Nevin Manimala

Front Psychiatry. 2022 Mar 9;13:791254. doi: 10.3389/fpsyt.2022.791254. eCollection 2022.

ABSTRACT

BACKGROUND: Internet gaming disorder (IGD) was recently added in the Diagnostic and Statistical Manual of Mental Disorder as a “condition for further studies.” There is no consensus regarding which rating scales should be used but many scholars suggest the GASA (Game Addiction Scale for Adolescents) and a ranking of the criteria, “the core approach” to avoid over-diagnosing of disordered gaming. Male gender and ADHD are commonly listed as risk factors for disordered gaming but little is known about sex differences in gaming and gender specific health correlates.

PURPOSE: The present study aims to evaluate the core approach and the specific indicators of gaming behavior in GASA from a multifactorial perspective and explore the gender differences in a clinical setting, focusing on ADHD.

PATIENTS AND METHODS: Children and adolescents aged 8-18 years (n = 144) from Child and adolescent psychiatry (CAP) in Skane were assessed with the GASA. Psychometric analyses including confirmatory factor analyses (CFA) and structural equation modeling (SEM) were used to identify well-defined constructs and gender differences. Refined factor scores for single constructs were the outcome of alignment, a procedure for assessing measurement equivalence across gender. New model-based gaming behavior variables were used for descriptive statistics and ANOVA testing of gender differences.

RESULTS: The results confirm that the core approach two-factor model is valid for the CAP sample, as well as a theory based psycho-social model for gaming behavior with over consumption and negative social and emotional consequences. Our findings suggest that negative consequences of over consumption take a social direction for boys and an emotional direction for girls. Also, ADHD was significantly associated with over consumption of video games and the negative consequences thereof for girls.

CONCLUSION: Guided by psychometric analyses, the GASA could be strengthened by advancing the questionnaire design and by adding complementary items in order to illuminate the complexity of gaming behavior. Our findings suggest that additional research on potential gender related discrepancies of disordered gaming is needed.

PMID:35356720 | PMC:PMC8959768 | DOI:10.3389/fpsyt.2022.791254

Front Psychiatry. 2022 Mar 9;13:778236. doi: 10.3389/fpsyt.2022.778236. eCollection 2022.

ABSTRACT

INTRODUCTION: Children of parents with a mental illness (COPMI) are at risk of behavioral, emotional, and cognitive difficulties and diagnoses. Support and information about parents’ mental illness may contribute to improve their lives, which is the purpose of the intervention Child Talks (CT). This study aimed to investigate the participation rate of CT, characteristics of participating patients and children, and themes in sessions with children.

MATERIALS AND METHODS: Data were collected from 424 electronic patient journals written by healthcare professionals (H) for patients admitted to a clinic for mental health and substance use disorders in the years 2010-2015. Both quantitative statistical analysis and qualitative thematic analysis were carried out.

RESULTS: Eighteen percent of assessed parents with minor children received the CT intervention and children participated in half of them. Participating children more often knew about their parent’s treatment and condition when initially assessed, and more often lived with the hospitalized parent. Three main themes were identified in sessions with children; communication about parental mental illness within the family, childrens’ struggles, and healthcare professionals’ (HCPs) evaluation of the child’s situation and need for further support.

DISCUSSION: Sessions with patients’ children appeared to be relatively rare, and participating children did not necessarily receive appropriate information, support, or follow-up. To ensure that HCPs provide quality support and follow-up to COPMI, the routines and the training of HCPs need to be improved.

PMID:35356710 | PMC:PMC8959383 | DOI:10.3389/fpsyt.2022.778236

Front Pediatr. 2022 Mar 8;9:785480. doi: 10.3389/fped.2021.785480. eCollection 2021.

ABSTRACT

BACKGROUND: Developmental dysplasia of the hip (DDH) is a common orthopedic disease in children. In clinical surgery, it is essential to quickly and accurately locate the exact position of the lesion, and there are still some controversies relating to DDH status. We adopt artificial intelligence (AI) to solve the above problems.

METHODS: In this paper, automatic DDH measurements and classifications were achieved using a three-stage pipeline. In the first stage, we used Mask-RCNN to detect the local features of the image and segment the bony pelvis, including the ilium, pubis, ischium, and femoral heads. For the second stage, local image patches focused on semantically related areas for DDH landmarks were extracted by high-resolution network (HRNet). In the third stage, some radiographic results are obtained. In the above process, we used 1,265 patient x-ray samples as the training set and 133 samples from two other medical institutions as the verification set. The results of AI were compared with three orthopedic surgeons for reliability and time consumption.

