Tag: nevin manimala

Am J Public Health. 2026 Mar;116(3):368-371. doi: 10.2105/AJPH.2025.308325.

ABSTRACT

Objectives. To determine the completeness of providers’ COVID-19 vaccine reporting to the Georgia Registry of Immunization Transactions and Services between October 1, 2023, and December 31, 2023. Methods. We performed active, population, and laboratory surveillance in metropolitan Atlanta, Georgia, to identify all residents hospitalized with COVID-19. We selected a subset of patients by using age-stratified random sampling. We telephoned patients or their proxies, pharmacies, and primary care physicians to verify vaccination status and obtain date of unrecorded vaccination (if applicable) for cases without recorded vaccination on or after September 1, 2023. Results. In the 8-county metro Atlanta catchment area, 2165 patients were hospitalized for COVID-19 during the study period, with 135 patients sampled for full chart reviews. Eighty-six patients required follow-up calls, resulting in 525 telephone calls and approximately 120 person-hours. From follow-up, we identified only 1 vaccine dose not in the registry. Conclusions. The registry is relatively reliable for obtaining information on COVID-19 vaccination status for patients in metropolitan Atlanta. Additional follow-up does not elucidate additional information. (Am J Public Health. 2026;116(3):368-371. https://doi.org/10.2105/AJPH.2025.308325).

PMID:41671540 | DOI:10.2105/AJPH.2025.308325

Am J Public Health. 2026 Mar;116(3):295-297. doi: 10.2105/AJPH.2026.308403.

NO ABSTRACT

PMID:41671538 | DOI:10.2105/AJPH.2026.308403

Neurology. 2026 Mar 10;106(5):e214674. doi: 10.1212/WNL.0000000000214674. Epub 2026 Feb 11.

ABSTRACT

BACKGROUND AND OBJECTIVES: Traumatic brain injury (TBI) is a leading cause of long-term disability in working-age populations. Return to work is a key marker of recovery, yet most studies assess it as binary at fixed time points. We aimed to estimate transition probabilities to and from work disability during 5 years after TBI and how injury severity and preinjury sociodemographic and medical factors influence these probabilities.

METHODS: We conducted a nationwide matched cohort study in Sweden using linked registers. Individuals aged 21-60 years with a TBI diagnosis between 2005 and 2016 were compared with up to 10 matched non-TBI individuals. TBI severity was proxied by care characteristics: TBI A (emergency visit or ≤2 days), TBI B (≥3 days), and TBI C (neurosurgery). Transition probabilities to and from work disability (>14 days sickness absence) were estimated with multistate models. Sociodemographic and medical factors were assessed with Cox regression.

RESULTS: The cohort included 98,256 individuals with TBI and 981,191 matched non-TBI individuals (median age 39 years; 43% women). Transition probabilities to work disability were higher in all TBI groups: at 30 days, 5.5% (95% CI 5.4-5.7) for TBI A, 29% (28.0-30.7) for TBI B, and 43% (38.2-47.3) for TBI C, vs 0.5% (0.5-0.6) in non-TBI; at 5 years, 7.1% (7.0-7.3), 10.9% (10.2-11.7), and 12.9% (10.7-15.7), vs 4.0% (4.0-4.1). In TBI A and B, higher probability was predicted by older age (TBI A hazard ratio 1.23, 95% CI 1.20-1.26; TBI B 1.34, 1.21-1.48), female sex (TBI A 1.59, 1.56-1.62; TBI B 1.35, 1.26-1.44), and psychiatric disorders (TBI A 1.34, 1.30-1.39; TBI B 1.28, 1.11-1.48), while higher education (TBI A 0.83, 0.81-0.86) and city residence (TBI A 0.92, 0.90-0.95; TBI B 0.88, 0.80-0.95) were protective. In TBI C, only older age remained significant (1.59, 1.17-2.14).

DISCUSSION: TBI was associated with persistently elevated transition probabilities to work disability across all severity groups, with early peaks in TBI B and C and a delayed increase in TBI A, influenced by sociodemographic and medical factors. However, the lack of standardized severity grading limits comparison with other studies. Still, these results suggest TBI increases long-term risk of work disability, supporting sustained individualized rehabilitation.

PMID:41671521 | DOI:10.1212/WNL.0000000000214674

JMIR Hum Factors. 2026 Feb 11;13:e77167. doi: 10.2196/77167.

ABSTRACT

BACKGROUND: The widespread use of digital technologies has raised growing concerns about their impact on mental health. While self-regulation has been proposed as a protective factor, little is known about how distinct psychological profiles based on self-regulatory and technology use patterns relate to psychological distress. Person-centered approaches, such as latent profile analysis, may offer deeper insights, particularly in underrepresented populations.

OBJECTIVE: This study aimed to identify latent psychological profiles based on self-regulation, nomophobia (fear of being without a phone), and problematic use of the internet and social media (defined by behavioral symptoms), to examine their associations with general psychological distress and the presence of emotional symptoms in a Colombian sample. Additionally, the predictive roles of age and gender in class membership were explored.

