Category: Nevin Manimala

J Dev Behav Pediatr. 2024 Sep-Oct 01;45(5):e422-e430. doi: 10.1097/DBP.0000000000001306. Epub 2024 Aug 13.

ABSTRACT

OBJECTIVE: An expert commission has proposed the term “profound” autism for children on the spectrum who are minimally verbal or nonverbal and have intellectual disability (ID), behavioral challenges, and co-occurring conditions. It is unknown whether parents’ rating of “severe” autism aligns with the definition of “profound” autism. Using the National Survey of Children’s Health, we sought to (1) estimate the prevalence of parent-reported severe autism, (2) identify child characteristics that are associated with severe autism, (3) compare health care utilization, and (4) compare caregiver stress and resilience between families of children with severe versus mild/moderate autism.

METHODS: Parent responses on the 2018 to 2019 NSCH were used to compare school-age children with parent-reported severe autism and those with mild/moderate autism. Descriptive statistics, χ 2 tests, and logistic regression were used for statistical analysis.

RESULTS: Among parents of 1,368 US children with autism, 10.1% characterized their child’s autism as severe, a prevalence of 1 in 333. Parents of children with severe autism were more likely to report ID (45% vs 12.1%, p < 0.001), language delay (88% vs 58.7%, p < 0.001), and difficulties in dressing and bathing (67% vs 19.2%, p < 0.001). Children with severe autism had more behavioral problems and co-occurring conditions but were no more likely to see specialists or receive autism-specific behavioral therapy. Their caregivers reported more stress and less resilience.

CONCLUSION: The characteristics of “profound” autism and parent-reported “severe” autism significantly overlap, allowing the use of the NSCH for studies of this vulnerable population. Children with profound/severe autism could benefit from more behavioral therapy, specialty care, and family support.

PMID:39413304 | DOI:10.1097/DBP.0000000000001306

J Orthop Trauma. 2024 Oct 15. doi: 10.1097/BOT.0000000000002927. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study was to investigate whether HWR after Lisfranc ORIF resulted in significant impact via PROMIS physical function (PF) and pain intensity (PI) scores.

METHODS: Design: Retrospective cohort.

SETTING: Level-1 trauma center.

PATIENT SELECTION CRITERIA: Adult patients with isolated Lisfranc injuries who were treated via ORIF between 2002-2023 that had PROMIS PF and PI scores through 6 months follow-up were included. Patients were excluded if they received index treatment other than ORIF or underwent secondary surgical intervention prior to HWR. A sub analysis was performed at 1 year follow- up.

OUTCOME MEASURES AND COMPARISONS: Primary outcomes were PROMIS PF and PI scores. The Wilcoxon signed-rank test compared differences between PROMIS scores within the HWR group. The Wilcoxon ranked-sum test compared differences between HWR vs no HWR. Distributive MCID was calculated using the 0.5 SD method.

RESULTS: There were 482 patients (489 feet) identified with isolated Lisfranc injuries. Seventy-seven feet underwent ORIF followed by HWR. Thirty feet underwent ORIF without HWR. The average age of the no HWR group was 45.8 (18.0-81.3) versus the HWR group which was 38.7 (18.3-74.1) (p=0.053). Nineteen (63.3%) were female in the no HWR group compared to 33 (42.9%) in the HWR group (p=0.084). HWR occurred an average of 4.43 months after ORIF. Patients who underwent HWR had a statistically significant increase in average PF scores (39.7 to 45.9, p<0.001) at their standard 6 week (1.5 month) postoperative visit. HWR patients had a non-significant decrease in average PI scores (56.5 to 53.9, p=0.24). Compared to those with retained hardware, the HWR group demonstrated a statistically significant net improvement in PF and PI scores from surgery, with an average improvement of 5.6 and 1.7, respectively (P=0.002, 0.008).

CONCLUSIONS: Patients experienced significant improvement in PROMIS PF scores for Lisfranc ORIF at 6 weeks after HWR. Compared to patients with retained hardware, they also experienced significant improvement in PROMIS PF and PI scores.

LEVEL OF EVIDENCE: III.

PMID:39413293 | DOI:10.1097/BOT.0000000000002927

MSMR. 2024 Sep 20;31(9):12-15.

