Nevin Manimala

Geospat Health. 2025 Jul 7;20(2). doi: 10.4081/gh.2025.1393. Epub 2025 Oct 27.

ABSTRACT

This study is a quantitative, ecological, descriptive, retrospective, cross-sectional study on dengue in the state of Paraíba in north-eastern Brazil aimed to compare the performance of spatial clustering methods based on epidemiological data. The population consisted of all people residing in the state, and the sample was all dengue fever cases reported annually between 2018 and 2022. The residence localization of people suffering from dengue fever was used to identify the spatial distribution of this infection in the Paraíba State. Scan Statistics, Besag-Newell, Getis-Ord, MStatistics and Tango were used and it was observed that the methods Getis-Ord, M-Statistic and Tango showed large spatial clusters, which included municipalities with high and low values. Scan Statistics and Besag-Newell’s method also showed most of these clusters, with Scan Statistic providing better agreement with the high Standardized Incidence Ratio (SIR) than Besag-Newell’s method. In conclusion, Scan statistic outperformed the other methods by identifying significant clusters in greater proportion in all study periods when mapping using Rigorous Impact Evaluation (RIE) was applied. However, it is necessary to consider each method’s assumptions to select the most appropriate method for each application. Thus, this study provides relevant elements to help decision makers manage and prevent diseases, such as dengue fever and other vector-borne diseases.

PMID:41147980 | DOI:10.4081/gh.2025.1393

Can J Diet Pract Res. 2025 Oct 28:1-9. doi: 10.3148/cjdpr-2025-022. Online ahead of print.

ABSTRACT

Purpose: Dietitians (RDs) are well-positioned to drive food system transformation by supporting dietary patterns sourced from sustainable food systems (SFS). This research aims to identify how RDs conceptualize sustainability, describe SFS activities, define success, and determine the knowledge and skills required to practice in this area. Methods: A convenience sample of Canadian RDs completed a cross-sectional survey with open- and close-ended questions. Quantitative data were analyzed using descriptive statistics. Qualitative responses were thematically analyzed. Practice activities were mapped using the Socioecological Framework (SEF). Results: A diverse sample (n = 92) reported using common SFS definitions, frameworks, or other documents. Practice activities were reported on all levels of the SEF. Dietitians reported successes; however, the vagueness or responses suggested it may be too early to quantify these. Dietitians reported needing foundational and practice area-specific knowledge and skills and practical examples to support SFS in practice. Conclusions: Canadian RDs in this study demonstrated significant work in SFS using skills they developed to practice in other areas of dietetics. There is an opportunity to expand impact by sharing existing resources, developing new supports that include Indigenous perspectives and systems thinking, evolving RD roles, increasing macro-level strategies, and identifying success indicators to monitor impact.

PMID:41147971 | DOI:10.3148/cjdpr-2025-022

Eur J Psychotraumatol. 2025 Dec;16(1):2568339. doi: 10.1080/20008066.2025.2568339. Epub 2025 Oct 28.

ABSTRACT

Background and objective: The revisions of the DSM-5 and ICD-11 introduced several changes that altered the conceptualization of posttraumatic stress disorder (PTSD), potentially affecting diagnosis of children and adolescents. This study investigates the differences in rates of PTSD, diagnostic agreement, and comorbidity in children and adolescents when using DSM-5 or ICD-11.Method: The study is based on secondary analysis of data. Sample 1 and 2 consist of children and adolescents referred to mental health clinics (CAMHS) across Norway and sample 3 includes children referred to community services for trauma treatment. The total sample consisted of 290 children and adolescents (ages 7-18). Cohen’s kappa, McNemar tests and bootstrapped estimates with 95% CI were used to investigate our research questions.Results: The rate of _DSM-5PTSD (55.9%) was significantly higher than _ICD-11PTSD (33.2%), which seems to be particularly related to the re-experiencing criterion. There was a weak agreement of 74.5% between the two diagnoses manuals (kappa = .51). Using DSM-5 showed larger overlap between depression and PTSD (24.5% vs. 12.3%), as well as attention difficulties and PTSD (21.8% vs. 12.1%) as compared to ICD-11. However, our results also suggest that comorbidity rates for those with PTSD may be higher when using ICD-11 criteria compared to DSM-5 criteria (61.9% vs 53.1.% for depression).Conclusions: The results indicate that choice of diagnostic manual can influence whether children meet diagnostic criteria. Using ICD-11 criteria may help identify a subgroup of children and adolescents with more severe PTSD symptom profiles. Whereas using ICD-11 criteria is associated with high specificity of the diagnosis, it seems to also increase the comorbidity among those diagnosed. In contrast, utilizing DSM-5 criteria may identify children and adolescents with less distinct symptom presentations. Choice of diagnostic manual may influence access to evidence-based treatment.

