Category: Nevin Manimala

AIDS Patient Care STDS. 2023 Feb 24. doi: 10.1089/apc.2022.0189. Online ahead of print.

ABSTRACT

Studies have observed neurodevelopmental (ND) challenges among young children perinatally HIV-exposed yet uninfected (CHEU) with in utero antiretroviral (ARV) exposure, without clear linkage to specific ARVs. Atazanavir (ATV) boosted with ritonavir has been a preferred protease inhibitor recommended for pregnant women, yet associations of ATV with ND problems in CHEU have been reported. Studies among early school-age children are lacking. The pediatric HIV/AIDS cohort study (PHACS) surveillance monitoring for antiretroviral therapy (ART) toxicities (SMARTT) study evaluated 5-year-old monolingual English-speaking CHEU using the behavior assessment system for children, Wechsler preschool and primary scales of intelligence, and test of language development-primary. A score ≥1.5 standard deviations worse than population norms defined a signal within each domain. Analyses of risk for signals were stratified by timing of any ARV initiation. Associations between ARV exposure and risk of ND signals were assessed using proportional odds models, adjusting for confounders. Among 230 children exposed to ARVs at conception, 15% had single and 8% had multiple ND problems; ATV exposure was not associated with higher risk of signals [adjusted cumulative odds ratio (cOR) = 0.66, confidence interval (CI): 0.28-1.56]. However, among 461 children whose mothers initiated ARVs during pregnancy, 21% had single and 12% had multiple ND problems; ATV exposure was associated with higher risk of signals (cOR = 1.70, CI: 0.82-3.54). The specific regimen tenofovir/emtricitabine/ATV was associated with higher risk (cOR = 2.31, CI: 1.08-4.97) relative to regimens using a zidovudine/lamivudine backbone combined with non-ATV ARVs. It remains important to monitor neurodevelopment of CHEU during early childhood and investigate the impact and the role of timing of in utero exposure to specific ARVs.

PMID:36827595 | DOI:10.1089/apc.2022.0189

Phys Rev Lett. 2023 Feb 10;130(6):069402. doi: 10.1103/PhysRevLett.130.069402.

NO ABSTRACT

PMID:36827561 | DOI:10.1103/PhysRevLett.130.069402

Phys Rev Lett. 2023 Feb 10;130(6):069401. doi: 10.1103/PhysRevLett.130.069401.

NO ABSTRACT

PMID:36827555 | DOI:10.1103/PhysRevLett.130.069401

Phys Rev Lett. 2023 Feb 10;130(6):067402. doi: 10.1103/PhysRevLett.130.067402.

ABSTRACT

Phase transitions in equilibrium and nonequilibrium systems play a major role in the natural sciences. In dynamical networks, phase transitions organize qualitative changes in the collective behavior of coupled dynamical units. Adaptive dynamical networks feature a connectivity structure that changes over time, coevolving with the nodes’ dynamical state. In this Letter, we show the emergence of two distinct first-order nonequilibrium phase transitions in a finite-size adaptive network of heterogeneous phase oscillators. Depending on the nature of defects in the internal frequency distribution, we observe either an abrupt single-step transition to full synchronization or a more gradual multistep transition. This observation has a striking resemblance to heterogeneous nucleation. We develop a mean-field approach to study the interplay between adaptivity and nodal heterogeneity and describe the dynamics of multicluster states and their role in determining the character of the phase transition. Our work provides a theoretical framework for studying the interplay between adaptivity and nodal heterogeneity.

PMID:36827552 | DOI:10.1103/PhysRevLett.130.067402

Am J Speech Lang Pathol. 2023 Feb 24:1-17. doi: 10.1044/2022_AJSLP-22-00138. Online ahead of print.

ABSTRACT

PURPOSE: This study characterized communicative participation and related aspects of functional communication for Jamaican Creole (JC)-English-speaking preschoolers with and without functionally defined speech sound disorders (fSSDs). This study included parent reports and direct assessment measures from an existing corpus of baseline data collected prior to the COVID-19 pandemic.

METHOD: The communicative participation of typically developing (TD; n = 226) bilingual JC-English-speaking preschoolers and those with fSSDs (n = 39) was documented using the Focus on the Outcomes of Communication Under Six (FOCUS). Functional speech intelligibility was recorded using the Intelligibility in Context Scale (ICS) in English and JC (ICS-JC). Objective measures of speech production were collected through direct child assessment in both languages and then transcribed and calculated for percent of consonants (PCC), vowels (PVC), and phonemes correct (PPC). Within-group relationships were explored using association testing, and differences between groups were explored through multivariate analyses.

RESULTS: FOCUS scores and ICS and ICS-JC scores were found to be minimally to moderately related for Jamaican preschoolers in the TD group (r = .28-.34, p < .002) and strongly related in the fSSD group (r = .56-.60, p < .002). No relations were observed between the FOCUS scores and PCC/PVC/PPC in either language. There was a statistically significant difference between all FOCUS scores for Jamaican preschoolers in the TD and fSSD groups (p ≤ .002).

