Burden Of Disease Research Articles

A tool for the assessment of the risk drivers and public perception of WASH in South Africa

Temporal trend analysis of the Google-search volumes and terms related to water, sanitation and hygiene (WASH) in South Africa was performed using a computer plugin between January 2004 and June 2022. This study was conducted as WASH has played an important role in the containment of the recent coronavirus disease 2019 (COVID-19) pandemic, and it is also one of the most effective and easiest-to-deploy tools in decreasing risk from infectious diseases. For the WASH-related terms, the monthly search volumes ranged from the minimum average of 480 for pit latrines to the maximum of 30236 for diarrhea or diarrhoea for the studied period. The Spearman correlation coefficients ranged from –0.29462 to 0.96647, with the p-values ranging from 0.00001 to 0.28789. On a yearly basis, there was a direct correlation between the WASH-related search volumes extracted and the access of the South African population to basic water and sanitation. There was an inverse relationship between the WASH-related search volumes extracted on an annual basis and the death rates from diarrhoeal diseases among children under 5 years of age in South Africa between 2004 and 2020. Results of the current study indicate that a Google-derived search volume can be useful in the assessment of the public’s interest in WASH-related topics in South Africa.Contribution: Therefore, the study findings could be used to optimise the design and targeting of public awareness campaigns on WASH during the coronavirus pandemic or similar infectious disease burdens and related disaster risks.

Burden of selenium deficiency and cost-effectiveness of selenium agronomic biofortification of staple cereals in Ethiopia.

Selenium (Se) deficiency among populations in Ethiopia is consistent with low concentrations of Se in soil and crops that could be addressed partly by Se-enriched fertilisers. This study examines the disease burden of Se deficiency in Ethiopia and evaluates the cost-effectiveness of Se agronomic biofortification. A disability-adjusted life years (DALY) framework was used, considering goiter, anaemia, and cognitive dysfunction among children and women. The potential efficiency of Se agronomic biofortification was calculated from baseline crop composition and response to Se fertilisers based on an application of 10 g/ha Se fertiliser under optimistic and pessimistic scenarios. The calculated cost per DALY was compared against gross domestic product (GDP; below 1-3 times national GDP) to consider as a cost-effective intervention. The existing national food basket supplies a total of 28·2 µg of Se for adults and 11·3 µg of Se for children, where the risk of inadequate dietary Se reaches 99·1 %-100 %. Cereals account for 61 % of the dietary Se supply. Human Se deficiency contributes to 0·164 million DALYs among children and women. Hence, 52 %, 43 %, and 5 % of the DALYs lost are attributed to anaemia, goiter, and cognitive dysfunction, respectively. Application of Se fertilisers to soils could avert an estimated 21·2-67·1 %, 26·6-67·5 % and 19·9-66·1 % of DALY via maize, teff and wheat at a cost of US$129·6-226·0, US$149·6-209·1 and US$99·3-181·6, respectively. Soil Se fertilisation of cereals could therefore be a cost-effective strategy to help alleviate Se deficiency in Ethiopia, with precedents in Finland.

Contribution of Other Respiratory Viruses During Influenza Epidemic Activity in Catalonia, Spain, 2008–2020

