Recent deb items

SEGUID v2: Extending SEGUID checksums for circular, linear, single- and double-stranded biological sequences

Thu, 8 Oct 2026 00:00:00 +0000

BACKGROUND: Synthetic biology involves combining different DNA fragments, each containing functional biological parts, to address specific problems. Fundamental gene-function research often requires cloning and propagating DNA fragments, such as those from the iGEM Parts Registry or Addgene, typically distributed as circular plasmids. Addgene's repository alone offers around 150,000 plasmids. To ensure data integrity, cryptographic checksums can be calculated for the sequences. Each sequence has a unique checksum, making checksums useful for validation and quick lookups of associated annotations. For example, the SEGUID checksum uniquely identifies protein sequences with a 27-character string. OBJECTIVES: The original SEGUID, while effective for protein sequences and single-stranded DNA (ssDNA), is not suitable for circular DNA since there is no natural starting position nor for double-stranded DNA (dsDNA) since two separate sequences are present. Challenges include how to uniquely...

Parental feeding practices and child weight status in Mexican American families: A longitudinal analysis

Tue, 6 Oct 2026 00:00:00 +0000

Background: Parental feeding practices are thought to influence children's weight status, through children's eating behavior and nutritional intake. However, because most studies have been cross-sectional, the direction of influence is unclear. Moreover, although obesity rates are high among Latino children, few studies of parental feeding practices have focused on this population. Methods: This 2-year longitudinal study examined mutual influences over time between parental feeding practices and children's weight status, in Mexican American families with children 18 years old at baseline. Mothers (n = 322) and fathers (n = 182) reported on their feeding practices at baseline, 1-year follow-up, and 2-year follow-up. Weight status, defined by waist-height ratio (WHtR) and body mass index (BMI), was ascertained at all assessments. Cross-lagged panel models were used to examine the mutual influences of parental feeding practices and child weight status over time, controlling for covariates....

Prostate-Specific Membrane Antigen Radioligand Therapy in Patients with Aggressive-Variant Prostate Cancer.

Mon, 5 Oct 2026 00:00:00 +0000

Aggressive-variant prostate cancer (AVPC) is characterized by several high-risk features and is typically treated with chemotherapy. In this study, we evaluated the outcomes of patients with AVPC who received prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT). Methods: This retrospective study included patients with AVPC with metastatic castration-resistant prostate cancer who received PSMA RLT at 3 academic centers. Patients with AVPC were further stratified into 2 subcategories: AVPC-C (clinicopathologic), referring to patients who met AVPC on the basis of clinical or pathologic features, and AVPC-MS (molecular signature), referring to patients who met AVPC criteria on the basis of genomic alterations. Prostate-specific antigen (PSA) response was calculated in the overall cohort, and PSA progression-free survival and overall survival (OS) were calculated in the paired cohort. In the segmentation cohort, SUV_mean and total tumor volume...

Feasibility and acceptability of remote smartphone cognitive testing in frontotemporal dementia research

Tue, 29 Sep 2026 00:00:00 +0000

Introduction: Remote smartphone assessments of cognition, speech/language, and motor functioning in frontotemporal dementia (FTD) could enable decentralized clinical trials and improve access to research. We studied the feasibility and acceptability of remote smartphone data collection in FTD research using the ALLFTD Mobile App (ALLFTD-mApp). Methods: A diagnostically mixed sample of 214 participants with FTD or from familial FTD kindreds (asymptomatic: CDR®+NACC-FTLD = 0 [N = 101]; prodromal: 0.5 [N = 49]; symptomatic ≥1 [N = 51]; not measured [N = 13]) were asked to complete ALLFTD-mApp tests on their smartphone three times within 12 days. They completed smartphone familiarity and participation experience surveys. Results: It was feasible for participants to complete the ALLFTD-mApp on their own smartphones. Participants reported high smartphone familiarity, completed ∼ 70% of tasks, and considered...

HIV Testing and Care Among Publicly Insured Enrollees With Schizophrenia: Is There a Benefit to Dual Eligibility?

Thu, 17 Sep 2026 00:00:00 +0000

Background: Patients with schizophrenia experience gaps in the human immunodeficiency virus (HIV) care continuum. We examined the impact of dual enrollment in Medicare upon HIV testing and retention among Medicaid-enrolled patients with schizophrenia. Methods: Using Medicaid Analytic eXtract and Medicare files from 2008 to 2012, we examined adult participants with schizophrenia enrolled in Medicaid or dually enrolled in Medicare and Medicaid. Our outcomes were (a) HIV testing probability among participants without HIV and (b) retention in HIV care among people living with HIV (PLWH) (two HIV viral loads or CD4+ counts >90 days apart and within 1 year). Results: The average annual HIV testing probability was 4.9% among dually enrolled and 7.4% among Medicaid-enrolled patients (p < 0.001). Compared to Medicaid-only, HIV testing for dually enrolled patients were highest among those with opioid use disorder or sexually transmitted infection (STI);...

Coronavirus Disease 2019 is an Occupational Disease for Teachers: How to Support the Teacher Workforce.

Fri, 11 Sep 2026 00:00:00 +0000

Analyzing a growing body of epidemiological research that considers coronavirus disease 2019 (COVID-19) as an occupational disease situates teaching (eg, pre-kindergarten, elementary, secondary) among the more vulnerable occupations. Teachers have experienced a higher risk of COVID-19 infection, hospitalization, death, and Long COVID than people from many other occupations. More research attending to occupational patterns and risk mitigation is needed. Taking an occupational epidemiology approach for teachers can inform a wide array of policy solutions, including school environment improvements that can support infection control, like air cleaning and ventilation, as well as supporting teachers experiencing disproportionate burdens of COVID-19, including those living with Long COVID.

Plasma proteomics defines two reproducible subphenotypes of sepsis-associated acute kidney injury with distinct outcomes

Thu, 10 Sep 2026 00:00:00 +0000

Sepsis is the leading cause of acute kidney injury in critically ill patients, and this complication carries a high risk of death. The biology underlying it varies between patients, which may explain why treatments have not succeeded. Here we show, using an ensemble method that groups patients by patterns across hundreds of blood proteins in three independent groups of patients, that sepsis-associated acute kidney injury comprises two reproducible subphenotypes. One subphenotype shows widespread activation of inflammation, metabolism, and oxidative stress; the other shows a quieter profile. Patients in the inflammatory subtype have higher mortality, more complications, and fewer days alive and out of the intensive care unit. A simple seven-protein test reproduces these groupings and identifies them accurately in separate cohorts. In a randomized trial, the drug ilofotase alfa appears to benefit the inflammatory subtype but not the other, suggesting that this classification could...

Return to Home, Days Spend at Home and Mortality in the Year Following Critical Illness: A Nationwide State Sequence Analysis in France

Thu, 10 Sep 2026 00:00:00 +0000

Return to Home, Days Spend at Home and Mortality in the Year Following Critical Illness: A Nationwide State Sequence Analysis in France

Ten simple rules for effective use of generative AI for code development in environmental science

Thu, 27 Aug 2026 00:00:00 +0000

Ten simple rules for effective use of generative AI for code development in environmental science

Prevalence of falls in a pooled US cohort of adults with systemic lupus erythematosus: a nested cross-sectional study.

Thu, 27 Aug 2026 00:00:00 +0000

Objective

Epidemiologic data on falls in the population with systemic lupus erythematosus (SLE) remain sparse. We estimated the prevalence and correlates of falls among adults with SLE and compared SLE prevalence estimates with those in the general US population.

Methods

We assessed falls in a nested cross-sectional study within two pooled population-based SLE cohorts in California (3/2025-2/2026) and Georgia (10/2019-5/2022). Stratified prevalence was assessed with marginal estimates from logistic regression models with falls as the outcome. Age-standardised and sex-standardised estimates in SLE were compared with 2023 US population estimates (ages ≥45 only).

Results

In this pooled SLE cohort (N=780; mean age, 47.9; 91.9% women; 14.5% Asian, 51.7% black, 13.2% Hispanic), 26.0% reported any fall in the prior year; among these, 59.1% reported falling two times or more and 31.0% reported associated injuries. General factors (oldest vs youngest age (37.4% vs...

Personalized modeling of stress and blood pressure reactivity using mobile health data

Thu, 27 Aug 2026 00:00:00 +0000

Psychological stress is a key driver of short-term blood pressure (BP) elevations and cardiovascular risk, yet its moment-to-moment impact in daily life remains difficult to predict. In this longitudinal observational study, we collected multimodal data from 20 adults with self-reported hypertension, including continuous wearable-derived heart rate and activity, ecological momentary assessment (EMA) stress ratings, and ambulatory BP measurements in free-living conditions. The dataset comprised 3694 EMA responses and 3812 BP measurements collected over approximately four weeks per participant (mean 24.1 ± 8.5 days). We evaluated whether participant-specific (“personalized”) models outperform a single pooled population model. Two prediction tasks were examined: (i) prediction of near-term BP elevations from wearable signals and stress EMA responses and (ii) prediction of self-reported stress from wearable signals and BP. Across both tasks, personalized models consistently improved...

Building a Global Research Network for Fair, Accountable, Interpretable, and Responsible AI in Emergency Care: Protocol for a FAIR-EC Study.

Thu, 13 Aug 2026 00:00:00 +0000

Background

The current landscape of emergency care (EC) is marked by high demand, leading to issues such as emergency department boarding, overcrowding, and subsequent delays that impact the quality and safety of patient care. Integrating data science into EC can enhance decision-making with predictive, preventative, personalized, and participatory approaches. However, gaps in adherence to fairness, accountability, interpretability, and responsibility are evident, particularly due to barriers to data-sharing, which often result in a lack of transparency and robust oversight in these applications.

Objective

The FAIR-EC (Fair, Accountable, Interpretable, and Responsible-Emergency Care) collaboration adapts the existing Fair, Accountable, Interpretable, and Responsible principles to address emerging challenges as data science integrates with EC. This initiative aims to transform EC by establishing ethical artificial intelligence standards specifically tailored for...

Fathers’ Presence Makes a Difference During Children’s Evening Meals

Tue, 4 Aug 2026 00:00:00 +0000

This observational study used descriptive analysis to improve understanding of the relationship between fathers’ presence or absence, the occurrence of mothers’ feeding practices, and child eating behaviors at evening meals. Participants were 141 Mexican-origin families with children aged 8 to 10 years. We coded behavioral observations of video-recorded meals. Three parental feeding practices were established a priori : (1) pressure to eat, (2) restriction of amount of food, and (3) positive involvement in child’s meals. Additionally, we identified child eating behaviors and food eaten. Fewer mothers engaged in certain types of positive involvement in child’s meals when fathers were present at the meals, compared to when fathers were absent. Regarding child eating behaviors, when fathers were present, more children engaged in positive talk about food, compared to when fathers were absent. Additionally, when fathers were present, more children ate grains and fewer ate fruit, compared...

Author Correction: Large-scale network analysis of the cerebrospinal fluid proteome identifies molecular signatures of frontotemporal lobar degeneration

Mon, 27 Jul 2026 00:00:00 +0000

Correction to: Nature Aginghttps://doi.org/10.1038/s43587-025-00878-2, published online 16 May 2025. This article was originally published under standard Springer Nature license (© The Author(s), under exclusive licence to Springer Nature America, Inc.). It is now available as an open-access paper under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license, © The Author(s). The error has been corrected in the HTML and PDF versions of the article.

