95038 research outputs found
Sort by
Prevalence and characteristics of metabolic dysfunction-associated steatohepatitis among pediatric patients in the MarketScan Databases
Get PDFIntroduction There are few epidemiologic studies of the prevalence of metabolic dysfunction-associated steatohepatitis (MASH) among pediatric populations.ObjectiveTo estimate the cross-sectional prevalence of MASH in the pediatric (<18 years) populations of MerativeTM MarketScan® Commercial Database (Commercial) and MerativeTM MarketScan® Multi-State Medicaid Database (Medicaid). Methods Pediatric patients with ≥1 medical encounter from 1/1/2020 to 12/31/2020 and ≥6 months of continuous enrollment before the most recent medical encounter were included. MASH was confirmed by an ICD-10-CM diagnosis code for MASH (K75.81) in the medical history since 1/1/2016. Results A total of 1,476 and 410 pediatric MASH patients were identified in Medicaid and Commercial databases respectively, with a prevalence of 0.036% (95% confidence interval (CI): 0.034%, 0.038%) in Medicaid, as compared to 0.011% (95% CI: 0.010%, 0.012%) in Commercial. Prevalence of MASH increased by age. MASH was more prevalent in those who were male, obese, had T2D, and had metabolic syndrome. Among all pediatric MASH patients, the majority were ≥10 years old, male, and obese. Discussion MASH is more prevalent among pediatric patients with comorbid conditions such as metabolic syndrome, obesity, and T2D, which appears to be similar to young adults. Rising prevalence of childhood obesity and related comorbid conditions, and the progressive nature of MASH, make this an area of increasing medical need. Prescreening MASH among high-risk patients with these comorbidities is needed for target intervention
Adapting a Health Impact Assessment Tool for Community-Engaged Research to Improve Health Equity Measurements for NIH RADx-UP Pilot Projects.
Get PDFThe National Institutes of Health (NIH) supported the Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) program, which aims to ensure that all Americans have access to COVID-19 testing and promotes health equity, especially in underserved communities. Under RADx-UP, there are two pilot programs - Community Collaboration Grants (C2G) and Rapid Research Pilot Program (RP2) - that fund projects to conduct community-engaged outreach and research to address COVID-19 testing disparities. As such, we sought to assess projects' health equity impacts within their priority populations. Our evaluation team used cognitive interviews with C2G and RP2 project representatives to revise health equity metrics within an existing Health Impact Assessment (HIA) tool to measure health equity impacts within these community-engaged research projects. During interviews, participants indicated that we needed to improve the clarity and readability of key terms and phrases related to health equity, and they provided suggestions for how to tailor metrics to community partners. In this paper, we highlight our process of adapting the original metrics and share lessons learned that other evaluators may apply to their work. Our project highlights the importance of cognitive interviewing as a critical methodology to tailor an existing pilot-tested HIA to a community-based audience; however, it also sheds light on the difficulties of measuring health equity within community-engaged research initiatives and future recommendations
Epigenetic Clocks
Get PDFThis document describes the generation of epigenetic clocks and immune cell counts from DNA methylation data from participants of the National Longitudinal Study of Adolescent to Adult Health (Add Health). It provides detailed definitions, computation methods, data descriptions, and guidance for interpretation to ensure consistent and reproducible use of these measures. The content here complements existing Add Health documentation on Wave V biospecimen collection and methylation data processing by focusing specifically on several established measures of epigenetic aging
AI Model Integrating Imaging and Clinical Data for Predicting CSF Diversion in Neonatal Hydrocephalus: A Preliminary Study
Get PDFPredictive tools for stratifying neonatal hydrocephalus into low- and high-risk groups for cerebrospinal fluid (CSF) diversion are currently lacking. We developed and validated an artificial intelligence (AI) model that integrates multimodal imaging and clinical data to predict CSF diversion needs. The development cohort included 116 neonates with suspicion of raised intracranial pressure (ICP) from a Chinese tertiary referral hospital (80 with intracranial pressure > 80 mm H2O, 36 with intracranial pressure ≤ 80 mm H2O). The external validation cohort consisted of 21 neonates with hydrocephalus from an American medical center, categorized by etiology: prenatal myelomeningocele (MMC) closure (n = 5), postnatal MMC closure (n = 6), and post-hemorrhagic hydrocephalus (PHH) (n = 10). Inclusion criteria required available MRI and complete clinical follow-up to confirm CSF diversion outcomes. The primary outcome was the need for CSF diversion. Model performance was assessed using under the receiver operating characteristics curve (AUC), sensitivity, and specificity. The hybrid AI model achieved an AUC of 0.824 in the development cohort in predicting raised ICP, outperforming both the clinical-only model (AUC 0.528, p < 0.001) and the image-only model (AUC 0.685, p = 0.007). In the external validation cohort, the fused MRI-based model achieved an AUC of 0.808. The model correctly predicted CSF diversion in 4/5 prenatal MMC, 4/6 postnatal MMC, and 9/10 PHH cases. The AI model demonstrated robust performance in predicting the need for CSF diversion, particularly in PHH cases, and has the potential to assist decision-making, especially in settings with limited pediatric neurosurgical expertise. Future work should focus on further refining model performance for complex etiologies such as MMC-associated hydrocephalus
