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Update and Expansion of an Interprofessional Education Search Strategy Validation Study for NLM PubMed, Ovid MEDLINE, and Elsevier Embase
Get PDFIn the original paper, an interprofessional research team created and validated PubMed IPE search hedges using relative recall methods. These offer search options for librarians and researchers, from a narrow, focused search for quick retrieval of useful publications to a broad, high-recall search for literature reviews. However, they arelimited to PubMed searching. This study extended the previous study by translating these PubMed searches for use in Ovid MEDLINE and Elsevier Embase and repeating the validation process
Advancing health-care equity for autistic people: mental health as a key priority
Get PDFAutistic people make up a substantial proportion of society, with global prevalence estimated at around 1%. This amounts to approximately 80 million people worldwide, with the majority living in low-income and middle-income countries (LMICs). The risk of poor mental health is substantially elevated in autistic people, with mental health problems typically emerging early in life. Estimates of lifetime prevalence in autistic adults are around 40% for both anxiety and depressive disorders. The prevalence of other psychiatric disorders is also substantially raised, and autistic people are three times more likely to die by suicide
Estimating cardiovascular effects of influenza vaccination in older adults: a target trial emulation using proximal causal inference
Get PDFBackground The substantial burden of cardiovascular diseases highlights the urgent need for cost-effective interventions to mitigate their impact. While existing evidence on the cardioprotective effect of the influenza vaccine comes primarily from populations with cardiovascular comorbidities, these studies remain susceptible to several sources of bias, including immortal time bias and unmeasured confounding. To attenuate these limitations, our study aimed to assess the effect of influenza vaccination on cardiovascular events in an older population in China, utilizing a target trial emulation framework in conjunction with a proximal causal inference (PCI) approach. Methods This is a sequentially designed, propensity score (PS) matched, vaccine effectiveness study under a target trial emulation framework. We used data from the Yinzhou Regional Health Care Database and included permanent residents of Yinzhou, China, aged 65 years or older. We employed a sequential trial approach in which participants were categorized as influenza vaccinees or non-vaccinees based on their vaccination regimen during the one-week enrollment period of each sequential trial from 2020 to 2022. The outcomes of interest were major adverse cardiovascular events (MACE) and acute coronary syndromes (ACS) within one year of follow-up. To address measured and unmeasured confounding, PS matching was performed in conjunction with PCI using a two-stage Poisson regression to estimate incidence rate ratios (IRRs). Findings A total of 8,181,638 older adults were included across the 50 emulated trials between 2020 and 2022. Of these, 170,011 received influenza vaccination, while 8,011,627 remained unvaccinated. Vaccinated participants were generally frailer (severely frail: 19.1% vs. 14.7%) and had a higher prevalence of hypertension (83.0% vs. 74.9%). After PS matching, all measured characteristics were well-balanced among 339,976 matched participants. In conjunction with the PCI approach, we found influenza vaccination was associated with a decrease in one-year risk of MACE (IRR: 0.86 [95% CI: 0.83–0.89]) and one-year risk of ACS (IRR: 0.87 [95% CI: 0.83–0.91]) compared to non-vaccination. Results were consistent across strata of enrollment year, age, sex, current smoking status, hypertension, hyperlipidemia, prior influenza vaccination status, and numerous sensitivity analyses. Interpretation Influenza vaccination may reduce the risk of MACE and ACS among older adults. Aligned with the World Health Organization guidelines, our findings further support influenza vaccination as an effective public health strategy for potentially reducing cardiovascular disease burden. Funding National Natural Science Foundation of China; Science and Technology Project of Science and Technology Bureau of Yinzhou District, Ningbo City; Zhejiang Provincial Centre for Disease Control and Prevention Science and Technology Program; Bill & Melinda Gates Foundation
Demystifying Clone‐Censor‐Weighting to Studying Treatment Initiation Windows: An Example Using Publicly Available Synthetic Medicare Claims Data
