At-risk Populations Research Articles

Remote organ cancer adversely alters renal function and induces kidney injury, inflammation, and fibrosis.

Approximately 30% of cancer patients experience kidney complications, which hinder optimal cancer management, imposing a burden on patients' quality of life and the healthcare system. The etiology of kidney complications in cancer patients is often attributed to nephrotoxic oncological therapies. However, the direct impact of cancer on kidney health is underestimated, as most nephrotoxic oncological therapies have been studied in animal models that do not have cancer. Our previous study demonstrated that advanced lung cancer adversely alters kidney physiology and function, and exacerbates chemotherapy-induced nephrotoxicity, indicating lung cancer-kidney crosstalk. This study examines whether this phenomenon is specific to the employed cancer model. Female and male mice of various strains were injected with different cell lines representing human and mouse lung cancer, breast cancer, and melanoma, and their kidney tissues were analyzed for toxicity and fibrosis. The impact of cancer on the kidney varied by cancer type. Breast cancer and specific subtypes of lung cancer, including KRAS- and EGFR-mutant cancer, pathologically altered kidney physiology and function in a manner dependent on the metastatic potential of the cell line. This was independent of mouse strain, sex, and cancer cell line origin. Moreover, tumor DNA was not detected in the renal tissue, excluding metastases to the kidney as a causative factor for the observed pathological alterations. Lewis lung carcinoma and B16 melanoma did not cause nephrotoxicity, regardless of the tumor size. Our results confirm cancer-kidney crosstalk in specific cancer types and highlight gaps in understanding the risk of renal complications in cancer patients. In the era of precision medicine, further research is essential to identify at-risk oncology populations, enabling early detection and management of renal complications.

A novel prediction model for the probability of aggressive behavior in patients with mood disorders: Based on a cohort study

BackgroundAccurately predicting the probability of aggressive behavior is crucial for guiding early intervention in patients with mood disorders. MethodsCox stepwise regression was conducted to identify potential influencing factors. Nomogram prediction models were constructed to predict the probabilities of aggressive behavior in patients with mood disorders, and their performance was assessed using consistency index (C-index) and calibration plots. ResultsResearch findings on 321 patients with mood disorders indicated that being older (HR = 0.92, 95% CI: 0.86–0.98), single (HR = 0.11, 95% CI: 0.02–0.68), having children (one child, HR = 0.07, 95%CI: 0.01–0.87; more than one child, HR = 0.33, 95%CI: 0.04–2.48), living in dormitory (HR = 0.25, 95%CI: 0.08–0.77), non-student (employee, HR = 0.24, 95% CI: 0.07–0.88; non-employee, HR = 0.09, 95% CI: 0.02–0.35), and higher scores in subjective support (HR = 0.90, 95% CI: 0.82–0.99) were protective factors. On the contrary, minorities (HR = 5.26, 95% CI: 1.23–22.48), living alone (HR = 4.37, 95% CI: 1.60–11.94), having suicide history (HR = 2.51, 95% CI: 1.06–5.95), and having higher scores in EPQ-E (HR = 1.04, 95% CI: 1.00–1.08) and EPQ-P (HR = 1.03, 95% CI: 1.00–1.07) were identified as independent risk factors for aggressive behavior in patients with mood disorders. The nomogram prediction model demonstrated high discrimination and goodness-of-fit. ConclusionsA novel nomogram prediction model for the probability of aggressive behavior in patients with mood disorders was developed, effective in identifying at-risk populations and offering valuable insights for early intervention and proactive measures.

Treatment of Post-Inflammatory Hyperpigmentation in Skin of Colour: A Systematic Review.

