Cost-effectiveness of monitoring and liver cancer surveillance among patients with inactive chronic hepatitis B.

Patients with chronic hepatitis B infection (CHB) have an increased risk for death from liver cirrhosis and hepatocellular carcinoma (HCC). In the United States, only an estimated 37% of adults with chronic hepatitis B diagnosis without cirrhosis receive monitoring with at least an annual alanine transaminase (ALT) and hepatitis B deoxyribonucleic acid (DNA), and an estimated 59% receive antiviral treatment when they develop active hepatitis or cirrhosis. A Markov model was used to calculate the costs, health impact and cost-effectiveness of increased monitoring of adults with HBeAg negative inactive or HBeAg positive immune tolerant CHB who have no cirrhosis or significant fibrosis and are not recommended by the current American Association for the Study of Liver Diseases (AASLD) clinical practice guidelines to receive antiviral treatment, and to assess whether the addition of HCC surveillance would be cost-effective.

Climate-driven variation in the phenology of juvenile Ixodes pacificus on lizard hosts.

Background: Ectothermic arthropods, like ticks, are sensitive indicators of environmental changes, and their seasonality plays a critical role in tick-borne disease dynamics in a warming world. Juvenile tick phenology, which influences pathogen transmission, may vary across climates, with longer tick seasons in cooler climates potentially amplifying transmission. However, assessing juvenile tick phenology is challenging in climates where desiccation pressures reduce the time ticks spend seeking blood meals.

Estimating the undetected burden and the likelihood of strain persistence of drug-resistant Neisseria gonorrhoeae.

Neisseria gonorrhoeae has developed resistance to all antibiotics recommended for treatment and reports of reduced susceptibility to ceftriaxone, the last-line treatment, are increasing. Since many asymptomatic infections remain undiagnosed and most diagnosed infections do not undergo antibiotic susceptibility testing, surveillance systems may underestimate resistant infections. In this modeling study, we simulated the spread of a new strain of ceftriaxone non-susceptible N.

Water First School Water Promotion and Access Intervention: A Cost Analysis Study.

Background: Adequate water intake is associated with improved cognitive and physical performance, prevention of dental caries, and overweight and obesity. However, access to free drinking water in schools remains inadequate. Water First, a school-based intervention promoting water consumption, was shown effective in preventing overweight, yet its costs have not been quantified.

Populationwide Screening for Chronic Kidney Disease: A Cost-Effectiveness Analysis.

Importance: Sodium-glucose cotransporter-2 (SGLT2) inhibitors have changed clinical management of chronic kidney disease (CKD) and made populationwide screening for CKD a viable strategy. Optimal age of screening initiation has yet to be evaluated.

Objective: To compare the clinical benefits, costs, and cost-effectiveness of population-wide CKD screening at different initiation ages and screening frequencies.

The roles of habitat isolation, landscape connectivity and host community in tick-borne pathogen ecology.

Habitat loss and forest fragmentation are often linked to increased pathogen transmission, but the extent to which habitat isolation and landscape connectivity affect disease dynamics through movement of disease vectors and reservoir hosts has not been well examined. Tick-borne diseases are the most prevalent vector-borne diseases in the United States and on the West Coast, is one of the most epidemiologically important vectors. We investigated the impacts of habitat fragmentation on pathogens transmitted by and sought to disentangle the effects of wildlife communities and landscape metrics predictive of pathogen diversity, prevalence and distribution.

Effects of the COVID-19 pandemic on TB outcomes in the United States: a Bayesian analysis.

Background: Tuberculosis (TB) cases and deaths in the United States fluctuated substantially during the COVID-19 pandemic. We analyzed multiple data sources to understand the factors contributing to these changes and estimated future TB trends.

Methods: We identified four mechanisms potentially contributing to observed TB trends during 2020-2023: immigration, respiratory contact rates, rates of accurate diagnosis and treatment initiation, and mortality rates for persons with TB disease.

Estimated Health and Economic Outcomes of Racial and Ethnic Tuberculosis Disparities in US-Born Persons.

Importance: Despite significant progress made toward tuberculosis (TB) elimination, racial and ethnic disparities persist in TB incidence and case-fatality rates in the US.

Objective: To estimate the health outcomes and economic cost of TB disparities among US-born persons from 2023 to 2035.

Design, Setting, And Participants: Generalized additive regression models projecting trends in TB incidence and case-fatality rates from 2023 to 2035 were fit based on national TB surveillance data for 2010 to 2019 in the 50 US states and the District of Columbia among US-born persons.

Feeding intolerance after pediatric cardiac surgery is associated with dysbiosis, barrier dysfunction, and reduced short-chain fatty acids.

Congenital heart disease (CHD) is the most common birth defect, occurring in roughly 40,000 U.S. births annually.

Standardized Reasons for Consultations on a French Telemedicine Platform.

