Tag: nevin manimala

Circ Cardiovasc Qual Outcomes. 2024 Nov;17(11):e010629. doi: 10.1161/CIRCOUTCOMES.123.010629. Epub 2024 Nov 19.

ABSTRACT

BACKGROUND: There is limited international agreement on defining care quality for the millions of people hospitalized with heart failure worldwide. Our objective was to compare and measure agreement across existing internationally published quality indicators (QIs) for the care of adults hospitalized for heart failure.

METHODS: Systematic review and evidence gap map of internationally published articles reporting on QIs for adults hospitalized for heart failure, using PubMed, MEDLINE, EMBASE, and TRIP from inception to July 18, 2022. Narrative synthesis and descriptive statistics characterized included articles and QIs using the Donabedian Framework of Structural, Process, and Outcomes. The methodological quality of QI sets was assessed using the Appraisal of Indicators through Research and Evaluation instrument. Agreement about QIs was defined as having at least 3 different cardiovascular societies recommend its use. An evidence gap map displayed each QI according to its clinically relevant category, methodological quality, and reporting articles.

RESULTS: Fourteen articles from 11 societies reported 75 unique QIs; 53 QIs were process, 16 were structural, and 7 were outcome measures. There was limited agreement on individual QIs across sets as a minority were recommended by ≥3 societies (12%; 9/75 QIs). The most common QIs included postdischarge follow-up (73%, 8/11 societies), specific pharmacotherapy (64%, 7/11 societies), patient education (45%, 5/11 societies), assessment of left ventricular ejection fraction (45%, 5/11 societies), 30-day readmission rate (45%, 5/11 societies), cardiac rehabilitation (36%, 4/11 societies), and multidisciplinary management (27%, 3/11 societies).

CONCLUSIONS: There was little agreement on defining high-quality care and limited agreement on measures including postdischarge follow-up, specific pharmacotherapies, patient education, assessment of left ventricular ejection fraction, 30-day readmission, cardiac rehabilitation, and multidisciplinary management. These measures may define high-quality care and highlight opportunities to improve the quality of care for adults hospitalized for heart failure.

PMID:39561228 | DOI:10.1161/CIRCOUTCOMES.123.010629

PLOS Digit Health. 2024 Nov 19;3(11):e0000650. doi: 10.1371/journal.pdig.0000650. eCollection 2024 Nov.

ABSTRACT

OBJECTIVES: Despite the development of efficacious wellness interventions, sustainable wellness behavior change remains challenging. To optimize engagement, initiating small behaviors that build upon existing practices congruent with individuals’ lifestyles may promote sustainable wellness behavior change. In this study, we crowd-sourced helpful, flexible, and engaging wellness practices to identify a list of those commonly used for improving sleep, productivity, and physical, emotional, and social wellness from participants who felt they had been successful in these dimensions.

METHOD: We recruited a representative sample of 992 U.S. residents to survey the wellness dimensions in which they had achieved success and their specific wellness practices.

RESULTS: Responses were aggregated across demographic, health, lifestyle factors, and wellness dimension. Exploration of these data revealed that there was little overlap in preferred practices across wellness dimensions. Within wellness dimensions, preferred practices were similar across demographic factors, especially within the top 3-4 most selected practices. Interestingly, daily wellness practices differ from those typically recommended as efficacious by research studies and seem to be impacted by health status (e.g., depression, cardiovascular disease). Additionally, we developed and provide for public use a web dashboard that visualizes and enables exploration of the study results.

CONCLUSIONS: Findings identify personalized, sustainable wellness practices targeted at specific wellness dimensions. Future studies could leverage tailored practices as recommendations for optimizing the development of healthier behaviors.

PMID:39561203 | DOI:10.1371/journal.pdig.0000650

PLoS One. 2024 Nov 19;19(11):e0314005. doi: 10.1371/journal.pone.0314005. eCollection 2024.

