Nevin Manimala

J Med Internet Res. 2025 Feb 11;27:e68881. doi: 10.2196/68881.

ABSTRACT

BACKGROUND: Despite the reinstatement of proactive human papillomavirus (HPV) vaccine recommendations in 2022, Japan continues to face persistently low HPV vaccination rates, which pose significant public health challenges. Misinformation, complacency, and accessibility issues have been identified as key factors undermining vaccine uptake.

OBJECTIVE: This study aims to examine the evolution of public attitudes toward HPV vaccination in Japan by analyzing social media content. Specifically, we investigate the role of misinformation, public health events, and cross-vaccine attitudes (eg, COVID-19 vaccines) in shaping vaccine hesitancy over time.

METHODS: We collected tweets related to the HPV vaccine from 2011 to 2021. Natural language processing techniques and large language models (LLMs) were used for stance analysis of the collected data. Time series analysis and latent Dirichlet allocation topic modeling were used to identify shifts in public sentiment and topic trends over the decade. Misinformation within opposed-stance tweets was detected using LLMs. Furthermore, we analyzed the relationship between attitudes toward HPV and COVID-19 vaccines through logic analysis.

RESULTS: Among the tested models, Gemini 1.0 pro (Google) achieved the highest accuracy (0.902) for stance analysis, improving to 0.968 with hyperparameter tuning. Time series analysis identified significant shifts in public stance in 2013, 2016, and 2020, corresponding to key public health events and policy changes. Topic modeling revealed that discussions around vaccine safety peaked in 2015 before declining, while topics concerning vaccine effectiveness exhibited an opposite trend. Misinformation in topic “Scientific Warnings and Public Health Risk” in the sopposed-stance tweets reached a peak of 2.84% (47/1656) in 2012 and stabilized at approximately 0.5% from 2014 onward. The volume of tweets using HPV vaccine experiences to argue stances on COVID-19 vaccines was significantly higher than the reverse.

CONCLUSIONS: Based on observation on the public attitudes toward HPV vaccination from social media contents over 10 years, our findings highlight the need for targeted public health interventions to address vaccine hesitancy in Japan. Although vaccine confidence has increased slowly, sustained efforts are necessary to ensure long-term improvements. Addressing misinformation, reducing complacency, and enhancing vaccine accessibility are key strategies for improving vaccine uptake. Some evidence suggests that confidence in one vaccine may positively influence perceptions of other vaccines. This study also demonstrated the use of LLMs in providing a comprehensive understanding of public health attitudes. Future public health strategies can benefit from these insights by designing effective interventions to boost vaccine confidence and uptake.

PMID:39933163 | DOI:10.2196/68881

Retina. 2025 Feb 6. doi: 10.1097/IAE.0000000000004426. Online ahead of print.

ABSTRACT

PURPOSE: To investigate any difference in the rate of serotonin reuptake inhibitor (SRI) use in patients with retinal vein occlusions (RVO), compared to an age matched control group.

METHODS: Retrospective data collection of risk factors and prescribed drugs from consecutive electronic patient records of all patients diagnosed with RVO over 5 years. Routine, age matched patients were identified for a control group. The two groups were compared with Chi2 test and multiple Logistic regression. Odds ratios (OR) were calculated.

RESULTS: In total, 775 patients were included in this study. 283 patients were in the RVO group and 492 in the control group. The rate of SRI and Statin use was significantly different in both groups for all ages (p<0.001). Logistic regression confirmed a significant reduction in RVO associated with SRI use (OR 0.39), Statins (OR 0.51) and combined drugs (OR 0.22) with all groups reaching statistical significance (p<0.001).

CONCLUSION: This study has found lower rates of RVO in patients receiving an SRI or a Statin compared to controls. This data suggests that individuals taking an SRI are less likely to suffer a RVO and SRIs may have an additive effect when combined with Statins.

PMID:39933153 | DOI:10.1097/IAE.0000000000004426

J Cataract Refract Surg. 2025 Feb 11. doi: 10.1097/j.jcrs.0000000000001630. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate a novel software program (SpikeFinder) that improves quality of measurements obtained by optical low coherence reflectometry (OLCR) biometry (Lenstar).

