AI News Archive: July 30, 2026 — Part 23
Sourced from 500+ daily AI sources, scored by relevance.
- Claude With Crypto
Pay for Claude Pro with crypto
- SmartVault
The honest AI tools directory — reviewed & compared
- VidLux AI
AI Video Generator with Reference & Motion Control
- Prompt Enhancer AI
Free AI Prompt Optimizer for ChatGPT, Gemini & Claude
- Poly Translators
Instant Fantasy Translators
- Letomix Background Remover
Remove image backgrounds online for free in seconds
- PostNexus AI
Post to All Your Socials From One Dashboard
- Glowmetra
AI-Powered dermatology
- AI in a Day: Solo Freelancer's Playbook
9 copy-paste AI workflows to automate freelancing admin
- ReviewPilot: AI Review Insights
AI-powered App Store Review Assistant
- FrameHatch
Turn prompts into editable React websites
- BulkUp AI - Calorie Tracker
AI food scanning built for gaining weight, not losing it
- Vireel AI Hugging Generator
Turn photos into warm, realistic hug videos instantly.
- Rest — AI Sleep Coach
A voice AI sleep coach built on CBT-I
- Seedeo AI Video Editor
Edit video with text prompts and motion control.
- VidLux - Image to Video AI
Bring photos to life with AI video.
- UGCVideo.ai
Turn product links into viral video ads instantly.
- AIto3D.ai
Turn text or images into downloadable 3D models.
- VEME AI
Turn images and text into stunning videos instantly.
- Seedeo Image Generator
Generate stunning images and videos with AI.
- Seedeo Music Generator
Turn words into original songs.
- Outlex
AI legal agent, with a real lawyer one click away.
- BacklinkGPT
Automate Your Link-Building with AI-Personalized Outreach
- Clipto
AI transcription, summaries and video search across all your media
- AI Detector by Getsolved
Detect AI-generated content instantly.
- AISA - AI Skills Assessment
Measure real life AI skills through conversation.
- HoneyChat
HoneyChat
- Branched C7-Substituted 7-Deaza-SAH Analogues Occupy the Entire SAM-Binding Pocket of Mpox Virus VP39 and Dengue Virus NS5 Methyltransferases
Viral RNA-cap MTases are attractive targets for antiviral drug development. We previously identified C7-substituted 7-deaza-SAH analogues as potent inhibitors of the mpox virus 2'-O-MTase VP39. Here, we used structure-guided design to develop branched C7-substituted analogues intended to engage multiple hydrophobic regions of the VP39 SAM-binding pocket. The synthesized compounds were characterized using biochemical and crystallographic approaches. Several analogues effectively inhibited VP39, with the most potent compound displaying an IC in the tens-of-nanomolar range. Crystal structures of VP39 in complex with STM1187 and STM1189 confirmed that the branched aromatic substituents extend towards hydrophobic regions adjacent to the SAM binding site. The precise ligand conformations were strongly influenced by linker geometry and the branching group's mode of attachment. STM1078 also inhibited DENV3 NS5 MTase with submicromolar potency, and the complex's structure revealed a conserved binding mode of the SAH-like core accompanied by conformational adaptability of the branched substituent. These results demonstrate how three-dimensional expansion from the 7-deaza position can generate potent inhibitors capable of binding structurally distinct viral MTases.
- Estimating Time-Inhomogeneous Transition Probabilities from District Level Daily COVID-19 Transmission Data in Sierra Leone
Abstract: Compartmental epidemic models conventionally treat the probability of moving between dis ease states as fixed over time, an assumption that sits uneasily with the reality of a pandemic in which lockdowns, mask mandates, vaccination roll-out, and the arrival of new variants continually reshape transmission. This paper develops a time-inhomogeneous Markov chain framework for the Susceptible-Exposed-Infectious-Removed (SEIR) process, in which each transition probability pab(t) is allowed to vary with calendar time while respecting the struc tural zeros implied by the SEIR compartmental flow. We derive the constrained maximum likelihood estimator of pab(t) under these structural constraints, establish its finite sample efficiency, asymptotic normality, and Wilson score confidence intervals, and construct a like lihood ratio test of the null hypothesis that a compartments exit probability is constant over time. We further propose a stochastic machine learning hybrid extension in which the raw, kernel smoothed transition probabilities are regressed on policy and mobility covariates using both a logistic generalized linear model and a random forest, allowing the framework to attribute time-inhomogeneity to observable interventions. The methodology is applied to a compiled daily, district level COVID-19 surveillance panel for Sierra Leone spanning March 2020 to December 2023 (16 districts, 1,401 days). The likelihood ratio test rejects time-homogeneity of the exposed to infectious transition in 15 of 16 districts and of the infectious-to-removed transition in 8 of 16 districts ( = 0.05), and the covariate augmented logistic model achieves an out of sample Brier score roughly 76 times smaller than a time homogeneous pooled baseline, with healthcare capacity and the time trend emerging as the most influential predictors in the random-forest component. These results provide statisti cal evidence that time-inhomogeneous, covariate informed Markov models offer a materially better description of district-level COVID-19 transmission in Sierra Leone than classical time homogeneous compartmental models, with implications for sub-national outbreak monitoring in resource constrained settings
- An interpretable omnigenic neural network architecture for the human genome
Genetic prediction of complex phenotypes typically relies on additive linear models, which scale well but cannot capture non-additive effects or deeply integrate molecular and clinical data. Domain-specific neural networks have driven advances in images, text, and other modalities, but genome-scale neural networks remain challenging because genotypes are sparse and high-dimensional, effective sample sizes are limited, and generic architectures lack interpretability. Here, we introduce the omnigenic neural network, a biologically structured architecture inspired by the omnigenic model of complex traits. The model learns hierarchical representations of biological processes, accommodates multimodal inputs, supports transfer learning, and enables multitask prediction. Models trained in the UK Biobank and evaluated in the All of Us cohort for ischemic heart disease, type 2 diabetes, and schizophrenia outperformed published PGS Catalog and PRS-CSx scores. A multitask model trained across 36 cardiovascular endpoints further outperformed corresponding single-phenotype models and baselines. The architecture provides systems-level interpretability by quantifying the contributions of biological processes, which were consistent with established disease mechanisms. It also captures non-linear interactions between variants. Analysis of these interactions using Integrated Hessians revealed patterns concordant with previously reported epistatic associations. Together, these findings establish the omnigenic neural network as a flexible framework for interpretable, multimodal, and multitask genomic prediction.
