Communications medicine最新文献

{"title":"The use of SatScan software to map spatiotemporal trends and detect disease clusters: a systematic review.","authors":"Ahmed Taha Aboushady, Fatma Mansour, Moustafa El Maghraby, Bárbara Teixeira, Sandra Cunha, Maria Manuel Dantas, Ahmed Nawwar, Amira Hegazy, José Chen-Xu","doi":"10.1038/s43856-024-00699-1","DOIUrl":"10.1038/s43856-024-00699-1","url":null,"abstract":"<p><strong>Background: </strong>Low and Middle-Income Countries (LMICs) often experience a disproportionate burden in health issues. One public health, epidemiology, and spatial statistics software tool has emerged as a stalwart for detecting disease clusters, mapping spatiotemporal trends, and analyzing health-related data-SatScan.</p><p><strong>Methods: </strong>This systematic review aims to provide a comprehensive overview of the extent of the use of spatiotemporal analysis, namely the use of SatScan for understanding health inequalities within LMICs within space and time parameters, shedding light on its potential to inform evidence-based public health interventions and policies. A systematic search was conducted in six electronic databases: PubMed, ScienceDirect, Web of Science, Cochrane, Scopus, and Embase. It included all human health-related articles, looking into data from LMICs. A descriptive analysis and quality assessment of the articles was performed.</p><p><strong>Results: </strong>Out of 5215 articles from different databases, 719 are included. Over 516 articles include themes on communicable diseases and over 50% of the articles come from China, Ethiopia, and Brazil. The Poisson-based model is the most commonly used model type, and more than 85% use secondary data sources, with the Demographic Health Surveys datasets being the most used.</p><p><strong>Conclusions: </strong>This systematic review allows us to understand which areas have been studied and which LMICs have developed research. This helps us detect health issues that have been neglected and the countries which require additional resources to increase their research capacities in this domain.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"82"},"PeriodicalIF":5.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformers and large language models are efficient feature extractors for electronic health record studies.","authors":"Kevin Yuan, Chang Ho Yoon, Qingze Gu, Henry Munby, A Sarah Walker, Tingting Zhu, David W Eyre","doi":"10.1038/s43856-025-00790-1","DOIUrl":"10.1038/s43856-025-00790-1","url":null,"abstract":"<p><strong>Background: </strong>Free-text data is abundant in electronic health records, but challenges in accurate and scalable information extraction mean less specific clinical codes are often used instead.</p><p><strong>Methods: </strong>We evaluated the efficacy of feature extraction using modern natural language processing methods (NLP) and large language models (LLMs) on 938,150 hospital antibiotic prescriptions from Oxfordshire, UK. Specifically, we investigated inferring the type(s) of infection from a free-text \"indication\" field, where clinicians state the reason for prescribing antibiotics. Clinical researchers labelled a subset of the 4000 most frequent unique indications (representing 692,310 prescriptions) into 11 categories describing the infection source or clinical syndrome. Various models were then trained to determine the binary presence/absence of these infection types and also any uncertainty expressed by clinicians.</p><p><strong>Results: </strong>We show on separate internal (n = 2000 prescriptions) and external test datasets (n = 2000 prescriptions), a fine-tuned domain-specific Bio+Clinical BERT model performs best across the 11 categories (average F1 score 0.97 and 0.98 respectively) and outperforms traditional regular expression (F1 = 0.71 and 0.74) and n-grams/XGBoost (F1 = 0.86 and 0.84) models. A zero-shot OpenAI GPT4 model matches the performance of traditional NLP models without the need for labelled training data (F1 = 0.71 and 0.86) and a fine-tuned GPT3.5 model achieves similar performance to the fine-tuned BERT-based model (F1 = 0.95 and 0.97). Infection sources obtained from free-text indications reveal specific infection sources 31% more often than ICD-10 codes.