ABSTRACT

This study aimed to determine the incidence of hair loss among U.S. active component service women, describe the types of hair loss, and summarize potential racial and ethnic disparities of hair loss among service women over the last 12 years. Estimates of traction alopecia among service members have been difficult, as there are no specific diagnosis codes for traction alopecia in the International Classification of Diseases, 9th and 10th revisions (ICD-9/ICD-10). A prior study on the prevalence of alopecia among female active component service women between 2010 and 2019 reported that 2.7% had traction alopecia diagnoses. That estimate may not be accurate, as the previous study used the ICD-9 code 704.01 (alopecia areata) and ICD-10 code Q84.0 (congenital alopecia), which are not fully representative of traction alopecia cases in administrative health records. This study used ICD-9/ICD-10 diagnostic codes 704.0 (ICD-9), L63, L64, L65, and L66 (ICD-10) to define cases of alopecia. The study population included female active component service members in the U.S. Army, Navy, Air Force, and Marine Corps between January 1, 2010 and December 31, 2022. The overall incidence rate of alopecia was 804.4 per 100,000 person-years. Non-Hispanic Black and Hispanic female active component service members had the highest incidence rates among all races and ethnicities, at 1,138.7 and 1,013.6 per 100,000 person-years, respectively. Non-Hispanic Black female active component service members were more than twice as likely to be diagnosed with alopecia compared to non-Hispanic White female active component service members.

PMID:39413275

Cancer Control. 2024 Jan-Dec;31:10732748241293640. doi: 10.1177/10732748241293640.

ABSTRACT

BACKGROUND: This case-control study investigated the relationship between sleep duration and quality with the occurrence of breast cancer among women, both pre- and post-menopausal, in the northwest Khyber Pakhtunkhwa (KP) region of Pakistan.

METHOD: This case-control research was carried in multiple tertiary care facilities. Newly diagnosed primary breast cancer patients were recruited as cases (n = 408), and 5+ years age-matched controls (n = 408) were randomly selected from the general population. Participants completed a Pittsburg sleeping quality index (PSQI) questionnaire that included questions on sleep characteristics. Statistical analysis included independent t-tests to compare mean sleep durations and quality scores between groups, and logistic regression to adjust for potential confounders.

RESULTS: Sleep onset latency between cases and controls was not significantly associated with health outcomes, with a P-value of .142. However, sleep duration showed a significant association (P = .049). For sleep duration, the adjusted odds ratio for ≤6 h was 1.02 (95% CI: .5-2.1), while for 7-8 h the adjusted odds ratio was 1.0 (95% CI: .6-1.6). Self-reported sleep quality did not demonstrate significant associations, with the P-value for “very good” sleep quality being .561. Sleep duration of less than 6 h among women with triple-negative breast cancer (TNBC) was found to be strongly associated with a more aggressive type of breast cancer, with an adjusted odds ratio of 1.5 (95% CI: 1.02-2.3, P < .05).

CONCLUSION: This study does not provide evidence to support an association between sleep duration or quality and the risk of breast cancer. However, it reports a significant association, with shorter sleep durations linked to an increased risk particularly in the context of aggressive breast cancer types such as TNBC.

PMID:39413266 | DOI:10.1177/10732748241293640

Chaos. 2024 Oct 1;34(10):103126. doi: 10.1063/5.0212322.

ABSTRACT

This study presents a modified stochastic diffusion particle tracking model (MSDPTM) that incorporates energy cascade theory to more accurately simulate suspended sediment transport. The impact of turbulent eddies on sediment particles is an intermittent process, which is also considered in this study. The study examines the time correlation between eddies using eddy turnover time and finds that closer-scale eddies exhibit higher correlations than those farther apart. The statistical properties of particle movement, such as the ensemble mean and variance of particle trajectories, have been calculated and compared with the stochastic diffusion particle tracking model (SDPTM) results. Notably, MSDPTM with intermittency demonstrates a significantly larger ensemble mean of particle trajectories in the streamwise direction than other particle tracking models. The proposed model is validated through comparison with available data, showing its enhanced performance. The results of the simulation indicate that MSDPTM outperforms SDPTM, especially when the intermittency effect of eddies is considered.

PMID:39413263 | DOI:10.1063/5.0212322

Chaos. 2024 Oct 1;34(10):101102. doi: 10.1063/5.0238827.

