Category: Nevin Manimala

Eur Psychiatry. 2025 Jan 10;68(1):e4. doi: 10.1192/j.eurpsy.2024.1807.

ABSTRACT

BACKGROUND: One of the most relevant risk factors for suicide is the presence of previous attempts. The symptomatic profile of people who reattempt suicide deserves attention. Network analysis is a promising tool to study this field.

OBJECTIVE: To analyze the symptomatic network of patients who have attempted suicide recently and compare networks of people with several attempts and people with just one at baseline.

METHODS: 1043 adult participants from the Spanish cohort “SURVIVE” were part of this study. Participants were classified into two groups: single attempt group (n = 390) and reattempt group (n = 653). Different network analyses were carried out to study the relationships between suicidal ideation, behavior, psychiatric symptoms, diagnoses, childhood trauma, and impulsivity. A general network and one for each subgroup were estimated.

RESULTS: People with several suicide attempts at baseline scored significantly higher across all clinical scales. The symptomatic networks were equivalent in both groups of patients (p > .05). Although there were no overall differences between the networks, some nodes were more relevant according to group belonging.

CONCLUSIONS: People with a history of previous attempts have greater psychiatric symptom severity but the relationships between risk factors show the same structure when compared with the single attempt group. All risk factors deserve attention regardless of the number of attempts, but assessments can be adjusted to better monitor the occurrence of reattempts.

PMID:39791330 | DOI:10.1192/j.eurpsy.2024.1807

J Glob Health. 2025 Jan 10;15:04011. doi: 10.7189/jogh.15.04011.

ABSTRACT

BACKGROUND: We aimed to identify the central lifestyle, the most impactful among lifestyle factor clusters; the central health outcome, the most impactful among health outcome clusters; and the bridge lifestyle, the most strongly connected to health outcome clusters, across 29 countries to optimise resource allocation for local holistic health improvements.

METHODS: From July 2020 to August 2021, we surveyed 16 461 adults across 29 countries who self-reported changes in 18 lifestyle factors and 13 health outcomes due to the pandemic. Three networks were generated by network analysis for each country: lifestyle, health outcome, and bridge networks. We identified the variables with the highest bridge expected influence as central or bridge variables. Network validation included nonparametric and case-dropping subset bootstrapping, and centrality difference tests confirmed that the central or bridge variables had significantly higher expected influence than other variables within the same network.

RESULTS: Among 87 networks, 75 were validated with correlation-stability coefficients above 0.25. Nine central lifestyle types were identified in 28 countries: cooking at home (in 11 countries), food types in daily meals (in one country), less smoking tobacco (in two countries), less alcohol consumption (in two countries), less duration of sitting (in three countries), less consumption of snacks (in five countries), less sugary drinks (in five countries), having a meal at home (in two countries), taking alternative medicine or natural health products (in one country). Six central health outcomes were noted among 28 countries: social support received (in three countries), physical health (in one country), sleep quality (in four countries), quality of life (in seven countries), less mental burden (in three countries), less emotional distress (in 13 countries). Three bridge lifestyles were identified in 19 countries: food types in daily meals (in one country), cooking at home (in one country), overall amount of exercise (in 17 countries). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05).

CONCLUSIONS: In 29 countries, cooking at home, less emotional distress, and overall amount of exercise emerged as common central lifestyle, health outcome, and bridge lifestyle factors, respectively. However, notable regional variations necessitate tailored interventions and resource allocations to effectively address unique local key variables and promote holistic health in each locale. The study’s cross-sectional design and self-reported data may limit generalisability, emphasising the need for cautious interpretation and further longitudinal research.

KEYWORDS: global; across-country comparisons; lifestyle; health outcomes; network analysis.

PMID:39791329 | DOI:10.7189/jogh.15.04011

JMIR Hum Factors. 2025 Jan 6;12:e53057. doi: 10.2196/53057.

ABSTRACT

BACKGROUND: Transgender and nonbinary (TGNB) individuals are increasingly intentionally becoming pregnant to raise children, and hospital websites should reflect these trends. For prospective TGNB parents, a hospital website is the only way they can assess their safety from discrimination while receiving perinatal care. Cisnormativity enforced by communication gaps between medical institutions and TGNB patients can and has caused delays in receiving urgent care during their pregnancy.

OBJECTIVE: The aim of this study was to evaluate the current prevalence of gender-inclusive terminology among labor and delivery services in the New York tristate area.

