Pub Date : 2024-06-06DOI: 10.1101/2024.06.05.24308517
O. Eales, J. McCaw, F. Shearer
Background: Monitoring how the incidence of influenza infections changes over time is important for quantifying the transmission dynamics and clinical severity of influenza. Infection incidence is difficult to measure directly, and hence other quantities which are more amenable to surveillance are used to monitor trends in infection levels, with the implicit assumption that they correlate with infection incidence. Method: Here we demonstrate, through mathematical reasoning, the relationship between the incidence of influenza infections and three commonly reported surveillance indicators: 1) the rate per unit time of influenza-like illness reported through sentinel healthcare sites, 2) the rate per unit time of laboratory-confirmed influenza infections, and 3) the proportion of laboratory tests positive for influenza (`test-positive proportion'). Results: Our analysis suggests that none of these ubiquitously reported surveillance indicators are a reliable tool for monitoring influenza incidence. In particular, we highlight how these surveillance indicators can be heavily biased by: the dynamics of circulating pathogens (other than influenza) with similar symptom profiles; changes in testing rates; and differences in infection rates, symptom rates, and healthcare-seeking behaviour between age-groups and through time. We make six practical recommendations to improve the monitoring of influenza infection incidence. The implementation of our recommendations would enable the construction of more interpretable surveillance indicator(s) for influenza from which underlying patterns of infection incidence could be readily monitored. Conclusion: The implementation of all (or a subset) of our recommendations would greatly improve understanding of the transmission dynamics, infection burden, and clinical severity of influenza, improving our ability to respond effectively to seasonal epidemics and future pandemics.
{"title":"Biases in routine influenza surveillance indicators used to monitor infection incidence and recommendations for improvement","authors":"O. Eales, J. McCaw, F. Shearer","doi":"10.1101/2024.06.05.24308517","DOIUrl":"https://doi.org/10.1101/2024.06.05.24308517","url":null,"abstract":"Background: Monitoring how the incidence of influenza infections changes over time is important for quantifying the transmission dynamics and clinical severity of influenza. Infection incidence is difficult to measure directly, and hence other quantities which are more amenable to surveillance are used to monitor trends in infection levels, with the implicit assumption that they correlate with infection incidence. Method: Here we demonstrate, through mathematical reasoning, the relationship between the incidence of influenza infections and three commonly reported surveillance indicators: 1) the rate per unit time of influenza-like illness reported through sentinel healthcare sites, 2) the rate per unit time of laboratory-confirmed influenza infections, and 3) the proportion of laboratory tests positive for influenza (`test-positive proportion'). Results: Our analysis suggests that none of these ubiquitously reported surveillance indicators are a reliable tool for monitoring influenza incidence. In particular, we highlight how these surveillance indicators can be heavily biased by: the dynamics of circulating pathogens (other than influenza) with similar symptom profiles; changes in testing rates; and differences in infection rates, symptom rates, and healthcare-seeking behaviour between age-groups and through time. We make six practical recommendations to improve the monitoring of influenza infection incidence. The implementation of our recommendations would enable the construction of more interpretable surveillance indicator(s) for influenza from which underlying patterns of infection incidence could be readily monitored. Conclusion: The implementation of all (or a subset) of our recommendations would greatly improve understanding of the transmission dynamics, infection burden, and clinical severity of influenza, improving our ability to respond effectively to seasonal epidemics and future pandemics.","PeriodicalId":506788,"journal":{"name":"medRxiv","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.1101/2024.06.05.24308513
A. Minoura, Y. Ihara, H. Kato, K. Murakami, Y. Watanabe, K. Hirano, Y. Ito, A. Kokaze
This cross-sectional study investigated the correlation between lip-seal strength, tongue pressure, and oral diadochokinesis (OD) in Japanese workers. The relationships between lip-seal strength, tongue pressure, and OD by age groups were investigated using multiple regression analyses on 496 workers. OD was measured using the number of consecutive "Pa," "Ta," and "Ka" vocalizations that could be produced in 5 s. In this study, 478 participants (437 males and 41 females) were included in the analysis after excluding 18 participants who could not complete all oral cavity measurements. This study revealed a significant positive correlation between "Pa," "Ta," and "Ka," with correlation coefficients of 0.500-0.665. Lip-seal strength only significantly correlated positively with "Pa"; however, tongue pressure significantly correlated positively with all of "Pa," "Ta," and "Ka" vocalizations. Regarding body mass index (BMI), no significant relationship with either "Pa," "Ta," or "Ka" was observed. As a result of aging, "Ta" and "Ka" showed a significant negative correlation with age. Multiple regression analyses, which included age, sex, BMI, alcohol consumption, and smoking, revealed a strong association between "Pa," "Ta," and "Ka" and lip-seal strength. However, only "Pa" showed a significant correlation with tongue pressure. Even in young and middle-aged adults, OD may be associated with lip-seal strength and tongue pressure. Measuring OD through dental screening of workers will help prevent the disease across a wide age range.