</p><p><strong>Conclusions: </strong>Modern transformer-based models have the potential to be used widely throughout medicine to extract information from structured free-text records, to facilitate better research and patient care.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"83"},"PeriodicalIF":5.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"H105A peptide eye drops promote photoreceptor survival in murine and human models of retinal degeneration.","authors":"Alexandra Bernardo-Colón, Andrea Bighinati, Shama Parween, Subrata Debnath, Ilaria Piano, Elisa Adani, Francesca Corsi, Claudia Gargini, Natalia Vergara, Valeria Marigo, S Patricia Becerra","doi":"10.1038/s43856-025-00789-8","DOIUrl":"10.1038/s43856-025-00789-8","url":null,"abstract":"<p><strong>Background: </strong>Photoreceptor death leads to inherited blinding retinal diseases, such as retinitis pigmentosa (RP). As disease progression often outpaces therapeutic advances, developing effective treatments is urgent. This study evaluates the efficacy of small peptides derived from pigment epithelium-derived factor (PEDF), which are known to restrict common cell death pathways associated with retinal diseases.</p><p><strong>Methods: </strong>We tested chemically synthesized peptides (17-mer and H105A) with affinity for the PEDF receptor, PEDF-R, delivered as eye drops to two RP mouse models: rd10 (phosphodiesterase 6b mutation) and Rho^P23H/+ (rhodopsin P23H mutation). Additionally, we engineered AAV-H105A vectors for intravitreal delivery in Rho^P23H/+ mice. To assess peptide effects in human tissue, we used retinal organoids exposed to cigarette smoke extract, a model of oxidative stress. Photoreceptor survival, morphology and function were evaluated.</p><p><strong>Results: </strong>Here we show that peptides 17-mer and H105A delivered via eye drops successfully reach the retina, promote photoreceptor survival, and improve retinal function in both RP mouse models. Intravitreal delivery of a AAV-H105A vector delays photoreceptor degeneration in Rho^P23H/+ mice up to six months. In human retinal organoids, peptide H105A specifically prevents photoreceptor death induced by oxidative stress, a contributing factor to RP progression.</p><p><strong>Conclusions: </strong>PEDF peptide-based eye drops offer a promising, minimally invasive therapy to prevent photoreceptor degeneration in retinal disorders, with a favorable safety profile.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"81"},"PeriodicalIF":5.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The unprecedented Paxlovid journey from milligrams to millions of patient doses during the Covid-19 pandemic.","authors":"Weili Yu, Mahesh K Krishnan, Matt Weekly, Ravi M Shanker, Pankaj Doshi, John A Ragan, Robert A Greene, Brett Gampper, Stéphane Caron, Andrew McKillop, John Ludwig, Mikael Dolsten","doi":"10.1038/s43856-025-00798-7","DOIUrl":"10.1038/s43856-025-00798-7","url":null,"abstract":"","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"80"},"PeriodicalIF":5.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acquired resistance to immune checkpoint therapy is caused by glycoprotein non-metastatic melanoma protein B signal cascade.","authors":"Jin-Sung Chung, Vijay Ramani, Lei Guo, Vinita Popat, Ponciano D Cruz, Lin Xu, Hans Hammers, Kiyoshi Ariizumi","doi":"10.1038/s43856-025-00786-x","DOIUrl":"10.1038/s43856-025-00786-x","url":null,"abstract":"<p><strong>Background: </strong>Acquired resistance (AR) is a major limitation of immune checkpoint inhibitor (ICI) therapy when treating renal cell carcinoma (RCC). Understanding who will get AR is currently unknown. We hypothesized the T-cell-inhibitory glycoprotein non-metastatic melanoma protein B (GPNMB) to be a prognostic marker for patients with AR.</p><p><strong>Methods: </strong>Alongside other markers, GPNMB was measured in the blood of RCC patients (n = 39) several times after starting ICI treatment and analyzed for association with Response Evaluation Criteria in Solid Tumors (RECIST) tumor response. To better understand the role of GPNMB in AR, we created an ICI-resistant RenCa mouse kidney cancer model by repeatedly selecting the largest tumors that grew in ICI-treated mice.