Nevin Manimala

Neurology. 2024 Apr 9;102(7_supplement_1):3368. doi: 10.1212/WNL.0000000000205091. Epub 2024 Apr 9.

ABSTRACT

OBJECTIVE: This study aimed to clarify the clinical significance of complex repetitive discharges (CRDs) identified on needle electromyography (EMG) in patients with radiculopathies.

BACKGROUND: CRDs are incompletely understood spontaneous needle EMG waveforms that can be seen in both myopathic and neurogenic disorders including radiculopathies.

DESIGN/METHODS: This case-control study randomly identified 100 patients with needle EMG evidence of radiculopathy demonstrating at least one CRD in the electrodiagnostically involved myotome between January 1, 2017 and January 1, 2022. These patients were compared with 100 randomly selected patients with EMG evidence of radiculopathy without CRDs matched to sex, age at EMG testing, and affected nerve root segment. Patient clinical symptoms, neurologic examination, EMG features, and imaging studies were analyzed. A paired sample t-test for continuous data and chi-square test for categorical data were used for statistical analysis with significance defined as p<0.05.

RESULTS: Patients with radiculopathies with CRDs had longer disease duration averaging 59 months (range 1-480) compared to patients with radiculopathies without CRDs averaging 26 months (range 1-192, p<0.01). Clinical symptoms of paresthesias and weakness were both significantly more common in patients with radiculopathies with CRDs than those patients without CRDs (p<0.01 and 0.01, respectively). Patients with radiculopathies with CRDs were referred more frequently for EMG testing specifically for a radiculopathy (p<0.01), had a higher average number of muscles with neurogenic motor unit potentials on EMG per radiculopathy (p=0.01), and had more evidence of active radiculopathies on EMG (p<0.01) compared with patients with radiculopathies without CRDs. Imaging studies of patients with radiculopathies with CRDs in the affected myotome were more likely to reveal evidence of potential nerve root compression (p<0.01).

CONCLUSIONS: The presence of CRDs in patients with radiculopathies is consistent with clinically more symptomatic radiculopathies and a longer duration of nerve root compromise. Disclosure: Dr. Skolka has nothing to disclose. Dr. Hass has nothing to disclose. Dr. Rubin has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Clinical Neurophysiology. Dr. Rubin has received intellectual property interests from a discovery or technology relating to health care. Dr. Rubin has received intellectual property interests from a discovery or technology relating to health care. Dr. Rubin has received publishing royalties from a publication relating to health care. Dr. Rubin has received publishing royalties from a publication relating to health care. Dr. Laughlin has nothing to disclose.

PMID:39977884 | DOI:10.1212/WNL.0000000000205091

Neurology. 2024 Apr 9;102(7_supplement_1):3371. doi: 10.1212/WNL.0000000000205092. Epub 2024 Apr 9.

ABSTRACT

OBJECTIVE: To collect real-world data to evaluate the effectiveness, safety, and tolerability of adding atogepant to onabotulinumtoxinA as combination preventive treatment for chronic migraine (CM).

BACKGROUND: Combination use of atogepant and onabotulinumtoxinA has the potential to be more effective than either alone for the preventive treatment of CM.

DESIGN/METHODS: This retrospective, longitudinal, multi-center chart review included adults with CM receiving ≥2 consecutive onabotulinumtoxinA cycles before ≥3mo of onabotulinumtoxinA and atogepant combination treatment. Charts at first atogepant prescription (index date) and 2 onabotulinumtoxinA injection visits (~3 and 6mo post-index) were reviewed for change from baseline in monthly headache days (MHDs), ≥50% reduction in MHDs, and rates and types of adverse events (AEs). Charts with CGRP agents for migraine prevention during baseline (~3mo pre-index) were excluded.