- Machine Learning Prediction of 6-Month Functional Outcomes in IVH Using the Brainstem Dorsal Line: A Multicenter Study
[Abstract] Objective: Intraventricular haemorrhage (IVH) carries high mortality and morbidity; accurate early prediction of 6-month functional outcome is essential for guiding treatment decisions and optimising prognosis. We developed and externally validated a prognostic model that integrates a novel neuroimaging marker, the Brainstem Dorsal Line (BSDL), with the TabICLv2 algorithm to predict 6-month functional outcomes after IVH. Methods: In this multicentre retrospective study, patients with IVH were enrolled from nine tertiary centres in China between Dec 1, 2020, and Dec 31, 2024; seven centres constituted the derivation cohort (8:2 training-validation split) , and two centres formed the external validation cohort. Feature selection followed a three-step pipeline comprising univariable testing, Spearman correlation analysis, and LASSO regression; eight machine-learning models were trained with five-fold cross-validated hyperparameter tuning. Performance was assessed by the area under the receiver operating characteristic curve (AUC), the area under the precision-recall curve (AUPRC), calibration curves, and decision curve analysis (DCA). Interpretability was evaluated using SHapley Additive exPlanations (SHAP). Results: In total, 728 eligible patients were enrolled 610 in the derivation cohort (unfavourable outcome, 27.9%) and 118 in the external validation cohort (26.3%). Feature selection identified nine optimal predictors, of which BSDL grade 2 ranked highest in feature importance. TabICLv2 showed the best performance in external validation (AUC 0.9014 [95% CI 0.825-0.985], AUPRC 0.8192 [0.688-0.916], F1 score 0.7742 [0.651-0.877]); calibration was excellent (Hosmer-Lemeshow test, P>0.05) and DCA showed clinical net benefit across threshold probabilities of 0.05-0.97. SHAP confirmed BSDL grade 2 as the strongest predictor of unfavourable outcome. Conclusions: Integrating BSDL with TabICLv2 yielded a robust, interpretable prognostic model for 6-month outcomes after IVH, providing a practical tool for early risk stratification and individualised treatment planning.
- On-site AASM-accredited sleep facility status and hospitalization outcomes among adults admitted with acute hypercapnic respiratory failure: a retrospective cohort study
Objectives: Acute hypercapnic respiratory failure (AHRF) is a common cause of hospitalization among adults with chronic respiratory and sleep-related disorders. We evaluated whether admission to hospitals with an on-site American Academy of Sleep Medicine (AASM)-accredited sleep facility was associated with length of stay (LOS) and hospitalization cost among adults admitted with AHRF. Methods: We conducted a retrospective cohort study using the Healthcare Cost and Utilization Project New York State Inpatient Database from 2017 to 2021. Adults admitted to hospitals outside New York City were included because hospital density, referral patterns, and access to specialty services differ from those in New York City. Hospitals were classified by the presence of an on-site AASM-accredited sleep facility, used as a structural proxy for institutional sleep medicine capacity. LOS and hospitalization cost were log10-transformed before analysis. We used bivariate analyses and hierarchical multivariable linear regression models adjusting for demographic, clinical, socioeconomic, and hospital-level covariates. Results: A total of 3,247 adults met inclusion criteria. In unadjusted analyses, admission to hospitals with an on-site AASM-accredited sleep facility was associated with shorter LOS and lower hospitalization cost. After adjustment, sleep facility status was not independently associated with either outcome and did not improve model fit. Greater comorbidity burden was the strongest independent predictor of both longer LOS and higher cost. Housing instability and race categorized as other than White were also associated with higher resource use. Chronic obstructive pulmonary disease was independently associated with shorter LOS and lower cost. Conclusions: Among adults hospitalized with AHRF, LOS and hospitalization cost were more strongly associated with comorbidity burden and socioeconomic disadvantage than with the presence of an on-site AASM-accredited sleep facility. These findings suggest that accreditation status alone may not capture inpatient sleep medicine processes most relevant to acute respiratory care.
