Tag: nevin manimala

JMIR Pediatr Parent. 2025 Oct 28;8:e75669. doi: 10.2196/75669.

ABSTRACT

BACKGROUND: Excessive infant crying affects approximately 20% of families and can lead to parental distress, anxiety, and strained relationships. Despite its prevalence, many parents report feeling misunderstood and unsupported during these challenging periods.

OBJECTIVE: This study aimed to gain in-depth insight into mothers’ perceptions of being understood and supported in the context of excessive infant crying, focusing on three key stakeholder groups: partners, the personal network, and health care professionals. Based on these results, the study sought to develop a maternal support framework regarding excessive crying that could guide future research and practice, as well as support strategies.

METHODS: Using a qualitative approach supplemented by quantitative measures, through an online survey, three open-ended questions were included on how mothers would like to be understood and supported by the three stakeholder groups (ideal situation) and six 6-point Likert scales on mothers’ current perceived understanding and support regarding the three stakeholder groups (current situation). Descriptive statistics were used to examine current levels of understanding and support, and an inductive thematic analysis was applied to identify the ideal key support elements.

RESULTS: Data were collected from 432 mothers (n=238, 55.1% Dutch; n=194, 44.9% Flemish; mean age 33 years, range 21-45 years). Regarding the current situation, mothers rated health care professionals lowest in perceived understanding and support, with 50.6% (n=219) feeling little or no understanding and 47.1% (n=203) reporting little or no support. Similar patterns were found in the personal network (n=184, 42.6%, and n=164, 38%, respectively). Partners were perceived as most supportive, with only 17.6% (n=76) of mothers reporting little or no understanding and 21.8% (n=94) reporting little or no support. Based on the thematic analysis of the qualitative data, the ideal situation was framed in the newly developed maternal support framework. This framework identifies 25 distinct support forms, of which 12 (48%) are common support forms (partner, personal network, health care professionals, eg, listen actively), 6 (24%) are related to partners (eg, be physically present), 6 (24%) concern the support of health care professionals (eg, refer appropriately), and 1 (4%) is specific to the personal network (cope with the crying).

CONCLUSIONS: This study underscores the need for holistic, family-centered approaches to supporting families with excessively crying infants. The proposed maternal support framework offers a foundation for developing tailored interventions that reflect the diverse roles of partners, personal networks, and health care professionals in maternal well-being.

PMID:41151046 | DOI:10.2196/75669

J Med Internet Res. 2025 Oct 28;27:e76177. doi: 10.2196/76177.

ABSTRACT

BACKGROUND: Telehealth is a potential tool to alleviate geographic clinician shortages, but there are limited data regarding current telehealth use for common cardiology conditions, including atrial fibrillation (AF).

OBJECTIVE: We aimed to evaluate variation in telehealth use in primary care and cardiology clinics for patients with incident AF in the Veterans Health Administration.

METHODS: We included patients diagnosed with AF in the outpatient setting between January 2022 and September 2023. We assessed the association between any video visit and any telehealth use (including phone) for primary care or cardiology visits within 90 days of an AF diagnosis, adjusting for selected patient- and facility-level characteristics using Bayesian logistic regression with facility-level random intercepts. We evaluated facility variation in video visit and telehealth use with the median odds ratio (MOR).