RESULTS: AI-aided diagnostic system’s Tönnis and International Hip Dysplasia Institute (IHDI) classification accuracies for both hips ranged from 0.86 to 0.95. The measurements of numerical indices showed that there was no statistically significant difference between surgeons and AI. Tönnis and IHDI indicators were similar across the AI system, intermediate surgeon, and junior surgeon. Among some objective interpretation indicators, such as acetabular index and CE angle, there were good stability and consistency among the four observers. Intraclass consistency of acetabular index and CE angle among surgeons was 0.79-0.98, while AI was 1.00. The measurement time required by AI was significantly less than that of the doctors.

CONCLUSION: The AI-aided diagnosis system can quickly and automatically measure important parameters and improve the quality of clinical diagnosis and screening referral process with a convenient and efficient way.

PMID:35356707 | PMC:PMC8959123 | DOI:10.3389/fped.2021.785480

Estuaries Coast. 2021 May 1;45:196-212. doi: 10.1007/s12237-021-00954-x.

ABSTRACT

Recent efforts to quantify biogeochemical and ecological processes in oyster habitats have focused on provision of habitat and regulation of the nitrogen cycle. However, it is unclear how these two processes may interact. In this study, seasonal patterns of habitat use and nitrogen removal from natural oyster beds were quantified for comparison with nearby bare sediment in Green Hill Pond, a temperate coastal lagoon in Rhode Island USA. Relationships were tested between benthic macrofaunal abundance and nitrogen removal via denitrification and burial in sediments. Nitrogen removal by oyster bio-assimilation was quantified and compared with nearby oyster aquaculture. Despite limited differences in habitat use by macrofauna, there were fewer non-oyster benthic organisms (e.g., filter-feeders, detritivores) where oysters were present, possibly due to competition for resources. Additionally, low rugosity of the native oyster beds provided little refuge value for prey. There was a shift from net N removal via denitrification in bare sediments to nitrogen fixation beneath oysters, though this change was not statistically significant (t₍₉₆₎ = 1.201; p = 0.233). Sediments contained low concentrations of N, however sediments beneath oysters contained almost twice as much N (0.07%) as bare sediments (0.04%; p < 0.001). There was no difference in tissue N content between wild oysters and those raised in aquaculture nearby, though caged oysters had more tissue per shell mass and length, and therefore removed more N on a shell length basis. These oyster beds lacked the complex structure of 3-dimensional oyster reefs which may have diminished their ability to provide habitat for refugia, foraging sites for macrofauna, and conditions known to stimulate denitrification.

PMID:35356701 | PMC:PMC8958940 | DOI:10.1007/s12237-021-00954-x

Clin Ophthalmol. 2022 Mar 23;16:893-904. doi: 10.2147/OPTH.S356436. eCollection 2022.

ABSTRACT

PURPOSE: To investigate the correlation between the photopic negative response (PhNR) of the light-adapted flash electroretinography (ERG) and measurements of standard automated perimetry (SAP) and optical coherence tomography (OCT) in assessment of retinal ganglion cells’ (RGCs) affection in glaucoma.

PATIENTS AND METHODS: A cross-sectional study included 40 eyes of glaucoma patients and 40 eyes of age- and gender-matched normal subjects. Participants underwent a complete ophthalmologic assessment, SAP, OCT, and light-adapted flash ERG using the extended PhNR protocol of the International Society for Clinical Electrophysiology of Vision (ISCEV). Glaucomatous eyes were divided into 3 subgroups: mild (n = 15), moderate (n = 11) and severe glaucoma (n = 14) according to the mean deviation (MD) of SAP. Measurements of SAP, OCT and ERG parameters were analyzed, and correlations between PhNR measurements and other study measurements were evaluated.

RESULTS: PhNR amplitudes and PhNR/b-wave ratios were significantly reduced in glaucoma cases compared to healthy controls, and they showed a significant and progressive decline across the three glaucoma subgroups (P < 0.05). An exception to this is PT (b-wave peak to PhNR trough) PhNR amplitude where its reduction was statistically non-significant when comparing between controls and mild glaucoma cases (P = 0.178), and between moderate and severe glaucoma cases (P = 0.714). PhNR amplitudes and PhNR/b-wave ratios correlated significantly with SAP and OCT parameters (P < 0.05).

CONCLUSION: PhNR correlates well with SAP and OCT parameters in glaucoma assessment. PhNR could be a valuable supplementary tool for objective assessment of the RGCs’ function in glaucoma.

PMID:35356699 | PMC:PMC8958198 | DOI:10.2147/OPTH.S356436

Mol Ther Nucleic Acids. 2022 Feb 28;28:77-86. doi: 10.1016/j.omtn.2022.02.015. eCollection 2022 Jun 14.