{"title":"Oral diadochokinesis, tongue pressure, and lip-seal strength in Japanese workers: A cross-sectional study","authors":"A. Minoura, Y. Ihara, H. Kato, K. Murakami, Y. Watanabe, K. Hirano, Y. Ito, A. Kokaze","doi":"10.1101/2024.06.05.24308513","DOIUrl":"https://doi.org/10.1101/2024.06.05.24308513","url":null,"abstract":"This cross-sectional study investigated the correlation between lip-seal strength, tongue pressure, and oral diadochokinesis (OD) in Japanese workers. The relationships between lip-seal strength, tongue pressure, and OD by age groups were investigated using multiple regression analyses on 496 workers. OD was measured using the number of consecutive \"Pa,\" \"Ta,\" and \"Ka\" vocalizations that could be produced in 5 s. In this study, 478 participants (437 males and 41 females) were included in the analysis after excluding 18 participants who could not complete all oral cavity measurements. This study revealed a significant positive correlation between \"Pa,\" \"Ta,\" and \"Ka,\" with correlation coefficients of 0.500-0.665. Lip-seal strength only significantly correlated positively with \"Pa\"; however, tongue pressure significantly correlated positively with all of \"Pa,\" \"Ta,\" and \"Ka\" vocalizations. Regarding body mass index (BMI), no significant relationship with either \"Pa,\" \"Ta,\" or \"Ka\" was observed. As a result of aging, \"Ta\" and \"Ka\" showed a significant negative correlation with age. Multiple regression analyses, which included age, sex, BMI, alcohol consumption, and smoking, revealed a strong association between \"Pa,\" \"Ta,\" and \"Ka\" and lip-seal strength. However, only \"Pa\" showed a significant correlation with tongue pressure. Even in young and middle-aged adults, OD may be associated with lip-seal strength and tongue pressure. Measuring OD through dental screening of workers will help prevent the disease across a wide age range.","PeriodicalId":506788,"journal":{"name":"medRxiv","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.1101/2024.06.05.24308529
A. Hallab, Alzheimer's Disease Neuroimaging Initiative
Introduction: This study explored the association between dyslipidemia and sleep and nighttime behavior disorders (SNBD) in the elderly. Methods: ADNI population with complete Cholesterol, Triglyceride, SNBD, and neurocognitive data were included. Logistic regression was performed to study the association between dyslipidemia and SNBD at baseline and 12 months. Relevant confounders were adjusted for. Results: Among the 2,216 included cases, 1,045 (47%) were females, and the median age was 73 (IQR: 68, 78). At baseline, 357 (16%) had SNBD, and 327 (18%) at 12 months; 187 were incident cases. There were more cases of baseline SNBD in the hypertriglyceridemia group than in those without (19% vs. 14%, p-value=0.003). Similarly, more follow-up SNBD cases had hypertriglyceridemia at baseline (21% vs. 16%, p-value=0.025). SNBD cases at baseline had significantly higher serum Triglyceride levels than those without (132 vs. 118mg/dL, p-value<0.001). Only hypertriglyceridemia was significantly associated with baseline SNBD (crude OR=1.43, 95%CI: 1.13,1.80, p-value=0.003), even after adjustment for confounding factors (adj.OR=1.36, 95%CI: 1.06,1.74, p-value=0.016) and (BMI-adj.OR=1.29, 95%CI: 1.00,1.66, p-value=0.048). None of the dyslipidemia forms did predict incident cases at 12 months. Conclusions: Hypertriglyceridemia, but not hypercholesterolemia, was associated with higher odds of SNBD. None of the dyslipidemia forms predicted incidental SNBD over 12 months.
{"title":"High serum Cholesterol and Triglyceride levels in older adults: associations with sleep and nighttime behavior disorders at baseline and a prediction analysis of incidental cases at 12 months follow-up","authors":"A. Hallab, Alzheimer's Disease Neuroimaging Initiative","doi":"10.1101/2024.06.05.24308529","DOIUrl":"https://doi.org/10.1101/2024.06.05.24308529","url":null,"abstract":"Introduction: This study explored the association between dyslipidemia and sleep and nighttime behavior disorders (SNBD) in the elderly. Methods: ADNI population with complete Cholesterol, Triglyceride, SNBD, and neurocognitive data were included. Logistic regression was performed to study the association between dyslipidemia and SNBD at baseline and 12 months. Relevant confounders were adjusted for. Results: Among the 2,216 included cases, 1,045 (47%) were females, and the median age was 73 (IQR: 68, 78). At baseline, 357 (16%) had SNBD, and 327 (18%) at 12 months; 187 were incident cases. There were more cases of baseline SNBD in the hypertriglyceridemia group than in those without (19% vs. 14%, p-value=0.003). Similarly, more follow-up SNBD cases had hypertriglyceridemia at baseline (21% vs. 16%, p-value=0.025). SNBD cases at baseline had significantly higher serum Triglyceride levels than those without (132 vs. 118mg/dL, p-value<0.001). Only hypertriglyceridemia was significantly associated with baseline SNBD (crude OR=1.43, 95%CI: 1.13,1.80, p-value=0.003), even after adjustment for confounding factors (adj.OR=1.36, 95%CI: 1.06,1.74, p-value=0.016) and (BMI-adj.OR=1.29, 95%CI: 1.00,1.66, p-value=0.048). None of the dyslipidemia forms did predict incident cases at 12 months. Conclusions: Hypertriglyceridemia, but not hypercholesterolemia, was associated with higher odds of SNBD. None of the dyslipidemia forms predicted incidental SNBD over 12 months.","PeriodicalId":506788,"journal":{"name":"medRxiv","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.1101/2024.06.05.24306788
Jack H. Ching, Steve Duff, John Hernandez
Background: Physical activity levels worldwide have declined over recent decades, with the average number of daily steps decreasing steadily since 1995. Given that physical inactivity is a major modifiable risk factor for chronic disease and mortality, increasing the level of physical activity is a clear opportunity to improve population health on a broad scale. The current study aims to assess the cost-effectiveness and budget impact of a Fitbit-based intervention among healthy, but insufficiently active, adults to quantify the potential clinical and economic value for a commercially insured population in the U.S. Methods: An economic model was developed to compare physical activity, health outcomes, costs, and quality-adjusted life-years (QALYs) associated with usual care and a Fitbit-based intervention that consists of a consumer wearable device alongside goal setting and feedback features provided in a companion software application. Improvement in physical activity was measured in terms of mean daily step count. The effects of increased daily step count were characterized as reduced short-term healthcare costs and decreased incidence of chronic diseases with corresponding improvement in health utility and reduced disease costs. Published literature, standardized costing resources, and data from a National Institutes of Health-funded research program were utilized. Cost-effectiveness and budget impact analyses were performed for a hypothetical cohort of middle-aged adults. Results: The base case cost-effectiveness results found the Fitbit intervention to be dominant (less costly and more effective) compared to usual care. Discounted 15-year incremental costs and QALYs were -$1,257 and 0.011, respectively. In probabilistic analyses, the Fitbit intervention was dominant in 93% of simulations and either dominant or cost-effective (defined as less than $150,000/QALY gained) in 99.4% of simulations. For budget impact analyses conducted from the perspective of a U.S. Commercial payer, the Fitbit intervention was estimated to save approximately $6.5-million dollars over 2 years and $8.5-million dollars over 5 years for a cohort of 8,000 participants. Although the economic analysis results were very robust, the short-term healthcare cost savings were the most uncertain in this population and warrant further research. Conclusions: There is abundant evidence documenting the benefits of wearable activity trackers when used to increase physical activity as measured by daily step counts. Our research provides additional health economic evidence supporting implementation of wearable-based interventions to improve population health and offers compelling support for payers to consider including wearable-based physical activity interventions as part of a comprehensive portfolio of preventive health offerings for their insured populations.