Background: During seasonal influenza activity, circulation of other respiratory viruses (ORVs) may contribute to the increased disease burden that is attributed to influenza without laboratory confirmation. The objective of this study was to characterize and evaluate the magnitude of this contribution over 12 seasons of influenza using the Acute Respiratory Infection Sentinel Surveillance system in Catalonia (PIDIRAC). Methods: A retrospective descriptive study of isolations from respiratory samples obtained by the sentinel surveillance network of physicians was carried out from 2008 to 2020 in Catalonia, Spain. Information was collected on demographic variables (age, sex), influenza vaccination status, epidemic activity weeks each season, and influenza laboratory confirmation. Results: A total of 12,690 samples were collected, with 46% (5831) collected during peak influenza seasonal epidemic activity. In total, 49.6% of the sampled participants were male and 51.1% were aged <15 years. Of these, 73.7% (4298) of samples were positive for at least one respiratory virus; 79.7% (3425 samples) were positive for the influenza virus (IV), with 3067 samples positive for one IV type, 8 samples showing coinfection with two types of IV, and 350 showing coinfection of IV with more than one virus. The distribution of influenza viruses was 64.2% IVA, 35.2% IVB, and 0.1% IVC. Of the other respiratory viruses identified, there was a high proportion of human rhinovirus (32.3%), followed by human adenovirus (24.3%) and respiratory syncytial virus (18; 7%). Four percent were coinfected with two or more viruses other than influenza. The distribution of coinfections with ORVs and influenza by age groups presents a significant difference in proportions for 0–4, 5–14, 15–64 and >64 (21.5%, 10.8%, 8.2% and 7.6%: p < 0.001). A lower ORVs coinfection ratio was observed in the influenza-vaccinated population (11.9% vs. 17.4% OR: 0.64 IC 95% 0.36–1.14). Conclusions: During the weeks of seasonal influenza epidemic activity, other respiratory viruses contribute substantially, either individually or through the coinfection of two or more viruses, to the morbidity attributed to influenza viruses as influenza-like illness (ILI). The contribution of these viruses is especially significant in the pediatric and elderly population. Identifying the epidemiology of most clinically relevant respiratory viruses will aid the development of models of infection and allow for the development of targeted treatments, particularly for populations most vulnerable to respiratory viruses-induced diseases.

Burden of diabetes mellitus in Weifang: Changing trends in prevalence and deaths from 2010 to 2021.

The objective of this study is to analyze the death characteristics and burden of disease (BOD) in diabetes mellitus (DM) patients in Weifang from 2010 to 2021. The findings will serve as a foundational data source and theoretical framework for public health administrative departments in the formulation of DM-related policies. The annual percent change (APC) and average annual percent change (AAPC) of the disability-adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD) in DM residents from 2010 to 2021 were analyzed using the Joinpoint software to reflect the changing trend of the BOD in DM patients. Additionally, we conducted an analysis of the various causes of death among these patients and compared BOD in diabetic patients with different backgrounds. From 2010 to 2021, the burden of disease, which includes DALY, YL, and YLD, has been increasing among patients with DM in Weifang. It is noteworthy that the burden of disease is particularly pronounced among male patients and those aged 75 or above. Additionally, it is observed that widowed and illiterate DM patients have comparatively longer survival times. Furthermore, among the DM patients who have unfortunately passed away, it has been identified that unspecified DM with ketoacidosis accounts for 10.03% of the deaths as a direct cause of death. In contrast, type 2 diabetes mellitus (T2DM) with kidney complications contributes to 10.23% of the deaths as the fundamental cause of death. The city is faced with a significant challenge of diabetes, which is influenced by factors such as gender, age, cultural background, and marital status. Unspecified diabetes mellitus (DM) with ketoacidosis (10.03%) and T2DM with renal complications (0.23%) are identified as the primary direct and underlying causes of death among diabetic patients, respectively. This study serves as a valuable reference for other regions in terms of diabetes prevention, control, and the management of chronic diseases.

Assessment of disability and disease burden in neuromyelitis optica spectrum disorders in the CIRCLES Cohort

Neuromyelitis optica spectrum disorders (NMOSD) comprise autoimmune diseases imposing substantial disability. We compared an NMOSD-targeted disability assessment of mobility, vision, and self-care domains (individually and composite) with the multiple sclerosis-targeted Expanded Disability Status Scale (EDSS) to assess NMOSD disease burden. An overall cohort (n = 505) and a subset of these patients with an enriched dataset (n = 198) were analyzed from the CIRCLES longitudinal, observational database of patients with AQP4-IgG–seropositive or –seronegative NMOSD in North America. Multinomial modeling was used to identify temporal correlates of disability improvement, stability, and worsening. Prior on-study relapse correlated with worsening mobility (OR, 3.08; 95% CI: 1.61–5.90), vision (OR, 3.99; 95% CI: 2.03–7.86), self-care disability (OR, 1.90; 95% CI: 1.07–3.38), and mean composite index disability (OR, 4.20; 95% CI: 1.71–10.34). Higher vision disability was associated with Black race, shorter time on-study, and AQP4-IgG–seropositive status in patients ≥ 18 years (p < 0.05). Disease onset phenotype and sex correlated with pain interference (p < 0.05). These correlates of NMOSD disability were undetected by EDSS. The CIRCLES real-world experience supports the need for NMOSD-specific disability assessment to improve recognition of disease burden, facilitate proactive clinical management, offer insights into resilience, and inform clinical trial design.

