Nevin Manimala

Demography. 2023 Nov 27:11075209. doi: 10.1215/00703370-11075209. Online ahead of print.

ABSTRACT

In this study, we provide an assessment of data accuracy from the 2020 Census. We compare block-level population totals from a sample of 173 census blocks in California across three sources: (1) the 2020 Census, which has been infused with error to protect respondent confidentiality; (2) the California Neighborhoods Count, the first independent enumeration survey of census blocks; and (3) projections based on the 2010 Census and subsequent American Community Surveys. We find that, on average, total population counts provided by the U.S. Census Bureau at the block level for the 2020 Census are not biased in any consistent direction. However, subpopulation totals defined by age, race, and ethnicity are highly variable. Additionally, we find that inconsistencies across the three sources are amplified in large blocks defined in terms of land area or by total housing units, blocks in suburban areas, and blocks that lack broadband access.

PMID:38009227 | DOI:10.1215/00703370-11075209

Demography. 2023 Nov 27:11077660. doi: 10.1215/00703370-11077660. Online ahead of print.

ABSTRACT

This article documents child suicide rates from 1980 to 2020 in the United States using the National Vital Statistics System Multiple Cause of Death database. After generally declining for decades, suicide rates among children aged 10-17 accelerated from 2011 to 2018 in an unprecedented rise in both duration and magnitude. I consider the role of the illicit opioid crisis in driving this mental health crisis. In August 2010, an abuse-deterrent version of OxyContin was introduced and the original formulation was removed from the market, leading to a shift to illicit opioids and stimulating growth in illicit opioid markets. Areas more exposed to reformulation-as measured by pre-reformulation rates of OxyContin misuse in the National Survey on Drug Use and Health-were more affected by the transition to illicit opioids and experienced sharper growth in child suicide rates. The evidence suggests that children’s illicit opioid use did not increase, implying that the illicit opioid crisis engendered higher suicide propensities by increasing suicidal risk factors for children, such as increasing rates of child neglect and altering household living arrangements. In complementary analyses, I document how living conditions declined for children during this time period.

PMID:38009202 | DOI:10.1215/00703370-11077660

Health Educ Behav. 2023 Nov 27:10901981231208396. doi: 10.1177/10901981231208396. Online ahead of print.

ABSTRACT

The workplace has been highlighted as a potential setting to deliver health promotion programs to target modifiable health behaviors that contribute to chronic disease. This review evaluated the effectiveness of interventions implemented within the workplace that targeted either smoking, nutrition, alcohol, physical activity, and/or overweight and obesity in men. A review protocol was prospectively registered through PROSPERO (CRD42021293398). Five electronic bibliographic databases were searched for randomized controlled trials conducted in the workplace assessing chronic disease risk factors in men from January 2010 to August 2021. Eleven studies were included, reporting on overweight and obesity n = 8, physical activity n = 7, nutrition n = 4, alcohol n = 3, smoking n = 3, with eight studies assessing multiple outcomes. Results were mixed. Narrative synthesis highlighted studies reporting improvements to snacking frequency, sugar sweetened beverage consumption, and physical activity (METs and Vo2 max). Meta-analysis highlighted pooled mean decrease in body weight of -0.28 kg up to 3 months; -1.38 kg for >3 months, and pooled mean decrease in body mass index 0.06 kg/m² up to 3 months; -0.27 kg/m² for >3 months. Despite the encouraging direction of the relationship, results were not statistically significant (p > .05). Findings underscore the potential of workplace health promotion programs targeting certain chronic disease risk factors in men; however, future research should consider long-term study designs to assess the efficacy of workplace health programs as a solution to the growing burden of global disease.

PMID:38009189 | DOI:10.1177/10901981231208396

Indian J Orthop. 2023 Nov 7;57(12):2040-2049. doi: 10.1007/s43465-023-01007-0. eCollection 2023 Dec.

ABSTRACT

BACKGROUND: Amputation of a limb is equivalent to loss of a person’s life. Psychological aspects are essential factors in dealing with the disability and functional outcome is a significant concern. Longitudinal studies have not examined the experience and determinants of common mental health problems and functional outcome in lower limb amputees.

MATERIALS AND METHODOLOGY: A total of 103 lower limb amputees were recruited and followed up for 6 months. Patients were assessed on Hospital Anxiety and Depression Scale (HADS) and Social Functioning (SF-36) Quality of life, semi-structured clinical interview for psychiatric disorders and phantom limb at baseline (in hospital), at 2 weeks, 3 months and 6 months, respectively after discharge. Holistic care was provided through psychological counselling, supportive sessions, medications if required, rehabilitation counselling, prosthesis implantation, and treatment as usual.

RESULTS: Holistic care resulted in a statistically significant reduction in anxiety, depression and overall psychiatric morbidity as measured on HADS (p < 0.001). There was a significant improvement in all the domains of SF-36 (p -< 0.001) except the role of limitation due to physical activity. The intervention also resulted in a statistically significant reduction in the presence of phantom limbs.