{"title":"Economic evaluation of a wearable-based intervention to increase physical activity among insufficiently active middle-aged adults","authors":"Jack H. Ching, Steve Duff, John Hernandez","doi":"10.1101/2024.06.05.24306788","DOIUrl":"https://doi.org/10.1101/2024.06.05.24306788","url":null,"abstract":"Background: Physical activity levels worldwide have declined over recent decades, with the average number of daily steps decreasing steadily since 1995. Given that physical inactivity is a major modifiable risk factor for chronic disease and mortality, increasing the level of physical activity is a clear opportunity to improve population health on a broad scale. The current study aims to assess the cost-effectiveness and budget impact of a Fitbit-based intervention among healthy, but insufficiently active, adults to quantify the potential clinical and economic value for a commercially insured population in the U.S. Methods: An economic model was developed to compare physical activity, health outcomes, costs, and quality-adjusted life-years (QALYs) associated with usual care and a Fitbit-based intervention that consists of a consumer wearable device alongside goal setting and feedback features provided in a companion software application. Improvement in physical activity was measured in terms of mean daily step count. The effects of increased daily step count were characterized as reduced short-term healthcare costs and decreased incidence of chronic diseases with corresponding improvement in health utility and reduced disease costs. Published literature, standardized costing resources, and data from a National Institutes of Health-funded research program were utilized. Cost-effectiveness and budget impact analyses were performed for a hypothetical cohort of middle-aged adults. Results: The base case cost-effectiveness results found the Fitbit intervention to be dominant (less costly and more effective) compared to usual care. Discounted 15-year incremental costs and QALYs were -$1,257 and 0.011, respectively. In probabilistic analyses, the Fitbit intervention was dominant in 93% of simulations and either dominant or cost-effective (defined as less than $150,000/QALY gained) in 99.4% of simulations. For budget impact analyses conducted from the perspective of a U.S. Commercial payer, the Fitbit intervention was estimated to save approximately $6.5-million dollars over 2 years and $8.5-million dollars over 5 years for a cohort of 8,000 participants. Although the economic analysis results were very robust, the short-term healthcare cost savings were the most uncertain in this population and warrant further research. Conclusions: There is abundant evidence documenting the benefits of wearable activity trackers when used to increase physical activity as measured by daily step counts. Our research provides additional health economic evidence supporting implementation of wearable-based interventions to improve population health and offers compelling support for payers to consider including wearable-based physical activity interventions as part of a comprehensive portfolio of preventive health offerings for their insured populations.","PeriodicalId":506788,"journal":{"name":"medRxiv","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.1101/2024.06.05.24308499
PhD Ryan Richard Ru, Dmd Richard Niederman
Background: Dental caries is the world's most prevalent noncommunicable disease, disproportionately affecting children from low-income rural areas. This study assessed the effectiveness of using silver diamine fluoride (SDF) for school-based caries prevention. Methods: The CariedAway 3.0 study was a cluster-randomized pragmatic non-inferiority trial comparing SDF to sealants and atraumatic restorations (ART) for the prevention and control of dental caries. All participants also received fluoride varnish. Analysis consisted of multilevel mixed-effects logistic and negative binomial regression for the prevalence and incidence of dental caries, respectively, and a non-inferiority margin of 10% for the difference between groups was used. Dental caries was defined as an ICDAS score of four or greater. Results: A total of 3345 children were enrolled in the trial, however there was a large proportion of children who were noncompliant and received external dental care. In adjusted analyses of compliant participants (n=1083, consisting of 543 in the SDF group and 540 in the sealant and ART group), there was no difference in the weighted risk difference between treatment groups (B=0.003, 95% CI = -0.0001, 0.0008). The odds of caries was elevated in the SDF group in longitudinal analyses (OR = 1.35, 95% CI = 0.86, 2.11) but was not significant and was below the non-inferiority margin. There were no significant differences between groups for caries incidence in adjusted models (IRR = 1.19, 95% CI = 0.81, 1.74). Results for intent to treat analyses were similar to that of per-protocol. Discussion: In this school-based clinical trial, the prevalence of dental caries in children treated with SDF and fluoride varnish was non-inferior compared to those treated with sealants, ART, and fluoride varnish, although the overall risk was slightly higher. Unfortunately, a high rate of dropout and participant noncompliance was observed, likely due to the impacts of COVID-19 on study procedures. As a result, observed effects may be unreliable beyond the short-term.