The 2024 Chapel Hill Expert Survey on political party positioning in Europe: Twenty-five years of party positional data
Get PDFThis research note introduces the 2024 Chapel Hill Expert Survey (CHES) on party positioning in Europe. When combined with earlier waves of CHES data, this new data set provides estimates of the ideological and policy positions of political parties over twenty-five years of European politics, 1999–2024. The note demonstrates the value of the time series by examining two important trends in European politics: potential changes in the economic left-right positioning of radical right parties, and the emergence of a transnational cleavage composed of European integration and immigration. The note further explores two new items in the 2024 survey designed to measure horizontal accountability: party positioning on executive constraints and judicial independence. This illustrates the value of CHES EU data on party positioning both over time and through innovations in the seventh and most recent survey
Prevalence of technology facilitated and other gender-based violence among adolescent girls in Gqeberha, South Africa and its association with probable common mental disorders
Get PDFEmerging evidence is raising alarms that technology facilitated gender-based violence (TF-GBV) is a growing public health concern with impacts on child wellbeing, yet little research on the topic has been conducted in middle-income country settings. This study aimed to investigate the prevalence of TF-GBV, other GBV, and their association with common mental disorder (CMD) symptoms among adolescent girls in South Africa. Trained enumerators facilitated surveys on exposure to physical and sexual violence with adolescent girls aged 10–19 from 14 low-income primary and secondary public schools. An index of TF-GBV assessed past-year exposure to acts such as public posting of sexual photos. CMD screening used Patient Health Questionnaire-2 and Generalized Anxiety Disorder-2 tools. Generalized estimating equations assessed associations between violence (TF-GBV, other GBV, or both) and CMD. A total of 1,540 adolescent girls participated in the study. Most participants identified as Black (84%). CMD symptoms were more prevalent among girls in secondary school (37%) than primary school (10%). All forms of past-year GBV were more prevalent among secondary school girls, including TF-GBV (43% vs. 11% in primary school girls). Exposure to both TF-GBV and other forms of GBV were significantly associated with a 3.68 times higher risk of CMD (aRR = 3.68, 95% CI 2.42–5.62) after adjusting for demographics and partnership status. These findings underscore the need for targeted content to address TF-GBV within existing GBV programs, and its impact on mental health among adolescent girls in similar contexts
Prenatal Phthalate Exposures and Adiposity Outcomes Trajectories: A Multivariate Bayesian Factor Regression Approach
Get PDFExperimental animal evidence and a growing body of observational studies suggest that prenatal exposure to phthalates may be a risk factor for childhood obesity. Using data from the Mount Sinai Children’s Environmental Health Study (MSCEHS), which measured urinary phthalate metabolites (including MEP, MnBP, MiBP, MCPP, MBzP, MEHP, MEHHP, MEOHP, and MECPP) during the third trimester of pregnancy (between 25 and 40 weeks) of 382 mothers, we examined adiposity outcomes—body mass index (BMI), fat mass percentage, waist-to-hip ratio, and waist circumference—of 180 children between ages 4 and 9. Our aim was to assess the effects of prenatal exposure to phthalates on these adiposity outcomes, with potential time-varying and sex-specific effects. We applied a novel Bayesian multivariate factor regression (BMFR) that (1) represents phthalate mixtures as latent factors—a DEHP and a non-DEHP factor, (2) borrows information across highly correlated adiposity outcomes to improve estimation precision, (3) models potentially non-linear time-varying effects of the latent factors on adiposity outcomes, and (4) fully quantifies uncertainty using state-of-the-art prior specifications. The results show that in boys, at younger ages (4–6), all phthalate components are associated with lower adiposity outcomes; however, after age 7, they are associated with higher outcomes. In girls, there is no evidence of associations between phthalate factors and adiposity outcomes
Spatial Neglect: A Review
Get PDFSpatial neglect is a specific syndrome in which there is unilateral brain injury, which is on one side of the brain and usually is related to stroke. Spatial neglect is most commonly in right hemisphere strokes, In the area that is around the middle cerebral artery and often can appear in as many as 80% of people in an acute stage. People with spatial neglect often are unable to see stimuli on the side opposite to the brain injury. Facial neglect can also occur due to parietal lesions as well as for parietal and temporal and frontal damage. It also can occur from subcortical stroke or white matter lesions.