CONCLUSION: Amputees should be provided holistic care under one roof, which was found to be very useful in treating psychiatric morbidity, social functioning and quality of life.

PMID:38009175 | PMC:PMC10673785 | DOI:10.1007/s43465-023-01007-0

Indian J Orthop. 2023 Oct 15;57(12):2073-2081. doi: 10.1007/s43465-023-01010-5. eCollection 2023 Dec.

ABSTRACT

PURPOSE: Our study aims to find the role of lateral retinacular release (LRR) on realigning the patella in knees with maltracking during primary total knee arthroplasty. We also compared the patellar morphological factors between the varus and valgus knees on predicting the need for LRR.

METHODS: We have retrospectively analyzed the incidence of LRR in consecutive 152 primary TKA (124 patients) from May 2018 to December 2018. We have evaluated the preoperative radiological parameters like Wiberg’s patellar morphological type, patellar angle, sulcus angle, patellar width and thickness, preoperative patellar tilt and patellar shift, lateral patellofemoral angle and congruent angle. Post-operatively, patellar shift and patellar tilt were measured. Multivariate regression analysis was used to find the association of LRR with the individual radiological parameters.

RESULTS: There was no statistical difference in the postoperative patellar shift and tilt between lateral released and non-released groups, suggesting realignment of the patella after LRR (p > 0.05). The morphological parameters like patellar shift, lateral patellofemoral angle and congruent angle were significantly increased in valgus knees compared to varus knees (p < 0.05). The preoperative patellar shift of > 3.5 mm have a specificity of 93.7% and a negative predictive value (NPV) of 92.7%, congruent angle > 16° have a specificity of 85.3% and NPV of 4.2% in varus knees in predicting LRR.

CONCLUSION: Radiological parameters of patellar maltracking like increased patellar tilt and lateral patellar shift get corrected postoperatively after performing the lateral release. Patella with Wiberg type 3 morphology, patellar shift > 3.5 mm and congruent angle > 16° in axial view tend to have an increased chance of lateral retinacular release.

PMID:38009173 | PMC:PMC10673791 | DOI:10.1007/s43465-023-01010-5

Indian J Orthop. 2023 Sep 12;57(12):1993-1999. doi: 10.1007/s43465-023-00982-8. eCollection 2023 Dec.

ABSTRACT

IMPORTANCE: Recently, peroneus longus (PL) autograft as a graft choice for ligament surgeries have attracted interest due to studies showing good clinical outcomes and minimal donor site morbidity. There remain concerns related to these grafts, especially the potential impact on ankle functions.

AIMS/OBJECTIVE: The purpose of this review and meta-analysis is to summarize the available evidence for ankle functional outcomes after PL harvest. This will provide objective clinical evidence for surgical decision making.

EVIDENCE REVIEW: Cochrane, Embase, Medline, and Google Scholar were all searched for articles published between January 2001 and May 2021. For the aim of a systematic review, certain inclusion and exclusion criteria were adopted in accordance with PRISMA recommendations. The primary outcome measure was the assessment of ankle functional outcomes using validated instruments (such as AOFAS score, FADI score etc.).

FINDINGS: A total of twelve studies representing pooled patient populations of 537 patients were included in this review. The average follow-up duration was 17 months (range; 6-32 months) across all studies. All twelve studies assessed AOFAS score and six studies also additionally assessed FADI score. The pooled mean outcomes measured showed a slight decrease in post-operative as compared to pre-operative AOFAS and FADI score (mean difference of AOFAS 1.92, 95% CI 1.021-3.123, p value < 0.05 and mean difference for FADI 1.50, 95% CI 0.561-2.445, p value < 0.05). Though statistically significant the magnitude of variance implies minimal clinical impact.

CONCLUSION AND RELEVANCE: This review and meta-analysis found that PL autograft harvest leads to statistically significant but minimal impact on ankle functional outcomes. This, in conjunction with various studies on ankle parameters after PL harvest, shows that PL harvest leads to minimal impact on ankle outcomes and function.

LEVEL OF EVIDENCE: Systematic review Level III.

PMID:38009168 | PMC:PMC10673779 | DOI:10.1007/s43465-023-00982-8

J Parasit Dis. 2023 Dec;47(4):778-786. doi: 10.1007/s12639-023-01624-4. Epub 2023 Aug 15.