背景：龋齿是世界上最普遍的非传染性疾病，对低收入农村地区的儿童影响尤为严重。本研究评估了使用二胺氟化银（SDF）进行校内龋齿预防的有效性。研究方法CariedAway3.0研究是一项分组随机实用性非劣效性试验，比较了SDF与密封剂和无损伤修复（ART）在预防和控制龋齿方面的效果。所有参与者还接受了氟化物涂膜。分析包括对龋齿流行率和发病率分别进行多层次混合效应逻辑回归和负二项回归，组间差异的非劣效差为 10%。龋齿的定义是 ICDAS 评分达到或超过 4 分。研究结果共有 3345 名儿童参加了试验，但有很大一部分儿童不遵守规定，接受了外部牙科治疗。对符合要求的参与者（1083 人，其中 SDF 组 543 人，封闭剂和 ART 组 540 人）进行调整分析后发现，治疗组之间的加权风险差异没有差异（B=0.003，95% CI = -0.0001，0.0008）。在纵向分析中，SDF 组发生龋齿的几率升高（OR = 1.35，95% CI = 0.86，2.11），但并不显著，低于非劣效边际。在调整模型中，各组之间的龋齿发生率没有明显差异（IRR = 1.19，95% CI = 0.81，1.74）。意向治疗分析的结果与按协议治疗的结果相似。讨论在这项以学校为基础的临床试验中，接受 SDF 和氟化物清漆治疗的儿童的龋齿患病率与接受封闭剂、ART 和氟化物清漆治疗的儿童相比并无劣势，但总体风险略高。遗憾的是，由于 COVID-19 对研究程序的影响，观察到了较高的辍学率和参与者违规率。因此，观察到的短期效果可能并不可靠。
{"title":"School-based caries prevention using silver diamine fluoride: A pragmatic randomized trial in low-income rural children","authors":"PhD Ryan Richard Ru, Dmd Richard Niederman","doi":"10.1101/2024.06.05.24308499","DOIUrl":"https://doi.org/10.1101/2024.06.05.24308499","url":null,"abstract":"Background: Dental caries is the world's most prevalent noncommunicable disease, disproportionately affecting children from low-income rural areas. This study assessed the effectiveness of using silver diamine fluoride (SDF) for school-based caries prevention. Methods: The CariedAway 3.0 study was a cluster-randomized pragmatic non-inferiority trial comparing SDF to sealants and atraumatic restorations (ART) for the prevention and control of dental caries. All participants also received fluoride varnish. Analysis consisted of multilevel mixed-effects logistic and negative binomial regression for the prevalence and incidence of dental caries, respectively, and a non-inferiority margin of 10% for the difference between groups was used. Dental caries was defined as an ICDAS score of four or greater. Results: A total of 3345 children were enrolled in the trial, however there was a large proportion of children who were noncompliant and received external dental care. In adjusted analyses of compliant participants (n=1083, consisting of 543 in the SDF group and 540 in the sealant and ART group), there was no difference in the weighted risk difference between treatment groups (B=0.003, 95% CI = -0.0001, 0.0008). The odds of caries was elevated in the SDF group in longitudinal analyses (OR = 1.35, 95% CI = 0.86, 2.11) but was not significant and was below the non-inferiority margin. There were no significant differences between groups for caries incidence in adjusted models (IRR = 1.19, 95% CI = 0.81, 1.74). Results for intent to treat analyses were similar to that of per-protocol. Discussion: In this school-based clinical trial, the prevalence of dental caries in children treated with SDF and fluoride varnish was non-inferior compared to those treated with sealants, ART, and fluoride varnish, although the overall risk was slightly higher. Unfortunately, a high rate of dropout and participant noncompliance was observed, likely due to the impacts of COVID-19 on study procedures. As a result, observed effects may be unreliable beyond the short-term.","PeriodicalId":506788,"journal":{"name":"medRxiv","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.1101/2024.06.05.24308376
M. Sunol, S. Pascual-Diaz, J. Dudley, M. F. Payne, C. Jackson, H. Tong, T. V. Ting, S. Kashikar-Zuck, R. C. Coghill, M. López-Solà
Objective Juvenile fibromyalgia (JFM) is a chronic pain syndrome predominantly affecting adolescent girls. Resilience may be a protective factor in coping with pain, reducing affective burden, and promoting positive outlooks. Brain regions affected in JFM overlap with those linked to resilience, particularly in the default-mode network (DMN). We investigate the role of resilience on core somatic and affective symptoms in JFM and assess the neurophysiological substrates for the first time. Methods Forty-one girls with JFM and 40 pain-free adolescents completed a resting-state fMRI assessment and self-report questionnaires. We used clustering analyses to group JFM participants based on resilience, and principal component analyses to summarize core somatic and affective symptoms. We estimated whole-brain and within-DMN connectivity and assessed differences between higher and lower resilience JFM groups and compared their connectivity patterns to pain-free participants. Results The higher resilience JFM group had less affective (T=4.03; p<.001) but similar core somatic symptoms (T=1.05; p=.302) than the lower resilience JFM group. They had increased whole-brain (T's>3.90, pFDR's<.03) and within-DMN (T=2.20, p=.03) connectivity strength, and higher connectivity between DMN nodes and self-referential, regulatory, and reward-processing regions. Conversely, higher DMN-premotor connectivity was observed in the lower resilience group. Conclusion JFM participants with higher resilience were protected affectively but not in core somatic symptoms. Greater resilience was accompanied by higher signal integration within the DMN, a network central to internally oriented attention and flexible attention shifting. Crucially, the connectivity pattern in highly resilient patients resembled that of pain-free adolescents, which was not the case for the lower resilience group.
