Nevin Manimala

JAMA Netw Open. 2024 Aug 1;7(8):e2431306. doi: 10.1001/jamanetworkopen.2024.31306.

ABSTRACT

IMPORTANCE: With the increasing legislation restricting health care access for transgender and nonbinary (trans) populations in recent years, there has been limited research on how awareness of and concerns about legislative restrictions and protections influence mental health outcomes.

OBJECTIVE: To examine whether awareness of and concerns about the current policy environment regarding trans individuals are associated with depression and anxiety symptoms among trans adults.

DESIGN, SETTING, AND PARTICIPANTS: This study uses cross-sectional data collected between March and April 2023 from the Washington Priority Assessment in Trans Health (PATH) Project, an online study designed by, with, and for trans communities. All participants were trans adults, aged 18 years or older, living in Washington state.

EXPOSURE: Awareness and concerns about the antitrans policy environment.

MAIN OUTCOMES AND MEASURES: The primary outcomes were depression and anxiety symptoms, assessed via the Patient Health Questionnaire-4. A series of multivariable regression models was used to assess the association between awareness and concerns about the antitrans policy environment and depression and anxiety symptoms. Models were adjusted for covariates, including demographics, social marginalization, and health care experiences.

RESULTS: A total of 797 participants (653 women [81.93%]; 455 aged 18-29 years [57.09%]) were included. The majority screened positive for current depression (689 individuals [86.45%]) and anxiety (686 individuals [86.07%]) symptoms. Trans individuals who were concerned or worried about their rights being taken away (vs not) had significantly higher odds of current depression symptoms (adjusted odds ratio [aOR], 1.66; 95% CI, 1.08-2.54), as well as current anxiety symptoms (aOR, 2.67; 95% CI, 1.63-4.36). Those who knew (vs did not know) about state-level protective legislation had significantly lower odds of current depression symptoms (aOR, 0.44; 95% CI, 0.28-0.67), as well as current anxiety symptoms (aOR, 0.11; 95% CI, 0.04-0.25). When examining interaction effect estimates, trans individuals who correctly knew about the protective policies and were not worried about having their rights taken away reported the lowest odds of depression and anxiety.

CONCLUSIONS AND RELEVANCE: The findings of this cross-sectional study are consistent with research elucidating the negative mental health consequences of policies limiting health care access and provide insights into informing policies and interventions that target trans populations’ worsened mental health outcomes as a result of antitrans legislation.

PMID:39172447 | DOI:10.1001/jamanetworkopen.2024.31306

JAMA. 2024 Aug 22. doi: 10.1001/jama.2024.14618. Online ahead of print.

ABSTRACT

IMPORTANCE: Safe and effective nonhormonal treatments for menopausal vasomotor symptoms (VMS) are needed.

OBJECTIVE: To evaluate the efficacy and safety of elinzanetant, a selective neurokinin-1,3 receptor antagonist, for the treatment of moderate to severe menopausal vasomotor symptoms.

DESIGN, SETTING, AND PARTICIPANTS: Two randomized double-blind phase 3 trials (OASIS 1 and 2) included postmenopausal participants aged 40 to 65 years experiencing moderate to severe vasomotor symptoms (OASIS 1: 77 sites in the US, Europe, and Israel from August 27, 2021, to November 27, 2023, and OASIS 2: 77 sites in the US, Canada, and Europe from October 29, 2021, to October 10, 2023).

INTERVENTION: Once daily oral elinzanetant, 120 mg, for 26 weeks or matching placebo for 12 weeks followed by elinzanetant, 120 mg, for 14 weeks.

MAIN OUTCOMES AND MEASURES: Primary end points included mean change in frequency and severity of moderate to severe vasomotor symptoms from baseline to weeks 4 and 12, measured by the electronic hot flash daily diary. Secondary end points included Patient-Reported Outcomes Measurement Information System Sleep Disturbance Short Form 8b total T score and Menopause-Specific Quality of Life questionnaire total score from baseline to week 12.