Deep learning-based quantification of knee effusion-synovitis volume on MRI – Technique development and validation

Tue, 21 Jul 2026 00:00:00 +0000

OBJECTIVE: To develop and validate a deep learning (DL)-based model for automatic quantification of knee effusion-synovitis volume (ESV) on MRI, assess correlations of ESV with semiquantitative effusion-synovitis (sqES) scores, and compare associations of ESV and sqES with MRI features and symptoms of knee osteoarthritis. DESIGN: A DL-based model was developed to quantify ESV on baseline right-knee MRI from the Osteoarthritis Initiative (n=4698), which was trained and tested using manual segmentations from 101 randomly selected knees. Dice coefficients were used to quantify segmentation performance. Spearman correlations were computed between ESV and sqES scores from Whole-Organ Magnetic Resonance Imaging Score (WORMS_ES) and MRI Osteoarthritis Knee Score (MOAKS_ES). Paired differences in standardized β coefficients (Δβ_std) from linear models were used to compare associations of ESV with tissue-specific WORMS scores and the total score of the Western...

386 DEEP-LEARNING BASED QUANTIFICATION OF KNEE JOINT EFFUSION-SYNOVITIS VOLUME ON MR IMAGES –TECHNIQUE DEVELOPMENT AND VALIDATION

Tue, 21 Jul 2026 00:00:00 +0000

386 DEEP-LEARNING BASED QUANTIFICATION OF KNEE JOINT EFFUSION-SYNOVITIS VOLUME ON MR IMAGES –TECHNIQUE DEVELOPMENT AND VALIDATION

Cost Considerations for Rapid Start Implementation: Analysis from Seven Rapid Start Provider Sites

Thu, 9 Jul 2026 00:00:00 +0000

Antiretroviral treatment (ART) initiation within days of HIV diagnosis, also known as “Rapid Start”, improves linkage to care, virologic suppression and retention in care. However, data on the costs of Rapid Start implementation in the United States are limited. We aimed to estimate the costs and cost-effectiveness of Rapid Start among seven geographically diverse Ryan White-funded programs with broad variability in populations served and services offered. Each site estimated the costs of ART initiation services, management, and Rapid Start planning activities in three 12-month periods: pre-, initial, and sustained implementation. We estimated quality-adjusted life years (QALY) saved, incremental costs per-person and incremental cost per QALY saved during implementation. We considered an intervention cost-effective if it cost <$76,399 USD per QALY saved (US per capita GDP, 2021). The number of persons initiating ART increased at most sites during implementation, which, together...

Structural disadvantage and HIV risk – comparing risk factors between trans women’s partnerships with cis men and trans women sexual partners

Tue, 23 Jun 2026 00:00:00 +0000

IntroductionLittle is known about differences in HIV risk for trans women by partner gender, particularly with respect to social determinants of health and partner-level factors that affect behavior. We examined differences in demographic, social determinants, and HIV-related risk behaviors for trans women with cisgender men and trans women sexual partners.Materials and methodsData are from a cross-sectional survey of trans women and their sexual partners conducted between April 2020 and January 2021. Interviews were held remotely via videoconference during shelter-in-place ordinances due to the Covid-19 pandemic. This analysis characterized associations between HIV risk and preventive behaviors comparing trans women with cisgender men partners to trans women with trans women partners.ResultsA total of 336 sexual partners were identified from 156 trans women. Trans women with cisgender men partners were significantly more likely to be from racial/ethnic minority populations and...

Discriminatory Experiences, Critical Consciousness Development, and Well-Being Among Emerging Adults in and Beyond the First Year of the COVID-19 Pandemic

Thu, 18 Jun 2026 00:00:00 +0000

As part of the developmental stage of emerging adulthood, youth may cultivate critical consciousness (CC) to transform oppressive systems. CC development may be influenced by discriminatory experiences and may affect well-being. To better understand longitudinal CC development and its relationship to discrimination and well-being (i.e., perceived stress, anxiety, hopefulness), we studied a U.S. national longitudinal cohort of emerging adult college students between the ages of 18 and 22 at baseline (M_age = 20.0, SD = 1.3) who completed four surveys between April 2020 and July 2021 (N = 684). The analytic sample was 63% women and 37% men (gender-diverse participants were removed due to small sample size) and 26% lesbian, gay, bisexual, queer/questioning, and other minoritized sexual identities. Self-identified race/ethnicity backgrounds were 54% white, 20% Asian/Pacific Islander, 9% Latinx, 5% Black, and 10% multiple races/ethnicities and/or as Middle...

Expanding vaginal microbiome pangenomes via a custom MIDAS database reveals Lactobacillus crispatus accessory genes associated with cervical dysplasia.

Thu, 18 Jun 2026 00:00:00 +0000

The vaginal microbiome plays a central role in reproductive health. Vaginal microbiome dysbiosis is associated with many adverse reproductive health outcomes, but most studies have focused on associations at the species level. The potential contribution of intraspecies microbial variation, especially gene content differences across bacterial strains, remains underexplored in reproductive health contexts. The Metagenomic Intra-Species Diversity Analysis (MIDAS) framework enables such analyses, but depends on comprehensive reference databases. We constructed a MIDAS-compatible pangenome database from over 18,000 genomes in the Vaginal Microbiome Genome Collection (VMGC). Compared to the Genome Taxonomy Database (GTDB)-derived reference, the VMGC-derived database expanded the pangenomes of prevalent vaginal species, better capturing vaginal-specific intraspecies diversity. Applying this database to vaginal samples from a cervical dysplasia cohort, we identified 13 Lactobacillus...

Species-specific chromatin architecture and neurogenesis mediated by a human enhancer

Thu, 18 Jun 2026 00:00:00 +0000
Genomic modifications underlie the evolution of human brain features, including a larger neocortex. Human accelerated regions (HARs) are highly conserved loci containing human-specific variants, with ∼50% identified as neurodevelopmental enhancers. However, the neurodevelopmental functions of HARs and their mechanisms of gene regulation are largely unknown. We show that human (Homo sapiens [Hs]) HAR1984 promotes neurogenesis by influencing species-specific transcription and chromatin interactions. Hs-HAR1984 knockin chimpanzee (Pan troglodytes [Pt]) cortical organoids contain more progenitors and neurons, whereas Pt-HAR1984 knockin human cortical organoids exhibit the opposite phenotype. Hs-HAR1984 knockin mice have increased neurogenesis and a thicker cortex with focal folds. HAR1984 exhibits chromatin looping with its target genes, ETV5 and TRA2B, in human fetal brains, which is notably reduced in chimpanzee, macaque, and mouse neural cells. We show that human-specific HAR1984...

Linkage of nucleotide and functional diversity varies across gut bacteria.

Thu, 18 Jun 2026 00:00:00 +0000
Understanding the forces shaping genomic diversity within bacterial species is essential for interpreting microbiome evolution, ecology, and host associations. Here, we analyze over one hundred prevalent gut bacterial species using the Unified Human Gut Genome collection to characterize patterns of intraspecific genomic variability. Gene content divergence scales predictably with divergence in core genome single nucleotide polymorphisms (SNPs), though there is substantial variability in evolutionary dynamics across species. Overall, accessory genes exhibit consistently faster linkage decay compared to core SNPs, highlighting the fluidity of functional repertoires within species boundaries. This signal is strongest for mobile genetic elements, which show minimal linkage to core genome SNPs. Together, our findings reveal species-specific recombination regimes in the gut microbiome, underscoring the importance of accounting for horizontal gene transfer and genome plasticity in microbiome-wide...

Industrial Pollution and Health in Louisiana: A Systematic Review of Quantitative and Qualitative Studies

Thu, 18 Jun 2026 00:00:00 +0000
Purpose of ReviewLouisiana has one of the largest concentrations of petrochemical industry in the USA. Many studies have assessed patterns of industrial pollution and health in Louisiana; we aim to systematically review this evidence.We systematically searched PubMed, Web of Science, Embase, APA PsycInfo, and GreenFILE for peer-reviewed papers published 1999–2024 that reported geographical variation in health or industrial pollution, and/or tested for an association between the two in Louisiana. We used Covidence to support standardized review and extraction.Recent Findings We identified 2485 non-duplicate papers in our search; 53 met the inclusion criteria. Most reported quantitative findings. All studies of industrial pollution described air pollution (some also described other pollution). Studies described various health outcomes, including cancer, respiratory health, mortality, and COVID-19. Overall, people who lived closer to industrial activity had higher pollution exposure...

The oligogenic inheritance test GCOD detects risk genes and their interactions in congenital heart defects

Thu, 18 Jun 2026 00:00:00 +0000
Exome sequencing of thousands of families has revealed many risk genes for congenital heart defects (CHDs), yet most cases cannot be explained by a single causal mutation. Even within the same family, individuals carrying a particular mutation in a known risk gene often demonstrate variable phenotypes, suggesting the presence of genetic modifiers. To explore oligogenic causes of CHD without assessing billions of variant combinations, we develop an efficient, simulation-based method to detect gene sets that carry co-occurring damaging variants in probands at a higher rate than expected given parental genotypes. We implement this approach in software called Gene Combinations in Oligogenic Disease (GCOD) and apply it to a cohort of 3377 CHD trios with exome sequencing. This analysis detects 160 gene pairs in which damaging variants are transmitted with higher-than-expected frequency to CHD probands but rarely or never appear in combination in their unaffected parents. Stratifying...

Strategies to Recruit Native American/American Indian/Alaska Native Adolescents and Emerging Adults Into Health Studies: A Systematic Review

Thu, 18 Jun 2026 00:00:00 +0000
American Indian/Alaska Native (AI/AN) adolescents and emerging adults' health has been understudied, despite pressing inequities beginning at this critical developmental period when lifelong health behaviors and chronic disease often emerge. Recruitment challenges are often described as a reason for underrepresentation of this population in health research. This paper systematically reviews research on recruitment approaches targeting AI/AN adolescents and emerging adults. We conducted a systematic review of the literature in June 2025. Inclusion criteria were articles focusing on recruitment of AI/AN participants ages 10 to 29 years into health research studies with >3 sentences on recruitment. Search generated 793 nonduplicate peer-reviewed articles. Sixteen met inclusion criteria. Identified recruitment strategies focused on relational work, decreasing recognition and participation barriers, and showing respect for culture and autonomy. Relational recruitment methods are...

A brief xerostomia inventory for young adults

Thu, 18 Jun 2026 00:00:00 +0000
OBJECTIVE: Xerostomia (dry mouth) is a common condition that negatively impacts life quality for adults of all ages. Yet, xerostomia has primarily been studied among older adults and populations at high risk of dry mouth, with no widely-available self-reported instrument to assess xerostomia accurately among younger populations. This study aimed to develop a brief xerostomia assessment tool specifically designed for young adults. METHODS: Students ages 18-24 at two California (USA) public universities (N = 278) completed a cross-sectional survey that included a 14-item xerostomia inventory, including new items and items previously tested among older adults. Using exploratory factor analysis and item response theory analysis, the inventory was reduced to a 5-item scale. Psychometric properties of the 5 items were examined. As further validity checks, associations were explored between scale sum scores and other oral health conditions and potential xerostomia risk indicators. RESULTS:...

Patterns in Civic Engagement and Health Among Diverse Adolescent Students.

