Category: Nevin Manimala

Disabil Rehabil Assist Technol. 2022 Oct 10:1-10. doi: 10.1080/17483107.2022.2129849. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to understand Bangladeshi users’ satisfaction with their assistive devices, including (a) device characteristics, e.g., size, weight, safety, ease of use, comfort, and effectiveness, and (b) availability of parts and repair services. We also described how frequently individuals with disabilities living in the community used assistive devices in their daily activities and how the use of assistive devices promoted individuals’ wellbeing.

METHOD: We conducted a cross-sectional survey with assistive device users or their guardians (if under 18) in Bangladesh about their experience and satisfaction with their assistive device 6 months after receiving it. The research team developed a survey questionnaire consisting of both closed and open-ended questions. All data were collected via telephone interviews. We employed descriptive statistics to analyse quantitative data and inductive analysis for the qualitative data.

RESULTS: We found that out of the 376 participants, nearly 95% used assistive devices on a regular basis, and their satisfaction with the devices was high. Participants reported that assistive devices improved mobility, independence, and wellbeing of persons with disabilities. A few participants (6.4%) reported that their devices were damaged. Some participants identified concerns with their assistive devices, including (i) inappropriate size of ankle-foot orthoses, manual self-propelled wheelchairs, and prostheses, (ii) back slabs (a type of brace) being too short, and (iii) walking frames being too large. Several participants noted pain and discomfort when they used their assistive device. Additionally, some participants stated that environmental factors (e.g., muddy roads) contributed to the disrepair of their assistive devices. Finally, participants recounted that repair services were limited in rural areas of Bangladesh.

CONCLUSION: These findings indicate that the provision of assistive devices requires accommodating individuals’ needs and ensuring appropriate environments in which to function. The results support the need for follow-up services after distributing assistive devices. Further research could explore the impact of assistive devices on the family quality of life of persons with disabilities.IMPLICATIONS FOR REHABILITATIONIt is essential for rehabilitation professionals to conduct follow-up services after distributing assistive devices among persons with disabilities.There is a need for the government of Bangladesh to revisit the Rights and Protection of Persons with Disability Act of 2013 and provide further clarity about their commitment to the provision of assistive devices and associated services (e.g., repair services) and its subsequent implementation.Policymakers in Bangladesh must be proactive to translate policy commitments into practice, as it relates to building an accessible environment for people using assistive devices. Further, government efforts are needed to educate policy implementers in all relevant ministries so that all responsible bodies are fully familiar with their national and international commitments regarding the rights of persons with disabilities.Future research could (i) include user’s satisfaction with the service delivery process and (ii) measure the impact of assistive devices on family quality of life of persons with disabilities.

PMID:36215415 | DOI:10.1080/17483107.2022.2129849

JAMA. 2022 Oct 10. doi: 10.1001/jama.2022.18931. Online ahead of print.

ABSTRACT

IMPORTANCE: Some individuals experience persistent symptoms after initial symptomatic SARS-CoV-2 infection (often referred to as Long COVID).

OBJECTIVE: To estimate the proportion of males and females with COVID-19, younger or older than 20 years of age, who had Long COVID symptoms in 2020 and 2021 and their Long COVID symptom duration.

DESIGN, SETTING, AND PARTICIPANTS: Bayesian meta-regression and pooling of 54 studies and 2 medical record databases with data for 1.2 million individuals (from 22 countries) who had symptomatic SARS-CoV-2 infection. Of the 54 studies, 44 were published and 10 were collaborating cohorts (conducted in Austria, the Faroe Islands, Germany, Iran, Italy, the Netherlands, Russia, Sweden, Switzerland, and the US). The participant data were derived from the 44 published studies (10 501 hospitalized individuals and 42 891 nonhospitalized individuals), the 10 collaborating cohort studies (10 526 and 1906), and the 2 US electronic medical record databases (250 928 and 846 046). Data collection spanned March 2020 to January 2022.

EXPOSURES: Symptomatic SARS-CoV-2 infection.

MAIN OUTCOMES AND MEASURES: Proportion of individuals with at least 1 of the 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after SARS-CoV-2 infection in 2020 and 2021, estimated separately for hospitalized and nonhospitalized individuals aged 20 years or older by sex and for both sexes of nonhospitalized individuals younger than 20 years of age.