SETTING: Tertiary care academic center.

DESIGN: Retrospective case series.

METHOD: ology: After applying inclusion criteria, 12,988 eyes scanned with OLCR biometry and swept-source OCT (SS-OCT) biometry (IOLMaster700) were analyzed. Measurements, including axial length (AL), anterior chamber depth (ACD), and lens thickness (LT), were compared. SpikeFinder was applied to eyes with the most prominent ACD and LT measurement differences. Statistical testing was performed using Wilcoxon (two variables) and Kruskal-Wallis ANOVA tests (multiple variables) with Tukey post-hoc adjustments. Heteroscedastic testing (WHWK Statistics Package) was used to assess differences after software application.

RESULTS: 99.1% of AL measurements were within 0.01 mm between the two biometers. SS-OCT LT was significantly longer than the OLCR LT: 33% differed by ≥ 0.50 mm (p<0.001). Correspondingly, SS-OCT ACD was significantly shorter than OLCR ACD: 14% differed by ≥ 0.50 mm (p<0.001). SS-OCT biometer – OLCR biometer values for ACD and LT before applying SpikeFinder were -0.64 ± 0.31 mm and 1.15 ± 0.38 mm, respectively (p<0.001). After applying SpikeFinder to a subgroup of 337 eyes, these differences were -0.02 ± 0.03 mm and 0.01 ± 0.11 mm, respectively. SpikeFinder ACD and LT values were similar to SS-OCT biometer-measured ACD (p=0.872) and LT (p=0.987) values.

CONCLUSION: The SpikeFinder program can help improve the accuracy of ACD and LT measurements obtained by the OLCR biometer, which may enhance the performance of formulas that utilize these measurements.

PMID:39933143 | DOI:10.1097/j.jcrs.0000000000001630

Neurol Neuroimmunol Neuroinflamm. 2025 Mar;12(2):e200371. doi: 10.1212/NXI.0000000000200371. Epub 2025 Feb 11.

ABSTRACT

BACKGROUND AND OBJECTIVES: Older studies reported an increased risk of relapse after in vitro fertilization (IVF) in women with multiple sclerosis (MS), which has not been confirmed by more recent works. All these studies had several limitations, such as small sample sizes, absence of a control population, or lack of neurologic validation of the relapses. The aim of this study was to determine the risk of relapse after IVF in women with MS.

METHODS: This retrospective cohort study included all women with MS who underwent IVF between 2009 and 2019 and a control group of women with MS who did not undergo IVF matched on age, MS duration, number of relapses, and MS-specific treatments in the previous year. Data on MS (disease duration, treatments, and relapses) were from the French MS Registry (OFSEP), whereas data on IVF (number of procedures, stimulation protocol type, and outcomes) were from the French national health insurance database. For this, the 2 databases were linked by indirect matching.

RESULTS: In total, 115 women with MS underwent 199 IVF procedures (mean age at first IVF: 33.9 ± 4.0 years; 45.2% had ≥2 IVF procedures), and 175 IVFs (88.0%) could be matched to specific patients. The risk of relapse in the 3 months after index date was the same in both IVF group and control group (0.06 relapse per patient-year), as confirmed also by the before-after analysis in the IVF group (0.06 vs 0.08).

DISCUSSION: This study, using a 10-year clinical and administrative dataset, did not find any increased risk of relapse after IVF. The maintenance of disease-modifying therapies until IVF was a determining factor in reducing the risk of relapse.

PMID:39933125 | DOI:10.1212/NXI.0000000000200371

JCO Oncol Pract. 2025 Feb 11:OP2400898. doi: 10.1200/OP-24-00898. Online ahead of print.

ABSTRACT

PURPOSE: Treatment of limited-stage small cell lung cancer (LS-SCLC) with twice-a-day radiation therapy (RT) has remained the standard of care for many decades. Growing evidence suggests that outcomes with dose escalated twice-a-day RT may further improve outcomes. However, once-daily treatment remains common. The purpose of this study was to evaluate individual treatment facilities for utilization of twice-a-day RT.