RESULTS: Eligible participants (mean [SD] age, OASIS 1: 54.6 [4.9] years; OASIS 2: 54.6 [4.8] years) were randomized to elinzanetant (OASIS 1: n = 199; OASIS 2: n = 200) or placebo (OASIS 1: n = 197; OASIS 2: n = 200). A total of 309 (78.0%) and 324 (81.0%) completed OASIS 1 and 2, respectively. For the elinzanetant and placebo groups, the baseline mean (SD) VMS per 24 hours were 13.4 (6.6) vs 14.3 (13.9) (OASIS 1) and 14.7 (11.1) v 16.2 (11.2) (OASIS 2). Baseline VMS severity was 2.6 (0.2) vs 2.5 (0.2) (OASIS 1) and 2.5 (0.2) vs 2.5 (0.2) (OASIS 2). Elinzanetant significantly reduced VMS frequency at week 4 (OASIS 1: -3.3 [95% CI, -4.5 to -2.1], P < .001; OASIS 2: -3.0 [95% CI, -4.4 to -1.7], P < .001) and at week 12 (OASIS 1: -3.2 [95% CI, -4.8 to -1.6], P < .001; OASIS 2: -3.2 [95% CI, -4.6 to -1.9], P < .001). Elinzanetant also improved VMS severity at week 4 (OASIS 1: -0.3 [95% CI, -0.4 to -0.2], P < .001; OASIS 2: -0.2 [95 CI, -0.3 to -0.1], P < .001) and week 12 (OASIS 1: -0.4 [95% CI, -0.5 to -0.3], P < .001; OASIS 2: -0.3 [95% CI, -0.4 to -0.1], P < .001). Elinzanetant improved sleep disturbances and menopause-related quality of life at week 12, and the safety profile was favorable.

CONCLUSIONS AND RELEVANCE: Elinzanetant was well tolerated and efficacious for moderate to severe menopausal VMS.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: OASIS 1: NCT05042362, OASIS 2: NCT05099159.

PMID:39172446 | DOI:10.1001/jama.2024.14618

Int J Oral Maxillofac Implants. 2024 Aug 16:1-20. doi: 10.11607/jomi.11103. Online ahead of print.

ABSTRACT

Purpose: Immediate implant placement is a reliable solution to replace hopeless teeth, but this procedure may be associated to an increased risk of soft tissue complications in case of thin biotype. The use of tissue-level implants with a convergent transmucosal profile has been advocated to increase space for soft tissue, contributing to improve their stability and esthetics. The aim of this retrospective study was to evaluate the esthetic outcomes and the Patient-Reported Outcome Measures (PROMs) of immediately placed implants with a convergent transmucosal profile. Materials and methods: This single-cohort, monocentric, retrospective clinical study was conducted on patients treated with an immediately placed implant in the esthetic zone (from premolar to premolar). All the eligible patients were recalled for a clinical and radiographic follow-up visit. Results: This study included 20 patients (8 males, 12 females) with an average age of 55.5± 6.8 years, who received 20 implants, with a mean follow-up of 46.5± 15.3 months. At the time of follow-up, immediately placed implants showed a mean Marginal Bone Loss of 0.42± 0.49 mm, and a statistically significant improvement of the esthetic parameters from baseline to the last available follow-up; in particular, Pink and White esthetic scores (p=.001) and Papilla Index at mesial and distal sites (p<.001). All the patients reported a high satisfaction (VAS>9) both from esthetic and functional point of view. Conclusion: Immediately placed implants with convergent transmucosal profile in the esthetic zone showed good clinical and esthetic outcomes, with stable results over time.

PMID:39172437 | DOI:10.11607/jomi.11103

Dev Psychol. 2024 Aug 22. doi: 10.1037/dev0001824. Online ahead of print.

ABSTRACT

Economic disadvantage has often been associated with poorer performance on measures of early childhood development. However, the causal impacts of income on child development remain unclear. The present study uses data from the Baby’s First Years randomized control trial to identify the causal impact of unconditional cash transfers on maternal reports of early childhood development. One thousand racially and ethnically diverse mothers residing in poverty were recruited from four U.S. metropolitan areas shortly after giving birth. Mothers were randomized to receive either a $333/month or $20/month unconditional cash transfer for the first several years of their child’s life. Maternal reports of language and socioemotional development, concerns for developmental delay, and enrollment in early intervention services were collected annually at the time of the child’s first, second, and third birthdays. In this registered report, we document no statistically detectable impacts of the high-cash gift on maternal reports of child development. We discuss the significance and implications of these findings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:39172428 | DOI:10.1037/dev0001824

Dev Psychol. 2024 Aug 22. doi: 10.1037/dev0001796. Online ahead of print.