Thu, 18 Jun 2026 00:00:00 +0000
This article examines patterns in civic engagement and health among U.S. adolescents currently enrolled in school. Adolescents engage in multiple forms of civic action (e.g., civic discussions, volunteering, and political activities) and form varied civic attitudes and skills, which, in turn, may shape their health and well-being. Further, such associations between civic engagement and health may be differentially influenced by students' social locations (e.g., socioeconomic position, race and ethnicity, and gender). The authors examined associations between civic engagement (behaviors, attitudes, and skills) and health (physical, mental, and well-being) and how these associations varied among four race-gender subgroups in the United States. Survey data from 1,286 adolescent students in grades 6-12 (average age = 14.56) were collected between fall 2021 and spring 2025. Analyses revealed that main effects for the full sample obscure distinct patterns of associations between civic...

National Analysis of Secular Trends and Racial Disparities in Age at Kasai Hepatoportoenterostomy for Infants with Biliary Atresia, 2005-2025

Thu, 18 Jun 2026 00:00:00 +0000
National Analysis of Secular Trends and Racial Disparities in Age at Kasai Hepatoportoenterostomy for Infants with Biliary Atresia, 2005-2025

Early-life Exposure to Punitive School Discipline and Midlife Cognitive Outcomes

Thu, 18 Jun 2026 00:00:00 +0000
INTRODUCTION: Suspension and expulsion are common in US schools and disproportionately target structurally marginalized children. No research has examined whether these punitive practices may have long-term cognitive-aging implications. METHODS: In the prospective National Longitudinal Survey of Youth 1979 data (N=8021), we used confounder-adjusted linear models to investigate associations between early-life suspension or expulsion and global cognition, memory, and attention z -scores at age 50. Using interaction terms, we tested for additive scale effect modification by race, gender, and at their intersections. RESULTS: In all, 21.5% of participants had been suspended and 4.4% expelled, with Black men and women overrepresented among these early-life experiences. Punitive school discipline was associated with lower midlife global cognition, memory, and attention z -scores (eg, global cognition, suspension: : -0.21; 95% CI: -0.26, -0.15; expulsion: :-0.27; 95% CI: -0.38, -0.16)....

A phase 2 study of olutasidenib in combination with azacitidine followed by olutasidenib maintenance after venetoclax plus a hypomethylating agent regimen for IDH1-mutated acute myeloid leukemia (University of California Hematologic Malignancies Consortium Study 2441).

Wed, 17 Jun 2026 00:00:00 +0000
TPS6603 Background: Acute myeloid leukemia (AML) with isocitrate dehydrogenase-1 (IDH1) mutations represents a subset of up to approximately 7-14% of patients. For patients with IDH1m AML ineligible for first line intensive induction, the combination of a hypomethylating agent (HMA) and venetoclax (VEN) is a standard of care based on the VIALE-A study. In patients with IDH1m, the HMA azacitidine (AZA) plus VEN regimen leads to a complete remission (CR) plus CR with incomplete count recovery (CRi) rate of 66.7%, duration of remission (DoR) 21.9 months, and median overall survival (OS) of 15.2 months. However, one of the limiting features of HMA-VEN is myelosuppression, leading to dose delays and reductions, and adverse events (AEs) led to discontinuation in up to 30% of patients on the VIALE-A study. Approaches to increase tolerability and improve outcomes are of interest. Olutasidenib (OLU) is a potent, oral and selective small-molecule IDH1m inhibitor currently approved for...

Association Between Age at Kidney Transplantation and Risk of Early Graft Loss.

Mon, 15 Jun 2026 00:00:00 +0000

Background
Adolescence has been identified as a high-risk period for graft failure. However, existing knowledge on this topic is largely limited to long-term graft outcomes. The aim of this study was to examine the association between age at kidney transplantation and early graft loss, defined as graft failure within 3 years post-transplantation in the contemporary era.
Methods
This study was a retrospective analysis of 55 973 first-time kidney transplant recipients identified in the U.S. Renal Data System from January 1, 2005, to December 31, 2021. Adjusted Cox proportional hazards regression models were used to evaluate the association between age at transplantation and early graft failure including an interaction term for race/ethnicity.
Results
Adolescents (12 to < 18 years) and young adults (18 to < 26 years) were at the highest risk of early death-censored graft loss compared to young adults (26 to < 40 years), with hazard ratios of 1.95 (95%...

Elevated AD biomarkers do not explain cognitive performance in a community‐recruited clinical trial cohort

Thu, 4 Jun 2026 00:00:00 +0000
INTRODUCTION: To examine the generalizability of Alzheimer's disease (AD) biomarker models in real-world older adults, we examined AD biomarker relationships with cognition in two multicenter cohorts that differ with respect to recruitment approach and health risk factors but were matched on a variety of characteristics. METHODS: We compared harmonized health and demographic data, AD and cerebrovascular biomarkers, and cognitive performance in the community-recruited U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) Imaging substudy and a matched sample from the Alzheimer's Disease Neuroimaging Initiative (ADNI) which recruited primarily from academic specialty clinics. RESULTS: Elevated β-amyloid (Aβ) and tau were associated with cognitive performance in ADNI but not U.S. POINTER. Findings were consistent across different cohort matching schemes, and were not explained by discrepancies in vascular risk. DISCUSSION: The role of Aβ...

Correlates of Fitness Tracker Ownership and Use in Cancer Survivors: Cross-Sectional Survey.

Thu, 4 Jun 2026 00:00:00 +0000

Background
Consumer fitness tracker devices offer scalable opportunities to monitor real-world behavior and support health in cancer survivorship. However, adoption and sustained use outside structured research settings remain incompletely characterized, limiting their integration into survivorship care.
Objective
The primary objectives were to describe the prevalence of fitness tracker ownership and use patterns among cancer survivors and to identify sociodemographic, psychosocial, and usability-related correlates of device ownership and frequent use.
Methods
We conducted a cross-sectional survey of 893 cancer survivors enrolled in the Total Cancer Care protocol at a comprehensive cancer center. Participants completed an adapted online questionnaire assessing fitness tracker ownership, frequency of use, and perceived barriers and facilitators. Multivariable logistic regression models were used to identify sociodemographic, psychosocial, and usability-related...

Abstract 2281: The interrelationship between maternal periconception folate nutritional intake and child’s genetic liability in the etiology of childhood acute lymphoblastic leukemia

Tue, 26 May 2026 00:00:00 +0000
Abstract Introduction Maternal prenatal folate intake is associated with a decreased risk of acute lymphoblastic leukemia (ALL) in children. Genome-wide association studies (GWAS) show that variations in genes regulating folate metabolism impact serum folate level irrespective of nutritional intake. Polygenic risk scores (PRS) summarize the cumulative genetic liability associated with specific phenotypes. This study aimed to examine if the child PRS related to folate level interacts with maternal periconception folate intake from food and supplements, contributing to ALL risk. Methods Data on periconceptional folate intake spanning the year prior to pregnancy were obtained from the California Childhood Leukemia Study (CCLS). Folate intake from diet and supplement was measured in dietary folate equivalents (DFE). A PRS related to folate level was constructed using summary statistics from a GWAS of serum folate levels among Europeans. After assigning genetically predicted folate...

The Interrelationship between Preconception Folate Nutritional Intake and Child Genetic Liability in the Risk of Childhood Acute Lymphoblastic Leukemia

Tue, 26 May 2026 00:00:00 +0000
BACKGROUND: Prenatal maternal folate intake is associated with a reduced risk of childhood acute lymphoblastic leukemia (ALL), but how this interacts with children's genetic predisposition to folate deficiency remains unclear. METHODS: We used Mendelian randomization to investigate the causal link among serum folate, total homocysteine, and B vitamins on ALL using independent genetic instruments. These were evaluated in two independent childhood ALL genome-wide association studies: the California Childhood Cancer Record Linkage Project and the California Childhood Leukemia Study, the latter with available self-reported periconceptional nutrition data. Logistic regressions assessed the interrelationship between maternal nutrition and children's folate metabolism-related polygenic risk score (PRS) and methylenetetrahydrofolate reductase rs1801133 genotype. RESULTS: Mendelian randomization analyses showed that higher genetically predicted serum folate was associated with reduced...

Care Ecosystem Collaborative Model and Health Care Costs in Medicare Beneficiaries With Dementia

Mon, 18 May 2026 00:00:00 +0000
Importance: Collaborative dementia care programs are effective in addressing the needs of patients with dementia and their caregivers. However, attempts to consider effects on health care spending have been limited, leaving a critical gap in the conversation around value-based dementia care. Objective: To determine the effect of participation in collaborative dementia care on total Medicare reimbursement costs compared with usual care. Design, Setting, and Participants: This was a prespecified secondary analysis of the Care Ecosystem trial, a 12-month, single-blind, parallel-group randomized clinical trial conducted from March 2015 to March 2018 at 2 academic medical centers in California and Nebraska. Participants were patients with dementia who were living in the community, aged 45 years or older, and had a primary caregiver and Medicare fee-for-service coverage for the duration of the trial. Intervention: Telehealth dementia care program that entailed assignment to an unlicensed...

The Long‐Term Effects of the Care Ecosystem Dementia Care Management Program on Quality of Life and Caregiver Well‐being

Mon, 18 May 2026 00:00:00 +0000
AbstractBackground
Dementia care management programs, including the Care Ecosystem, have been shown to improve patient and caregiver outcomes, reduce unnecessary healthcare expenditures, and are the focus of Medicare’s new GUIDE payment model. Until now, prior research has focused on evaluating the effectiveness of participating for a short (eg, 12‐month) time frame. The purpose of this study was to evaluate the effects of the Care Ecosystem when delivered for up to 5 years or end of life.
Methods
Of the 804 PLWD‐caregiver dyads enrolled in the previously reported single‐blind 12‐month RCT of the Care Ecosystem (NCT02213458), 456 reported high baseline caregiver burden and were included in this extension trial (NCT04287738). Telephone‐based dementia care management was delivered by a trained care team navigator, with a team of dementia specialists. Primary outcome: PLWD quality of life (QoL‐AD); Secondary: caregiver depression (PHQ‐9), self‐efficacy (Care Ecosystem Self‐Efficacy...

The Effect of the Care Ecosystem Collaborative Care Model on End-of-Life Outcomes for People With Dementia and Their Caregivers

Mon, 18 May 2026 00:00:00 +0000
ContextCollaborative care models that feature care navigation have been found to have a range of benefit for people with dementia (PWD) and their caregivers, but their effect on end-of-life (EOL) outcomes has not been robustly evaluated.ObjectivesOur primary objective was to evaluate the effect of the Care Ecosystem-a telephone-based collaborative care model for dementia with care navigation-on EOL outcomes for PWD and their caregivers. Our secondary objective was to use qualitative feedback from participants to identify supports and services that would be helpful at end of life, including how the Care Ecosystem and other EOL supports could be improved.MethodsMixed-methods analysis of the Care Ecosystem trial conducted 2015-2022. Pre-mortem and post-mortem surveys included close-ended validated measures (eg, satisfaction with end-of-life care, caregiver self-efficacy) and open-ended questions about EOL care.ResultsThere were 138/124 dyads randomized to Care Ecosystem and 76/65...

The Association of Menopause With Lung Function in Women With and Without HIV

Fri, 8 May 2026 00:00:00 +0000
BACKGROUND: Menopause accelerates lung function decline in women without HIV, but whether menopause modifies lung function in women with HIV (WWH) is unknown. RESEARCH QUESTION: Is menopause associated with lung function in WWH and women at risk for HIV? STUDY DESIGN AND METHODS: Pulmonary function tests (spirometry: n = 1,116; diffusing capacity for carbon monoxide [Dlco]: n = 615) collected from 2018 to 2019 in 1,206 participants from the Women's Interagency HIV Study were included. In this cross-sectional analysis, women were categorized into groups defined by age (41-50 and 51-60 years of age) and by menopausal phase as determined by anti-Müllerian hormone, a biomarker of ovarian reserve. Linear regression models determined the differences in mean FEV₁, FVC, and Dlco by menopausal phase compared with women in the same age group. RESULTS: Overall, 71% were WWH, 65% were Black, and the median age was 52 years. Of the participants, 36% and 31% reported current and...

