26,828 results match your criteria: "Harvard T.H. Chan School of Public health[Affiliation]"

Background: Dementia is a life-changing condition for patients and caregivers. Response to a diagnosis often includes grief, shock, and despair. Unfortunately, evidence demonstrates inadequate use of person-centered communication practices during diagnostic disclosure, which adds to psychological distress.

View Article and Find Full Text PDF

Background: Treatment with monoclonal antibodies against amyloid-β slowed cognitive decline in recent randomized clinical trials in patients with mild cognitive impairment (MCI) and early dementia due to Alzheimer's disease (AD). However, trial eligibility criteria may affect generalizability to clinical practice.

Methods: We extracted eligibility criteria for trials of aducanumab, lecanemab and donanemab from published reports, and applied these to participants with MCI and early clinical AD dementia from the population-based Rotterdam Study.

View Article and Find Full Text PDF

The TRIPOD-LLM reporting guideline for studies using large language models.

Nat Med

January 2025

Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA.

Large language models (LLMs) are rapidly being adopted in healthcare, necessitating standardized reporting guidelines. We present transparent reporting of a multivariable model for individual prognosis or diagnosis (TRIPOD)-LLM, an extension of the TRIPOD + artificial intelligence statement, addressing the unique challenges of LLMs in biomedical applications. TRIPOD-LLM provides a comprehensive checklist of 19 main items and 50 subitems, covering key aspects from title to discussion.

View Article and Find Full Text PDF

Premetastatic cancer cells often spread from the primary lesion through the lymphatic vasculature and, clinically, the presence or absence of lymph node metastases impacts treatment decisions. However, little is known about cancer progression via the lymphatic system or of the effect that the lymphatic environment has on cancer progression. This is due, in part, to the technical challenge of studying lymphatic vessels and collecting lymph fluid.

View Article and Find Full Text PDF

A Small-Molecule Inhibitor of Gut Bacterial Urease Protects the Host from Liver Injury.

ACS Chem Biol

January 2025

Harvard University, Department of Chemistry and Chemical Biology, Cambridge, Massachusetts 02138, United States.

Hyperammonemia is characterized by the accumulation of ammonia within the bloodstream upon liver injury. Left untreated, hyperammonemia contributes to conditions such as hepatic encephalopathy that have high rates of patient morbidity and mortality. Previous studies have identified gut bacterial urease, an enzyme that converts urea into ammonia, as a major contributor to systemic ammonia levels.

View Article and Find Full Text PDF

Divide and conquer, mitochondrial edition: Subpopulations direct cellular energy and nutrient supply.

Cell Metab

January 2025

Department of Molecular Metabolism, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Dana-Farber Cancer Institute, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA. Electronic address:

Mitochondria produce energy and building blocks essential for cell growth. How these competing processes are balanced and sustained during nutrient scarcity remains unclear. Ryu et al.

View Article and Find Full Text PDF

Objective: The global prevalence of nontuberculous mycobacterial pulmonary disease (NTM-PD) has been steadily increasing. A few small retrospective studies have reported a poor prognosis associated with chronic pulmonary aspergillosis (CPA) as a complication of NTM-PD. Furthermore, the prognostic impact of CPA may have been inadequately assessed due to differences in background factors.

View Article and Find Full Text PDF

Background: Large Language Models (LLMs) hold promise in enhancing psychiatric research efficiency. However, concerns related to bias, computational demands, data privacy, and the reliability of LLM-generated content pose challenges. GAP: Existing studies primarily focus on the clinical applications of LLMs, with limited exploration of their potentials in broader psychiatric research.

View Article and Find Full Text PDF

Importance: Pregnant people with opioid use disorder (OUD) are at high risk for potentially avoidable maternal morbidity. The majority of pregnant people with OUD receive health insurance through state Medicaid programs, but there is little comprehensive data on the burden of severe maternal morbidity (SMM)-a composite measure of adverse maternal health outcomes-among this high-risk group.

Objective: To estimate rates of SMM among Medicaid-enrolled pregnant people with OUD from 2016 to 2018.

View Article and Find Full Text PDF

Toward Resilient Maternal, Neonatal and Child Health Care: A Qualitative Study Involving Afghan Refugee Women in Pakistan.

Health Serv Insights

January 2025

CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy.

Background: Afghan refugees in Pakistan, particularly in Quetta, Balochistan, encounter formidable barriers in accessing maternal, newborn, and child health (MNCH) services. These challenges have been intensified by the COVID-19 pandemic and entrenched systemic health inequities.

Methods: This qualitative study, conducted from February to April 2023, aimed to assess the obstacles within health systems and community environments that hinder MNCH service access among Afghan refugees.

View Article and Find Full Text PDF

Serious mental health conditions and exposure to adulthood trauma in low- and middle-income countries: a scoping review.

Glob Ment Health (Camb)

November 2024

South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Background: There is a strong link between trauma exposure and serious mental health conditions (SMHCs), such as schizophrenia and bipolar disorder. The majority of research in the field has focused on childhood trauma as a risk factor for developing an SMHC and on samples from high-income countries. There is less research on having an SMHC as a risk factor for exposure to traumatic events, and particularly on populations in low- and middle-income countries (LMICs).

View Article and Find Full Text PDF

Social jetlag and diet quality among US young adults: interactions with race/ethnicity.

