CONCLUSIONS: The cardio-obstetric referral population exhibited a high overall SVI. Higher social vulnerability was associated with delayed access to care but not independently associated with most adverse maternal and fetal pregnancy outcomes.

CONCLUSION: Repeated COH did not significantly alter overall gut microbial diversity in mice under the conditions tested. However, specific taxonomic shifts and biomark-er signatures were detected, indicating associations-not causality-between COH exposure and changes in microbi-ota composition. Further studies are needed to determine the functional and physiological implications of these as-sociations.

Complex lymphatic anomalies (CLAs) are a spectrum of lymphatic malformations affecting multiple organ systems. These disorders are characterized by a wide variability in presentation features, which often delays accurate diagnosis and complicates characterization and differentiation. Little is known about the gynecologic and reproductive effects of CLAs or their associated treatments, such as long term systemic immunosuppressive medications and repurposed single molecule inhibitors. In this case

A 69-year-old male individual with Child-Pugh class C alcoholic cirrhosis and 2-vessel coronary artery disease underwent combined robotic off-pump minimally invasive direct coronary artery bypass (MIDCAB) and simultaneous orthotopic liver transplant. The patient tolerated the procedure without complications, was extubated on postoperative day 1, and discharged home on day 9. At 15 months postprocedure he had preserved graft function, stable liver tests, and no major adverse cardiac events. This.