- Association Between Number of Missing Teeth and Abnormal Bowel Habits: A Cross-Sectional Study from NHANES 2005-2010
Background/Objectives Tooth loss may impair masticatory function, potentially affecting gastrointestinal health. This study examined the association between clinically examined tooth loss and abnormal bowel habits among US adults. Methods This cross-sectional study used NHANES 2005-2010 data. Adults aged [≥]20 with clinical oral examination (OHX) and Bristol Stool Scale (BSS) data were included. Missing teeth (0-28) were categorized as 0, 1-5, 6-10, 11-27, and 28. The primary outcome was abnormal bowel habits (BSS 1-2 or 6-7 vs. 3-5); secondary outcomes included constipation, diarrhea, and fecal incontinence symptoms. Survey-weighted logistic regression with progressive covariate adjustment was used, with Benjamini-Hochberg FDR correction for secondary outcomes. Results Among 9,988 participants (14.5% prevalence), the P-for-trend for abnormal bowel habits was significant (OR = 1.015, 95% CI: 1.006-1.024, P = 0.001), corroborated by omnibus Wald (P = 0.006) and restricted cubic spline analyses (P = 0.019). Complete edentulism was associated with 1.5-fold higher odds (OR = 1.545, P = 0.006). Constipation survived FDR correction (FDR-adjusted P = 0.032). Results were robust across most of five sensitivity analyses, with modest attenuation noted after denture use adjustment in a restricted subset. Conclusions Tooth loss was significantly associated with abnormal bowel habits, with constipation surviving FDR correction. These findings support the oral-gut axis hypothesis and highlight the importance of maintaining natural dentition for gastrointestinal health.
- How Predictable Was the 2026 Bundibugyo Virus Disease Outbreak? A Rolling-Origin Evaluation of Short-Term Forecast Models, an Empirically Recalibrated Bayesian Model, and a Data-Driven Baseline-Bayesian Ensemble, Using Daily Surveillance Data
Background The 2026 Bundibugyo virus disease outbreak in the Democratic Republic of the Congo became the largest recorded epidemic caused by Bundibugyo virus and showed unusually rapid early growth. Initial projections warned that it could become one of the largest Ebola-family outbreaks on record, but these were based on assumed mortality totals and intervention scenarios rather than repeated comparison with subsequently observed surveillance data. We assessed how accurately the outbreak could have been forecast in real time from routinely published national situation reports, whether a simple ensemble improved on its component models, and how forecasts should inform operational capacity planning. Methods We conducted a retrospective pseudo-prospective rolling-origin study using daily cumulative confirmed cases and deaths reported from 14 May to 20 July 2026 (68 calendar days; 61 numeric reports). Each date with a newly reported national total became an eligible forecast origin once seven numeric observations were available, yielding 55 origins. At each origin, all later data were withheld. Two prespecified models were refitted using only information then available: a recent seven-increment baseline and a Bayesian negative-binomial surveillance-maturity model fitted by Markov Chain Monte Carlo. A Gompertz model was fitted identically as a benchmark. Forecasts were produced for 7, 14, and 21 days and evaluated only when an observation existed on the exact target date. Bayesian forecasts were prospectively recalibrated using only previously realised errors from forecast-maturity-qualified origins. We also evaluated a baseline-Bayesian ensemble, with horizon- and outcome-specific weights selected prospectively by an expanding-origin procedure using an asymmetric operational loss function. Findings A statistically and externally corroborated surveillance-maturity discontinuity occurred on 28 May 2026 (robust z score 13{middle dot}0). The Gompertz model had the poorest 80% predictive-interval coverage at every horizon and for both outcomes (25{middle dot}9-34{middle dot}1% for cases; 0{middle dot}0-23{middle dot}5% for deaths) and was excluded. Recalibration corrected consistent Bayesian underprediction and was applied at 24 of 55 origins for 21-day forecasts. It substantially improved case coverage (7-day, 60{middle dot}0% to 80{middle dot}0%; 14-day, 41{middle dot}0% to 76{middle dot}9%) and improved death forecasting in both accuracy and calibration (7-day median absolute percentage error, 10{middle dot}3% to 7{middle dot}7%; 80% coverage, 33{middle dot}3% to 95{middle dot}6%). Ensemble weights differed by outcome: case forecasts were baseline-heavy (w{approx}0{middle dot}8-0{middle dot}9), whereas death forecasts were near parity (w{approx}0{middle dot}5-0{middle dot}6). For deaths, the ensemble improved mean weighted interval score over both component models at every horizon (7-day: baseline 24{middle dot}8, Bayesian 20{middle dot}5, ensemble 17{middle dot}9). Interpretation Routine situation-report data supported useful short-term forecasting, but no single model was best on every criterion. Three forms of maturity shaped forecast reliability: epidemic, surveillance, and forecast maturity. Forecast maturity was the most robust and model-independent finding and supports 21 days, rather than 28 days, as the longest routine operational horizon. The study provides a reproducible and adjustable framework for combining simple and complex models and communicating uncertainty to operational decision-makers.
- What does a health-zone case-fatality ratio measure during an active outbreak? Reported mortality, mapped health-facility context, and case-death reporting heterogeneity in the 2026 Bundibugyo virus disease epidemic in DR Congo
Abstract Background. During an active outbreak, deaths divided by confirmed cases can be mistaken for biological severity or quality of care even though outcomes remain unresolved and reporting and ascertainment differ across places. We examined what health-zone case-fatality ratios measured during the 2026 Bundibugyo virus disease epidemic in the Democratic Republic of the Congo. Methods and principal findings. We analysed national and health-zone cumulative confirmed cases and deaths through 20 July 2026. We calculated reported crude case-fatality ratios, examined case-death reporting synchronisation, and fitted beta-binomial partial-pooling models with four-chain Markov chain Monte Carlo. Exploratory models added mapped clinical-facility availability or distance to the nearest mapped hospital. Reporting-date delay, under-ascertainment, and mortality forecasting were evaluated as diagnostics, scenarios, or developmental analyses rather than patient-level fatality estimation. The national ratio reached 40.4% (999/2,473). Among 14 zones with at least 20 cases, crude ratios ranged from 28.3% to 68.5%. In the primary model, North Kivu had higher posterior odds than Ituri, but with substantial uncertainty (OR 1.80, 95% credible interval 0.92-3.37); epidemic maturity was positively associated (1.49, 1.04-2.19). In exploratory models, greater mapped clinical-facility availability was associated with lower reported fatality (0.67, 0.48-0.96), while greater distance to a mapped hospital was associated with higher reported fatality (1.46, 1.06-2.00). Same-day case-death co-reporting was common, and materially different reporting-delay assumptions fitted similarly. Interpretation. Health-zone ratios revealed meaningful surveillance heterogeneity but did not identify biological fatality risk or causal effects of facilities, access, care, or conflict. Epidemic maturity, selective ascertainment, referral, and administrative reporting plausibly shaped the numerator and denominator. These ratios should guide investigation rather than rank health-zone performance; linked patient records are required for clinical fatality and competing-risks analyses.
