Category: Nevin Manimala

Subst Abuse Treat Prev Policy. 2023 Jun 22;18(1):36. doi: 10.1186/s13011-023-00550-1.

ABSTRACT

BACKGROUND: In 2018, Canada legalized recreational cannabis use with the purpose of protecting youth and restricting access. However, concerns have been raised that this objective has not been met as rates of cannabis use among youth aged 16-24 have not declined. Youth cannabis use is associated with various adverse effects including psychosis, anxiety, depression, suicidality, respiratory distress, cannabinoid hyperemesis syndrome, and intoxications. Service providers play a crucial role in addressing youth cannabis use. This study aimed to understand Ontario service providers’ perceptions, practices, and recommendations on youth cannabis use.

METHODS: This mixed method study included a survey and two focus groups. The survey was distributed to mental health service providers serving youth aged 16-24 across Ontario who were given the option to participate in a focus group. The survey included closed and open-ended questions regarding perceptions, practices, and recommendations, while the focus groups explored these categories in greater depth. Descriptive statistics were used to analyze close-ended questions and interpretative content analysis was applied for open-ended questions. Focus group data were analyzed using thematic analysis.

RESULTS: The survey was completed by 160 service providers and 12 participated in two focus groups. Regarding perceptions, 60% of survey participants agreed with legalization, 26% had a strong understanding of medical versus recreational cannabis, 84% believed that cannabis has physical and mental health risks, and 49% perceived stigmatization. Less than half of the survey participants reported screening or assessing cannabis use, 16% stated they are highly familiar with treating cannabis use, and 67% reported that they rarely work with families. Subthemes identified in the focus groups under perceptions included normalization and stigmatization, harms for youth, and stigma, racism, and discrimination. Subthemes under practice included cannabis not being the primary focus, challenges with screening, assessment, and intervention, and referral to specialized services. Both the survey and focus group participants recommended increasing public education, enhancing service provider training, improving regulation and policies, reducing stigma and minimization, improving service access, and providing more culturally responsive services.

CONCLUSION: Youth cannabis use in Canada remains a significant public health concern, necessitating a more comprehensive plan to protect Ontario youth and reduce associated harms.

PMID:37349741 | DOI:10.1186/s13011-023-00550-1

Addict Behav. 2023 Jun 18;145:107779. doi: 10.1016/j.addbeh.2023.107779. Online ahead of print.

ABSTRACT

INTRODUCTION: Transgender and non-binary people use more alcohol and report a greater need for help to reduce their consumption than their cisgender counterparts. They experience anticipated and enacted discrimination when seeking alcohol reduction healthcare. This study aimed to identify any alcohol reduction interventions for trans and non-binary people.

METHODS: A systematic scoping review was completed according to PRISMA-ScR guidelines. Following an extensive search across five databases, two independent reviewers carried out abstract screening, full-text screening, data extraction and quality assessment. Findings were synthesised narratively.

RESULTS: The search generated 1399 unique records. Ten texts were reviewed in full, and the final sample comprised six studies of moderate quality. Included records all reported adaptations of various psychosocial interventions including individual therapies, group therapy, a trans-affirmative clinical environment, and a specialist inpatient rehabilitation service. Four interventions resulted in alcohol reduction with modest effect size. However, the change in alcohol consumption was not statistically significant in two studies. Trans women were disproportionately investigated through the lens of HIV risk reduction.

CONCLUSION: Interventions developed for one population cannot be presumed effective in another, particularly those as heterogeneous as trans and non-binary communities. There is some suggestion that psychosocial interventions adapted for the needs of the trans community are effective in achieving alcohol reduction. However, it is unclear how these will fare with trans men and non-binary people and specialist interventions may be needed.

PMID:37348175 | DOI:10.1016/j.addbeh.2023.107779

J Mech Behav Biomed Mater. 2023 Jun 19;144:105960. doi: 10.1016/j.jmbbm.2023.105960. Online ahead of print.