Temporal trends of the burden of ischemic stroke attributable to high low-density lipoprotein cholesterol in China from 1999 to 2019

BackgroundHigh levels of low-density lipoprotein cholesterol (LDL-C) can lead to the occurrence and development of atherosclerosis, which is one of the important risk factors for ischemic stroke (IS). However, details regarding the evolution of the IS burden attributable to high LDL-C in China has not been available. The objective of this study was to examine the changes over time, from 1990 to 2019, in the burden of IS attributed to high levels of LDL-C in China and to estimate the individual impacts of age, period, and cohort on the burden of IS associated with high LDL-C.MethodsDetailed data on IS burden attributable to high LDL-C from 1990 to 2019 in China were extracted from the Global Burden of Disease (GBD) Study 2019. The numbers and age-standardized rates of IS-related mortality and disability-adjusted life years (DALYs) attributable to high LDL-C were assessed by age and sex. The annual percentage change (APC) and average annual percentage change (AAPC) in the burden of IS due to high LDL-C were analyzed using Joinpoint regression model. The age-period-cohort analysis was carried out to assess the individual impacts of age, period, and cohort on the trends over time of mortality and DALY rate.ResultsThe number of IS-related deaths and DALYs due to high LDL-C in China were 182.7 thousand and 4.43 million in 2019, respectively, both more than double the corresponding numbers reported in 1990. However, despite these increased, the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) remained unchanged. In 2019, men under 84 years of age had higher death and under 79 years of age had higher DALYs than women. However, above these ages, the gender disparities were reversed. Furthermore, age-specific rates of death, as well as DALY of IS attributable to high LDL-C in 2019 increased with age for both women and men, except for death in adults over 95 years old; and were greater in men than in women. From 1990 to 2019, males consistently had a higher ASMR and ASDR than females in China. During 1990–2019, the ASMR in women slightly decreased before 1997, sharply increased from 1997 to 2004, and then continuously decreased from 2004 to 2019, with an overall AAPC value of -0.4% (95% CI -0.8%, -0.0%). However, for the ASMR of men in China, the overall trend is upward and the AAPC is 0.5%(95% CI 0.1%, 0.8%). The ASDR in women and men had the similar trend as the ASMR over the time, with an AAPC of -0.4% (95% CI -0.7%, -0.1%) and 0.3% (95% CI 0.1%, 0.5%), respectively. The age-period-cohort analysis indicated a rise in period effects and a decline in cohort effects on mortality and DALY rate associated with IS caused by high LDL-C in both genders. Age effect on mortality rates from IS due to high LDL-C showed an exponential increased with age in all women and men except for the 60–69 age group and over 95 age group. The age relative risk of IS DALY rate due to high LDL-C increased with age in both genders except for 65–74 age group and over 95 age group.ConclusionsFrom 1990 to 2019, the burden of IS caused by high LDL-C in China significantly increased among both sexes combined and among men, while significantly decreased among women. Elderly have a substantial burden of IS attributable to high LDL-C. Therefore, effective and tailored strategies based on gender and age for IS primary prevention and management of IS and high LDL-C are urgently needed in China.