- Association between early arterial oxygenation and neurological outcome after pediatric out-of-hospital cardiac arrest: a multicenter retrospective study
Background: Optimal arterial oxygen targets after return of spontaneous circulation (ROSC) in pediatric out-of-hospital cardiac arrest (OHCA) remain uncertain. We examined whether arterial oxygen tension on the first arterial blood gas after ROSC is associated with neurological or survival outcomes. Methods: Using the Japanese Association for Acute Medicine OHCA Registry, we retrospectively studied pediatric patients (<18 years) with OHCA in whom ROSC was confirmed at or after hospital arrival. Patients were categorized by PaO? on the first arterial blood gas after ROSC as normoxemia (60?200 mmHg) or hyperoxemia (>200 mmHg). Missing covariate data were handled using multiple imputation, and associations were estimated using inverse probability-weighted logistic regression. Outcomes were favorable neurological status at 30 days, defined as a Pediatric Cerebral Performance Category score of 1?3, and 30-day survival. Multiple sensitivity analyses were performed, including analyses using an alternative PaO? threshold, restricting the timing of PaO? measurement, and excluding extracorporeal cardiopulmonary resuscitation cases. Results: A total of 189 patients were included (95 normoxemia, 94 hyperoxemia). A favorable neurological outcome occurred in 21 of 95 (22.1%) normoxemia and 13 of 94 (13.8%) hyperoxemia patients, and 30-day survival in 40 of 95 (42.1%) and 42 of 94 (44.7%), respectively. After weighting, covariate balance was achieved with standardized mean differences below 0.1. Hyperoxemia was not significantly associated with favorable neurological outcome (adjusted odds ratio [aOR] 0.94, 95% confidence interval [CI] 0.49?1.77) or 30-day survival (aOR 1.49, 95% CI 0.88?2.54). Sensitivity analyses yielded consistent results. Conclusions: Early hyperoxemia after ROSC was not significantly associated with neurological or survival outcomes in pediatric out-of-hospital cardiac arrest. These findings suggest that a single early PaO? measurement may be insufficient to characterize the clinical impact of oxygen exposure after resuscitation. Future research should focus on phase-specific and individualized oxygen management incorporating serial physiological assessment.
- Serotype distribution and risk factors associated with pneumococcal carriage among children with otitis media in Peninsular Malaysia (2023-2025): A cross-sectional study in the early post-vaccination era
Background Otitis media is a leading cause of childhood morbidity and presents a significant healthcare burden worldwide. Streptococcus pneumoniae is a major aetiological agent of OM, and the introduction of pneumococcal conjugate vaccines into the Malaysian National Immunisation Programme in 2020 would have altered pneumococcal carriage and serotype distribution. This study aimed to determine pneumococcal carriage, serotype distribution, and associated risk factors among children with OM in the early post-PCV era in Peninsular Malaysia. Methods and Findings A total of 360 children with OM were recruited from hospitals on the east and west coasts of Peninsular Malaysia between 2023 and 2025. Nasopharyngeal and middle ear fluid samples were collected for Spn isolation by culture, followed by serotyping using multiplex PCR. Sociodemographic, environmental, and medical history data were analysed for associations with pneumococcal carriage using chi-square, Fishers exact tests, and logistic regression. Pneumococcal carriage was detected in 26.7% of children in either NP or MEF samples, with carriage rates of 25.6% and 1.9% in NP and MEF samples, respectively. The most prevalent serotypes were 23A, 15B/15C, non-typable strains, 19F, and 11A/11D. Daycare attendance (p = 0.012, aOR [95% CI]: 2.177 [1.186 - 3.995] and residence in rural areas (p = 0.019, aOR [95% CI]: 2.476 [1.159 - 5.292] were significantly associated with pneumococcal carriage. The main limitation of the study was the reliance on self-reported questionnaire data, which may have introduced recall bias and reporting errors. Conclusions The predominance of non-vaccine serotypes and non-typable Spn indicates ongoing serotype replacement and the emergence of phase-variant strains in the early post-PCV era. Continued surveillance is essential to monitor these changes and inform the development of next-generation pneumococcal vaccines. This study was registered under clinical trial registration number NCT05429541.