Post inflammatory hyperpigmentation (PIH) affects all skin types with a heightened predilection for darker skin tones. Its course is chronic once developed and treatment is often difficult. This systematic review aims to summarize the treatment outcomes for PIH with a focus on skin of colour (SOC) individuals. A literature search was conducted using MEDLINE (from 1946), Embase (from 1974), PubMed, and Cochrane in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline. Results from 48 studies summarized 1356 SOC individuals. The mean age was 29 years (n = 1036) and 78% were female (n = 786). The ethnic prevalence was 70% Black, 27% Asian, and 3% Latin. Overall, 20% were Fitzpatrick skin type (FST) III, 40% FST IV, 34% FST V, and 6% FST VI. Most cases were precipitated by inflammatory conditions (89%) and localized to the face (83%). The most frequently reported interventions were topical retinoids (22%) and laser therapy (17%). Partial improvement was seen in 85% and 66% of participants, respectively. Laser was the only intervention that offered complete resolution in a subgroup of patients (26%); however, there were reported cases of PIH exacerbation following treatment. Chemical peels (9%) and hydroquinone (7%) were among other treatments with less effective outcomes. PIH and its persistence is a prevalent issue, significantly affecting many affected individuals with darker skin tones. Our results show a lack of robust efficacy across all treatment modalities. There is considerable room for improvement in interventions for at-risk populations.

Potential Impacts of Lead on Health: A Review of Environmental Exposure, Population at Risk, and Toxic Effects

Introduction: Lead, a heavy metal, has been proven to influence the ecosystem negatively. The use of lead in processing or as raw materials increases Pb exposure to humans from various sources, including waste or consumed products. This study aims to determine the most recent information regarding lead contamination sourced from the environment, at-risk populations, and the health impacts of this heavy metal contamination. Results and Discussion: This systematic review used a database sourced from Google Scholar. The keywords searched were "lead exposure, environment, or health" in articles published in 2020-2023. After article screening and exclusion, 26 research articles were eventually reviewed. Lead was detected in water, air, and soil, generally in various foods or products consumed by humans. Environmental factors were the most frequent source of contamination. The population at risk of lead exposure were children. Several studies have found that various health impacts were significantly associated with lead exposure from different environmental sources and lead concentrations in biomarkers. Conclusion: Pb contamination was increasingly widespread in the environment through various sources. Exposure to lead may cause diverse health problems.

Safety and tolerability of the protein C activator AB002 in end-stage renal disease patients on hemodialysis: a randomized phase 2 trial

BackgroundThe protein C system regulates blood coagulation, inflammation, and vascular integrity. AB002 is an injectable protein C activating enzyme under investigation to safely prevent and treat thrombosis. In preclinical models, AB002 is antithrombotic, cytoprotective, and anti-inflammatory. Since prophylactic use of heparin is contraindicated during hemodialysis in some end-stage renal disease (ESRD) patients, we propose using AB002 as a short-acting alternative to safely limit blood loss due to clotting in the dialysis circuit.MethodsThis phase 2, randomized, double-blind, placebo-controlled, single-dose study evaluates the safety and tolerability of AB002 administered into the hemodialysis line of ESRD patients during hemodialysis at one study center in the United States (ClinicalTrials.gov: NCT03963895). In this study, 36 patients were sequentially enrolled into two cohorts and randomized to AB002 or placebo in a 2:1 ratio. In cohort 1, patients received 1.5 µg/kg AB002 (n = 12) or placebo (n = 6); in cohort 2, patients received 3 µg/kg AB002 (n = 12) or placebo (n = 6). Patients underwent five heparin-free hemodialysis sessions over 10 days and were dosed with AB002 or placebo during session four.ResultsHere we show that AB002 is safe and well-tolerated in ESRD patients, with no treatment-related adverse events. Clinically relevant bleeding did not occur in any patient, and the time to hemostasis at the vascular access sites is not affected by AB002.ConclusionsAs far as we are aware, this proof-of-concept study is the first clinical trial assessing the therapeutic potential of protein C activation. The results herein support additional investigation of AB002 to safely prevent and treat thrombosis in at-risk populations.