The association of osteoarthritis with metabolic disorders

Osteoarthritis (OA) is the most common form of synovial joint arthritis that causes chronic pain and disability to a large number of people worldwide. Most often, osteoarthritis affects the joints of the knees, hips, spine and hands. The Global Burden of Disease (GBD, 2021) estimates that osteoarthritis will be the fourth leading cause of disability by 2030, with enormous healthcare costs for treatment, as well as significant indirect costs due to loss of productivity and premature retirement. The aim of our research is to determine in what way prevalent metabolic syndrome is among participants with osteoarthritis of one of the synovial joints (knees, hips, hands), and whether metabolic disorders are a risk factor for the development and worsening of osteoarthritis. A prospective clinical study was conducted at the Public Health Institution Health Center Živinice, from July 2022 to May 2024, on a random sample of 200 participants with a confirmed clinical diagnosis of osteoarthritis (OA), who were divided into a group with metabolic syndrome and a group without metabolic syndrome based on the NCEP ATP III panel criteria for metabolic syndrome. The prevalence of knee osteoarthritis is significantly higher compared to the prevalence of hip and hand osteoarthritis, and it is greater among participants with a higher BMI (in participants with the highest BMI, knee osteoarthritis occurs with a 100% probability) and with the presence of metabolic syndrome, especially in more severe forms, specifically radiologically confirmed osteoarthritis, regardless of age and gender. Unlike OA knees the prevalence of OA hips and hands shows no correlation with BMI and metabolic syndrome. Multiple comparative analysis of differences in the average severity of osteoarthritis of the knee of subjects with normal glycemia / prediabetes / diabetes type 2 it showed a statistically significant difference in the average severity of knee osteoarthritis in subjects with regular blood sugar compared to subjects with prediabetes/diabetes mellitus type 2 regardless of age and gender. This means that with an increase in blood sugar levels, the degree of severity of osteoarthritis of the knee increases, since each subsequent Group has a higher average value of this indicator (p&lt;0.05; CI 95%).

CAF to the rescue! Potential and challenges of combination antifungal therapy for reducing morbidity and mortality in hospitalized patients with serious fungal infections

Abstract The global burden of invasive fungal disease (IFD) is substantial and escalating. Combination antifungal therapy (CAF) may improve patient outcomes by reducing development of resistance, improving drug penetration and rate of fungal clearance, and allowing for lower, less toxic antifungal drug doses; yet, increased cost, antagonism, drug-drug interactions, and toxicity are concerns. Clinical practice guidelines recommend antifungal monotherapy, rather than CAF, for most IFDs due to a lack of comparative randomized clinical trials. An examination of the existing body of CAF research should frame new hypotheses and determine priorities for future CAF clinical trials. We performed a systematic review of CAF clinical studies for invasive candidiasis, cryptococcosis, invasive aspergillosis, and mucormycosis. Additionally, we summarize findings from animal models of CAF and assess laboratory methods available to evaluate CAF efficacy. Future CAF trials should be prioritized according to animal models showing improved survival and observational clinical data supporting efficacy and safety.

Designing persuasive communication models for vaccine acceptance in isolated communities: A mass communication approach

This study introduces the Persuasive Communication Model as a novel approach to address vaccine hesitancy in isolated U.S. communities, where infectious diseases such as measles and influenza continue to pose significant public health threats. By integrating mass communication theories like the Elaboration Likelihood Model (ELM) and Social Cognitive Theory (SCT), with AI-driven message personalization, the model effectively tailors health communication strategies to the cultural, cognitive, and socio-economic contexts of vaccine-hesitant populations. In a randomized controlled trial, the model increased vaccination uptake by over 20% compared to traditional methods, while also enhancing trust in healthcare systems. The model’s adaptive communication, utilizing both digital platforms and community leaders, was instrumental in overcoming barriers related to geographic isolation, religious beliefs, and cultural resistance. These findings are particularly relevant for enhancing national public health security and reducing the economic burden of vaccine-preventable diseases. The study highlights the model's superiority over static communication frameworks, offering scalable applications for broader public health interventions.