{"title":"Neurophysiology of Resilience in Juvenile Fibromyalgia","authors":"M. Sunol, S. Pascual-Diaz, J. Dudley, M. F. Payne, C. Jackson, H. Tong, T. V. Ting, S. Kashikar-Zuck, R. C. Coghill, M. López-Solà","doi":"10.1101/2024.06.05.24308376","DOIUrl":"https://doi.org/10.1101/2024.06.05.24308376","url":null,"abstract":"Objective Juvenile fibromyalgia (JFM) is a chronic pain syndrome predominantly affecting adolescent girls. Resilience may be a protective factor in coping with pain, reducing affective burden, and promoting positive outlooks. Brain regions affected in JFM overlap with those linked to resilience, particularly in the default-mode network (DMN). We investigate the role of resilience on core somatic and affective symptoms in JFM and assess the neurophysiological substrates for the first time. Methods Forty-one girls with JFM and 40 pain-free adolescents completed a resting-state fMRI assessment and self-report questionnaires. We used clustering analyses to group JFM participants based on resilience, and principal component analyses to summarize core somatic and affective symptoms. We estimated whole-brain and within-DMN connectivity and assessed differences between higher and lower resilience JFM groups and compared their connectivity patterns to pain-free participants. Results The higher resilience JFM group had less affective (T=4.03; p<.001) but similar core somatic symptoms (T=1.05; p=.302) than the lower resilience JFM group. They had increased whole-brain (T's>3.90, pFDR's<.03) and within-DMN (T=2.20, p=.03) connectivity strength, and higher connectivity between DMN nodes and self-referential, regulatory, and reward-processing regions. Conversely, higher DMN-premotor connectivity was observed in the lower resilience group. Conclusion JFM participants with higher resilience were protected affectively but not in core somatic symptoms. Greater resilience was accompanied by higher signal integration within the DMN, a network central to internally oriented attention and flexible attention shifting. Crucially, the connectivity pattern in highly resilient patients resembled that of pain-free adolescents, which was not the case for the lower resilience group.","PeriodicalId":506788,"journal":{"name":"medRxiv","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.1101/2024.06.05.24308468
Mariluz Rojo Domingo, D. Do, C. Conlin, Aditya Bagrodia, Tristan Barrett, Madison T Baxter, Matthew Cooperberg, Felix Feng, M. E. Hahn, M. Harisinghani, G. Hollenberg, Juan Javier-Desloges, Karoline Kallis, Sophia Kamran, Christopher J. Kane, Dimitri Kessler, J. Kuperman, Kang-Lung Lee, Jonathan Levine, Michael A. Liss, D. Margolis, Ian Matthews, Paul M Murphy, Nabih Nakrour, Michael Ohliger, C. Ollison, Thomas Osinski, Anthony J. Pamatmat, Isabella R Pompa, R. Rakow-Penner, Jacob L Roberts, Karan Santhosh, A. Shabaik, Yuze Song, David Song, C. M. Tempany, Natasha Wehrli, E. Weinberg, Sean Woolen, George Xu, A. Y. Zhong, Anders M. Dale, Tyler M Seibert
Background and Objective. Positive predictive value of PI-RADS for clinically significant prostate cancer (csPCa, grade group [GG][≥]2) varies widely between institutions and radiologists. The Restriction Spectrum Imaging restriction score (RSIrs) is a metric derived from diffusion MRI that could be an objectively interpretable biomarker for csPCa. Methods. In patients scanned for suspected or known csPCa at 7 centers, we calculated patient-level csPCa probability based on maximum RSIrs in the prostate, without relying on subjectively defined lesions. We used area under the ROC curve (AUC) to compare patient-level csPCa detection for RSIrs, ADC, and PI-RADS. Finally, we combined RSIrs with clinical risk factors via multivariable regression, training in a single-center cohort and testing in an independent, multi-center dataset. Key Findings and Limitations. Among all patients (n=1892), probability of csPCa increased with higher RSIrs. GG[≥]4 csPCa was most common in patients with very high RSIrs. Among biopsy-naive patients (n=877), AUCs for GG[≥]2 vs. non-csPCa were 0.73 (0.69-0.76), 0.54 (0.50-0.57), and 0.75 (0.71-0.78) for RSIrs, ADC, and PI-RADS, respectively. RSIrs significantly outperformed ADC (p<0.01) and was comparable to PI-RADS (p=0.31). The combination of RSIrs and PI-RADS outperformed either alone. Combining RSIrs with PI-RADS, age, and PSA density in a multivariable model achieved the best discrimination of csPCa. Conclusions and Clinical Implications. RSIrs is an accurate and reliable quantitative biomarker that performs better than conventional ADC and comparably to expert-defined PI-RADS for patient-level detection of csPCa. RSIrs provides objective estimates of probability of csPCa that do not require radiology expertise.
{"title":"Restriction Spectrum Imaging as a quantitative biomarker for prostate cancer with reliable positive predictive value","authors":"Mariluz Rojo Domingo, D. Do, C. Conlin, Aditya Bagrodia, Tristan Barrett, Madison T Baxter, Matthew Cooperberg, Felix Feng, M. E. Hahn, M. Harisinghani, G. Hollenberg, Juan Javier-Desloges, Karoline Kallis, Sophia Kamran, Christopher J. Kane, Dimitri Kessler, J. Kuperman, Kang-Lung Lee, Jonathan Levine, Michael A. Liss, D. Margolis, Ian Matthews, Paul M Murphy, Nabih Nakrour, Michael Ohliger, C. Ollison, Thomas Osinski, Anthony J. Pamatmat, Isabella R Pompa, R. Rakow-Penner, Jacob L Roberts, Karan Santhosh, A. Shabaik, Yuze Song, David Song, C. M. Tempany, Natasha Wehrli, E. Weinberg, Sean Woolen, George Xu, A. Y. Zhong, Anders M. Dale, Tyler M Seibert","doi":"10.1101/2024.06.05.24308468","DOIUrl":"https://doi.org/10.1101/2024.06.05.24308468","url":null,"abstract":"Background and Objective. Positive predictive value of PI-RADS for clinically significant prostate cancer (csPCa, grade group [GG][≥]2) varies widely between institutions and radiologists. The Restriction Spectrum Imaging restriction score (RSIrs) is a metric derived from diffusion MRI that could be an objectively interpretable biomarker for csPCa. Methods. In patients scanned for suspected or known csPCa at 7 centers, we calculated patient-level csPCa probability based on maximum RSIrs in the prostate, without relying on subjectively defined lesions. We used area under the ROC curve (AUC) to compare patient-level csPCa detection for RSIrs, ADC, and PI-RADS. Finally, we combined RSIrs with clinical risk factors via multivariable regression, training in a single-center cohort and testing in an independent, multi-center dataset. Key Findings and Limitations. Among all patients (n=1892), probability of csPCa increased with higher RSIrs. GG[≥]4 csPCa was most common in patients with very high RSIrs. Among biopsy-naive patients (n=877), AUCs for GG[≥]2 vs. non-csPCa were 0.73 (0.69-0.76), 0.54 (0.50-0.57), and 0.75 (0.71-0.78) for RSIrs, ADC, and PI-RADS, respectively. RSIrs significantly outperformed ADC (p<0.01) and was comparable to PI-RADS (p=0.31). The combination of RSIrs and PI-RADS outperformed either alone. Combining RSIrs with PI-RADS, age, and PSA density in a multivariable model achieved the best discrimination of csPCa. Conclusions and Clinical Implications. RSIrs is an accurate and reliable quantitative biomarker that performs better than conventional ADC and comparably to expert-defined PI-RADS for patient-level detection of csPCa. RSIrs provides objective estimates of probability of csPCa that do not require radiology expertise.","PeriodicalId":506788,"journal":{"name":"medRxiv","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.1101/2024.06.05.24308424