RESULTS: A total of 1.2 million individuals who had symptomatic SARS-CoV-2 infection were included (mean age, 4-66 years; males, 26%-88%). In the modeled estimates, 6.2% (95% uncertainty interval [UI], 2.4%-13.3%) of individuals who had symptomatic SARS-CoV-2 infection experienced at least 1 of the 3 Long COVID symptom clusters in 2020 and 2021, including 3.2% (95% UI, 0.6%-10.0%) for persistent fatigue with bodily pain or mood swings, 3.7% (95% UI, 0.9%-9.6%) for ongoing respiratory problems, and 2.2% (95% UI, 0.3%-7.6%) for cognitive problems after adjusting for health status before COVID-19, comprising an estimated 51.0% (95% UI, 16.9%-92.4%), 60.4% (95% UI, 18.9%-89.1%), and 35.4% (95% UI, 9.4%-75.1%), respectively, of Long COVID cases. The Long COVID symptom clusters were more common in women aged 20 years or older (10.6% [95% UI, 4.3%-22.2%]) 3 months after symptomatic SARS-CoV-2 infection than in men aged 20 years or older (5.4% [95% UI, 2.2%-11.7%]). Both sexes younger than 20 years of age were estimated to be affected in 2.8% (95% UI, 0.9%-7.0%) of symptomatic SARS-CoV-2 infections. The estimated mean Long COVID symptom cluster duration was 9.0 months (95% UI, 7.0-12.0 months) among hospitalized individuals and 4.0 months (95% UI, 3.6-4.6 months) among nonhospitalized individuals. Among individuals with Long COVID symptoms 3 months after symptomatic SARS-CoV-2 infection, an estimated 15.1% (95% UI, 10.3%-21.1%) continued to experience symptoms at 12 months.

CONCLUSIONS AND RELEVANCE: This study presents modeled estimates of the proportion of individuals with at least 1 of 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after symptomatic SARS-CoV-2 infection.

PMID:36215063 | DOI:10.1001/jama.2022.18931

JAMA Netw Open. 2022 Oct 3;5(10):e2234445. doi: 10.1001/jamanetworkopen.2022.34445.

ABSTRACT

IMPORTANCE: Obesity rates have risen in the United States since the 1980s. Several studies have shown links between obesity and the incidence of specific cancer types, but none have systematically examined obesity prevalence at the time of cancer diagnosis, or among clinical trial participants, all of which may affect clinical outcomes.

OBJECTIVE: To examine the prevalence of obesity and, separately, overweight and obesity over 30 years among patients with cancer enrolled in clinical treatment trials for obesity-related cancers; and to compare trends with corresponding trends in the US.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study examined clinical treatment trials for obesity-related cancers conducted by the SWOG Cancer Research Network at community and academic sites. Participants included adult patients enrolled in phase 2 or phase 3 clinical treatment trials in obesity-related cancers between 1986 and 2016. Statistical analysis was performed from June 2020 to July 2022.

EXPOSURES: Year of enrollment to a clinical trial.

MAIN OUTCOMES AND MEASURES: Prevalence of obesity (body mass index [BMI] ≥ 30) and overweight or obesity (BMI > 25) at the time of clinical trial enrollment. Multivariable logistic regression analysis, adjusted for demographic and clinical factors, was used to analyze patient height and weight collected at clinical trial enrollment.

RESULTS: Among 23 926 patients (median [IQR] age, 58 [51-66] years; 17 594 [73.5%] female; 969 [4.0%] Hispanic, 2173 [9.1%] non-Hispanic Black, 19 890 [83.1%] non-Hispanic White) enrolled between 1986 and 2016, unadjusted obesity rates increased from 23.5% (in 1986 to 1990 [n = 657]) to 42.3% (in 2011 to 2016 [n = 836]). There was an increasing linear trend in obesity (odds ratio [OR], 1.23 for each 5-year increase; 95% CI, 1.21-1.26; P < .001), which persisted after covariate adjustment for demographic and clinical characteristics. Findings were consistent for the combined prevalence of overweight and obesity. The observed overall increasing trend in obesity prevalence from 1999-2000 to 2015-2016 was greater in trial patients (21.3% [SE = 0.7] to 49.1% [SE = 1.6]) than in US adults (30.5% [SE = 1.5] to 39.6% [SE = 1.6]) (P for trend = .03), but was similar to US cancer survivors (18.9% [SE = 1.9] to 42.2% [SE = 2.1]; P for trend = .31).

