Tag: pubmed

J Phys Chem B. 2025 Feb 25. doi: 10.1021/acs.jpcb.4c06069. Online ahead of print.

ABSTRACT

Diffusion at the molecular level involves random collisions between particles, the structure of local microscopic environments, and interactions among the molecules involved. Sampling all of these aspects, along with correcting for finite-size effects, can make the calculation of infinitely dilute diffusion coefficients computationally difficult. We present a new approach for estimating the translational diffusion coefficient of biomolecular structures by encapsulating these driving forces of diffusion through piecewise assembly of the component residues of the protein structure. By linking the local chemistry of a solvent-exposed patch of a molecule to its contribution to the overall hydrodynamic radius, an accurate prediction of the computationally and experimentally comparable diffusion coefficients can be constructed following a solvent-excluded surface area calculation. We demonstrate that the resulting predictions for diffusion coefficients from peptides through to protein structures are comparable to explicit molecular simulations and improve on statistical mass-based predictions, which tend to rely on limited training data. As this approach uses the chemical identity of molecular structures, we find that it is able to predict and identify differences in diffusivity for structures that would be indistinguishable by mass information alone.

PMID:39999471 | DOI:10.1021/acs.jpcb.4c06069

Health Rep. 2025 Feb 19;36(2):15-28. doi: 10.25318/82-003-x202500200002-eng.

ABSTRACT

BACKGROUND: The prevalence of Canadians living with obesity has increased over the past four decades. Disease and mortality risk increase as the number of years lived with obesity increases.

METHODS: This study used self-reported weight history and health data collected from 2007 to 2011 via the Canadian Health Measures Survey (n = 5,761) to examine whether increased exposure to obesity during adulthood increases the odds of having poor health outcomes.

RESULTS: The percentage of respondents with an obesity-related chronic condition was lower among those who did not have obesity at the time of survey or report having obesity in the past (50.6%) compared with those who did not have obesity at the time of the survey but did in the past (65.9%) or who had obesity at the time of the survey and in the past (71.1%). Relative to never having obesity, having obesity in the past but not at present or having obesity in the past and at present were associated with increased odds of having a range of chronic conditions. The highest odds were observed for type 2 diabetes (odd ratio (OR) = 3.26, 95% confidence interval (CI): 2.40 to 4.43 and OR = 5.36, 95% CI: 3.88 to 7.41), hypertension (OR = 2.41, 95% CI: 1.69 to 3.44 and OR = 3.76, 95% CI: 2.84 to 4.97), and poor or fair self-rated general health (OR = 2.04, 95% CI: 1.51 to 2.76 and OR = 2.68, 95% CI: 2.11 to 3.40).

INTERPRETATION: Having had obesity in the past, regardless of current obesity status, was associated with increased odds of poor health outcomes. Obesity history information should be considered when estimating the population burden of obesity.

PMID:39999465 | DOI:10.25318/82-003-x202500200002-eng

Am J Trop Med Hyg. 2025 Feb 25:tpmd240630. doi: 10.4269/ajtmh.24-0630. Online ahead of print.

ABSTRACT

We assessed the effect of active follow-ups on viral load (VL) suppression among people living with HIV (PLWH) who had missed their clinic visit(s) and were receiving intensive adherence counseling (IAC) at a large referral hospital in mid-western Uganda. We designed a quasi-experimental study, using a locator map (a local map showing residence) as an external factor (instrumental variable) that influenced active follow-up. We performed instrumental variable analysis. Of the 165 participants included, 24.8% had a client locator map, and possessing a map was associated with active follow-up (F-statistics 53.1; P <0.0001). Active follow-up did not significantly improve VL suppression at varying cutoffs, namely <1,000 copies/ml (P = 0.607), less than 200 copies/ml (P = 0.684), and less than 50 copies/ml (P = 0.435). Although active follow-up did not significantly improve VL suppression among PLWH on IAC, it showed a modest trend toward improvement. Large, randomized trials are needed.

PMID:39999462 | DOI:10.4269/ajtmh.24-0630

Am J Trop Med Hyg. 2025 Feb 25:tpmd240390. doi: 10.4269/ajtmh.24-0390. Online ahead of print.