R. J. G. Vreeburg, F. van Leeuwen, G. T. Manley, J. K. Yue, P. M. Brennan, X. Sun, S. Jain, T. V. van Essen, W. C. Peul, A. I. R. Maas, D. K. Menon, E. W. Steyerberg, The CENTER-TBI Investigators and Participants, The TRACK-TBI Investigators and Participants, The Clinical Working Group of the NIH-NINDS initiative Tbi
Objective: To compare the incremental prognostic value of pupillary reactivity as captured in the GCS-Pupils score (GCS-P) or added as separate variable to the Glasgow Coma Scale (GCS) in traumatic brain injury (TBI). Methods: We analyzed patients enrolled between 2014 and 2018 in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI, n=3521) and the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI, n=1439) cohorts. We used logistic regression to quantify the prognostic performances of GCS-P versus GCS according to Nagelkerke R2. Endpoints were mortality and unfavorable outcome (Glasgow Outcome Scale-Extended score 1-4) at 6 months after injury. We estimated 95% confidence intervals with bootstrap resampling to summarize the improvement in prognostic capability. Results: GCS as a linear score had a R2 of 24% (95% confidence interval [CI] 17-30) and 30% (95%CI 17-43) for mortality and 29% (95%CI 25-34) and 38% (95%CI 29-47) for unfavorable outcome in CENTER-TBI and TRACK-TBI respectively. In the meta-analysis, pupillary reactivity as a separate variable improved the R2 by an absolute value of 6% and 2% for mortality and unfavorable outcome (95%CI 4.0-7.7 and 1.2-3.0, respectively), with half the improvement captured in the GCS-P score (3%, 95%CI 2.1-3.3 and 1%, 95%CI 1-1.7, respectively). Conclusions: GCS-P has a stronger association with outcome after TBI than the GCS alone. However, for prognostic models, inclusion of GCS and pupillary reactivity as separate scores is preferable.
{"title":"Validation of the GCS-Pupil scale in Traumatic Brain Injury Incremental prognostic performance of pupillary reactivity with GCS in the prospective observational cohorts CENTER-TBI and TRACK-TBI","authors":"R. J. G. Vreeburg, F. van Leeuwen, G. T. Manley, J. K. Yue, P. M. Brennan, X. Sun, S. Jain, T. V. van Essen, W. C. Peul, A. I. R. Maas, D. K. Menon, E. W. Steyerberg, The CENTER-TBI Investigators and Participants, The TRACK-TBI Investigators and Participants, The Clinical Working Group of the NIH-NINDS initiative Tbi","doi":"10.1101/2024.06.05.24308424","DOIUrl":"https://doi.org/10.1101/2024.06.05.24308424","url":null,"abstract":"Objective: To compare the incremental prognostic value of pupillary reactivity as captured in the GCS-Pupils score (GCS-P) or added as separate variable to the Glasgow Coma Scale (GCS) in traumatic brain injury (TBI). Methods: We analyzed patients enrolled between 2014 and 2018 in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI, n=3521) and the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI, n=1439) cohorts. We used logistic regression to quantify the prognostic performances of GCS-P versus GCS according to Nagelkerke R2. Endpoints were mortality and unfavorable outcome (Glasgow Outcome Scale-Extended score 1-4) at 6 months after injury. We estimated 95% confidence intervals with bootstrap resampling to summarize the improvement in prognostic capability. Results: GCS as a linear score had a R2 of 24% (95% confidence interval [CI] 17-30) and 30% (95%CI 17-43) for mortality and 29% (95%CI 25-34) and 38% (95%CI 29-47) for unfavorable outcome in CENTER-TBI and TRACK-TBI respectively. In the meta-analysis, pupillary reactivity as a separate variable improved the R2 by an absolute value of 6% and 2% for mortality and unfavorable outcome (95%CI 4.0-7.7 and 1.2-3.0, respectively), with half the improvement captured in the GCS-P score (3%, 95%CI 2.1-3.3 and 1%, 95%CI 1-1.7, respectively). Conclusions: GCS-P has a stronger association with outcome after TBI than the GCS alone. However, for prognostic models, inclusion of GCS and pupillary reactivity as separate scores is preferable.","PeriodicalId":506788,"journal":{"name":"medRxiv","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.1101/2024.06.05.24308511
Timothy Hudson, David Culasino Carandang, Dianne Jaula Cunanan, Gail S. Co, John David Pilapil, Juan Ignacio Garcia, Blanca I. Restrepo, Marcel Yotebieng, Jordi B. Torrelles, K. Notarte
Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB) infection, remains a significant public health threat. The timeliness, portability, and capacity of nanopore sequencing for diagnostics can aid in early detection and drug susceptibility testing (DST), which is crucial for effective TB control. This study synthesized current evidence on the diagnostic accuracy of the nanopore sequencing technology in detecting MTB and its DST profile. A comprehensive literature search in PubMed, Scopus, MEDLINE, Cochrane, EMBASE, Web of Science, AIM, IMEMR, IMSEAR, LILACS, WPRO, HERDIN Plus, MedRxiv, and BioRxiv was performed. Quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled sensitivity, specificity, predictive values (PV), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated. Thirty-two studies were included; 13 addressed MTB detection only, 15 focused on DST only, and 4 examined both MTB detection and DST. No study used Flongle or PromethION. Seven studies were eligible for meta-analysis on MTB detection and five for DST; studies for MTB detection used GridION only while those for DST profile used MinION only. Our results indicate that GridION device has high sensitivity [88.61%; 95% CI (83.81-92.12%)] and specificity [93.18%; 95% CI (85.32-96.98%)], high positive predictive value [94.71%; 95% CI (89.99-97.27%)], moderately high negative predictive value [84.33%; 95% CI (72.02-91.84%)], and excellent DOR [107.23; 95% CI (35.15-327.15)] and AUC (0.932) in detecting MTB. Based on DOR and AUC, the MinION excelled in detecting pyrazinamide and rifampicin resistance; however, it underperformed in detecting isoniazid and ethambutol resistance. Additional studies will be needed to provide more precise estimates for MinION's sensitivity in detecting drug-resistance, as well as DOR in detecting resistance to pyrazinamide, streptomycin, and ofloxacin. Studies on detecting resistance to bedaquiline, pretomanid, and linezolid are lacking.
