Nevin Manimala

Oral Maxillofac Surg. 2025 Jan 10;29(1):29. doi: 10.1007/s10006-024-01322-2.

ABSTRACT

PURPOSE: This study aimed to clarify the applicability of smartphone-based three-dimensional (3D) surface imaging for clinical use in oral and maxillofacial surgery, comparing two smartphone-based approaches to the gold standard.

METHODS: Facial surface models (SMs) were generated for 30 volunteers (15 men, 15 women) using the Vectra M5 (Canfield Scientific, USA), the TrueDepth camera of the iPhone 14 Pro (Apple Inc., USA), and the iPhone 14 Pro with photogrammetry. Smartphone-based SMs were superimposed onto Vectra-based SMs. Linear measurements and volumetric evaluations were performed to evaluate surface-to-surface deviation. To assess inter-observer reliability, all measurements were performed independently by a second observer. Statistical analyses included Bland-Altman analyses, the Wilcoxon signed-rank test for paired samples, and Intraclass correlation coefficients.

RESULTS: Photogrammetry-based SMs exhibited an overall landmark-to-landmark deviation of M = 0.8 mm (SD = ± 0.58 mm, n = 450), while TrueDepth-based SMs displayed a deviation of M = 1.1 mm (SD = ± 0.72 mm, n = 450). The mean volumetric difference for photogrammetry-based SMs was M = 1.8 cc (SD = ± 2.12 cc, n = 90), and M = 3.1 cc (SD = ± 2.64 cc, n = 90) for TrueDepth-based SMs. When comparing the two approaches, most landmark-to-landmark measurements demonstrated 95% Bland-Altman limits of agreement (LoA) of ≤ 2 mm. Volumetric measurements revealed LoA > 2 cc. Photogrammetry-based measurements demonstrated higher inter-observer reliability for overall landmark-to-landmark deviation.

CONCLUSION: Both approaches for smartphone-based 3D surface imaging exhibit potential in capturing the face. Photogrammetry-based SMs demonstrated superior alignment and volumetric accuracy with Vectra-based SMs than TrueDepth-based SMs.

PMID:39792225 | DOI:10.1007/s10006-024-01322-2

J Appl Genet. 2025 Jan 10. doi: 10.1007/s13353-024-00930-8. Online ahead of print.

ABSTRACT

Gilles de la Tourette syndrome (GTS) and other tic disorders (TDs) have a substantial genetic component with their heritability estimated at between 60 and 80%. Here we propose an oligogenic risk score of TDs using whole-genome sequencing (WGS) data from a group of Polish GTS patients, their families, and control samples (n = 278). In this study, we first reviewed the literature to obtain a preliminary list of 84 GTS/TD candidate genes. From this list, 10 final risk score genes were selected based on single-gene burden tests (SKAT p < 0.05) between unrelated GTS cases (n = 37) and synthetic control samples based on a database of local allele frequencies. These 10 genes were CHADL, DRD2, MAOA, PCDH10, HTR2A, SLITRK5, SORCS3, KCNQ5, CDH9, and CHD8. Variants in and in the vicinity (± 20 kbp) of the ten risk genes (n = 7654) with a median minor allele frequency in the non-Finnish European population of 0.02 were integrated into an additive classifier. This risk score was then applied to healthy and GTS-affected individuals from 23 families and 100 unrelated healthy samples from the Polish population (AUC-ROC = 0.62, p = 0.02). Application of the algorithm to a group of patients with other tic disorders revealed a continuous increase of the oligogenic score with healthy individuals with the lowest mean, then patients with other tic disorders, then GTS patients, and finally with severe GTS cases with the highest oligogenic score. We have further compared our WGS results with the summary statistics of the Psychiatric Genomics Consortium genome-wide association study (PGC GWAS) of TDs and found no signal overlap except for the CHADL gene locus. Polygenic risk scores from common variants of GTS GWAS show no difference between patient and control groups, except for the comparison between patients with non-GTS TDs and patients with severe GTS. Overall, we leveraged WGS data to construct a GTS/TD risk score based on variants that may cooperatively contribute to the aetiology of these disorders. This study provides evidence that typical and severe adult GTS as well as other tic disorders may exist on a single spectrum in terms of their genetic background.