METHODS: The labor and delivery web pages of 189 hospitals from New York, New Jersey, and Connecticut were examined for gender-inclusive language. “Fully inclusive” websites explicitly acknowledged lesbian, gay, bisexual, transgender, queer, intersex, and asexual plus other gender- and sexual-oriented (LGBTQIA+) parents, “inclusive” websites did not use gendered terminology for parents, and “noninclusive” websites used gendered terms at least once in the text reviewed. The hospitals’ web pages were further stratified by Healthcare Equality Index scores and population classifications defined by the 2013 National Center for Health Statistics Urban-Rural classification given to the county that each hospital was located in.

RESULTS: Of the 300 hospital websites reviewed, only 189 websites met the criteria for inclusion. Overall, only 6.3% (n=12) of labor and delivery web pages were “inclusive” or “fully inclusive.” No geographic areas (P=.61) or Healthcare Equality Index scores (P=.81) were associated with inclusive or fully inclusive language.

CONCLUSIONS: Hospitals need to use inclusive language to help TGNB people identify hospitals where their existence and needs are acknowledged and thus feel more comfortable in their transition to parenthood.

PMID:39791326 | DOI:10.2196/53057

Disaster Med Public Health Prep. 2025 Jan 10;19:e13. doi: 10.1017/dmp.2024.308.

ABSTRACT

OBJECTIVES: This study sought to assess undergraduate students’ knowledge and attitudes surrounding perceived self-efficacy and threats in various common emergencies in communities of higher education.

METHODS: Self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, obligation to respond, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond were investigated through 3 representative scenarios via a web-based survey.

RESULTS: Among 970 respondents, approximately 60% reported their university had adequately prepared them for various emergencies while 84% reported the university should provide such training. Respondents with high self-efficacy were significantly more likely than those with low self-efficacy to be willing to respond in whatever capacity needed across all scenarios.

CONCLUSIONS: There is a gap between perceived student preparedness for emergencies and training received. Students with high self-efficacy were the most likely to be willing to respond, which may be useful for future training initiatives.

PMID:39791325 | DOI:10.1017/dmp.2024.308

JMIR Form Res. 2025 Jan 8. doi: 10.2196/58262. Online ahead of print.

ABSTRACT

BACKGROUND: After suffering for an average of 7 years before diagnosis, endometriosis patients are usually left with more questions than answers about managing their symptoms in the absence of a cure. To help women with endometriosis after their diagnosis, we developed an online support program combining user research, evidence-based medicine, and clinical expertise. Structured around CBT and the quality-of-life metrics from the EHP score, the program is designed to guide participants over a 3-month and is available in France.

OBJECTIVE: This cohort study was designed to measure the impact of a digital health program on the symptom and quality of life levels of women with endometriosis.

METHODS: Ninety-two participants were included in the pilot study, among a total of 146 program participants who volunteered and assessed for eligibility for this research. They were recruited either free of charge through employer health insurance or via individual direct access. A control group of women with endometriosis who did not follow the program was recruited (n=404) through social media and mailing campaign. Questionnaires assessing quality of life and symptom levels were sent to program participants and controls at baseline and at three months via email. The control group was sampled according to initial pain level in order to obtain a similar pain profile between controls and program participants (n=149). Descriptive statistics and statistical tests (Chi-square, Fisher’s exact, Wilcoxon, Mann-Whitney U, Student t-tests) were used to analyze intra- and inter-group differences, with Cohen’s D measuring effect size for significant results.

RESULTS: Over three months, global symptom burden, the general level of pain, anxiety, depression, dysmenorrhea, dysuria, chronic fatigue, neuropathic pain, and endobelly levels improved significantly among program participants. These improvements were significantly different from the control group for global symptom burden (mean±SD: participants=-0.7±1.6, controls=-0.3±1.3, P=.048, small d), anxiety (participants=-1.1±2.8, controls=0.2±2.5, P<.001, medium d) and depression levels (participants=-0.9±2.5, controls=0.0±3.1, P=.04, small d), neuropathic pain (participants=-1.0±2.7, controls=-0.1±2.6, P=.004, small d), and endobelly (participants=-0.9±2.5, controls=-0.3±2.4, P=.03, small d). Participant quality of life evolution between baseline and three months improved and significantly differed from the control group for the core part of the EHP-5 (participants=-5.9±21.0, controls=1.0±14.8, P=.03, small d) and the EQ-5D (participants=0.1±0.1, controls=-0.0±0.1, P=.001, medium d). Perceived knowledge of endometriosis was significantly greater at three months among participants than in controls (P<.001).

CONCLUSIONS: The results from this pilot study suggest that a digital health program providing medical and scientific information about endometriosis and multidisciplinary self-management tools may be useful to reduce global symptom burden, anxiety, depression, neuropathic pain, and endobelly while improving knowledge on endometriosis and quality of life among participants.