RESULTS: 31 charts met eligibility criteria (mean age 46.7 years, 94% female). Atogepant 60 mg and 30 mg were administered QD to 30 and 1 patients, respectively. Throughout the study, patients received a mean dose of 170U onabotulinumtoxinA. Pre-onabotulinumtoxinA, the mean MHD was 24.0d, reduced by a mean -8.15d (95%CI -11.44,-4.85; n=25) after onabotulinumtoxinA pre-index (mean 3.97yr). MHD additionally decreased by mean -4.53d [95%CI -7.44,-1.61] after ~3mo of combination treatment (n=31) and -8.75d total [95%CI -13.21, -4.29] after ~6mo of combination treatment in patients with data available (n=23). Nearly half of patients (n=14/31) achieved ≥50% reduction in MHDs ~3mo post-index. Overall, 95% CIs indicate that reductions from baseline were statistically significant. No new safety signals were identified when atogepant was added to onabotulinumtoxinA. The most commonly reported AEs (≥5%) were constipation and fatigue.

CONCLUSIONS: This real-world pilot study of patients with CM demonstrated clinically meaningful treatment benefit in the reduction of headache days with onabotulinumtoxinA alone and additive benefits with co-administration of atogepant. Safety results were consistent with the known safety profiles of onabotulinumtoxinA and atogepant. Disclosure: Dr. Blumenfeld has received personal compensation for serving as an employee of The Los Angeles Headache Center. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Allergan. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Best Doctors. Dr. Blumenfeld has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Guidepoint. Dr. Blumenfeld has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GLG. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Theranica. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Aeon. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Revance. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lilly. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Abbvie. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aeon. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Revance. Dr. Blumenfeld has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theranica. Dr. Blumenfeld has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axsome. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Allergan. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen. Dr. Blumenfeld has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Teva. Dr. Blumenfeld has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Lilly. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biohaven. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lundbeck. Dr. Mechtler has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Jushi Inc. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Novartis. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lilly. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biohaven. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lundbeck. Dr. Mechtler has received stock or an ownership interest from Jushi Co.. The institution of Dr. Mechtler has received research support from The Harry Dent Family Foundation, Inc. The institution of Dr. Mechtler has received research support from Amgen/Novartis. The institution of Dr. Mechtler has received research support from Alder/ Lundbeck. The institution of Dr. Mechtler has received research support from Abbvie/Allergan. The institution of Dr. Mechtler has received research support from Miles for Migraine. The institution of Dr. Mechtler has received research support from American Migraine Foundation. The institution of Dr. Mechtler has received research support from Charlotte’s Web. Dr. Cook has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbvie. Dr. Cook has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva. Dr. Cook has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Impel. The institution of Dr. Cook has received research support from Abbvie . The institution of Dr. Cook has received research support from Aeon. The institution of Dr. Cook has received research support from Axsome . The institution of Dr. Cook has received research support from Lilly . Dr. Rhyne has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie/Allergan. Dr. Rhyne has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie/Allergan. Dr. Rhyne has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Abbvie/Allergan. Dr. Rhyne has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen. Dr. Rhyne has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva. Dr. Rhyne has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biohaven. Dr. Rhyne has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Lilly. Dr. Rhyne has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Theranica. Dr. Rhyne has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lundbeck. Dr. Rhyne has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker with Diamond Headache Clinic Research and Education Foundation. Dr. Rhyne has received personal compensation in the range of $500-$4,999 for serving as a Speaker with National Headache Foundation. Dr. Jenkins has received personal compensation for serving as an employee of Abbvie. Dr. Jenkins has received personal compensation for serving as an employee of Allergan. Dr. Jenkins has received personal compensation for serving as an employee of Teva. Dr. Jenkins has received personal compensation for serving as an employee of Biohaven. Dr. Jenkins has received personal compensation for serving as an employee of Lundbeck . Dr. Jenkins has received personal compensation for serving as an employee of Amgen and Novartis. Dr. Jenkins has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbvie. Dr. Jenkins has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Allergan . Dr. Jenkins has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva. Dr. Jenkins has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biohaven . Dr. Jenkins has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lundbeck . Dr. Jenkins has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen and Novartis. Dr. Jenkins has stock in Prevacus. Dr. Jenkins has received intellectual property interests from a discovery or technology relating to health care. Ms. Hughes has received personal compensation for serving as an employee of ICON plc. Dr. Dabruzzo has received personal compensation for serving as an employee of AbbVie. Dr. Dabruzzo has stock in AbbVie. Dr. Manack Adams has received personal compensation for serving as an employee of Abbvie. Dr. Manack Adams has stock in Abbvie. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Allergan/AbbVie . Merle Diamond has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck Pharmaceutical . Merle Diamond has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Impel NeuroPharma. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Promius. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck Pharmaceuticals . Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/AbbVie. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Assertio. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly . Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Promius Pharma. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Supernus . Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva Pharma. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Upsher-Smith . Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Impel Neuro Pharma . Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axsome. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Assertio. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amgen. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Axsome Pharma . Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Assertio Therapeutics . Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eli Lilly . Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lundbeck . Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Supernus Pharma. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva . Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Upsher Smith. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Impel Neuro Pharma. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Allergan/AbbVie. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Lundbeck . Merle Diamond has received research support from Amgen . Merle Diamond has received research support from Lundbeck. Merle Diamond has received research support from Teva . Merle Diamond has received research support from Eli Lilly. Merle Diamond has received research support from Allergan. Merle Diamond has received personal compensation in the range of $500-$4,999 for serving as a Course Directory, Speaker with Diamond Research & Educational Foundation.