</p><p><strong>Results: </strong>Here we show that among patients who positively respond to ICI, a subset of patients (n = 9) acquire resistance within 2 years that coincides with an increase in serum GPNMB. Our mouse model recapitulates this elevation in GPNMB at the onset of AR which is triggered by cytoplasmic motif signaling via the Programmed cell death ligand 1 (PDL1) receptor that is known to protect tumors from Interferon-gamma (IFN-γ) cytotoxicity. This PDL1-induced signal leads to upregulation of the SRY-box transcription factor 10 (SOX10), dysregulation of the microphthalmia-associated transcription factor (MITF) pathway, and overexpression of GPNMB. Indeed, activation of SOX10-MITF signaling is present in plasma cell-free RNA from RCC patients who develop AR.</p><p><strong>Conclusions: </strong>Elevation of the SOX10-MITF-GPNMB signal cascade via the PDL1 receptor leads to AR. Therefore, GPNMB can be both a prognosticator of and a potential treatment target for overcoming AR to ICI treatment in RCC.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"79"},"PeriodicalIF":5.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Titanium micro-particles are commonly found in soft tissues surrounding dental implants.","authors":"Carlotta Dionigi, Gyula Nagy, Jan Derks, Yuki Ichioka, Cristiano Tomasi, Lena Larsson, Daniel Primetzhofer, Tord Berglundh","doi":"10.1038/s43856-025-00756-3","DOIUrl":"10.1038/s43856-025-00756-3","url":null,"abstract":"<p><strong>Background: </strong>Dental implants are one of the most frequently used medical devices for therapeutic purposes in dentistry. Peri-implantitis is a severe, microbial biofilm-associated condition, characterized by inflammation in peri-implant soft tissues and destruction of supporting bone. It has been suggested that metal particles originating from the implant may influence the local host response to microbial biofilms.</p><p><strong>Methods: </strong>Soft tissue biopsies were collected from implant sites with and without peri-implantitis in 21 patients. Micro Proton-induced X-ray Emission (µ-PIXE) analysis was used to localize, quantify and characterize titanium micro-particles within tissues. RNA sequencing was performed to evaluate potential associations between titanium micro-particles and gene expression profiles in peri-implantitis lesions.</p><p><strong>Results: </strong>Titanium micro-particles are consistent findings in soft tissues surrounding dental implants. Their occurrence varies across patients but not between sites with and without peri-implantitis within the same individual. Most particles reside in a 2-mm wide tissue portion close to the implant/tissue interface. The time in function of the implants does not influence the volumetric density of titanium micro-particles, while implant systems do. Fourteen differentially expressed genes are identified when comparing peri-implantitis samples with high and low densities of titanium micro-particles. The gene-set enrichment analysis reveals functions related to the regulation of the immune response and epithelial development.</p><p><strong>Conclusions: </strong>The present results indicate that titanium micro-particles are commonly found in tissues surrounding dental implants and are not associated with the occurrence of peri-implantitis.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"78"},"PeriodicalIF":5.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility and cost-effectiveness of LiverMultiScan for MASLD diagnosis: a real-world multi-national randomised clinical trial.","authors":"Elizabeth Shumbayawonda, Marika French, Jane Elizabeth Carolan, Cayden Beyer, Paula Lorgelly, Dimitar Tonev, Rajarshi Banerjee, Michael H Miller, Christopher D Byrne, Janisha Patel, Saima Ajaz, Kosh Agarwal, Johanna Backhus, Minneke J Coenraad, Jelte J Schaapman, Andrew Fraser, Miguel Castelo Branco, Stephen Barclay, Matthias M Dollinger, Daniel J Cuthbertson, Daniel Forton, Hildo J Lamb","doi":"10.1038/s43856-025-00796-9","DOIUrl":"10.1038/s43856-025-00796-9","url":null,"abstract":"<p><strong>Background: </strong>Increasing prevalence of metabolic dysfunction-associated liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) poses a growing healthcare burden. Noninvasive diagnostic tools to replace liver biopsy are urgently needed. We investigated the utility and cost-effectiveness of including multiparametric magnetic resonance imaging (mpMRI) to the management of adults with suspected MASLD multi-nationally.