CONCLUSIONS AND RELEVANCE: This cohort study found that patients with cancer and obesity are currently well-represented in cancer clinical trials, increasing confidence that trial findings are generalizable to patients with obesity in clinical practice. Availability of data on height and weight at diagnosis through cancer registries will enable a more rigorous analysis of obesity prevalence among patients with cancer.

PMID:36215073 | DOI:10.1001/jamanetworkopen.2022.34445

Med Educ. 2022 Oct 10. doi: 10.1111/medu.14949. Online ahead of print.

ABSTRACT

CONTEXT: Applicant perceptions of selection methods can affect motivation, performance and withdrawal, and may therefore be of relevance in the context of widening access. However, it is unknown how applicant subgroups perceive different selection methods.

OBJECTIVES: Using organizational justice theory, the present multi-site study examined applicant perceptions of various selection methods, rationales behind perceptions, and subgroup differences.

METHODS: Applicants to five Dutch undergraduate health professions programs (N=704) completed an online survey including demographics and a questionnaire on applicant perceptions applied to 11 commonly used selection methods. Applicants rated general favorability and justice dimensions (7-point Likert scale), and could add comments for each method.

RESULTS: Descriptive statistics revealed a preference for selection methods on which applicants feel more “in control”: general favorability ratings were highest for curriculum-sampling tests (mean [M]=5.32) and skills tests (M=5.13), while weighted lottery (M=3.05) and unweighted lottery (M=2.97) were perceived least favorable. Additionally, applicants preferred to distinguish themselves on methods that assess attributes beyond cognitive abilities. Qualitative content analysis of comments revealed several conflicting preferences, including a desire for multiple selection methods versus concerns of experiencing too much stress. Results from a linear mixed model of general favorability indicated some small subgroup differences in perceptions (based on gender, migration background, prior education and parental education), but practical meaning of these differences was negligible. Nevertheless, concerns were expressed that certain selection methods can hinder equitable admission due to inequal access to resources.

CONCLUSIONS: Our findings illustrate that applicants desire to demonstrate a variety of attributes on a combination of selection tools, but also observe that this can result in multiple drawbacks. The present study can help programs in deciding which selection methods to include, which more negatively perceived methods should be better justified to applicants, and how to adapt methods to meet applicants’ needs.

PMID:36215062 | DOI:10.1111/medu.14949

JAMA Neurol. 2022 Oct 10. doi: 10.1001/jamaneurol.2022.3185. Online ahead of print.

ABSTRACT

IMPORTANCE: No lifestyle-based randomized clinical trial directly targets psychoaffective risk factors of dementia. Meditation practices recently emerged as a promising mental training exercise to foster brain health and reduce dementia risk.

OBJECTIVE: To investigate the effects of meditation training on brain integrity in older adults.

DESIGN, SETTING, AND PARTICIPANTS: Age-Well was a randomized, controlled superiority trial with blinded end point assessment. Community-dwelling cognitively unimpaired adults 65 years and older were enrolled between November 24, 2016, and March 5, 2018, in France. Participants were randomly assigned (1:1:1) to (1) an 18-month meditation-based training, (2) a structurally matched non-native language (English) training, or (3) no intervention arm. Analysis took place between December 2020 and October 2021.

INTERVENTIONS: Meditation and non-native language training included 2-hour weekly group sessions, practice of 20 minutes or longer daily at home, and 1-day intensive practices.

MAIN OUTCOMES AND MEASURES: Primary outcomes included volume and perfusion of anterior cingulate cortex (ACC) and insula. Main secondary outcomes included a global composite score capturing metacognitive, prosocial, and self-regulatory capacities and constituent subscores.