Using Vascular Deserts as a Guide for Limb Preservation Outreach Programs Successfully Targets Underserved Populations

Vascular deserts, regions without vascular providers, previously described targets for limb salvage efforts. The Comprehensive Heart and Multidisciplinary Limb Preservation Outreach Networks (CHAMPIONS) programs targeted regions for outreach and evaluated the population using desert maps. At 2 events targeting underserved regions between 2022 and 2023, providers screened and educated participants on peripheral arterial and cardiovascular disease (PACD). Demographics and cardiovascular risk factors were collected. Using Arc geographic information system, vascular surgeons, and Vascular Quality Initiative (VQI) participating facilities were mapped with a 30-mile buffer. Participants were mapped with census data, and the healthy places index (HPI) was overlayed for population and social determinants of health data analysis in medical service study areas (MSSA), a geographical analysis unit. (Figure1) Results were compared to prior statewide deserts. Outreach program participants' mean age was 56 (range 6-88); 39% were male, and the majority were Hispanic (86%). 27% had no primary care provider (PCP). 30% had diabetes, 10% undiagnosed before the event, 38% had hypertension, 40% undiagnosed prior to the event, and 21% described intermittent claudication. 81% made <$30,000 annually, and 28% reported no health insurance. Similarities were observed when comparing program participant demographics to the population-level data from the targeted regions. Patients were more frequently Hispanic than other desert regions (68% vs. 36%, P<0.001). Compared to other vascular desert regions, the target population was more disadvantaged in all HPI domains, including economic (18 vs. 38%, P<0.001), education (21 vs. 39%, P<0.001), and transportation (30 vs. 40%, P<0.001). Worse education, financial, and transportation resources correspond to decreased care access due to poor literacy and travel burdens. CHAMPIONS programs successfully targeted populations needing care based on vascular care desert maps, demonstrating that at-risk populations can be successfully identified and screened for cardiovascular disease.

Chagas Disease in the Non-Endemic Area of Rome, Italy: Ten Years of Experience and a Brief Overview.

Chagas disease (CD) is a parasitic infection endemic in Latin America and also affects patients in Western countries due to migration flows. This has a significant impact on health services worldwide due to its high morbidity and mortality burden. This paper aims to share our experience at the National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS, in Rome, Italy, where to date, a total of 47 patients-mainly Bolivian women-diagnosed with CD have received treatment with benznidazole, with all but one presenting with chronic disease. Most of the patients were recruited through the first extensive screening program held in 2014 at our Institute. About a quarter of our patients showed adverse effects to benznidazole, including a case of severe drug-induced liver injury, but 83% completed a full course of treatment. In addition to the description of our cohort, the paper reports a brief overview of the disease compiled through a review of the existing literature on CD in non-endemic countries. The growing prevalence of CD in Western countries highlights the importance of screening at-risk populations and urges public concern and medical awareness about this neglected tropical disease. There are still many unanswered questions that need to be addressed to develop a personalized approach in treating patients.

What medical students want from Mental Health Self-Help Resources: A focus group study

BackgroundMedical students frequently report higher levels of psychological distress than the general population, and emotional regulation skills learnt during their time of study underpin future psychological self-management. There have been few self-help mental health resources designed for this population, and it remains unclear what formats medical students prefer these resources to take on. Therefore, this study sought to understand what medical students want from self-help mental health resources. MethodsOtago Medical School students in their second, third, or Honors research years of study participated in focus groups where questions were posed to them about their preferences about format, perceived benefits, and interactions with self-help mental health resources. The data was recorded, transcribed, and thematically analyzed to identify relevant themes. ResultsThirty-four participants took part in six focus groups which lasted an average of 34 min each. Themes emerged around format, usefulness, and engagement. Formats included passively used resources like podcasts, actively used like reflective journals and social group-based resources to strengthen communities. Useful resources included novel, targeted approaches that would assist with navigating specific struggles as opposed to previously taught academic content. Recommendations included advertising through trusted student bodies and providing short, gamified resources. ConclusionParticipants reported a strong preference for brief, visually appealing, and gamified resources. It is recommended that universities provide a diverse collection of these self-help mental health resources tailored specifically to at-risk student populations like medical students to increase their uptake and, in doing so, provide them with more effective mental health support.