PMID:39792217 | DOI:10.1007/s13353-024-00930-8

JMIR Form Res. 2025 Jan 9;9:e64137. doi: 10.2196/64137.

ABSTRACT

BACKGROUND: While the significance of care navigation in facilitating access to health care within the lesbian, gay, bisexual, transgender, queer, and other (LGBTQ+) communities has been acknowledged, there is limited research examining how care navigation influences an individual’s ability to understand and access the care they need in real-world settings. By analyzing private sector data, we can bridge the gap between theoretical research findings and practical applications, ultimately informing both business strategies and public policy with evidence grounded in real-world efficacy.

OBJECTIVE: The objective of this study was to evaluate the impact of specialized virtual care navigation services on LGBTQ+ individuals’ ability to comprehend and access necessary care within a national cohort of commercially insured members.

METHODS: This case study is based on the experience of commercially insured members, aged 18 or older, who used the LGBTQ+ Health Care Navigation (LGBTQ+ Navigation) service by Included Health between January 26 and July 31, 2023. Care coordinators assisted members by connecting them with vetted identity-affirming in-network providers, helping them navigate and understand their LGBTQ+ health benefits, and providing education and advocacy for clinical and nonclinical needs. We examined the impact of navigation on 5 member-reported outcomes. In addition to reporting the proportion who agreed or strongly agreed, we calculated an impact score that averaged assigned numerical values to all 5 question responses (1=strongly disagree to 5=strongly agree) for each respondent. We used ANOVA with Tukey post hoc tests and t tests to explore the relationships between the impact score and member characteristics, including optional self-reported demographics.

RESULTS: Out of 4703 LGBTQ+ Navigation cases, 7.53% (n=354) had member-reported outcomes. A large majority of LGBTQ+ members agreed or strongly agreed that care navigation resulted in less stress (315/354, 89%), less care avoidance (305/354, 86.2%), higher confidence in finding an identity-affirming provider (327/354, 92.4%), improved ability to comprehend health care information (312/354, 88.1%), and improved ability to engage with providers (308/354, 87%). The average impact score was 4.44 (SD 0.69), with statistically significant differences by gender identity (P=.003), race (P=.01), ethnicity (P=.008), and pronouns (P=.02). The scores were highest for members with multiple gender identities (mean 4.56, SD 0.37), and members who did not provide their race, ethnicity, or their pronouns (mean 4.55, SD 0.64). Impact scores were lowest for transgender members (mean 4.11, SD 0.95).

CONCLUSIONS: The LGBTQ+ Navigation service, by enhancing members’ comprehension and use of necessary care, demonstrates potential public health utility and value. Continuous evaluation of navigation services can serve as a supplementary tool for employers seeking to promote health equity and improve belonging among employees. This is particularly important as discrimination and stigma against LGBTQ+ communities persist in the United States. Therefore, scalable and system-level changes that use navigation services are essential to reach a larger proportion of the LGBTQ+ population.

PMID:39791359 | DOI:10.2196/64137

Med Phys. 2025 Jan 10. doi: 10.1002/mp.17604. Online ahead of print.

ABSTRACT

PURPOSE: With the widespread introduction of dual energy computed tomography (DECT), applications utilizing the spectral information to perform material decomposition became available. Among these, a popular application is to decompose contrast-enhanced CT images into virtual non-contrast (VNC) or virtual non-iodine images and into iodine maps. In 2021, photon-counting CT (PCCT) was introduced, which is another spectral CT modality. It allows for scans with more than two different detected spectra. With these systems, it becomes possible to distinguish more than two materials. It is frequently proposed to administer more than one contrast agent, perform a single PCCT scan, and then calculate the VNC images and the contrast agent maps. This may not be optimal because the patient is injected with a material, only to have it computationally extracted again immediately afterwards by spectral CT. It may be better to do an unenhanced scan followed by one or more contrast-enhanced scans. The main argument for the spectral material decomposition is patient motion, which poses a significant challenge for approaches involving two or more temporally separated scans. In this work, we assume that we can correct for patient motion and thus are free to scan the patient more than once. Our goal is then to quantify the penalty for performing a single contrast-enhanced scan rather than a clever series of unenhanced and enhanced scans. In particular, we consider the impact on patient dose and image quality.