PMID:41147898 | DOI:10.1080/20008066.2025.2568339

Bone Jt Open. 2025 Oct 28;6(10):1330-1342. doi: 10.1302/2633-1462.610.BJO-2025-0098.R1.

ABSTRACT

AIMS: This systematic review and meta-analysis aimed to compare the patient-reported outcomes of operative and nonoperative management in adults with a fracture of the distal radius, with a focus on the outcomes in older patients (aged ≥ 65 years).

METHODS: Randomized controlled trials comparing operative and nonoperative management of patients aged ≥ 18 years with dorsally displaced distal radius fractures were included. Operative management included open reduction and internal fixation (ORIF), manipulation and Kirschner-wiring, or external fixation. Nonoperative management included cast/splint immobilization with or without closed reduction. Primary outcome was the 12-month Patient-Rated Wrist Evaluation (PRWE). Additional outcomes included the Disabilities of Arm, Shoulder and Hand (DASH), pain, complications, and radiological parameters. A sub-group analysis was undertaken for studies that reported outcomes in older adults (aged ≥ 65 years).

RESULTS: After screening 1,635 studies, 19 trials with 2,178 patients (mean age 63 years (18 to 98), 74% female) were included. Seven studies reported outcomes in older patients (n = 773). There were statistical but not clinically significant differences favouring surgery for PRWE at three months (mean difference (MD) -8.70, 95% CI -14.45 to -2.95; p = 0.003) and 12 months (MD -2.96, 95% CI -5.15 to -0.77; p = 0.008). There was a statistical but not clinically significant difference in DASH at three months (MD -10.58, 95% CI -13.15 to -8.01; p < 0.00001) and 12 months (MD -4.17, 95% CI -6.05 to -2.30; p < 0.001) favouring surgery. There was no difference in complications (odds ratio (OR) 0.95, 95% CI 0.52 to 1.76; p = 0.880). For older adults, there was no difference in the PRWE at three months (MD -8.53, 95% CI -18.13 to 1.07; p = 0.080) or 12 months (MD -2.13, 95% CI -4.60 to 0.33; p = 0.090), with no difference in complications (OR 0.73, 95% CI 0.21 to 2.49; p = 0.620).

CONCLUSION: Operative management of adult dorsally displaced distal radius fractures was associated with superior functional outcomes according to the PRWE and DASH, but whether these are clinically meaningful is debatable. However, in older adults there was no significant or clinically meaningful benefit of surgery.

PMID:41147259 | DOI:10.1302/2633-1462.610.BJO-2025-0098.R1

Biol Rev Camb Philos Soc. 2025 Oct 28. doi: 10.1111/brv.70090. Online ahead of print.

ABSTRACT

A series of terminological, technical, conceptual, and statistical challenges present themselves when trying to study correlations between measures of performance abilities (what an animal can do) and behavioural traits (what an animal chooses to do). We attempt to synthesise literature on this topic, with a specific focus on locomotor performance and behavioural traits measured with standardised tests. We argue that measures of forced performance (e.g. endurance on a motorised treadmill) and voluntary behaviour (e.g. wheel running) often fall along a continuum, sometimes grading into each other. On the performance end of the continuum, tests should measure what an animal can do when motivation is maximal and/or it is given no choice but to exert itself maximally. On the behavioural end of the continuum, tests should capture what animals choose to do of their own free volition, with no experimental attempt to affect motivation. Hence, performance tests attempt to eliminate variation in motivation by forcing all individuals to be maximally motivated, whereas variation in motivation is an inherent component of all behavioural tests. In some cases, however, differentiating between measures of performance versus behaviour can seem almost arbitrary. Moreover, individuals may consistently differ in how willing they are to ‘perform’ even when ‘forced’ to do so. We compiled studies reporting any association (covariation, correlation or linear regression) between putative measures of locomotor performance and behaviour in various taxa. The vast majority of those studies report phenotypic correlations, and only a handful have reported genetic correlations or explored potential correlated responses to selection on performance or behaviour. To our knowledge, this is the first global overview of how locomotor performance and behaviour covary in animals, and we believe that our synthesis will be useful to guide future research on locomotor performance and its relationship with other ecologically relevant traits. For example, we argue that a multi-level (co)variance partitioning approach is necessary to gain insights into the importance of how motivation differs across levels (e.g. among- versus within-individual variation, genetic versus environmental variation). Finally, we outline a multitude of compensation and co-specialisation mechanisms that may occur between performance and behaviour, and propose future avenues for research that include selection and manipulative studies to help identify the role of correlational selection, individual experience, and predation detectability on the relationships between behaviour and performance.

