Individuals In Population Research Articles

Exploring the Perspectives of Older Adults Living With HIV on Virtual Care: Qualitative Study.

As the population of individuals with HIV ages rapidly due to advancements in antiretroviral therapy, virtual care has become an increasingly vital component in managing their complex health needs. However, little is known about perceptions of virtual care among older adults living with HIV. This study aimed to understand the perceptions of older adults living with HIV regarding virtual care. Using an interpretive, qualitative, descriptive methodology, semistructured interviews were conducted with 14 diverse older adults living with HIV. The participants lived in Ontario, Canada, self-identified as HIV-positive, and were aged 50 years or older. Efforts were made to recruit individuals with varying experience with virtual health care. Reflexive thematic analysis was conducted with the interview transcripts to identify prevalent themes. The identified themes included (1) the importance of relationships in virtual care for older adults living with HIV; (2) privacy and confidentiality in virtual care; and (3) challenges and solutions related to access and technological barriers in virtual care. These themes highlight the perceptions of diverse older adults living with HIV concerning virtual care, emphasizing the fundamental role of trust, privacy, and technology access. By embracing the unique perspectives and experiences of this population, we can work toward building more inclusive and responsive health care systems that meet the needs of all individuals, regardless of age, HIV status, or other intersecting identities.

A connectome manipulation framework for the systematic and reproducible study of structure–function relationships through simulations

Abstract Synaptic connectivity at the neuronal level is characterized by highly non-random features. Hypotheses about their role can be developed by correlating structural metrics to functional features. But to prove causation, manipulations of connectivity would have to be studied. However, the fine-grained scale at which non-random trends are expressed makes this approach challenging to pursue experimentally. Simulations of neuronal networks provide an alternative route to study arbitrarily complex manipulations in morphologically and biophysically detailed models. Here, we present Connectome-Manipulator, a Python framework for rapid connectome manipulations of large-scale network models in SONATA format. In addition to creating or manipulating the connectome of a model, it provides tools to fit parameters of stochastic connectivity models against existing connectomes. This enables rapid replacement of any existing connectome with equivalent connectomes at different levels of complexity, or transplantation of connectivity features from one connectome to another, for systematic study. We employed the framework in a detailed model of rat somatosensory cortex in two exemplary use cases: transplanting interneuron connectivity trends from electron microscopy data and creating simplified connectomes of excitatory connectivity. We ran a series of network simulations and found diverse shifts in the activity of individual neuron populations causally linked to these manipulations.

Payoff-driven migration promotes the evolution of trust in networked populations

Establishing and maintaining trustworthy behaviors in large populations of self-interested individuals is a significant problem which received extensive attentions from research fields such as evolutionary biology, economics, sociology and engineering. As a well-known model that captures social trust dilemmas, the N-player trust game is adopted to investigate the evolution of trust in groups consisting of investors and trustees. In addition, to model real scenarios in dynamic environments, we introduce a novel migration mechanism, called adaptive environment-benefit-driven migration, which considers the influence of individuals’ payoffs on migration. Through theoretical analysis and Monte Carlo simulations, we demonstrate the effectiveness of the migration mechanism on facilitating trust behaviors in the framework of evolutionary game theory. We find that the population density plays a crucial role in establishing trust. Simulation results reveal that trust can be fostered in a dynamic environment influenced by individual migration with the medium vacancy rate. This work significantly contributes to the understanding of mutual trust behaviors in networked social systems from a more realistic perspective.