METHODS: Patients with LS-SCLC treated with definitive chemoradiation from 2004 to 2019 were identified in the National Cancer Database. RT was classified as twice-a-day (45 Gy in 30 fractions) or once-daily (59.4-70.2 Gy in 30-39 fractions). Patients were excluded if surgery was performed. All patients received doublet chemotherapy. Unique treatment facilities delivering at least one twice-a-day treatment course during the study period were classified as BID-treating. Facilities not delivering any twice-a-day RT were classified as QD-only. The proportion of QD-only facilities was identified. Facility-level characteristics associated with QD-only classification were analyzed.

RESULTS: A total of 22,362 patients with LS-SCLC were treated at 1,222 unique facilities. A slight majority of facilities (n = 644, 52.7%) were BID-treating, whereas fewer (n = 578, 47.3%) were QD-only. A total of 73.9% of academic facilities were BID-treating versus 48.3% of nonacademic facility types (P < .001). Only 20.7% of low volume treatment facilities (lowest quartile of patients with LS-SCLC treated) used twice-a-day fractionation versus 78.2% of the highest quartile volume facilities (P < .001). On multivariable analysis, academic and high-volume facilities were statistically significantly associated with BID-treating classification (adjusted odds ratio, 2.5 [P < .001] and 4.2 [P < .001], respectively).

CONCLUSION: Nearly half of facilities treating LS-SCLC with definitive chemoradiation do not use twice-a-day fractionation schedules despite ongoing and growing evidence of superiority to once-daily fractionation. High-volume, academic facilities were more likely to offer twice-a-day fractionation.

PMID:39933118 | DOI:10.1200/OP-24-00898

Oncol Nurs Forum. 2024 Dec 12;52(1):61-69. doi: 10.1188/25.ONF.61-69.

ABSTRACT

OBJECTIVES: To retrospectively evaluate the incidence of palliative care (PC) consultations for older adults with lung cancer who died in the past five years, as well as the impact of social determinants of health (SDOHs) on PC consultations.

SAMPLE &AMP; SETTING: 63 participants aged 65 years or older with a lung cancer diagnosis who died in the past five years. Electronic health records were used to extract data.

METHODS &AMP; VARIABLES: A medical record extraction form was used to collect the following data: (a) lung cancer diagnosis, (b) PC consultations, (c) patient demographic information, and (d) SDOHs factors. All data were entered into a secure research electronic data capture management site.

RESULTS: Older adults who were married, White, and female and lived in a below-average rural or suburban area were more often benefactors of a PC consultation.

IMPLICATIONS FOR NURSING: It is imperative for nurses to support patients from diagnosis to end of life by facilitating PC consultations. This study highlights the importance of collecting SDOHs for all patients admitted to the hospital in the electronic health record. Awareness of SDOHs can help nurses facilitate end-of-life care plans.

PMID:39933111 | DOI:10.1188/25.ONF.61-69

Oncol Nurs Forum. 2024 Dec 12;52(1):51-60. doi: 10.1188/25.ONF.51-60.

ABSTRACT

OBJECTIVES: To explore and describe the health outcomes and levels of environmental enrichment (EE) in participants with brain tumors after radiation therapy (RT).

SAMPLE &AMP; SETTING: 39 participants with glioma (grades 2-3) treated with RT were recruited within five years of original diagnosis from a neuro-oncology clinic.

METHODS &AMP; VARIABLES: A cross-sectional design was employed. EE measures included social connectedness, physical activity, employment, and financial stability. Health outcome measures included the Montreal Cognitive Assessment, Symbol Digit Modalities Test, global cortical atrophy rate scale, Karnofsky Performance Status Scale, and MD Anderson Symptom Inventory-Brain Tumor Module. Descriptive statistics characterized the health outcomes between participants who received photon RT and proton beam RT.