PMID:39791286 | DOI:10.2196/58262

Hum Brain Mapp. 2025 Jan;46(1):e70084. doi: 10.1002/hbm.70084.

ABSTRACT

The human brain connectome is characterized by the duality of highly modular structure and efficient integration, supporting information processing. Newborns with congenital heart disease (CHD), prematurity, or spina bifida aperta (SBA) constitute a population at risk for altered brain development and developmental delay (DD). We hypothesize that, independent of etiology, alterations of connectomic organization reflect neural circuitry impairments in cognitive DD. Our study aim is to address this knowledge gap by using a multi-etiologic neonatal dataset to reveal potential commonalities and distinctions in the structural brain connectome and their associations with DD. We used diffusion tensor imaging of 187 newborns (42 controls, 51 with CHD, 51 with prematurity, and 43 with SBA). Structural weighted connectomes were constructed using constrained spherical deconvolution-based probabilistic tractography and the Edinburgh Neonatal Atlas. Assessment of brain network topology encompassed the analysis of global graph features, network-based statistics, and low-dimensional representation of global and local graph features. The Cognitive Composite Score of the Bayley scales of Infant and Toddler Development 3rd edition was used as outcome measure at corrected 2 years for the preterm born individuals and SBA patients, and at 1 year for the healthy controls and CHD. We detected differences in the connectomic structure of newborns across the four groups after visualizing the connectomes in a two-dimensional space defined by network integration and segregation. Further, analysis of covariance analyses revealed differences in global efficiency (p < 0.0001), modularity (p < 0.0001), mean rich club coefficient (p = 0.017), and small-worldness (p = 0.016) between groups after adjustment for postmenstrual age at scan and gestational age at birth. Moreover, small-worldness was significantly associated with poorer cognitive outcome, specifically in the CHD cohort (r = -0.41, p = 0.005). Our cross-etiologic study identified divergent structural brain connectome profiles linked to deviations from optimal network integration and segregation in newborns at risk for DD. Small-worldness emerges as a key feature, associating with early cognitive outcomes, especially within the CHD cohort, emphasizing small-worldness’ crucial role in shaping neurodevelopmental trajectories. Neonatal connectomic alterations associated with DD may serve as a marker identifying newborns at-risk for DD and provide early therapeutic interventions. Trial Registration: ClinicalTrials.gov identifier: NCT00313946.

PMID:39791277 | DOI:10.1002/hbm.70084

Pest Manag Sci. 2025 Jan 10. doi: 10.1002/ps.8629. Online ahead of print.

ABSTRACT

BACKGROUND: Identifying robust integrated pest management (IPM) strategies requires the testing of multiple factors at the same time and assessing their combined effects e.g., on disease control. This makes field-based experiments large, resource intensive and expensive. Hence, there are limits to the number of treatment combinations that can be practically tested under field conditions. Taguchi approach to design of experiments (DOE) or the Taguchi approach is commonly employed to enhance the quality of industrial products. It uses smaller experiments than classical DOE but its applicability to late blight research, and agricultural research, has not been widely evaluated.

RESULTS: Two existing datasets, following the same protocol and investigating the effectiveness of different IPM treatments to control late blight, caused by Phytophthora infestans, on potato, were used to test the Taguchi approach. Disease severity was quantified as area under the disease progress curve (AUDPC). The method could accurately predict the performance of a cultivar and fungicide-based integrated disease management strategy from a small dataset and identified cultivar as a key factor for disease control. Linear regression demonstrated a strong and statistically significant relationship between AUDPC values collected during the original experiments and the predicted disease severity values generated using the Taguchi method.

CONCLUSIONS: The Taguchi approach can accurately predict disease severity, with predicted values similar to those collected during the original experiments. Moreover, associated analyses identified the most effective treatment combinations and the factors that exert the greatest influence on disease control. The relevance of this approach when designing and interpreting IPM strategies is discussed. © 2025 Society of Chemical Industry.

PMID:39791274 | DOI:10.1002/ps.8629

J Hypertens. 2024 Dec 9. doi: 10.1097/HJH.0000000000003938. Online ahead of print.

ABSTRACT

OBJECTIVES: Patients with advanced chronic kidney disease suffer from hypertension, and kidney transplantation (KT) has potential to induce hypertension resolution. We hypothesized that hypertension resolution after KT is associated with better KT outcomes.

METHODS: We identified KT recipients (2006-2015) who had pretransplant hypertension. They were categorized into two groups based on their hypertension status after KT: persistent vs. resolved hypertension, using data from the Korea National Health Insurance System. Cox proportional hazard analyses were performed to assess the risk of graft failure and mortality, adjusting for various clinical factors.