ABSTRACT

This prospective study was done to compare the initial presentation and treatment outcomes of tuberculosis among adult patients who have diabetes mellitus with those without diabetes mellitus. In this study, all adult patients (age 18 years old or older) with microbiologically confirmed drug-sensitive pulmonary tuberculosis who were put on treatment in Ballabgarh block in Haryana were enrolled. Information on clinical, radiological, and microbiological parameters at baseline was obtained by interview or record review. Symptom score was calculated by assigning one point for each symptom from zero to seven. Patients were followed for 6 months from the start of treatment to assess treatment outcomes. Data were analyzed using the χ2 or Fisher exact test. Logistic regression was used to assess the factors associated with death or unfavorable outcomes. In total, 412 patients were included in the study, of which 17.5% had diabetes mellitus. The mean symptom scores among those with and without diabetes were 3.7 (SD 1.3) and 3.6 (SD 1.4), respectively. Treatment success was achieved in 83.6% of patients with diabetes and 86.4% of patients without diabetes. Death was observed in 12.3% of patients with diabetes compared with 7.1% of patients without diabetes. There was no significant difference in clinical presentation, radiology, or sputum smear grade at baseline between patients with or without diabetes. Although treatment success rate was less and death rate was higher in patients with tuberculosis who had diabetes compared with those who did not have diabetes, the difference was not statistically significant.

PMID:39999456 | DOI:10.4269/ajtmh.24-0390

Am J Trop Med Hyg. 2025 Feb 25:tpmd240321. doi: 10.4269/ajtmh.24-0321. Online ahead of print.

ABSTRACT

The WHO has a simplified grading system for assessing trachoma. However, even for experts, it can be difficult to classify certain cases as strictly positive or negative for a given grade. Given the absence of a true gold standard, we performed a Latent Class Analysis (LCA) on a set of 200 graded photos of the superior tarsal conjunctiva. Ten trained graders assessed the presence of two trachoma grades: trachomatous inflammation-follicular (TF) and trachomatous inflammation-intense (TI). The LCA was modeled in two different ways: first with two classes (presence/absence), and then with three classes, with the extra class presumed to represent a more discrepant “borderline” case. Cohen’s κ-statistics measuring agreement between graders were calculated for TF and TI grades (separately) before and after removing the third latent class. The κ-statistic increased by 0.10 (95% CI = 0.72-0.85; P <0.001) for TF and 0.13 (95% CI = 0.81-0.90; P <0.001) for TI, indicating that the third latent class represented a discrepant-case borderline class. The identification of borderline grading cases using a three-class LCA may be useful in creating balanced grader certification examinations that represent the full spectrum of disease. Additionally, a multiclass LCA could act as a probabilistic gold standard used to train and analyze future convolutional neural network models.

PMID:39999453 | DOI:10.4269/ajtmh.24-0321

Am J Trop Med Hyg. 2025 Feb 25:tpmd240161. doi: 10.4269/ajtmh.24-0161. Online ahead of print.

ABSTRACT

A critical impediment to efficient outbreak response is the availability of timely and complete data on cases and their linkage to care. To inform solutions to this issue, this study investigated the utility of self-testers reporting their coronavirus disease 2019 results using a mobile health platform. Our study has demonstrated that the mobile health platform is feasible; it achieved a 74.5% reporting rate, indicating a strong likelihood of data entry into the unstructured supplementary service data platform. Support from community health workers (CHWs) and healthcare professionals, particularly nurses, contributed to this success, especially among users with limited digital literacy. Specifically, 44.9% of self-test results were submitted by study participants themselves, 24.7% were submitted with the assistance of healthcare professionals, and 30.4% were submitted with the assistance of CHWs. The platform broadens the population base by increasing access and equity, allowing participation even among users without smartphones. Additionally, it integrates rapid antigen diagnostic tests with digital reporting, simplifying data processing and enabling standardized screening, real-time data capture, and effective patient follow-up. This technology also lays a foundation for pandemic preparedness in low- and middle-income countries by demonstrating the feasibility of fully integrating response loops for disease management and interventions. Future response loops could leverage artificial intelligence, machine learning, and integration with existing health surveillance systems, directly benefiting users through enhanced support.

PMID:39999452 | DOI:10.4269/ajtmh.24-0161

JMIR Mhealth Uhealth. 2025 Feb 25;13:e60115. doi: 10.2196/60115.

ABSTRACT

BACKGROUND: Lung cancer ranks as the leading cause of cancer-related deaths. For lung cancer survivors, cardiopulmonary fitness is a strong independent predictor of survival, while surgical interventions impact both cardiovascular and pulmonary function. Home-based cardiac telerehabilitation through wearable devices and mobile apps is a substitution for traditional, center-based rehabilitation with equal efficacy and a higher completion rate. However, it has not been widely used in clinical practice.

OBJECTIVE: The objective of this study was to broaden the use of digital health care in the cardiopulmonary rehabilitation of lung cancer survivors and to assess its impact on cardiopulmonary fitness and quality of life (QOL).

