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BMC Public Health Jun 2024Due to the increase in the prevalence of non-communicable diseases and the Colombian demographic transition, the necessity of palliative care has arisen. This study used... (Observational Study)
Observational Study
OBJECTIVES
Due to the increase in the prevalence of non-communicable diseases and the Colombian demographic transition, the necessity of palliative care has arisen. This study used accessibility and coverage indicators to measure the geographic barriers to palliative care.
METHODS
Population-based observational study focused on urban areas and adult population from Colombia, which uses three measurements of geographic accessibility to services: a) density of palliative care services per 100,000 inhabitants, b) analysis of geographic distribution by territorial nodes of the country, and c) spatial analysis of palliative care services using Voronoi diagrams. ArcGIS Pro software was used to map services' locations and identify geographic disparities.
RESULTS
A total of 504 palliative care services were identified, of which 77% were primary health care services. The density of palliative care services in Colombia is 1.8 primary care services per 100,000 inhabitants and 0.4 specialized services per 100,000 inhabitants. The average palliative care coverage is 41%, two regions of the country have a coverage below 30%. Twenty-eight percent of the services provide care for a population greater than 50,000 inhabitants within their coverage area, exceeding the acceptable limit by international standards.
CONCLUSIONS
Palliative care services are concentrated in three main regions (Bogotá D.C., the Center, and the Caribbean) and are limited in the Orinoquia and Amazonia nodes. Density of specialized palliative care services is extremely low and there are regions without palliative services for adults with palliative needs.
Topics: Colombia; Humans; Palliative Care; Health Services Accessibility; Adult; Healthcare Disparities; Primary Health Care; Spatial Analysis
PubMed: 38907204
DOI: 10.1186/s12889-024-19132-2 -
Scientific Reports Jun 2024The applicability of the specific human IgG antibody response to Anopheles gambiae salivary Gland Protein-6 peptide 1 (gSG6-P1 salivary peptide) as a biomarker able to...
The applicability of the specific human IgG antibody response to Anopheles gambiae salivary Gland Protein-6 peptide 1 (gSG6-P1 salivary peptide) as a biomarker able to distinguish the level of exposure to mosquito bites according to seasonal variations has not yet been evaluated in Central African regions. The study aimed to provide the first reliable data on the IgG anti-gSG6-P1 response in rural area in Cameroon according to the dry- and rainy-season. Between May and December 2020, dry blood samples were collected from people living in the Bankeng village in the forest area of the Centre region of Cameroon. Malaria infection was determined by thick-blood smear microscopy and multiplex PCR. The level of IgG anti-gSG6-P1 response, was assessed by enzyme-linked immunosorbent assay. Anopheles density and aggressiveness were assessed using human landing catches. The prevalence of malaria infection remains significantly higher in the rainy season than in the dry season (77.57% vs 61.44%; p = 0.0001). The specific anti-gSG6-P1 IgG response could be detected in individuals exposed to few mosquito bites and showed inter-individual heterogeneity even when living in the same exposure area. In both seasons, the level of anti-gSG6-P1 IgG response was not significantly different between Plasmodium infected and non-infected individuals. Mosquito bites were more aggressive in the rainy season compared to the dry season (human biting rate-HBR of 15.05 b/p/n vs 1.5 b/p/n) where mosquito density was very low. Infected mosquitoes were found only during the rainy season (sporozoite rate = 10.63% and entomological inoculation rate-EIR = 1.42 ib/p/n). The level of IgG anti-gSG6-P1 response was significantly higher in the rainy season and correlated with HBR (p ˂ 0.0001). This study highlights the high heterogeneity of individual's exposure to the Anopheles gambiae s.l vector bites depending on the transmission season in the same area. These findings reinforce the usefulness of the anti-gSG6-P1 IgG response as an accurate immunological biomarker for detecting individual exposure to Anopheles gambiae s.l. bites during the low risk period of malaria transmission in rural areas and for the differentiating the level of exposure to mosquitoes.