ABSTRACT

To be efficient, problem solvers need to be adaptive, tailoring their information search to the specific problem at hand. Across two studies, we investigated the emergence and early development of children’s ability to adapt their information search to a given goal (Studies 1 and 2) and to the statistical structure of the problem space (Study 2) to maximize effectiveness. In Study 1, 3-6-year-olds (n = 105) decided which of two cues to look up, the arms or the legs of two monsters, to predict the winner of a throwing or jumping challenge, knowing that monsters with long arms were good throwers and those with long legs were good jumpers. Children’s ability to adaptively select relevant information and tailor their search to the goal increased with age, surpassing chance level between the ages of 4 and 5. Study 2 (7-14-year-olds and adults, n = 175) demonstrated this competence in a more complex task, additionally investigating whether children tailor their search to the statistical structure, that is, the distribution of cue values, in their search environment (e.g., how common long legs are). The results suggest high reliability in ignoring irrelevant cues (confirming the results from Study 1) and developmental patterns in children’s preferential treatment of cues of differing statistical frequency. Together, these studies contribute to the literature on information search adaptiveness by tracing for the first time the emergence and developmental trajectory of children’s ability to tailor predecisional search to the changing goals and environmental resources of the problem at hand. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:39172427 | DOI:10.1037/dev0001796

Dev Psychol. 2024 Aug 22. doi: 10.1037/dev0001797. Online ahead of print.

ABSTRACT

Based on data for N = 2,756 children (1,410 girls; M_age = 8.10 years) from 16 data sets spanning five nations, this study investigated relations between national gender disparities and children’s beliefs about gender and academic subjects. One national-level gender disparity involved inequalities in socioeconomic standing favoring adult males over females (U.N. Human Development Index). The other involved national-level gaps in standardized math achievement, favoring boys over girls (Trends in International Mathematics and Science Study Grade 4). Three novel findings emerged. First, girls’ results from a Child Implicit Association Test showed that implicit associations linking boys with math and girls with reading were positively related to both national male advantages in socioeconomic standing and national boy advantages in Trends in International Mathematics and Science Study. Second, these relations were obtained for implicit but not explicit measures of children’s beliefs linking gender and academic subjects. Third, implicit associations linking gender to academic subjects increased significantly as a function of children’s age. We propose a psychological account of why national gender disparities are likely to influence children’s developing implicit associations about gender and academic subjects, especially for girls. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:39172414 | DOI:10.1037/dev0001797

Dev Psychol. 2024 Aug 22. doi: 10.1037/dev0001828. Online ahead of print.

ABSTRACT

Kagan theorized biologically based temperament types that are present in infancy, stable across development, and essential for understanding individual differences. Despite evidence, temperament research remains focused on a few prominent dimensions of temperament, without adequately addressing covariance among dimensions and temperament types. Using longitudinal twin data, we took a person-centered statistical approach to identify temperament types and examined continuity and change across five developmental periods (N_infancy = 602; N_toddlerhood = 522; N_{early childhood} = 390; N_{late childhood} = 718; Nearly adolescence = 700). We then examined the genetic and environmental etiology of temperament types. Twins were boys and girls (51-53% female), primarily Hispanic/Latinx (23-30%) and non-Hispanic/Latinx White (56-63%), and from socioeconomically diverse families (28-38% near-or-below the poverty line). Using latent profile analysis, we identified three temperament types at each age characterized by negative reactivity and dysregulation, positive reactivity and strong self-regulation, and moderate reactivity and regulation. Latent transition analyses revealed considerable continuity in membership type for “negative dysregulated” beginning in infancy, log odds = 1.58 (SE = .65) to 3.16 (SE = .77), p < .01, of remaining relative to transitioning to “typical expressive”, and “positive well-regulated” beginning in early childhood, log odds = 1.41 (SE = .56) to 2.25 (SE = .47), p < .05. Twin analyses revealed moderate heritability and a consistent role of the shared environment on positive well-regulated, with negative dysregulated and typical expressive also moderately heritable with the shared environment being important at some ages. Findings support the presence of theorized biologically based temperament types that develop rapidly in infancy and toddlerhood and provide a foundation for the study of individual differences and risk and resilience processes across the lifespan. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:39172413 | DOI:10.1037/dev0001828

Psychol Bull. 2024 Aug;150(8):1011-1019. doi: 10.1037/bul0000444.

ABSTRACT

Our meta-analysis on gender differences in sex drive found a stronger sex drive in men compared to women (Frankenbach et al., 2022). Conley and Yang (2024) criticized how we interpreted the findings and provided suggestions regarding the origins of these gender differences, an undertaking that we had refrained from doing in our original work. We concur with several important points made by Conley and Yang (2024): (a) women’s sexual experiences are generally more negative than men’s, which could partly explain why men report more sex drive; (b) lack of statistical moderation by some sociocultural variables does not imply that the sex drives of men and women are generally unaffected by the social environment; and (c) gender differences in sexuality are likely smaller than they are often portrayed in research, and that the practical impact of this difference is largely unknown. Still, we reject other assertions made by Conley and Yang (2024): (a) we did not frame our findings in support of the view that gender differences in sex drive are determined by biology, (b) we did not conflate response bias with sociocultural biases more broadly, and (c) we did not fail to incorporate and consider gendered cultural messages about sexuality in our methods and discussion. We make several suggestions about future research on these matters. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:39172391 | DOI:10.1037/bul0000444

Rehabil Psychol. 2024 Aug 22. doi: 10.1037/rep0000570. Online ahead of print.