Consent in the practice of molecular HIV epidemiology: A qualitative study of the perspectives of diverse communities of interest
Get PDFBACKGROUND: The practice of using molecular HIV epidemiology (MHE) to enhance surveillance activities has generated much discussion, partly because it typically involves sequencing viral samples from persons living with HIV without their knowledge or consent. METHODS: Using individual, semi-structured in-depth interviews, we asked 41 individuals from a range of groups affected and/or involved in MHE and related health services in North Carolina their views about consent and MHE. FINDINGS: Although there was no unanimity of opinion, our interview participants were largely (82.5%) supportive using MHE for public health surveillance without obtaining consent, including those living with HIV, though there was also broad support across groups for raising public awareness about MHE. The reasons against consent for MHE included: consent is not traditionally solicited or required in other medical or public health surveillance activities; consent for MHE could deter people from getting tested or entering care; refusals could diminish the accuracy and utility of MHE data due to the resulting evidence gaps; and consent is impractical when there is an urgent need for data during disease outbreaks. Reasons in favor of consent included: a sample is something personal for which it is appropriate to ask permission for its use; failure to ask for consent is an unjustified curtailment of personal rights; people should be able to choose what information related to themselves that they share or do not share with others. There were also mixed responses, where the appropriateness of asking for consent depended on certain conditions. CONCLUSION: These study findings reveal some support among communities of interest for the current approach to consent along with a need for greater community awareness of MHE, and contribute to the ongoing policy conversation about whether the current practice of not obtaining consent for MHE and HIV surveillance purposes should be revisited
Statistical Shape and Fibre Orientation Model for Muscle Architecture Characterisation of the Medial Gastrocnemius
Get PDFPurpose Cerebral palsy (CP) is a heterogeneous, neurodevelopmental disorder arising from a static brain lesion and leading to progressive muscle degeneration. Quantitative understanding of 3D muscle morphology and fibre architecture effects of CP are lacking. Here, we present a novel imaging and computational method to investigate morphology and 3D fibre orientations of skeletal muscles in adolescents with CP. Methods Principal component analysis was performed on data derived from conventional MRI and diffusion tensor MRI; principal components (PCs) described dominant variations in each cohort. We applied this method to the medial gastrocnemius muscles of seven young people with CP and eight typically developing controls to quantitatively assess deviations in muscle structure associated with CP. Results Morphology and architecture models in each cohort had similar variance of dominant features, with size being the predominant mode of variation in both cohorts. The first three PCs accounted for a cumulative variance of CP and TD cohort of 96 and 97%, and 95 and 97% for shape models and shape and fibre orientation models, respectively. Size differences were greatest in the proximal and distal regions, rather than middle, of the muscle. Models revealed localised variation in 3D fibre orientations between the two cohorts in medial-distal region of the muscle. Local variations were observed in the medial-distal regions of the mean muscle of about 10° in the TD model compared to the CP model. PCs of architecture models indicated that greater localised angular differences in the 3D fibre orientations were associated with larger-than-average muscles. Conclusion This work offers insights into both muscle morphology and architecture of the medial gastrocnemius in individuals with CP, including variations of overall size and localised muscle fibre orientations. The quantitative descriptions of muscle architecture we present here may contribute to greater understanding of muscle function and dysfunction and may motivate imaging-informed perspectives on therapeutic interventions for CP