The hospitalisation risk of chronic circulatory and respiratory diseases associated with coal mining in the general population in Queensland, Australia

Queensland is the main coal mining state in Australia where populations in coal mining areas have been historically exposed to coal mining emissions. Although a higher risk of chronic circulatory and respiratory diseases has been associated with coal mining globally, few studies have investigated these associations in the Queensland general population. This study estimates the association of coal production with hospitalisations for chronic circulatory and respiratory diseases in Queensland considering spatial and temporal variations during 1997–2014.An ecological analysis used a Bayesian hierarchical spatiotemporal model to estimate the association of coal production with standardised rates of each, chronic circulatory and respiratory diseases, adjusting for sociodemographic factors and considering the spatial structure of Queensland's statistical areas (SA2) in the 18-year period. Two specifications; with and without a space-time interaction effect were compared using the integrated nested Laplace approximation -INLA approach. The posterior mean of the best fit model was used to map the spatial, temporal and spatiotemporal trends of risk.The analysis considered 2,831,121 hospitalisation records. Coal mining was associated with a 4 % (2.4—5.5) higher risk of hospitalisation for chronic respiratory diseases in the model with a space-time interaction effect which had the best fit. An emerging higher risk of either chronic circulatory and respiratory diseases was identified in eastern areas and some coal-mining areas in central and southeast Queensland. There were important disparities in the spatiotemporal trend of risk between coal -and non-coal mining areas for each, chronic circulatory and respiratory diseases.Coal mining is associated with an increased risk of chronic respiratory diseases in the Queensland general population. Bayesian spatiotemporal analyses are robust methods to identify environmental determinants of morbidity in exposed populations. This methodology helps identifying at-risk populations which can be useful to support decision-making in health. Future research is required to investigate the causality links between coal mining and these diseases.

Standardization and clinical applications of retinal imaging biomarkers for cardiovascular disease: a Roadmap from an NHLBI workshop.

The accessibility of the retina with the use of non-invasive and relatively low-cost ophthalmic imaging techniques and analytics provides a unique opportunity to improve the detection, diagnosis and monitoring of systemic diseases. The National Heart, Lung, and Blood Institute conducted a workshop in October 2022 to examine this concept. On the basis of the discussions at that workshop, this Roadmap describes current knowledge gaps and new research opportunities to evaluate the relationships between the eye (in particular, retinal biomarkers) and the risk of cardiovascular diseases, including coronary artery disease, heart failure, stroke, hypertension and vascular dementia. Identified gaps include the need to simplify and standardize the capture of high-quality images of the eye by non-ophthalmic health workers and to conduct longitudinal studies using multidisciplinary networks of diverse at-risk populations with improved implementation and methods to protect participant and dataset privacy. Other gaps include improving the measurement of structural and functional retinal biomarkers, determining the relationship between microvascular and macrovascular risk factors, improving multimodal imaging 'pipelines', and integrating advanced imaging with 'omics', lifestyle factors, primary care data and radiological reports, by using artificial intelligence technology to improve the identification of individual-level risk. Future research on retinal microvascular disease and retinal biomarkers might additionally provide insights into the temporal development of microvascular disease across other systemic vascular beds.

Synergistic susceptibility to environmental lead toxicity in chronic kidney disease.

