95038 research outputs found
Sort by
Socio‐Economic Determinants and Regional Prevalence of Disorders of Gut‐Brain Interaction in the Netherlands: Results From the Rome Foundation Global Epidemiology Study
Get PDFBACKGROUND: Disorders of gut-brain interaction (DGBI) impose significant burdens worldwide, yet reliable regional prevalence estimates are lacking, limiting insight into potential geographic variation. Socio-economic status (SES) may contribute but remains underexplored. METHODS: Data were obtained from the Dutch cohort of the Rome Foundation Global Epidemiology Study, including the Rome IV Adult Diagnostic Questionnaire, sociodemographic items, and SES indicators. The Netherlands was divided into three regions (Region 1: South; Region 2: West; Region 3: North-East). Regional prevalence was calculated for any DGBI, groups, and subtypes. Associations with SES were examined using logistic regression. KEY RESULTS: 2008 participants (50% female; age: 48 years [IQR: 31]; BMI: 25.25 kg/m2 [IQR: 5.98]) were included. Overall DGBI prevalence was 30.63% (95% CI: 28.65-32.68), with no significant regional differences (Region 1: 30.40%, 95% CI [26.61-34.47]; Region 2: 30.19%, 95% CI [27.19-33.36]; Region 3: 31.45%, 95% CI [27.96-35.16]; p = 1.000). No regional variation was found across DGBI groups or subtypes (all p > 0.05). Younger age (OR = 0.98, 95% CI [0.98-0.99]), female sex (OR = 2.10, 95% CI [1.70-2.59]), underweight (OR = 2.53, 95% CI [1.36-4.73]), and obesity (OR = 1.59, 95% CI [1.19-2.13]) were associated with higher odds of DGBI. In models adjusted for age, sex, and BMI, limited/no healthcare access (OR = 2.47, 95% CI [1.62-3.77], p < 0.0001) was associated with higher DGBI odds, whereas employment showed lower odds (OR = 0.65, 95% CI [0.52-0.81], p < 0.001). Other SES indicators were not associated. CONCLUSION AND INFERENCES: DGBI affect nearly one-third of adults in the Netherlands, with no regional variation in prevalence. Putative risk factors include limited/no healthcare access and unemployment, supporting consideration of socioeconomic determinants in DGBI care, although further research is warranted
TestMyBrain User Guide
Get PDFGiven the breadth of measures and longitudinal design, Add Health offers a unique opportunity to explore the early origins of cognitive functioning and to track changes in dementia risk within a nationally representative cohort that has been followed since early adolescence. A key objective of Wave VI of Add Health was to significantly expand the measurement of cognitive domains. This wave introduced the Add Health Cognitive Assessment, Physical, and Sensory Function (Add CAPS) battery, designed to support long-term tracking of cognitive, physical, and sensory function. These data provide a foundation for identifying early midlife signs of cognitive impairment that may help map future risk for Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD).
The inclusion of TestMyBrain (TMB) reflects our commitment to collecting web-based cognitive measures in early midlife among a nationally representative sample. This approach also enables comparison with standard in-person assessments, helping to evaluate the feasibility and value of remote cognitive testing at scale in Add Health
Accessible, Realistic Genome Simulation with Selection Using stdpopsim.
Get PDFSelection is a fundamental evolutionary force that shapes patterns of genetic variation across species. However, simulations incorporating realistic selection along heterogeneous genomes in complex demographic histories are challenging, limiting our ability to benchmark statistical methods aimed at detecting selection and to explore theoretical predictions. stdpopsim is a community-maintained simulation library that already provides an extensive catalog of species-specific population genetic models. Here, we present a major extension to the stdpopsim framework that enables simulation of various modes of selection, including background selection, selective sweeps, and arbitrary distributions of fitness effects (DFE) acting on annotated subsets of the genome (for instance, exons). This extension maintains stdpopsim's core principles of reproducibility and accessibility while adding support for species-specific genomic annotations and published DFE estimates. We demonstrate the utility of this framework by comparing methods for demographic inference, DFE estimation, and selective sweep detection across several species and scenarios. Our results demonstrate the robustness of demographic inference methods to selection on linked sites, reveal the sensitivity of DFE-inference methods to model assumptions, and show how genomic features, like recombination rate and functional sequence density, influence power to detect selective sweeps. This extension to stdpopsim provides a powerful new resource for the population genetics community to explore the interplay between selection and other evolutionary forces in a reproducible, user-friendly framework
Investigating predictive value and effect estimates between two commonly used depression scales via secondary data from HPTN 068, a conditional cash transfer trial of adolescent girls and young women in South Africa
Get PDFIntro
The Child Depression Index (CDI) and Center for Epidemiologic Studies Depression scale (CESD) are scales to measure and screen for depression. CDI is a version of the Beck Depression Inventory simplified for minors, and CESD is generally used for adults. Secondary data from HPTN 068 provided a unique opportunity to assess scale concordance in an adolescent female sample, a time period when minors transition to young adulthood.
