mxfda: a comprehensive toolkit for functional data analysis of single-cell spatial data.

Summary: Technologies that produce spatial single-cell (SC) data have revolutionized the study of tissue microstructures and promise to advance personalized treatment of cancer by revealing new insights about the tumor microenvironment. Functional data analysis (FDA) is an ideal analytic framework for connecting cell spatial relationships to patient outcomes, but can be challenging to implement. To address this need, we present mxfda, an R package for end-to-end analysis of SC spatial data using FDA.

Walking fingerprinting.

We consider the problem of predicting an individual's identity from accelerometry data collected during walking. In a previous paper, we transformed the accelerometry time series into an image by constructing the joint distribution of the acceleration and lagged acceleration for a vector of lags. Predictors derived by partitioning this image into grid cells were used in logistic regression to predict individuals.

Integrating an Ethics Advisory Committee Into Public Health Response: A Case Study of COVID-19, Infection Prevention and Control, and Essential Work in the United States.

A lack of infection prevention and control protections for essential industries in the United States led to increased risk and incidence of COVID-19 among essential workers during the COVID-19 pandemic. When the nation deems an industry essential during a disease outbreak, an ethical obligation exists to safeguard the health of workers who are at increased risk of being exposed to disease. The Global Center for Health Security at the University of Nebraska Medical Center began work to rapidly develop and disseminate infection prevention and control guidance for essential industries, such as meat processing.

Exploring the acceptability of a decision aid for rural women with a history of prior cesarean birth regarding subsequent mode of birth in Coatepeque, Guatemala.

Background: Decisions regarding mode of delivery in the context of a prior cesarean birth is complicated because both trial of labor after cesarean and elective repeat cesarean birth have risks and benefits.

Purpose: The objective of this study was to understand the perspective of women and obstetricians in Coatepeque, Guatemala, to guide the development of a decision aid about mode of birth for women with a history of prior cesarean.

Methods: We conducted in-depth semi-structured interviews with obstetricians at Coatepeque Hospital and women at the Center for Human Development in the southwest Trifinio region of Guatemala in February 2020.

Trade Liberalization and Mortality Rates: Evidence of Pro-Cyclical Mortality From Brazil.

We trace the evolution of all-cause mortality rates in Brazilian regions with varying exposure to trade-induced economic shocks before, during, and after liberalization reforms in the 1990s. We find consistent evidence of pro-cyclical mortality, with areas more exposed to tariff reductions experiencing larger declines in mortality across varying time horizons. The observed decline in mortality rates is evident across sex, age groups, and for both internal and external causes of mortality.

The Effect of the "Safety in Dementia" Online Tool to Assist Decision Making for Caregivers of Persons With Dementia and Access to Firearms : A Randomized Trial.

Background: Caregivers face challenges (including competing desires to prevent injury, respect autonomy, and avoid conflict) when addressing firearm access by community-dwelling persons with Alzheimer disease and related dementias (ADRD).

Objective: To test the effect of the online Safety in Dementia (SiD) decision aid on caregivers' decision making about firearm access for people with ADRD.

Design: Prospective 2-group randomized trial with longitudinal follow-up.

A Hierarchical Bayesian Model for Estimating Age-Specific COVID-19 Infection Fatality Rates in Developing Countries.

The COVID-19 infection fatality rate (IFR) is the proportion of individuals infected with SARS-CoV-2 who subsequently die. As COVID-19 disproportionately affects older individuals, age-specific IFR estimates are imperative to facilitate comparisons of the impact of COVID-19 between locations and prioritize distribution of scarce resources. However, there lacks a coherent method to synthesize available data to create estimates of IFR and seroprevalence that vary continuously with age and adequately reflect uncertainties inherent in the underlying data.

Kernel machine tests of association using extrinsic and intrinsic cluster evaluation metrics.

Modeling the network topology of the human brain within the mesoscale has become an increasing focus within the neuroscientific community due to its variation across diverse cognitive processes, in the presence of neuropsychiatric disease or injury, and over the lifespan. Much research has been done on the creation of algorithms to detect these mesoscopic structures, called communities or modules, but less has been done to conduct inference on these structures. The literature on analysis of these community detection algorithms has focused on comparing them within the same subject.

Depictions of Strabismus in Children's Animated Films.

Background: Strabismus is known to negatively affect patients' self-confidence and ability to interact with society. Strabismus is commonly depicted in animated films marketed to children, potentially influencing the perception of strabismus by young impressionable audiences.

Methods: We reviewed all animated films released by Walt Disney Animation Studios from 1989 to 2022 and all films released by Pixar, DreamWorks, and Studio Ghibli before 2023 and identified all characters with strabismus.

Evolution of WHO COVID-19 mask guidelines amid intense demands for rapid advice.

During a health emergency, there is an urgent need to rapidly develop guidelines that meet minimum quality standards, as exemplified by the development of WHO guidelines on mask use in health care and community settings during the COVID-19 pandemic. Between January 2020 and October 2023, WHO developed 21 guideline updates on the use of masks as part of infection prevention and control (IPC) practices. Guideline developers had to deal with an ever-growing volume of evidence of variable quality.

Estimating effects of aging and disease progression in current and former smokers using longitudinal models.

Objectives: To separate estimates of mean change in a health outcome into components of aging and disease progression for different severity groups of chronic obstructive pulmonary disease (COPD).

Study Design And Methods: A longitudinal model can be used to estimate mean change in a health outcome over time. Methods to separate this change into portions due to aging and disease progression are discussed, including conditions that allow for accurate estimation.