Thirteen standardized reasons for e-visits were implemented in March 2024 on a French telemedicine platform to improve the analysis of needs in telemedicine, educate patients on what is possible in e-visit and adapt the offer. Patients could select 1 to 3 reasons for consultations among a list of 13 reasons. Our aim was to evaluate their impact on use of e-visits.

Novel co-initiators of polymerization: Cytotoxicity profile and modulation of inflammatory mediators in human dental pulp stem cells.

Objectives: The aim of this study was to assess the cytotoxicity of novel polymerization co-initiators and their effect on cytokine release from human dental pulp stem cells (hDPSCs), comparing them with commonly used co-initiators.

Methods: Cells were isolated from the dental pulp of healthy human third molars. The new co-initiators, namely HDa1, HD4, HD1, and MHPTm, were evaluated and compared with the compounds dimethylaminoethyl amine benzoate (EDAB) and 2-(dimethylamino)ethyl methacrylate (DMAEMA).

Comparative analysis of optical and numerical models for reflectance and color prediction of monolithic dental resin composites with varying thicknesses.

Objective: To assess the prediction accuracy of recent optical and numerical models for the spectral reflectance and color of monolithic samples of dental materials with different thicknesses.

Methods: Samples of dental resin composites of Aura Easy Flow (Ae1, Ae3 and Ae4 shades) and Estelite Universal Flow Super Low (A1, A2, A3, A3.5, A4 and A5 shades) with thicknesses between 0.

The long-term effects of domestic and international tuberculosis service improvements on tuberculosis trends within the USA: a mathematical modelling study.

Background: For settings with low tuberculosis incidence, disease elimination is a long-term goal. We investigated pathways to tuberculosis pre-elimination (incidence <1·0 cases per 100 000 people) and elimination (incidence <0·1 cases per 100 000 people) in the USA, where incidence was estimated at 2·9 per 100 000 people in 2023.

Methods: Using a mathematical modelling framework, we simulated how US tuberculosis incidence could be affected by changes in tuberculosis services in the countries of origin for future migrants to the USA, as well as changes in tuberculosis services inside the USA.

Risk factors underlying racial and ethnic disparities in tuberculosis diagnosis and treatment outcomes, 2011-19: a multiple mediation analysis of national surveillance data.

Background: Despite an overall decline in tuberculosis incidence and mortality in the USA in the past two decades, racial and ethnic disparities in tuberculosis outcomes persist. We aimed to examine the extent to which inequalities in health and neighbourhood-level social vulnerability mediate these disparities.

Methods: We extracted data from the US National Tuberculosis Surveillance System on individuals with tuberculosis during 2011-19.

Acute respiratory distress syndrome: A review of ARDS across the life course.

Acute respiratory distress syndrome (ARDS) is a multifactorial, inflammatory lung disease with significant morbidity and mortality that predominantly requires supportive care in its management. Although initially described in adult patients, the diagnostic definitions for ARDS have evolved over time to accurately describe this disease process in pediatric and, more recently, neonatal patients. The management of ARDS in each age demographic has converged in the application of lung-protective ventilatory strategies to mitigate the primary disease process and prevent its exacerbation by limiting ventilator-induced lung injury.

Modelling the potential impact of global hepatitis B vaccination on the burden of chronic hepatitis B in the United States.

About 80% of persons with chronic hepatitis B virus (HBV) infection in the United States are non-US-born. Despite improvements in infant hepatitis B vaccination globally since 2000, work remains to attain the World Health Organization's (WHO) global 2030 goal of 90% vaccination. We explore the impacts on the United States of global progress in hepatitis B vaccination since 2000 and of achieving WHO hepatitis B vaccination goals.

Potential impact of curative and preventive interventions toward hepatitis C elimination in people who inject drugs-A network modeling study.

Background: Injection-equipment-sharing networks play an important role in hepatitis C virus (HCV) transmission among people who inject drugs (PWID). Direct-acting antiviral (DAA) treatments for HCV infection and interventions to prevent HCV transmission are critical components of an overall hepatitis C elimination strategy, but how they contribute to the elimination outcomes in different PWID network settings are unclear.

Methods: We developed an agent-based network model of HCV transmission through the sharing of injection equipment among PWID and parameterized and calibrated the model with rural PWID data in the United States.

Assessing thresholds of resistance prevalence at which empiric treatment of gonorrhea should change among men who have sex with men in the US: A cost-effectiveness analysis.

Background: Since common diagnostic tests for gonorrhea do not provide information about susceptibility to antibiotics, treatment of gonorrhea remains empiric. Antibiotics used for empiric therapy are usually changed once resistance prevalence exceeds a certain threshold (e.g.

Combining genomic data and infection estimates to characterize the complex dynamics of SARS-CoV-2 Omicron variants in the US.

Omicron surged as a variant of concern in late 2021. Several distinct Omicron variants appeared and overtook each other. We combined variant frequencies and infection estimates from a nowcasting model for each US state to estimate variant-specific infections, attack rates, and effective reproduction numbers (R).