Contrasting pollution responses of native and non-native fish communities in anthropogenically disturbed estuaries unveiled by eDNA metabarcoding

Understanding the influence of environmental pollutants on the assembly mechanisms of estuarine fish communities is vital for addressing conservation challenges in these biodiverse ecosystems. Although significant research has explored the toxic impacts of pollutants such as petroleum, heavy metals, and eutrophication on individual species and populations, their effects on community assembly processes and the differential responses of native versus non-native fish at the meta-community level remain inadequately understood. This study utilized environmental DNA (eDNA) metabarcoding to analyze fish community diversity across 28 subtropical estuaries in China, assessing how these pollutants affect community composition and assembly mechanisms. Results indicated that eDNA was 2.54 times more effective than traditional methods in species identification, while also enabling the detection of a higher number of non-native fish species and more diverse functional guilds within estuarine ecosystems. A significant distance decay pattern (p < 0.05) was observed among native fish, whereas non-native species exhibited non-significant patterns. Neutral and null models showed that non-native species had significantly higher migration rates (0.005939 vs 0.001757) and a greater contribution of stochastic processes (82.38% vs 70.59%) compared to native species. Additionally, distance-based redundancy analysis (db-RDA), variance partitioning analysis (VPA), and correlation analyses revealed that native species were strongly constrained by environmental factors, particularly oil, Hg, Zn, Pb, Cr6+, and NH4+, while non-native species displayed notable resilience to these pollutants. These findings highlight the potential for non-native species to disproportionately influence community dynamics and assembly through unrestricted random dispersal amid environmental disturbances. This research clarifies the contrasting ecological responses of native and non-native fish communities to anthropogenic pressures in estuarine environments, offering essential insights into ecosystem resilience and informing biodiversity conservation strategies in rapidly changing coastal ecosystems.

Organ-specific sympathetic innervation defines visceral functions.

The autonomic nervous system orchestrates thefunctions of the brain and body through the sympathetic and parasympathetic pathways1. However, our understanding of the autonomic system, especially the sympathetic system, at the cellular and molecular levels is severely limited. Here we show topological representations of individual visceral organs in the major abdominal sympathetic ganglion complex. Using multi-modal transcriptomic analyses, we identified molecularly distinct sympathetic populations in the coeliac-superior mesenteric ganglia (CG-SMG). Of note, individual CG-SMG populations exhibit selective and mutually exclusive axonal projections to visceral organs, targeting either the gastrointestinal tract or secretory areas including the pancreas and bile tract. This combinatorial innervation pattern suggests functional segregation between different CG-SMG populations. Indeed, our neural perturbation experiments demonstrated that one class of neurons regulates gastrointestinal transit, and another class of neurons controls digestion and glucagon secretion independent of gut motility. These results reveal the molecularly diverse sympathetic system and suggest modular regulation of visceral organ functions by sympathetic populations.

Utilising a livestock model for wildlife health planning

Health planning provides a structure for the application of epidemiological data to managed populations with the intention of maximising health and identifying targets for intervention. Whilst this is established practice in livestock health, such schemes are rarely applied to free-living wild animal populations. The health of wildlife is important for a variety of reasons including conservation, human health, and ecosystem health, and so it is recommended that a formalised health planning approach be adopted for wildlife, based upon advantages of livestock health schemes identified here. Six key strengths of livestock herd health plans are identified in that these plans are: (1) Outcome driven, (2) Structured and repeatable, (3) They can incorporate both health and welfare considerations and in doing so, establish multidisciplinary management teams, (4) Evidence-based allowing for the prioritisation of key risk factors, (5) Encompassing of both population and individual metrics, and (6) Offer the opportunity for accreditation schemes. The benefits highlighted have implications for both wildlife management and research agendas where the structured format of the health plans will highlight knowledge gaps. Challenges are acknowledged, and it is recognised that livestock health planning cannot simply be copied across to a wildlife context. However, the strengths identified are great enough that it is recommended that wildlife population health planning is developed for active management of individual populations, learning lessons from existing plans.

Evidence of Directional Structural Superlubricity and Lévy Flights in a van der Waals Heterostructure.

