Tag: nevin manimala

Nat Commun. 2024 Nov 6;15(1):9552. doi: 10.1038/s41467-024-53213-5.

ABSTRACT

In response to gradual nanoindentation, the surface of muscovite mica deforms by sudden stochastic nanometer-scale displacement bursts. Here, the statistics of these displacement events are interpreted using a statistical model previously used to model earthquakes to understand how chemically reactive environments alter the surface properties of this material. We show that the statistics of nanoindentation displacement bursts in muscovite mica are tuned by chemomechanical weakening in a manner similar to how the statistics of model events are tuned by a mechanical weakening parameter that describes how easily system-spanning cracks can be nucleated. Because the predictions of this model are independent of any surface defects or structural details, these results suggest this simple model can be universally used to describe chemomechanical weakening in many systems prone to slip avalanches on a wide range of spatio-temporal scales.

PMID:39505851 | DOI:10.1038/s41467-024-53213-5

J Aging Soc Policy. 2024 Nov 6:1-17. doi: 10.1080/08959420.2024.2423102. Online ahead of print.

ABSTRACT

Increase in life expectancy around the world puts aging societies with all their challenges on the Global Public Health agenda. In Austria, additional years of life gained are not spent in good health, as healthy life expectancy is far below the European average. Using repeated cross-sectional data from three waves of the Austrian Health Interview Survey (2006, 2014 and 2019), including a total of 10,056 participants aged 65 years and above, this study examined the change in self-reported quality-of-life (QoL) over time and explored associated factors. QoL, estimated by domain scores of the WHOQOL-BREF questionnaire, increased over time but decreased with age in all survey waves. Observed mean scores were significantly higher in males than in females in all QoL domains except the social domain but sex differences disappeared in most domains in the multivariable regression analyses. Instead, factors associated with significantly higher QoL scores included younger age, higher socioeconomic status, living in Western Austria and having no chronic conditions. Statistically significant observed sex differences in QoL in the older-aged Austrian population disappeared when adjusting for income and education. Strategies and measures to increase financial capabilities may have a significant impact on QoL and well-being in this age group.

PMID:39505834 | DOI:10.1080/08959420.2024.2423102

Acad Psychiatry. 2024 Nov 6. doi: 10.1007/s40596-024-02080-9. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was designed to investigate if artificial intelligence (AI) detection software can determine the use of AI in personal statements for residency applications.

METHOD: Previously written personal statements were collected from physicians who had already matched to residency through the Electronic Residency Application System. Physicians were recruited for the study through collegial relationships and were given study information via email. The study team constructed five parallel statements from the shared personal statements to prompt AI to create a personal statement of similar content. An online AI detection tool, GPTZero, was used to assess all the personal statements. Statistical analyses were conducted using R. Descriptive statistics, t-tests, and Pearson correlations were used to assess the data.

RESULTS: Eight physicians’ statements were compared to eight AI-generated statements. GPTZero was able to correctly identify AI-generated writing, assigning them significantly higher AI probability scores compared to human-authored essays. Human-generated statements were considered more readable, used shorter words with fewer syllables, and had more sentences compared to AI-generated essays. Longer average sentence length, low readability scores, and high SAT word percentages were strongly associated with AI-generated essays.

CONCLUSIONS: This study shows the capacity of GPTZero to distinguish human-created versus AI-generated writing. Use of AI can pose significant ethical challenges and carries a risk of inadvertent harm to certain applicants and erosion of trust in the application process. Authors suggest standardization of protocol regarding the use of AI prior to its integration in post-graduate medical education.

PMID:39505810 | DOI:10.1007/s40596-024-02080-9

Braz J Otorhinolaryngol. 2024 Nov 5;91(2):101520. doi: 10.1016/j.bjorl.2024.101520. Online ahead of print.

ABSTRACT

OBJECTIVE: To understand the characteristics of cervical lymph node metastasis in Oropharyngeal Squamous Cell Carcinoma (OPSCC) patients, explore the risk factors for lymph node metastasis, and its impact on prognosis.

METHODS: Retrospective cohort study. Statistical analysis of the relationship between various clinicopathological factors and lymph node involvement, as well as the independent risk factors affecting lymph node metastasis and their impact on prognosis.

RESULTS: The cervical lymph node metastasis rate in this group was 89.2%, with the palatine tonsils and base of the tongue more prone to cervical lymph node metastasis (p=0.007); lower pathological differentiation of OPSCC was more likely to develop cervical lymph node metastasis (p=0.017). The P16 protein positive rate in this group was 58.8%. P16 protein expression did not affect the incidence rate of cervical lymph node metastasis in OPSCC (p=1.000) but influenced the risk of multiple lymph node metastases (p=0.011) and was a risk factor affecting the prognosis of OPSCC (p=0.003). However, the lymph node metastasis status did not affect the survival time of OPSCC patients.