PMID:41147254 | DOI:10.1111/brv.70090

Pediatr Pulmonol. 2025 Oct;60(10):e71284. doi: 10.1002/ppul.71284.

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the risk factors for chronic coughing in children diagnosed with mycoplasma pneumoniae pneumonia (MPP) and provide a reference for a foundation for clinical diagnosis and therapy.

METHODS: A retrospective analysis was conducted by gathering pertinent clinical data from children with MPP who were hospitalized in the First Affiliated Hospital of Zhengzhou University. Relevant clinical data were collected during their hospitalization. At least 4 weeks after discharge from the hospital, the children were followed up by telephone and outpatient clinic to determine whether they had developed chronic cough. The number of sequential courses of azithromycin and the duration of the out-of-hospital nebulizer treatment were recorded. Results 28 cases (14.9%) with chronic cough among the 188 children with MPP were included in the case group, while 160 cases (85.1%) were included in the control group. Age, C reactive protein (CRP), CT feature, Mycoplasma antibody titers, the number of sequential courses of azithromycin and the number of days of nebulization therapy in the case group were statistically different from those in the control group (p < 0.05). Through logistic regression analysis, we found that the history of atopic constitution, serum IgE levels, the number of sequential courses of azithromycin, and the number of days of nebulization therapy influenced chronic cough in MPP children. (p < 0.05).

CONCLUSION: Our findings indicate a potential association between atopic constitution and the development of chronic cough in MPP children, and suggest that sequential azithromycin and nebulization therapy might help reduce the likelihood of chronic cough.

PMID:41147253 | DOI:10.1002/ppul.71284

Pediatr Pulmonol. 2025 Oct;60(10):e71191. doi: 10.1002/ppul.71191.

ABSTRACT

BACKGROUND: Perfluorooctanoic acid (PFOA) is widely used in daily life; however, research has shown its immune suppression effects. This study aimed to investigate the association between prenatal exposure to PFOA and allergic diseases in children.

METHODS: A prospective birth cohort study involving 648 pregnant women was conducted. Prenatal information was collected through interviews with the women and from medical records. Umbilical cord blood was collected at birth, and concentration of PFOA was measured and genotype of IL-13 rs20541 was detected. Children were followed at 6, 12 and 24 months and information on the development of allergic diseases was recorded. Multivariate logistic regression analysis was used to examine the association between PFOA and allergic diseases. Stratified analysis was performed based on child sex and genotype of IL-13 rs20541.

RESULTS: In multivariate adjusted models, the highest PFOA quartile was associated with increased odds of atopic dermatitis (AD) (OR: 1.66, 95% CI: 1.09-2.55), wheezing (OR: 4.06, 95% CI: 1.30-12.68), and allergic diseases (OR: 1.71, 95% CI: 1.15-2.54). Among females, the highest PFOA quartile was associated with higher odds of AD (OR: 2.25, 95% CI: 1.20-4.23) and allergic diseases (OR: 1.93, 95% CI: 1.07-3.46). Although IL-13 rs20541 alone was not associated with allergic outcomes, children with the GG genotype of IL-13 rs20541 and the highest PFOA quartile have higher odds of AD (OR: 2.82, 95% CI: 1.41-5.67), wheezing (OR: 15.16, 95% CI: 1.38-166.59), and allergic diseases (OR: 2.42, 95% CI: 1.27-4.61).

CONCLUSIONS: Prenatal exposure to PFOA is associated with an increased risk of allergic diseases in early childhood, especially for the female children and those with the GG genotype of IL-13 rs20541.

PMID:41147248 | DOI:10.1002/ppul.71191

Psychol Med. 2025 Oct 28;55:e324. doi: 10.1017/S0033291725102146.

ABSTRACT

BACKGROUND: Anorexia nervosa has potential to influence the development and function of the gastrointestinal system. We assessed the association between maternal anorexia nervosa and risk of gastrointestinal morbidity in offspring.

METHODS: We analyzed a longitudinal cohort of 1,269,370 children born in Quebec, Canada, between 2006 and 2022. The exposure was maternal anorexia nervosa. The outcome was hospitalization for pediatric gastrointestinal disorders, including hypertrophic pyloric stenosis, inflammatory bowel disease, and other digestive morbidity. Follow-up ranged from 1 to 17 years. We used adjusted Cox regression models to obtain hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between maternal anorexia nervosa and pediatric gastrointestinal disorders.