ABSTRACT

Toxoplasma gondii is a worldwide opportunistic protozoan causing life-threatening infection in immunocompromised patients, while frequently asymptomatic in immunocompetent individuals. The current study aimed to detect T. gondii; serologically and molecularly in ß. thalassemia patients and evaluate the association of infection with some hematological parameters in these patients. Blood samples were collected from 100 ß. thalassemia patients. Serological diagnosis of T. gondii using ELISA for IgG and IgM antibodies was performed. Molecular diagnosis by Real-Time (RE) PCR was performed using specifically designed primers amplifying 389 bp fragments of Toxoplasma genome. 45 patients (45%) had anti-Toxoplasma IgG antibodies with no detectable IgM antibodies while both anti-Toxoplasma IgM and IgG antibodies were noticed in 10 patients (10%). IgM only antibodies were discovered in two cases (2%). The total seropositivity rate among patients was 57%. RE PCR analysis revealed Toxoplasma DNA in 20% out of 100 patients. PCR and serological examination showed slight agreement. A statistically significant relation was observed between the results of IgG and IgM ELISA and PCR for the detection of T. gondii infection among patients with ß. thalassemia. None of the studied risk factors (age, gender, contact with cats, consumption of undercooked meat) or hematological parameters (ESR, anemia degree, ferritin level, type of blood transfusion, spleen status) showed statistically significant association with Toxoplasma infection. It can be concluded that patients with thalassemia have a high risk of infection with T. gondii. RE PCR should be used as a diagnostic method in association with serology especially in immunocompromised patients to increase sensitivity.

PMID:38009154 | PMC:PMC10667183 | DOI:10.1007/s12639-023-01624-4

J Parasit Dis. 2023 Dec;47(4):787-792. doi: 10.1007/s12639-023-01622-6. Epub 2023 Aug 22.

ABSTRACT

This study aimed to determine whether autochthonous high-intensity D. repens microfilaremia leads to haematological changes in companion dogs. Dogs with hypermicrofilaremia presented to the District Veterinary Centre, Kannur were selected for the study. A total of 100 dogs were positive for hypermicrofilariaemia with D. repens based on peripheral blood smear examination and Knott’s test. Of these, 3 dogs were concurrently positive for sheathed microfilaria (MF) of Brugia spp. Interestingly, an adult live worm of D. repens approximately eight cm in length was detected on a subcutaneous mass on the hind limb of a hypermicrofilaremic dog in the study. We compared the hematological parameters of 100 autochthonous hypermicrofilaremic dogs and 15 uninfected dogs. The hematological findings in the study are mild to moderate anemia, moderate to severe thrombocytopenia, leucocytosis with granulocytosis, lymphocytosis and monocytosis as compared to the uninfected group of dogs. The pathogenicity of naturally occurring hypermicrofilaremia is poorly studied, and knowledge of its epidemiology, host-parasite relationship and impact on various organs is warranted for better prevention and control, especially in hot-spot areas.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12639-023-01622-6.

PMID:38009152 | PMC:PMC10667202 | DOI:10.1007/s12639-023-01622-6

Harv Data Sci Rev. 2022;4(SI3). doi: 10.1162/99608f92.116c43fe. Epub 2022 Sep 8.

ABSTRACT

This article, an introduction to HDSR‘s “Personalized (N-of-1) Trials: Methods, Applications, and Impact” special issue, describes the rationale for a primer of the methods, data types and management, designs, and use cases for personalized (N-of-1) trials. It explains that the design and implementation of personalized (N-of-1) trials is only useful if patients volunteer for research involving them and actively participate in clinical services that use them. However, ‘N-of-1 trials’ may be an inadequate name to enact such patient engagement. The authors briefly review what patients have reported about the ‘N-of-1’ label and propose a more consumer-friendly moniker for this type of research and clinical approach to improve evidence-based science.

PMID:38009132 | PMC:PMC10673636 | DOI:10.1162/99608f92.116c43fe

Harv Data Sci Rev. 2022;4(SI3). doi: 10.1162/99608f92.d99e6ff5. Epub 2022 Sep 8.

ABSTRACT

Treatment of patients who suffer from concurrent health conditions is not well served by (1) evidence-based clinical guidelines that mainly specify treatment of single conditions and (2) conventional randomized controlled trials (RCTs) that identify treatments as safe and effective on average. Clinical decision-making based on the average patient effect may be inappropriate for treatment of those with multimorbidity who experience burdens and obstacles that may be unique to their personal situation. We describe how the personalized (N-of-1) trials can be integrated with an automatic platform and virtual/remote technologies to improve patient-centered care for those living with multimorbidity. To illustrate, we present a hypothetical clinical scenario-survivors of both coronavirus disease 2019 (COVID-19) and cancer who chronically suffer from sleeplessness and fatigue. Then, we will describe how the four standard phases of conventional RCT development can be modified for personalized trials and applied to the multimorbidity clinical scenario, outline how personalized trials can be adapted and extended to compare the benefits of personalized trials versus between-subject trial design, and explain how personalized trials can address special problems associated with multimorbidity for which conventional trials are poorly suited.

PMID:38009131 | PMC:PMC10673634 | DOI:10.1162/99608f92.d99e6ff5