Tag: pubmed

J Glob Health. 2025 Mar 28;15:04079. doi: 10.7189/jogh.15.04079.

ABSTRACT

BACKGROUND: Modelling can contribute to disease prevention and control strategies. Accurate predictions of future cases and mortality rates were essential for establishing appropriate policies during the COVID-19 pandemic. However, no single model yielded definite conclusions, with each having specific strengths and weaknesses. Here we propose an ensemble learning approach which can offset the limitations of each model and improve prediction performances.

METHODS: We generated predictions for the transmission and impact of COVID-19 in South Korea using seven individual models, including mathematical, statistical, and machine learning approaches. We integrated these predictions using three ensemble methods: stacking, average, and weighted average ensemble (WAE). We used train and test errors to measure a model’s performance and selected the best covariate combinations based on the lowest train error. We then evaluated model performance using five error measures (r², weighted mean absolute percentage error (WMAPE), autoregressive integrated moving average (ARIMA), mean squared error (MSE), root mean squared error (RMSE), and mean absolute percentage error (MAPE)) and selected the optimal covariate combination accordingly. To validate the generalisability of our approach, we applied the same modelling framework to USA data.

RESULTS: Booster shot rate + Omicron variant BA.5 rate was the most commonly selected combination of covariates. For raw data evaluated using the WMAPE, individual models achieved the following: Generalised additive modelling (GAM) reached a value of 0.244 for the daily number of confirmed cases, a value of 0.172 for the time series Poisson for the daily number of confirmed deaths, and a value of 0.022 for both ARIMA and time series Poisson for the daily number of ICU patients. For smoothed data, the Holt-Winters model achieved a value of 0.058 for daily confirmed cases, while ARIMA attained a value of 0.058 for the daily number of confirmed deaths and 0.013 for the daily number of ICU patients. Among ensemble models, the SVM-based stacking ensemble achieved error values of 0.235 for the daily number of confirmed cases, 0.118 for the daily number of deaths, and 0.019 for the daily number of ICU patients on raw data. For smoothed data, the average ensemble and weighted average ensemble achieved 0.060 for the daily number of confirmed cases and 0.013 for daily ICU patients. The ensemble models also generalised well when applied to data from the USA.Booster shot rate + Omicron variant BA.5 rate was the most commonly selected combination of covariates. For raw data, GAM (0.244) predicted daily confirmed cases best, time series Poisson (0.172) predicted daily confirmed deaths, and both ARIMA and time series Poisson (0.022) predicted daily ICU patients, based on WMAPE. For smoothed data, time series Poisson predicted daily confirmed cases (0.065) best, while ARIMA best predicted daily confirmed deaths (0.058) and ICU patients (0.013). For ensemble models, stacking ensemble using SVM was the best model for predicting daily confirmed cases (0.228), deaths (0.11), and ICU patients (0.02). With smoothed data, average ensemble and WAE were the best models for predicting daily confirmed cases (0.058) and ICU patients (0.011). The performance of ensemble models was generalised to other countries using the USA data for predictive performance.

CONCLUSIONS: No single model performed consistently. While the ensemble models did not always provide the best predictions, a comparison of first-best and second-best models showed that they performed considerably better than the single models. If an ensemble model was not the best performing model, its performance was always not far from the best single model: a look at the mean and variance of the error measures shows that ensemble models provided stable predictions without much variation in their performances compared to single models. These results can be used to inform policymaking during future pandemics.

PMID:40146993 | DOI:10.7189/jogh.15.04079

JMIR Res Protoc. 2025 Mar 27;14:e66975. doi: 10.2196/66975.

ABSTRACT

BACKGROUND: Caregivers of persons with Alzheimer disease and related dementias (ADRD) neglect their health, including by ignoring stress levels. African American women are vulnerable and susceptible to hypertension. Chronic caregiving stress and hypertension place them at high risk for cardiovascular disease. Addressing stress reactivity or resilience is vital in lessening their caregiving stress, enhancing their quality of life (QOL), and fostering healthy blood pressure (BP) self-care behaviors.

