Evaluating hypothetical prevention strategies for internalizing symptoms in the general population and at-risk children.

Objective: Specific modifiable factors (e.g., screen time [ST], sleep duration, physical activity, or social connections) are targets for reducing depression risk in adults.

Reconceptualizing rurality: Exploring community capital to identify distinct rural classes in the United States.

Background: In population health research, rurality is often defined using broad population density measures, which fail to capture the diverse and complex characteristics of rural areas. While researchers have developed more nuanced approaches to study neighborhood and area effects on health in urban settings, similar methods are rarely applied to rural environments. To address this gap, we aimed to explore dimensions of contextual heterogeneity across rural settings in the US.

Invited Commentary: Why use methods that require proportional hazards?

We recently questioned the utility of testing for proportional hazards in survival analysis. Here we expand on why the proportional hazards assumption is both implausible and unnecessary in most medical studies, particularly in randomized trials. We conclude that using survival analysis methods that do not rely on proportional hazards is typically the preferred course of action.

Exploring novel determinants of exercise behavior: a lagged exposure-wide approach.

Unlabelled: Many middle-aged to older adults do not engage in regular exercise at all, despite its importance for healthy aging. Extensive research grounded in behavioral and social science theories has identified numerous determinants of exercise. However, few studies used an exposure-wide approach, a data-driven exploratory method particularly useful for identifying novel determinants.

DOME: Directional medical embedding vectors from electronic health records.

Motivation: The increasing availability of electronic health record (EHR) systems has created enormous potential for translational research. Recent developments in representation learning techniques have led to effective large-scale representations of EHR concepts along with knowledge graphs that empower downstream EHR studies. However, most existing methods require training with patient-level data, limiting their abilities to expand the training with multi-institutional EHR data.

Large floods drive changes in cause-specific mortality in the United States.

Flooding greatly endangers public health and is an urgent concern as rapid population growth in flood-prone regions and more extreme weather events will increase the number of people at risk. However, an exhaustive analysis of mortality following floods has not been conducted. Here we used 35.

Updated Geriatrics Competencies for Graduating Medical Students: Training Physicians to Provide Age-Friendly Care.

Purpose: Medical student education in geriatrics is a critical need for every doctor-in-training as the population ages, with fewer than 7,000 geriatricians, and older patients, who now approach 20% of the U.S. population, having unique health care needs.

Demographic, social and health system factors associated with maternal mortality in Pakistan: A nested case-control study.

Background: Pakistan has experienced a significant reduction in maternal mortality with a decline of 33 percent between 2006 and 2019. However, the country still grapples with a high number (186 per 100,000 live births) of maternal deaths each year. This study aims to identify socio-demographic and health system related factors associated with maternal mortality.

US State Public Health Agencies' Use of Twitter From 2012 to 2022: Observational Study.

Background: Twitter (subsequently rebranded as X) is acknowledged by US health agencies, including the US Centers for Disease Control and Prevention (CDC), as an important public health communication tool. However, there is a lack of data describing its use by state health agencies over time. This knowledge is important amid a changing social media landscape in the wake of the COVID-19 pandemic.

Fatty acids and telomere length.

Purpose Of Review: This narrative review includes the latest clinical and preclinical evidence on fatty acid exposure and telomere length, a widely accepted hallmark of aging.

Recent Findings: A large body of literature focused on n-3 (omega-3) polyunsaturated fatty acids (PUFAs). Observational studies reported beneficial associations with telomere length for self-reported consumption of n-3 PUFA-rich foods; for estimated intake of n-3 PUFAs; and for n-3 PUFAs blood-based biomarkers in most (but not all) studies involving lipidomics, a promising tool in the field.

Religion and flourishing among Afro-Trinidadians: the influence of proneness to guilt/shame and forgiveness by God on the relationship between religious commitment and health.

Background: Religiousness has been consistently linked to positive health outcomes and flourishing, yet the underlying mechanisms are complex and not well-understood. The forgiveness and relational spirituality model offers a framework to explore the moderated mediation among religious commitment, health, and forgiveness by God. Understanding these relationships among university students and community residents in Trinidad and Tobago can provide valuable insights into the role of religiousness in promoting wellbeing.

Heparin and Bivalirudin in Percutaneous Coronary Intervention for Acute Coronary Syndromes: A Review Article.

Acute coronary syndrome (ACS) is one of the most common leading global causes of mortality, encompassing ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA). Percutaneous coronary intervention (PCI) has become a pivotal therapeutic approach for ACS, underscoring the importance of anticoagulation strategies. Among the commonly employed anticoagulants in PCI, heparin and bivalirudin take precedence, with heparin serving as the archetypal choice.