ABSTRACT

Limited research has assessed the accuracy of imputation methods in aerobiological datasets. We conducted a simulation study to evaluate, for the first time, the effectiveness of Gappy Singular Value Decomposition (GSVD), a data-driven approach, comparing it with the moving mean interpolation, a statistical approach. Utilizing complete pollen data from two monitoring stations in northeastern Italy for 2022, we randomly generated missing data considering the combination of various proportions (5%, 10%, 25%) and gap lengths (3, 5, 7, 10 days). We imputed 4800 time series using the GSVD algorithm, specifically implemented for this study, and the moving mean algorithm of the “AeRobiology” R package. We assessed imputation accuracy by calculating the Root Mean Square Error and employed multiple linear regression models to identify factors independently affecting the error (e.g. pollen variability, simulation settings). The results showed that the GSVD was as good as the well-established moving mean method and demonstrated its strong generalization capabilities across different data types. However, the imputation error was primarily influenced by pollen characteristics and location, regardless of the imputation method used. High variability in pollen concentrations and the distribution of missing data negatively affected imputation accuracy. In conclusion, we introduced and tested a novel imputation method, demonstrating comparable performance to the statistical approach in aerobiological data reconstruction. These findings contribute to advancing aerobiological data analysis, highlighting the need for improving imputation methods.

PMID:39561200 | DOI:10.1371/journal.pone.0314005

PLoS Comput Biol. 2024 Nov 19;20(11):e1012592. doi: 10.1371/journal.pcbi.1012592. Online ahead of print.

ABSTRACT

Bovine tuberculosis (bTB) has significant socio-economic and welfare impacts on the cattle industry in parts of the world. In the United Kingdom and Ireland, disease control is complicated by the presence of infection in wildlife, principally the European badger. Control strategies tend to be applied to whole populations, but better identification of key sources of transmission, whether individuals or groups, could help inform more efficient approaches. Mechanistic transmission models can be used to better understand key epidemiological drivers of disease spread and identify high-risk individuals and groups if they can be adequately fitted to observed data. However, this is a significant challenge, especially within wildlife populations, because monitoring relies on imperfect diagnostic test information, and even under systematic surveillance efforts (such as capture-mark-recapture sampling) epidemiological events are only partially observed. To this end we develop a stochastic compartmental model of bTB transmission, and fit this to individual-level data from a unique > 40-year longitudinal study of 2,391 badgers using a recently developed individual forward filtering backward sampling algorithm. Modelling challenges are further compounded by spatio-temporal meta-population structures and age-dependent mortality. We develop a novel estimator for the individual effective reproduction number that provides quantitative evidence for the presence of superspreader badgers, despite the population-level effective reproduction number being less than one. We also infer measures of the hidden burden of infection in the host population through time; the relative likelihoods of competing routes of transmission; effective and realised infectious periods; and longitudinal measures of diagnostic test performance. This modelling framework provides an efficient and generalisable way to fit state-space models to individual-level data in wildlife populations, which allows identification of high-risk individuals and exploration of important epidemiological questions about bTB and other wildlife diseases.

PMID:39561196 | DOI:10.1371/journal.pcbi.1012592

PLoS Genet. 2024 Nov 19;20(11):e1011483. doi: 10.1371/journal.pgen.1011483. Online ahead of print.

ABSTRACT

Meta-analysis is used to aggregate the effects of interest across multiple studies, while its methodology is largely underexplored in mediation analysis, particularly in estimating the total mediation effect of high-dimensional omics mediators. Large-scale genomic consortia, such as the Trans-Omics for Precision Medicine (TOPMed) program, comprise multiple cohorts with diverse technologies to elucidate the genetic architecture and biological mechanisms underlying complex human traits and diseases. Leveraging the recent established asymptotic standard error of the R-squared (R2)-based mediation effect estimation for high-dimensional omics mediators, we have developed a novel meta-analysis framework requiring only summary statistics and allowing inter-study heterogeneity. Whereas the proposed meta-analysis can uniquely evaluate and account for potential effect heterogeneity across studies due to, for example, varying genomic profiling platforms, our extensive simulations showed that the developed method was more computationally efficient and yielded satisfactory operating characteristics comparable to analysis of the pooled individual-level data when there was no inter-study heterogeneity. We applied the developed method to 5 TOPMed studies with over 5800 participants to estimate the mediation effects of gene expression on age-related variation in systolic blood pressure and sex-related variation in high-density lipoprotein (HDL) cholesterol. The proposed method is available in R package MetaR2M on GitHub.

PMID:39561194 | DOI:10.1371/journal.pgen.1011483

Am J Health Promot. 2024 Nov 19:8901171241302001. doi: 10.1177/08901171241302001. Online ahead of print.

