All-cause nursing home mortality rates have remained above pre-pandemic levels after accounting for decline in occupancy.

During the initial year of the COVID-19 pandemic, a disproportionate share of COVID-19-related deaths occurred among nursing home residents. Initial estimates of all-cause mortality rates also spiked in early and late 2020 before falling to near or below historical rates by early 2021. During the first 3 years of the pandemic, the US nursing home resident population also decreased by 18% (239 000 fewer residents) compared with pre-pandemic levels.

Multi-Source Conformal Inference Under Distribution Shift.

Recent years have experienced increasing utilization of complex machine learning models across multiple sources of data to inform more generalizable decision-making. However, distribution shifts across data sources and privacy concerns related to sharing individual-level data, coupled with a lack of uncertainty quantification from machine learning predictions, make it challenging to achieve valid inferences in multi-source environments. In this paper, we consider the problem of obtaining distribution-free prediction intervals for a target population, leveraging multiple potentially biased data sources.

Revisiting diabetes risk of olanzapine versus aripiprazole in serious mental illness care.

Background: Exposure to second-generation antipsychotics (SGAs) carries a risk of type 2 diabetes, but questions remain about the diabetogenic effects of SGAs.

Aims: To assess the diabetes risk associated with two frequently used SGAs.

Method: This was a retrospective cohort study of adults with schizophrenia, bipolar I disorder or severe major depressive disorder (MDD) exposed during 2008-2013 to continuous monotherapy with aripiprazole or olanzapine for up to 24 months, with no pre-period exposure to other antipsychotics.

Learning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial.

Objective: To evaluate the effectiveness of a clinical decision support system (CDSS) in improving the use of guideline accordant antihypertensive treatment in primary care settings in China.

Design: Pragmatic, open label, cluster randomised trial.

Setting: 94 primary care practices in four urban regions of China between August 2019 and July 2022: Luoyang (central China), Jining (east China), and Shenzhen (south China, including two regions).

A systematic benchmarking framework for future assessments of soil health: An example from Denmark.

Based on current evidence and established critical thresholds for soil degradation indicators, it is concerning that over 60-70% of European soils are unhealthy due to unsustainable management and the impact of climate change. Despite European and national efforts to improve soil health, significant gaps remain. The proposal for a Soil Monitoring and Resilience Law, to be implemented by the European Union, seeks to establish a framework for soil monitoring and promote sustainable management practices to achieve healthy soils by 2050.

Temporal trends in mortality and associated factors among persons with mental disorders: A register-based cohort study.

This study aims to examine 20-year temporal trends in all-cause mortality among psychiatric patients and investigating impacts of risk factors on the time trends based on 218,703 Finnish adults with mental disorders who were discharged from 87 psychiatric hospitals between 1 Jan 1995 and 31 Dec 2014. The age-period-cohort analysis of Poisson model with random hospital effects estimated temporal trends in death rate and associated factors at individual, healthcare system, and society levels, following the WHO multilevel intervention framework model for six major psychiatric diagnosis. The adjusted annual mortality declined by 2.

Racial-Ethnic Disparities in Quality of Care Among Medicaid Beneficiaries With Schizophrenia.

Objective: The authors sought to update and expand the evidence on the quality of health care and disparities in care among Medicaid beneficiaries with schizophrenia.

Methods: Adult beneficiaries of New York State Medicaid with schizophrenia receiving care during 2016-2019 were identified. Composite quality scores were derived from item response theory models by using evidence-based indicators of the quality of mental and general medical health care.

Unveiling the frontiers: Historical expansion and modern implications of agricultural land use in Denmark.

This study offers a first-of-its-kind investigation into the spatial and temporal transformation of agricultural land use and expansion in crops and livestock at national scale during the middle and latter half of the 19th century. We introduce an innovative methodological framework that combines historical data with advanced spatial analysis to trace and map the evolution of frontiers of agricultural land use changes, illustrating Denmark's agricultural evolution towards the modern era. Our research uncovers critical shifts in cropland, grazing land, and livestock density offering unprecedented insights into the mechanisms driving agricultural expansion and intensification.