RESULTS: A total of 2,447 children (0.2%) had a mother with anorexia nervosa. By age 17 years, the cumulative incidence of gastrointestinal disorders was higher among children whose mothers had anorexia nervosa than other children (165.7 vs. 129.4 per 1,000). Compared with no anorexia, maternal anorexia nervosa was associated with a greater risk of any childhood gastrointestinal disorder (HR: 1.42, 95% CI: 1.26-1.61), particularly hypertrophic pyloric stenosis (HR: 2.51, 95% CI: 1.35-4.66), inflammatory bowel disease (HR: 2.46, 95% CI: 1.67-3.64), and rectal hemorrhage (HR: 3.46, 95% CI: 1.97-6.09). Children whose mothers developed anorexia nervosa after age 20 years or were hospitalized more than once for anorexia had the greatest risk of gastrointestinal morbidity. The associations were not explained by digestive birth defects.

CONCLUSION: Maternal anorexia nervosa is associated with pediatric gastrointestinal disorders that could potentially be mitigated with psychosocial support, nutritional rehabilitation, and breastfeeding.

PMID:41147221 | DOI:10.1017/S0033291725102146

Acta Cardiol. 2025 Oct 28:1-12. doi: 10.1080/00015385.2025.2576446. Online ahead of print.

ABSTRACT

BACKGROUND: Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) is increasingly used for the treatment of surgical bioprosthetic valve degeneration (sBVD).

METHODS: We investigated clinical outcomes and hemodynamic valve performance in all consecutive patients undergoing ViV-TAVI for sBVD in a single centre and assessed differences in patients who received a balloon-expandable (BEV) versus self-expandable valve (SEV) at 1, 6 and 12 months (m), and annually thereafter.

RESULTS: Between 25 November 2011 and 4 September 2023, 86 patients (mean age 80.3 ± 6.6y; 53.5% female; median STS score 5.1% (3.7%;8.6%) underwent ViV-TAVI with BEV (n = 53) or SEV (n = 33). Overall, the cumulative incidences of all-cause and cardiovascular mortality at 12 m were 7.4% (3.4%;15.8%) and 3.6% (0.9%; 9.3%), respectively (comparison of SEV versus BEV within the first year: p = 0.253 and p = 0.168, and comparison for the entire follow-up (median 2.6 (0.9;4.6) years): p = 0.962 and p = 0.942). Aortic valve area (AVA) and peak and mean transprosthetic gradients (TPG) improved significantly from baseline to 1, 6 and 12 m follow-up (p < 0.001 for all). Peak and mean TPG were 10.5 (1.8;19.2) and 7.1 (1.6;12.7) mmHg lower in SEV as compared with BEV at 1 m (p = 0.019 and 0.012, respectively). Similarly, AVA of SEV was 0.23 (0.03;0.44) and 0.54 (0.28;0.81) cm² larger as compared with BEV at 1 and 6 m (p = 0.027 and p < 0.001, respectively). No significant differences in hemodynamic valve performance between BEV and SEV were observed during further follow-up.

CONCLUSION: ViV-TAVI is a safe and effective treatment for patients presenting sBVD. Improved hemodynamic valve performance with SEV over BEV observed during early follow-up did not translate into long-term lower mortality rates.

PMID:41147217 | DOI:10.1080/00015385.2025.2576446

Can J Psychiatry. 2025 Oct 28:7067437251389872. doi: 10.1177/07067437251389872. Online ahead of print.

ABSTRACT

ObjectivesThe objectives of this study were to quantify the associations between preterm birth and adolescent-to-adult psychiatric disorders in the Quebec (Canada) population and to determine whether sex and socioeconomic status (SES) modified this relationship.MethodsThis was an observational cohort study using administrative data from the province of Quebec, Canada. All eligible children born preterm between 1976 and 1995 were identified (N = 100,040) and matched 1:2 with term-born children. Individuals were followed from age 11 years until either incident diagnosis of a psychiatric disorder (attention-deficit/hyperactivity disorder [ADHD], psychosis, bipolar disorder, anxiety, or depression), death, or December 2019. Preterm birth was considered as a binary (<37 weeks gestational age) and categorical exposure (extreme, <28; very, 28-31; moderate-to-late, 32-36 weeks gestational age), in addition to continuous gestational age in weeks. Cox proportional hazard models were applied. Effect-modifying roles of sex and SES were investigated in interaction analyses.ResultsCompared to term-born children, those born preterm had a higher risk of all outcomes, with magnitudes ranging from HR 1.16 for ADHD (95% confidence interval 1.13, 1.19) to 1.05 for anxiety (1.04, 1.07). A dose-response relationship was observed, with increasing risks of ADHD, psychosis, and anxiety as the degree of preterm birth increased. Despite some statistically significant associations, there was no clinically significant evidence of effect modification by sex or SES.ConclusionsChildren born preterm had an increased risk of psychiatric disorders in adolescence-to-adulthood, with similar risks across sexes and socioeconomic strata of the population. Policies for early and continued mental health surveillance in this susceptible group are important to initiate appropriate interventions.

PMID:41147193 | DOI:10.1177/07067437251389872