ABSTRACT

OBJECTIVES: Aim of this study was to determine the forces and moments during simulated initial orthodontic tooth movements using a novel biomechanical test setup.

METHODS: The test setup consisted of an industrial precision robot with a force-torque sensor, a maxillary model and a control computer and software. Forces and moments acting on the corresponding experimental tooth during the motion simulations were dynamically measured for two 0.016″ NiTi round archwires (Sentalloy Light/Sentalloy Medium). Intrusive (#1), rotational (#2) and angular (#3) tooth movements were simulated by a control program based on the principle of force control and executed by the robot. The results were statistically analysed using K-S-test and Mann-Whitney U test with a significance level of α = 5%.

RESULTS: Sentalloy Medium archwires generated higher forces and moments than the Sentalloy Light archwires in all simulations. In simulation #1 the mean initial forces/moments reached 1.442 N/6.781 Nmm for the Light archwires and 1.637 N/9.609 Nmm for the Medium archwires. In movement #2 Light archwires generated mean initial forces/moments of 0.302 N/-8.271 Nmm whereas Medium archwires generated 0.432 N/-9.653 Nmm. Simulation #3 showed mean initial forces/moments of -0.122 N/8.477 Nmm from the Light archwires compared to -0.300 N/11.486 Nmm for the Medium archwires.

SIGNIFICANCE: The measured forces and moments were suitable for initial orthodontic tooth movement in simulations #2 and #3, however inadequate in simulation #1. Reduced archwire dimensions (<0.016″) should be selected for initial leveling of vertical malocclusions.

PMID:37348170 | DOI:10.1016/j.jmbbm.2023.105960

J Mech Behav Biomed Mater. 2023 Jun 1;144:105939. doi: 10.1016/j.jmbbm.2023.105939. Online ahead of print.

ABSTRACT

We propose a computational framework to study the effect of corrosion on the mechanical strength of magnesium (Mg) samples. Our work is motivated by the need to predict the residual strength of biomedical Mg implants after a given period of degradation in a physiological environment. To model corrosion, a mass-diffusion type model is used that accounts for localised corrosion using Weibull statistics. The overall mass loss is prescribed (e.g., based on experimental data). The mechanical behaviour of the Mg samples is modeled by a state-of-the-art Cazacu-Plunkett-Barlat plasticity model with a coupled damage model. This allowed us to study how Mg degradation in immersed samples reduces the mechanical strength over time. We performed a large number of in vitro corrosion experiments and mechanical tests to validate our computational framework. Our framework could predict both the experimentally observed loss of mechanical strength and the ductility due to corrosion for both tension and compression tests.

PMID:37348169 | DOI:10.1016/j.jmbbm.2023.105939

EBioMedicine. 2023 Jun 20;93:104669. doi: 10.1016/j.ebiom.2023.104669. Online ahead of print.

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has rapidly spread worldwide in the population since it was first detected in late 2019. The transcription and replication of coronaviruses, although not fully understood, is characterised by the production of genomic length RNA and shorter subgenomic RNAs to make viral proteins and ultimately progeny virions. Observed levels of subgenomic RNAs differ between sub-lineages and open reading frames but their biological significance is presently unclear.

METHODS: Using a large and diverse panel of virus sequencing data produced as part of the Danish COVID-19 routine surveillance together with information in electronic health registries, we assessed the association of subgenomic RNA levels with demographic and clinical variables of the infected individuals.

FINDINGS: Our findings suggest no significant statistical relationship between levels of subgenomic RNAs and host-related factors.

INTERPRETATION: Differences between lineages and subgenomic ORFs may be related to differences in target cell tropism, early virus replication/transcription kinetics or sequence features.

FUNDING: The author(s) received no specific funding for this work.