Topics: Animals; Anopheles; Humans; Cameroon; Immunoglobulin G; Insect Bites and Stings; Female; Adult; Male; Salivary Proteins and Peptides; Rural Population; Seasons; Adolescent; Young Adult; Malaria; Middle Aged; Child; Mosquito Vectors; Child, Preschool; Insect Proteins
PubMed: 38906949
DOI: 10.1038/s41598-024-58337-8 -
Nature Communications Jun 2024CETP inhibitors are a class of lipid-lowering drugs in development for treatment of coronary heart disease (CHD). Genetic studies in East Asian ancestry have interpreted... (Comparative Study)
Comparative Study
CETP inhibitors are a class of lipid-lowering drugs in development for treatment of coronary heart disease (CHD). Genetic studies in East Asian ancestry have interpreted the lack of CETP signal with low-density lipoprotein cholesterol (LDL-C) and lack of drug target Mendelian randomization (MR) effect on CHD as evidence that CETP inhibitors might not be effective in East Asian participants. Capitalizing on recent increases in sample size of East Asian genetic studies, we conducted a drug target MR analysis, scaled to a standard deviation increase in high-density lipoprotein cholesterol. Despite finding evidence for possible neutral effects of lower CETP levels on LDL-C, systolic blood pressure and pulse pressure in East Asians (interaction p-values < 1.6 × 10), effects on cardiovascular outcomes were similarly protective in both ancestry groups. In conclusion, on-target inhibition of CETP is anticipated to decrease cardiovascular disease in individuals of both European and East Asian ancestries.
Topics: Female; Humans; Male; Middle Aged; Anticholesteremic Agents; Blood Pressure; Cardiovascular Diseases; Cholesterol Ester Transfer Proteins; Cholesterol, HDL; Cholesterol, LDL; Coronary Disease; East Asian People; Mendelian Randomization Analysis; Polymorphism, Single Nucleotide; White People
PubMed: 38906890
DOI: 10.1038/s41467-024-49109-z -
Scientific Reports Jun 2024Intergroup aggression often results in the production of public goods, such as a safe and stable social environment and a home range containing the resources required to...
Intergroup aggression often results in the production of public goods, such as a safe and stable social environment and a home range containing the resources required to survive and reproduce. We investigate temporal variation in intergroup aggression in a growing population of colobus monkeys (Colobus vellerosus) to ask a novel question: "Who stepped-up to produce these public goods when doing so became more difficult?". Both whole-group encounters and male incursions occurred more frequently as the population grew. Males and females were both more likely to participate in whole-group encounters when monopolizable food resources were available, indicating both sexes engaged in food defence. However, only females increasingly did so as the population grew, suggesting that it was females who increasingly produced the public good of home range defence as intergroup competition intensified. Females were also more active in male incursions at high population densities, suggesting they increasingly produced the public good of a safe and stable social environment. This is not to say that males were chronic free-riders when it came to maintaining public goods. Males consistently participated in the majority of intergroup interactions throughout the study period, indicating they may have lacked the capacity to invest more time and effort.
Topics: Animals; Female; Male; Aggression; Colobus; Population Growth; Competitive Behavior; Social Behavior; Behavior, Animal
PubMed: 38906888
DOI: 10.1038/s41598-024-64188-0 -
Nature Communications Jun 2024The Living Planet Index (LPI) measures the average change in population size of vertebrate species over recent decades and has been repeatedly used to assess the...
The Living Planet Index (LPI) measures the average change in population size of vertebrate species over recent decades and has been repeatedly used to assess the changing state of nature. The LPI indicates that vertebrate populations have decreased by almost 70% over the last 50 years. This is in striking contrast with current studies based on the same population time series data that show that increasing and decreasing populations are balanced on average. Here, we examine the methodological pipeline of calculating the LPI to search for the source of this discrepancy. We find that the calculation of the LPI is biased by several mathematical issues which impose an imbalance between detected increasing and decreasing trends and overestimate population declines. Rather than indicating that vertebrate populations do not substantially change, our findings imply that we need better measures for providing a balanced picture of current biodiversity changes. We also show some modifications to improve the reliability of the LPI.