</p><p><strong>Methods: </strong>RADIcAL-1, a 1:1 randomised controlled trial (standard-of-care [SoC] vs. imaging arm [IA; SoC+mpMRI]) included 802 participants from Germany, Netherlands, Portugal and UK. Wilcoxon-rank tests were used to compare access to healthcare practitioners, patient assessments and proportion of patients with a diagnosis (%diagnosis). Liver fat and disease activity (corrected T1 [cT1]) were used to identify patients not requiring biopsy in the imaging arm. Primary endpoint was mpMRI cost-effectiveness and improvement in resource use (visits avoided) using mpMRI.</p><p><strong>Results: </strong>mpMRI is cost-effective with an ICER of €4968/QALY gained. 403 were randomised to IA and 399 to SoC. SoC has significantly more specialist appointments (p = 0.015) and patient assessments (p < 0.001). Across all involved hospitals, %diagnosis is significantly higher in the imaging arm (p = 0.0012). cT1 correctly classifies 50% of patients without MASH with fibrosis and can avoid biopsy. Including all costs, the imaging arm incurs higher short-term per-patient healthcare expenditure compared to the SoC arm (€1,300 vs. €830).</p><p><strong>Conclusion: </strong>Adding mpMRI to SoC for the management of adults with suspected MASLD multi-nationally is cost-effective, enhances rate of diagnosis multi-nationally and increases rate of diagnosis without increasing other liver-related health care resource use. Due to the need for standardisation of SoC, widespread use can support optimisation of the MASLD clinical pathway and improve long-term patient management.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"74"},"PeriodicalIF":5.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying and ranking non-traditional risk factors for cardiovascular disease prediction in people with type 2 diabetes.","authors":"Katarzyna Dziopa, Nishi Chaturvedi, Folkert W Asselbergs, Amand F Schmidt","doi":"10.1038/s43856-025-00785-y","DOIUrl":"10.1038/s43856-025-00785-y","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) prediction models perform poorly in people with type 2 diabetes (T2DM). We aimed to identify potentially non-traditional CVD predictors for six facets of CVD (including coronary heart disease, ischemic stroke, heart failure, and atrial fibrillation) in people with T2DM.</p><p><strong>Methods: </strong>We analysed data on 600+ features from the UK Biobank, stratified by history of CVD and T2DM: 459,142 participants without diabetes or CVD, 14,610 with diabetes but without CVD, and 4432 with diabetes and CVD. A penalised generalized linear model with a binomial distribution was used to identify CVD-related features. Subsequently, a 20% hold-out set was used to replicate identified features and provide an importance based ranking.</p><p><strong>Results: </strong>Here we show that non-traditional risk factors are of particular importance in people with diabetes. Classical CVD risk factors (e.g. family history, high blood pressure) rank highly in people without diabetes. For individuals with T2DM but no CVD, top predictors include cystatin C, self-reported health satisfaction, biochemical measures of ill health. In people with diabetes and CVD, key predictors are self-reported ill health and blood cell counts. Unique diabetes-related risk factors include dietary patterns, mental health and biochemistry measures (e.g. oestradiol, rheumatoid factor). Adding these features improves risk stratification; per 1000 people with diabetes, 133 CVD and 165 HF cases receive a higher risk.</p><p><strong>Conclusions: </strong>This study identifies numerous replicated non-traditional CVD risk factors for people with T2DM, providing insight to improve guideline recommended risk prediction models which currently overlook these features.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"77"},"PeriodicalIF":5.