ABSTRACT

DNA methylation plays a pivotal role in the progression of renal fibrosis. Methyl-CpG-binding domain protein 2 (MBD2), a protein reader of methylation, is involved in the development of acute kidney injury (AKI) caused by vancomycin. However, the role and mechanism of action of MBD2 in renal remain unclear. In this study, MBD2 mediated extracellular matrix (ECM) production induced by TGF-β1 in Boston University mouse proximal tubule (BUMPT) cells，and upregulated the expression EGR1 to promote ECM production in murine embryonic NIH 3T3 fibroblasts. ChIP analysis demonstrated that MBD2 physically interacted with the promoter region of the CpG islands of EGR1 genes and then activated their expression by inducing hypomethylation of the promoter region. In vivo, PT-MBD2-KO attenuated unilateral ureteral obstruction (UUO)-induced renal tubulointerstitial fibrosis via downregulation of EGR1, which was demonstrated by the downregulation of fibronectin (FN), collagen I and IV, α-SMA, and EGR1. Injection of MBD2-siRNA attenuated the UUO- and I/R-induced renal fibrosis. Those molecular changes were verified by biopsies from patients with obstructive nephropathy (OB). These data collectively demonstrated that inhibition of MBD2 reduces renal fibrosis via downregulating EGR1, which could be a target for treatment of fibrotic kidney disease.

PMID:35356685 | PMC:PMC8933641 | DOI:10.1016/j.omtn.2022.02.015

Res Pract Thromb Haemost. 2022 Mar 25;6(2):e12686. doi: 10.1002/rth2.12686. eCollection 2022 Feb.

ABSTRACT

BACKGROUND: BAY81-8973 (Kovaltry; Bayer, Berkeley, CA, USA) was reported with enhanced pharmacokinetic (PK) profiles compared with some other standard half-life (SHL) factor VIII (FVIII) concentrates. Limited head-to-head comparative studies were conducted in a real-world setting.

OBJECTIVE: To make head-to-head comparisons of PK and clinical outcomes between Kovaltry and three other SHL FVIII concentrates.

METHODS: Forty-seven boys with severe hemophilia A were enrolled and divided into three groups according to their previously used FVIII concentrates (Kogenate FS, N = 22; Advate, N = 14; GreenMono, N = 11). Two separate PK tests were conducted in each participant with a five-point assay during the study period from 6 months before switching to 6 months after switching. FVIII levels were detected by one-stage assay, and PK profiles were calculated by noncompartmental assay. Annualized bleeding rates were collected through participant’ bleed logs.

RESULTS: Longer half-life time (Kogenate FS group: 14.4 vs 11.9 hours, P < .0001; Advate group: 13.4 vs 9.7 hours, P < .0001; GreenMono group: 15.1 vs 10.7 hours, P < .001]) and lower clearance (Kogenate FS group: 3.3 vs 3.9 mL/kg/h, P < .01; Advate group: 3.7 vs 5.9 mL/kg/h, P < .01; GreenMono group: 3.0 vs 5.1 mL/kg/h, P < .01) were observed with Kovaltry. In addition, longer mean residential time (P < .01) and higher area under the curve (P < .01) were demonstrated. No statistical difference was found in in vivo recovery between Kovaltry and the other FVIII products. Participants who switched to Kovaltry from three other FVIII concentrates with the same dosing regimens obtained higher trough FVIII levels and better protection with reduced annualized bleeding rates.

CONCLUSION: Compared with Kogenate FS, Advate, and GreenMono, Kovaltry showed enhanced PK profiles, which contributed to reduced bleeding rates.

PMID:35356665 | PMC:PMC8956787 | DOI:10.1002/rth2.12686

J Glob Health. 2022 Mar 19;12:04025. doi: 10.7189/jogh.12.04025. eCollection 2022.

ABSTRACT

BACKGROUND: Fever and malaria are highly prevalent among children under five across sub-Saharan Africa, but utilization and quality of care for febrile illness remain insufficient. Many studies examine socioeconomic and demographic determinants of care seeking; however, few assess how women’s empowerment influences care seeking and quality. We examine associations of women’s empowerment with: a) care utilization for children with fever and malaria and b) the quality of that care in 16 sub-Saharan African countries.

METHODS: This cross-sectional study used data from Demographic and Health Surveys conducted between 2010 and 2018. We constructed indices for economic, educational, sociocultural, and health-related empowerment and calculated the proportion of children with fever and malaria who sought care and received a range of recommended clinical actions. We used multivariable Poisson hurdle models to assess associations between empowerment, utilization, and number of components of quality care, controlling for socioeconomic and demographic factors.