Structural superlubricity is a special frictionless contact in which two crystals are in incommensurate arrangement such that relative in-plane translation is associated with vanishing energy barrier crossing. So far, it has been realized in multilayer graphene and other van der Waals (2D crystals with hexagonal or triangular crystalline symmetries, leading to isotropic frictionless contacts. Directional structural superlubricity, to date unrealized in 2D systems, is possible when the reciprocal lattices of the two crystals coincide in one direction only. Here, directional structural superlubricity a α-bismuthene/graphite van der Waals system is evidenced, manifested by spontaneous hopping of the islands over hundreds of nanometers at room temperature, resolved by low-energy electron microscopy and supported by registry simulations. Statistical analysis of individual and collective α-bismuthene islands populations reveal a heavy-tailed distribution of the hopping lengths and sticking times indicative of Lévy flight dynamics, largely unobserved in condensed-mattersystems.

Barriers and Facilitators to the Inclusion of Naturopaths in Interprofessional Health Care Teams: A Scoping Review.

Objective: The growing population of individuals with chronic pain presents a challenge to a globally overburdened health care workforce. Naturopaths are trained as primary health care providers who manage patients with chronic pain and, yet, are often overlooked in health care teams. This scoping review aims to identify barriers and facilitators affecting naturopathic inclusion into interprofessional health care teams managing patients with chronic pain. Methods: This study protocol was registered a priori through Open Science (https://doi.org/10.17605/OSF.IO/2G3JT). A search was conducted using databases AMED, CINAHL, MEDLINE, SCOPUS, Web of Science, APA PsycInfo, and Health Business Elite. Search limits included English language from 2012 to 2023. Included publications were from academic and gray literature. Search terms used included the following: "Naturopath*" OR "Integrative medicine" AND "Health care system*" OR "Health system*" OR "Models of health care" OR "Professional autonomy" OR "Professional regulation" OR "Professional govern*" OR "Interprofessional practice (IPP)" OR "Multidisciplinary communication." The scoping review utilized Covidence software and was analyzed using thematic analysis. Themes were identified following Arksey and O'Malley's (2005) framework to inform a narrative approach. Results: Five themes emerged that relate to the inclusion of naturopaths in health care teams as follows: (1) perceptions of naturopathy, (2) practice standards, (3) legitimacy, (4) resources, and (5) shifting power dynamics and cooperation. Conclusions: Barriers for naturopathic inclusion into health care teams are influenced by perceptions of naturopathy, naturopathic education standards, regulations, research, and patient equity and access. Facilitators for inclusion include the growing shift toward person-centered care, greater interprofessional education, and shared assets, including colocation.

Evaluation of Cardiomyopathy-Related Target Genes by Next-Generation Sequencing Method and Investigation of the Phenotype-Genotype Relationship

Background: Primary heart muscle diseases called cardiomyopathy (CMP) constitute an important group of subsequent heart disorders. CMPs are basically divided into four subgroups associated with the heart muscle but clinically distinguishable: hypertrophic CMP (HCM), dilated CMP (DCM), restrictive CMP (RCM), and left ventricular non-compaction CMP. Material and Methods: The results of the patients who applied to the Genetic Diseases Evaluation Center with the preliminary diagnosis of clinical CMP were evaluated retrospectively in the current study. In the current study, 103 cases were included and evaluated for phenotype-genotype association with the CMP next-generation sequencing (NGS) panel. Results: Fifty-eight different variants were identified in 45 patients. Sixteen out of those 58 variants were novel. Of these variants, 19 (32.75%) were likely pathogenic (LP)/pathogenic (P), and 35 (60.34%) were variants of uncertain significance. Conclusion: The prevalence of pathogenic variants in target genes associated with CMP is important for our current country's population, and multiple gene groups associated with CMP can be screened through NGS. The contribution rate to the clinical diagnosis was 18.44% in terms of the individual population who applied to our medical genetics center and were compatible with the CMP indication.