RESULTS: Our cohort included 36,929 patients with 80,596 visits across 125 facilities. Of the 63,835 primary care visits, 2088 (3.27%) were delivered via video and 13,403 (21%) via telehealth; of the 16,761 cardiology visits, 323 (1.93%) were delivered via video and 3288 (19.62%) via telehealth. On average, the mean age of the patients was 73.6 (SD 10.9) years; 2.91% (1075/36,929) were female; 77.71% (28,698/36,929) were White. In adjusted analyses, older age was associated with lower use of video visits for both primary and cardiology care and lower use of any telehealth for cardiology care (eg, adjusted odds ratio [AOR] 0.61, 95% credible interval [CrI] 0.42-0.85 for the use of video cardiology care for patients aged above 77 years). Living more than 65 km from the care site was associated with increased use of both video and any telehealth for primary and cardiology care (eg, AOR 1.91, 95% CrI 1.21-3.00 for video cardiology care); however, living in a rural location was associated with lower odds of using video or any telehealth for primary care (video: AOR 0.73, 95% CrI 0.64-0.84; telehealth: AOR 0.89, 95% CrI 0.83-0.96). There was marked variability across facilities in the use of video care (range 0%-17.4% of visits for cardiology care; 0%-12.5% for primary care) and telehealth (range 0%-82.6% for cardiology care; 3.8%-61.6% for primary care). The facility-level adjusted MOR for video care use was 1.97 (95% CrI 1.77-2.24) for primary care and 4.95 (95% CrI 3.39-7.98) for cardiology care. Similarly, the adjusted MOR for any telehealth use was 1.79 for primary care (95% CrI 1.65-1.96) and 2.61 for cardiology care (95% CrI 2.25-3.13).

CONCLUSIONS: Following an incident AF diagnosis, telehealth may increase access to primary and cardiology care for veterans living at a distance, but its use remains lower for older patients and those in rural areas. There was substantial variation in telehealth use across facilities, which was not explained by differences in patient and facility characteristics. Standardizing telehealth use across Veterans Health Administration facilities may improve access to AF care.

PMID:41151044 | DOI:10.2196/76177

J Orthop Trauma. 2025 Oct 28. doi: 10.1097/BOT.0000000000003112. Online ahead of print.

ABSTRACT

OBJECTIVE: To characterize functional recovery related to Patient-Reported Outcomes Measurement Information System (PROMIS) scores following surgical fixation of tibial plateau fractures. It was hypothesized that improvement may be seen in PROMIS scores up to the two-year timepoint.

METHODS: Design: Retrospective cohort study.

SETTING: Single Level I Trauma Center (2022-2024).

PATIENT SELECTION CRITERIA: Adults who sustained a tibial plateau fracture (AO/OTA 41) treated operatively and completed PROMIS surveys were included.

OUTCOME MEASURES AND COMPARISONS: PROMIS-physical function (PF), pain interference (PI), depression, anxiety, global physical health (GPH), and global mental health (GMH). Scores for each domain were compared across timepoints ranging from 2 weeks to 24 months postoperatively.

RESULTS: 270 patients met inclusion criteria (mean age 49.1 years [range: 18-88 years], 57.0% male). PROMIS-PF improved from 28.1 at 2 weeks to 40.6 at 1 year (+12.5, p < 0.001) and remained significantly above the two-week postoperative baseline at 2 years (39.7, +11.6, p < 0.001), though no additional change was observed between 1 and 2 years (p = 0.996). PROMIS-PI decreased from 66.1 at baseline to 58.3 at 1 year (-7.9, p < 0.001) and 60.8 at 2 years (-5.3, p = 0.004), with no significant difference between 1 and 2 years (p = 0.767). PROMIS-GPH increased from 37.3 at baseline to 43.8 at 1 year (+6.5, p < 0.001) and remained improved at 2 years (40.8, +3.5, p = 0.044). In contrast, PROMIS-GMH declined from 46.8 at baseline to 42.6 at 2 years (-4.2, p = 0.043). PROMIS-depression (54.6) and anxiety (55.0) scores did not change significantly. Patients with consistent survey participation through 6 months demonstrated significantly lower PROMIS-PF scores at 2 weeks (24.1 vs 28.1, p < 0.001) but significantly higher scores at 6 weeks (34.9 vs 28.6, p < 0.001), 3 months (36.2 vs 31.2, p < 0.001), and 6 months (40.0 vs 36.6, p < 0.001) compared with those with intermittent participation.

CONCLUSION: In patients with operatively treated tibial plateau fractures, patient-reported physical function, pain interference, and global physical health demonstrated statistically and clinically significant improvements over time, most pronounced within the first postoperative year.

LEVEL OF EVIDENCE: III.

PMID:41151038 | DOI:10.1097/BOT.0000000000003112

JMIR Hum Factors. 2025 Oct 28;12:e70479. doi: 10.2196/70479.