PMID:39977883 | DOI:10.1212/WNL.0000000000205092

Neurology. 2024 Apr 9;102(7_supplement_1):6861. doi: 10.1212/WNL.0000000000208139. Epub 2024 Apr 9.

ABSTRACT

OBJECTIVE: Our study aimed to determine a more precise treatment effect of balloon-expanding stents (BES) compared with self-expanding stents (SES) than be derived from considering each study with a small sample size individually.

BACKGROUND: There is limited data regarding the comparison of balloon-expanding stents (BES) and self-expanding stents (SES) for the treatment of intracranial arterial stenosis.

DESIGN/METHODS: We conducted a systematic review to identify studies that compared SES and BES in patients with symptomatic intracranial arterial stenosis. Data were extracted from relevant studies found through a search of PubMed, Scopus, and Web of Science until May 2023. Statistical pooling with random-effects meta-analysis was undertaken to compare the rates/severity of post-procedure stenosis, technical success, stroke and/or mortality, long-term events, and restenosis rates between BES and SES.

RESULTS: A total of 20 studies were included. The standardized mean difference (SMD) for post-procedure stenosis (%) was significantly lower (SMD: -0.52, 95% confidence interval [CI]: -0.79 to -0.24, p < 0.001, 10 studies involving 1515 patients) with BES. The odds for technical success were non-significantly lower (odds ratio [OR]: 0.99, 95% CI 0.43-2.26, p = 0.983, 9 studies involving 1001 patients) with BES. The odds for post-procedure 30-day stroke and/or death were significantly lower (OR 0.68, 95% CI: 0.50-0.94, p = 0.019, 15 studies involving 2431 patients), and stroke and/or death beyond 30 days were non-significantly lower (OR 0.64, 95% CI: 0.30-1.37, p = 0.250, 10 studies involving 947 patients) with BES. The odds for restenosis rate were significantly lower (OR 0.50, 95% CI: 0.31-0.80, p = 0.004, 13 studies involving 1115 patients) with BES.

CONCLUSIONS: Compared with SES, BES were associated with lower rates of post-procedure 30-day stroke and/or death presumably due to less severe post procedure stenosis in treatment of symptomatic intracranial arterial stenosis. Disclosure: Dr. Lodhi has nothing to disclose. Mr. Ma has nothing to disclose. Dr. Ahmed has nothing to disclose. Dr. Liaqat has nothing to disclose. Mr. Maqsood has nothing to disclose. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stryker. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Penumbra. Dr. Hassan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cerenovus. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Viz.ai. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Hassan has received research support from GE Healthcare. Dr. Siddiq has nothing to disclose. Dr. Gomez has nothing to disclose. Dr. Suri has nothing to disclose. Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.

PMID:39977881 | DOI:10.1212/WNL.0000000000208139

JMIR Res Protoc. 2025 Feb 20;14:e59842. doi: 10.2196/59842.

ABSTRACT

BACKGROUND: Standard lifestyle interventions have shown limited efficacy in preventing type 2 diabetes among individuals with isolated impaired fasting glucose (i-IFG). Hence, tailored intervention approaches are necessary for this high-risk group.