Associations of Food Group Intakes with Serum Carbon Isotope Ratio Values in Youth: Results from 2 Prospective Pediatric Cohort Studies.

Background: The carbon isotope ratio (CIR) is a candidate biomarker for sugar-sweetened beverage (SSB) intake in the United States. However, research specific to youth, who differ in their physiology and dietary patterns compared with adults, is lacking.

Objectives: We evaluated longitudinal associations of SSB intakes across childhood/adolescence with serum CIR.

Polygenic and transcriptional risk scores identify chronic obstructive pulmonary disease subtypes in the COPDGene and ECLIPSE cohort studies.

Background: Genetic variants and gene expression predict risk of chronic obstructive pulmonary disease (COPD), but their effect on COPD heterogeneity is unclear. We aimed to define high-risk COPD subtypes using genetics (polygenic risk score, PRS) and blood gene expression (transcriptional risk score, TRS) and assess differences in clinical and molecular characteristics.

Methods: We defined high-risk groups based on PRS and TRS quantiles by maximising differences in protein biomarkers in a COPDGene training set and identified these groups in COPDGene and ECLIPSE test sets.

Factors Associated with Medical Care-Seeking and Stool Sample Submission for Diarrheal Illness, FoodNet, United States, 2018-2019.

Laboratory-based surveillance for enteric pathogens causing diarrhea is foundational for monitoring foodborne diseases in the United States. However, diarrheal illnesses are not always confirmed by laboratory testing, so estimates of the true number of illnesses must adjust for underdiagnosis, including underdiagnosis due to ill persons not seeking medical care or submitting a stool sample for laboratory testing. We assessed these factors among persons with an acute diarrheal illness who responded to the most recent Foodborne Diseases Active Surveillance Network (FoodNet) Population Survey (2018-2019).

Mutational signature analyses in multi-child families reveal sources of age-related increases in human germline mutations.

Whole-genome sequencing studies of parent-offspring trios have provided valuable insights into the potential impact of de novo mutations (DNMs) on human health and disease. However, the molecular mechanisms that drive DNMs are unclear. Studies with multi-child families can provide important insight into the causes of inter-family variability in DNM rates but they are highly limited.

Looking back at the TEDDY study: lessons and future directions.

The goal of the TEDDY (The Environmental Determinants of Diabetes in the Young) study is to elucidate factors leading to the initiation of islet autoimmunity (first primary outcome) and those related to progression to type 1 diabetes mellitus (T1DM; second primary outcome). This Review outlines the key findings so far, particularly related to the first primary outcome. The background, history and organization of the study are discussed.

Epidemiologic Study of Myasthenia Gravis in the Elderly US Population: A Longitudinal Analysis of the Medicare Claims Database, 2006-2019.

Background And Objectives: Epidemiologic studies suggest increasing incidence and prevalence of myasthenia gravis (MG) among the elderly population outside the United States. We aimed to provide an estimation of MG incidence and prevalence and their trend among the Medicare Fee-For-Service (FFS)-covered elderly US population.

Methods: We performed a retrospective longitudinal study using Medicare claims data (2006-2019).

SARS-CoV-2 seroprevalence screening study of a children's hospital health care workers.

Background: Health care workers (HCWs) are front line responders to the COVID-19 pandemic, but limited data is available for pediatric HCWs, as the research response has largely focused on adult patients and medical personnel that treat these patients.

Methods: We conducted a cross-sectional study of SARS-CoV-2 seroprevalence and risk factors in HCWs at a Children's Hospital in CO, USA from September 2020 to April 2021. Pediatric HCWs were defined as clinical care providers and administrative staff.

Individual and social-environmental factors among young drivers informing decisions to ride with an impaired driver and drive impaired: A sequential mixed methods assessment.

Objective: To contextually examine facilitators of young driver decisions to ride with an impaired driver (RWI) or drive while impaired (DWI).

Methods: Data were from the NIH's NEXT Generation Health Study (NEXT), a 7-year longitudinal nationally representative study with a U.S.

Designing LTC Physical Work Environments to Support Worker Well-being: A Review and Recommendations.

Objectives: Well-designed, health-promoting physical work environments have the potential to reduce burnout and attrition for employees who work in long-term care (LTC) facilities. Unfortunately, there is limited existing guidance for LTC facility owners and operators related to specific health-promoting design strategies for LTC work environments. This narrative review aims to fill this knowledge gap.

Methodological challenges and actionable recommendations in studying the health effects of high-concentration THC products.

In conducting a scoping review on the health effects of high-concentration cannabis products, we have uncovered pervasive methodological shortcomings within the cannabis literature. This paper begins by defining the 'causal effect' of interest for public health and delineating the desirable features of study design that can address crucial questions pertaining to public health and policy. We further delve into the methodological complexities inherent in studying the health effects of high-concentration cannabis products, describing challenges associated with the measurement of exposures and outcomes, confounding, selection bias, and the generalizability of findings.

Initial Evaluation of Acceptability, Engagement, and Effectiveness of the MO App to Provide Tailored and Comprehensive Support for Smoking Cessation: Development and Usability Study.

Background: Despite the growing availability of smoking cessation apps, low engagement and cessation rates have remained a significant challenge. To address this issue, we used a user-centered design to iteratively develop a mobile app (MO) to provide comprehensive, tailored, and evidence-based content to support smokers in their quitting journey.

Objective: This study examined the acceptability, use, and preliminary efficacy of the MO app for smoking cessation.