Topics: Animals; Vertebrates; Population Dynamics; Biodiversity; Population Density; Bias; Earth, Planet; Ecosystem
PubMed: 38906876
DOI: 10.1038/s41467-024-49070-x -
BMJ Paediatrics Open Jun 2024Peripheral perfusion index (PPI) is useful in a variety of neonatal settings. Currently, available reference values are from small numbers and highly variable.
BACKGROUND
Peripheral perfusion index (PPI) is useful in a variety of neonatal settings. Currently, available reference values are from small numbers and highly variable.
METHODS
We sought to generate reference values of PPI by analysing previously collected data from newborns who underwent mandated universal pulse oximetry and PPI screening from 2018 to 2021 using uniform protocol and equipment. Q-Q plots and boxplots were used to visualise distributions. Kernel density estimation for heaped and rounded data was used to estimate percentiles of the distributions.
RESULTS
Data from 388 205 newborns who underwent universal pulse oximetry screening in the first week of life were used for this analysis. Pre and postductal values showed a non-normal distribution and skewed to the left, the former had a thicker tail with more extreme values. Minor, but statistically significant differences were seen in the PPI values from day 1 to 7. Median preductal PPI (2.77, IQR:1.83-3.93) was significantly higher than postductal (2.38 IQR: 1.41-3.55) (p<0.01). PPI values increased with weight and boys had higher PPI. Kernel estimates of the percentiles in the overall sample and subgroups for gender and weight have been provided for preductal and post-ductal values.
CONCLUSION
This study, based on the largest available dataset, provides reference values for PPI in newborns. A significant influence of gender and birth weight on PPI values in newborns has been identified. Future research on understanding the influence of age, sex, birth weight, gestational age, ambient temperature and genetic factors on PPI is recommended.
Topics: Humans; Infant, Newborn; Reference Values; Male; Female; Oximetry; Neonatal Screening; Perfusion Index
PubMed: 38906560
DOI: 10.1136/bmjpo-2024-002607 -
Science Advances Jun 2024Communities in resource-poor areas face health, food production, sustainability, and overall survival challenges. Consequently, they are commonly featured in global...
Communities in resource-poor areas face health, food production, sustainability, and overall survival challenges. Consequently, they are commonly featured in global debates surrounding societal collapse. Rapa Nui (Easter Island) is often used as an example of how overexploitation of limited resources resulted in a catastrophic population collapse. A vital component of this narrative is that the rapid rise and fall of pre-contact Rapanui population growth rates was driven by the construction and overexploitation of once extensive rock gardens. However, the extent of island-wide rock gardening, while key for understanding food systems and demography, must be better understood. Here, we use shortwave infrared (SWIR) satellite imagery and machine learning to generate an island-wide estimate of rock gardening and reevaluate previous population size models for Rapa Nui. We show that the extent of this agricultural infrastructure is substantially less than previously claimed and likely could not have supported the large population sizes that have been assumed.
Topics: Agriculture; Islands; Humans; Satellite Imagery; Machine Learning; Population Density; Conservation of Natural Resources
PubMed: 38905341
DOI: 10.1126/sciadv.ado1459 -
Aging Clinical and Experimental Research Jun 2024The Single Point Insulin Sensitivity Estimator (SPISE) index is a surrogate marker for insulin sensitivity. Given the emerging role of bone as an active endocrine organ,...
BACKGROUND
The Single Point Insulin Sensitivity Estimator (SPISE) index is a surrogate marker for insulin sensitivity. Given the emerging role of bone as an active endocrine organ, its associations with non-invasive measures of extra-skeletal functions such as insulin sensitivity warrant investigation.
AIMS
This study aimed to explore the relationship between the SPISE index and Bone Mineral Density (BMD) in an adult population.
METHODS
Data from a total of 1270 Arab adults (84% females, mean age 56.7 ± 8.1 years) from the Osteoporosis Registry Database of the Chair for Biomarkers of Chronic Diseases in King Saud University, Riyadh, Saudi Arabia was used in this study. T-scores and SPISE were calculated. Regression models were used to determine associations between SPISE and bone health indices.