PMID:37348163 | DOI:10.1016/j.ebiom.2023.104669

Nurse Educ. 2023 Jun 20. doi: 10.1097/NNE.0000000000001471. Online ahead of print.

ABSTRACT

BACKGROUND: First-semester prelicensure nursing students commonly report experiencing math anxiety that negatively affects academic performance and triggers fear of causing patient harm. Students often turn to social media platforms to supplement their learning experience.

PURPOSE: To explore the feasibility of using Instagram tutorials to reduce math anxiety of first-semester prelicensure nursing students.

METHODS: A quasi-experimental descriptive survey design was used to evaluate the utility of posting supplemental math tutorials on Instagram and examined the effect of tutorials on math anxiety levels. A convenience sample of 20 students used the tutorials. Math anxiety levels were evaluated using the Single-Item Math Anxiety Scale.

RESULTS: A statistically significant inverse relationship was observed between math anxiety levels and tutorial use. The Instagram platform was familiar to students and simple to access. Brief tutorials appealed to audio-visual learners.

CONCLUSIONS: Using Instagram-based tutorials is feasible and appears effective in reducing medication math anxiety.

PMID:37348141 | DOI:10.1097/NNE.0000000000001471

Ann Work Expo Health. 2023 Jun 22:wxad036. doi: 10.1093/annweh/wxad036. Online ahead of print.

ABSTRACT

Task-based respirable crystalline silica (RCS) exposure monitoring data was collected from construction work sites across 3 Canadian provinces: Alberta, British Columbia (BC), and Manitoba. In total 373 RCS samples were obtained from 70 worksites across 44 companies. Sampling was conducted between May 2015 and August 2020. The overall geometric mean (GM) RCS exposure was 0.045 mg/m3 (geometric standard deviation, GSD = 6.8). Alberta had the highest average exposure and the highest variability with GM of 0.060 mg/m3 (GSD = 9.3), the GM in BC was 0.044 (GSD = 4.3), and in Manitoba the GM was 0.033 (GSD = 7.0). A multivariable model was built using forward stepwise linear regression modeling. Province, task type, work environment (indoor vs. outdoor), construction material, sampling duration, and engineering control use were all statistically significant predictors of exposure level in partial F-tests (P < 0.05). Overall, the model explained 42% of the RCS concentration variability. Task type contributed most to the model’s explanatory power. The task type with highest average exposure levels was demolition (GM 0.30 mg/m3, GSD 0.49). Breaking (GM 0.16 mg/m3, GSD 8.4) and grinding (GM 0.081 m/m3, GSD 7.4) also had high-exposure levels. Working outdoors was associated with exposure levels 39% lower than indoors. Exposure control measures such as local exhaust ventilation and wetting were also associated with lower exposure levels. Among construction materials, Cement, sand, and stone were associated with higher RCS exposure levels relative to the reference material, concrete. The results of this study indicate that workers in western Canada remain exposed to RCS at levels that exceed the health-based American Congress for Governmental Industrial Hygienists Threshold Limit Value of 0.025 mg/m3. Although there were some differences in exposure levels between the provinces, the determinants of exposure were similar in all 3. The overall GM RCS exposure was 0.045 mg/m3 (geometric standard deviation, GSD = 6.8). Alberta had the highest average exposure and the highest variability with GM of 0.060 mg/m3 (GSD = 9.3), the GM in BC was 0.044 (GSD = 4.3), and in Manitoba the GM was 0.033 (GSD = 7.0).

PMID:37348109 | DOI:10.1093/annweh/wxad036

Urogynecology (Phila). 2023 Jul 1;29(7):641-645. doi: 10.1097/SPV.0000000000001328. Epub 2023 Jan 29.

ABSTRACT

IMPORTANCE: Urinary tract infection (UTI) is common in urogynecology patients. Patients with fecal incontinence (FI) often attribute their UTIs to FI, but this association has not been evaluated.