Navigating ecological novelty towards planetary stewardship: challenges and opportunities in biodiversity dynamics in a transforming biosphere.

Human-induced global changes, including anthropogenic climate change, biotic globalization, trophic downgrading and pervasive land-use intensification, are transforming Earth's biosphere, placing biodiversity and ecosystems at the forefront of unprecedented challenges. The Anthropocene, characterized by the importance of in shaping the Earth system, necessitates a re-evaluation of our understanding and stewardship of ecosystems. This theme issue delves into the multifaceted challenges posed by the ongoing ecological planetary transformation and explores potential solutions across four key subthemes.

Towards a novel biosphere in 2300: rapid and extensive global and biome-wide climatic novelty in the Anthropocene.

Recent climate change has effectively rewound the climate clock by approximately 120 000 years and is expected to reverse this clock a further 50 Myr by 2100. We aimed to answer two essential questions to better understand the changes in ecosystems worldwide owing to predicted climate change. Firstly, we identify the locations and time frames where novel ecosystems could emerge owing to climate change.

Targeting Peer Contagion Dynamics in Children with ADHD: Effects from a Two-Site Randomized Controlled Trial.

Objective: Parental Friendship Coaching (PFC) teaches parents to coach their children in friendship skills. This paper examines whether PFC fosters positive peer contagion processes (i.e.

Racial and Ethnic Differences in Telemedicine Use.

Importance: Individuals of racial and ethnic minority groups may be less likely to use telemedicine in part due to lack of access to technology (ie, digital divide). To date, some studies have found less telemedicine use by individuals of racial and ethnic minority groups compared with White individuals, and others have found the opposite. What explains these different findings is unclear.

Data sources and applied methods for paclitaxel safety signal discernment.

Background: Following the identification of a late mortality signal, the Food and Drug Administration (FDA) convened an advisory panel that concluded that additional clinical study data are needed to comprehensively evaluate the late mortality signal observed with the use of drug-coated balloons (DCB) and drug-eluting stent (DES). The objective of this review is to (1) identify and summarize the existing clinical and cohort studies assessing paclitaxel-coated DCBs and DESs, (2) describe and determine the quality of the available data sources for the evaluation of these devices, and (3) present methodologies that can be leveraged for proper signal discernment within available data sources.

Methods: Studies and data sources were identified through comprehensive searches.

Questioning a Sensible Result.

Contemporary data collection strategies, storage capabilities, and modern statistical methodology have made retrospective analyses of observational databases commonplace. Such databases afford opportunities to learn about the effectiveness and risks of interventions or health behaviors that generally cannot be randomized. In this issue of , Cho et al.

How Treatment Effect Heterogeneity Works.

How Treatment Effect Heterogeneity WorksThis Stats, STAT! animated video explores the concept of treatment effect heterogeneity. Differences in the effectiveness of treatments across participants in a clinical trial is important to understand when deciding how to apply clinical trial results to clinical practice.

Data-driven coaching to improve statewide outcomes in CABG: before and after interventional study.

Background: The impact of quality improvement initiatives program (QIP) on coronary artery bypass grafting surgery (CABG) remains scarce, despite improved outcomes in other surgical areas. This study aims to evaluate the impact of a package of QIP on mortality rates among patients undergoing CABG.

Materials And Methods: This prospective cohort study utilized data from the multicenter database Registro Paulista de Cirurgia Cardiovascular II (REPLICCAR II), spanning from July 2017 to June 2019.

How Statistical Power Works.

How Statistical Power WorksThis Stats, STAT! animated video explores the concept of statistical power and explains how clinical investigators determine how many participants to enroll in a randomized trial.

How Censoring Works.

How Censoring WorksA common challenge in clinical research is determining the time to occurrence of a given event. This animated video explores the concept of censoring in survival analysis and how investigators deal with ambiguity in the time of an event's occurrence.

Bayesian Way.

Bayesian WayThis animated video explores two possible approaches to analyzing data in a randomized controlled trial: "Frequentist" versus "Bayesian."