Methods
Young women (n = 2530) in rural South Africa were randomized 1:1 to a conditional cash transfer (CCT) or control. Participants were eligible to receive the CCT while they remained unmarried and maintained school attendance. Both the CDI and the CESD were administered at final study visit. Without a gold standard, we compared positive predictive values (PPV) of CDI and CESD for each other across age and intervention assignment and explored how choice of metric impacted CCT effect estimate.
Results
At study conclusion, participants had a median age of 18 (IQR: 17,18). The prevalence of depression was 26% via CDI and 27% via CESD. But PPV for CDI in detecting depression via CESD was only 53%, and the PPV of CESD for CDI was 57%. The PPVs were lower for <18 participants and higher for 18+ participants. The PPV of CDI for CESD was 52% for the <18 group and 57% for the 18+ group. The PPV of CESD for CDI was 41% for the <18 group and 62% for the 18+ group. Comparing risk difference estimates, the CCT reduced depression by 0.8 percentage points (95% CI: -4.9, 3.2) via CDI and by 4.1 percentage points (95% CI: 0.0, 8.2) via CESD.
Conclusion
The PPV between CDI and CESD are surprisingly low, given the same stated construct and similar prevalence and effect estimates. The PPV of the CESD for CDI is greater than the PPV of CDI for CESD among 18+ participants, and vice versa for <18 participants. These results suggest that CDI and CESD measure different (sets of) constructs with age-based differences in depression symptoms or scale interpretation.
Lipids
Get PDFThis document summarizes the rationale, equipment, protocol, assay, internal quality control, data cleaning, external quality control, and procedures for the measurement and classification of lipid concentrations at the Wave VI home exam. Whenever possible, data collection and methods in Wave VI mirrored those of Wave V to ensure comparability of data between waves, although important inter-Wave differences between Waves IV-VI exist and are grey-highlighted herein. This document is one in a set of Wave V user guides.
Measures of Glucose Homeostasis
Get PDFThis document summarizes the rationale, equipment, protocol, assays, internal quality data, data cleaning, external quality control, and procedures for the measurement and classification of glucose homeostasis at the Wave VI home exam. Whenever possible, data collection and methods in Wave VI mirrored those of Wave V to ensure comparability of data between waves, although important inter-Wave differences between Waves IV-VI exist and are grey-highlighted herein. This document is one in a set of Wave VI user guides.
The Reporting and Methodological Recommendations for Observational Studies Estimating the Effects of Deprescribing Medications (REMROSE‐D) ISPE‐Endorsed Guidance
Get PDFPurpose Pharmacoepidemiologic studies on deprescribing are challenging to implement, yet little guidance exists on methods to avoid bias and minimum reporting for replicability and appraisal. We developed consensus recommendations for the methods and reporting of observational studies that aim to examine the effects of deprescribing. Methods We formed candidate recommendations based on our prior systematic review that methodologically appraised observational studies on deprescribing. We then conducted a two‐round modified Delphi process with researchers working in deprescribing pharmacoepidemiology to refine, select, and reach consensus on recommendations for a checklist based on > 70% agreement of their importance. We termed this list the REMROSE‐D (Reporting and Methodological Recommendations for Observational Studies estimating the Effects of Deprescribing medications) guidance. Results Twenty‐three candidate recommendations were presented to the Delphi panel. The round 1 survey was completed by 55 participants, and 18 of the 23 candidate recommendations were selected for inclusion. Five candidate recommendations without consensus plus two additional items suggested by participants were included in a round 2 survey of 25 deprescribing researchers. Five of these seven items garnered consensus for inclusion, and two were excluded. The final REMROSE‐D guidance contains 23 recommendations for the methods and reporting of observational research on deprescribing. Conclusion To ensure rigor and reproducibility in observational studies of the effects of deprescribing, the REMROSE‐D guidance provides recommendations for important reporting and methods considerations, including time zero, precise definitions of deprescribing, addressing confounding by indication, and careful consideration of follow‐up to avoid immortal time bias
Unmet needs of adults living with mucopolysaccharidosis II: data from the Hunter Outcome Survey