METHODS: We simulate CT scans of three differently sized phantoms containing various contrast agents. We do this for a variety of tube voltage settings, a variety of patient-specific prefilter (PSP) thicknesses and a variety of threshold settings of the photon-counting detector with up to four energy bins. The reconstructed bin images give the expectation values of soft tissue and of the contrast agents. Error propagation of projection noise into the images yields the image noise. Dose is quantified using the total CT dose index (CTDI) value of the scans. When combining multiple scans, we further consider all possible tube current (or dose) ratios between the scans. Material decomposition is done image-based in a statistical optimal way. Error propagation into the material-specific images yields the signal-to-noise ratio at unit dose (SNRD). The winning scan strategy is the one with the highest total SNRD, which is related to the SNRD of the material that has the lowest signal-to-noise ratio (SNR) among the materials to decompose into. We consider scan strategies with up to three scans and up to three materials (water W, contrast agent X and contrast agent Y).

RESULTS: In all cases, those scan strategies yield the best performance that combine differently enhanced scans, for example, W+WX, W+WXY, WX+WXY, W+WX+WY, with W denoting an unenhanced scan and WX, WY and WXY denoting X-, Y-, and X-Y-enhanced scans, respectively. The dose efficiency of scans with a single enhancement scheme, such as WX or WXY, is far lower. The dose penalty to pay for these single enhancement strategies is about two or greater. Our findings also apply to scans with a single energy bin and thus also to CT systems with conventional, energy-integrating detectors, that is, conventional DECT. Dual source CT (DSCT) scans are preferable over single source CT scans, also because one can use a PSP on the high Kilovolt spectrum to better separate the detected spectra. For the strategies and tasks considered here, it does not make sense to simultaneously scan with two different types of contrast agents. Iodine outperforms other high Z elements in nearly all cases.

CONCLUSIONS: Given the significant dose penalty when performing only one contrast-enhanced scan rather than a series of unenhanced and enhanced scans, one should consider avoiding the single-scan strategies. This requires to invest in the development of accurate registration algorithms that can compensate for patient and contrast agent motion between separate scans.

PMID:39791354 | DOI:10.1002/mp.17604

Eur Psychiatry. 2025 Jan 10;68(1):e2. doi: 10.1192/j.eurpsy.2024.1800.

ABSTRACT

BACKGROUND: Temperature increases in the context of climate change affect numerous mental health outcomes. One such relevant outcome is involuntary admissions as these often relate to severe (life)threatening psychiatric conditions. Due to a shortage of studies into this topic, relationships between mean ambient temperature and involuntary admissions have remained largely elusive.

AIMS: To examine associations between involuntary admissions to psychiatric institutions and various meteorological variables.

METHODS: Involuntary admissions data from 23 psychiatric institutions in the Netherlands were linked to meteorological data from their respective weather stations. Generalized additive models were used, integrating a restricted maximum likelihood method and thin plate regression splines to preserve generalizability and minimize the risk of overfitting. We thus conducted univariable, seasonally stratified, multivariable, and lagged analyses.

RESULTS: A total of 13,746 involuntary admissions were included over 21,549 days. In univariable and multivariable models, we found significant positive associations with involuntary admissions for ambient temperature and windspeed, with projected increases of up to 0.94% in involuntary admissions per degree Celsius temperature elevation. In the univariable analyses using all data, the strongest associations in terms of significance and explained variance were found for mean ambient temperature (p = 2.5 × 10^-6, Variance Explained [r²] = 0.096%) and maximum ambient temperature (p = 8.65 × 10^-4, r² = 0.072%). We did not find evidence that the lagged associations explain the associations for ambient temperature better than the direct associations.