Bridging community-engaged research and implementation science methods to advance public health practice

Thu, 7 May 2026 00:00:00 +0000
Addressing public health challenges through equitable, evidence-based strategies remains a pressing global need. Implementation science bridges research and practice, offering methods to improve intervention design, delivery, and evaluation. Concurrently, community-engaged research embeds equity and trust into public health initiatives. This paper introduces selected community engagement methods and related implementation science approaches to address characteristic common constraints in public health practice, illustrated with real-world examples. Adapting the Knowledge to Action framework, we present a discussion of community-engaged methods and accompanying case studies. The discussion follows four phases present in applied public health research: (1) identifying and defining the problem, (2) designing and modifying the intervention, (3) evaluating the intervention, and (4) communicating and disseminating findings. For each phase, we highlight...

Use of Paracervical Blocks for Patients Who Undergo Intrauterine Device Insertion

Thu, 7 May 2026 00:00:00 +0000
Paracervical blocks can reduce pain during intrauterine device (IUD) insertions, but the extent and context in which they are used in practice are unclear. To evaluate paracervical block use during IUD insertions in an academic health system. This retrospective cross-sectional time-series study was performed at the University of California, San Francisco (UCSF), academic health care system using electronic health record data. Participants included individuals who underwent IUD insertions between July 2, 2012, and August 16, 2024. Data were analyzed from October 2023 to April 2025. Clinic-, clinician-, and patient-level variables. Paracervical block receipt was determined from clinical notes. Associations of paracervical block receipt with variables at the clinic, clinician, and patient levels were estimated with multilevel models. The role of clinic specialty (pediatrics or adolescent medicine vs all other specialties) in accounting for the association of age less than 18 years...

Unleashing Diffusion and State Space Models for Medical Image Segmentation

Thu, 7 May 2026 00:00:00 +0000
Existing segmentation models trained on a single medical imaging dataset often lack robustness when encountering unseen organs or tumors. Developing a robust model capable of identifying rare or novel tumor categories not present during training is crucial for advancing medical imaging applications. We propose DSM, a novel framework that leverages diffusion and state space models to segment unseen tumor categories beyond the training data. DSM utilizes two sets of object queries trained within modified attention decoders to enhance classification accuracy. Initially, the model learns organ queries using an object-aware feature grouping strategy to capture organ-level visual features. It then refines tumor queries by focusing on diffusion-based visual prompts, enabling precise segmentation of previously unseen tumors. Furthermore, we incorporate diffusion-guided feature fusion to improve semantic segmentation performance. By integrating CLIP text embeddings, DSM captures category-sensitive...

Integrating Mobile Text Messaging Pre-Exposure Prophylaxis Navigation Services Into a Home HIV and Sexually Transmitted Infection Self-Testing Program in the United States: Formative Work and Pilot Implementation Study.

Fri, 1 May 2026 00:00:00 +0000

Background
HIV testing is the gateway to the HIV prevention continuum and offers an important opportunity to provide HIV prevention services. TakeMeHome.org is an online program that enables state and local health departments to offer free in-home HIV and sexually transmitted infection self-testing. As few TakeMeHome users have used pre-exposure prophylaxis (PrEP), there is an opportunity to link TakeMeHome users to PrEP information and services.
Objective
The aim of this study is to develop an implementation strategy to link HIV or sexually transmitted infection self-testers from online orders to PrEP services via direct digital linkage to a novel SMS text messaging navigation program.
Methods
PrEPmate is an evidence-based bidirectional text-messaging platform that has demonstrated increased PrEP retention and adherence. We developed a novel program to link TakeMeHome testers to mobile SMS text messaging PrEP navigation via PrEPmate. We conducted focus groups...

Muscle mass, function and performance across the adult lifespan: the study of muscle, mobility and ageing

Wed, 22 Apr 2026 00:00:00 +0000
BACKGROUND: D3-creatine (D3Cr) dilution provides an accurate estimate of total body skeletal muscle mass, yet few studies have examined its relationship with function and performance across the lifespan, particularly before age 70. We modelled the association of age with D₃Cr muscle mass across adulthood and compared it with age-related differences in muscle function and performance. METHODS: Adults aged 30-69 years (n = 69; 33 men) and 70+ (n = 826; 344 men) from the Study of Muscle, Mobility and Ageing completed assessments of D3Cr muscle mass, magnetic resonance imaging (MRI) thigh muscle volume, 1-RM leg strength and leg extension power, 4 m walking speed and cardiorespiratory fitness (VO2 peak). Regression models estimated annualised percent differences with age for each outcome. RESULTS: In men, progressively lower D₃Cr muscle mass with advancing age (-0.5%/year in young adults to -1.4%/year in oldest-old) paralleled the pattern observed for leg strength and walking...

Enhanced Prenatal Care Models and Postpartum Depression

Thu, 9 Apr 2026 00:00:00 +0000
Racial, ethnic, and income disparities in perinatal depression prevalence and treatment are partially driven by social determinants of health. Effective treatments addressing these determinants are needed. To determine whether enhanced group prenatal care (eGPC) outperforms enhanced individual prenatal care (eIPC) for reducing perinatal depressive symptoms. This randomized clinical trial was conduced in 10 Medicaid-serving clinics in California’s San Joaquin Valley, enrolling English- or Spanish-speaking Medicaid-eligible pregnant individuals at less than 25 weeks’ gestation, from November 2019 to January 2024, with 2 follow-up surveys through 12 weeks postpartum. Analyses were conducted as intention-to-treat. Data were analyzed from December 2024 to December 2025. Participants were randomized to eIPC or eGPC. eIPC enhancements included assessments tailored to individual psychosocial, clinical, oral health, and substance use needs. eGPC enhancements included childcare, perinatal...

Development of the Preparation for Community‐Based Labor and Birth Instrument Centering Black Perspectives in the United States: A Participatory Adaptation

Wed, 1 Apr 2026 00:00:00 +0000
INTRODUCTION: Community-based birth supported by midwives and nurses is increasing in the United States amid stark racial disparities in maternal outcomes and worsening access to pregnancy care. Although studies examining prenatal confidence have shown that persons with higher confidence are more likely to give birth vaginally, reporting less pain, anxiety, and dissatisfaction, existing measurement tools have focused on hospital births. Accordingly, we adapted the previously validated Preparation for Labor and Birth (P-LAB) instrument, which measures third-trimester confidence for physiologic birth, for community-based births, centering the perspectives of Black populations. METHODS: Expert stakeholders (N = 5) including practicing midwives and maternal health researchers assessed the relevance and completeness of the P-LAB. Following individual reviews, stakeholders adapted the tool during a group review session. Virtual cognitive interviews were then conducted with community...

Long‐term safety of early discontinuation of antiseizure medication after resolution of acute provoked neonatal seizures

Thu, 26 Mar 2026 00:00:00 +0000
OBJECTIVE: To assess long-term safety of antiseizure medication (ASM) discontinuation after resolution of acute provoked neonatal seizures and prior to hospital discharge. METHODS: Prospective, observational, comparative effectiveness cohort study of neonates with acute provoked seizures born from July 2015 to March 2018, and followed until September 2024, at nine U.S. Neonatal Seizure Registry centers with Level IV neonatal intensive care units and Level IV pediatric epilepsy programs. Duration of ASM treatment was quantified as (1) discontinuation before discharge from the neonatal seizure admission or (2) maintenance at the time of hospital discharge. Outcomes were adjusted for propensity to receive ASM at discharge. Propensity for ASM maintenance was defined among enrolled participants by a logistic regression model including seizure etiology, gestational age, therapeutic hypothermia, worst electroencephalography (EEG) background, days of EEG seizures, and discharge neurological...

Behavioral interventions related to plastic waste management in low-and middle-income countries: a systematic review using the behavior change wheel and the theoretical domains framework

Thu, 26 Mar 2026 00:00:00 +0000
Abstract
Addressing the mounting plastic waste problem requires system-level solutions, along with interventions that promote behavioral change. In low-resource countries, inadequate, if not absent, waste management systems lead to unsafe disposal practices, including open burning. While theory-informed approaches are essential for identifying enablers and barriers to target behavior change, their application is limited in these settings. Given the lack of a theory-driven synthesis of behavioral strategies to address plastic waste, this systematic review aimed to: (1) synthesize behavioral interventions related to plastic waste management in low-resource countries; (2) map these interventions to the behavior change wheel (BCW), using the capability-opportunity-motivation-behavior model, and the theoretical domains framework (TDF); and (3) classify implementation strategies to inform theory-driven intervention design. This review is the first to use the BCW to examine behavioral...

Individualized Atrophy‐Based Prediction of Dementia Progression in Familial Frontotemporal Lobar Degeneration With Bayesian Linear Mixed‐Effects Modeling

Tue, 24 Mar 2026 00:00:00 +0000
OBJECTIVE: Age of symptom onset is highly variable in familial frontotemporal lobar degeneration (f-FTLD). Accurate prediction of onset would inform clinical management and trial enrollment. Prior studies indicate that individualized maps of brain atrophy can predict conversion to dementia in f-FTLD. We used a Bayesian linear mixed-effect (BLME) prediction method for identifying accelerated brain volume loss to predict conversion to dementia. METHODS: Participants included 234 asymptomatic or prodromal carriers of C9orf72, GRN, or MAPT mutations (including 21 dementia converters) with ≥3 longitudinal magnetic resonance imaging (MRI) T1-weighted scans. The BLME models established individual voxel-wise gray matter trajectories using the first 2 scans. Person-specific clusters of accelerated volume loss were estimated in subsequent scans and tested as predictors of dementia conversion compared with other approaches in time-varying Cox proportional hazard models covarying for age....

Intensity of Cyclophosphamide-Based Bridging Therapy Before Chimeric Antigen Receptor T Cell Therapy in Myeloma

Fri, 13 Mar 2026 00:00:00 +0000
Patients receiving autologous chimeric antigen receptor T cell (CAR-T) therapy for multiple myeloma (MM) may require bridging therapy (BT) before CAR-T infusion to maintain some level of disease control. Alkylators, such as cyclophosphamide (Cy), are often used in regimens, either in high-intensity regimens, such as modified hyperCVAD (cyclophosphamide, vincristine, doxorubicin, and dexamethasone), or once-weekly regimens, such as KCd (carfilzomib, cyclophosphamide, and dexamethasone). However, there is no consensus regarding the optimal BT alkylator dose intensity in MM. We performed a single-center analysis of all instances of BT before planned autologous CAR-T for MM during a 5-year period ending in April 2022. We classified bridging regimens into 3 cohorts: (1) hyperfractionated Cy (HyperCy) with inpatient Cy every 12 to 24 hours or as a continuous i.v. infusion; (2) less intensive Cy dosing (WeeklyCy), such as KCd; and (3) NonCy, in which no alkylators were used in BT. Demographic,...