ML-powered Internet of Medical Things (MLIoMT) Structure for Heart Disease Prediction

Background ML-powered Internet of Medical Things (MLIoMT) is a burgeoning framework poised to transform healthcare, particularly in the timely identification of heart disease. Objectives This article proposes an innovative MLIoMT structure aimed at leveraging machine learning (ML) algorithms for heart disease detection. Materials and Methods Through the integration of wearable sensors, mobile applications, cloud computing, and advanced ML techniques, MLIoMT enables continuous monitoring of vital signs and cardiac health indicators in real time. By analyzing this data stream, abnormalities indicative of heart disease can be detected early, facilitating timely intervention and personalized healthcare recommendations. The MLIoMT framework employs diverse ML methods, such as deep learning and ensemble techniques to enhance the accuracy and reliability of heart disease prediction models. Results The proposed structure holds promise for revolutionizing preventive healthcare, enabling proactive management of cardiac health, and ultimately reducing the burden of heart disease. Results in terms of accuracy, precision, recall and F1 score show that the proposed system has better performance and efficiency. Conclusion Overall, MLIoMT represents a significant advancement in healthcare technology, with the potential to improve patient outcomes and enhance overall quality of life.

Climate change and epidemiological trends of malaria and Lassa fever transmission in Nigeria (2015-2022): A systematic review and meta-analysis

Background: Climate change exacerbates infectious disease transmission in Nigeria, a country with a high burden of infectious diseases. Objective: To conduct a systematic review and meta-analysis examining the relationship between climate variability and infectious disease transmission in Nigeria. Methods: We systematically searched major databases, identifying 25 studies, with 11 studies meeting the inclusion criteria for meta-analysis using R version 4.4.1. Results: The meta-analysis revealed significant associations between temperature increases and malaria (pooled effect estimate = 1.034, 95% CI: 1.016-1.052) and Lassa fever (pooled effect estimate = 1.029, 95% CI: 1.015-1.043) transmission. Egger's funnel plot showed no significant publication bias, and sensitivity analysis confirmed the robustness of the findings. Conclusion: This study provides evidence for the association between climate variability and infectious disease transmission in Nigeria. This underscores the urgent need for targeted interventions to protect vulnerable populations, including children under 5, pregnant women, the elderly, people with comorbidity, and low-income communities.

The critical need for child and youth perceptions of active living in India: capturing context complexity in rural and urban regions

Background The physical inactivity pandemic not only has a negative impact on the physical and mental health of children and youth, but it is also a key contributor to the non-communicable disease (NCD) burden, particularly among low- and middle-income countries. The widespread effects of climate change, ranging from extreme weather events to worsening air quality, are exacerbating the physical inactivity pandemic, highlighting the need to undertake holistic interventions to address environmental barriers while promoting physical activity. Despite the potential benefits of active school transportation (AST) on physical activity and the environment, no study has examined the intersection between perceptions of AST, environmental perceptions, and moderate-to-vigorous physical activity (MVPA) among children and youth in India from a child and youth perspective. Methods As a part of this cross-sectional, observational study, digital survey links were administered to 1,042 children and youth aged 5 to 17 (50.3% boys; 49.7% girls). Participants were recruited from 41 schools across 28 rural and urban regions in India. Children and youth provided information on various sociodemographic factors, perceptions of crime and air pollution, and peer support factors. MVPA data were collected using an adapted version of the IPAQ short-form questionnaire. The overall sample was stratified by age, gender, and location, resulting in a total of seven multiple linear regression models to assess the association between AST and MVPA. Results Children and youth who engaged in AST were associated with higher MVPA than those who did not engage in AST (β = 18.020, 95% CI [5.890 to 30.149], p = 0.004), after adjusting for age, gender, and location. In contrast, perceptions of high crime in the neighbourhood (β = − 21.921, CI [−36.195 to −7.647], p = 0.003) and perceptions of air pollution (β = − 12.472, CI [−23.797 to −1.147], p = 0.031) were associated with lower MVPA. Moreover, having active friends was associated with higher MVPA (β = 32.391, CI [9.264 to 55.518], p = 0.006) than not having active friends. AST was significantly associated with higher MVPA in the boys, rural, and aged 13 to 17 models; however, this association was not statistically significant in the girls, urban, and aged 5 to 12 models. Conclusions These findings highlight that promoting AST can potentially promote MVPA and contribute to mitigating the NCD burden among children and youth in India. Future policies and interventions should prioritize initiatives that promote AST, considering diverse sociodemographic factors, and addressing environmental challenges such as perceptions of crime and air pollution.

