the article in which the calculator was publicised. Studies were eligible if they presented data evaluating the calculator, either by retrospective case review or prospective cohort study. The primary outcome measure was numbers of culture positive EOS cases where the calculator did not recommend empirical antibiotics, but NICE guidelines would have. Data were pooled using a random effect meta-analysis. A subgroup analysis was performed using data from studies of babies exposed to chorioamnionitis. Findings Eleven studies were included. There were a total of 75 EOS cases across the studies and a minimum of 14 (best case scenario), and a maximum of 22 (worst case scenario) cases where use of the calculator would have resulted in delayed or missed treatment, compared to if NICE guidelines had been followed. The probability of missed/delayed treatment for an EOS case were best case 0.19 [95% confidence intervals 0.11 - 0.29], worst case 0.31 [95% CI 0.17 - 0.49]. The probability of missing cases was significantly more in babies exposed to chorioamnionitis. Interpretation A large proportion of EOS cases were 'missed' by the calculator. Further evaluation of the calculator is recommended before it is introduced into UK clinical practice. Funding None. © 2019 Published by Elsevier Ltd.Background Septo-optic dysplasia (SOD) is a heterogeneous congenital condition. The aim of this study was to investigate the clinical phenotypes of a large cohort of children with SOD, Multiple Pituitary Hormone Deficiency (MPHD) and Optic Nerve Hypoplasia (ONH), with a focus on endocrine testing. Methods Retrospective single-centre longitudinal study of children with SOD (n171), MPHD (n53) and ONH (n35). SOD+ and SOD- indicate patients with or without hypopituitarism, respectively. Findings All deficits were more frequent and occurred earlier in MPHD than SOD+ [Hazard Ratios (HR) 0·63(0·45,0·89) for GH, 0·48(0·34,0·69) for TSH, 0·55(0·38,0·80) for ACTH, 0·28(0·11,0·68) for gonadotropins], except Diabetes Insipidus (DI) [HR 2·27(0·88,5·9)]. Severe hypothalamo-pituitary (H-P) abnormalities were more frequent in MPHD [80·0% vs 41·6%, p less then 0·0001 for Ectopic Posterior Pituitary (EPP)]. Selleck MRTX1719 Stalk and PP abnormalities were associated with more severe endocrine phenotypes and placed a subgroup of SOD+ at risk of developing deficits earlier.