ABSTRACT

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder affecting 3%-7% of children globally. Alternative treatments are needed to address the limitations of traditional pharmacotherapy and nonpharmacotherapy, such as drug side effects and substantial time and financial costs. In this light, digital therapeutics for childhood ADHD are emerging as an effective alternative, with the benefits of potentially being free from serious side effects associated with software-based treatments and facilitating easy home use without constraints on time or space.

OBJECTIVE: This study aims to evaluate whether a 4-week digital treatment program can improve symptoms, problem behaviors, and neurocognitive functions in children with ADHD, independent of medication status, while also gauging participant satisfaction with the program.

METHODS: We recruited 22 Korean children aged 6-12 years with a diagnosis of ADHD. During the preintervention visit, we collected data on ADHD symptoms, relevant behavior scales, and neurocognitive assessments. Participants then used the program 5 times per day, 5 days a week for 4 weeks at home. At the postintervention visit, we collected the same data as during the preintervention visit and gathered additional feedback on their experience over the 4 weeks.

RESULTS: A total of 19 participants were included in the statistical analysis, showing significant decreases in scores across various categories. These included the Korean ADHD Rating Scale (Total: P=.004; Inattentive: P=.004; and Hyperactive-impulsive: P=.01) and Korean Conners’ Parent Rating Scale (Total: P<.001; Impulsive-hyperactive: P=.001; and Conduct Problem I: P=.04). Significant improvements were also noted in the Stroop word (P=.004), color (P<.001), and color-word (P<.001) scores. No significant differences in treatment effects were found between medicated and unmedicated participants. Caregiver and child satisfaction surveys yielded mean ratings of 4.3 and 4.1 out of 5, respectively.

CONCLUSIONS: A 4-week gamified intervention improves attention and hyperactivity-impulsivity in children with ADHD, irrespective of medication status, demonstrating its potential effectiveness and acceptability as a treatment option. As this is a small pilot study and underpowered, larger studies with appropriate control groups are needed in future research.

PMID:41151037 | DOI:10.2196/70479

Otol Neurotol. 2025 Oct 28. doi: 10.1097/MAO.0000000000004647. Online ahead of print.

ABSTRACT

HYPOTHESIS: Photon-counting detector CT (PCD-CT) with deep learning-supported denoising can significantly reduce the radiation dose for cochlear implant (CI) planning without compromising the accuracy of cochlear duct length (CDL) measurements.

BACKGROUND: Optimal electrode placement in CI surgery requires detailed cochlear anatomy from CT scans, but reducing radiation exposure is critical. This study explores PCD-CT with denoising algorithms to lower doses while preserving diagnostic accuracy.

METHODS: Four body donors without inner ear malformations were scanned using PCD-CT at 100%, 50%, 25%, 10%, and 5% dose levels. Images were denoised with ClariAce, a deep learning algorithm, and CDL was measured using OTOPLAN software. Neurotologists compared the results to manual segmentations. Statistical analyses evaluated accuracy across dose levels, with Bland-Altman plots assessing systematic errors.

RESULTS: Automatic segmentation succeeded across all doses but showed increased failure below 50%. At 100% and 50% doses, CDL measurements closely matched the gold standard, with minor deviations (eg, -0.17 mm at 50%). Below 50%, CDL underestimation increased (-1.25 mm at 25% and -4.0 mm at 5%). Denoising improved segmentation but minimally affected CDL accuracy at low doses, where manual segmentation performed better.

CONCLUSIONS: PCD-CT enables significant dose reduction for CI planning, with reliable CDL accuracy down to 50%. Deep learning denoising enhances image quality but is less effective below 50%, necessitating manual segmentation. These findings align with ALARA principles and suggest further refinement of AI algorithms for lower-dose applicability in CI diagnostics.

PMID:41151028 | DOI:10.1097/MAO.0000000000004647

JMIR Form Res. 2025 Oct 28;9:e74208. doi: 10.2196/74208.

