Category: Nevin Manimala

JAMA Netw Open. 2024 Oct 1;7(10):e2441499. doi: 10.1001/jamanetworkopen.2024.41499.

ABSTRACT

IMPORTANCE: Youth, parents, educators, and policymakers are concerned about the potential relationship between social media use and negative mental health outcomes, including risk for suicidal thoughts and behaviors.

OBSERVATIONS: Current research shows complex and conflicting relationships between social media use and suicide risk. A key limiting factor in clarifying these relationships is a dearth of available information on contextual factors around social media use, with most research focusing only on hours or amount of engagement. Whereas there are clear associations between some types of social media use and suicide risk, there are also many opportunities to mitigate suicide risk through social media. Several methodologic and measurement issues make research challenging. Researchers have only begun to explore how specific risk factors interact with individual vulnerabilities, how social media can be used to enhance youth well-being, and whether and under what circumstances mitigation strategies can be helpful.

CONCLUSIONS AND RELEVANCE: This overview identifies research gaps and methodological challenges that need to be addressed to guide intervention strategies and future policy relevant to youth and suicide risk.

PMID:39453651 | DOI:10.1001/jamanetworkopen.2024.41499

Technol Health Care. 2024 Sep 5. doi: 10.3233/THC-240602. Online ahead of print.

ABSTRACT

BACKGROUND: The incidence of posterior malleolus fractures in ankle fractures ranges from 7% to 44%. Studies have indicated a poorer prognosis for ankle joint function when a posterior malleolar fracture is present, underscoring the significance of active intervention for optimal postoperative ankle function recovery. Hence, the selection of treatment for such fractures holds particular importance.

OBJECTIVE: Screw fixation is a key treatment for posterior malleolus fractures (PMFs) or Haraguchi Type 1 fractures involving less than 25% of the distal tibia’s articular surface. However, the optimal screw placement direction – anteroposterior (AP) or posterior-anterior (PA) – remains debated. This meta-analysis aims to compare these two approaches for treating posterior ankle fractures, focusing on the efficacy of PA fixation.

METHODS: We searched the Cochrane Library, EMBASE, PubMed, SinoMed, and Web of Science databases from their inception to October 20, 2022. Methodological quality was assessed using the Cochrane Collaboration’s tool for assessing bias risk in randomized controlled trials (RCTs). Stata MP17 software was used to compare the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, full weight-bearing time, and fracture healing time at the last follow-up between the two fixation methods.

RESULTS: A total of 403 patients with posterior malleolar fractures from six RCTs met the inclusion criteria. The meta-analysis revealed a higher AOFAS score at the last follow-up for PA placement compared to AP placement [SMD = 0.512, 95% CI (0.244 to 0.780), z= 3.74, P< 0.001]. Postoperative full weight-bearing time and fracture healing time did not show statistically significant differences between the two groups.

CONCLUSION: PA fixation demonstrated a superior AOFAS score compared to AP fixation for posterior malleolar fractures. PA screw placement offers advantages in restoring ankle joint stability and enhancing joint function recovery post-surgery.

PMID:39453647 | DOI:10.3233/THC-240602

Hum Antibodies. 2024 Sep 23. doi: 10.3233/HAB-240036. Online ahead of print.

ABSTRACT

BACKGROUND: The autoimmune disorder known as Graves’ disease. The condition is due to the binding of thyroid-stimulating immunoglobulins to the thyrotropin receptor located on the thyroid gland. The result is an excess of thyroidal hormones. symptoms of hyperthyroidism, and the formation of diffuse goiter.

OBJECTIVES: This research intends to quantify the levels of CD40L, TSAB in people who suffer from Graves’ disease. It also aims to determine the relationship between TSAB and the duration of the disease, as well as analyze the role of CD40L as a predictive marker for Graves’ disease using medcalc Statistical Software version 16.4.3 and SAS (2018).

METHODS: In a case-control study, randomly selected 90 graves disease patients were included, the randomly selected patients were divided equally and matched into a case group who have graves disease and graves disease-free patients as a control group. For both groups whole blood sample was examined to compare for (TSAB), and (CD40L) levels determination by ELISA technique.

RESULTS: The average serum levels of CD40L showed a highly significant correlation (P value < 0.01) among the groups examined for Graves’ disease. The patient group consisted of 13 males (28.89%) and 32 females (71.11%). No significant correlation was identified between TSAB and the duration of the condition.