RESULTS: Participants who received photon RT with high EE showed higher scores on the Montreal Cognitive Assessment, Symbol Digit Modalities Test, and Karnofsky Performance Status Scale, and lower scores on the global cortical atrophy rate scale and MD Anderson Symptom Inventory-Brain Tumor Module.

IMPLICATIONS FOR NURSING: EE may reduce symptom burden, promote healthy brain aging, and improve cognitive and functional status in glioma survivors receiving photon RT.

PMID:39933110 | DOI:10.1188/25.ONF.51-60

Oncol Nurs Forum. 2024 Dec 12;52(1):15-22. doi: 10.1188/25.ONF.15-22.

ABSTRACT

OBJECTIVES: To describe the trajectories of food insecurity and examine their associations with sociodemographic and health-related factors in older adult cancer survivors.

SAMPLE &AMP; SETTING: Data from 2015 to 2021 from the National Health and Aging Trends Study, a nationally representative cohort study of community-dwelling older adults aged 65 years or older, were extracted and analyzed.

METHODS &AMP; VARIABLES: Food insecurity was annually measured based on five self-reported items. Group-based trajectory modeling was used to identify food insecurity trajectory groups. Data analysis accounted for the complex survey design and analytic weights.

RESULTS: The sample consisted of 1,935 older adult cancer survivors. The weighted prevalence of food insecurity ranged from 2.46% to 4.73% from 2015 to 2021. The following two food insecurity trajectory groups were identified: low-stable (n = 1,796, 93%) and medium-stable (n = 139, 7%). Individuals who were younger, female, not non-Hispanic and White, and physically frail, and those with lower household income and higher levels of anxiety and depression, were more likely to experience persistent food insecurity.

IMPLICATIONS FOR NURSING: Food security in older adult survivors is persistent and distributed inequitably among those who are female, not non-Hispanic and White, and younger, and those with lower household income.

PMID:39933107 | DOI:10.1188/25.ONF.15-22

Oncol Nurs Forum. 2024 Dec 12;52(1):E1-E11. doi: 10.1188/25.ONF.E1-E11.

ABSTRACT

OBJECTIVES: To evaluate the safety and efficacy of aromatherapy on symptom burden and associated outcomes.

SAMPLE &AMP; SETTING: 92 inpatients who underwent hematopoietic stem cell transplantation on hematology-oncology units in an academic hospital.

METHODS &AMP; VARIABLES: Participants in this pilot randomized controlled trial received essential oil-infused or blank aromatherapy patches and completed a symptom journal. Mixed-model analysis of variance was used to analyze chemotherapy-induced nausea, vomiting, and retching (CINVR) and anxiety symptoms. A t test was used to analyze medications administered for CINVR. Descriptive statistics were used to analyze additional study aims.

RESULTS: There was no significant difference in mean symptom scores or medications administered between the intervention and control groups. On a 1-10 rating scale (10 = extremely satisfied/extremely likely), aromatherapy was rated 8 or higher for satisfaction (n = 50) and likeliness to use again (n = 53).

IMPLICATIONS FOR NURSING: Aromatherapy can be used for holistic symptom management to improve the patient experience.

PMID:39933106 | DOI:10.1188/25.ONF.E1-E11

Orthopedics. 2025 Feb 11:1-5. doi: 10.3928/01477447-20250206-02. Online ahead of print.

ABSTRACT

There is debate over the treatment of displaced femoral neck fractures with either hemiarthroplasty or total hip arthroplasty. This study aimed to evaluate the fragility index (FI) of randomized controlled trials (RCTs) comparing these methods. We queried for these RCTs containing dichotomous outcomes, finding 11 RCTs with 63 dichotomous outcomes. The median FI for all outcomes was 6, signifying that 6 event reversals would change the statistical significance of an outcome. The median FI was 2 for significant outcomes and 6 for nonsignificant outcomes, indicating that outcomes favoring one surgical method are more statistically fragile than those demonstrating equivalency. [Orthopedics. 202x;4x(x):xx-xx.].

PMID:39933103 | DOI:10.3928/01477447-20250206-02