CONCLUSIONS: These findings provide additional evidence for using the FOCUS beyond documenting change in communicative participation to support clinical decision-making in planning and developing speech-language interventions. This study also documents an important characterization of JC-English-speaking children with and without fSSDs, offering data on children’s abilities that can be used in future comparisons of communicative participation and speech functioning observed during the COVID-19 pandemic and beyond.

PMID:36827540 | DOI:10.1044/2022_AJSLP-22-00138

Eur J Gastroenterol Hepatol. 2023 Apr 1;35(4):371-375. doi: 10.1097/MEG.0000000000002527. Epub 2023 Feb 13.

ABSTRACT

OBJECTIVES: Vedolizumab is a mAb used for the treatment of moderate to severe ulcerative colitis and Crohn’s disease. There is evidence that administration of vedolizumab has been associated with either new onset or reactivation of extra-intestinal manifestations, among which arthralgia is the most prominent. We aimed to study the incidence, characteristics and predictors for the occurrence of arthralgias in patients with inflammatory bowel disease (IBD) who receive vedolizumab.

METHODS: A retrospective cohort study was implemented in patients with IBD. The occurrence of new-onset and recurrent arthralgias were recorded. Multivariate Cox proportional-hazards models were used to identify factors associated with the endpoints of interest.

RESULTS: A total of 115 vedolizumab-treated IBD patients (male = 50.4%; ulcerative colitis = 70.4%; median follow-up = 12.7 months) participated. New-onset arthralgia occurred in 20.9%, and recurrent in 46.7% (45 patients at risk). Among patients with ulcerative colitis, multivariate Cox’s proportional-hazards models showed, that new onset arthralgia was significantly associated with extensive colitis (hazard ratio = 2.91; 95% confidence interval, 1.04-8.12). Of 15 patients with concomitant treatment of azathioprine, no one manifested new-onset arthralgia (X2P = 0.03; Fisher’s exact test P = 0.038). No predictors were identified for recurrent arthralgia.

CONCLUSION: Arthralgias is a common manifestation of vedolizumab treatment. Patients with extensive ulcerative colitis demonstrate a higher risk for new-onset arthralgia, whereas, concomitant treatment with azathioprine appears to be protective. These associations may be mediated by re-directed lymphocyte trafficking and may support concomitant immunomodulator administration in specific patient subpopulations who commence treatment with vedolizumab.

PMID:36827531 | DOI:10.1097/MEG.0000000000002527

J Psychoactive Drugs. 2023 Feb 24:1-11. doi: 10.1080/02791072.2023.2177908. Online ahead of print.

ABSTRACT

The aim of this study was to define the typical groups of users of psychedelics and alike psychoactive substances in Czechia regarding various variables such as demographics, their patterns of use, or motivation for use. Data from 890 Czech respondents were collected through an online questionnaire as a part of The National Psychedelic Research Project. Subjects reported experience with the use of 29 selected substances by answering 133 questions of the questionnaire. Cluster analysis based on answers on last year use was performed, and descriptive statistics was used for 18 questions from the questionnaire. Six groups of users were identified with distinguished users and demographic characteristics, namely, The most experienced; Pure smokers; Highly educated mild users; Past-time users with families; Responsible (party) students and Deep meaning natural substance users. Groups differ mainly in the type of substances used, frequency of use last year, and demographics. Our findings highlight several patterns typical for psychedelics and alike psychoactive substances use in Czechia in each of the groups and the need for targeted drug prevention services, the raise of public awareness regarding this topic, and a possible reevaluation of the legal status of some substances. Results can be useful for health-care providers, social workers, and policy-makers.

PMID:36827494 | DOI:10.1080/02791072.2023.2177908

JMIR Form Res. 2022 Oct 19. doi: 10.2196/40518. Online ahead of print.

ABSTRACT

BACKGROUND: It is unclear whether heavy alcohol use and associated hangover symptoms changed as a result of the COVID-19 pandemic. Due to a lack of available accurate and non-retrospective self-reported data, it is difficult to directly assess hangover symptoms during the COVID-19 pandemic.

OBJECTIVE: To examine whether alcohol induced hangover-related internet searches (e.g. ‘how to cure a hangover?’) increased, decreased or remained the same in England before vs. during the COVID-19 pandemic (2020-2021) and during periods of national lockdown. Secondary aims were to examine if hangover-related internet searches differed in England to a country that did not impose similar COVID-19 lockdown restrictions.

METHODS: Using historical data from Google Trends for England, we compared relative search volume (RSV) of hangover-related searches in the years before (2016-2019) vs. during the COVID-19 pandemic (2020-2021), as well as in periods of national lockdown vs. the same periods in 2016-2019. We also compared RSV of hangover-related searches during the same time frames in a European country that did not introduce national COVID-19 lockdowns at the beginning of the pandemic (Sweden). Hangover-related search terms were identified through consultation with a panel of alcohol researchers and a sample from the general public. Statistical analyses were pre-registered prior to data collection.