J Nutr Sci

January 2025

Sleep Disorders Center, Division of Sleep Medicine, Department of Neurology, Michigan Medicine, Ann Arbor, MI, USA.

The objective was to examine associations between social jetlag and diet quality among young adults in the US using nationally representative data from the 2017-2018 NHANES survey, and evaluate effect modification by gender and race/ethnicity. Social jetlag was considered ≥2-hour difference in sleep midpoint (median of bedtime and wake time) between weekends and weekdays. Diet quality was assessed with the Healthy Eating Index (HEI)-2015 and its 13 dietary components.

View Article and Find Full Text PDF

Coffee drinking timing and mortality in US adults.

Eur Heart J

January 2025

Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, New Orleans, LA 70112, USA.

Background And Aims: To identify the patterns of coffee drinking timing in the US population and evaluate their associations with all-cause and cause-specific mortality.

Methods: This study included 40 725 adults from the National Health and Nutrition Examination Survey 1999-2018 who had complete information on dietary data and 1463 adults from the Women's and Men's Lifestyle Validation Study who had complete data on 7-day dietary record. Clustering analysis was used to identify patterns of coffee drinking timing.

View Article and Find Full Text PDF

Although prediction models for heart transplantation outcomes have been developed previously, a comprehensive benchmarking of survival machine learning methods for mortality prognosis in the most contemporary era of heart transplants following the 2018 donor heart allocation policy change is warranted. This study assessed seven statistical and machine learning algorithms-Lasso, Ridge, Elastic Net, Cox Gradient Boost, Extreme Gradient Boost Linear, Extreme Gradient Boost Tree, and Random Survival Forests in a post-policy cohort of 7,160 adult heart-only transplant recipients in the Scientific Registry of Transplant Recipients (SRTR) database who received their first transplant on or after October 18, 2018. A cross-validation framework was designed in mlr.

View Article and Find Full Text PDF

Aims/hypothesis: A positive association between sugar-sweetened beverages (SSBs) and diabetes risk has been shown, with inconsistent evidence between artificially sweetened beverages (ASBs) and diabetes. Moreover, it is uncertain if physical activity can mitigate the negative effects of these beverages on diabetes development. Therefore, we aimed to evaluate the independent and joint associations between SSB or ASB consumption and physical activity on the risk of type 2 diabetes.

View Article and Find Full Text PDF

Background: The association between subclinical cardiovascular disease (CVD) and cognitive decline in hypertensive adults and the underlying brain pathologies remain unclear. It is also undetermined whether intensifying blood pressure (BP) treatment slows down cognitive decline associated with subclinical CVD.

Methods: We conducted a post hoc analysis of the Systolic Blood Pressure Intervention Trial.

View Article and Find Full Text PDF

Background: The COVID-19 pandemic was associated with an increase in conspiracy theories worldwide. However, in Japan, the prevalence of COVID-19 conspiracy beliefs has remained unclear. This study aimed to estimate the prevalence and correlates of COVID-19 conspiracy beliefs using a survey of 28,175 residents of Japan aged 16-81 years old.

View Article and Find Full Text PDF

Background: Digital data sources such as mobile phone call detail records (CDRs) are increasingly being used to estimate population mobility fluxes and to predict the spatiotemporal dynamics of infectious disease outbreaks. Differences in mobile phone operators' geographic coverage, however, may result in biased mobility estimates.

Methods: We leverage a unique dataset consisting of CDRs from three mobile phone operators in Bangladesh and digital trace data from Meta's Data for Good program to compare mobility patterns across these sources.

View Article and Find Full Text PDF

Antiretroviral therapy (ART) is needed across the lifetime to maintain viral suppression for people living with HIV. In South Africa, obstacles to reliable access to ART persist and are magnified in rural areas, where HIV services are also typically costlier to deliver. A recent pilot randomized study (the Deliver Health Study) found that home-delivered ART refills, provided at a low user fee, effectively overcame logistical barriers to access and improved clinical outcomes in rural South Africa.

View Article and Find Full Text PDF

Objectives: Whereas some work links trauma exposure to poor subjective sleep quality, studies largely rely upon limited trauma measures and self-reported sleep at one time point. It is unknown whether trauma is related to persistent poor sleep, whether associations differ based on childhood versus adulthood trauma, and whether trauma exposure is related to poorer objectively assessed sleep. We tested whether childhood or adult trauma associated with persistent poor objectively and subjectively measured sleep at two time points in midlife women.

View Article and Find Full Text PDF

Women's Empowerment and Health: A Narrative Review.

Int J Environ Res Public Health

December 2024

Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia 2220, Cyprus.

Empowerment, the process by which a person is enabled to increase control over decisions concerning their life, is a multidimensional construct that has been extensively discussed by various disciplines for more than four decades. Several empowerment models have been presented, based on different approaches. This paper proposes a four-step model, based on individual and contextual awareness and advancement.

View Article and Find Full Text PDF

The American College of Obstetricians and Gynecologists provided updated guidance in 2021, recommending that reproductive health professionals should include discussion of environmental exposures with their patients. However, environmental health is seldom included in medical training, with endocrine-disrupting chemicals, such as phthalates-linked to adverse pregnancy outcomes-being among the least discussed. We developed a one-hour virtual educational intervention to train reproductive health professionals on the routes of phthalate exposure, potential associated health impacts, and suggestions on how to discuss exposure reduction with patients.

View Article and Find Full Text PDF