METHODS: Early-stage nonsmall cell lung cancer survivors aged 18-70 years were included. All the participants received surgery 1-2 months before enrollment and did not require further antitumor therapy. Participants were randomly assigned to receive cardiac telerehabilitation or usual care for 5 months. Artificial intelligence-driven exercise prescription with a video guide and real-time heart rate (HR) monitoring was generated based on cardiopulmonary exercise testing. Aerobic exercise combining elastic band-based resistance exercises were recommended with a frequency of 3-5 d/wk and a duration of 90-150 min/wk. The effective exercise duration was recorded when patients’ HR reached the target zone (HR_resting + [HR_max – HR_resting] × [≈40%-60%]), representing the duration under the target intensity. The prescription used a gradual progression in duration and action intensity based on the exercise data and feedback. Outcome measurements included cardiopulmonary fitness; lung function; cardiac function; tumor marker; safety; compliance; and scales assessing symptoms, psychology, sleep, fatigue, and QOL.

RESULTS: A total of 40 (85%) out of 47 patients finished the trial. The average prescription compliance rate of patients in the telerehabilitation group reached 101.2%, with an average exercise duration of 151.4 min/wk and an average effective exercise duration of 92.3 min/wk. The cardiac telerehabilitation was associated with higher improvement of maximal oxygen uptake peak (3.66, SD 3.23 mL/Kg/min vs 1.09, SD 3.23 mL/Kg/min; P=.02) and global health status or QOL (16.25, SD 23.02 vs 1.04, SD 13.90; P=.03) compared with usual care. Better alleviation of affective interference (-0.88, SD 1.50 vs 0.21, SD 1.22; P=.048), fatigue (-8.89, SD 15.96 vs 1.39, SD 12.09; P=.02), anxiety (-0.31, SD 0.44 vs -0.05, SD 0.29; P=.048), and daytime dysfunction (-0.55, SD 0.69 vs 0.00, SD 0.52; P=.02) was also observed in the telerehabilitation group. No exercise-related adverse events were identified during the intervention period.

CONCLUSIONS: The 5-month, digital therapeutics-based telerehabilitation improved cardiorespiratory fitness in lung cancer survivors with good compliance and safety. Patients receiving telerehabilitation also reported improved QOL with reduced levels of fatigue, anxiety, and daytime dysfunction.

TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200064000; https://www.chictr.org.cn/showproj.html?proj=180594.

PMID:39999435 | DOI:10.2196/60115

J Med Internet Res. 2025 Feb 25;27:e68462. doi: 10.2196/68462.

ABSTRACT

BACKGROUND: Regular exercise may counteract obesity-related health risks, but adherence is low among individuals with obesity. Personal trainers may positively influence exercise behavior by providing motivational support. Individuals who receive regular exercise coaching are more likely to adhere to their exercise routine, compared with those who exercise individually. However, investing in personalized exercise guidance, such as a personal trainer, can be expensive for the individual. Thus, integrating web-based coaching could be a more economically sustainable option, offering both flexibility and reduced costs compared with in-person coaching only. Yet, research is needed to assess the effect of hybrid models in improving psychosocial factors among women with obesity.

OBJECTIVE: This 20-week, pragmatic randomized controlled trial aimed to investigate the effect of weekly in-person coaching compared with 2 combinations of in-person and web-based coaching on 5 psychosocial factors in women with obesity (BMI ≥30 kg/m²).

METHODS: Participants were invited through Facebook and Instagram advertisements posted by various fitness clubs across rural and urban locations in Norway (7 different counties and 12 different municipalities). Women with low activity (n=188; <150 minutes of moderate-intensity physical activity/week; 42.7, SD 10.5 years; mean BMI of 35.1, SD 6.9 kg/m²) were allocated into 3 groups of in-person coaching-weekly (n=47), twice weekly (n=47), and once monthly (n=47)-and as controls (n=47). Those with twice weekly and once monthly in-person coaching received web-based coaching of 15 minutes during weeks without in-person coaching. Data included background variables, motivation (Behavioral Regulation in Exercise Questionnaire-2), barriers, self-efficacy (The Self-Efficacy Survey), social support (Social Support Questionnaire), and health-related quality of life (36-Item Short Form Health Survey [SF-36]).

RESULTS: A total of 120 (64%) out of 188 participants completed baseline and postintervention assessments. A minor difference was observed in one item of the SF-36, where all intervention groups reported a greater “change in health last year” than the control group (mean difference: 14.2-17.1, 95% CI 2.04-29.5; g=0.79-1.14; P≤.01). No other effects were found on the selected psychosocial factors. It should be noted that controls reported higher intrinsic motivational regulation at baseline than intervention groups (mean difference: 0.43-0.93; P≤.05). All intervention arms exercised more frequently than controls (mean difference: 1.1-1.5; P≤.001), with no differences in weekly exercise frequency between the 3 intervention arms (P=.30).