ABSTRACT

BACKGROUND: HIV incidence is increasing among Latino gay, bisexual, and other men who have sex with men (MSM) in the Atlanta metropolitan area. Mobile phone apps represent an innovative tool to promote pre-exposure prophylaxis (PrEP) use, HIV testing, and condom use.

OBJECTIVE: This study aimed to assess the acceptability and usability of Saludfindr, an Android-based HIV prevention app tailored to the needs of Latino MSM in the Atlanta area.

METHODS: We recruited adult Latino MSM to interact with the app for 4 months. Saludfindr included initial and periodic health assessments; provision of suggestions regarding PrEP, HIV testing, and condom use; in-app product ordering; customized motivational messages; a customized sexual health clinic list; and a “Contact Us” button. To assess acceptability, we measured use of each app feature, PrEP and HIV testing uptake, and participant ratings of the app’s usefulness. We assessed usability using the System Usability Scale.

RESULTS: We enrolled 31 participants; the median age was 27 (IQR 24.5-32) years, 97% (30/31) were cisgender men, 81% (25/31) identified as MSM, and 61% (19/31) used the app in Spanish. All participants completed the initial health screening, with 84% (26/31) and 77% (24/31) completing the 2- and 4-month health screenings, respectively. Of all participants, 52% (16/31) and 23% (7/31) ordered condoms and home HIV tests through the app at least once, respectively. During the study period, 71% (22/31) of the participants got tested for HIV, of whom 68% (15/22) accessed it through clinic-based HIV testing. Of the participants not on PrEP at baseline, 41% (7/17) initiated PrEP during the study, and all of them did so at one of the clinics listed on the app. Saludfindr reached a System Usability Scale score of 74.5/100 (excellent).

CONCLUSIONS: Saludfindr was highly acceptable and usable among Latino MSM participants in the Atlanta area. In-app assistance to access PrEP and clinic-based HIV testing referrals was well received. Further efforts are needed to increase users’ self-efficacy with home HIV self-testing.

PMID:41150996 | DOI:10.2196/74208

ACS Nano. 2025 Oct 28. doi: 10.1021/acsnano.5c10753. Online ahead of print.

ABSTRACT

The study of thin films and two-dimensional (2D) materials, including transition metal dichalcogenides such as WSe₂ offers opportunities to leverage their properties in advanced sensors, quantum technologies, and devices to optimize functional performance. In this work, we characterize thin WSe₂ samples with variable thicknesses using scanning electron microscope (SEM)-based techniques focused on analysis of the backscattered electron signal and Kikuchi diffraction patterns. These data were collected via a pixelated electron-counting direct electron detector positioned below the pole piece primarily configured for reflection Kikuchi diffraction (RKD), and a similar detector placed in the more conventional electron backscatter diffraction (EBSD) geometry. In addition to conventional pattern analysis for orientation microscopy, multivariate statistical methods (MSA) based on principal component analysis were applied to analyze diffraction patterns and differentiate thickness variations and crystal orientations within the thin films through data clustering. These results were compared with atomic force microscopy to validate thickness measurements. Our findings indicate that RKD combined with MSA is highly effective for characterizing 2D materials, enabling simultaneous assessment of thickness and crystallographic orientation. Systematic acceleration voltage variations in RKD experiments and comparisons with EBSD data suggest that the thickness dependency arises from inelastic scattering of diffracted electrons, which affects pattern contrast in the thin-film regime. Collection and analysis of patterns obtained from monolayer, bilayer, and trilayer of WSe₂ are also demonstrated. This work reinforces the utility of SEM-based techniques, such as RKD, as valuable tools for the materials characterization toolkit, particularly for thin films and 2D materials.

PMID:41150995 | DOI:10.1021/acsnano.5c10753

Salud Publica Mex. 2025 Sep 26;67(5 (sept-oct)):447-454. doi: 10.21149/16253.

ABSTRACT

OBJECTIVE: Describe the purchasing behavior reported by Mexican adults regarding the Mexican front-of-pack warning labeling system (FoPWL).

MATERIALS AND METHODS: Data from the Mexican National Health and Nutrition Survey 2021 labeling questionnaire were analyzed, and logistical modeling was performed. Frequencies, proportions, odds ratio, and 95% confidence intervals were reported.