由结核分枝杆菌（MTB）感染引起的结核病（TB）仍然是一个重大的公共卫生威胁。纳米孔测序诊断的及时性、便携性和能力有助于早期检测和药敏试验（DST），这对有效控制结核病至关重要。本研究综述了纳米孔测序技术在检测 MTB 及其 DST 特征方面的诊断准确性的现有证据。研究人员在 PubMed、Scopus、MEDLINE、Cochrane、EMBASE、Web of Science、AIM、IMEMR、IMSEAR、LILACS、WPRO、HERDIN Plus、MedRxiv 和 BioRxiv 中进行了全面的文献检索。研究质量采用诊断准确性研究质量评估-2工具进行评估。计算了汇总灵敏度、特异性、预测值 (PV)、诊断几率比 (DOR) 和曲线下面积 (AUC)。共纳入 32 项研究，其中 13 项仅涉及 MTB 检测，15 项仅关注 DST，4 项同时研究了 MTB 检测和 DST。没有研究使用 Flongle 或 PromethION。有 7 项研究符合 MTB 检测的荟萃分析条件，5 项符合 DST 的荟萃分析条件；MTB 检测研究仅使用了 GridION，而 DST 资料研究仅使用了 MinION。我们的结果表明，GridION 设备具有较高的灵敏度[88.61%；95% CI (83.81-92.12%)]和特异性[93.18%；95% CI (85.32-96.98%)]，较高的阳性预测值[94.71%；95% CI (89.99-97.27%)]，中高阴性预测值[84.33%；95% CI (72.02-91.84%)]，在检测 MTB 方面具有极佳的 DOR [107.23；95% CI (35.15-327.15)]和 AUC (0.932)。根据 DOR 和 AUC，MinION 在检测吡嗪酰胺和利福平耐药性方面表现出色；但在检测异烟肼和乙胺丁醇耐药性方面表现不佳。还需要进行更多的研究，以便对 MinION 检测耐药性的灵敏度以及检测吡嗪酰胺、链霉素和氧氟沙星耐药性的 DOR 作出更精确的估计。目前还缺乏对贝达喹啉、普托马尼和利奈唑胺耐药性的检测研究。
{"title":"Diagnostic Accuracy of Nanopore Sequencing for Detecting Mycobacterium tuberculosis and Drug-Resistant Strains: A Systematic Review and Meta-Analysis","authors":"Timothy Hudson, David Culasino Carandang, Dianne Jaula Cunanan, Gail S. Co, John David Pilapil, Juan Ignacio Garcia, Blanca I. Restrepo, Marcel Yotebieng, Jordi B. Torrelles, K. Notarte","doi":"10.1101/2024.06.05.24308511","DOIUrl":"https://doi.org/10.1101/2024.06.05.24308511","url":null,"abstract":"Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB) infection, remains a significant public health threat. The timeliness, portability, and capacity of nanopore sequencing for diagnostics can aid in early detection and drug susceptibility testing (DST), which is crucial for effective TB control. This study synthesized current evidence on the diagnostic accuracy of the nanopore sequencing technology in detecting MTB and its DST profile. A comprehensive literature search in PubMed, Scopus, MEDLINE, Cochrane, EMBASE, Web of Science, AIM, IMEMR, IMSEAR, LILACS, WPRO, HERDIN Plus, MedRxiv, and BioRxiv was performed. Quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled sensitivity, specificity, predictive values (PV), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated. Thirty-two studies were included; 13 addressed MTB detection only, 15 focused on DST only, and 4 examined both MTB detection and DST. No study used Flongle or PromethION. Seven studies were eligible for meta-analysis on MTB detection and five for DST; studies for MTB detection used GridION only while those for DST profile used MinION only. Our results indicate that GridION device has high sensitivity [88.61%; 95% CI (83.81-92.12%)] and specificity [93.18%; 95% CI (85.32-96.98%)], high positive predictive value [94.71%; 95% CI (89.99-97.27%)], moderately high negative predictive value [84.33%; 95% CI (72.02-91.84%)], and excellent DOR [107.23; 95% CI (35.15-327.15)] and AUC (0.932) in detecting MTB. Based on DOR and AUC, the MinION excelled in detecting pyrazinamide and rifampicin resistance; however, it underperformed in detecting isoniazid and ethambutol resistance. Additional studies will be needed to provide more precise estimates for MinION's sensitivity in detecting drug-resistance, as well as DOR in detecting resistance to pyrazinamide, streptomycin, and ofloxacin. Studies on detecting resistance to bedaquiline, pretomanid, and linezolid are lacking.","PeriodicalId":506788,"journal":{"name":"medRxiv","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-06DOI: 10.1101/2024.06.05.24308524
S. Damtew, Mahari Yihdego Gidey, Fitsum Tariku Fantaye, Niguse Tadele Atianfu, T. Dejene, Kelemua Mengesha Sene, Tefamichael Awoke, Hailay Gkidan, A. Seme, S. Shiferaw
Abstract Introduction: In this era of SDG countries relatively achieving maternal and newborn health geographic coverage are moving to a new paradigm called completion of maternal and new born care continuum (MN-CoC). Measuring the influence of significant others: partner/or husband and community engagement are considered as pivotal and one of the pillar strategies to achieve of completion of MN-CoC. Unfortunately, there is a lack of policy framework for partner and/or husband involvement in pregnancy, childbirth and postnatal care and when exists there is a gap in policy and practice in developing countries context. Articulating and endorsing such policy is likely to promote husband and/or partner encouragement and support during at the enrollment to maternal and newborn care continuum (MN-CoC). Hence, quantifying the level of MN-CoC partner dynamics on antenatal care visit and/or discussion about where to deliver the index child at and identifying its correlates among a panel of six weeks postpartum women provides evidence for the policy articulation endeavor by the Federal Health Ministry of the Federal Democratic Republic of Ethiopian and developmental partners working on reproductive and maternal and newborn health care. Methods: Community based nationally representative longitudinal data collected from a panel of pregnant and six weeks postpartum women were further analyzed. A total of 2,207 six weeks postpartum women who were married and/or living a partner were included in this