CONCLUSIONS: We found no effects on motivation, barriers, self-efficacy, perceived social support, or other health domains compared with controls. All intervention groups reported a slight improvement in self-perceived health in 1 of the 8 subscales of the SF-36. Combined in-person and web-based coaching may give a minor improvement in self-perceived health in women with obesity. However, the lack of impact on motivation, barriers, and self-efficacy warrants further research.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05792657; https://clinicaltrials.gov/study/NCT05792657.

PMID:39999434 | DOI:10.2196/68462

Neurology. 2025 Mar 25;104(6):e213445. doi: 10.1212/WNL.0000000000213445. Epub 2025 Feb 25.

ABSTRACT

OBJECTIVES: The aim of the study was to assess US inpatient and emergency department (ED) charges for functional neurologic disorder (FND), investigate subtype variations, and compare costs with research funding.

METHODS: We used 2009-2019 Healthcare Cost and Utilization Project data to assess adult and pediatric inpatient/ED stays and associated charges in 2019 inflation-adjusted dollars, for ICD-10-defined FND (F.44.4-F44.7) vs neurologic comparators neuroinflammatory/demyelinating diseases, refractory epilepsy, and anterior horn cell diseases. NIH research funding (2017-2023) was assessed using NIH RePORTER.

RESULTS: Inpatient charges in 2019 were $1,614.1 million (95% CI $1,492.8-1,735.4 million) for adult FND, a 47% increase since 2017, higher than for comparators, and $105.7 million (95% CI $83.5-127.8 million) for pediatric FND, a 37% increase since 2012, lower than for comparators. ED charges in 2019 were $257.9 million (95% CI $230.1-285.8 million) for adult FND, a 67% increase since 2017, exceeding those of all comparators except refractory epilepsy, and $257.9 million (95% CI $230.1-285.8 million) for pediatric FND, a 108% increase, greater than for comparators. Functional seizures accounted for most FND costs while motor/mixed FND had the highest per-patient costs. Inpatient/ED charges in 2019 for adult/pediatric FND were $2.0 billion, a 49% increase since 2017. The relative proportion of NIH funding to total inpatient/ED charges was lowest for FND vs all neurologic comparators.

DISCUSSION: Rising inpatient/ED costs of FND care surpass those of similarly complex neurologic conditions, yet FND receives minimal research funding relative to health care costs.

PMID:39999398 | DOI:10.1212/WNL.0000000000213445

Med Sci Sports Exerc. 2025 Feb 25. doi: 10.1249/MSS.0000000000003686. Online ahead of print.

ABSTRACT

OBJECTIVES: Cooling interventions mitigating heat-related declines in autonomic nervous system (ANS) function are understudied in American football.

METHODS: This study exposed fifty, collegiate male athletes during their 2023 season to two bouts of cold air via air-conditioning prior to (60 mins) and during (5 min) training sessions in a hot and humid climate. Armband monitors, (Warfighter MonitorTM, Tiger Tech Solutions, Inc., Miami, FL, USA), were used to continuously measure core temperature (°C) during training and baseline heart rate (HR), HR recovery and HR variability (HRV) 24 hours post training. Two HRV time-domain indices were estimated: root mean square of the standard deviation of the NN interval (rMSSD) and the standard deviation of the NN interval (SDNN). These data (2023) were then compared to data collected throughout the previous season (2022) during which players were not provided a cold-air intervention. As such, the 2022 cohort served as a “control” group.

RESULTS: Linear regression models no statistically significant associations at the following core temperature thresholds: ≥ 37.0 °C (baseline HR: p = 0.74; HR recovery: p = 0.71, rMSSD: p = 0.74; SDNN: p = 0.78), ≥ 38.0 °C baseline HR: p = 0.74; HR Recovery: p = 0.74; rMSSD: p = 0.68 and SDNN: p = 0.89) and ≥ 39.0 °C: baseline HR: p = 0.75; HR Recovery: p = 0.82; rMSSD: p = 0.78 and SDNN: p = 0.83). Compared to the 2022 season, the athletes spent considerably less time training under the higher core temperature thresholds (≥ 38 °C: 19.5 min vs 9.7 min; ≥ 39 °C: 10.5 min vs 0.9 min), respectively, despite longer overall training duration, (161.1 min vs 187.4 min).

CONCLUSIONS: Our findings suggest that incorporating bouts of cold air exposure when training in high heat and humidity may mitigate the established heat-related deterioration in ANS function.

PMID:39999367 | DOI:10.1249/MSS.0000000000003686