RESULTS
The low BMD group (N = 853; T-score <-1.0) had significantly higher SPISE values than those with normal BMD (N = 417; T-score - 1.0 and above) (4.6 ± 1.3 vs. 4.3 ± 1.2, p < 0.001). Multivariate linear regression, adjusted for covariates, confirmed a significant inverse association between SPISE and BMD for all participants (β=-0.22, p < 0.001), as well as both groups [normal BMD (β = -0.10, p = 0.02) and low BMD groups (β = -0.15, p < 0.001)]. SPISE, family history of T2DM, and history of fractures collectively account for 17% of the variances perceived in T-score for all participants (p < 0.001).
CONCLUSIONS
A significant inverse association between the SPISE index and BMD was observed in adults, suggesting a link between BMD and extra-skeletal health. Underlying mechanisms need to be investigated prospectively using BMD as secondary outcomes in lifestyle modification programs.
Topics: Humans; Female; Male; Middle Aged; Bone Density; Arabs; Insulin Resistance; Saudi Arabia; Osteoporosis; Aged; Adult
PubMed: 38904881
DOI: 10.1007/s40520-024-02789-5 -
Endocrine Connections Jun 2024To create a nomogram-based model to estimate the Chinese population's 5-year risk of metabolic dysfunction-associated steatotic liver disease (MASLD).
OBJECTIVE
To create a nomogram-based model to estimate the Chinese population's 5-year risk of metabolic dysfunction-associated steatotic liver disease (MASLD).
METHODS
We randomly divided 7582 participants into two groups in a 7:3 ratio: one group was assigned to work with the training set, which consisted of 5307 cases, and the other group was assigned to validate the model using 2275 cases. The least absolute shrinkage and selection operator (LASSO) model was employed to ascertain the variables with the highest correlation among all potential variables. A logistic model was constructed by incorporating these selected variables, which were subsequently visualized using a nomogram. The discriminatory ability, calibration, and clinical utility of the model were assessed using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).
RESULTS
During the 5-year follow-up, 1034 (13.64%) total participants were newly diagnosed with MASLD. Using 8 variables (gender, body mass index, waist, hemoglobin, alanine aminotransferase, uric acid, triglycerides and high-density lipoprotein) , we built a 5-year MASLD risk prediction model. The nomogram showed an area under the ROC of 0.795 (95% confidence intervals (CI): 0.779-0.811) in the training set and 0.785 (95% CI: 0.760-0.810) in the validation set. The calibration curves revealed a 5-year period of agreement between the observed and predicted MASLD risks. DCA curves illustrated the practicality of this nomogram over threshold probability profiles ranging from 5% to 50%.
CONCLUSIONS
We created and tested a nomogram to forecast the risk of MASLD prevalence over the next 5 years.
PubMed: 38904472
DOI: 10.1530/EC-24-0186 -
IScience Jun 2024The UN (United Nations) collects global data on the country-level Percentage of Population Residing in Urban Area (PPRUA). However, variations in urban definitions make...
The UN (United Nations) collects global data on the country-level Percentage of Population Residing in Urban Area (PPRUA). However, variations in urban definitions make these data incomparable across countries. This study assesses national defined PPRUA within UN statistics against estimates we derived using global comparable definitions. Refer to the UN's Degree of Urbanization framework, we propose 90 global harmonized methods for estimating PPRUA by combining different configurations of three global population datasets, six urban total population thresholds, and five urban population density thresholds. This approach demonstrated significant variations in country-level PPRUA estimations, with wide 95% confidence intervals using the score method. Most national defined PPRUA fall between the upper 95% CI and the median of the estimations, underscoring the need for globally harmonious PPRUA estimates. This study advocates for a reassessment of datasets and thresholds in the future and for investigating urbanization on a scale beyond the country level.
PubMed: 38904069
DOI: 10.1016/j.isci.2024.110125