RESULTS: Among 137 participants (mean [SD] age, 69.4 [3.8] years; 83 [60.6%] female; 54 [39.4%] male) assigned to the meditation (n = 45), non-native language training (n = 46), or no intervention (n = 46) groups, all but 1 completed the trial. There were no differences in volume changes of ACC (0.01 [98.75% CI, -0.02 to 0.05]; P = .36) or insula (0.01 [98.75% CI, -0.02 to 0.03]; P = .58) between meditation and no intervention or non-native language training groups, respectively. Differences in perfusion changes did not reach statistical significance for meditation compared with no intervention in ACC (0.02 [98.75% CI, -0.01 to 0.05]; P = .06) or compared with non-native language training in insula (0.02 [98.75% CI, -0.01 to 0.05]; P = .09). Meditation was superior to non-native language training on 18-month changes in a global composite score capturing attention regulation, socioemotional, and self-knowledge capacities (Cohen d, 0.52 [95% CI, 0.19-0.85]; P = .002).

CONCLUSIONS AND RELEVANCE: The study findings confirm the feasibility of meditation and non-native language training in elderly individuals, with high adherence and very low attrition. Findings also show positive behavioral effects of meditation that were not reflected on volume, and not significantly on perfusion, of target brain areas.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02977819.

PMID:36215061 | DOI:10.1001/jamaneurol.2022.3185

Prosthet Orthot Int. 2022 Oct 1;46(5):459-465. doi: 10.1097/PXR.0000000000000159. Epub 2022 Jul 1.

ABSTRACT

BACKGROUND: The aim of this study was to compare the thicknesses of intact talar cartilage, tibialis anterior (TA), gastrocnemius medialis (GCM), and gastrocnemius lateralis (GCL) muscles of traumatic unilateral transtibial amputees with that of nonamputated individuals by ultrasound and to investigate the relationship between cartilage and muscle thickness measurements with clinical parameters.

METHODS: Thirty-six patients with unilateral traumatic transtibial amputation, and 36 age-matched, sex-matched, and body mass index-matched nonamputated controls were included in this cross-sectional study. Subjects’ talar cartilage, TA, GCM, and GCL muscle thickness measurements were performed using musculoskeletal ultrasound. Other outcome measures were 6-minute walking test, the Foot and Ankle Outcome Score, and Short Form-36.

RESULTS: TA and GCM muscles were thicker on the intact limbs of the patients than those of the controls (p = 0.015 and p = 0.014, respectively). There was no statistically significant difference in talar cartilage and GCL muscle thicknesses when patients were compared with control subjects. Talar cartilage thickness was positively correlated with body mass index, 6-minute walking test, and sport and recreation subscale score of the Foot and Ankle Outcome Score. TA and GCM muscle thicknesses were positively correlated with the duration of prosthesis use and role limitations because of the physical health subscale score of Short Form-36.

CONCLUSIONS: TA and GCM muscles were found to be thickened on the intact sides of traumatic unilateral transtibial amputees. The correlations between lower leg muscle thicknesses and clinical parameters suggest that the observed thickness change is not necessarily pathological and has potential impact on function at least in our young cohort.

PMID:36215056 | DOI:10.1097/PXR.0000000000000159

J Agromedicine. 2022 Oct 10:1-10. doi: 10.1080/1059924X.2022.2134243. Online ahead of print.

ABSTRACT

BACKGROUND: Farmers are disproportionally affected by depression and suicide. Social connectedness has been shown to reduce depression and suicide among the general population but its impact on farmers is less well-known. Our previous research indicated that farmers who had cooperative resources and social support reported decreased symptoms of depression. However, it was unclear whether farmers who were not cooperative members or utilized resources from non-cooperative organizations differed from cooperative farmers in mental health.

METHODS: A survey consisted of online self-completion and phone interviews was conducted among 307 participants (197 co-op, 110 non-co-op) to examine whether Midwest (north central United States) cooperative and non-cooperative farmers differ in perceived stress and symptoms of depression and whether potential differences were impacted by program use, program satisfaction, and social support.

RESULTS: Cooperative farmers reported lower perceived stress and symptoms of depression than non-cooperative farmers and the difference was statistically significant for perceived stress. Use of educational programs, such as training and mentorship, was associated with decreased perceived stress but not symptoms of depression. Satisfaction with programs and social support were associated with decreased perceived stress and symptoms of depression. Program satisfaction was observed to have more associations with decreased perceived stress and symptoms of depression than program use.

CONCLUSIONS: Results reveal that organizational resources and social support can mitigate mental health risks among farmers. This study highlighted an opportunity for future investigation of social connectedness in addressing farmers’ mental health.