Individual-level metabolic connectivity from dynamic [18F]FDG PET reveals glioma-induced impairments in brain architecture and offers novel insights beyond the SUVR clinical standard.

This study evaluates the potential of within-individual Metabolic Connectivity (wi-MC), from dynamic [18F]FDG PET data, based on the Euclidean Similarity method. This approach leverages the biological information of the tracer's full temporal dynamics, enabling the direct extraction of individual metabolic connectomes. Specifically, the proposed framework, applied to glioma pathology, seeks to assess sensitivity to metabolic dysfunctions in the whole brain, while simultaneously providing further insights into the pathophysiological mechanisms regulating glioma progression. We designed an index (Distance from Healthy Group, DfHG) based on the alteration of wi-MC in each patient (n = 44) compared to a healthy reference (from 57 healthy controls), to individually quantify metabolic connectivity abnormalities, resulting in an Impairment Map highlighting significantly compromised areas. We then assessed whether our measure of metabolic network alteration is associated with well-established markers of disease severity (tumor grade and volume, with and without edema). Subsequently, we investigated disruptions in wi-MC homotopic connectivity, assessing both affected and seemingly healthy tissue to deepen the pathology's impact on neural communication. Finally, we compared network impairments with local metabolic alterations determined from SUVR, a validated diagnostic tool in clinical practice. Our framework revealed how gliomas cause extensive alterations in the topography of brain networks, even in structurally unaffected regions outside the lesion area, with a significant reduction in connectivity between contralateral homologous regions. High-grade gliomas have a stronger impact on brain networks, and edema plays a mediating role in global metabolic alterations. As compared to the conventional SUVR-based analysis, our approach offers a more holistic view of the disease burden in individual patients, providing interesting additional insights into glioma-related alterations. Considering our results, individual PET connectivity estimates could hold significant clinical value, potentially allowing the identification of new prognostic factors and personalized treatment in gliomas or other focal pathologies.

Lifestyle related health risk factors regarding non-communicable diseases among adults in Morang District

Introduction: Non-communicable diseases are the leading causes of disease burden worldwide. According to World Health Organization estimates, NCDs are responsible for 74% of all deaths globally, with around 77% of premature deaths from NCDs occurring in low- and middle-income countries. This study aims to assess the lifestyle related health risk factors of non-communicable diseases among adults in Nepal, in which two- third of annual deaths are attributable to non-communicable diseases. Methods: A cross sectional study was conducted among adults in Morang district, Nepal. Data collection involved the assessment of the risk factors of obesity, smoking, alcohol consumption, inadequate fruits and vegetable consumption, inadequate physical activity, are raising blood pressure. Ethnical approval was obtained. Results: Two hundred forty participants participated in the study, of which the most prevalent risk factor was obesity (58.3%). Out of total participants, 41.6% had consumed tobacco, 31.2% had consumed alcohol, 41.6% had consumed inadequate fruits and vegetables, 30.4% had inadequate physical activity, and 29.1% had raised blood pressure. Similarly, education is statistically associated with lifestyle risk factors. Male participants of age above 40 years were found to be statistically associated with current tobacco and alcohol consumption. Conclusion: Health related risk factors are causes of non-communicable disease. Most of the participants had two or more risk factors for non-communicable disease. Education is significantly associated with all the risk factors among the participants.

