Tag: pubmed

Neurology. 2024 Dec 24;103(12):e209940. doi: 10.1212/WNL.0000000000209940. Epub 2024 Nov 19.

ABSTRACT

OBJECTIVES: In aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-IgG NMOSD), disability accrual is mostly attributed to relapses. This study aimed to assess the prevalence of progression independent of relapse activity (PIRA) and relapse-associated worsening (RAW) in AQP4-IgG NMOSD.

METHODS: This was a retrospective cohort study of patients with AQP4-IgG NMOSD enrolled in the MSBase international data registry. Patients required a minimum of 3 recorded Expanded Disability Status Scale (EDSS) scores: baseline, event, and a 6-month confirmation score. Presence and absence of relapses between the baseline and event EDSS scores determined RAW and PIRA, respectively. Descriptive statistics were used to present the results.

RESULTS: A total of 181 patients followed for a median of 4.5 years (Q1 1.7, Q3 7.8) were included. Most patients were female (88.4%), and the median age at disease onset was 38.1 years. Overall, 4 patients (2.2%) developed 5 incidences of PIRA and 13 patients developed RAW (7.2%).

DISCUSSION: This multicenter study highlights that PIRA is very rare in AQP4-IgG NMOSD. Limitations of this study include the sole focus of overall EDSS to measure disability, lack of requirement for a second EDSS score to confirm baseline EDSS, and the absence of magnetic resonance imaging information for all patients.

PMID:39561307 | DOI:10.1212/WNL.0000000000209940

Clin Infect Dis. 2024 Nov 20:ciae561. doi: 10.1093/cid/ciae561. Online ahead of print.

ABSTRACT

BACKGROUND: Tuberculosis (TB) incidence remains disproportionately high in people migrating to Canada and other low TB incidence countries, but systematic TB screening and prevention in migrants is often cost-prohibitive for TB programs. We aimed to develop and validate a TB risk prediction model to inform TB screening decisions in foreign-born permanent residents of Canada.

METHODS: We developed and validated a proportional baselines landmark supermodel for TB risk prediction using health administrative data from British Columbia and Ontario, two distinct provincial healthcare systems in Canada. Demographic (age, sex, refugee status, year of entry, TB incidence in country of origin), TB exposure, and medical (HIV, kidney disease, diabetes, solid organ transplantation, cancer) covariates were used to derive and test models in British Columbia; one model was chosen for external validation in the Ontario cohort. The model’s ability to predict 2- and 5-year TB risk in the Ontario cohort was assessed using discrimination and calibration statistics.

RESULTS: The study included 715,423 individuals (including 1,407 people with TB disease) in the British Columbia derivation cohort, and 958,131 individuals (including 1,361 people with TB disease) in the Ontario validation cohort. The 2- and 5-year concordance statistic in the validation cohort was 0.77 (95%CI: 0.75-0.78) and 0.77 (95%CI: 0.76-0.78), respectively. Calibration-in-the-large values were 0.14 (95% CI: 0.08-0.21) and -0.05 (95% CI: -0.12-0.02) in 2- and 5-year prediction windows.

CONCLUSIONS: This prediction model, available online at https://tb-migrate.com, may improve TB risk stratification in people migrating to low incidence countries and may help inform TB screening policy and guidelines.

PMID:39561254 | DOI:10.1093/cid/ciae561

Fam Pract. 2024 Nov 19:cmae061. doi: 10.1093/fampra/cmae061. Online ahead of print.

ABSTRACT

INTRODUCTION: The evolving landscape of general practice (GP)/family medicine (FM) in the post-COVID-19 era, focussing on integrating telemedicine and remote consultations requires a new definition for this specialty. Hence, a broader consensus-based definition of post-COVID-19 GP/FM is warranted.

METHODS: This study involved a modified electronic Delphi technique involving 27 specialists working in primary care recruited via convenient and snowball sampling. The Delphi survey was conducted online between August 2022 and April 2023, utilizing the Google Forms platform. Descriptive statistics were employed to analyse consensus across Delphi rounds.

RESULTS: Twenty-six international experts participated in the survey. The retention rate through the second and third Delphi rounds was 96.2% (n = 25). The broader consensus definition emphasizes person-centred care, collaborative patient-physician partnerships, and a holistic approach to health, including managing acute and chronic conditions through in-person or remote access based on patient preferences, medical needs, and local health system organization.

CONCLUSION: The study highlights the importance of continuity of care, prevention, and coordination with other healthcare professionals as core values of primary care. It also reflects the role of GP/FM in addressing new challenges post-pandemic, such as healthcare delivery beyond standard face-to-face care (e.g. remote consultations) and an increasingly important role in the prevention of infectious diseases. This underscores the need for ongoing research and patient involvement to continually refine and improve primary healthcare delivery in response to changing healthcare landscapes.

PMID:39561247 | DOI:10.1093/fampra/cmae061

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