RESULTS: 38.2% [95%CI 36.5,40.0] of the respondents modified their purchase behavior, representing 25 953 736 Mexicans, with females and participants ≥60 years making the greatest proportion of changes. Among those who modified their purchases, 30.5% [95%CI 28.1,32.9] chose a product with fewer “excess” labels, while 38.7% [95%CI 36.1,41.4] decided not to buy the product. Sweetened carbonated beverages and bakery items were the most modified purchases. The odds of making purchase changes are 1.6 [95%CI 1.35,1.91] times when looking at FoPWL.

CONCLUSION: The study identifies changes in purchase behavior in products with FoPWL, highlighting a positive impact on women and older people. These findings suggest that FoPWL, alongside other public policies, could contribute to improving food environments and the health of the Mexican population.

PMID:41150992 | DOI:10.21149/16253

Salud Publica Mex. 2025 Sep 26;67(5 (sept-oct)):455-465. doi: 10.21149/16485.

ABSTRACT

bjective. To identify dairy consumption patterns, trends, and associated characteristics in Mexican adults from 2012-2018.

MATERIALS AND METHODS: We used data from 25 218 adults aged ≥20 years participating in the Mexican National Health and Nutrition Survey (Ensanut, by its acronym in Spanish) 2012, 2016 and 2018. Through a semiquantitative food frequency questionnaire, we estimated the energy-adjusted intake of 23 dairy products. Dairy patterns were identified using the principal component analysis. To identify associated characteristics and trends, we used independent linear regression models for each pattern. We included survey year as an independent variable in trend estimation (stratified by sex and region).

RESULTS: We identified three dairy patterns: 1) skim milk/light yogurt, 2) fresh cheese/high-fat milk and yogurt, and 3) mature cheese/ cream. The highest consumption of all dairy patterns was associated with high education and/or socioeconomic level. Consumption of the “skim milk/light yogurt” and “mature cheeses/cream” patterns increased, whereas “fresh cheese/high-fat milk and yogurt pattern” decreased steadily. These changes were similar among women and men and in all regions.

CONCLUSION: Our findings support the existence of different population-specific dairy consumption patterns with variations over time, mainly determined by socioeconomic characteristics. This approach must be considered to evaluate the association between dairy consumption and health outcomes.

PMID:41150991 | DOI:10.21149/16485

Salud Publica Mex. 2025 Sep 26;67(5 (sept-oct)):485-493. doi: 10.21149/16774.

ABSTRACT

OBJETIVO: Describir las tendencias de los niveles de plomo en sangre (NPS) de la población menor de 16 años ambientalmente expuesta a plomo desde el año 2010 a 2022. Material y métodos. Se cuantificaron los NPS por espectrometría de absorción atómica de 34 261 niños entre el 1 de enero de 2010 y el 31 de diciembre de 2022 en sangre venosa. Se examinaron las tendencias en los NPS por año y edad de los niños.

RESULTADOS: Los NPS disminuyeron a partir de 2010 (mediana= 5.1 µg/dL; percentiles 5º y 95º= 2.1-12.9 µg/dL) a 2022 (3.3 µg/dL; 1.18-11.1 µg/dL). El porcentaje de niños con NPS superior a 5 µg/dL fue de 52.82% en 2010 y disminuyó a 30.21% en 2022. Por edad, los NPS alcanzan su máximo al año de edad en el periodo de estudio (5.5 µg/dL; 1.7-15.2 µg/dL), disminuyendo paulatinamente a partir de los dos años. Las mujeres tuvieron NPS más bajos en comparación con los hombres (3.4 y 3.8 µg/dL, respectivamente) y disminuyeron más rápido.

CONCLUSIONES: Los NPS han disminuido notablemente de 2010 a 2022, en parte debido a los esfuerzos de remediación ambiental y vigilancia epidemiológica, sin embargo, siguen siendo altos comparados con otras áreas nacionales e internacionales.

PMID:41150988 | DOI:10.21149/16774