ABSTRACT

Understanding how species interactions shape biodiversity is a core challenge in ecology. While much focus has been on long-term stability, there is rising interest in transient dynamics-the short-lived periods when ecosystems respond to disturbances and adjust toward stability. These transitions are crucial for predicting ecosystem reactions and guiding effective conservation. Our study introduces a model that uses convex combinations to blend pairwise and higher-order interactions (HOIs), offering a more realistic view of natural ecosystems. We find that pairwise interactions slow the journey to stability, while HOIs speed it up. Employing global stability analysis and numerical simulations, we establish that as the proportion of HOIs increases, mean transient times exhibit a significant reduction, thereby underscoring the essential role of HOIs in enhancing biodiversity stabilization. Our results reveal a robust correlation between the most negative real part of the eigenvalues of the Jacobian matrix associated with the linearized system at the coexistence equilibrium and the mean transient times. This indicates that a more negative leading eigenvalue correlates with accelerated convergence to stable coexistence abundances. This insight is vital for comprehending ecosystem resilience and recovery, emphasizing the key role of HOIs in promoting stabilization. Amid growing interest in transient dynamics and its implications for biodiversity and ecological stability, our study enhances the understanding of how species interactions affect both transient and long-term ecosystem behavior. By addressing a critical gap in ecological theory and offering a practical framework for ecosystem management, our work advances knowledge of transient dynamics, ultimately informing effective conservation strategies.

PMID:39413260 | DOI:10.1063/5.0238827

MSMR. 2024 Sep 20;31(9):7-11.

ABSTRACT

In May 2022, cases of mpox emerged beyond its historically endemic parts of Central and West Africa, primarily affecting men who have sex with men (MSM), and spreading via sexual networks. During this global outbreak the novel clinical and epidemiological characteristics of mpox disease were thoroughly documented in civilian populations but comparable data have not been reported for Military Health System (MHS) populations including beneficiaries. MHS cases were identified through a variety of data sources, including the Disease Reporting System internet (DRSi) and a customized query of ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) encounter codes. Contemporaneous chart reviews of patients’ electronic health records in the Armed Forces Health Longitudinal Technology Application (AHLTA) and MHS GENESIS were performed to characterize cases. A total of 146 confirmed and probable MHS cases were identified from May 2022 through April 2024. Most cases occurred among MSM, with the majority developing classic prodromal symptoms and some experiencing anogenital and urinary symptoms.

PMID:39413256

JMIR Form Res. 2024 Sep 23. doi: 10.2196/52871. Online ahead of print.

ABSTRACT

BACKGROUND: Before the COVID-19 pandemic, it was already recognized that internet-based misinformation and disinformation could influence individuals to refuse or delay vaccination for themselves, their families, or their child(ren). Reinformation, which refers to hyperpartisan and ideologically biased content, can propagate polarizing messages on vaccines, thereby contributing to vaccine hesitancy even if it is not outright disinformation.

OBJECTIVE: This study aimed to evaluate the impact of online reinformation on vaccine hesitancy. Specifically, our goal was to investigate how misinformation presented in the style and layout of a news article could influence the perceived tentativeness (credibility) of COVID-19 vaccine information and confidence in COVID-19 vaccination.

METHODS: We conducted a web-based randomized controlled trial (RCT) by recruiting English-speaking Canadians aged 18 years and above from across Canada through the Qualtrics paid opt-in panel system. Participants were randomly assigned to one of four distinct versions of a news article on COVID-19 vaccines, each featuring variations in writing style and presentation layout. After reading the news article, participants self-assessed the tentativeness of the information provided, their confidence in COVID-19 vaccines, and their attitude toward vaccination in general.

RESULTS: The survey included 537 participants, with 12 excluded for not meeting the task completion time. The final sample comprised 525 participants distributed about equally across the four news article versions. Chi-square (χ2) analyses revealed a statistically significant association between general attitude toward vaccination and the perceived tentativeness of the information about COVID-19 vaccines included in the news article (χ21 = 37.79, P<.0001). The effect size was small to moderate, with Cramer’s V = 0.27. An interaction was found between vaccine attitude and writing style (χ²₁ = 6.17, P= 0.01), with a small effect size, Cramer’s V = 0.11. Additionally, a Pearson correlation revealed a significant moderate-to-strong correlation between perceived tentativeness and confidence in COVID-19 vaccination, r(523) = .48, P<.0001. The coefficient of determination (r²) was 0.23, indicating that 23% of the variance in perceived tentativeness was explained by confidence in COVID-19 vaccines. In comparing participants exposed to a journalistic-style news article with those exposed to an ideologically biased article, Cohen’s d was calculated to be 0.38, indicating a small to medium effect size for the difference in the perceived tentativeness between these groups.

CONCLUSIONS: Exposure to an online news article conveying misinformation may not be sufficient to change an individual’s level of vaccine hesitancy. The study reveals that the predominant factor in shaping individuals’ perception of COVID-19 vaccines is their attitude toward vaccination in general. This attitude also moderates the influence of writing style on perceived tentativeness; the stronger one’s opposition to vaccines, the less pronounced the impact of writing style on perceived tentativeness.