OBJECTIVE: This study aims to (1) assess the feasibility of conducting a high-intensity interval training (HIIT) study and the intervention acceptability among individuals with i-IFG, and (2) investigate the preliminary efficacy of HIIT in reducing fasting plasma glucose levels and addressing the underlying pathophysiology of i-IFG.

METHODS: This study is a 1:1 proof-of-concept randomized controlled trial involving 34 physically inactive individuals (aged 35-65 years) who are overweight or obese and have i-IFG. Individuals will undergo a 3-step screening procedure to determine their eligibility: step 1 involves obtaining clinical information from electronic health records, step 2 consists of completing questionnaires, and step 3 includes blood tests. All participants will be fitted with continuous glucose monitoring devices for approximately 80 days, including 10 days prior to the intervention, the 8-week intervention period, and 10 days following the intervention. Intervention participants will engage in supervised HIIT sessions using stationary “spin” cycle ergometers in groups of 5 or fewer. The intervention will take place 3 times a week for 8 weeks at the Aerobic Exercise Laboratory in the Rehabilitation Hospital at Emory University. Control participants will be instructed to refrain from engaging in intense physical activities during the study period. All participants will receive instructions to maintain a eucaloric diet throughout the study. Baseline and 8-week assessments will include measurements of weight, blood pressure, body composition, waist and hip circumferences, as well as levels of fasting plasma glucose, 2-hour plasma glucose, and fasting insulin. Primary outcomes include feasibility parameters, intervention acceptability, and participants’ experiences, perceptions, and satisfaction with the HIIT intervention, as well as facilitators and barriers to participation. Secondary outcomes comprise between-group differences in changes in clinical measures and continuous glucose monitoring metrics from baseline to 8 weeks. Quantitative data analysis will include descriptive statistics, correlation, and regression analyses. Qualitative data will be analyzed using framework-driven and thematic analyses.

RESULTS: Recruitment for the study is scheduled to begin in February 2025, with follow-up expected to be completed by the end of September 2025. We plan to publish the study findings by the end of 2025.

CONCLUSIONS: The study findings are expected to guide the design and execution of an adequately powered randomized controlled trial for evaluating HIIT efficacy in preventing type 2 diabetes among individuals with i-IFG.

TRIAL REGISTRATION: Clinicaltrials.gov NCT06143345; https://clinicaltrials.gov/study/NCT06143345.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/59842.

PMID:39977858 | DOI:10.2196/59842

J Med Internet Res. 2025 Feb 20;27:e59101. doi: 10.2196/59101.

ABSTRACT

BACKGROUND: Men who have sex with men (MSM) are at high risk for HIV infection and sexually transmitted diseases (STDs). However, there is a lack of accurate and convenient tools to assess this risk.

OBJECTIVE: This study aimed to develop machine learning models and tools to predict and assess the risk of HIV infection and STDs among MSM.

METHODS: We conducted a cross-sectional study that collected individual characteristics of 1999 MSM with negative or unknown HIV serostatus in Western China from 2013 to 2023. MSM self-reported their STD history and were tested for HIV. We compared the accuracy of 6 machine learning methods in predicting the risk of HIV infection and STDs using 7 parameters for a comprehensive assessment, ranking the methods according to their performance in each parameter. We selected data from the Sichuan MSM for external validation.

RESULTS: Of the 1999 MSM, 72 (3.6%) tested positive for HIV and 146 (7.3%) self-reported a history of previous STD infection. After taking the results of the intersection of the 3 feature screening methods, a total of 7 and 5 predictors were screened for predicting HIV infection and STDs, respectively, and multiple machine learning prediction models were constructed. Extreme gradient boost models performed optimally in predicting the risk of HIV infection and STDs, with area under the curve values of 0.777 (95% CI 0.639-0.915) and 0.637 (95% CI 0.541-0.732), respectively, demonstrating stable performance in both internal and external validation. The highest combined predictive performance scores of HIV and STD models were 33 and 39, respectively. Interpretability analysis showed that nonadherence to condom use, low HIV knowledge, multiple male partners, and internet dating were risk factors for HIV infection. Low degree of education, internet dating, and multiple male and female partners were risk factors for STDs. The risk stratification analysis showed that the optimal model effectively distinguished between high- and low-risk MSM. MSM were classified into HIV (predicted risk score <0.506 and ≥0.506) and STD (predicted risk score <0.479 and ≥0.479) risk groups. In total, 22.8% (114/500) were in the HIV high-risk group, and 43% (215/500) were in the STD high-risk group. HIV infection and STDs were significantly higher in the high-risk groups (P<.001 and P=.05, respectively), with higher predicted probabilities (P<.001 for both). The prediction results of the optimal model were displayed in web applications for probability estimation and interactive computation.