CONCLUSION: Thyroid stimulating antibody (TSAb) test and ultrasonography of the thyroid gland are valuable diagnostic techniques for autoimmune Graves’ disease (GD). CD40L could potentially serve as a predictive diagnostic marker for Graves’ disease. However, there is no observed link between the duration of the disease and the concentration of TSAB.

PMID:39453646 | DOI:10.3233/HAB-240036

JAMA Health Forum. 2024 Oct 4;5(10):e243669. doi: 10.1001/jamahealthforum.2024.3669.

ABSTRACT

IMPORTANCE: Research suggests the social, physical, and socioeconomic contexts of residing in segregated neighborhoods may negatively affect mental health.

OBJECTIVE: To assess the association between racial residential segregation and prenatal mental health among Asian, Black, Hispanic, and White individuals.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cross-sectional study was conducted in Kaiser Permanente Northern California (KPNC), an integrated health care delivery system. Participants included self-identified Asian, Black, Hispanic, and White pregnant individuals who attended at least 1 prenatal care visit at KPNC between January 1, 2014, and December 31, 2019. Data were analyzed from January 14, 2023, to August 15, 2024.

EXPOSURES: Racial residential segregation, defined by the local Getis-Ord Gi* statistic, was calculated in each racial and ethnic group and categorized as low (<0), medium (0-1.96), or high (>1.96). A positive Gi* statistic indicates overrepresentation (greater clustering or segregation) of the racial and ethnic group in an index census tract and neighboring tracts compared with the larger surrounding geographic area.

MAIN OUTCOMES AND MEASURES: Prenatal depression and anxiety defined by diagnoses codes documented in the electronic health record between the first day of the last menstrual period and the day prior to birth.

RESULTS: Among the 201 115 participants included in the analysis (mean [SD] age, 30.8 [5.3] years; 26.8% Asian, 6.6% Black, 28.0% Hispanic, and 38.6% White), prenatal depression and anxiety were highest in Black individuals (18.3% and 18.4%, respectively), followed by White (16.0% and 18.2%, respectively), Hispanic (13.0% and 14.4%, respectively), and Asian (5.7% and 6.4%, respectively) individuals. Asian (40.8% vs 31.1%) and Black (43.3% vs 22.6%) individuals were more likely to live in neighborhoods with high vs low segregation, while Hispanic individuals were equally likely (34.3% vs 34.7%). High compared with low segregation was associated with greater odds of prenatal depression (adjusted odds ratio [AOR], 1.25 [95% CI, 1.10-1.42]) and anxiety (AOR, 1.14 [95% CI, 1.00-1.29]) among Black individuals. High segregation was associated with lower odds of prenatal depression among Asian (AOR, 0.75 [95% CI, 0.69-0.82]), Hispanic (AOR, 0.88 [95% CI, 0.82-0.94]), and White (AOR, 0.91 [95% CI, 0.86-0.96]) individuals. Similar associations were found for anxiety among Asian (AOR, 0.80 [95% CI, 0.73-0.87]) and Hispanic (AOR, 0.88 [95% CI, 0.82-0.93]) but not White (AOR, 0.95 [95% CI, 0.90-1.00]) individuals.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, racial and ethnic residential segregation was associated with worse prenatal mental health for Black individuals but better mental health for Asian, Hispanic, and White individuals. Policies reducing segregation and its impact may improve mental health outcomes in pregnant Black individuals.

PMID:39453637 | DOI:10.1001/jamahealthforum.2024.3669

Sleep. 2024 Oct 25:zsae252. doi: 10.1093/sleep/zsae252. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: The umbrella term “Disorders of Arousal” (DoA), encompassing sleepwalking, confusional arousals, and sleep terrors, refers to parasomnias manifesting during non-rapid eye movement (NREM) sleep, commonly thought to arise from an aberrant arousal process. While previous studies have detailed EEG changes linked to DoA episodes, it remains uncertain how these alterations differ from a physiological arousal process. This study directly compared brain activity between DoA episodes and arousals associated with physiological movements (motor arousal) in individuals with DoA and healthy sleepers.

METHODS: Fifty-three adult patients with DoA (25 males, 32.2±15.5years) and 33 control subjects (14 males, 31.4±11.4years) underwent one or more home-EEG recordings. A semiparametric regression model was employed to elucidate the complex relationship between EEG activity across channels, within and across different groups, including motor arousals in DoA (n=169), parasomnia episodes in DoA (n=361), and motor arousals in healthy sleepers (n=137).