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting the retinoid signaling pathway with YCT-529 for effective and reversible oral contraception in mice and primates.","authors":"Nadja Mannowetz, Sanny S W Chung, Soma Maitra, Md Abdullah Al Noman, Henry L Wong, Narsihmulu Cheryala, Akash Bakshi, Debra J Wolgemuth, Gunda I Georg","doi":"10.1038/s43856-025-00752-7","DOIUrl":"10.1038/s43856-025-00752-7","url":null,"abstract":"<p><strong>Background: </strong>The retinoic acid receptor alpha (Rarα) has been validated as a male contraceptive target by genetic knockouts resulting in male sterility. The effects on spermatogenesis in the absence of RARα resemble the loss of RAR signaling in vitamin A deficiency, and the mice are otherwise normal. The effects on spermatogenesis in animals treated orally with the dual RARα/RARγ antagonist BMS-189453 closely phenocopies the absence of RARα function. Notably, the resulting male sterility is reversible. We, therefore, wished to identify RARα-selective inhibitors for potential male non-hormonal contraception.</p><p><strong>Methods: </strong>YCT-529 was investigated for RARα selective inhibition, physicochemical characteristics, oral bioavailability, and pharmacokinetic properties in mice and non-human primates. It was assessed in mouse mating trials to determine the most effective dosing regimen to induce infertility in male mice and in male non-human primates to reduce sperm levels.</p><p><strong>Results: </strong>Characterization of YCT-529 shows suitable biochemical, physicochemical, and pharmacokinetic properties for in vivo testing. YCT-529 inhibits mouse fertility of male mice within 4 weeks of oral administration, correlating with disrupted spermatogenesis demonstrating specific inhibition of the RARα pathway. Within 6 weeks after cessation of dosing, mouse fertility reverses. Furthermore, YCT-529 inhibits sperm production in a non-human primate model within 2 weeks of oral dosing without adverse side effects. Within 10-15 weeks after cessation of dosing, non-human primates' sperm counts fully reverses.</p><p><strong>Conclusions: </strong>These results lay the groundwork for evaluating YCT-529 in human clinical trials.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"68"},"PeriodicalIF":5.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age- and vaccination status-dependent isolation guidelines based on simulation of SARS-CoV-2 Delta cases in Singapore.","authors":"Keisuke Ejima, Marco Ajelli, Ananya Singh, Hoong Kai Chua, Luis Ponce, Yuqian Wang, Yong Dam Jeong, Shingo Iwami, Kenji Shibuya, Kiyosu Taniguchi, Norio Ohmagari, Po Ying Chia, Sean W X Ong, Kelvin Bryan Tan, David Chien Lye, Barnaby E Young","doi":"10.1038/s43856-025-00797-8","DOIUrl":"10.1038/s43856-025-00797-8","url":null,"abstract":"<p><strong>Background: </strong>In the absence of effective pharmaceutical interventions early in an infectious disease outbreak, non-pharmaceutical measures, especially isolating infected individuals, critically limit its impact. The ongoing COVID-19 pandemic has sparked debates on optimal isolation guidelines. This study proposes a variable isolation period approach (variable-period approach), tailoring isolation durations for distinct population groups with varied viral load dynamics.</p><p><strong>Methods: </strong>To compare our variable-period approach with a fixed-period strategy, we developed a simulation model generating synthetic longitudinal SARS-CoV-2 viral load data. The data was generated from the viral dynamics model parameterized using SARS-CoV-2 Delta patient data in Singapore, accounting for age and vaccination status.</p><p><strong>Results: </strong>Findings show that age and vaccination status significantly influence viral dynamics, with younger age and vaccination linked to shorter viral shedding durations. The variable-period framework suggests longer isolation lengths for older and unvaccinated individuals. By setting the leaking risk (risk of remaining infectious at the end of isolation) below 10%, the optimal fixed-period isolation is 14 days, with an average excess isolation burden of 7.4 unnecessary days. In contrast, the variable-period guideline reduces the excess isolation burden to 6.0 days, with the optimal isolation periods ranging from 9 to 16 days, depending on the population group. We confirmed similar results when we used the effective reproduction number as an alternative to the leaking risk.</p><p><strong>Conclusions: </strong>In this case, study using the SARS-CoV-2 Delta variant, our analysis demonstrates that unnecessary time spent in isolation can be reduced by adopting variable-period guidelines based on patient characteristics.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"76"},"PeriodicalIF":5.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}