Machine learning to optimize precision in the analysis of randomized trials: A journey in pre-specified, yet data-adaptive learning

Thu, 12 Mar 2026 00:00:00 +0000
Covariate adjustment is an approach to improve the precision of trial analyses by adjusting for baseline variables that are prognostic of the primary endpoint. Motivated by the SEARCH Universal HIV Test-and-Treat Trial (2013-2017), we tell our story of developing, evaluating, and implementing a machine learning-based approach for covariate adjustment. We provide the rationale for as well as the practical concerns with such an approach for estimating marginal effects. Using schematics, we illustrate our procedure: targeted machine learning estimation (TMLE) with Adaptive Pre-specification. Briefly, sample-splitting is used to data-adaptively select the combination of estimators of the outcome regression (i.e. the conditional expectation of the outcome given the trial arm and covariates) and known propensity score (i.e. the conditional probability of being randomized to the intervention given the covariates) that minimizes the cross-validated variance estimate and, thereby, maximizes...

Intrauterine SARS-CoV-2 Exposure and Infant Neurodevelopment through 18 Months of Age: Findings from the RECOVER Pregnancy Study

Thu, 12 Mar 2026 00:00:00 +0000
OBJECTIVE: To assess associations between exposure to intrauterine SARS-CoV-2 and subsequent child neurodevelopment in a large, diverse cohort with confirmation of maternal SARS-CoV-2 status. STUDY DESIGN: The Researching COVID to Enhance Recovery (RECOVER) Pregnancy Cohort enrolled adults with and without SARS-CoV-2 during pregnancy and their offspring born January 2020 through December 2023 at 23 sites across the US. Neurodevelopment was assessed at 12 months with the Ages and Stages Questionnaire, 3^rd edition (ASQ-3) and at 18 months with the ASQ Social-Emotional (ASQ-SE) and the Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R). We compared exposed and unexposed infants' ASQ-3 total and subdomain scores, ASQ-SE and M-CHAT-R scores, and proportions meeting published referral thresholds, using multivariable linear and logistic regression. RESULTS: Among 1179 participants enrolled, 1008 (85.5%) had exposure, with 806 (80.0%) exposed during Omicron predominance....

The accuracy of self-reported height, weight and BMI in a sample of emerging adult college students across California: an observational study

Thu, 26 Feb 2026 00:00:00 +0000
BackgroundSelf-reported height and weight are pragmatic, lower-cost alternatives for objective measurements but are potentially less accurate. This study examines the accuracy of self-reported measurements in a population of emerging adults.MethodsParticipants were 603 emerging adult college students aged 18 to 24 who attend public Hispanic-Serving Institutions of higher education in California, USA. The population was heterogeneous by race/ethnicity, gender, socioeconomic position, and body size. Participants self-reported height and weight; height and weight were then objectively measured during an in-person visit.ResultsRelative to objective measurements, participants, on average, overreported their height by 1.53 cm and underreported their weight by 0.77 kg, leading to an average body mass index (BMI) underestimation of 0.73 kg/m2. The discrepancy between self-report and objective measures significantly differed by gender, race/ethnicity, and weight but not...

Well-being of health workers providing maternal and newborn care: A qualitative evidence synthesis.

Tue, 17 Feb 2026 00:00:00 +0000
Health workers providing maternal and newborn care can experience burnout and emotional distress, which harms their well-being and, consequently, their ability to deliver respectful care. The World Health Organization (WHO) Compendium on respectful maternal and newborn care identifies health workers well-being as a critical area for intervention, but no specific definition or domains of well-being exist for this group. We conducted a qualitative evidence synthesis to synthesise key domains of well-being for health workers providing maternal and newborn care, by exploring health workers perceptions and experiences about their well-being. We searched MEDLINE, CINAHL and MIDIRS from 2010 to 20 August 2025 to identify studies reporting health workers perceptions and experiences of well-being while providing routine maternal and newborn care in any context. Using maximum variation purposive sampling, we sampled papers for data extraction. Thematic synthesis was employed for analysis,...

Effects of an agricultural intervention on psychosocial health among pregnant and nonpregnant women with HIV in Kenya

Fri, 13 Feb 2026 00:00:00 +0000
OBJECTIVES: We examined whether effects of an agricultural livelihood intervention on food insecurity and psychosocial outcomes remained robust in pregnant compared to nonpregnant women living with HIV, and whether potentially negative associations between pregnancy and these outcomes were alleviated by the intervention. DESIGN: Secondary analysis of the Shamba Maisha cluster-randomized controlled trial ( N = 396 women; NCT02815579). The intervention included agribusiness training and supplies. METHODS: Food insecure women with HIV in Kenya were followed for 24 months between 2016 and 2019. Food insecurity, empowerment, social support, depression, HIV stigma, and intimate partner violence were collected at all visits. We estimated the effect of the intervention on trends for each outcome via mixed-effects regression, separately for women who did and did not become pregnant during follow-up, and whether trends differed by pregnancy status, separately by arm and adjusted for demographic...

Integrating nonpharmacologic strategies for pain with Inclusion, Respect, and Equity (INSPIRE): a digital health study protocol for a pragmatic multisite randomized controlled trial

Fri, 6 Feb 2026 00:00:00 +0000
BackgroundChronic pain (CP) is among the most common medical conditions, is the leading cause of disability, and is often refractory to medical treatment. The CDC and the American College of Physicians recommend nonopioid and nonpharmacologic treatment as first-line strategies, including cognitive-behavioral therapy (CBT), mindfulness-based interventions (MBI), and movement-focused interventions (MFI); however, only 3% of people with chronic pain (CP) have access to these evidence-based treatments. Patients from historically minoritized populations and those speaking languages other than English are particularly underserved and may go untreated. Stigma regarding CP and interventions to manage it present additional obstacles.MethodsThe Integrating Nonpharmacologic Strategies for Pain with Inclusion, Respect, and Equity (INSPIRE) study evaluates a blend of these non-pharmacologic, evidence-based interventions using a pragmatic, parallel, two-arm RCT comparing intervention participants...

Metabolic response to extended continuous positive airway pressure in premature infants

Thu, 29 Jan 2026 00:00:00 +0000
BackgroundExtending the duration of continuous positive airway pressure (CPAP) in preterm infants with respiratory distress may improve lung function.ObjectiveAssess the impact of extended CPAP (eCPAP) on the metabolomic profile and relationship to lung function.Design/methodsInfants ≤32 weeks’ gestational age were randomized to bubble eCPAP with room air or discontinued CPAP (dCPAP). Functional residual capacity (FRC) was measured at randomization and at 2 weeks. Blood samples obtained during treatment were subjected to UHPLC:MS/MS (Metabolon Inc.) and metabolomic data were analyzed by ANCOVA.ResultseCPAP infants had greater increases in both FRC (2.1-fold, p = 0.005) and weight (1.13-fold, p = 0.03). Of 1230 total metabolites detected, levels of 87 were higher at p < 0.05 and 75 were lower in eCPAP infants. A new plateau level for key metabolites occurred at 5 ± 2 days after discontinuing CPAP. Sub pathway enrichment (p < 0.05) occurred for bilirubin degradation products...

Neuropathological comorbidities in Frontotemporal Lobar Degeneration: Implications for Diagnosis

Thu, 15 Jan 2026 00:00:00 +0000
AbstractBackground
Frontotemporal lobar degeneration (FTLD) is an umbrella term encompassing neurodegenerative diseases that either feature tau, TDP‐43, or FET inclusions. As FTLD is associated with a younger age of onset, there has been less focus on studying age‐related co‐pathologies. The presence of co‐pathology affects clinical manifestations and has implications for diagnosis as well as management. To investigate the frequency and type of co‐pathologies in the FTLD spectrum, we examined a large postmortem clinicopathological cohort.
Method
We included all FTLD cases at the Neurodegenerative Disease Brain Bank (NDBB) at UCSF collected between 2005 and 2024 (Table 1). All brains underwent standardized neuropathological assessment. We investigated the frequency of the most common age‐related neurodegenerative changes in primary neuropathological diseases including FTLD‐TDP43 type A (n = 43), type B (n = 48), type C (n = 43) and unclassifiable...

HPV vaccine awareness and uptake in rural Indigenous communities in Guatemala: a cross-sectional study.

Sat, 10 Jan 2026 00:00:00 +0000

Objectives
To assess human papillomavirus (HPV) vaccine awareness and uptake among caregivers in rural Indigenous communities in Guatemala and to identify sociodemographic predictors of vaccine unawareness and non-uptake.
Methods
This cross-sectional survey was conducted across 12 rural Indigenous communities in Guatemalas Central Highlands. Using a community-engaged research approach, trained multilingual health workers administered surveys in Spanish, Kaqchikel or Kiche. Eligible participants were adults who served as primary caregivers to children. The survey assessed HPV vaccine awareness, vaccine attitudes and uptake among those with daughters aged 8 or older. Logistic regression was used to examine predictors of vaccine unawareness and bivariate analysis explored differences in vaccine uptake.
Results
Among 602 participants (92.5% identified as Indigenous), 95% expressed willingness to vaccinate a child against cervical cancer, yet only 56% had heard...

Beyond pain presence: the impact of multisite pain and pain interference on cognitive functioning among middle-aged and older adults

Fri, 9 Jan 2026 00:00:00 +0000
OBJECTIVES: This study investigates the relationship between chronic pain and cognitive function in the U.S. middle-aged and older population, focusing on the impact of the number of pain sites. It also explores whether pain interference mediates the association between pain sites and cognition. METHODS: Data were drawn from the 2004-2006 and 2013-2017 waves of the Midlife in the United States Study (MIDUS 2 and MIDUS 3, N = 2,219). We fit inverse-probability-weighted models to examine the associations between pain status, number of pain sites (none vs. 1-2 vs. 3+ sites), and cognitive function in MIDUS 3, controlling for confounders from MIDUS 2. The Sobel-Goodman mediation test with Bonferroni-adjusted significance level was applied to assess the mediating role of pain interference in five domains: activities, mood, relationships, sleep, and enjoyment. RESULTS: Among those with chronic pain, 40% report pain in three or more sites. There was no significant difference in cognitive...

Evaluating segregated school attendance as a mediator of geographic inequities in late‐life cognitive function: evidence from the Study of Healthy Aging in African Americans (STAR)

Thu, 8 Jan 2026 00:00:00 +0000
INTRODUCTION: Birth in the Southern United States is associated with poorer late-life cognitive health, especially among Black Americans, yet the role of school segregation is unclear. METHODS: Utilizing decomposition methods, we estimated the total effect, natural direct effect (NDE), and natural indirect effect (NIE) of Southern birth on domain-specific cognition among 727 older Black adults, adjusting for early-life covariates. We also estimated the proportion of the total effect mediated by self-reported segregated school attendance. RESULTS: Southern birth was associated with lower late-life executive function and semantic memory; estimates were negative but not significant for verbal episodic memory. The direct effect of Southern birth was negative but not significant for all domains. Attending a segregated school mediated 35% and 49% of the total association between Southern birth and executive function (NIE: -0.07, 95% confidence interval [CI]: [-0.18, 0.02]) and...

Alzheimers Imaging Consortium.

Tue, 6 Jan 2026 00:00:00 +0000

Background
Amyloid PET use has been associated with change in clinical management among cognitively impaired older adults but various ethnoracial groups were underrepresented in prior studies. New IDEAS examined whether this association exists among cognitively impaired ethnoracially diverse Medicare beneficiaries and beneficiaries presenting with clinically atypical (non-memory predominant) presentations of Alzheimers disease (AD).
Methods
New IDEAS was a national, multi-site, prospective, longitudinal study that enrolled Medicare beneficiaries with mild cognitive impairment (MCI) or dementia who underwent amyloid PET scan as recommended by their treating dementia specialists at real-world clinics. The study examined association between amyloid PET and subsequent change in clinical management within 90 days of PET. Primary endpoint was change in management between pre- and post-PET visits defined as a composite inclusive of change in AD and non-AD drugs and change...