RESULTS: Parasomnia episodes and motor arousals in both groups were preceded by a diffuse increase in slow-wave activity (SWA) and beta power, and a widespread decrease in sigma power. However, motor arousals in DoA displayed lower beta and central sigma than in healthy sleepers. Within DoA patients, episodes were preceded by lower beta, frontal sigma, and higher SWA than motor arousals.

CONCLUSIONS: Our findings suggest that the arousal process is altered in DOA patients, and that specific EEG patterns are required for DOA episodes to emerge. These insights will help guide future research into the underlying circuits and objective markers of DOA.

PMID:39453616 | DOI:10.1093/sleep/zsae252

J Racial Ethn Health Disparities. 2024 Oct 25. doi: 10.1007/s40615-024-02197-5. Online ahead of print.

ABSTRACT

BACKGROUND: While the National Institutes of Health emphasize integrating sex as a biological variable into research, specific considerations of sex-related differences in pulmonary embolism (PE) mortality trends remain scarce. This study examines sex-based PE mortality trends across regional and demographic groups in the USA from 1999 to 2020.

METHODS: A retrospective analysis of National Center for Health Statistics mortality data from 1999 to 2020 was conducted. Using ICD-10 code I26, PE decedents were identified. Piecewise linear regression assessed sex-based temporal trends in PE mortality by age, race/ethnicity, and census region. Annual percentage changes and average annual percentage changes were derived using Weighted Bayesian Information Criteria. The 95% confidence intervals were estimated using the empirical quantile method.

RESULTS: From 1999 to 2020, a total of 179,273 individuals died in the USA due to PE, resulting in an age-adjusted mortality rate of 2.5 per 100,000 persons (95% CI, 2.5-2.5). While men and women exhibited comparable rates in recent time segments and across most subcategories, a higher mortality trend among males compared to females was observed among non-Hispanic White and Hispanic individuals and residents of the Western US census region. These results remained robust even after excluding data from 2020, accounting for the potential impact of the COVID-19 pandemic.

CONCLUSIONS: Our study highlights sex-based disparities in PE mortality trends in the USA from 1999 to 2020. Despite overall stable mortality rates, higher trends among males were evident in specific demographic groups and regions. These findings emphasize the importance of targeted interventions to mitigate PE-related mortality discrepancies across diverse populations.

PMID:39453605 | DOI:10.1007/s40615-024-02197-5

Dermatol Ther (Heidelb). 2024 Oct 25. doi: 10.1007/s13555-024-01293-y. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite advancements in the treatment of psoriasis (PsO), there are few head-to-head studies assessing comparative effectiveness of the newest therapies approved to treat PsO. Our objective was to assess the comparative clinical effectiveness of risankizumab and deucravacitinib in patients with moderate-to-severe PsO.

METHODS: This placebo-anchored matching-adjusted indirect comparison (MAIC) analysis utilized data from UltIMMa-1/2 risankizumab and POETYK PSO-1/2 deucravacitinib trials. Individual patient data from UltiMMA-1/2 were weighted via propensity score to match POETYK PSO-1/2 published summary data. Rate differences between risankizumab and deucravacitinib were assessed for Psoriasis Area and Severity Index (PASI) 75/90/100, the Static Physician Global Assessment (sPGA = 0 or 0/1), and the Dermatology Life Quality Index (DLQI) 0/1.

RESULTS: At 16 weeks, risankizumab-treated patients demonstrated statistically significantly higher rates of skin clearance and greater improvement in quality of life (QoL) compared to those treated with deucravacitinib. Across all outcomes, risankizumab demonstrated a lower number needed to treat compared to deucravacitinib. Limitations are potential bias due to unobserved/unmeasurable differences and limited generalizability of the results.

CONCLUSIONS: This indirect comparison demonstrates that risankizumab has higher rates of skin clearance and greater improvements in QoL than deucravacitinib. This study will help inform healthcare providers in their treatment and management strategy of PsO.

PMID:39453596 | DOI:10.1007/s13555-024-01293-y

Environ Monit Assess. 2024 Oct 25;196(11):1104. doi: 10.1007/s10661-024-13261-2.