CONCLUSIONS: Machine learning methods have demonstrated strengths in predicting the risk of HIV infection and STDs among MSM. Risk stratification models and web applications can facilitate clinicians in accurately assessing the risk of infection in individuals with high risk, especially MSM with concealed behaviors, and help them to self-monitor their risk for targeted, timely diagnosis and interventions to reduce new infections.

PMID:39977856 | DOI:10.2196/59101

JCO Glob Oncol. 2025 Feb;11:e2400313. doi: 10.1200/GO-24-00313. Epub 2025 Feb 20.

ABSTRACT

PURPOSE: Ovarian cancer remains among the most aggressive tumors with the lowest survival probability. Projections are that ovarian cancer will claim more than 8 million lives between 2022 and 2050 without better prevention or control measures.

METHODS: We built an Excel-based instrument that uses a prevalence-based cost-of-illness approach and a societal perspective to estimate the burden of ovarian cancer. The instrument leverages data from editions of the World Ovarian Cancer Coalition’s Every Woman Study, contains a micro-costing framework to assess the resources and costs of providing care, and uses data from novel systematic reviews and meta-analyses conducted to estimate the effect of ovarian cancer on patient labor productivity outcomes and the time caregivers devote to caring for people living with the disease.

RESULTS: Across 11 countries, we estimated US dollars 70 billion in socioeconomic losses attributable to ovarian cancer. Health expenditures to cover treatment in the first 2 years after diagnosis were 7, 41, and 118 times total health spending per capita in high-, upper-middle-, and low- and lower-middle countries, respectively. Patients spent 3,663 years traveling to or receiving treatment. Women lost labor productivity equivalent to 2.5 million workdays due to ill-health from ovarian cancer, and 9,403 women living with ovarian cancer or survivors were estimated to be missing from the workforce. Caregivers spent 17,112 person-years providing practical support to patients-an average of 33 days per woman living with ovarian cancer.

CONCLUSION: This study is the first to quantify the social and economic burden of ovarian cancer in 11 countries and highlights its significant cost and defines actions needed to improve ovarian cancer outcomes.

PMID:39977710 | DOI:10.1200/GO-24-00313

JCO Glob Oncol. 2025 Feb;11:e2400340. doi: 10.1200/GO-24-00340. Epub 2025 Feb 20.

ABSTRACT

PURPOSE: Triple-negative breast cancer (TNBC) presents notable treatment difficulties, especially in the public health care systems of low- and middle-income countries where access to advanced therapies is restricted. This study investigates TNBC’s clinical, epidemiologic, and economic effects on survival within Brazil’s public health care system.

METHODS: We conducted a retrospective cohort study of patients with TNBC treated between 2010 and 2019. Overall survival (OS) rates by stage were analyzed across various patient groups, including those receiving neoadjuvant or adjuvant treatment, patients with or without complete pathologic response, Black and non-Black patients, and those treated with or without carboplatin-based therapy. Cox proportional hazards models were applied to estimate hazard ratios (HRs) with 95% CIs, and annual treatment costs were calculated per stage.

RESULTS: Among 1,266 patients with TNBC, 710 met eligibility criteria. Kaplan-Meier analysis indicated stage II patients had a 47% lower mortality risk than stage III (HR, 0.53 [95% CI, 0.33 to 0.85]; P = .009). Patients in the adjuvant treatment group had a reduced risk (HR, 0.48 [95% CI, 0.34 to 0.69]) compared with the neoadjuvant group. Achieving complete pathologic response (pCR) greatly improved OS (HR, 0.21 [95% CI, 0.11 to 0.43]; P < .001). Black patients had better survival rates than non-Black (HR, 0.58 [95% CI, 0.40 to 0.86]; P = .006). Carboplatin use did not significantly affect OS (HR, 0.96 [95% CI, 0.65 to 1.43]; P = .857). The average monthly cost for systemic TNBC treatment increased with disease progression, from $101.87 in US dollars (USD) for stage I to $314.77 USD for stage IV second-line therapy.