Alzheimers Imaging Consortium.

Tue, 6 Jan 2026 00:00:00 +0000

Background
Socioeconomic vulnerabilities and healthcare environment contribute to disparities in dementia assessment. Whether these affect dementia management, however, remains unclear. We used Imaging Dementia - Evidence for Amyloid Scanning (IDEAS) study data to compare the impact of amyloid PET on pharmacological management across social factors, patient comorbidities, and physician practice settings.
Methods
We analyzed rates of pharmacological change in IDEAS participants with visually interpretable amyloid PET, completed pre- and post-PET case reports, social determinants (racioethnic identity of Asian, Black, Hispanic, or White, area deprivation index (ADI), living arrangement, education) and medical history. Outcomes included any change between pre-PET and post-PET visits in prescription of Alzheimers disease (AD) drugs, and of non-AD drugs treating dementia risk factors or affecting cognition/mood/behavior. We used multilevel logistic regression with a...

Hotspot exons are common targets of splicing perturbations

Mon, 22 Dec 2025 00:00:00 +0000
High-throughput splicing assays have demonstrated that many exonic variants can disrupt splicing; however, splice-disrupting variants distribute non-uniformly across genes. We propose the existence of exons that are particularly susceptible to splice-disrupting variants, which we refer to as hotspot exons. Hotspot exons are also more susceptible to splicing perturbation through drug treatment and knock-down of RNA-binding proteins. We develop a classifier for exonic splice-disrupting variants and use it to infer hotspot exons. We estimate that 1400 exons in the human genome are hotspots. Using panels of splicing reporters, we demonstrate how the ability of an exon to tolerate a mutation is inversely proportional to the strength of its neighboring splice sites.

Decreased limb muscle and increased central adiposity are associated with 5-year all-cause mortality in HIV infection

Fri, 5 Dec 2025 00:00:00 +0000
BACKGROUND: Unintentional loss of weight and muscle due to aging and disease has been associated with increased mortality. Wasting and weight loss occur in HIV infection even in the modern era of effective antiretroviral therapy. METHODS: We determined the association of MRI-measured regional and total skeletal muscle and adipose tissue with 5-year, all-cause mortality in 922 HIV-infected persons in the study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM). RESULTS: After 5 years of follow-up, HIV-infected participants with arm skeletal muscle in the lowest tertile had a mortality rate of 23%, compared with 11 and 8% for those in the middle and highest tertiles. After multivariable adjustment for demographics, cardiovascular risk factors, HIV-related factors, inflammatory markers, and renal disease, we found that lower arm skeletal muscle, lower leg skeletal muscle and higher visceral adipose tissue (VAT) were each independently associated with increased mortality....

Regional Adipose Tissue and Lipid and Lipoprotein Levels in HIV-Infected Women

Fri, 5 Dec 2025 00:00:00 +0000
BACKGROUND: HIV infection and antiretroviral therapy are associated with dyslipidemia, but the association between regional body fat and lipid levels is not well described. METHODS: Multivariable linear regression analyzed the association between magnetic resonance imaging-measured regional adipose tissue and fasting lipids in 284 HIV-infected and 129 control women. RESULTS: Among African Americans, HIV-infected women had higher triglyceride (116 vs. 83 mg/dL; P < 0.001), similar high-density lipoprotein (HDL; 52 vs. 50 mg/dL; P = 0.60), and lower low-density lipoprotein (LDL; 99 vs. 118 mg/dL; P = 0.008) levels than controls. Among whites, HIV-infected women had higher triglyceride (141 vs. 78 mg/dL; P < 0.001), lower HDL (46 vs. 57 mg/dL; P < 0.001), and slightly lower LDL (100 vs. 107 mg/dL; P = 0.059) levels than controls. After adjustment for demographic and lifestyle factors, the highest tertile of visceral adipose tissue (VAT) was associated with higher triglyceride...

Psychometric Validation of Trust, Commitment, and Satisfaction Scales to Measure Marital Relationship Quality Among Newly Married Women in Nepal

Sun, 30 Nov 2025 00:00:00 +0000
Marital relationship quality significantly influences health outcomes, but validated measurement tools for South Asian populations remain limited. To validate scales measuring trust, commitment, and satisfaction as key components of marital relationship quality among newly married women in Nepal, we conducted a two-wave psychometric validation study in rural Nawalparasi district. The study included 200 newly married women aged 18-25 years, with 192 participants (96% retention) completing 6-month follow-up. We assessed factor structure, internal consistency, test-retest reliability, and criterion validity of trust (eight items), commitment (five items), and satisfaction (seven items) scales using exploratory and confirmatory factor analysis. Exploratory factor analysis identified single-factor solutions for trust and commitment scales and a two-factor model for satisfaction. Confirmatory factor analysis confirmed these structures, with satisfaction comprising marital conflict/dissatisfaction...

Data Resource Profile: Global Trachoma Serology Data Repository

Thu, 20 Nov 2025 00:00:00 +0000
Data Resource Profile: Global Trachoma Serology Data Repository

Pharmacist care for attention-deficit/hyperactivity disorder electronic medication refills: A cluster randomized trial.

Thu, 20 Nov 2025 00:00:00 +0000
BACKGROUND: During the pandemic, the US government loosened restrictions on telemedicine prescribing for controlled substance refills. Parent requests for attention-deficit/hyperactivity disorder (ADHD) medication refills have increased electronic inbox workload for physicians. Pharmacists can now fulfill these requests via collaborative practice agreements, but scant information exists on the effectiveness of this approach. OBJECTIVE: To compare pharmacist with pediatrician management of ADHD medication refill requests regarding quality, timeliness, and parent ratings. METHODS: This cluster randomized clinical trial assigned electronic ADHD medication refill requests from 63 medical facilities in a regional health care system to either Pharmacist Care by a regional team (32 facilities) or local Pediatrician Care (31 facilities) from May 14, 2024, to June 21, 2024. The primary outcome was prespecified in the study protocol as a quality measure to be evaluated among patients without...

Social Media Recruitment in Indigenous and Native American Populations: Challenges in the AI Age

Mon, 17 Nov 2025 00:00:00 +0000
Unlabelled: Using social media recruitment for public health research presents both opportunities and challenges. Despite its increased use, few studies have detailed the practical issues, challenges encountered, and alternative strategies available for social media recruitment. This paper explores strategies for recruiting Indigenous and Native American populations in California for a study on COVID-19 vaccination and social networks. We describe different recruitment approaches, challenges faced, and pros and cons of strategies used to enhance data quality and efficiency, including survey design considerations, Facebook targeting versus use of research panels, quality assurance checks, and decisions around participant incentives. Our local setting involved recruiting Native American and Mesoamerican Indigenous individuals living in California through social media platforms. We highlight key adaptations to survey design, recruitment strategies, and data cleaning processes, noting...

Intergenerational upward educational mobility and cognitive performance: results from the Study of Latinos‐Investigation of Neurocognitive Aging (SOL‐INCA)

Fri, 7 Nov 2025 00:00:00 +0000
INTRODUCTION: Upward educational attainment is associated with better cognitive function; differences by Hispanic/Latino heritage are unclear. METHODS: We analyzed data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and its ancillary study SOL-Investigation of Neurocognitive Aging (SOL-INCA; n = 3300) to compare cognitive function and 7-year cognitive change between first-generation and multigenerational high school (HS) graduates (i.e., neither parent vs 1+ parent graduated HS) using survey-linear regression models, and assessing for heterogeneity by heritage and nativity. RESULTS: First-generation Cuban, Mexican, and Puerto Rican HS graduates had significantly lower baseline cognitive scores than multigenerational graduates, while Dominican, Central, and South American graduates had similar cognitive scores. We found some evidence of heterogeneity by nativity. Cognitive change was similar across groups. DISCUSSION: More studies of Latinos across...

The I-ACTED study (investigating action civics training through an experimental design): a cluster randomized controlled trial of a school-based action civics education intervention on adolescent wellbeing

Thu, 6 Nov 2025 00:00:00 +0000
BackgroundObservational studies have found that youth civic engagement is associated with positive mental health, education, and socioeconomic outcomes. However, access to civic opportunities is not evenly distributed. Many classrooms in the United States of America (USA) do not have access to high-quality civics education. Action civics approaches to civic education prepare students for civic engagement by developing the necessary civic skills, knowledge, and character. Through action civics, classes take action on a real-world issue students choose together. Some evidence suggests that action civics may positively affect participants’ wellbeing through the feelings of civic connection and empowerment. The aim of this study is to investigate, through a randomized controlled trial, the impact of a school-based action civics education intervention on civic and wellbeing outcomes, and the mechanisms of any impact observed, among middle and high school students in the USA.MethodsThis...

The Complex Relationship of Genetic Ancestry With Self‐Reported Race/Ethnicity

Wed, 29 Oct 2025 00:00:00 +0000
Race and ethnicity are demographic constructs used to characterize individuals in biomedical research, and in particular to assess health disparities. Their use in medicine and research has been discussed and challenged, as well as the degree to which they represent strictly social constructs, or ones also with biological meaning. The relationship of race and ethnicity with genetic ancestry has also been described, and how genetic ancestry reflects historical continental isolation, migration, and mating structure. Race and ethnicity are currently most often assessed by self-report in epidemiology and biomedical applications. Here we further interrogate the relationship between how people self-report their race and ethnicity and their genetic ancestry by examining self-report patterns of 97,671 individuals who are participants in the Kaiser Permanente Northern California Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort. Genetic ancestry was determined from...

The Earth BioGenome Project 2020: Starting the clock

Mon, 20 Oct 2025 00:00:00 +0000
Description

Strategies Facilitating Video Visit Implementation by a Medical Group Serving a Diverse Population.

Sun, 12 Oct 2025 00:00:00 +0000
IntroductionVideo visits have created new opportunities to enhance access to care, but limited information exists on strategies medical groups can employ to facilitate video visit use by higher-risk patients. Our objective was to identify generalizable strategies to facilitate successful delivery of video visits by systems serving highly diverse patient populations. MethodsThe authors conducted a qualitative study of physicians and staff members in a large group practice with 4.5 million patients with diverse race and ethnicity and socioeconomic status. Semi-structured interviews were conducted between January 2021 and April 2021, with key informants identified via purposive and snowball sampling. Video-recorded interviews were transcribed and analyzed using thematic analysis to identify major themes and subthemes. ResultsThe 42 key informants included regional and medical center leaders, primary care physicians, service managers, and medical assistants. Participants described...

Pharmacist vs physician management of e-visit requests for COVID-19 medication: A randomized clinical trial.

Sun, 12 Oct 2025 00:00:00 +0000
BACKGROUND: Electronic visits (e-visits), defined as structured asynchronous electronic messages between patients and clinicians requiring clinical decision-making, are being increasingly used to enhance access to outpatient health care services, but the primary care physicians who typically manage them face work overflow. Pharmacists have been proposed to manage e-visits that lead to prescription requests, but scant evidence exists about the effectiveness of this approach. OBJECTIVE: To compare pharmacist management of structured asynchronous e-visit requests for COVID-19 medication with physician management regarding quality of care, timeliness, and patient care experience. METHODS: This cluster-randomized clinical trial included adults from 17 medical facilities of Kaiser Permanente Northern California who made e-visits requesting COVID-19 medication (nirmatrelvir-ritonavir) from October 9 to December 11, 2023. In the Pharmacist Care group, a regional team of pharmacists managed...