ABSTRACT

PURPOSE: Given the high prevalence of food insecurity among college students, there is an interest in identifying whether the use of a single item can adequately screen for food insecurity. The current study aimed to determine the validity of a single-item food insecurity screening question among college students.

DESIGN: Cross-sectional study exploring food insecurity among racial and ethnic undergraduate college students.

SETTING: Large urban U.S. research university.

SAMPLE: Undergraduate students (n = 667) 18 years or older.

MEASURES: Food Insecurity screening was assessed via a single-item from the USDA Household Food Security Short Form (USDA FSSM-SF). Food security was assessed via the USDA FSSM-SF, a validated six-item scale that assesses food insecurity and hunger.

ANALYSIS: Logistic regression assessed the validity of the single-item food insecurity question tested against the USDA FSSM-SF.

RESULTS: The full model was statistically significant, χ2(1) = 161.44, P < .001 explaining 54.5% of the variance in food insecurity status correctly classifying 95.7% of cases. Sensitivity of the model was found to be 97.6%; specificity was found to be 69.6%. Positive predictive value was calculated to be 97.74%; negative predictive value was computed to be 68.09%.

CONCLUSION: Results support for the test validity of a single-item screening question that can be used to detect food insecurity among college students and inform secondary prevention programs aimed at food insecurity.

PMID:39561187 | DOI:10.1177/08901171241302001

PLoS One. 2024 Nov 19;19(11):e0312684. doi: 10.1371/journal.pone.0312684. eCollection 2024.

ABSTRACT

BACKGROUND: Evidence indicates that criminal behaviour in youth is linked with a range of negative physical, mental, and social health consequences. Despite a global decrease over the last 30 years, youth crime remains prevalent. Identifying and mapping the most robust risk and protective factors, and intervention strategies for youth crime could offer important keys for predicting future offense outcomes and assist in developing effective preventive and early intervention strategies. Current reviews in the area do not include literature discussing at risk populations such as First Nations groups from countries such as Australia, Canada and New Zealand. This is a critical gap given the disproportionally high rates of incarceration and youth detention among First Nations people globally, particularly in countries with a colonial past. The aim of this scoping review is to identify and map the key risk and protective factors, along with intervention strategies, that are essential for recognizing adolescents and young adults at risk of crime.

METHODS: This scoping review protocol has been developed in line with the Arksey and O’Malley framework and the Joanna Briggs Institute (JBI) Reviewers’ Manual. The review protocol was preregistered with Open Science Framework (https://osf.io/kg4q3). ProQuest, PubMed, Web of Science, Scopus, and PsycInfo were used to retrieve relevant articles. Grey literature was searched using Google searches and ProQuest dissertations databases. Original research articles examining protective factors, risk factors, and intervention strategies for prevention and reduction of crime in 12-24-year-olds were included. Two independent reviewers conducted eligibility decisions and data extraction. Findings has been reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.

CONCLUSION: Anticipated findings suggest that current research has extensively examined factors across all levels of the socioecological model, from individual to community levels, revealing a predominant focus on individual-level predictors such as substance use, prior criminal history, and moral development. The review is expected to identify effective interventions that address critical factors within each domain, including Multisystemic Therapy (MST) and Multidimensional Treatment Foster Care (MTFC), which have shown promise in reducing youth crime. Additionally, it will likely highlight significant trends in risk and protective factors, such as the dual role of academic achievement-both as a risk and protective factor-and the impact of family-based interventions. The review will also address gaps in research, particularly regarding Indigenous youth, underscoring the need for targeted studies to better understand their unique challenges. These findings will guide future research and inform the development of comprehensive prevention and early intervention programs tailored to diverse youth populations.

PMID:39561166 | DOI:10.1371/journal.pone.0312684

Genet Med. 2024 Nov 15:101330. doi: 10.1016/j.gim.2024.101330. Online ahead of print.

ABSTRACT

PURPOSE: Exome and genome sequencing (ES, GS) are useful tests to diagnose rare disease in pediatric patients in critical care settings. Genomic test stewardship can increase appropriate use of these tests leading to improved diagnostics and cost savings.