Twenty Years of Lyme Borreliosis in the Netherlands: Temporal Trends in Seroprevalence and Risk Factors

Lyme borreliosis (LB) is not notifiable in many European countries, and the patchwork of surveillance strategies in Europe perpetuates knowledge gaps. In the Netherlands, LB incidence has been estimated from recurring general practitioner surveys since the 1990s. To complement the incidence data, this study aimed to estimate the prevalence of antibodies against Borrelia burgdorferi sensu lato in the general population of the Netherlands in 1995/1996, identify risk factors for seropositivity, and compare these findings to data from 2016/2017 to identify temporal trends. Sera from participants (n = 8041, aged 0–80 years) in a cross-sectional nationwide surveillance study were assessed for the presence of antibodies against B. burgdorferi s.l., using a screening ELISA and immunoblot confirmation. Risk factors associated with seropositivity were evaluated using multivariable analysis. A significant difference in weighted seroprevalence was observed between 1995/1996 (2.8%) and 2016/2017 (4.3%). In both cohorts, the seroprevalence was significantly higher among men than among women, and increased with age and tick bite frequency. The upward trend in age-specific seropositivity in individuals over 50 was steeper in 2016/2017 than in 1995/1996, possibly due to improved fitness among contemporary elderly, allowing increased outdoor activities. This study highlights significant trends in the seroprevalence of B. burgdorferi s.l. antibodies in the general population of the Netherlands over 20 years. The doubling of seroprevalence underscores the increasing burden of LB, and the importance of continued surveillance. Targeted interventions, particularly for elderly populations, may help raise awareness to the risks of tick bites and reduce the growing disease burden and societal costs associated with LB.

The role of preventive medicine in reducing chronic disease Burden in the USA: A Systematic Review

Chronic diseases, including cardiovascular disease, diabetes, cancer, and respiratory illnesses, are the leading causes of morbidity and mortality in the United States, placing a significant burden on individuals, healthcare systems, and the economy. Preventive medicine, encompassing primary, secondary, and tertiary strategies, plays a crucial role in mitigating this burden by focusing on disease prevention and health promotion. This systematic review aims to evaluate the effectiveness of preventive medicine in reducing the chronic disease burden in the USA. Through a comprehensive search of peer-reviewed studies, we explore the impact of screening programs, early detection, lifestyle interventions, and health policies designed to prevent chronic diseases. The review highlights the success of preventive measures in decreasing disease incidence, improving health outcomes, and reducing healthcare costs. However, challenges such as disparities in access to care, patient adherence, and the integration of preventive services into the broader healthcare system remain significant barriers. The review concludes by discussing policy implications, recommending strategies to overcome implementation challenges, and outlining future research directions to enhance the role of preventive medicine in combating chronic diseases in the USA.

Mycobacterium abscessus pulmonary infection and associated respiratory function in cystic fibrosis-like βENaC mice

IntroductionChronic pulmonary infection with Mycobacterium abscessus (M. abscessus) is a significant cause of morbidity and mortality in people with cystic fibrosis (CF). Developing an animal model of M. abscessus pulmonary infection, especially under CF conditions, is essential to understanding clinical pulmonary M. abscessus infection. βENaC transgenic mice are known to develop spontaneous CF-like disease characterized by airway mucus obstruction and inflammation. The aim of this study was to evaluate the suitability of βENaC mice as a preclinical model and characterize their respiratory function during M. abscessus lung infection.MethodsMice received an intrapulmonary aerosol of M. abscessus using a high-pressure syringe device (Penn-Century) for subsequent characterization of disease progression and respiratory function. Whole body unrestrained plethysmography (WBP) data was collected to monitor lung function and endpoints determined organ bacterial burden and associated pathology.ResultsEndpoint CFU data in the lung and spleen showed that there was no significant difference in bacterial clearance between βENaC and WT mice. WBP data showed an impairment in overall respiratory function during and after M. abscessus infection in both strains of mice. Interestingly, even in wildtype control mice, lung dysfunction persisted after bacterial clearance.DiscussionEven with CF-like features, the βENaC transgenic mice cleared M. abscessus at a similar rate than WT mice, however, the associated respiratory monitoring revealed that there are long-term implications of M. abscessus lung exposure. The clear decline in respiratory function, even after M. abscessus clearance, suggests that WBP coupled animal modeling provides important insight that is relevant to disease burden and treatment efficacy. The M. abscessus clearance in the βENaC mice may help improve the fields understanding of CF-modulated immune deficiencies in M. abscessus pulmonary infection.