- Resources and Functional Maintenance Among Older Adults With Persistent Pain: A Harmonised Analysis of Three International Cohorts
Abstract Background Persistent pain in later life is associated with functional decline. Identifying resources associated with preserved daily function may broaden pain research beyond symptom burden alone. Objective To examine six prespecified resource indicators-physical activity, depressive symptoms, recall performance, current partner status, education and wealth-in relation to subsequent maintenance of independence in activities of daily living (ADL). Methods This longitudinal observational study analysed adults aged 50 years or older with pain at both the initial and baseline assessments in the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA) and the Survey of Health, Ageing and Retirement in Europe (SHARE). ADL maintenance was defined as no difficulty in all five prespecified ADL activities at baseline and no difficulty in all five at follow-up. Indicator-specific risk ratios were estimated using modified Poisson regression with robust variance and pooled using random-effects meta-analysis. The six meta-analysis P values were adjusted using the Holm procedure. Each indicator used a separate complete-case sample; no common six- indicators sample was constructed. Results The descriptive samples comprised 8,279 HRS person-windows contributed by 4,688 unique participants, 1,200 ELSA participants and 6,995 SHARE participants; indicator-specific denominators varied. Physical activity was associated with a higher probability of ADL maintenance across all three cohorts (pooled risk ratio, 1.145; 95% CI, 1.097-1.195; P = .005; Holm-adjusted P = .032) and was the only prespecified hypothesis to meet the Holm-adjusted criterion. The other five hypotheses did not meet this criterion; failure to do so should not be interpreted as evidence that the corresponding associations were absent. Several of these pooled estimates showed substantial heterogeneity. Conclusions Among older adults with persistent pain, physical activity was associated with a higher probability of ADL maintenance, and the physical activity hypothesis was the only one of the six prespecified hypotheses to meet the Holm-adjusted criterion in the three-cohort meta-analysis. These observational findings support further study of physical activity and functional maintenance but do not establish causal benefit.
- Genotype-Phenotype Correlations Identify Phenotypic Differences in Sarcomere Mutation-Positive Hypertrophic Cardiomyopathy in the NHLBI HCM Registry
Background: Previous studies of genotype-phenotype correlations in hypertrophic cardiomyopathy (HCM) have presented inconsistent conclusions, potentially reflecting small studies and non-uniform phenotyping. Objectives: We aimed to identify genotype-phenotype correlations in sarcomeric variant-positive HCM cardiac magnetic resonance (CMR) imaging and adverse outcome data in the National Heart, Lung, and Blood Institute (NHLBI) HCM Registry. Methods: Of 2750 overall patients, 915 sarcomeric variant-positive ones were subgrouped by genotype. CMR measures of left ventricular (LV) hypertrophy, fibrosis and function, and adverse events, were compared. Findings were meta-analyzed with prior studies from systematic review. Results: Patients with pathogenic variants in thick-filament genes had greater hypertrophy than those in thin-filament genes - maximal LV wall thickness (maxLVWT) (21.7 {+/-} 5.0 vs. 20.0 {+/-} 4.4mm, P<0.01) and indexed LV mass (81.9 {+/-} 26.0 vs. 71.7 {+/-} 13.3g/m2, P<0.001). Of the former, MYBPC3 carriers had greater maxLVWT than MYH7 carriers (22.2 {+/-} 5.2 vs. 20.9 {+/-} 4.5mm, P<0.01) but lower LV ejection fraction (63.1 {+/-} 8.4 vs. 65.3 {+/-} 8.4%, P<0.001). Findings remained significant after covariate adjustment and meta-analysis. 23 (~1%) patients had >1 disease-linked variants with only 3 (~0.11%) carrying >1 pathogenic variants. MYBPC3 carriers had lower risk of a multiple event composite than MYH7 carriers. Conclusions: In the largest CMR-based study to date, we identified significant phenotypic differences that characterize disease-gene subgroups and resolved prior discrepancies through systematic review and meta-analysis. However, carriage of >1 sarcomeric variants did not contribute much to variation in phenotypic severity in the general HCM population due to its rarity.
- DIETARY PRACTICES AND NUTRITION STATUS OF PREGNANT ADOLESCENTS IN KAJIADO COUNTY, KENYA
Kajiado County ranks eighth in the country for adolescent pregnancy, with one in five teenagers between the ages of 15 and 19 (21.8%) likely to be pregnant or have begun having children. The objectives of the study were to establish the dietary practices and nutrition status of pregnant adolescents in Kajiado County. The study employed a cross-sectional analytical design in a target population of 196 pregnant adolescents living in Kajiado West, Ewauso and Keekonyoike wards which were randomly selected. Qualitative data was gathered through key informant interview guides with facility nurse in charge and head teacher/principal. Dietary data was collected using a 24-hour dietary recall questionnaire.Dietary diversity was established using the minimal dietary diversity questionnaire for women of reproductive age (MDD-W). Nutrisurvey software was to analyze dietary data. Married respondent was at 41.8% (40.8 users and 44.1% non-users) of ANC with a p-value of 0.212. Dietary energy intake was 1086.82 {+/-} 90.57kcals having RDA of 29.0% (users at 1105.72 {+/-}95.43 and RDA 29.6%, non-users 1070.12{+/-}8.36 with RDA of 28.4%). The Minimum Dietary Diversity (MDD-W) for Women of Reproductive Age 98.4% users was 68.3% of women who utilized antenatal care (ANC) services consumed foods and beverages from 5 or more food groups on the previous day, compared to only 31.7% non-users having a p-value 0.24. Respondent having (MUAC < 22 cm) indicates potential malnutrition or nutritional risk at 31.2% (users at 30.8% and non-users 32.2%) with a p-value 0.534.Overall mean hemoglobin level is 12.35g/dl with a standard deviation of 0.93g/dl having low ranges of < 11.5g/dl (users at 30 and non-users at 12) total of 42 adolescent. These findings underscore the urgent need for targeted interventions at increasing nutrient intake and dietary diversity among pregnant adolescents towards improved nutrition status.
- Tracing Tuberculosis Patients Lost to Follow-up: A Mixed-Methods Study of Community Health Promoter-Led Tracing in Kenya.