The Future Hospital in Global Health Systems: The Future Hospital as an Entity.

Health care is changing rapidly. Hospitals are, and will remain, an essential setting to deliver it. We discuss how to maximise the benefits of hospitals in the future in different geographic and health system settings, highlighting a series of cross-cutting issues.

Profiling lateral gene transfer events in the human microbiome using WAAFLE.

Lateral gene transfer (LGT), also known as horizontal gene transfer, facilitates genomic diversification in microbial populations. While previous work has surveyed LGT in human-associated microbial isolate genomes, the landscape of LGT arising in personal microbiomes is not well understood, as there are no widely adopted methods to characterize LGT from complex communities. Here we developed, benchmarked and validated a computational algorithm (WAAFLE or Workflow to Annotate Assemblies and Find LGT Events) to profile LGT from assembled metagenomes.

Fine-mapping causal tissues and genes at disease-associated loci.

Complex diseases often have distinct mechanisms spanning multiple tissues. We propose tissue-gene fine-mapping (TGFM), which infers the posterior inclusion probability (PIP) for each gene-tissue pair to mediate a disease locus by analyzing summary statistics and expression quantitative trait loci (eQTL) data; TGFM also assigns PIPs to non-mediated variants. TGFM accounts for co-regulation across genes and tissues and models uncertainty in cis-predicted expression models, enabling correct calibration.

The revised colorectal cancer screening guideline and screening burden at community health centers.

Colorectal cancer (CRC) is the third most common cancer among men and women combined, and the second leading cause of cancer death in the US. The revised USPSTF CRC screening recommendations increased CRC screening needs across health systems, which may create particular challenges for community health centers (CHCs) given their resource constraints. The objective of our study is to assess CRC screening rates across 10 CHCs in Massachusetts and estimate the additional increase in the number of average-risk screening-eligible individuals after the revision in guidelines.

Immune correlates of early clearance of Mycobacterium tuberculosis among tuberculosis household contacts in Indonesia.

Some individuals, even when heavily exposed to an infectious tuberculosis patient, do not develop a specific T-cell response as measured by interferon-gamma release assay (IGRA). This could be explained by an IFN-γ-independent adaptive immune response, or an effective innate host response clearing Mycobacterium tuberculosis (Mtb) without adaptive immunity. In heavily exposed Indonesian tuberculosis household contacts (n = 1347), a persistently IGRA negative status was associated with presence of a BCG scar, and - especially among those with a BCG scar - with altered innate immune cells dynamics, higher heterologous (Escherichia coli-induced) proinflammatory cytokine production, and higher inflammatory proteins in the IGRA mitogen tube.

A Bayesian active learning platform for scalable combination drug screens.

Large-scale combination drug screens are generally considered intractable due to the immense number of possible combinations. Existing approaches use ad hoc fixed experimental designs then train machine learning models to impute unobserved combinations. Here we propose BATCHIE, an orthogonal approach that conducts experiments dynamically in batches.

Designing, implementing and evaluating multidisciplinary healthcare training programmes in the wartime humanitarian context of Ukraine.

Introduction: Civilian healthcare workers (HCW) and medical facilities are directly and indirectly impacted by armed conflict. In the Russia-Ukraine war, acute trauma care needs grew, the workforce was destabilised by HCW migrating or shifting roles to meet conflict needs, and facilities faced surge events. Chemical, biological, radiological, nuclear and explosive (CBRNE) exposure risks created unique preparedness needs.

Rare germline structural variants increase risk for pediatric solid tumors.

Pediatric solid tumors are a leading cause of childhood disease mortality. In this work, we examined germline structural variants (SVs) as risk factors for pediatric extracranial solid tumors using germline genome sequencing of 1765 affected children, their 943 unaffected parents, and 6665 adult controls. We discovered a sex-biased association between very large (>1 megabase) germline chromosomal abnormalities and increased risk of solid tumors in male children.

Timing of depression in relation to risk of ovarian cancer.

Objective: Several studies have suggested that depression may be associated with increased risk of ovarian cancer. Less is known about whether timing matters regarding when depression occurs. To provide evidence for an etiologically relevant exposure period, we examined depression occurring during the time in which precursor lesions develop and progress to invasive carcinoma with risk of developing ovarian cancer.

A novel approach for inferring effects on pregnancy loss.

Identifying the determinants of pregnancy loss is a critical public health concern. However, pregnancy loss is often not noticed, and even when it is, it is inconsistently recorded. Thus, past studies have been limited to medically-identified losses or small, highly selected cohorts, which can lead to biased or non-generalizable results.