An Overview of Continuing Medical Education/Continuing Professional Development Systems in Latin America: A Mixed Methods Assessment

ABSTRACT The aims of this regional assessment of continuing medical education (CME)/continuing professional development (CPD) systems in Latin America were to describe the current requirements, if any, for physicians to engage in CME/CPD, explore perceptions of national CME/CPD systems from in-country subject matter experts (SMEs), to describe the perceptions of interprofessional continuing education (IPCE) and independent CME/CPD from in-country physicians and to provide recommendations that may be adopted by organisations/countries to improve the quality and effectiveness of their current CME/CPD systems and better meet their learners’ needs. An assessment of 11 CME/CPD systems in Latin America was conducted using a mixed-methods approach that included 1:1 interviews with in-country SMEs and an electronic survey capturing qualitative and quantitative data from practicing in-country physicians. This assessment reflected countries with CME/CPD systems that are in various stages of maturity. Only three countries have systems that are self-regulated by the profession, several systems lack independence from pharmaceutical influence, and educational activities are described more in terms of traditional CME/CPD as compared to education focused on individual or team gaps or population health care needs. There was little description of incorporating learner self-assessment and evaluation of change and little focus on interprofessional education. This mixed-method assessment of 11 Latin American countries demonstrated CME/CPD systems that are developing in maturity. Participation was often voluntary, and there was relatively little regulation. Physicians overall have been resistant to regulation and have preferred to use a voluntary, incentive-based model. There was a relatively high degree of influence by the pharmaceutical industry. Affordability and access remain challenges. There is an opportunity to better tie country/population health outcomes to CME/CPD, implement interprofessional continuing education, increase faculty skills and learner engagement, and increase funding and access across geographic regions.

Gamification and Immersive Experiences: A Gamified Approach for Promoting Active Aging

With the global population of individuals aged 60 and above steadily increasing, the need for effective and realistic solutions to promote healthy aging has become imperative. Leveraging the potential of serious games, gamification, and immersive technologies, this study focuses on developing and implementing a practical and tailored gamified platform to foster active aging in older adults. This platform was designed to incorporate game elements such as points, badges, levels, rankings, achievements, and immersive 360-degree images to provide a realistic and captivating user experience. Six distinct games and challenges have been developed through an extensive and iterative design process, each carefully calibrated to accommodate the aging population’s diverse cognitive abilities and interests. By combining the engagement-enhancing features of gamification with the immersive realism of 360-degree images, our platform offers a gamified and immersive solution for older adults. The gamified experiences are enjoyable and directly target cognitive functions, enhancing memory, attention, and problem-solving skills. The platform’s design has been refined through user feedback and usability testing, ensuring its relevance and effectiveness in real-life scenarios. The outcomes of this research shed light on a practical approach to active aging, emphasizing the importance of incorporating gaming experiences to engage and stimulate older adults. This study provides insights for the design and implementation of future interventions aimed at promoting digital literacy and technological proficiency among older populations, ultimately contributing to their active and fulfilling participation in the digital age.

Initial development and validation of item banks to measure problematic hypersexuality

Background Problematic Hypersexuality (PH) is defined as a distress caused by hypersexuality, to the extent that seeking treatment is considered. PH was previously measured with instruments stemming from different perspectives on problems related to hypersexuality. These instruments might best be analyzed in unison to discover the most optimal set of characteristics to measure PH. Methods A total of 58 items were investigated with Item Response Theory (IRT). We included 1211 participants (592 women, 618 men, 1 other) from a representative Dutch general population sample of 18 years or older. In addition, 371 participants (116 women, 253 men, 2 other) in a web-based survey who sought information on their current level of PH were included. This latter group was divided into those that did or did not consider treatment and group differences in item averages were assessed. Results After item selection, 26 out of 58 items were retained and divided in two scales: Emotion Dysregulation-PH – 9 items representing the distressing emotional patterns coinciding with hypersexual preoccupation – and Negative Effects-PH – 17 items representing the negative consequences of patterns of hypersexual thoughts and behavior. Assumptions for IRT analyses were met (unidimensionality, local independence and monotonicity). After an IRT graded response model was fit, the scales showed sufficient reliability for the target population of hypersexual individuals. In the general population the scales showed large floor effects and were less reliable. Conclusions With this study a first step is taken in validating two complementary item banks to measure PH. Further development of the item banks should include the investigation of responsiveness. New items should be constructed to assess less-explored areas of PH and improve differentiating power of the scales. This study showed that diagnostic accuracy for PH is currently difficult to attain with a survey, even when using an extended item set representing the most unique characteristics of PH.