Tuberculosis (TB) remains a major global public health threat, with an estimated 10.7 million incident cases and 1.23 million deaths in 2024. Treatment interruption undermines TB control efforts, yet the effectiveness of Community Health Promoters (CHPs) in tracing patients lost to follow-up (LTFU) is poorly understood. We assessed the proportion of LTFU TB patients successfully traced through CHP-led tracing strategy and explored challenges of implementation CHP strategy. We conducted a mixed-methods cross-sectional study in Kilifi County, Kenya, among adult TB patients recorded as LTFU between July 2022 and December 2023. Patients identified through the national electronic TB surveillance system were linked to their respective community health units and assigned to CHPs for tracing. CHPs attempted to contact patients by telephone and through repeated household visits and, where necessary, sought information from relatives, neighbours, and local administrative leaders. For successfully traced patients, quantitative data were collected using structured questionnaires. Qualitative data were collected through five focus group discussions with 30 traced TB patients and 30 in-depth interviews with CHPs, TB clinic staff, programme managers, and County Health Management Team members. Qualitative data were coded and analysed thematically using a primarily deductive approach guided by the study objectives, while allowing additional themes to emerge. Of 140 patients identified for tracing, 36 (25.7%, 95% confidence interval 18.7-33.8) were successfully traced; 90 (64.3%) had relocated outside Kilifi County and 14 (10.0%) had died. Qualitative findings indicated that treatment interruption was driven by financial hardship, including transport costs, medication side effects, stigma, and difficulties maintaining continuity of care after relocation. CHPs supported treatment adherence through health education, counselling, appointment reminders, and household follow-up. However, their ability to trace patients was constrained by patient mobility, limited financial support for community-based activities, shortages of health workers, competing responsibilities, and gaps in systems for tracking patients across administrative boundaries. CHP-led tracing reached only one-quarter of LTFU TB patients, largely because many had relocated outside the county. Health systems should strengthen patient tracking across county boundaries and equip CHPs with the resources, staffing, and support needed for effective community-based TB tracing.
- A Community-Based, Dietician-Led Nutrition Education Intervention to Improve Glycemic Control in Adults with Type 2 Diabetes in an Underserved Urban Community
Background: Diabetes is a major global public health challenge, associated with substantial medical, economic, and social burden worldwide. As clinicians working at the intersection of medicine and nutrition, we observed that despite advances in pharmacologic therapy, many individual, particularly those living in underserved urban communitie, continue to experience suboptimal diabetes control due to persistent barriers related to food insecurity, cultural food practices, and limited access to practical nutrition education. In response, we implemented a community-based pilot study in an underserved urban area that focused on dietitian-led nutrition education grounded in Food Is Medicine principles. Aims: The intervention emphasized culturally responsive, cost-conscious, and client-centred approaches designed to make healthy eating simple and intuitive, with the goal of complementing standard diabetic medical therapy. Methods: We used conventional diabetic marker responses, fasting blood sugar (FBS), HgbA1c (percentage of glycosylated hemoglobin, subsequently documented as A1c), and urinary albumin:creatinine ratio (UACR) in a dual cohort design study measuring whether groups receiving dietitian-led nutrition education in addition to conventional therapy would show improvements in diabetic markers relative to groups receiving conventional therapy alone. Summary: Our pilot study summed over both cohorts support the hypothesis that additional dietitian-led nutrition education synergizes with conventional pharmaceutical therapy to improve diabetic control as gauged by improved FBS, A1c and UACR, implying a significant role for this combined approach to community based diabetic health care.
- Incidence of bacterial sexually transmitted infections and associated factors in men who have sex with men: results from the ANRS 12 400/DepIST-H cohort
Background. The objective was through an analysis of longitudinal data from the DepIST-H cohort to estimate the incidence, describe the dynamics and factors associated with CT/NG infection in MSM in Togo. Methods. A total of 200 MSM in Lome, Togo, were included in the ANRS I MIE 12400/DepIST-H cohort, half living with HIV. After inclusion in the study, participants received follow-up clinical visits at 6 and 18 months, and laboratory tests were performed at baseline (M0) and at 12 and 24 months (M12 and M24). PCR tests for CT and NG were performed from pharyngeal, anal and urine samples collected using the Xpert(R) CT/GC kit (Sunnyvale, CA, USA). To identify the factors associated with anal bacterial STIs, offset term Poisson regression models were performed. Results. Among 200 MSM (median age 24 years), CT and NG incidence rates were high ({approx}22 cases per 100 person-years), particularly at the anal site. Multiple partners significantly increased anal NG incidence (aIRR 2.35). Anal NG incidence was significantly lower among participants with income-generating activity (aIRR 0.57). Trends suggested higher anal CT and NG incidence in the presence of pharyngeal infection, but associations were not statistically significant Conclusion. This study confirms that MSM remain highly exposed to STIs in Togo and highlights the need to strengthen prevention efforts within this population. Postexposure doxycycline prophylaxis and multisite pooled-sample screening represent promising avenues to strengthen prevention efforts within these populations.