OBJECTIVE: This pilot study aims to investigate the feasibility and acceptability of implementing the Mindfulness in Motion (MIM) plus the Dietary Approaches to Stop Hypertension (DASH) intervention in this population and to evaluate its effect on ADRD caregivers’ stress and QOL. Additionally, it explores the mediation of stress reactivity or resilience between interventions and self-care behaviors.

METHODS: A small randomized controlled trial pilot study will recruit 28 African American or Black female caregivers aged 40 years diagnosed with hypertension and on an antihypertensive medication. Participants will be randomly assigned to either the MIM DASH or the Alzheimer’s Association caregiver training group (attention control). Trained facilitators will deliver both interventions over 8 weeks through 1-hour, group, internet-based sessions, via video or telephone. After completion, both groups will receive coaching calls over 9 months, beginning with 8 weekly calls followed by 4 monthly calls to encourage use of the educational materials. Primary outcome measures include feasibility (recruitment and retention) and acceptability (attendance). Secondary measures assess caregiver stress (Perceived Stress Scale), QOL, and self-care behaviors (Food Frequency Questionnaire and self-reported physical activity). Data collection occurs at baseline, 3 months, and 9 months. Quantitative data will be analyzed using descriptive statistics, CIs, and mediation models.

RESULTS: This study was approved by the institutional review board in April 2022 and funded in May 2022. The first data were collected in January 2023, and the last data were collected in September 2024. The completion of all aims’ data analysis is anticipated in spring 2025. The participants’ mean age was 62.4 (SD 7.98) years, with a mean baseline systolic BP of 128 (SD 19) mm Hg and diastolic BP of 79 (SD 10) mm Hg. Participants reported that MIM DASH was acceptable (at a mean score of 59.08, SD 7.38, compared to 60.83, SD 5.56 for caregiver training). Regarding feasibility, as reflected in attendance, MIM DASH participants had a mean attendance of 6.3 (SD 2.3) sessions, and the caregiver training group had 4.9 (SD 2.9) sessions.

CONCLUSIONS: This study’s findings demonstrate the feasibility of conducting an internet-based intervention (MIM DASH) for African American women with hypertension who also care for families living with ADRD. These results will inform the design of a larger randomized controlled trial to evaluate the intervention’s efficacy and scalability further.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05721482; https://clinicaltrials.gov/study/NCT05721482.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/66975.

PMID:40146982 | DOI:10.2196/66975

PLoS One. 2025 Mar 27;20(3):e0306358. doi: 10.1371/journal.pone.0306358. eCollection 2025.

ABSTRACT

Nanofluids achieve high thermal transport efficiency by uniformly dispersing small particles in base liquids, significantly enhancing the heat transfer coefficients and making them vital in various thermal engineering applications. The research examines non-uniform thermal conductivity and activation energy critical for accurately describing fluid behaviour. The study incorporates bioconvection to prevent nanoparticle settling and ensure fluid stability through motile microorganisms. The governing partial differential equations are converted into ordinary differential equations that are solved using the Homotopy Analysis Method (HAM), to provide a strong mathematical framework for the analysis. This study finds that the velocity of the fluid decreases with magnetic constraint intensification and time retardation. however, heat transfer increases at higher radiation, and heat absorption/emission parameters but decreases with a higher Prandtl number, while an increased Schmidt number leads to decreased concentration profiles. This paper investigates a nano-Williamson fluid (NWF) flow over an exponentially stretched surface in a permeable medium, considering essential variables such as mixed convection, electromagnetic forces, non-linear thermal radiation, heat production, Joule heating and ohmic dissipation that are essential for understanding its complicated behavior.

PMID:40146967 | DOI:10.1371/journal.pone.0306358

JMIR Hum Factors. 2025 Mar 27. doi: 10.2196/67685. Online ahead of print.