ABSTRACT

Due to the continued increase in land use changes and changing climatic patterns in the Lake Victoria basin, understanding the impacts of these changes on the water quality of Lake Victoria is imperative for safeguarding the integrity of the freshwater ecosystem. Thus, we analyzed spatial and temporal patterns of land cover, precipitation, and water quality changes in the Lake Victoria basin between 2000 and 2022 using global satellite products. Focusing on chlorophyll-a (Chl-a) and turbidity (TUR) in Lake Victoria, we used statistical metrics (correlation coefficient, trend analysis, change budget, and intensity analysis) to understand the relationship between land use and precipitation changes in the basin with changes in Chl-a and TUR at two major pollution hotspots on the lake, i.e., Winam Gulf and Inner Murchison Bay (IMB). Results show that the Chl-a and TUR concentrations in the Winam gulf increase with increases in precipitation. Through increases in precipitation, the erosion risks are increased and transport of nutrients from land to the lake system, promoting algal growth and turbidity. In the IMB, Chl-a and TUR concentrations decrease with an increase in precipitation, possibly due to dilution, but peak during moderate rainfall. Interestingly, changes in land use and land cover (LULC) at 5-year intervals showed no substantial correlation with water quality changes at selected hotspots even though a broader LULC change analysis over the past two decades indicated a notable 300% increase in built-up areas across the Lake Victoria basin. These findings underscore the dominant influence of precipitation changes over LULC changes on the water quality of Lake Victoria for the selected hotspot areas.

PMID:39453572 | DOI:10.1007/s10661-024-13261-2

Eur Geriatr Med. 2024 Oct 25. doi: 10.1007/s41999-024-01082-y. Online ahead of print.

ABSTRACT

OBJECTIVE: This study explores the effectiveness of 3D pose estimation technology in Yi Jin Jing (a traditional Chinese exercise) interventions for sarcopenic older individuals.

DESIGN: A randomized controlled trial involving 93 participants (mean age: 71.64 ± 7.09 years; 41 males and 52 females) divided into three groups: a face-to-face offline traditional training group (OFFG), a general remote online training group (ONG), and an AI-based online remote training group (AIONG).

METHODS: Participants in each group underwent their respective training programs. The effectiveness of the interventions was measured using Appendicular Skeletal Muscle Mass Index, Grip Strength, 6-meter Walking Speed, Timed-Up-and-Go Test, and Quality of Life assessments.

RESULTS: Significant improvements were observed across all groups in ASMI, Grip Strength, 6-meter Walking Speed, TUGT, and QoL. However, there were no statistically significant differences between the groups in terms of the magnitude of these improvements. AIONG showed outcomes comparable to OFFG and ONG methods.

CONCLUSIONS: AI-based telerehabilitation with 3D pose estimation is a viable and effective alternative for remote exercise interventions. It offers precise guidance and enhances the quality of rehabilitation training, demonstrating outcomes comparable to traditional and general online methods.

PMID:39453567 | DOI:10.1007/s41999-024-01082-y

Acta Neurol Belg. 2024 Oct 25. doi: 10.1007/s13760-024-02584-z. Online ahead of print.

ABSTRACT

BACKGROUND: Findings from functional neuroimaging techniques, such as single-photon emission computed tomography (SPECT), may add useful evidence improving Frontotemporal Dementia (FTD) diagnosis. The aim of the present study was to investigate patterns of hypoperfusion in a group of patients diagnosed with the behavioral variant of FTD (bvFTD) and to explore the relationship between brain perfusion and clinical characteristics.

MATERIALS AND METHODS: Brain perfusion of 23 bvFTD patients was measured with SPECT scintigraphy in lobes and Brodmann areas (BAs) and the NeurogamTM software was used for image analysis. To assess behavioral disturbances and dementia severity, patients’ informants completed the Frontotempotal Behavioral Inventory and the Frontotemporal Dementia Rating Scale. Descriptive statistics were used for the detection of pathological hypoperfusion in lobes and selected BAs. Associations among patients’ clinical characteristics and perfusion in lobes were explored via non-parametric correlations.

RESULTS: Participants presented pathological hypoperfusion in frontal, limbic and temporal lobes. The most prominent deficit was observed in limbic lobes, where all participants showed pathological hypoperfusion. Decreased perfusion was also observed in limbic, frontal and temporal BAs. Perfusion in the left and right frontal lobe was associated with behavioral disturbances and disease severity, which was also correlated with perfusion in right limbic, left and right temporal areas.

CONCLUSION: Patterns of limbic, frontal and temporal hypopefusion were reported in the present study, along with associations between brain perfusion, behavioral disturbance and severity of dementia. Perfusion patterns can help to understand further associated brain biomarkers, contributing to early diagnosis and intervention in bvFTD.

PMID:39453559 | DOI:10.1007/s13760-024-02584-z