- Treatment-Structured Modeling of Tuberculosis Transmission with Threshold Dynamics, Stability Analysis and Implications for Disease Control
Background: Tuberculosis remains a persistent infectious disease whose control is complicated by latent infection, delayed treatment, incomplete recovery, reinfection, and continuing transmission from infectious individuals. Although treatment is central to tuberculosis management, it is frequently represented only as a transition parameter in mathematical models rather than as a separate epidemiological state. In this study, treatment was therefore incorporated explicitly as an independent compartment so that its influence on transmission, recovery, disease-induced mortality, and long-term disease persistence could be evaluated. Methods: A deterministic nonlinear compartmental model was formulated by dividing the total population into susceptible, exposed, actively infected, treated, and recovered classes. Reinfection of recovered individuals, progression from latent infection to active disease, movement of infectious individuals into treatment, treatment-associated recovery, natural mortality, and disease-induced mortality were included. Positivity and boundedness of the solutions were examined to establish biological validity. The basic reproduction number, R0, was derived through the next-generation matrix approach. Disease-free and endemic equilibria were determined, and their local and conditional global stability properties were investigated using Jacobian analysis, the Routh-Hurwitz criterion, center manifold theory, Lyapunov functions, and LaSalles invariance principle. Normalized sensitivity indices, Latin hypercube sampling, partial rank correlation coefficients, and numerical simulations were also applied. Results: The disease-free equilibrium was shown to be locally asymptotically stable when ,R0<1 whereas sustained transmission and a unique endemic equilibrium were associated with R0>1. Under the stated reduced-model assumptions, stability of the endemic equilibrium was established. Transmission-related parameters were identified as the strongest positive contributors to disease persistence. In contrast, treatment and recovery parameters were found to reduce the reproduction number and infectious burden. Numerical simulations indicated that stronger treatment implementation and reduced transmission opportunities produced substantial reductions in active tuberculosis cases. Conclusion: Treatment was shown to function as both a clinical pathway and an epidemiological control mechanism. The proposed framework may support the design of treatment-centered strategies for reducing tuberculosis prevalence and preventing long-term endemic persistence.
- Drink more, sleep less: Applying compositional data analysis to investigate day-to-day associations between alcohol use and 24-hour movement behaviors
Background. Alcohol use impacts sleep; however, sleep is also impacted by other 24-hour movement behaviors, including sedentary behavior (SB) and physical activity (PA). This study used compositional data analysis (CoDA) to simultaneously account for SB and PA and investigate within- and between-person associations between sleep and alcohol use behaviors. Methods. Participants were 21-44-year-old overweight/obese adults. Across 21 days, participants wore an activPAL monitor to assess sleep, PA, and SB hours, and completed morning surveys of past day alcohol use to assess drinks/day. CoDA identified the daily proportions of time spent in sleep, PA, and SB. Multilevel models investigated within- and between-person associations between sleep, demographic factors, and alcohol use. Differences in sleep, SB, and PA across drinking versus non-drinking days were investigated with individual MANOVAs for each participant. Results. Participants (N=91, Mage=30.7{+/-}6.5, 57% female, 75% White) reported drinking on 23% (n=437) of days, consumed 1 drink/day, and averaged 8.5{+/-}2.3 sleep hours, 7.4{+/-}2.8 SB hours, and 8.0{+/-}2.7 PA hours per day. Multilevel models indicated that participants slept 16.6 fewer minutes on drinking days (p=.046) each additional drink corresponded with 4.4 fewer minutes of sleep (p=.04). There was large between-person variability in time use allocations across drinking versus non-drinking days. For many the change was non-significant; however, three participants spent significantly less time sleeping on drinking days (1.16-4.74 fewer hours of sleep) and one participant spent significantly (2.62) more hours sleeping on drinking versus non-drinking days. Conclusions. Drinking days and greater alcohol consumption were associated with fewer minutes of sleep within-people; however, shifts towards PA and SB were inconsistent. Investigating contextual factors, such as the physical/social context of alcohol use, the time-of-day drinking occurs, the type of alcohol consumed, or the type of PA a person engages in could provide deeper insight into the conditions under which alcohol use detrimentally impacts sleep.
- Biomarker-Informed Interpretation of Dyadic Cognitive Function Index Scores in Cognitively Unimpaired Older Adults
Introduction: Participant- and study partner-reported Cognitive Function Index scores may provide complementary information, but it remains unclear whether Alzheimer's disease biomarkers are associated with CFI scores across reporters, reporter-specific imbalance, or both. Methods: Using A4/LEARN screening data (screening sample, N = 1,686; primary dyadic analytic sample, N = 1,682; CDR global score = 0), we jointly modeled participant-reported (CFI-PT) and study partner-reported (CFI-SP) scores in long format to evaluate biomarker associations with CFI scores and biomarker x reporter interactions. As a secondary analysis, we compared tau PET with plasma p-tau217. Results: In an A4/LEARN-adapted regional extent model, reporter balance varied across amyloid regional extent categories, with the largest participant-leading contrast observed in the exploratory restricted early cortical subgroup. Tau PET was associated with higher CFI scores, but this association did not differ detectably between reporters. Plasma p-tau217 showed no clear CFI association or reporter-specific interaction in the A4-derived, amyloid-enriched subset. Discussion: Amyloid regional extent and tau PET were associated with different features of dyadic CFI data: reporter balance and CFI burden across reporters, respectively. Joint interpretation of CFI-PT and CFI-SP may support biomarker-informed interpretation of the instrument, although the cross-sectional findings require replication and longitudinal validation.