CONCLUSION: Mean ambient temperature is consistently but weakly associated with involuntary psychiatric admissions. Our findings set the stage for further epidemiological and mechanistic studies into this topic, as well as for modeling studies examining future involuntary psychiatric admissions.

PMID:39791337 | DOI:10.1192/j.eurpsy.2024.1800

Clin Appl Thromb Hemost. 2025 Jan-Dec;31:10760296241311268. doi: 10.1177/10760296241311268.

ABSTRACT

Percutaneous valve implantation or surgical replacement with mechanical or biological valves are standard therapies for severe valvular heart diseases. Prosthetic valve thrombosis, though rare, is a serious complication, particularly with mechanical prostheses. This study aimed to investigate the predictive value of platelet volume parameters, including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR), for valvular thrombosis risk in patients undergoing valve replacement therapy. A retrospective cross-sectional study was conducted from May 2002 to May 2020, involving 108 patients with a history of mitral or aortic valve replacement and valvular thrombosis, and 216 controls with a history of valve surgery without valvular malfunction. PDW was significantly associated with an increased risk of thrombosis after adjusting for confounders, while MPV showed a clinical difference but did not reach statistical significance. P-LCR did not exhibit a significant association. These findings suggest PDW as a potential predictor of valvular thrombosis in such patients. The ease of measuring platelet volume parameters suggests their utility in routine hematological analysis for identifying patients at higher risk of valvular thrombosis post-replacement surgery. Further studies are warranted to validate these findings and explore additional laboratory markers, such inflammatory markers, for thrombotic risk assessment in this population.

PMID:39791334 | DOI:10.1177/10760296241311268

Eur Psychiatry. 2025 Jan 10;68(1):e4. doi: 10.1192/j.eurpsy.2024.1807.

ABSTRACT

BACKGROUND: One of the most relevant risk factors for suicide is the presence of previous attempts. The symptomatic profile of people who reattempt suicide deserves attention. Network analysis is a promising tool to study this field.

OBJECTIVE: To analyze the symptomatic network of patients who have attempted suicide recently and compare networks of people with several attempts and people with just one at baseline.

METHODS: 1043 adult participants from the Spanish cohort “SURVIVE” were part of this study. Participants were classified into two groups: single attempt group (n = 390) and reattempt group (n = 653). Different network analyses were carried out to study the relationships between suicidal ideation, behavior, psychiatric symptoms, diagnoses, childhood trauma, and impulsivity. A general network and one for each subgroup were estimated.

RESULTS: People with several suicide attempts at baseline scored significantly higher across all clinical scales. The symptomatic networks were equivalent in both groups of patients (p > .05). Although there were no overall differences between the networks, some nodes were more relevant according to group belonging.

CONCLUSIONS: People with a history of previous attempts have greater psychiatric symptom severity but the relationships between risk factors show the same structure when compared with the single attempt group. All risk factors deserve attention regardless of the number of attempts, but assessments can be adjusted to better monitor the occurrence of reattempts.

PMID:39791330 | DOI:10.1192/j.eurpsy.2024.1807

J Glob Health. 2025 Jan 10;15:04011. doi: 10.7189/jogh.15.04011.

ABSTRACT

BACKGROUND: We aimed to identify the central lifestyle, the most impactful among lifestyle factor clusters; the central health outcome, the most impactful among health outcome clusters; and the bridge lifestyle, the most strongly connected to health outcome clusters, across 29 countries to optimise resource allocation for local holistic health improvements.

METHODS: From July 2020 to August 2021, we surveyed 16 461 adults across 29 countries who self-reported changes in 18 lifestyle factors and 13 health outcomes due to the pandemic. Three networks were generated by network analysis for each country: lifestyle, health outcome, and bridge networks. We identified the variables with the highest bridge expected influence as central or bridge variables. Network validation included nonparametric and case-dropping subset bootstrapping, and centrality difference tests confirmed that the central or bridge variables had significantly higher expected influence than other variables within the same network.