CONCLUSION: This study provides insight into TNBC in Brazil’s public health system, showing that OS decreases with disease progression but is higher among Black patients. pCR and adjuvant therapy improve survival, although costs increase significantly at advanced stages, highlighting the economic burden of late-stage TNBC management.

PMID:39977709 | DOI:10.1200/GO-24-00340

Nurse Educ. 2025 Mar-Apr 01;50(2):84-89. doi: 10.1097/NNE.0000000000001772. Epub 2024 Nov 12.

ABSTRACT

BACKGROUND: Interprofessional team training (IPTT) prepares students from health care professions for team-based care. Evaluating different learning environments to inform decisions about delivery format is timely and important.

PURPOSE: To compare in-person and online IPTT learner outcomes.

METHOD: Undergraduate and graduate students (n = 866) from 11 professions participated. Using retrospective pre-/post-methodology, 20 item Interprofessional Collaboration Competency Attainment Survey (ICCAS) scores were compared, and qualitative responses analyzed.

RESULTS: Mean ICCAS scores improved for in-person and online delivery (P < .0001) with large effect sizes (Cohen’s D = 0.94-1.86). In-person delivery resulted in greatest improvement (P = .038), offset by online logistical benefits. Qualitative themes highlighted impact on learning, importance of facilitator competence, and setting expectations.

CONCLUSION: IPTT achieved learning consistent with competency development. Advantages from in-person delivery should be weighed against online logistical advantages.

PMID:39977695 | DOI:10.1097/NNE.0000000000001772

Nurse Educ. 2025 Mar-Apr 01;50(2):79-83. doi: 10.1097/NNE.0000000000001770. Epub 2024 Nov 12.

ABSTRACT

BACKGROUND: Seventeen percent of individuals in the United States live with substance use disorder (SUD). Nursing curricula may not adequately address SUD, and stigma can impact care.

PURPOSE: This project aimed to measure stigma toward people with SUD among nursing students.

METHODS: Surveys were administered to prelicensure nursing students. Stigma was measured using the Opening Minds Provider Attitudes Toward Opioid-Use Scale. Students were asked about personal experience with SUD and perceived adequacy of SUD-related curricula.

RESULTS: A total of 193 students participated. The mean stigma score was 31.35. Those with personal experience had lower stigma scores than those without ([95% CI 2.26-9.23]; P value = .0014). Most students (71.0%) desired to see content from individuals with lived experience incorporated into curriculum.

CONCLUSION: Addressing stigma in SUD education is critical for improving future patient care. Nursing schools should consider incorporating stigma-reducing content, including perspectives from individuals with lived experiences, into SUD curricula.

PMID:39977694 | DOI:10.1097/NNE.0000000000001770

Psychol Methods. 2025 Feb 20. doi: 10.1037/met0000730. Online ahead of print.

ABSTRACT

Confirmatory bifactor models have become very popular in psychological applications, but they are increasingly criticized for statistical pitfalls such as tendency to overfit, tendency to produce anomalous results, instability of solutions, and underidentification problems. In part to combat this state of affairs, many different reliability and dimensionality measures have been proposed to help researchers evaluate the quality of the obtained bifactor solution. However, in empirical practice, the evaluation of bifactor models is largely based on structural equation model fit indices. Other critical indicators of solution quality, such as patterns of general and group factor loadings, whether all estimates are interpretable, and values of reliability coefficients, are often not taken into account. In addition, in the methodological literature, some confusion exists about the appropriate interpretation and application of some bifactor reliability coefficients. In this article, we accomplish several goals. First, we review reliability coefficients for bifactor models and their correct interpretations, and we provide expectations for their values. Second, to help steer researchers away from structural equation model fit indices and to improve current practice, we provide a checklist for evaluating the statistical fit of bifactor models. Third, we evaluate the state of current practice by examining 96 empirical articles employing confirmatory bifactor models across different areas of psychology. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:39977687 | DOI:10.1037/met0000730