RESULTS: There was no overall significant difference in RSV of hangover-related terms in England during 2016-2019 vs. 2020-2021 (P = .104, robust d = 0.02 [95% CI: 0.00 – 0.03]). However, during national lockdowns searches for hangover-related terms were lower, particularly during the first national lockdown in England (P < .001, d = .19 [95% CI: 0.16 – 0.24, relative 44% decrease]. In a comparison country that did not introduce a national lockdown in the early stages of the pandemic (Sweden) there was no significant decrease in hangover-related during the same time period. However, across both England and Sweden, during later periods of COVID-19 restrictions in 2020 and 2021 RSV of hangover-related terms was lower than in the same periods during 2016-2019. Exploratory analyses revealed that national monthly variation in alcohol sales both before and during the COVID-19 pandemic were positively correlated with frequency of hangover-related searches, suggesting changes in hangover-related searches may act as a proxy for changes in alcohol consumption.

CONCLUSIONS: Hangover-related internet searches did not differ pre vs. during the COVID-19 pandemic in England but did reduce during periods of national lockdown. Further research is required to confirm how changes in hangover-related search volume relate to heavy episodic alcohol use.

CLINICALTRIAL: The study protocol and analysis strategy was pre-registered on the Open Science Framework (DOI 10.17605/OSF.IO/2Y86E).

PMID:36827489 | DOI:10.2196/40518

Plast Reconstr Surg. 2023 Feb 27:e010318. doi: 10.1097/PRS.0000000000010318. Online ahead of print.

ABSTRACT

BACKGROUND: Massive weight loss (MWL) may have suboptimal effects on tissues used for autologous reconstruction. With the rise of obesity and bariatric surgery, more MWL patients will be presenting for breast reconstruction. We hypothesize that autologous breast reconstruction in patients with a history of MWL will have more complications and require more revisions compared to patients without a history of MWL.

METHODS: A retrospective review was performed on patients who underwent autologous breast reconstruction by five microsurgeons at an academic institution from 2009 to 2020. Patients with a history of bariatric surgery or >50-pound weight loss were identified and compared to non MWL patients. Analysis compared demographics, operative details, complications, revision rates, and BREAST-Q scores.

RESULTS: Of 916 patients who underwent 1465 flaps, 39 MWL patients (4.3%) underwent 68 flaps (4.6%) and 877 non MWL patients underwent 1397 flaps. MWL patients were more likely to require blood transfusions postoperatively (p=.005). MWL patients experienced more surgical site infections (p=.02), wound healing complications of flap (p=.007) and donor sites (p=.03), and late partial flap losses (p=.03). More revisional surgeries for flap (p=.009) and donor sites (p=.01) were required. BREAST-Q scores were not statistically different for satisfaction with breasts or surgeon but were lower in MWL patients for psychosocial (p=.01) and sexual well-being (p=.04).

CONCLUSION: Reconstructive surgeons should expect increased postoperative complications when performing autologous breast reconstruction in MWL patients. These patients should be counseled on the possibility of more postoperative complications and need for revisional surgeries.

PMID:36827470 | DOI:10.1097/PRS.0000000000010318

J Womens Health (Larchmt). 2023 Feb 24. doi: 10.1089/jwh.2022.0388. Online ahead of print.

ABSTRACT

Background: National guidelines recommend Papanicolaou (Pap) testing and human papillomavirus (HPV) vaccination for cervical cancer prevention; however, certain subgroups may be at risk for underutilization. Prior studies have identified motherhood as a predictor of health outcomes, but this research has not been extended to cervical cancer prevention. Informed by the Health Belief Model, we explored the relationship between motherhood, health beliefs, and Pap testing and HPV vaccination. Methods: This study used an observational, cross-sectional design. Participants assigned female at birth (N = 417) completed an online survey assessing motherhood, health beliefs (perceived risk, perceived benefits, perceived barriers, and self-efficacy), and prior Pap testing and HPV vaccination. Bootstrapped mediation analyses determined whether motherhood was associated with prior Pap testing and HPV vaccination and whether health beliefs mediated these relationships. Results: Of mothers (25%), 75% were up-to-date with Pap testing and 36% had previously received ≥1 dose of the HPV vaccine. There was no direct effect of motherhood on Pap testing (p = 0.873) or HPV vaccination (p = 0.921) and no significant indirect effects via health beliefs (ps ≥ 0.096). However, perceived benefits and self-efficacy were significantly related to both Pap testing (ps ≤ 0.003) and HPV vaccination (ps ≤ 0.010). Mothers reported lower self-efficacy for HPV vaccination than nonmothers (p = 0.035). Discussion: Consistent with nationwide statistics, most eligible participants were up-to-date with Pap testing and HPV vaccination. Although motherhood was not significantly associated with either behavior, mothers reported lower self-efficacy for HPV vaccination. Perceived benefits and self-efficacy may be important targets for future interventions aiming to increase cervical cancer prevention and screening behaviors.

PMID:36827467 | DOI:10.1089/jwh.2022.0388