Smaller and bolder fish enhance ecosystem-scale primary production around artificial reefs in seagrass beds.

Effective management of wild animals requires understanding how predation and harvest alter the composition of populations. These top-down processes can alter consumer body size and behavior and thus should also have consequences for bottom-up processes because (1) body size is a critical determinant of the amount of nutrients excreted and (2) variation in foraging behavior, which is strongly influenced by predation, can determine the amount and spatial distribution of nutrients. Changes to either are known to affect ecosystem-scale nutrient dynamics, but the consequences of these dynamics on ecosystem processes are poorly understood. We used an individual-based model of an artificial reef (AR) and reef fish in a subtropical seagrass bed to test how fish body size can interact with variation in foraging behavior at the population and individual levels to affect seagrass production in a nutrient-limited system. Seagrass production dynamics can be driven by both belowground (BGPP) and aboveground primary production (AGPP); thus, we quantified ecosystem-scale production via these different mechanistic pathways. We found that (1) populations of small fish generated greater total primary production (TLPP = BGPP + AGPP) than large fish, (2) fish that foraged more increased TLPP more than those that spent time sheltering on ARs, and (3) small fish that foraged more led to greatest increases in TLPP. The mechanism by which this occurred was primarily through increased BGPP, highlighting the importance of cryptic belowground dynamics in seagrass ecosystems. Populations of extremely bold individuals (i.e., foraged significantly more) slightly increased TLPP but strongly affected the distribution of production, whereby bold individuals increased BGPP, while populations of shy individuals increased AGPP. Taken together, these results provide a link between consumer body size, variation in consumer behavior, and primary production-which, in turn, will support secondary production for fisheries. Our study suggests that human-induced changes-such as fishing-that alter consumer body size and behavior will fundamentally change ecosystem-scale production dynamics. Understanding the ecosystem effects of harvest on consumer populations is critical for ecosystem-based management, including the development of ARs for fisheries.

The Processuality of ‘Sex’ in Biomedicine: Exploring Stem Cell Research, Cancer Medicine and Vaccine Safety Research

Incorporating sex into biomedical research is envisioned as key to addressing inequalities in health. However, feminist research suggests that it is a complicated task. This is, we argue, especially the case with research that seeks to mobilise sex across different scales involving bodies, samples and populations to provide a basis for personalised biomedical prevention and treatment. Through case studies from stem cell research, cancer medicine and vaccine safety research, we analyse how sex is enacted, foregrounded and sidelined at different stages of research. We argue that sex becomes suspended between individual bodies, samples and population groups, and that this postpones biomedical analysis of sex differences in health. Yet, research on sex differences in complex embodied processes, such as drug metabolism or immunity, appears as a future potentiality. This potentiality shapes research practices that may open biomedicine towards multi-disciplinary study settings that bring together physiological and social dimensions of bodily difference.

Promising strategies for the prevention of alcohol-related brain damage through optimised management of acute alcohol withdrawal: A focussed literature review.

There is an increasing awareness of the link between chronic alcohol consumption and the development of cognitive, behavioural and functional deficits. Currently, preventative strategies are limited and require engagement in dedicated long-term rehabilitation and sobriety services, the availability of which is low. The acute alcohol withdrawal syndrome is an episode of neurochemical imbalance leading to autonomic dysregulation, increased seizure risk and cognitive disorientation. In addition to harm from symptoms of alcohol withdrawal (e.g. seizures), the underpinning neurochemical changes may also lead to cytotoxicity through various cellular mechanisms, which long-term, may translate to some of the cognitive impairments observed in Alcohol-Related Brain Damage (ARBD). Here we review some of the pharmacological and neurochemical mechanisms underpinning alcohol withdrawal. We discuss the cellular and pharmacological basis of various potential neuroprotective strategies that warrant further exploration in clinical populations with a view to preventing the development of ARBD. Such strategies, when integrated into the clinical management of acute alcohol withdrawal, may impact large populations of individuals, who currently face limited dedicated service delivery and healthcare resource.