OBJECTIVES: The objectives of this study were to compare the prevalence of UTI in urogynecology patients with and without FI and to characterize factors associated with UTI and recurrent UTI.

STUDY DESIGN: This retrospective cohort study included all new adult patients who presented to an academic female pelvic medicine and reconstructive surgery practice with FI from January 2014 through December 2017. Patients were age-matched to new adult patients with stage <2 pelvic organ prolapse without FI. All urine culture results from 1 year before and 1 year after the first visit were identified. Logistic regression identified factors associated with UTI.

RESULTS: Among 399 patients, 106 (27%) had a culture-confirmed UTI in the year before or after their first urogynecology visit; the prevalence of UTI was 23% (45/198) in patients with FI and 30% (61/201) in those without FI (P = 0.09). The rate of recurrent UTI was 11.5% overall and did not differ among those with and without FI. In multivariate models, variables that were statistically significantly associated with UTI included age, diabetes mellitus, anterior vaginal wall prolapse, and sexual activity. Fecal incontinence was not associated with any or recurrent UTI.

CONCLUSIONS: The prevalence of UTI and recurrent UTI was similar in urogynecology patients with and without FI. Variables that were associated with UTI risk included older age, sexual activity, diabetes mellitus, and anterior vaginal wall prolapse.

PMID:37348087 | DOI:10.1097/SPV.0000000000001328

Genetics. 2023 Jun 22:iyad116. doi: 10.1093/genetics/iyad116. Online ahead of print.

ABSTRACT

The strong reduction in the frequency of recombination in heterozygotes for an inversion and a standard gene arrangement causes the arrangements to become partially isolated genetically, resulting in sequence divergence between them and changes in the levels of neutral variability at nucleotide sites within each arrangement class. Previous theoretical studies on the effects of inversions on neutral variability have either assumed that the population is panmictic or that it is divided into two populations subject to divergent selection. Here, the theory is extended to a model of an arbitrary number of demes connected by migration, using a finite island model with the inversion present at the same frequency in all demes. Recursion relations for mean pairwise coalescent times are used to obtain simple approximate expressions for diversity and divergence statistics for an inversion polymorphism at equilibrium under recombination and drift, and for the approach to equilibrium following the sweep of an inversion to a stable intermediate frequency. The effects of an inversion polymorphism on patterns of linkage disequilibrium are also examined. The reduction in effective recombination rate caused by population subdivision can have significant effects on these statistics. The theoretical results are discussed in relation to population genomic data on inversion polymorphisms, with an emphasis on Drosophila melanogaster. Methods are proposed for testing whether or not inversions are close to recombination-drift equilibrium, and for estimating the rate of recombinational exchange in heterozygotes for inversions; difficulties involved in estimating the ages of inversions are also discussed.

PMID:37348059 | DOI:10.1093/genetics/iyad116

Genetics. 2023 Jun 22:iyad115. doi: 10.1093/genetics/iyad115. Online ahead of print.

ABSTRACT

Exonic variants present some of the strongest links between genotype and phenotype. However, these variants can have significant inter-individual pathogenicity differences, known as variable penetrance. In this study, we propose a model where genetically controlled mRNA splicing modulates the pathogenicity of exonic variants. By first cataloging exonic inclusion from RNA-seq data in GTEx v8, we find that pathogenic alleles are depleted on highly included exons. Using a large-scale phased WGS data from the TOPMed consortium, we observe that this effect may be driven by common splice-regulatory genetic variants, and that natural selection acts on haplotype configurations that reduce the transcript inclusion of putatively pathogenic variants, especially when limiting to haploinsufficient genes. Finally, we test if this effect may be relevant for autism risk using families from the Simons Simplex Collection, but find that splicing of pathogenic alleles has a penetrance reducing effect here as well. Overall, our results indicate that common splice-regulatory variants may play a role in reducing the damaging effects of rare exonic variants.

PMID:37348055 | DOI:10.1093/genetics/iyad115