- Altered T1w/T2w-FLAIR Ratio in White Matter Hyperintensities as an Indicator of Structural Integrity Loss: Association with Alzheimer's Disease and Vascular Dementia
Background: White matter hyperintensities (WMH) are prevalent in dementia, but lesion volume does not capture their microstructural heterogeneity. The T1-weighted to fluid-attenuated inversion recovery (T1w/T2w-FLAIR) ratio is sensitive to myelin, gliosis, and tissue water. We tested whether lesion-specific T1w/T2w-FLAIR ratio, referenced to each participant's normal-appearing white matter (NAWM), differs by diagnosis and reflects distinct amyloid and vascular mechanisms in Alzheimer's disease (AD) and vascular dementia (VD). Methods: We analyzed 576 participants from the multicentre BICWALZS cohort (seven South Korean sites), spanning subjective cognitive impairment (SCI, n=71), mild cognitive impairment (n=270), AD (n=125) and VD (n=88). WMH T1w/T2w-FLAIR ratio was regressed on NAWM ratio, yielding standardized residuals as the outcome. Regression and mediation models tested diagnosis, plasma biomarkers, APOE genotype, amyloid PET and vascular risk burden, adjusting for age, sex, education and site. We conducted regression and mediation analyses after multiple imputation for missing variables. We adjusted for hierarchical models using Bonferroni correction. We tested for insensitivity to site effects by applying ComBat harmonization. Results: Older age, AD, VD, and high vascular risk burden were associated with higher residualized T1w/T2w-FLAIR ratios relative to SCI. Lower plasma amyloid-beta 42 (greater amyloid burden) was associated with lower T1w/T2w-FLAIR ratios. Greater vascular burden was associated with greater T1w/T2w-FLAIR ratios, which partially mediated the VD association with T1w/T2w-FLAIR. Lower amyloid-beta 42 (greater amyloid) was associated with lower T1w/T2w-FLAIR, which partially mediated the effect between AD and T1w/T2w-FLAIR ratio. Findings were robust to harmonization. Conclusions: Residualized WMH T1w/T2w-FLAIR ratio captures lesion-specific microstructural variation missed by volumetric measures, consistent with vascular-gliotic injury in VD and coexisting amyloid-linked demyelination in AD. Limitations include the cross-sectional design, no cognitively normal comparison group, and a predominantly Korean sample.
- Data-Driven Biological Subtypes of Parkinson ' s Disease
The heterogenous clinical and pathophysiological presentation of idiopathic Parkinson's Disease (iPD) suggests the existence of underlying distinct biological subtypes. A better definition of PD subtypes is crucial for the development of target disease modifier approaches. Using data from the Parkinson ' s Precision Medicine Initiative (PPMI) cohort, we aimed to identify distinct biological subtypes of iPD through data-driven cluster analysis leveraging currently available biomarker data. We included n=225 de novo iPD subjects. Individuals with known genetic forms of PD were excluded. A total of 22 biomarkers reflecting different biological pathways (neurodegeneration, proteinopathy, neuroinflammation, mitochondrial impairment, and lipid metabolism/autophagy-lysosomal dysfunction) and measured in cerebrospinal fluid (CSF), whole blood, serum, plasma, or urine were selected. Hierarchical clustering was performed using ward.D2 method and Gower dissimilarity. Clinical-demographic characteristics of the identified clusters were compared at baseline and 5-year follow-up. We identified three clusters: Cluster I (''Mitochondrial-Predominant'' subtype); Cluster II (''Cryptic'' subtype); Cluster III (''Mixed Pathology'' subtype). The ''Mitochondrial-Predominant'' and ''Mixed Pathology'' subtypes showed higher levels of CSF mitochondrial DNA deletions and ND1 compared to the ''Cryptic'' subtype. The ''Mixed Pathology'' subtype was also characterized by higher levels of serum NfL, CSF p-tau, CSF GFAP, CSF YKL-40, and lower levels of plasma total ceramide, glucosylceramide, and sphingomyelin compared to the other subtypes. In the ''Cryptic'' subtype no clear dominant biological profile was detected. Clinically, subjects belonging to the ''Mixed Pathology'' subtype were older and predominantly male. No differences in 5-year clinical progression were found between clusters. While most of the previous research has performed a biological characterization of the clinical subtypes of PD, with our work we propose a biology-driven clustering in a large cohort if subjects with iPD. We identified three biological subtypes. The ''Mitochondrial-Predominant'' subtype was characterized by alterations exclusively of biomarkers reflecting mitochondrial dysfunction. The ''Mixed Pathology'' subtype, in contrast, was characterized by biomarker alterations across all explored pathological pathways. Finally, the ''Cryptic'' subtype included subjects whose biomarker signature did not indicate predominant alterations in any of the explored pathways. The clusters did not differ in terms of baseline clinical-demographic characteristics, except for age and sex. No difference in mid-term clinical progression was observed between subtypes.
- Benchmarking sex and gender incorporation into health and medical research, policy and education in Victoria prior to 2026
Objective: To investigate and establish a baseline for sex and gender considerations in policy, research and curricula across the state of Victoria. Design and setting: Victoria was selected as a case study for Australia, using a mixed-methods approach to examine health and medical university curricula, research organisation policies and research funding between 2020-2025 prior to mandated inclusion. Main outcome measures: Primary outcomes include identification of predefined sex- and gender-related terms in university curricula descriptors and funded grant descriptions; and questionnaire responses from university course coordinators and organisational leads. Results: Data mining across nine Victorian universities (318 courses/3383 units) identified ~93% of units and ~60% of healthcare courses lacked sex and gender terms in their descriptors. Among medical research organisations operating in Victoria, including peak bodies, research institutes, hospitals and universities, ~70% (18/26) of the survey responders reported having no sex and gender policy. Rates of sex- and gender-term inclusion in research grants allocated in Victoria (3388) and Australia-wide (8974) validated Victoria as a case study for Australia for National Health and Medical Research Council (9.5%/8.9% respectively), Medical Research Future Funds (11%/10.2%), and Australian Research Council (4.8%/4.1%). One in nine Victorian awards from five government initiatives and one in ten from 12 non-government agencies included sex- and gender-term related terms in their guidelines. Conclusions: These baseline metrics indicate that sex and gender are still not widely considered in the education and research ecosystems. These findings support the need to build inclusive research policy at a national and state level, and accreditation standards across university education.
- Fueletics
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