Get PDFBACKGROUND: Clone-censor-weighting (CCW) can compare treatment regimens that are initially indistinguishable (such as starting treatment within specific time windows) without using landmarks or creating immortal time. The causal contrasts estimated in these cases and the analyses themselves can become quite complex; however. OBJECTIVE: Provide a tutorial on CCW for comparing initiation windows and illustrate the causal contrasts underlying such comparisons. METHODS: We identified patients with myocardial infarctions without past aspirin or clopidogrel use in Medicare's synthetic public data files. We assigned "clones" to three regimens: (1) initiation within 30 days; (2) initiation within 90 days; or 3) initiation from 30 to 90 days. Clones were censored when deviating from their assigned regimen by failing to initiate treatment in time or by initiating treatment too early. We addressed informative censoring using inverse probability of censoring weights (IPCW), calculated weighted 180-day risks of re-hospitalization or death using Kaplan-Meier methods, and visualized the portion of the population exposed during the first 90 days to compare exposure distributions underlying regimens. RESULTS: We identified 1589 patients experiencing myocardial infarction with no past medication use. 15% initiated within 30 days and 26% initiated between 30 and 90 days. After IPCW, the 180-day outcome risk was 40.2% in the 30-day regimen, 35.7% in the 90-day regimen, and 35.2% in the 30-to-90 day regimen. CONCLUSIONS: Though CCW can be complex to implement and the effects it estimates can vary substantially across study populations that initiate treatments at different times, it is a useful tool for contrasting initiation windows
Intersection of Black race and carbohydrate antigen 19‐9 nonproduction underpins worse pathologic response to neoadjuvant therapy in pancreatic cancer
Get PDFBackground Black patients with pancreatic ductal adenocarcinoma (PDAC) are less likely to have a major pathologic response (MPR) after neoadjuvant chemotherapy (NAC). Data suggest lower baseline carbohydrate antigen 19‐9 (CA 19‐9) among Black patients. Whether CA 19‐9 nonproduction contributes to racial differences in NAC response was evaluated, and the biological mechanisms underlying the reduced response in CA 19‐9 nonproducers (CAnonprod) were investigated. Methods Black and White patients with PDAC who received ≥2 NAC cycles and pancreatectomy at seven centers were reviewed. Patients were categorized as CA 19‐9 producers (CAprod; CA 19‐9 > 5 U/mL) or CAnonprod (CA 19‐9 ≤ 5 U/mL). Univariable and multivariable models assessed CAnonprod rates by race and the association of CAnonprod with MPR. The Pancreatic Cancer Action Network’s SPARK platform was queried for genomic data. Differentially mutated genes were identified by Fisher exact test; differentially expressed gene analysis used an absolute fold change of ≥2 and an adjusted p value of <.05. Results Among 415 patients (385 CAprod and 30 CAnonprod), Black patients comprised more CAnonprod than CAprod (50% vs. 13%; p < .01). MPR rates were lower among CAnonprod versus CAprod (8% vs. 26%; p = .03). CA nonproduction was associated with decreased odds of an MPR (odds ratio [OR], 0.21; 95% CI, 0.04–0.99), and Black race was associated with increased odds of CA 19‐9 nonproduction (OR, 8.7; 95% CI, 3.8–19.7). CAnonprod had higher rates of SWI/SNF alterations than CAprod (52% vs. 34%; p < .01; p‐adjusted, not significant). LIPF was downregulated and CTCFL was upregulated in CAnonprod. Conclusions CA 19‐9 nonproduction is more prevalent in Black patients, and potentially mediates lower rates of MPR. CAnonprod have a distinct molecular profile, which suggests a biological basis for racial differences in chemoresponsivity. Carbohydrate antigen 19‐9 (CA 19‐9) nonproduction is more prevalent in Black patients with pancreatic ductal adenocarcinoma, and may underlie poor pathologic response to neoadjuvant therapy in this population. Molecular analyses of CA 19‐9 nonproducers reveal a distinct genomic and transcriptomic profile, which suggests a biological basis for racial differences in chemoresponsivity
A Cross-sectional Conceptual Replication and Longitudinal Evaluation of the PANSS-Autism-Severity-Score Measure Suggests it Does Not Capture Autistic Traits in Individuals With Psychosis
Get PDFBACKGROUND: Autism and psychosis co-occur at elevated rates, with implications for clinical outcomes, functioning, and suicidality. The PANSS-Autism-Severity-Score (PAUSS) is a measure of autism trait severity which has not yet been validated externally or longitudinally. STUDY DESIGN: Participants were derived from the GROUP and SCOPE datasets. Participants included 1448 adults with schizophrenia spectrum disorder (SSD), 800 SSD-siblings, 103 adults diagnosed with an autistic spectrum condition (ASC), and 409 typically-developing controls (TC). Analyses from the original validation study were conducted with SSD participants, and extended into ASC, SSD-sibling, and TC participants. Test-retest reliability of the PAUSS at 2-weeks and long-term stability 3 and 6-years was also examined. STUDY RESULTS: Results differed in important ways from the original validation. SSD participants reported higher PAUSS scores than other groups, with only a fraction of ASC participants scoring as "PAUSS-Autistic." Cronbach's alpha was acceptable for the SSD cohort only. Two-week stability of the PAUSS was fair to good for all PAUSS scores. Long-term stability was poor for most PAUSS items but fair for total PAUSS score. CONCLUSIONS: Results suggest that the PAUSS does not appear appropriate for assessing autism, with the low rate of PAUSS-Autistic in the ASC population suggesting the PAUSS may not accurately reflect characteristics of autism. The relative lack of long-term stability is cause for concern and suggestive that the PAUSS is capturing features of psychosis rather than autism traits
Diverse roles of quaking in endothelial cell biology.