METHODS: Mandatory review of ES and GS orders for admitted patients was implemented in March 2023. Outcomes of the reviews, cost analysis, and subsequent test results through February 2024 were analyzed with descriptive statistics.

RESULTS: There were 444 Genetic Test Request (GTR) orders placed for 412 unique patients. Of these, 81 (18.2%) were redirected and 57 (12.8%) required modification after approval leading to an overall cost savings of $345,821.00 USD or $778 USD per order. The combined diagnostic rate was 28.2% in this patient population.

CONCLUSION: Stewardship of ES/GS orders for pediatric inpatients is an effective tool to improve appropriate usage of these genomic tests. Additional collaboration with stakeholders and expansion of genomic stewardship initiatives may shorten the diagnostic odyssey for critically ill pediatric patients and result in cost savings.

PMID:39559977 | DOI:10.1016/j.gim.2024.101330

East Mediterr Health J. 2024 Sep 1;30(8):561-569. doi: 10.26719/2024.30.8.561.

ABSTRACT

BACKGROUND: Pediculus humanus capitis (head lice) infestation is a global health concern, yet no study has examined its occurrence among primary school children in Tunisia.

AIM: To assess the prevalence of Pediculus capitis and its epidemiological characteristics among primary school children living in rural and urban areas of Monastir, Tunisia.

METHODS: We used 2-step stratified cluster sampling to randomly select 2396 children from 14 primary schools in Monastir during the 2022/2023 academic year. Head lice infestation was assessed through visual inspection of the hair, and data on the socio-demographic characteristics, lifestyle and pediculosis history of the children were collected. We used SPSS version 20 to analyse the data and used descriptive statistics to rate the frequencies. Multivariate logistic regression was used to examine the association between pediculosis and the predictor variables.

RESULTS: Overall infestation rate was 17.5% (95% CI 16.0-19.1%); infestation was 5 times higher among girls (29.1%) than boys (6.3%). Schoolchildren living in crowded family households, those in the third and fourth grades and whose parents had low education level were more exposed to infestation. Combing frequency, comb sharing and history of previous infestation had significant impact (P < 0.05) on the prevalence of pediculosis. Multivariate logistic regression showed gender and treatment outcome as the main potentiating factors.

CONCLUSION: These findings highlight the need for pediculosis prevention and integrated health promotion programmes among primary school children and their parents, teachers and nurses in Monastir and other parts of Tunisia.

PMID:39559973 | DOI:10.26719/2024.30.8.561

Pediatr Transplant. 2024 Dec;28(8):e14894. doi: 10.1111/petr.14894.

ABSTRACT

BACKGROUND: Rejection remains an important cause of morbidity and mortality after pediatric heart transplantation (HT). Endomyocardial biopsy (EMB) is the gold standard for rejection diagnosis, but it comes with procedural risk. The frequency of EMB varies significantly across centers. Since April 2018, our center’s surveillance EMB schedule is based on a rejection risk prediction score employing age, pre-HT diagnosis, and panel reactive antibodies (PRA). We aimed to evaluate outcomes in the 1st year post-HT before and after risk score implementation.

METHODS: Patients who underwent HT at our center at ≤ 18 years of age from January 2015 to December 2020 were reviewed. The primary endpoint was rejection-free survival at 1 year-post- HT. Clinical characteristics were compared for patients transplanted in Era 1 (January 2015-April 2018) and Era 2 (April 2018-December 2020). Cumulative 1-year survival free from rejection and from rejection with hemodynamic compromise (RHC) was compared between eras using Kaplan-Meier survival analysis.

RESULTS: 115 patients underwent HT during our study period (52 in Era 1 and 63 in Era 2). There was an increase in VAD utilization between eras (19% in Era 1 vs. 40% in Era 2, p = 0.025), but otherwise no significant difference in demographic or clinical variables between the two eras. No statistically significant difference in freedom from rejection or freedom from RHC was identified between the two eras. There was a 60% reduction in the median number of EMB per patient in the first year post-HT after employing the score (5 in Era 1 vs. 2 in Era 2, p < 0.001).

CONCLUSIONS: After employing a rejection risk prediction score, our center decreased the frequency of EMB without worsening early post-HT outcomes, thus establishing the clinical applicability of this tool.

PMID:39559942 | DOI:10.1111/petr.14894