The Integration of Clinical Trials With the Practice of Medicine

Sun, 12 Oct 2025 00:00:00 +0000
Importance: Optimal health care delivery, both now and in the future, requires a continuous loop of knowledge generation, dissemination, and uptake on how best to provide care, not just determining what interventions work but also how best to ensure they are provided to those who need them. The randomized clinical trial (RCT) is the most rigorous instrument to determine what works in health care. However, major issues with both the clinical trials enterprise and the lack of integration of clinical trials with health care delivery compromise medicine's ability to best serve society. Observations: In most resource-rich countries, the clinical trials and health care delivery enterprises function as separate entities, with siloed goals, infrastructure, and incentives. Consequently, RCTs are often poorly relevant and responsive to the needs of patients and those responsible for care delivery. At the same time, health care delivery systems are often disengaged from clinical trials and...

A cross‐sectional study comparing men who have sex with men and inject drugs and people who inject drugs who are men and have sex with men in San Francisco: Implications for HIV and hepatitis C virus prevention

Sun, 12 Oct 2025 00:00:00 +0000
A cross‐sectional study comparing men who have sex with men and inject drugs and people who inject drugs who are men and have sex with men in San Francisco: Implications for HIV and hepatitis C virus prevention

Associations between widowhood status/duration, depression, and cognitive function among community-dwelling Indians age 60 years or older: Exploration of sex and residential factors

Fri, 10 Oct 2025 00:00:00 +0000
BackgroundThe death of a spouse is considered one of the most life challenging stressors. Widowhood has a profound influence on health and may increase the risk of depression and poorer cognitive function. Discriminatory practices in India, such as taboos against remarrying, a lack of occupational opportunities, and social support, may lead to differential widowhood experiences, especially among women. This study examined the associations between widowhood status/duration, depression and cognitive function among community-dwelling men and women in India. Considering the unique cultural and societal context in India, this study also sought to examine differences by sex, rural/urban residence, and multigenerational living status.MethodsWe used baseline data from the Longitudinal Aging Study in India. Data were collected between 2017 and 2019. The study sample consisted of 14,691 men and 15,948 women age ≥ 60 years. Depression was measured using the Short Form Composite International...

Phenotypic pleiotropy of missense variants in human B cell confinement receptor P2RY8

Thu, 9 Oct 2025 00:00:00 +0000
Missense variants can have pleiotropic effects on protein function, and predicting these effects can be difficult. We performed near-saturation deep mutational scanning of P2RY8, a G protein-coupled receptor that promotes germinal center B cell confinement. We assayed the effect of each variant on surface expression, migration, and proliferation. We delineated variants that affected both expression and function, affected function independently of expression, and discrepantly affected migration and proliferation. We also used cryo-electron microscopy to determine the structure of activated, ligand-bound P2RY8, providing structural insights into the effects of variants on ligand binding and signal transmission. We applied the deep mutational scanning results to both improve computational variant effect predictions and to characterize the phenotype of germline variants and lymphoma-associated variants. Together, our results demonstrate the power of integrating deep mutational scanning,...

Identifying the vulnerable among the vulnerable: applying quantitative intersectionality methods to assess potential inequities in the HIV continuum of care for people living with schizophrenia in the united States

Wed, 1 Oct 2025 00:00:00 +0000
BackgroundPeople living with schizophrenia face disproportionate risk of HIV, yet HIV testing remains low. Differential testing rates and engagement in care may be impacted by compounding social marginalization, partly linked to structural barriers. Grounded in intersectionality, we set out to identify the riskiest intersectional positions for HIV testing and engagement in HIV care in the United States.MethodsWe created a retrospective cohort of people living with schizophrenia and matched controls, using 2012 national Medicaid claims data. We coded intersectional positions based on schizophrenia diagnosis, race/ethnicity, sex, and age. We used Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) models to assess intersectional effects for two outcomes, HIV testing and retention in HIV care (RIC) defined as ≥2 CD4 or HIV viral load tests ≥90 days apart.ResultsOf 777,887 patients in the testing cohort, 7.7% tested for HIV; 39% of the 17,913 patients...

Falls Among Individuals With Systemic Lupus Erythematosus: An Observational Study

Fri, 12 Sep 2025 00:00:00 +0000
OBJECTIVE: Systemic lupus erythematosus (SLE) is thought to accelerate the aging process. However, there is limited research on geriatric syndromes, such as falls, in this potentially vulnerable population. This study aimed to describe the prevalence of and contributors to falls in the SLE population. METHODS: Participants were recruited from an ongoing population-based cohort of individuals with validated SLE. Falls (number of falls and fall-related injuries requiring medical attention over the past year) and perceived contributing factors were self-reported. Descriptive statistics were calculated, and age-, sex-, and race-adjusted odds ratios (aORs) of participant characteristics with falls were estimated using multivariable logistic regression. RESULTS: Nearly one-third (30.7%) of participants (overall N = 447; 40.9% aged ≥50 years, 91.7% female, and 82.6% Black) reported falling in the past year; 19.2% fell twice or more. Loss of balance (78.1% of falls), slipping/tripping...

Racial/ethnic and socioeconomic disparities in survival among children with acute lymphoblastic leukemia in California, 1988–2011: A population‐based observational study

Fri, 12 Sep 2025 00:00:00 +0000
BACKGROUND: Despite advances in treatment, survival from acute lymphoblastic leukemia (ALL) remains lower among non-White children than White children in the US. We investigated the association of race/ethnicity and socioeconomic status (SES) with survival. PROCEDURES: We analyzed 9,295 Californian children (3,251 Whites, 4,890 Hispanics, 796 Asians, and 358 Blacks) aged ≤ 19 years diagnosed with a first primary ALL during 1988-2011. We used the Kaplan-Meier method to estimate survival at 1, 5, and 10 years after diagnosis for three calendar periods. Hazard ratios of death for race/ethnicity, SES, and clinical factors were estimated by Cox regression models. RESULTS: Median follow-up time was 7.4 years (range 0-25 years). Over time, survival after ALL improved steadily, but inequalities persisted across races/ethnicities. Five-year survival (95% confidence interval) was 85.0% (83.6-86.2) for White, 81.4% (78.3-84.0) for Asian, 79.0% (77.8-80.2) for Hispanic, and 74.4% (69.4-78.8)...

Efficiency of Evidence Accumulation as a Formal Model-Based Measure of Task-General Executive Functioning in Adolescents

Thu, 11 Sep 2025 00:00:00 +0000
Difficulties with executive functioning are implicated in various forms of psychopathology. However, executive functioning task performance frequently demonstrates poor test-retest reliability, questionable convergent validity, and unstable associations with clinical measures. Model-based approaches may improve measurement by providing richer information about mechanisms underlying performance. The present study systematically compared a model-based measure of task-general executive functioning, efficiency of evidence accumulation (EEA), with traditional summary metrics extracted from the same tasks in a longitudinal study of adolescents (N = 637, age = 7-19). EEA demonstrated reasonable stability across development and strong cross-task reliability. Reflecting traditional metrics, EEA related to self-reported effortful control and parent-reported attention, externalizing and total problems. EEA and one traditional metric (go/no-go standard deviation of reaction time) correlated...

Safety and efficacy of a STAT3-targeted cyclic oligonucleotide: From murine models to a phase 1 clinical trial in pet cats with oral cancer

Wed, 10 Sep 2025 00:00:00 +0000
STAT3 is an oncogenic transcription factor that activates cancer cell signaling and induces an immunosuppressive immune environment, making it an attractive therapeutic target. Transcription factors are exceptionally challenging targets and there are no Food and Drug Administration-approved STAT3 inhibitors. We previously reported positive pharmacodynamics of a linear STAT3 decoy oligonucleotide administered intratumorally in a phase 0 trial in patients with head and neck cancer squamous cell carcinoma (HNSCC). Here, we describe the anti-tumor and immune effects of a systemically administered cyclic STAT3 decoy (CS3D) in immunocompetent HNSCC murine models and the safety and efficacy of CS3D in a clinical trial in pet cats with HNSCC. Responders in the clinical trial (35% disease control rate) showed significant differences in selected peripheral blood immune parameters as well as elevated PD-1 expression in the tumors compared with non-responders. These findings support a clinical...

Modeling the importance of life exposure factors on memory performance in diverse older adults: A machine learning approach

Sat, 23 Aug 2025 00:00:00 +0000
INTRODUCTION: Many health life exposure factors (LEFs) influence cognitive decline and dementia incidence, but their relative importance to episodic memory (an early indicator of cognitive decline) among diverse older adults is unclear. We used machine learning to rank LEFs for memory performance in a large and diverse US cohort. METHODS: Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) and Study of Healthy Aging in African Americans (STAR), participants underwent neuropsychological testing and answered questionnaires about multiple LEFs. XGBoost and Shapley Additive exPlanation values ranked the importance of factors influencing cross-sectional episodic memory in the full sample and by sex and ethnic group. RESULTS: Among 2245 adults (mean age: 74 years; range 54-90), age, sex, education, volunteering, income, vision, hearing, sleep, and exercise contributed to memory performance regardless of group stratification. DISCUSSION: This innovative methodology can help identify...

Perceptions of pharmacist-furnished nicotine replacement therapy among participants who smoke in California

Tue, 19 Aug 2025 00:00:00 +0000
BACKGROUND AND OBJECTIVE: California's Central Valley has high rates of tobacco product use and low rates of access to primary care providers. In 2016, California sought to increase access to cessation treatment by allowing pharmacists to prescribe nicotine replacement therapy (NRT). We sought to identify the extent to which this prescribing authority has been integrated into practice. METHODS: From December 2023 to May 2024, we surveyed adult California participants (n = 271) who smoke about their smoking patterns, perceptions towards NRT, experiences with receiving tobacco cessation resources in pharmacies. Participants were recruited via email and in person. We analyzed participants' smoking and quitting history, perceptions of NRT, and experiences with tobacco cessation, comparing residents of California's Central Valley (n = 52) to other regions of the state (n = 219). RESULTS: Smoking rates were comparable for respondents in the Central Valley and those residing in other...

Improved detection of microbiome-disease associations via population structure-aware generalized linear mixed effects models (microSLAM)

Thu, 14 Aug 2025 00:00:00 +0000
Microbiome association studies typically link host disease or other traits to summary statistics measured in metagenomics data, such as diversity or taxonomic composition. But identifying disease-associated species based on their relative abundance does not provide insight into why these microbes act as disease markers, and it overlooks cases where disease risk is related to specific strains with unique biological functions. To bridge this knowledge gap, we developed microSLAM, a mixed-effects model and an R package that performs association tests that connect host traits to the presence/absence of genes within each microbiome species, while accounting for strain genetic relatedness across hosts. Traits can be quantitative or binary (such as case/control). MicroSLAM is fit in three steps for each species. The first step estimates population structure across hosts. Step two calculates the association between population structure and the trait, enabling detection of species for...