ABSTRACT

BACKGROUND: Perinatal nurses are increasingly encountering patients who have engaged in perinatal substance use (PSU). Despite growing evidence demonstrating the need to reduce nurses’ stigmatizing attitudes toward PSU, limited interventions are available to target these attitudes and support behavior change – especially those that reflect the overwhelming evidence that education alone is insufficient to change practice behavior. Arts-based interventions are associated with increasing nursing empathy, changing patient attitudes, improving reflective practice, and decreasing stigma. We adapted ArtSpective™ for PSU, a previously evaluated arts-based intervention to reduce stigma among perinatal nurses, into an interactive digital responsive platform that facilitates intervention delivery asynchronously.

OBJECTIVE: This study aimed to evaluate the usability, acceptability, and feasibility of the interactive, responsive platform version of ArtSpective™ for PSU, designed to deliver an adapted version of the in-person intervention to improve nurses’ stigmatizing attitudes toward PSU, following a mixed methods approach. Our goal was to elicit user experience strengths and weaknesses related to the design of the responsive platform and identify strategies to overcome them.

METHODS: This study used a mixed-methods approach to explore the platform’s usability and user experience and its acceptability as an intervention to address stigma and implicit bias related to PSU. Theatre testing was used to qualitatively assess usability and acceptability perspectives with nurses and experts, as well as a modified version of the previously validated 8-item Abbreviated Acceptability Rating Profile for quantitative assessment. Analyses of quantitative data regarding acceptability and satisfaction were performed using descriptive statistics (mean, standard deviation, frequency, percentage). All qualitative data were analyzed iteratively using an inductive framework analysis approach.

RESULTS: A total of 21 nurses and four experts in stigma, implicit bias, and instructional design completed theatre-testing sessions. The mean duration of interviews for nurses was 31.92 (SD 11.32) minutes, and for experts, 40.73 (SD 8.57) minutes. All participants indicated that they found the digital adaptation of the intervention to be highly acceptable, with mean acceptability items ranging from 5.0 (SD 1.0) to 5.5 (SD 0.6) on a 1-6 agreement scale. Nurses reported high satisfaction with the platform on a 1-6 agreement scale, with mean satisfaction items ranging from 5.14 (SD 0.56) to 5.29 (SD 0.63) on a 1-6 agreement scale. 1,797 interview segments were coded from the theatre-testing sessions with four major themes: appearance, navigation, characterization, and overall platform, and 16 subthemes were identified. Consistent with the quantitative findings, the results were positive overall, with participants expressing high satisfaction related to the platform’s appearance, ease with which they could navigate the various modules, engagement, clarity of the presentation, and feasibility to be completed asynchronously.

CONCLUSIONS: Developing and evaluating the usability of a digital adaptation of ArtSpective™ for PSU resulted in strong support for the usability, acceptability, and satisfaction of the program and provided insight into key aspects related to acceptability and usability that should be considered when designing a digital adaptation of an arts-based intervention for healthcare providers.

PMID:40146964 | DOI:10.2196/67685

N Z Med J. 2025 Mar 28;138(1612):71-82. doi: 10.26635/6965.6823.

ABSTRACT

AIM: The 2006 New Zealand national multiple sclerosis (MS) prevalence study (NZMSPS) provided invaluable information about the prevalence of MS in Aotearoa and characteristics of people with this debilitating condition. This study aimed to update the NZMSPS by identifying people with MS using linked administrative health records.

METHODS: Cases of MS were identified from hospitalisation, pharmaceutical dispensing, needs assessments for older adults and disability support records between January 1988 and June 2022. MS prevalence was estimated, and characteristics described and compared by sub-groups.

RESULTS: A total of 7,890 people (73% female) with MS were identified across the study period. The estimated crude national prevalence of MS in 2022 was 96.6 per 100,000 (72.4 in 2006). MS prevalence exhibited a strong latitudinal gradient. Estimated age-adjusted prevalence was highest for Europeans (124.7 per 100,000), followed by Middle Eastern/Latin American/African (MELAA) (85.5), Māori (41.8), Asian (16.8) and Pacific peoples (11.1) ethnic groups.