ABSTRACT

PURPOSE/OBJECTIVE: The current study examined the psychometric properties of common mental health questionnaires among women survivors of intimate partner violence (IPV) with and without brain injuries due to IPV and evaluated whether women with and without IPV-related brain injuries differed in depression, anxiety, and posttraumatic stress disorder (PTSD) symptom severity.

RESEARCH METHOD/DESIGN: Women survivors of IPV with and without IPV-related brain injuries were recruited online through Prolific (N = 205, M = 39.8 ± 11.9 years old, 83.9% non-Hispanic White, 42.4% college-educated). They completed the eight-item Patient Health Questionnaire (PHQ-8), seven-item Generalized Anxiety Disorder scale (GAD-7), and PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) (PCL-5). Model fit and internal consistency were estimated for each scale. Groups were compared on mental health symptom severity, with and without controlling for age, education, and IPV severity.

RESULTS: Both one-factor and multifactor models showed excellent fit for all scales. PHQ-8 (ω = .91), GAD-7 (ω = .94), and PCL-5 total scores (ω = .95) had strong reliability, and all subscale scores had acceptable-to-strong reliability (ω range = .79-.94). Women with IPV-related brain injuries reported greater physical IPV severity, higher rates of depression, and higher somatic anxiety and PTSD symptom severity. No group differences in mental health symptoms were significant after controlling for IPV severity.

CONCLUSIONS/IMPLICATIONS: The PHQ-8, GAD-7, and PCL-5 showed evidence for reliability and validity among women survivors of IPV. Women with IPV-related brain injuries had higher PTSD symptom severity, attributable to greater physical violence exposure in general. Brain injury screening among survivors appears warranted for women with extensive physical IPV experiences. Interventions addressing PTSD, violence prevention, and brain injury recovery may best serve this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:39172371 | DOI:10.1037/rep0000570

Clin Drug Investig. 2024 Aug 22. doi: 10.1007/s40261-024-01368-w. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Plaque psoriasis is commonly treated topically with glucocorticoids and vitamin D derivatives. However, potential side effects such as skin atrophy underscore the need for safe and effective alternative topical therapies. Recently, the US Food and Drug Administration (FDA) and Health Canada approved roflumilast 0.3% cream as an option for treating this disease. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to assess the efficacy and safety of topical roflumilast 0.3% compared with vehicle for plaque psoriasis.

METHODS: PubMed, Embase, ClinicalTrials.gov, and Cochrane databases were searched from inception to 1 May 2024, assessing the outcomes of Investigator’s Global Assessment (IGA) or body-IGA success (clear or almost clear status plus an at least 2-grade improvement from baseline), Psoriasis Area and Severity Index (PASI)-50, PASI-75, PASI-90, intertriginous-IGA success (clear or almost clear status on the intertriginous-IGA plus an at least 2-grade improvement from baseline), and adverse events (AEs). Statistical analysis was performed using Review Manager, R software, and RStudio. Heterogeneity was determined using the Cochran Q test and I² statistics.

RESULTS: Four RCTs were included, comprising a total of 1403 patients, of whom 885 (63.1%) received topical roflumilast 0.3% and 518 (36.9%) received vehicle. At week 8, the achievement of IGA or body-IGA success was significantly higher among those treated with topical roflumilast than in the vehicle group [relative risk (RR) 5.07; 95% confidence interval (CI) 3.55-7.23; p < 0.01]. Similar findings were observed at week 8 for PASI-50 (RR 2.73; 95% CI 2.27-3.29; p < 0.01), PASI-75 (RR 4.48; 95% CI 2.26-8.89; p < 0.01), and PASI-90 (RR 5.61; 95% CI 2.57-12.25; p < 0.01). Corresponding outcomes were found at weeks 2, 4, and 6. Additionally, a higher percentage of patients treated with topical roflumilast 0.3% once daily achieved intertriginous-IGA success, compared with those receiving vehicle, at week 8 (71.9% versus 20.5%; RR 3.32; 95% CI 2.11-5.22; p < 0.01), with similar findings at weeks 2, 4, and 6. While a significant difference was observed in the overall incidence of AEs between the topical roflumilast and vehicle groups, there was no difference in treatment-related AEs, serious AEs, or AEs leading to study discontinuation.

CONCLUSION: These findings support the superiority of topical roflumilast 0.3% over vehicle and suggest its use as a valuable asset for the treatment of plaque psoriasis.

PROTOCOL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO), CRD42023456494.

PMID:39172296 | DOI:10.1007/s40261-024-01368-w