While high levels of lead exposure, as occurs accidentally or occupationally, can cause toxicity across multiple organ systems, the hazard of commonly encountered levels of lead in the environment remains unresolved. Challenges to researching the health effects of lead include its complex interplay with renal function, rendering analyses at risk of unaccounted confounding, and the likely small effect size of environmental levels of exposure. While children are known to be disproportionately susceptible to lead toxicity, resulting in appropriately more stringent regulatory surveillance for those under 5 years old, emerging evidence suggests that those with chronic kidney disease (CKD) similarly are at a greater risk. This review summarizes the role of environmental lead toxicity as a potential cause and consequence of CKD. Whether environmental lead exposure causes CKD remains debatable, with little recent research advancing the conflicting, mostly cross-sectional, analyses from years ago. However, an emerging body of evidence suggests that CKD increases the susceptibility to lead toxicity. Higher circulating lead levels and lower urinary excretion result in greater lead accumulation in CKD, with simultaneous greater risk of clinically meaningful disease. Recent studies suggest that levels of lead found commonly in the United States drinking water supply, and currently permissible by the Environmental Protection Agency, associate with hematologic toxicity in those with advanced CKD. Whether environmental lead contamination may have additional negative health impact among this at-risk population, including cardiovascular and neurocognitive disease, warrants further study. The underlying pathophysiology of kidney disease synergizes the susceptibility to environmental lead toxicity for those with CKD. Low levels of exposure, as found commonly in the United States water supply, may have adverse health impact in CKD. Further research will be needed to determine if more stringent environmental regulations are warranted to protect the health of all.

On rhetorical distortion: Examining mutated hashtags in pro-an(orexi)a communities

In writing, rhetoric, and composition studies, researchers have examined hashtags through their collectivizing, signifying, and disrupting qualities. In this piece, we propose that hashtags can also be deployed in ways that are distortive, meaning that individuals and communities can rhetorically implement hashtags that may appear illegible to outsiders while still being meaningful to those within the group. Specifically, we carry this conversation through the context of hashtags deployed by members of the pro-anorexia (pro-ana) community/ies on the microblogging site Tumblr. While researchers in health and medical fields have found it useful to turn to studying aggregable hashtag data to make recommendations for working with at-risk populations such as these, problems can arise when these communities use distorted hashtags to avoid algorithmic detection/aggregation processes. To illustrate, collecting data from hashtags such as #anorexic may not yield useful information when members of this population might use tags such as #anar3cic to communicate with one another. Thus, we suggest that researchers of digital rhetorics and in rhetorics of health and medicine pay closer attention to the affordances of distortions, rather than dismissing them as irrelevant to larger narratives of clarity. We also end with ethical considerations that arise from focusing on the rhetorical distortions of at-risk populations.

ATAGI targeted review 2023: Vaccination for preventing influenza in Australia.

Annual seasonal influenza epidemics cause substantial disease and economic burden worldwide. During the coronavirus disease 2019 (COVID-19) pandemic in 2020 and 2021, influenza activity significantly declined. However, influenza resurged in Australia following the relaxation of non-pharmaceutical interventions, with increased influenza virus circulation in early 2022 coinciding with the SARS-CoV-2 Omicron BA.2 variant wave. Together with other respiratory virus diseases, these disease impacts on the Australian population and healthcare system have re-emphasised the importance of influenza vaccination and control. We aim to provide an overview of the current seasonal influenza vaccination program in Australia and summarise evidence and considerations underpinning potential future immunisation strategies. Influenza causes disproportionately higher morbidity and mortality in young children and older adults. Other populations at elevated risk from influenza include Aboriginal and Torres Strait Islander peoples, pregnant women, and people with certain underlying medical conditions. All Australians aged ≥ 6 months are recommended to receive influenza vaccine every year. The National Immunisation Program (NIP) provides free vaccine for eligible at-risk populations. While approximately 70% of older adults had received influenza vaccine in 2022, coverage in other age groups remains suboptimal. There are several key unmet needs and challenges, but also potential strategies for enhancing the influenza vaccination program in Australia. Improved monitoring and evaluation, including the use of relevant linked datasets for such purposes, is imperative to better understand variations in coverage and vaccination impact in specific populations. Adoption of evidence-based strategies, such as culturally appropriate resources that consider the characteristics of diverse Australian populations, may also help to achieve higher vaccine coverage rates. Additionally, greater vaccine uptake across the population could be facilitated by expanding the NIP-eligible population where cost-effective, and adopting the use of more effective and different types of vaccines when available.