Improved prediction and flagging of extreme random effects for non-Gaussian outcomes using weighted methods

Mon, 4 Aug 2025 00:00:00 +0000
Investigators often focus on predicting extreme random effects from mixed effects models fitted to longitudinal or clustered data, and on identifying or "flagging" outliers such as poorly performing hospitals or rapidly deteriorating patients. Our recent work with Gaussian outcomes showed that weighted prediction methods can substantially reduce mean square error of prediction for extremes and substantially increase correct flagging rates compared to previous methods, while controlling the incorrect flagging rates. This paper extends the weighted prediction methods to non-Gaussian outcomes such as binary and count data. Closed-form expressions for predicted random effects and probabilities of correct and incorrect flagging are not available for the usual non-Gaussian outcomes, and the computational challenges are substantial. Therefore, our results include the development of theory to support algorithms that tune predictors that we call "self-calibrated" (which control the incorrect...

Characterisation of between-cluster heterogeneity in malaria cluster randomised trials to inform future sample size calculations

Sun, 3 Aug 2025 00:00:00 +0000
Cluster randomised trials (CRTs) are important tools for evaluating the community-wide effect of malaria interventions. During the design stage, CRT sample sizes need to be inflated to account for the cluster heterogeneity in measured outcomes. The coefficient of variation (k), a measure of such heterogeneity, is typically used in malaria CRTs yet is often predicted without prior data. Underestimation of k decreases study power, thus increases the probability of generating null results. In this meta-analysis of cluster-summary data from 24 malaria CRTs, we calculate true prevalence and incidence k values using methods-of-moments and regression modelling approaches. Using random effects regression modelling, we investigate the impact of empirical k values on original trial power and explore factors associated with elevated k. Results show empirical estimates of k often exceed those used in sample size calculations, which reduces study power and effect size precision. Elevated...

Cluster randomised controlled trial of a household-level, group preconception nutrition awareness and norm intervention (SUMADHUR) combined with multiple micronutrient supplements (MMS) for newly married households: a protocol

Sat, 2 Aug 2025 00:00:00 +0000
INTRODUCTION: Micronutrient deficiencies remain prominent drivers of adverse maternal and child health outcomes in Nepal. Gender-based inequalities and norms around women's status and access to nutrition exacerbate poor nutritional status. Many newly married, preconception women lack adequate nutrition due to delayed engagement with the health system and limited autonomy to prioritise their own health. To address this gap, the Sumadhur trial provides multiple micronutrient supplements (MMS) alongside a household-level behavioural intervention targeting newly married women, their husbands and mothers-in-law. METHODS AND ANALYSIS: This will be a village-cluster randomised controlled trial across three districts in Nepal, enrolling 700 households, each comprising a triad of newly married woman, husband and mother-in-law. Villages will be randomised to receive either Sumadhur behavioural intervention+MMS (intervention) or standard of care (control). In intervention villages, participants...

Development of a machine learning algorithm to predict the residual cognitive reserve index

Wed, 30 Jul 2025 00:00:00 +0000
Elucidating the mechanisms by which late-life neurodegeneration causes cognitive decline requires understanding why some individuals are more resilient than others to the effects of brain change on cognition (cognitive reserve). Currently, there is no way of measuring cognitive reserve that is valid (e.g. capable of moderating brain-cognition associations), widely accessible (e.g. does not require neuroimaging and large sample sizes), and able to provide insight into resilience-promoting mechanisms. To address these limitations, this study sought to determine whether a machine learning approach to combining standard clinical variables could (i) predict a residual-based cognitive reserve criterion standard and (ii) prospectively moderate brain-cognition associations. In a training sample combining data from the University of California (UC) Davis and the Alzheimer's Disease Neuroimaging Initiative-2 (ADNI-2) cohort (N = 1665), we operationalized cognitive reserve using an...

Overheated and Understudied: A Scoping Review of Heat‐Related Health Impacts in the Arabian Peninsula

Wed, 16 Jul 2025 00:00:00 +0000
Extreme heat is worsening due to climate change, and, in combination with increasing urban growth, is an escalating public health concern. In the Arabian Peninsula, the wet-bulb temperature is projected to surpass theoretical human tolerance limits during the 21st century. Yet, heat research in the region has generally not focused on health impacts, and it is unclear how epidemiologic literature has investigated this. We performed a scoping review to examine the existing literature that assessed the relationship between extreme heat and health outcomes in the Arabian Peninsula, collecting papers published from 2010 to 2024 from three databases. We identified and extracted detailed information from a limited number of studies (n = 12). The greatest number of studies were conducted in Kuwait (n = 8), with others in Saudi Arabia (n = 4), and Qatar, Oman, Yemen, and the United Arab Emirates (n = 1 each). Average temperature...

Development of chronic pain and high‐impact chronic pain across the US rural–urban continuum, 2019–2020

Mon, 7 Jul 2025 00:00:00 +0000
PURPOSE: Rural health disadvantages are well documented in previous literature; however, research on rural-urban disparities in chronic pain outcomes is scarce. This paper fills this gap by examining pain prevalences and longitudinal transitions across the rural-urban continuum (i.e., large central metro, large fringe metro, medium and small metro, and nonmetropolitan). METHODS: Based on the 2019-2020 National Health Interview Survey Longitudinal Cohort (NHIS-LC) data, we examined the disparities in pain prevalences and transitions among different pain statuses, including no pain, nonchronic pain, chronic pain, and high-impact chronic pain (HICP), across the rural-urban continuum and by age, sex, race/ethnicity, and region. A test for linear trend was conducted to examine the significance of linear changes across the rural-urban continuum. FINDINGS: The findings reveal significant linear increases in the prevalence of chronic pain and HICP, as well as transitions from no pain...

Adult child educational attainment and older parents’ psychosocial outcomes during the COVID-19 pandemic

Mon, 7 Jul 2025 00:00:00 +0000
BackgroundOlder adults’ psychosocial outcomes during the COVID-19 pandemic have been inequitable by socio-economic status (SES). However, studies have focused solely on own SES, ignoring emerging evidence of the relationship between adult child SES and late-life health. We evaluated whether adult child educational attainment – a core marker of SES – is associated with older parents’ psychosocial outcomes during the pandemic.MethodsWe used data from the Survey of Health, Aging, and Retirement in Europe (SHARE) 2004–2018 and the SHARE Corona Surveys (SCS) 2020 and 2021. We included 40,392 respondents ≥ 65 years who had pre-pandemic information on adult child educational attainment and self-reported psychosocial outcomes during the pandemic, including self-assessments of worsened psychosocial outcomes compared to the pre-pandemic period. We used generalized estimating equations with a Poisson distribution and a log link, adjusted for respondent and family-level characteristics,...

Neonatal Seizures and Associated Neurobehavioral Profiles in Preschool Age Children

Fri, 27 Jun 2025 00:00:00 +0000
BACKGROUND: Neonatal seizures are common with acute brain injury. Up to 25% of survivors develop postneonatal epilepsy. We hypothesized postneonatal epilepsy diagnosed by age 24 months would increase risk for early markers of neurobehavioral disorders than acute provoked neonatal seizures alone. METHODS: Neonates with acute provoked seizures born from July 2015 to March 2018 were enrolled at nine Neonatal Seizure Registry sites. Composite scores from parent-completed standardized ratings assessed Adaptive, Social, Externalizing, Internalizing, Self-Regulation, and Sensory Seeking domains. Linear regression demonstrated relationships between composite scores for children who developed postneonatal epilepsy compared with those who did not. Results were adjusted for seizure etiology, sex, gestational age, and cerebral palsy (CP) severity. RESULTS: A total of 151 children (n = 20, 13% with postneonatal epilepsy), 4.1 years median age, participated. Children with epilepsy...

Preferred Parental Language and Neurodevelopmental Outcomes Among Infants With Acute Provoked Neonatal Seizures in the United States

Fri, 27 Jun 2025 00:00:00 +0000
BACKGROUND: Parental non-English language preference (NELP) is associated with worse pediatric health outcomes. However, little is known about its relationship with developmental outcomes in infants with neonatal seizures. This study evaluated the relationship between parental NELP and neurodevelopment in a multicenter cohort of infants with neonatal seizures. METHODS: Infants in the Neonatal Seizure Registry-II were included. Parental NELP was defined by the use of a professional interpreter for research consent and survey completion. The Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS) assessment was conducted at age 24 months. Multivariate regression was used to examine the association between parental NELP and WIDEA-FS. Functional developmental impairment was defined as a WIDEA-FS score 2 S.D.s below the normative mean. RESULTS: Among 270 infants with neonatal seizures, 15 (6%) had parental NELP. Children with parental NELP had a WIDEA-FS...

Effect of mass drug administration on malaria incidence in southeast Senegal during 2020–22: a two-arm, open-label, cluster-randomised controlled trial

Sat, 21 Jun 2025 00:00:00 +0000
BACKGROUND: In Africa, the scale-up of malaria-control interventions has reduced malaria burden, but progress towards elimination has stalled. Mass drug administration (MDA) is promising as a transmission-reducing strategy, but evidence from low-to-moderate transmission settings is needed. We aimed to assess the safety, coverage, and effect of three cycles of MDA with dihydroartemisinin-piperaquine plus single, low-dose primaquine on Plasmodium falciparum incidence and prevalence in southeast Senegal. METHODS: We conducted a two-arm, open-label, cluster-randomised controlled trial in villages in the Tambacounda health district of southeast Senegal. Eligible villages had a population size of 200-800, were within a health-post catchment area with an annual malaria incidence of 60-160 cases per 1000 people, and had an established or planned Prise en Charge à Domicile Plus model. We randomly assigned villages (1:1) using a stratified, constrained randomisation approach to receive...

Integration of MRI radiomics and germline genetics to predict the IDH mutation status of gliomas

Fri, 20 Jun 2025 00:00:00 +0000
The molecular profiling of gliomas for isocitrate dehydrogenase (IDH) mutations currently relies on resected tumor samples, highlighting the need for non-invasive, preoperative biomarkers. We investigated the integration of glioma polygenic risk scores (PRS) and radiographic features for prediction of IDH mutation status. We used 256 radiomic features, a glioma PRS and demographic information in 158 glioma cases within elastic net and neural network models. The integration of glioma PRS with radiomics increased the area under the receiver operating characteristic curve (AUC) for distinguishing IDH-wildtype vs. IDH-mutant glioma from 0.83 to 0.88 (PΔAUC = 6.9 × 10−5) in the elastic net model and from 0.91 to 0.92 (PΔAUC = 0.32) in the neural network model. Incorporating age at diagnosis and sex further improved the classifiers (elastic net: AUC = 0.93, neural network: AUC = 0.93). Patients predicted to have IDH-mutant vs. IDH-wildtype tumors had significantly lower mortality risk...

Adapting and Validating the G‐NORM (Gender Norms Scale) in Nepal: An Examination of How Gender Norms Are Associated with Agency and Reproductive Health Outcomes

Fri, 20 Jun 2025 00:00:00 +0000
Research calls for the sexual and reproductive rights field to prioritize gender norms to ensure that women can act on their reproductive rights. However, there is a gap in accepted measures. We addressed this by including important theoretical components of gender norms: differentiating between descriptive and injunctive norms and adding a referent group. Our team originally developed and validated the G-NORM, a gender norms scale, in India. In this paper, we describe how we subsequently adapted and validated it in Nepal. We administered items to women of reproductive age, conducted exploratory and confirmatory factor analysis, and examined associations between the subscales and reproductive health outcomes. Like the original G-NORM, our factor analyses showed that descriptive norms and injunctive norms comprise two distinct scales which fit the data well and had Cronbach alphas of 0.92 and 0.89. More equitable descriptive gender norms were associated with higher decision-making...