Thematic Layers of Genomic Susceptibility for Conservation Monitoring.

Population genomics has great potential to inform applied conservation management and associated policy. However, the bioinformatic analyses and interpretation of population genomic datasets can be daunting and difficult to convey to nonspecialists, including on-the-ground conservationists that work with many state, federal and international agencies. We think that individual population genomic metrics of interest can be interpolated and ultimately distilled into thematic GIS layers that represent spatiotemporal genomic potential (or conversely, susceptibility) in conservation monitoring. As examples relevant to ongoing conservation efforts, we use introgressive hybridisation and individual heterozygosity to illustrate a conceptual approach for mapping population genomic susceptibility. The general framework of thematic layers could be extended to integrate key genomic metrics (e.g., runs of homozygosity and genomic load) that are relevant to many conservation efforts.

Primary Care, Health Services, and the Latino Mortality Paradox.

In the United States, populations of Latino individuals tend to have better mortality outcomes than socioeconomically similar racial and ethnic comparators; this has been termed the "Latino Paradox". However, advantages from the Latino paradox seem to fade and may be susceptible to other factors (like the COVID-19 pandemic). Quality primary care may improve mortality, but the effect of the intersection of all of these factors in Latino patients is uncertain. There is burgeoning evidence that Latino patients may have more robust utilization of high value primary care services, especially when accessible in a community-oriented fashion. This utilization may become less robust, especially in services that require a more integrated delivery system, as individuals and generations spend more time in the United States. Primary care research may provide additional insights into the underpinnings of the Latino paradox and may complement the public health foundation that has undergirded work on the paradox in the last few decades. Investments in primary care infrastructure and research may be beneficial to the health of Latinos in the United States, and incorporating the needs of this diverse population into primary care system design at scale may pay large dividends for our societal health.

Notes from the Editors, November 2024

buy this issueMonthly Review editors elucidate Samir Amin's concept of "delinking" in the context of the rise of global multipolarity. Delinking, they write, does not aim to isolate individual nations and populations economically, "but rather finding a way to sever connections with the main mechanisms of imperial dominance."

The impact of HIV antiretroviral therapy on gut microbiota: the need for well-designed longitudinal studies.

Human immunodeficiency virus (HIV) infection remains a major public health concern despite a significant decline in HIV-related mortality and morbidity. These significant advances are linked mostly to effective antiretroviral therapy (ART). However, these treatments are not without consequences on other microorganisms in our body, especially when they must be used for life. Balanced gut microbiota is essential for maintaining human health through symbiotic relationship with the host cells. This review focuses on ART and its potential impact on the intestinal microbial population of HIV-infected individuals. Therefore, we retrieved studies focusing on the impact of HIV ART on the gut microbiota, that were published from 2010 to 2021. It was observed that most studies on HIV ART and associated gut microbiota have been cross-sectional, and the findings, in general, showed significant damages caused by the ART to the gut microbial community (dysbiosis), with the impact varying in different studies. These changes also revealed dysfunction in microbial translocation and some immune markers, including T lymphocyte rates and the overall inflammation balance. There are significant gaps in our understanding of the impact of HIV ART on gut microbiota. Thus, a longitudinal study is likely needed with a considerable sample size from different settings and classes of ART to better understand the impact of HIV ART on the gut microbiota, and develop remedial (restorative) and adjunctive host-directed strategies during HIV ART.

Neurocognitive training through VR and develop of Executive Functions in ASD

In this study we will focus on the transformative potential of neurocognitive training, particularly in the context of immersive virtual reality (VR), to promote the development of executive functions in people with ASD. This exploration will navigate current research findings by highlighting the innovative ways in which neurocognitive training, in combination with virtual reality technology, offers tailored interventions to address the unique challenges associated with executive function deficits in the population of individuals with ASD.