Addressing the psychological impact of infertility risk arising from breast cancer treatment: Education and self-compassion interventions

Breast cancer incidence is increasing globally, including populations of childbearing age. Infertility risk from cancer treatment can negatively impact mental health in breast cancer patients and survivors, in part due to a lack of understanding of the risk and mitigation options ahead of treatment. In this commentary, recent literature on understanding of breast cancer treatment risk to infertility is reviewed, and recommendations are made for improving knowledge for at-risk populations. In addition, we propose a novel integration of self-compassion interventions be applied within breast cancer clinical care, building on groundwork from both breast cancer and primary infertility research areas that indicate the psychological benefits of self-compassion. Considerations for the application of self-compassion interventions to address fertility concerns within breast cancer patient and survivor populations are discussed.

Exploring Mental Health Services for Youth Experiencing Homelessness in East Asian Pacific Regions: A Systematic Scoping Review.

Youth experiencing homelessness (YEH) in East Asian Pacific (EAP) regions represent one of the most at-risk populations due to cultural and geographical factors. Effective mental health interventions, primarily researched in Western contexts, may not fully apply to YEH in EAP. Their lack of stable shelter, disrupted social networks, and limited access to mental health services elevate their susceptibility to adverse mental health, making urgent interventions essential to address their needs. The objective of this study is to explore and systematically search the types of mental health services and interventions available for YEH in EAP and their impact on overall quality of life and wellbeing. Electronic databases (e.g., Medline, PsycINFO, PubMed, Scopus) were systematically searched (publication dates between 1 January 1990 and 13 May 2023), as well as additional online resources specific to homelessness. Articles were screened, and a critical appraisal assessed the quality of the included studies. Eight studies with different interventions were identified in Indonesia (n = 2), Malaysia (n = 1), South Korea (n = 3), and the Philippines (n = 1). These were thematically clustered into six categories: art, cognitive behavioural therapy, life skills education, resilience enhancement, family strengthening, and government interventions/services. This review highlights effective mental health interventions' positive impact on YEH mental health outcomes and quality of life in EAP, stressing the urgent need to implement socio-culturally sensitive services. Future research should address knowledge gaps through comprehensive studies covering diverse EAP regions and populations, prioritising socio-culturally specific psychological measures.

Safety and Effectiveness of COVID-19 Vaccines During Pregnancy: A Living Systematic Review and Meta-analysis.