CONCLUSION: Characteristics of MS cases were broadly similar to previous research, excepting a greater estimated prevalence among Māori, and a lower relative estimated prevalence for Auckland than surrounding regions. Linked administrative health data can be used to identify people with MS in Aotearoa, providing a mechanism for further research.

PMID:40146958 | DOI:10.26635/6965.6823

N Z Med J. 2025 Mar 28;138(1612):60-70. doi: 10.26635/6965.6718.

ABSTRACT

Using data extracted from the New Zealand Health Survey (NZHS), the purpose of this study was to compare lesbian, gay and bisexual people and heterosexual people on engagement with general practitioner (GP) and nursing services and patient experiences of GP services. Quantitative data spanning four waves of NZHS from the years 2017/2018 to 2020/2021 were used to undertake a comparative analysis of lesbian females, bisexual females, gay males, bisexual males and heterosexual males and females. Statistically significant differences were observed in the percentage of GP and nurse utilisation across sexual identity groups. Our analysis showed that both bisexual females and gay/bisexual males were significantly more likely to report poorer levels of trust in GPs and experience poorer explanation of doctors and health conditions. The findings of this study indicate that lesbian, gay and bisexual people have a poorer experience of GP services than do their heterosexual counterparts. These findings indicate the need for GPs and nurses to better understand the ways in which the health needs of lesbian, gay and bisexual people differ from those of heterosexuals to facilitate the provision of culturally appropriate care.

PMID:40146957 | DOI:10.26635/6965.6718

N Z Med J. 2025 Mar 28;138(1612):21-46. doi: 10.26635/6965.6789.

ABSTRACT

AIM: The aim of this study is to understand patterns and experiences of smoking and electronic cigarette use, as well as related attitudes and behaviours among adults in Aotearoa New Zealand who smoke or recently stopped smoking.

METHODS: We analysed data from the Evidence for Achieving Smokefree Aotearoa Equitably/International Tobacco Control New Zealand Survey (N=1,230), conducted between November 2020 and February 2021.

RESULTS: Among people who smoked, 77.5% (95% confidence interval [CI] 74.0-80.8%) reported regretting having started smoking, 73.6% (95% CI 69.5-77.4) intended to quit, 87.3% (95% CI 84.1-89.9) reported being addicted to smoking and 86.3% (95% CI 83.3-88.8) had tried to quit smoking in the past. Among people who smoked, 24.8% (95% CI 21.3-28.6) used electronic cigarettes (ECs) daily and 4.6% (95% CI 3.3-6.6) used heated tobacco products (HTPs) daily. Among people who had recently stopped smoking, 33.4% (95% CI 25.6-42.2) used ECs daily and less than 1% used HTPs daily.

CONCLUSION: High levels of regret for starting smoking, addiction and intent to quit smoking highlight the importance of implementing effective and equitable smokefree measures to prevent people from starting to smoke and to support people to stop smoking.

PMID:40146955 | DOI:10.26635/6965.6789

N Z Med J. 2025 Mar 28;138(1612):13-20. doi: 10.26635/6965.6774.

ABSTRACT

AIM: The aim was to determine whether changes made to the Southern Cochlear Implant Programme (SCIP) following a previous audit in 20141 have affected referral patterns, and to identify ongoing areas of potential need that may inform future service provision and organisational policy. The primary objective was to assess whether changes in referral patterns (specifically distance to referral centre, ethnicity) occurred following interventions in SCIP service provision. The secondary objective was to evaluate the distribution of socio-economic deprivation for referrals to SCIP.

METHODS: A retrospective review of all adult patients referred for consideration of cochlear implantation to the SCIP was conducted between 1 December 2014 and 1 December 2022. Distances to nearest SCIP referral centre were calculated based on patients’ regions of domicile. This was modelled with linear regression to assess the relationship between incidence of referrals and distance to nearest SCIP centre. Along with demographic data, this was compared to the 2014 audit and baseline New Zealand population demographics from the 2018 New Zealand Census.

RESULTS: In total, 793 individual patient referrals were identified and included. An improvement in referrals relative to distance to SCIP centre was demonstrated, along with a more even distribution of referrals across socio-economic groups. Assessment of ethnicity data was limited by the amount of unrecorded data.