Get PDFBackground Mucopolysaccharidosis II (MPS II) is a rare, life-limiting lysosomal storage disease caused by deficient iduronate-2-sulfatase activity. The current standard of care for MPS II is intravenous enzyme replacement therapy (ERT), which has been shown to improve somatic signs and symptoms and to increase life expectancy by approximately 12 years. This study reported on the somatic disease burden and clinical requirements of adult male patients in the Hunter Outcome Survey (ClinicalTrials.gov Identifier: NCT03292887). Results Of the 373 patients in the analysis, 88 (23.6%) had cognitive impairment and 332 (89.0%) had received ERT. Almost half of all ERT-treated patients (47.0%) had undergone surgery in adulthood; the most common surgery was hernia repair (17.8% of patients). Over one-third (38.6%) reported hearing aid use. The median 6-min walk test distance for 151 treated patients was 436.0 m at the latest assessment after 18 years of age. Cardiovascular signs and symptoms were present in 71.6% (192/268) of patients and 27.3% (60/220) reported oxygen dependency after 18 years of age. Approximately half (50.9%) of ERT-treated patients experienced at least one serious adverse event in adulthood, with the most common being respiratory disorders. Intravenous ERT was well tolerated, with a rate of serious infusion-related reactions in adulthood of 0.03 per 10 patient-years. Conclusions Overall, adult patients with neuronopathic and non-neuronopathic MPS II had a high disease burden and requirement for surgeries, emphasizing the need to continue multidisciplinary management and regular assessments in adulthood. Further research into the differences in care needs of adult patients with MPS II is warranted. Trial registration NCT03292887
Genome-wide association meta-analysis and rare copy number variant analysis of treatment-resistant depression
Get PDFTreatment-resistant depression (TRD), defined as major depressive disorder (MDD) with multiple failed responses to antidepressant treatments, has been suggested to be heritable, but identifying its genetic component is challenging. Using a restrictive TRD definition based on antidepressant medication followed by electroconvulsive therapy (ECT), which may represent a severe subset of TRD cases, we investigated both common variants and rare copy number variations (CNVs) associated with a) TRD risk (2 062 TRD vs. 441 037 healthy controls) and b) treatment resistance in MDD (2 062 TRD vs. 38 544 non-TRD) across three Nordic countries. We observed a significant SNP-based heritability for TRD risk at 26% (SE = 5%). Genome-wide association analysis identified one locus on chromosome 3 (intronic region of SPATA16) for TRD risk and one suggestive locus for treatment resistance in MDD. TRD risk showed positive genetic correlations (rg) with other psychiatric disorders, with notably rg with bipolar disorder (0.86, SE = 0.20) and schizophrenia (0.57, SE = 0.13), as well as a negative rg with intelligence (−0.13, SE = 0.07). Analyses using PRS showed that TRD had higher common-variant burdens of various psychiatric disorders compared to non-TRD. Furthermore, TRD carried a higher CNV deletion burden in total and average lengths than healthy controls or non-TRD cases and was associated with a group of 54 known neuropsychiatric CNVs (ORs = 1.74–2.86). Given that our definition of TRD involves the use of ECT, our findings may reflect a severe form of treatment resistance. This work adds evidence on a genetic basis and provides insights into the genetic architecture of TRD, underscoring the need for further genomic research into this ‘difficult-to-treat’ condition
International Perspectives on the Acceptability of Rangers Shooting at Suspected Criminals Inside Protected and Conserved Areas in Sub‐Saharan Africa
Get PDFUsing military‐type strategies and equipment to conserve wildlife, also known as militarized conservation, is highly contested. In sub‐Saharan Africa (SSA), one acutely controversial aspect of militarized conservation is when armed rangers shoot at suspected criminals inside protected and conserved areas (PCAs). We quantified perceptions among members of eight international publics on the acceptability of this particularly contentious aspect of militarized conservation, testing whether acceptability depended on the specific crime rangers suspect people of committing. Overall, acceptability of rangers shooting at suspected criminals inside PCAs in SSA was low across all eight publics, but acceptability was generally higher among participants living further away from PCAs in SSA than those living closer to PCAs in SSA. Shooting in self‐defense and to prevent poaching were consistently most acceptable across all eight publics. Our findings contribute new comparative evidence about international public perceptions of a very sensitive aspect of PCA management in SSA. This evidence may be useful to decision‐makers balancing competing pressures to protect biodiversity, respect local values, and operate with legitimacy in an international context. Our findings are especially relevant in light of international aspirations to simultaneously increase PCAs while respecting the rights and interests of people living in high‐biodiversity areas