RESULTS: Among 11 317 KT recipients with pretransplant hypertension, 7269 (64%) remained hypertensive, while 4048 (36%) experienced hypertension resolution. Recipients with resolved hypertension exhibited a lower prevalence of delayed graft function and major comorbidities, including diabetes, ischemic heart disease, and stroke. Graft failure and mortality rates were significantly lower in resolved hypertension group. After adjusting for multiple covariates, hazard ratios of resolved hypertension were 0.61 (95% confidence interval 0.52-0.72) for graft failure and 0.68 (0.56-0.81) for all-cause mortality.

CONCLUSIONS: A significant proportion of patients experienced hypertension resolution after KT, which is associated with improved graft and overall survival. The post-KT hypertension resolution can be used as a prognostic indicator for predicting better KT outcomes.

PMID:39791265 | DOI:10.1097/HJH.0000000000003938

Clin Trials. 2025 Jan 10:17407745241302488. doi: 10.1177/17407745241302488. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: When conducting a randomised controlled trial in surgery, it is important to consider surgical learning, where surgeons’ familiarity with one, or both, of the interventions increases during the trial. If present, learning may compromise trial validity. We demonstrate a statistical investigation into surgical learning within a trial of cleft palate repair.

METHODS: The Timing of Primary Surgery compared primary surgery, using the Sommerlad technique, for cleft palate repair delivered at 6 or 12 months of age. Participating surgeons had varying levels of experience with the intervention and in repair across the age groups. Trial design aimed to reduce the surgical learning via pre-trial surgical technique training and balancing the randomisation process by surgeon. We explore residual learning effects by applying visual methods and statistical models to a surgical outcome (fistula formation) and a process indicator (operation time).

RESULTS: Notably, 26 surgeons operated on 521 infants. As the trial progressed, operation time reduced for surgeons with no pre-trial Sommerlad experience (n = 2), before plateauing at 30 operations, whereas it remained stable for those with prior experience. Fistula rates remained stable regardless of technique experience. Pre-trial age for primary surgery experience had no impact on either measures.

CONCLUSION: Managing learning effects through design was not fully achieved but balanced between trial arms, and residual effects were minimal. This investigation explores the presence of learning, within a randomised controlled trial that may be valuable for future trials. We recommend such investigations are undertaken to aid trial interpretation and generalisability, and determine success of trial design measures.

PMID:39791255 | DOI:10.1177/17407745241302488

Worldviews Evid Based Nurs. 2025 Feb;22(1):e12765. doi: 10.1111/wvn.12765.

ABSTRACT

BACKGROUND: Coronary artery disease (CAD) is a major health problem of atherosclerotic cardiovascular (CV) disease and early intervention is regarded important. Given the proven effect of a lifestyle intervention with nursing telephone counselling and mHealth use in health care, yet the comparisons of both support are lacking, this study is proposed.

OBJECTIVES: This study aimed to compare the effects of a coronary artery disease (CAD) support program using a mobile application versus nurse phone advice on exercise amount and physical and psychological outcomes for clients at risk of CAD.

METHODS: A prospective randomized controlled trial was conducted. Ethical approval was obtained. Two-hundred and twenty-six clients were screened, and a total of 168 clients who were at risk of CAD and routinely used smartphones were randomized into the app support group (App group) or the nurse phone advice (NPA) group. Although all participants received the same health talk delivered by a cardiac nurse at the community center, the App group received additional CAD app support, whereas the NPA group received nurse phone advice for 20 min monthly. The app content comprised (1) CAD knowledge in 10 modules, (2) individual exercise records with their own goals and health measures, and (3) a chest pain action list. The intervention lasted for 3 months. Health outcome data were collected at baseline (T0) and after 1 (T1) and 3 (T2) months. The outcomes were the total amount of exercise (primary outcome), self-efficacy in illness management, perceived stress, and CAD risk profile (body weight, body mass index, and lipid concentration). Generalized estimating equation models were used to assess differential changes in all outcomes within 3 months.

RESULTS: The attrition rates at 3 months were 3.49% and 9.30% for the App and NPA groups, respectively. The App support group was superior to the NPA group in significantly increasing total exercise amount and reducing body weight, waist circumference, triglycerides, and increased self-efficacy in illness management.

LINKING EVIDENCE TO ACTION: The result provides further insights of app development to support health promotion programs for community-dwelling adults at risk of CAD.

PMID:39791254 | DOI:10.1111/wvn.12765