CONCLUSION: Publicly funded cochlear implantation is currently a limited resource in New Zealand. Findings from this audit help assess both current and past service provisions, providing insights to guide future service developments. Interventions targeted at improving access to SCIP for those more geographically isolated from the service appear to be effective. These interventions, along with ongoing collection, audit and reporting of demographic data including ethnicity, should continue and help inform future service planning.

PMID:40146954 | DOI:10.26635/6965.6774

Womens Health (Lond). 2025 Jan-Dec;21:17455057251326008. doi: 10.1177/17455057251326008. Epub 2025 Mar 27.

ABSTRACT

BACKGROUND: In the United States, Black women have the second highest incidence of cervical cancer (CC) due to high incidence of human papillomavirus (HPV), slow HPV clearance rates, and low receipt of preventive pap smears and vaccines.

OBJECTIVE: A Black Feminist Thought framework was used to examine how the media portrayal of Black women, racial identity, and familial factors impact CC prevention behaviors among young Black women.

DESIGN: Black women enrolled at a large southeastern university consented and participated in an online mixed-methods survey examining facilitators and barriers to CC prevention behaviors. Quantitative items were analyzed via descriptive statistics, and qualitative items were thematically evaluated using an interpretative phenomenological analysis.

METHOD: Black undergraduate women completed an online survey that collected quantitative data on demographic information, CC knowledge, perceived eHealth literacy, and CC prevention behaviors. Participants also responded to seven qualitative items that explored how the media portrayal of Black women, racial identity, and familial factors impact their CC prevention behaviors.

RESULTS: Participants (N = 146) were Black college women aged 18-26 who primarily identified as cisgender, non-Hispanic/Latine/x, and heterosexual. Most participants self-reported as having high e-Health literacy (78.1%, n = 114) but demonstrated inadequate CC knowledge (90.3%, n = 131). All age-eligible participants received pap smears within their lifetime (n = 6), and most received at least one dose of the HPV vaccine (77.5%, n = 86), with the majority reporting series completion. Qualitative findings highlighted participants experiences of oppression co-existed with self-advocacy, primarily in medical settings.

CONCLUSION: Results provide insight for culturally tailored interventions in care settings serving young Black women that may encourage preventive care to reduce the prevalence of CC in later adulthood.

PMID:40146936 | DOI:10.1177/17455057251326008

Eur J Dent Educ. 2025 Mar 27. doi: 10.1111/eje.13090. Online ahead of print.

ABSTRACT

BACKGROUND: Periodontal surgery is part of the dental curriculum at German universities. A particular challenge is to provide a basic understanding of surgery. This is the first pilot study evaluating the extent to which regenerative therapy or lower molar hemisection can be learned using a specially produced 3D-individualised patient model compared to a porcine cadaveric model.

METHODS: During the periodontal surgery block practical, 14 students performed lower molar hemisection and regenerative therapy with bone graft substitute (Bio Oss, Bio Gide; Geistlich Pharma AG, Wolhusen, Switzerland) on an individualised 3D model. Interventions were then evaluated using a validated questionnaire. Differences between groups were statistically assessed for individual items and the overall questionnaire using the Wilcoxon test (p < 0.05).

RESULTS: In the overall evaluation, the 3D-printed patient and animal cadaveric model did not differ significantly, with the animal cadaveric model scoring a slightly higher score. The 3D-printed patient model was considered more realistic for the anatomical appearance of each part, being evaluated superior for practicing regenerative therapy, removing inflammatory tissue and performing molar hemisections. The animal cadaveric model was rated better for soft and hard tissue tactile feedback.

CONCLUSION: With the 3D-individualised model, hemisection and regenerative therapy can be performed realistically, but soft and hard tissue feedback still needs to be optimised. 3D models are useful for teaching periodontal surgery. In the future, if optimised, 3D printing could completely replace the animal cadaveric model, as it offers clear advantages (e.g., easier organisation, better hygiene).

PMID:40146918 | DOI:10.1111/eje.13090