analysis which was adequate to yield an unbiased estimates for MN-CoC partner dynamics. Multinomial logistics regression was run to identify correlates of partner Dynamics. Results were presented in the form percentages and odds ratio with 95% Confidence Intervals. Statistical significance was declared at p-value of 0.05. Results: The proportion of partner and/or husband dynamics on MN-CoC of among six weeks postpartum women who reported that their partner and/or husband encouraged them to go to clinic for ANC and discussed with them about place of delivery for the index child was nearly 2/3 (64.67%; 62.21%, 67.04%).Besides, nearly one in 5 of them reported that their husband and/or partner did not encourage (18.2%; 16.64%, 20.33) and encouraged either of the first two MN-CoC two domains (17.08%, 15.25%, 19.10%). The region women residing, being in a polygamy marriage, contraceptive ever use history, attainment secondary/higher education and index child delivery place were found to contribute for the variation in MN-CoC partner dynamics. The finding calls up on regionally sensitive activities and efforts with public-private partnership in service provision and targeting women with polygamy which in turn empower women to control over their fertility through increasing higher education enrollment, and diversifying access to contraceptive commodities are hoped to improve MN-CoC partner dynamics. Such endeavors and interventions are hoped to facilitate the ministry and
{"title":"Partner Dynamics at Maternal and New born Continuum of Care Enrollment among a Panel of Six Weeks Postpartum Women in Ethiopia, Community based Longitudinal Study; A multinomial Logistics Regression Analysis","authors":"S. Damtew, Mahari Yihdego Gidey, Fitsum Tariku Fantaye, Niguse Tadele Atianfu, T. Dejene, Kelemua Mengesha Sene, Tefamichael Awoke, Hailay Gkidan, A. Seme, S. Shiferaw","doi":"10.1101/2024.06.05.24308524","DOIUrl":"https://doi.org/10.1101/2024.06.05.24308524","url":null,"abstract":"Abstract Introduction: In this era of SDG countries relatively achieving maternal and newborn health geographic coverage are moving to a new paradigm called completion of maternal and new born care continuum (MN-CoC). Measuring the influence of significant others: partner/or husband and community engagement are considered as pivotal and one of the pillar strategies to achieve of completion of MN-CoC. Unfortunately, there is a lack of policy framework for partner and/or husband involvement in pregnancy, childbirth and postnatal care and when exists there is a gap in policy and practice in developing countries context. Articulating and endorsing such policy is likely to promote husband and/or partner encouragement and support during at the enrollment to maternal and newborn care continuum (MN-CoC). Hence, quantifying the level of MN-CoC partner dynamics on antenatal care visit and/or discussion about where to deliver the index child at and identifying its correlates among a panel of six weeks postpartum women provides evidence for the policy articulation endeavor by the Federal Health Ministry of the Federal Democratic Republic of Ethiopian and developmental partners working on reproductive and maternal and newborn health care. Methods: Community based nationally representative longitudinal data collected from a panel of pregnant and six weeks postpartum women were further analyzed. A total of 2,207 six weeks postpartum women who were married and/or living a partner were included in this analysis which was adequate to yield an unbiased estimates for MN-CoC partner dynamics. Multinomial logistics regression was run to identify correlates of partner Dynamics. Results were presented in the form percentages and odds ratio with 95% Confidence Intervals. Statistical significance was declared at p-value of 0.05. Results: The proportion of partner and/or husband dynamics on MN-CoC of among six weeks postpartum women who reported that their partner and/or husband encouraged them to go to clinic for ANC and discussed with them about place of delivery for the index child was nearly 2/3 (64.67%; 62.21%, 67.04%).Besides, nearly one in 5 of them reported that their husband and/or partner did not encourage (18.2%; 16.64%, 20.33) and encouraged either of the first two MN-CoC two domains (17.08%, 15.25%, 19.10%). The region women residing, being in a polygamy marriage, contraceptive ever use history, attainment secondary/higher education and index child delivery place were found to contribute for the variation in MN-CoC partner dynamics. The finding calls up on regionally sensitive activities and efforts with public-private partnership in service provision and targeting women with polygamy which in turn empower women to control over their fertility through increasing higher education enrollment, and diversifying access to contraceptive commodities are hoped to improve MN-CoC partner dynamics. Such endeavors and interventions are hoped to facilitate the ministry and","PeriodicalId":506788,"journal":{"name":"medRxiv","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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