Pregnant persons are susceptible to significant complications following COVID-19, even death. However, worldwide COVID-19 vaccination coverage during pregnancy remains suboptimal. This study assessed the safety and effectiveness of COVID-19 vaccines administered to pregnant persons and shared this evidence via an interactive online website. We followed Cochrane methods to conduct this living systematic review. We included studies assessing the effects of COVID-19 vaccines in pregnant persons. We conducted searches every other week for studies until October 2023, without restrictions on language or publication status, in ten databases, guidelines, preprint servers, and COVID-19 websites. The reference lists of eligible studies were hand searched to identify additional relevant studies. Pairs of review authors independently selected eligible studies using the web-based software COVIDENCE. Data extraction and risk of bias assessment were performed independently by pairs of authors. Disagreements were resolved by consensus. We performed random-effects meta-analyses of adjusted relative effects for relevant confounders of comparative studies and proportional meta-analyses to summarize frequencies from one-sample studies using R statistical software. We present the GRADE certainty of evidence from comparative studies. Findings are available on an interactive living systematic review webpage, including an updated evidence map and real-time meta-analyses customizable by subgroups and filters. We included 177 studies involving 638,791 participants from 41 countries. Among the 11 types of COVID-19 vaccines identified, the most frequently used platforms were mRNA (154 studies), viral vector (51), and inactivated virus vaccines (17). Low to very low-certainty evidence suggests that vaccination may result in minimal to no important differences compared to no vaccination in all assessed maternal and infant safety outcomes from 26 fewer to 17 more events per 1000 pregnant persons, and 13 fewer to 9 more events per 1000 neonates, respectively. We found statistically significant reductions in emergency cesarean deliveries (9%) with mRNA vaccines, and in stillbirth (75-83%) with mRNA/viral vector vaccines. Low to very low-certainty evidence suggests that vaccination during pregnancy with mRNA vaccines may reduce severe cases or hospitalizations in pregnant persons with COVID-19 (72%; 95% confidence interval [CI] 42-86), symptomatic COVID-19 (78%; 95% CI 21-94), and virologically confirmed SARS-CoV-2 infection (82%; 95% CI 39-95). Reductions were lower with other vaccine types and during Omicron variant dominance than Alpha and Delta dominance. Infants also presented with fewer severe cases or hospitalizations due to COVID-19 and laboratory-confirmed SARS-CoV-2 infection (64%; 95% CI 37-80 and 66%; 95% CI 37-81, respectively). We found a large body of evidence supporting the safety and effectiveness of COVID-19 vaccines during pregnancy. While the certainty of evidence is not high, it stands as the most reliable option available, given the current absence of pregnant individuals in clinical trials. Results are shared in near real time in an accessible and interactive format for scientists, decision makers, clinicians, and the general public. This living systematic review highlights the relevance of continuous vaccine safety and effectiveness monitoring, particularly in at-risk populations for COVID-19 impact such as pregnant persons, during the introduction of new vaccines. PROSPERO: CRD42021281290.

Benchmarking and Optimization of Methods for the Detection of Identity-By-Descent in High-Recombining Plasmodium falciparum Genomes.

Genomic surveillance is crucial for identifying at-risk populations for targeted malaria control and elimination. Identity-by-descent (IBD) is increasingly being used in Plasmodium population genomics to estimate genetic relatedness, effective population size (N e ), population structure, and signals of positive selection. Despite its potential, a thorough evaluation of IBD segment detection tools for species with high recombination rates, such as P. falciparum, remains absent. Here, we perform comprehensive benchmarking of IBD callers - probabilistic (hmmIBD, isoRelate), identity-by-state-based (hap-IBD, phased IBD) and others (Refined IBD) - using population genetic simulations tailored for high recombination, and IBD quality metrics at both the IBD segment level and the IBD-based downstream inference level. Our results demonstrate that low marker density per genetic unit, related to high recombination relative to mutation, significantly compromises the accuracy of detected IBD segments. In genomes with high recombination rates resembling P. falciparum, most IBD callers exhibit high false negative rates for shorter IBD segments, which can be partially mitigated through optimization of IBD caller parameters, especially those related to marker density. Notably, IBD detected with optimized parameters allows for more accurate capture of selection signals and population structure; IBD-based N e inference is very sensitive to IBD detection errors, with IBD called from hmmIBD uniquely providing less biased estimates of N e in this context. Validation with empirical data from the MalariaGEN Pf 7 database, representing different transmission settings, corroborates these findings. We conclude that context-specific evaluation and parameter optimization are essential for accurate IBD detection in high-recombining species and recommend hmmIBD for quality-sensitive analysis, such as estimation of N e in these species. Our optimization and high-level benchmarking methods not only improve IBD segment detection in high-recombining genomes but also enhance overall genomic analysis, paving the way for more accurate genomic surveillance and targeted intervention strategies for malaria.