Get PDFQuaking (QKI), a member of the signal transduction and activators of RNA (STAR) family of RNA-binding proteins, affects a wide range of functions, including alternative splicing, mRNA precursor processing, mRNA transport and localization, mRNA stabilization, and translation. Recently, QKI has been found to have critical roles in vasculogenesis and angiogenesis due to its effects on alternate splicing and other post-transcriptional modifications involving small RNAs in the endothelial cells (ECs). Aberrant expression or mutation of QKI in ECs can result in pro- or anti-angiogenic effects under different physiological and pathological conditions, including tumor angiogenesis. However, the regulatory roles of QKI in EC biology remain poorly described. This review summarizes our current understanding of the QKI isoforms and their functions in ECs, as well as the potential utility of QKI as an emerging translational target for angiogenic-based therapies
FROM CLASSROOMS TO COMMUNITIES: ADDRESSING THE YOUNG ADULT BEHAVIORAL HEALTH CRISIS THROUGH LIFELONG LEARNING AND EARLY INTERVENTION IN GRANVILLE AND VANCE COUNTIES
Get PDFThis proposal outlines an upstream strategy to strengthen lifelong learning and well-being for young adults in Granville and Vance Counties, North Carolina. Grounded in the Vital Conditions for Health and Well-Being framework, it responds to the County Commissioners’ call for equitable, long-term solutions to youth mental health needs, educational disparities, and key social determinants. Both counties face significant behavioral health challenges, limited school-based resources, and fragmented data systems shaped by socioeconomic inequities and rural barriers. At the same time, strong community assets—including early literacy efforts, faith-based engagement, and partnerships with UNC and Duke—support coordinated action. The proposal recommends a School-Based Behavioral Health Initiative with four components: expanding in-school behavioral health services, developing an adolescent mental health data dashboard, establishing a representative steering committee, and implementing a community engagement strategy centered on youth and family voice. A six-month pilot and alignment with state investments will promote sustainable improvement.Master of Public Healt
Significance in scale space for Hi-C data
Get PDFMOTIVATION: Hi-C technology has been developed to profile genome-wide chromosome conformation. So far Hi-C data have been generated from a large compendium of different cell types and different tissue types. Among different chromatin conformation units, chromatin loops were found to play a key role in gene regulation across different cell types. While many different loop calling algorithms have been developed, most loop callers identified shared loops as opposed to cell-type-specific loops. RESULTS: We propose SSSHiC, a new loop calling algorithm based on significance in scale space, which can be used to understand data at different levels of resolution. By applying SSSHiC to neuronal and glial Hi-C data, we detected more loops that are potentially engaged in cell-type-specific gene regulation. Compared with other loop callers, such as Mustache, these loops were more frequently anchored to gene promoters of cellular marker genes and had better APA scores. Therefore, our results suggest that SSSHiC can effectively capture loops that contain more gene regulatory information. AVAILABILITY AND IMPLEMENTATION: The Hi-C data used in this study can be accessed through the PsychENCODE Knowledge Portal at https://www.synapse.org/#! Synapse: syn21760712. The code utilized for Curvature SSS cited in this study is available at https://github.com/jsmarron/MarronMatlabSoftware/blob/master/Matlab9/Matlab9Combined.zip. All custom code used in this research can be found in the GitHub repository: https://github.com/jerryliu01998/HiC. The code has also been submitted to Code Ocean with the doi: 10.24433/CO.1912913.v1
From Virtual to Physical: Testing Design Features for First-Time User Engagement in Makerspaces
Get PDFThis study examines how spatial design choices shape first-time user experiences in academic makerspaces