CONCLUSION: In the Shanxi region of China, HPV-related OPSCC accounts for a higher proportion; OPSCC has a high rate of cervical lymph node metastasis, but lymph node metastasis does not significantly increase the mortality risk of OPSCC patients, which may be related to the unique characteristics of HPV-related OPSCC. LEVEL OF EVIDENCE Ⅳ: Retrospective cohort study.

PMID:39504599 | DOI:10.1016/j.bjorl.2024.101520

Sleep Med. 2024 Oct 30;124:618-626. doi: 10.1016/j.sleep.2024.10.037. Online ahead of print.

ABSTRACT

Narcolepsy is a rare, chronic neurological disorder characterized by a dysregulated sleep-wake cycle, with core clinical features including excessive daytime sleepiness (EDS), cataplexy, hypnopompic/hypnagogic hallucinations, and sleep paralysis. Several treatment options are available for the symptomatic management of narcolepsy, but they have limitations. Comorbidities of narcolepsy further limit the treatment choices. Blocking of histamine 3 (H3) receptors has been demonstrated to be a viable approach for the management of symptoms of narcolepsy. Samelisant (SUVN-G3031) is a new H3 receptor inverse agonist. The efficacy, safety, tolerability, and pharmacokinetics of Samelisant in narcolepsy patients were evaluated in a phase 2, double-blind, placebo-controlled study (ClinicalTrials.gov identifier: NCT04072380). Patients diagnosed with narcolepsy according to the International Classification of Sleep Disorders criteria and having an Epworth Sleepiness Scale (ESS) score of ≥12 and a mean Maintenance of Wakefulness Test (MWT) time of <12 min across the 4 sessions at baseline were enrolled. The total study duration was up to 7 weeks, which included a screening period of 4 weeks, a treatment period of 2 weeks, and a safety follow-up 1 week after the last study drug administration. The primary efficacy measure was the change in total ESS score compared to placebo. Secondary and exploratory assessments included the Clinical Global Impression of Severity, MWT, Clinical Global Impression of Change, Patient Global Impression of Change and cataplexy rate. Safety assessments included monitoring adverse events (AEs) and laboratory assessments. Of the 426 patients screened, 190 were randomized. The safety and intention-to-treat population included 188 and 164 patients, respectively. A statistically significant treatment effect of Samelisant was observed on the primary endpoint, indicating improvements in EDS. The treatment’s impact on EDS was also evident on the other patients’ and clinicians’ perspectives scales. The AEs reported in ≥5 % patients in any treatment groups were insomnia, abnormal dreams, nausea, and hot flush. Global phase 3 studies and long-term safety and efficacy assessments of Samelisant are planned to reaffirm the current findings.

PMID:39504585 | DOI:10.1016/j.sleep.2024.10.037

JMIR Cancer. 2024 Nov 6;10:e51936. doi: 10.2196/51936.

ABSTRACT

BACKGROUND: Tobacco use has been identified as a risk factor for oral cancer worldwide. However, relative oral cancer incidence among adults who smoke cigarettes, use smokeless tobacco products (ST), have transitioned from cigarettes to ST, quit cigarettes and/or ST (“quitters”), or never used tobacco has not been well studied.

OBJECTIVE: We aim to present population-based oral cancer incidence rates for adults who smoke cigarettes, use ST, are former smokers who now use ST, or quit.

METHODS: We estimated cross-sectional incidence rates and incidence rate ratios (IRRs) using data from statewide cancer registries (Colorado, Florida, North Carolina, and Texas) and population counts derived from national surveys using combined data from 2014-2017. A random-effect meta-analysis approach was used to summarize estimates among these groups, based on multiple imputation-based IRR estimates by state and age group while considering potential heterogeneity.

RESULTS: A total of 19,536 oral cancer cases were identified among adult males 35 years and older in the study geographies and period. The oral cancer incidence rate among adults who smoke was significantly higher than the ST group (2.6 times higher, 95% CI 2.0-3.3, P<.001), 3.6 (95% CI 3.2-4.1, P<.001) times higher than the never users, and 2.4 (95% CI 1.8-3.1, P<.001) times higher compared to former smokers who now use ST. The IRR among the ST group relative to never users was 1.4 (95% CI 1.1-1.9, P=.02). The IRR between former smokers who now use ST and those who quit was 1.4 (95% CI 1.0-2.1, P=.08).

CONCLUSIONS: Findings from this population-based study with a large number of oral cancer cases support significantly high oral cancer incidence among adults who smoke and a lower risk of oral cancer incidence among never users, quitters, users of ST, and former smokers who now use ST compared to cigarettes. Future studies with detailed control of tobacco history and other relevant confounders are needed to confirm these findings.