RESULTS: Our sample consisted of 25 871 febrile children, 4731 of whom had malaria diagnosed by rapid diagnostic test. Empowerment among mothers of children with fever was 0.50 (interquartile range, 0.38-0.63). In both the fever and malaria groups, over 30% of children were not taken for care. Among care seekers, febrile children received on average 0.47 (SD = 0.37) of components of quality care, and children with malaria received 0.38 (SD = 0.34). Multidimensional women’s empowerment was significantly associated with care seeking and quality among febrile children, and with quality among children with malaria. Associations persisted after adjustment for socioeconomic and demographic characteristics.

CONCLUSIONS: Results demonstrate substantial gaps in women’s empowerment and poor utilization and quality of care for fever and malaria among children. Increased women’s empowerment is associated with seeking care and, separately, obtaining high-quality care. To improve health outcomes, consideration of how empowering women can promote care seeking and extract quality from the health system is warranted.

PMID:35356662 | PMC:PMC8932460 | DOI:10.7189/jogh.12.04025

J Glob Health. 2022 Mar 19;12:11002. doi: 10.7189/jogh.12.11002. eCollection 2022.

ABSTRACT

BACKGROUND: Creating an enabling environment (EE) can help foster the development and health of children. The Chinese government implemented a new health care reform (NHR) in 2009 in a move to promote an EE for health. The purpose of this study was to evaluate the impact of the NHR on EE for children’s health.

METHODS: An interrupted time-series analysis was used to evaluate the changes in the EE before and after 2009 in China. This study analysed the EE through five quantitative indicators, including policy element coverage rate (PECR), service meeting with children’s needs rate (SMCNR), multisector participation rate (MPR), and accountability mechanism clarity rate (AMCR), based on the content analysis of available public policy documents (updated as of 2019) from 31 provinces in mainland China, and the number of health care personnel of maternity and child care centres per 10 000 population (HP per 10 000 population), based on the 2002-2019 China Health Statistical Yearbook and China Statistical Yearbook.

RESULTS: The average values of PECR, SMCNR, and MPR increased rapidly to 90.96%, 82.46%, and 81.31%, respectively, in 2019, representing a higher value compared to the AMCR (7.38%). The NHR promoted the EE, in which HP per 10 000 population showed the fastest increase (β₁ = 0.03, P < 0.01; β₃ = 0.10, P < 0.01), followed by SMCNR (β₁ = 0.94, P < 0.01; β₃ = 1.83, P < 0.01), AMCR (β₁ = 0.13, P < 0.01; β₃ = 0.24, P = 0.14), MPR (β₁ = 1.35, P < 0.01; β₃ = 2.47, P < 0.01) and PECR (β₁ = 1.43, P < 0.01; β₃ = 1.47, P < 0.01).

CONCLUSIONS: The NHR has a positive impact on the EE, especially on the human resources and service provision for children. Efforts should be intensified to improve the clarity of the accountability mechanism of the health-related sectors.

PMID:35356653 | PMC:PMC8932608 | DOI:10.7189/jogh.12.11002

J Glob Health. 2022 Mar 26;12:04013. doi: 10.7189/jogh.12.04013. eCollection 2022.

ABSTRACT

BACKGROUND: Complications associated with preterm birth (PTB) are the largest contributor to under-five mortality globally. Success in reaching the Sustainable Development Goal target requires identifying potentially modifiable risk factors for PTB, estimating the relative importance of these risk factors, and identifying/implementing effective prevention strategies to address them.

METHODS: We conducted a literature review to define risk relationships and estimate prevalence for established risk factors for spontaneous PTB (sPTB). We then estimated population attributable fractions (PAF) for the sPTB risk factors identified in the review as statistically significant for the 81 low- and middle-income (LMIC) countries included in the Countdown 2030 initiative. We summed country-level findings to produce PAFs for each risk factor and regional estimates for sub-Saharan Africa and South Asia.

RESULTS: Forty-four potential sPTB risk factors were identified. and the final analysis included twenty-four risk factors with evidence of significant associations with sPTB. A second model with three additional risk factors with borderline insignificant associations was also run. Taken together, the twenty-four risk factors had a total PAF of 73% for all 81 countries and 77% and 72% of sPTB in sub-Saharan Africa and South Asia, respectively. For all countries, maternal undernutrition had the highest PAF (17.5%), followed by maternal infections (16.6%), environmental exposures (16%) and pregnancy history (8.7%).

CONCLUSIONS: While multiple risk factors contribute to sPTB, no single risk factor addresses a predominant fraction, and 27% of spontaneous preterm births are not associated with risk factors that we identified. Despite the significant role of preterm birth in child survival, there are major data gaps in LMIC settings. Furthermore, there is a paucity of evidence for effective interventions to prevent preterm birth. Preventing sPTB requires understanding underlying mechanisms leading to sPTB in different populations, and the identification/implementation of effective interventions.

PMID:35356651 | PMC:PMC8959104 | DOI:10.7189/jogh.12.04013