CLINICALTRIAL: The study was part of a broader initiative with a registered protocol. The protocol was recorded on October 17, 2022, under the International Registered Report Identifier (IRRID): DERR1-10.2196/41012.

INTERNATIONAL REGISTERED REPORT: RR2-10.2196/41012.

PMID:39413215 | DOI:10.2196/52871

Natl Vital Stat Rep. 2024 Jul 24;(6). doi: 10.15620/cdc/157007.

ABSTRACT

OBJECTIVES: This study examines trends in the numbers, percentages, and rates of first and second and higher-order births to teenagers younger than age 20 and for those ages 15-17 and 18-19 by race and Hispanic origin.

METHODS: Data for this analysis are from the National Vital Statistics System birth data files from 2000 and 2022. Analyses are limited to births to females younger than age 20. Changes in the numbers, percentages, and rates of total, first, and second and higher-order teen births from 2000 to 2022 were calculated for all teenagers and for non-Hispanic American Indian and Alaska Native, non-Hispanic Black, non-Hispanic White, and Hispanic teenagers.

RESULTS: The number of first teen births declined 67% and the number of second and higher-order teen births declined 79%, while the population of female teenagers increased 7% from 2000 to 2022. The declines were greater for younger teenagers compared with older teenagers. First and second and higher-order teen birth rates declined 69% and 80%, respectively. Similar declines were found for each race and Hispanic-origin group. In 2000 and 2022, first and second and higher-order birth rates were lowest among White teenagers. First birth rates were highest among Hispanic teenagers in 2000 and for Hispanic and non-Hispanic American Indian and Alaska Native teenagers in 2022. In 2000, second and higher-order birth rates were highest for non-Hispanic Black and Hispanic teenagers; second and higher-order birth rates were more similar by race and Hispanic-origin group in 2022.

PMID:39412875 | DOI:10.15620/cdc/157007

JMIR Form Res. 2024 Oct 16;8:e60434. doi: 10.2196/60434.

ABSTRACT

BACKGROUND: Menopause presents a period of heightened vulnerability for mental health issues. Despite this, mental health screening is not consistently integrated into menopausal health care, and access to psychological interventions is limited. Digital technologies, such as web and smartphone apps, may offer a way to facilitate and improve mental health care provision throughout menopause. However, little is known about potential users’ intention to use such technologies during this critical phase of life.

OBJECTIVE: To examine the factors that impact the intention of potential users to use a mental health app during menopause, we used the Health Belief Model (HBM), a psychological framework widely used to understand and predict individuals’ health-related behaviors.

METHODS: An online survey was generated. Convenience sampling was used, with participants recruited via social media and email, through relevant foundations and support groups, and by word of mouth. Structural equation modeling with maximum likelihood estimation was conducted to explore whether the factor structure of the HBM is a good fit for predicting the intention to use a mental health app for menopause. A Cronbach α value of .05 was used for determining statistical significance.

RESULTS: A total of 1154 participants commenced the survey, of which 82.49% (n=952) completed at least 97% of the survey. Of these, 86.76% (n=826) expressed that their menopausal symptoms had negatively affected their mental health, and went on to answer questions regarding their experiences and interest in using a web or smartphone app for mental health symptoms related to menopause. Data from this subgroup (N=826) were analyzed. In total, 74.09% (n=612) of respondents sought online help for mental health symptoms related to menopause. The most common topics searched for were symptom characteristics (n=435, 52.66%) and treatment or therapy options (n=210, 25.42%). Psychoeducation (n=514, 62.23%) was the most desired mental health app feature, followed by symptom tracking (n=499, 60.41%) and self-help tips (n=469, 56.78%). In terms of the intention to use a mental health app, the Satorra-Bentler-scaled fit statistics indicated a good fit for the model (χ2278=790.44, P<.001; comparative fit index=0.933, root mean square error of approximation=0.047, standardized root mean square residual=0.056), with cues to action emerging as the most significant predictor of intention (β=.48, P<.001). This was followed by perceived barriers (β=-.25, P<.001), perceived susceptibility (β=.15, P<.001), and perceived benefits (β=.13, P<.001). Perceived severity (β=.01, P=.869) and self-efficacy (β=.03, P=.286) were not significantly associated with behavioral intention.

CONCLUSIONS: This study reveals important factors that influence the intention to use a mental health app during menopause. It emphasizes the need to address barriers to app usage, while highlighting the impact of credible endorsements and psychoeducation. Furthermore, the study underscores the significance of improving accessibility for users with lower digital literacy or limited resources.

PMID:39412868 | DOI:10.2196/60434