PMID:39504575 | DOI:10.2196/51936

JMIR Med Inform. 2024 Nov 6;12:e58276. doi: 10.2196/58276.

ABSTRACT

BACKGROUND: Coprescribing naloxone with opioid analgesics is a Centers for Disease Control and Prevention (CDC) best practice to mitigate the risk of fatal opioid overdose, yet coprescription by emergency medicine clinicians is rare, occurring less than 5% of the time it is indicated. Clinical decision support (CDS) has been associated with increased naloxone prescribing; however, key CDS design characteristics and pragmatic outcome measures necessary to understand replicability and effectiveness have not been reported.

OBJECTIVE: This study aimed to rigorously evaluate and quantify the impact of CDS designed to improve emergency department (ED) naloxone coprescribing. We hypothesized CDS would increase naloxone coprescribing and the number of naloxone prescriptions filled by patients discharged from EDs in a large health care system.

METHODS: Following user-centered design principles, we designed and implemented a fully automated, interruptive, electronic health record-based CDS to nudge clinicians to coprescribe naloxone with high-risk opioid prescriptions. “High-risk” opioid prescriptions were defined as any opioid analgesic prescription ≥90 total morphine milligram equivalents per day or for patients with a prior diagnosis of opioid use disorder or opioid overdose. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to evaluate pragmatic CDS outcomes of reach, effectiveness, adoption, implementation, and maintenance. Effectiveness was the primary outcome of interest and was assessed by (1) constructing a Bayesian structural time-series model of the number of ED visits with naloxone coprescriptions before and after CDS implementation and (2) calculating the percentage of naloxone prescriptions associated with CDS that were filled at an outpatient pharmacy. Mann-Kendall tests were used to evaluate longitudinal trends in CDS adoption. All outcomes were analyzed in R (version 4.2.2; R Core Team).

Between November 2019 and July 2023, there were 1,994,994 ED visits. CDS reached clinicians in 0.83% (16,566/1,994,994) of all visits and 15.99% (16,566/103,606) of ED visits where an opioid was prescribed at discharge. Clinicians adopted CDS, coprescribing naloxone in 34.36% (6613/19,246) of alerts. CDS was effective, increasing naloxone coprescribing from baseline by 18.1 (95% CI 17.9-18.3) coprescriptions per week or 2,327% (95% CI 3390-3490). Patients filled 43.80% (1989/4541) of naloxone coprescriptions. The CDS was implemented simultaneously at every ED and no adaptations were made to CDS postimplementation. CDS was maintained beyond the study period and maintained its effect, with adoption increasing over time (τ=0.454; P<.001).

CONCLUSIONS: Our findings advance the evidence that electronic health record-based CDS increases the number of naloxone coprescriptions and improves the distribution of naloxone. Our time series analysis controls for secular trends and strongly suggests that minimally interruptive CDS significantly improves process outcomes.

PMID:39504560 | DOI:10.2196/58276

Am J Public Health. 2024 Dec;114(12):1375-1383. doi: 10.2105/AJPH.2024.307839.

ABSTRACT

Objectives. To (1) compare responses to 2 survey questions designed to measure sexual orientation and (2) understand how variation in responses is associated with mental health. Methods. Data were from the National Longitudinal Study of Adolescent to Adult Health (Add Health) Sexual Orientation/Gender Identity, Socioeconomic Status, and Health Across the Life Course (SOGI-SES) study (2020-2021) in the United States. We used the adjusted Wald test to compare proportions of respondents who were (1) categorized as heterosexual or straight and sexual minorities using the sexual orientation questions designed for the Add Health study and the National Health Interview Survey (NHIS) and (2) diagnosed with depression or anxiety or panic disorder. Results. The Add Health question detected more than twice as many sexual minority respondents as the NHIS question. Those who responded as sexual minorities to the Add Health question but as heterosexual or straight to the NHIS question, primarily “mostly heterosexuals,” had mental health outcomes that were more like those who were consistently classified as sexual minorities versus those consistently classified as heterosexual or straight. Conclusions. Current measures of sexual orientation in national-level surveys may underestimate the sexual minority population and sexual orientation‒related health disparities. Public Health Implications. Results illustrate the need for further research to expand measurement of sexual orientation on population-based health surveys. (Am J Public Health. 2024;114(12):1375-1383. https://doi.org/10.2105/AJPH.2024.307839).

PMID:39504554 | DOI:10.2105/AJPH.2024.307839

JMIR Public Health Surveill. 2024 Nov 6;10:e63211. doi: 10.2196/63211.

ABSTRACT

BACKGROUND: Evidence has shown that HIV prevalence among young people, especially college students, has increased disproportionately. Preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) are two of the most effective ways to prevent HIV, which are vital for college students with sexual experiences who have sexual risks.