PMID:36215041 | DOI:10.1080/1059924X.2022.2134243

Nucleic Acids Res. 2022 Oct 10:gkac859. doi: 10.1093/nar/gkac859. Online ahead of print.

ABSTRACT

Elucidating the role of 3D architecture of DNA in gene regulation is crucial for understanding cell differentiation, tissue homeostasis and disease development. Among various chromatin conformation capture methods, HiChIP has received increasing attention for its significant improvement over other methods in profiling of regulatory (e.g. H3K27ac) and structural (e.g. cohesin) interactions. To facilitate the studies of 3D regulatory interactions, we developed a HiChIP interactions database, HiChIPdb (http://health.tsinghua.edu.cn/hichipdb/). The current version of HiChIPdb contains ∼262M annotated HiChIP interactions from 200 high-throughput HiChIP samples across 108 cell types. The functionalities of HiChIPdb include: (i) standardized categorization of HiChIP interactions in a hierarchical structure based on organ, tissue and cell line and (ii) comprehensive annotations of HiChIP interactions with regulatory genes and GWAS Catalog SNPs. To the best of our knowledge, HiChIPdb is the first comprehensive database that utilizes a unified pipeline to map the functional interactions across diverse cell types and tissues in different resolutions. We believe this database has the potential to advance cutting-edge research in regulatory mechanisms in development and disease by removing the barrier in data aggregation, preprocessing, and analysis.

PMID:36215037 | DOI:10.1093/nar/gkac859

Nucleic Acids Res. 2022 Oct 10:gkac863. doi: 10.1093/nar/gkac863. Online ahead of print.

ABSTRACT

Cotton is an important economic crop, and many loci for important traits have been identified, but it remains challenging and time-consuming to identify candidate or causal genes/variants and clarify their roles in phenotype formation and regulation. Here, we first collected and integrated the multi-omics datasets including 25 genomes, transcriptomes in 76 tissue samples, epigenome data of five species and metabolome data of 768 metabolites from four tissues, and genetic variation, trait and transcriptome datasets from 4180 cotton accessions. Then, a cotton multi-omics database (CottonMD, http://yanglab.hzau.edu.cn/CottonMD/) was constructed. In CottonMD, multiple statistical methods were applied to identify the associations between variations and phenotypes, and many easy-to-use analysis tools were provided to help researchers quickly acquire the related omics information and perform multi-omics data analysis. Two case studies demonstrated the power of CottonMD for identifying and analyzing the candidate genes, as well as the great potential of integrating multi-omics data for cotton genetic breeding and functional genomics research.

PMID:36215030 | DOI:10.1093/nar/gkac863

Int Ophthalmol. 2022 Oct 10. doi: 10.1007/s10792-022-02480-6. Online ahead of print.

ABSTRACT

PURPOSE: To synthesize existing evidence on adverse events, complications, and unfavorable outcomes of current treatment modalities for treatment-requiring retinopathy of prematurity (TR-ROP).

METHODS: PubMed, Cochrane Central Register of Controlled Trials, Scopus, EMBASE, Trip Database, and the gray literature available were searched. Randomized Clinical Trials and observational studies comparing the adverse events of intravitreal anti-VEGF injections (bevacizumab, ranibizumab, aflibercept, pegaptanib, conbercept) and laser photocoagulation (LPC) as treatment modalities for infants with TR-ROP were included. The main outcomes compared between the two treatment modalities were: 1. Refractive Errors and Biometry Parameters, 2. Adverse events, complications, and unfavorable outcomes, 3. Disease Recurrence/Disease Regression/Need for retreatment, 4. Neurodevelopmental Outcomes.

RESULTS: Higher quality studies concluded that LPC leads to greater rates of myopia than intravitreal anti-VEGF treatment while the rate of adverse events and of unfavorable neurodevelopmental outcomes is similar. However, there was controversy among the included studies concerning the rate of ROP recurrence between intravitreal anti-VEGF injections and LPC.

CONCLUSION: There is need for future primary studies assessing the adverse events of intravitreal anti-VEGF injections compared with LPC as treatment modalities for infants with TR-ROP.

PMID:36214992 | DOI:10.1007/s10792-022-02480-6