RESULTS: Among 87 networks, 75 were validated with correlation-stability coefficients above 0.25. Nine central lifestyle types were identified in 28 countries: cooking at home (in 11 countries), food types in daily meals (in one country), less smoking tobacco (in two countries), less alcohol consumption (in two countries), less duration of sitting (in three countries), less consumption of snacks (in five countries), less sugary drinks (in five countries), having a meal at home (in two countries), taking alternative medicine or natural health products (in one country). Six central health outcomes were noted among 28 countries: social support received (in three countries), physical health (in one country), sleep quality (in four countries), quality of life (in seven countries), less mental burden (in three countries), less emotional distress (in 13 countries). Three bridge lifestyles were identified in 19 countries: food types in daily meals (in one country), cooking at home (in one country), overall amount of exercise (in 17 countries). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05).

CONCLUSIONS: In 29 countries, cooking at home, less emotional distress, and overall amount of exercise emerged as common central lifestyle, health outcome, and bridge lifestyle factors, respectively. However, notable regional variations necessitate tailored interventions and resource allocations to effectively address unique local key variables and promote holistic health in each locale. The study’s cross-sectional design and self-reported data may limit generalisability, emphasising the need for cautious interpretation and further longitudinal research.

KEYWORDS: global; across-country comparisons; lifestyle; health outcomes; network analysis.

PMID:39791329 | DOI:10.7189/jogh.15.04011

JMIR Hum Factors. 2025 Jan 6;12:e53057. doi: 10.2196/53057.

ABSTRACT

BACKGROUND: Transgender and nonbinary (TGNB) individuals are increasingly intentionally becoming pregnant to raise children, and hospital websites should reflect these trends. For prospective TGNB parents, a hospital website is the only way they can assess their safety from discrimination while receiving perinatal care. Cisnormativity enforced by communication gaps between medical institutions and TGNB patients can and has caused delays in receiving urgent care during their pregnancy.

OBJECTIVE: The aim of this study was to evaluate the current prevalence of gender-inclusive terminology among labor and delivery services in the New York tristate area.

METHODS: The labor and delivery web pages of 189 hospitals from New York, New Jersey, and Connecticut were examined for gender-inclusive language. “Fully inclusive” websites explicitly acknowledged lesbian, gay, bisexual, transgender, queer, intersex, and asexual plus other gender- and sexual-oriented (LGBTQIA+) parents, “inclusive” websites did not use gendered terminology for parents, and “noninclusive” websites used gendered terms at least once in the text reviewed. The hospitals’ web pages were further stratified by Healthcare Equality Index scores and population classifications defined by the 2013 National Center for Health Statistics Urban-Rural classification given to the county that each hospital was located in.

RESULTS: Of the 300 hospital websites reviewed, only 189 websites met the criteria for inclusion. Overall, only 6.3% (n=12) of labor and delivery web pages were “inclusive” or “fully inclusive.” No geographic areas (P=.61) or Healthcare Equality Index scores (P=.81) were associated with inclusive or fully inclusive language.

CONCLUSIONS: Hospitals need to use inclusive language to help TGNB people identify hospitals where their existence and needs are acknowledged and thus feel more comfortable in their transition to parenthood.

PMID:39791326 | DOI:10.2196/53057

Disaster Med Public Health Prep. 2025 Jan 10;19:e13. doi: 10.1017/dmp.2024.308.

ABSTRACT

OBJECTIVES: This study sought to assess undergraduate students’ knowledge and attitudes surrounding perceived self-efficacy and threats in various common emergencies in communities of higher education.

METHODS: Self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, obligation to respond, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond were investigated through 3 representative scenarios via a web-based survey.

RESULTS: Among 970 respondents, approximately 60% reported their university had adequately prepared them for various emergencies while 84% reported the university should provide such training. Respondents with high self-efficacy were significantly more likely than those with low self-efficacy to be willing to respond in whatever capacity needed across all scenarios.

CONCLUSIONS: There is a gap between perceived student preparedness for emergencies and training received. Students with high self-efficacy were the most likely to be willing to respond, which may be useful for future training initiatives.

PMID:39791325 | DOI:10.1017/dmp.2024.308