Trends in body image among Australian queer men during COVID-19 lockdowns

ABSTRACT Existing literature demonstrates that COVID-19 lockdowns negatively impacted body image for most people. However, the exact nature of body image shifts during lockdowns and the impact sexuality had on these shifts remains understudied. We sought to investigate this phenomenon among queer men – an at-risk population for negative body image. Participants were 268 (M age = 35.30 years) queer Australian men. They completed measures for lockdown-induced body dissatisfaction, disordered eating and exercising, dysmorphic symptomology, anxiety, depression, and suicidality. Increases in body dissatisfaction and disordered eating during lockdowns were associated with increases in anxiety, depression, and suicidality symptomology. Furthermore, the relationship between body dissatisfaction and depression was moderated by disordered eating and exercise, whereby body dissatisfaction predicted depression only for participants who engaged in heightened disordered eating and overexercise during lockdowns. In other words, body dissatisfaction was most harmful to queer men who specifically sought to remedy this dissatisfaction by engaging in problematic eating/exercise behaviours. These findings have clinical implications for supporting queer men with negative body image in the wake of COVID-19 lockdowns. Namely, queer men might benefit from therapies that build on body neutrality frameworks to help normalise experiences of body dissatisfaction and discourage subsequent disordered eating and exercise.

How to assess survival prognosis in patients hospitalized for community-acquired pneumonia in 2024?

Community-acquired pneumonia (CAP) is increasingly recognized as a complex, multisystemic disease with the potential to cause both acute and long-term sequelae, significantly impacting patient mortality rates. In this manuscript, the authors review the current methodologies for assessing mortality risk among CAP patients. The most common prediction scores for ICU care and short-term mortality include Pneumonia Severity Index (PSI), CURB-65, SMART COP, SCAP, and ATS/IDSA criteria. These models have clinical utility in the prediction of short-term mortality, but they have significant limitations in addressing long-term mortality. For patients who are discharged alive from the hospital, we do not have scores to predict long term mortality. The development of an optimal prognostic tool for postacute sequelae of CAP is imperative. Such a tool should identify specific populations at increased risk. Moreover, accurately identifying at-risk populations is essential for their inclusion in clinical trials that evaluate potential therapies designed to improve short and long-term clinical outcomes in patients with CAP.

An Alternative Non-Invasive Screening Model for Liver Fibrosis among US Adults at Risk of MASLD.

Background and Aims: Screening for liver fibrosis presents a clinical challenge. This study aimed to explore a useful alternative method for assessing fibrosis risk among US adults at risk of metabolic dysfunction-associated steatotic liver disease (MASLD). Methods: A liver stiffness score (LSS) model was proposed and tested using data from 3976 participants at possible risk of MASLD, obtained from the US National Health and Nutrition Examination Survey (NHANES). Results: The LSS model was developed using liver stiffness measurements, blood biochemistry, and body measurement data from 2414 NHANES participants at risk of MASLD, sampled between 2017 and 2020: LSS = exp(0.007035 × bodyweightkg - 0.1061 × raceblack1,0 + 0.183221 × diabetes1,0 + 0.008539 × ASTIU/L - 0.0018 × plateletcount1000cell/UL - 0.21011 × albuming/dL + 2.259087). The probability (P) of having fibrosis F3 + F4 is calculated as follows: P = 0.0091 × LSS2 - 0.0791 × LSS + 0.1933. The developed LSS model was tested on 1562 at-risk participants from the 2017-2018 cycle. The results showed that the LSS model achieved AUROC values of 0.79 and 0.78 for diagnosing cirrhosis (F4) and advanced fibrosis (F3 + F4) in the US population, respectively. It outperformed existing models such as NFS, FIB-4, SAFE, and FIB-3. For screening F3 + F4 fibrosis, the LSS model's top decile outperformed the NFS and FIB-4 models by 37.7% and 42.6%, respectively. Additionally, it showed superior performance compared to the waist circumference classification method by 29.5%. Conclusions: derived from an ethnically diverse population dataset, the LSS screening model, along with its probability equation, may offer clinicians a valuable alternative method for assessing the risk of liver fibrosis in the at-risk adult population.