OBJECTIVE: To provide evidence for effective intervention to reduce the risk of HIV infection among young students, this study aimed to analyze the awareness and uptake of HIV PrEP and PEP among college students with sexual experiences.

METHODS: An institutional-based cross-sectional study design was used to collect data through an electronic questionnaire from college students in 5 colleges located in Zhejiang Province. A total of 21,962 college students were investigated, of which 2605 students with sexual experiences were included in the data analysis with the following information collected: sociodemographic characteristics, awareness and uptake of HIV PrEP and PEP, sexual behaviors, and HIV tests. Binary logistic regression analysis was used to explore the factors on seeking PrEP and PEP.

RESULTS: The average age of college students with sexual experiences was 21.25 (SD 2.75) years. Overall, 61.4% (n=1600) of the participants were aware of PrEP, and 53.0% (n=1380) of them were aware of PEP. Moreover, 5.6% (n=146) of them have sought PrEP or/and PEP, and 89.1% (n=2321) have not sought PrEP or PEP. College students who had more than 6 sexual partners, have always had unprotected sex, have subjective perceived risk behavior, and undergo HIV testing were more likely to seek PrEP or/and PEP. The main ways for the participants to learn PrEP and PEP were through school clubs, the internet, and the Centers for Disease Control and Prevention. Moreover, senior students and those who had not undergone an HIV test had a lower likelihood of seeking PrEP and PEP. College students who did not have risky sexual behaviors (odds ratio 0.468, P=.004) and homosexual students (odds ratio 0.318, P=.03) were more likely not to seek PEP.

CONCLUSIONS: College students with sexual experiences rarely seek PrEP and PEP, with a relatively low awareness of PrEP and PEP. It is very important to increase the knowledge and uptake of PrEP and PEP by educational and behavioral interventions among young students at risk for HIV infection.

PMID:39504545 | DOI:10.2196/63211

JMIR Public Health Surveill. 2024 Nov 6;10:e60001. doi: 10.2196/60001.

ABSTRACT

BACKGROUND: Crisis pregnancy centers (CPCs) are religious nonprofit organizations with a primary mission of diverting people from having abortions. One CPC tactic has been to locate near abortion facilities. Despite medical groups’ warnings that CPCs do not adhere to medical and ethical standards and pose risks, government support for CPCs has significantly increased.

OBJECTIVE: This study aims to map CPCs, abortion facilities, and geographical areas in the United States into 4 zones based on their proximity to CPCs and abortion facilities. We sought to describe the number and percentage of reproductive-aged women living in each zone and the proximity of CPCs to abortion facilities.

METHODS: Using 2021 data from CPC Map and the Advancing New Standards in Reproductive Health Abortion Facility Database, we determined the ratio of CPCs to abortion facilities. Along with census data, we categorized and mapped US block groups into 4 distinct zones based on locations of block group centroids within 15-mile (1 mile is approximately 1.609 km) radii of CPCs and abortion facilities, namely “no presence,” “CPC only,” “abortion facility only,” and “dual presence.” We calculated the number and percentage of block groups and reproductive-aged (15-49 years) women living in each zone. We calculated driving distances and drive times from abortion facilities to the nearest CPC and mapped abortion facilities with CPCs in close proximity. All analyses were conducted nationally and by region, division, and state.

RESULTS: Nationally, the ratio of CPCs to abortion facilities was 3.4, and 54.9% (131,410/239,462) of block groups were categorized in the “dual presence” zone, 26.6% (63,679/239,462) as “CPC only,” and 0.8% (63,679/239,462) as “abortion facility only.” Most reproductive-aged women (45,150,110/75,582,028, 59.7%) lived in a “dual presence” zone, 26.1% (19,696,572/75,582,028) in a “CPC only” zone, and 0.8% (625,403/75,582,028) in an “abortion facility only” zone. The number of block groups and women classified as living in each zone varied by region, division, and state. Nationally, the median distance from abortion facilities to the nearest CPC was 2 miles, and the median drive time was 5.5 minutes. Minimum drive times were <1 minute in all but 11 states. The percentages of abortion facilities with a CPC within 0.25, 0.5, 1, and 3 miles were 14.1% (107/757), 22.6% (171/757), 36.1% (273/757), and 66.3% (502/757), respectively.

CONCLUSIONS: The findings suggest that CPCs’ tactic of locating near abortion facilities was largely realized before the 2022 US Supreme Court decision that overturned the federal right to abortion. Research on CPCs’ locations and tactics should continue given the dynamic abortion policy landscape and risks posed by CPCs. Tailored programming to raise awareness about CPCs and help people identify and access safe sources of health care may mitigate harm. Increased regulation of CPCs and government divestment may also mitigate CPC harms.

PMID:39504544 | DOI:10.2196/60001