Disease burden among patients with Arginase 1 deficiency and their caregivers: A multinational, cross‐sectional survey

AbstractArginase 1 deficiency (ARG1‐D) is an ultrarare, metabolic disease which may cause spastic paraplegia, cognitive deficiency, seizures, and ultimately severe disability. The aim of this study was to assess disease burden in ARG1‐D by performing a cross‐sectional survey of patients with ARG1‐D and their caregivers in four European countries (France, Portugal, Spain, and the United Kingdom). Patients were enrolled at participating clinics and data were collected using a web‐based questionnaire. The findings indicate that there is a significant share of patients who experience severe cognitive and mobility impairment but also that there is a considerable variance in symptom severity among patients. Disease management was mostly in line with treatment guidelines and self‐reported adherence to treatment was reported to be high among a majority although following diet restrictions was perceived as difficult. However, despite this, since a large share of patients experienced severe cognitive and mobility impairment an unmet need among this patient population is suggested. The introduction of disease‐modifying therapies and early identification and diagnosis may help alleviate the disease burden associated with ARG1‐D in the future.

High sodium intake increases interstitial lung disease and pulmonary sarcoidosis based on the Global Burden of Disease study 1999–2019

This study investigated the relationships between dietary sodium intake and the incidence and prevalence of interstitial lung disease (ILD) and pulmonary sarcoidosis using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. This study assessed the strength of the abovementioned relationships via LASSO analysis and a generalized additive model with Poisson regression and determined the nonlinear and lagged effects via a distributed lag nonlinear model (DLNM). In the past three decades, global dietary sodium intake has decreased gradually. Two LASSO and generalized additive analyses both suggested that dietary sodium intake is obviously correlated with the incidence and prevalence of ILD and pulmonary sarcoidosis. The overall exposure‒response curve revealed a dose‒effect relationship between dietary sodium intake and the incidence and prevalence of ILD and pulmonary sarcoidosis. The maximum lag-specific RR of extremely high dietary sodium intake was 1.75 (95% CI: 1.61–1.91, lag 0 year) for incidence and 3.19 (95% CI: 2.24–4.53, lag 0 year) for prevalence relative to the reference. Our study suggests that dietary sodium intake is positively associated with the incidence and prevalence of ILD and pulmonary sarcoidosis. These findings may have important policy implications for dietary sodium intake-reduction strategies to decrease the burden of respiratory diseases and promote public health.

Interpretable machine learning model for new-onset atrial fibrillation prediction in critically ill patients: a multi-center study

BackgroundNew-onset atrial fibrillation (NOAF) is the most common arrhythmia in critically ill patients admitted to intensive care and is associated with poor prognosis and disease burden. Identifying high-risk individuals early is crucial. This study aims to create and validate a NOAF prediction model for critically ill patients using machine learning (ML).MethodsThe data came from two non-overlapping datasets from the Medical Information Mart for Intensive Care (MIMIC), with MIMIC-IV used for training and subset of MIMIC-III used as external validation. LASSO regression was used for feature selection. Eight ML algorithms were employed to construct the prediction model. Model performance was evaluated based on identification, calibration, and clinical application. The SHapley Additive exPlanations (SHAP) method was used for visualizing model characteristics and individual case predictions.ResultsAmong 16,528 MIMIC-IV patients, 1520 (9.2%) developed AF post-ICU admission. A model with 23 variables was built, with XGBoost performing best, achieving an AUC of 0.891 (0.873–0.888) in validation and 0.769 (0.756–0.782) in external validation. Key predictors included age, mechanical ventilation, urine output, sepsis, blood urea nitrogen, percutaneous arterial oxygen saturation, continuous renal replacement therapy and weight. A risk probability greater than 0.6 was defined as high risk. A friendly user interface had been developed for clinician use.ConclusionWe developed a ML model to predict the risk of NOAF in critically ill patients without cardiac surgery and validated its potential as a clinically reliable tool. SHAP improves the interpretability of the model, enables clinicians to better understand the causes of NOAF, helps clinicians to prevent it in advance and improves patient outcomes.