METHODS: Participants were recruited through a convenience sampling strategy aimed at ensuring heterogeneity of the sample in terms of age and gender. A total of 453 participants aged 12 to 57 years (mean 21.03, SD 8.41 years; 257/453, 56.7% female) completed validated measures of self-regulation (Abbreviated Self-Regulation Questionnaire), nomophobia (Nomophobia Questionnaire), internet and social media use (MULTICAGE-TIC, a multidomain screening questionnaire based on the CAGE framework), and psychological distress (General Health Questionnaire-12). Latent profile analysis was conducted using standardized scores of continuous variables. Model fit was assessed using the Bayesian information criterion, entropy, and bootstrapped likelihood ratio test. Differences in psychological distress scores across latent classes were examined through variance analysis (ANOVA) and regression models. A multinomial logistic regression tested the predictive value of age and gender for class membership.

RESULTS: The optimal solution revealed 4 distinct latent profiles (entropy=0.85). Class 1 showed high self-regulation and low problematic technology use, displaying the lowest psychological distress scores. Class 2 presented moderate levels across all indicators but the highest level of psychological distress. Classes 3 and 4 showed mixed patterns. Class 3 (higher information and communication technology [ICT] use and lower self-regulation) exhibited lower distress than class 2, whereas class 4 (younger individuals with low self-regulation and moderately high ICT use) showed higher distress than class 3. Psychological distress differed significantly across profiles (ANOVA, P<.001). Age and gender predicted class membership. Older males were more likely to belong to class 1, and younger females were more likely to be classified into classes 3 and 4.

CONCLUSIONS: Latent profile analysis identified distinct configurations of digital behavior, self-regulation, and psychological distress. Self-regulation consistently differentiated profiles with lower distress scores, suggesting its relevance for understanding how individuals manage ICT use. These findings support the value of person-centered approaches to characterize heterogeneous patterns of technology-related behaviors. The study provides evidence from a Spanish-speaking sample, offering a novel perspective on psychological distress and problematic technology use in contexts that remain underrepresented in the literature.

PMID:41671506 | DOI:10.2196/77167

JMIR Form Res. 2026 Feb 11;10:e67800. doi: 10.2196/67800.

ABSTRACT

BACKGROUND: Digital health interventions (DHIs) can extend the reach of disease prevention interventions; however, few are evidence-based, theoretically grounded, or developed for high-risk youth and families. Co-design approaches engage end users in the design and development of the DHI, which can lead to increased accessibility and engagement.

OBJECTIVE: This study aimed to describe the adaptation of an evidence-based diabetes prevention program for remote, digital delivery.

METHODS: The adaptation of the in-person intervention was guided by a modified Inclusive Digital Health Intervention Design to Promote Health Equity framework and conducted in collaboration with Hispanic adolescents (n=23) with obesity (BMI ≥95th percentile) and their parents (n=15). Focus groups identified digital, health education, and support needs. An expert and community panel assisted in developing solutions based on these findings. A sample content session with a food tasting experience was created and reviewed by participants. The research team subsequently built a digital platform to host the content. Participants assessed the usability of the platform, including the ease of use, design components, and technical issues. A second meeting of the expert panel provided recommendations for further refinement and feedback.

RESULTS: Findings from focus groups indicated that most participants (31/36, 86.1%) reported stable internet access and multiple digital devices. With regard to format, a few parents (2/9, 22.2%) preferred synchronous content sessions, while most youth and parents favored asynchronous sessions (7/9, 77.8%) lasting 40 to 60 minutes. Health education needs included interactive content, healthy recipes, and the ability to ask questions. Experts suggested offering asynchronous sessions with monthly synchronous meetings to meet both parent and youth needs. After viewing a sample session, families found the content easy to understand and mostly engaging, with (17/21) 81% participating in the food tasting activity and all participants reporting that the activity was feasible. Experts recommended using a more conversational, interactive teaching style to improve the content and using a food box with nonperishable items to increase the ease of food tasting activities. While the digital platform was functional and easy to use, families highlighted the need for larger font and icon sizes, easier navigation, and better color contrasts. On the basis of this feedback, experts advised creating tutorial videos and an orientation session for platform training. The content and platform will continue to be refined before further evaluation in a 12-week feasibility pilot study.

CONCLUSIONS: The use of a co-design approach provided opportunities to make content more interactive and engaging and to increase the ease of use of the digital platform. Describing the adaptation process using a guiding framework in collaboration with the focus population will inform future studies aiming to adapt evidence-based interventions to a digital platform.

PMID:41671476 | DOI:10.2196/67800

JMIR Res Protoc. 2026 Feb 11;15:e80243. doi: 10.2196/80243.

ABSTRACT

BACKGROUND: Autism spectrum disorder (ASD) represents a significant public health challenge characterized by persistent social communication deficits and restricted, repetitive patterns of behavior. Current interventions show limited efficacy, particularly for core symptoms. Repetitive transcranial magnetic stimulation (rTMS) and auditory integration training (AIT) have independently demonstrated promise in addressing neurophysiological abnormalities associated with ASD.

OBJECTIVE: This study aims to evaluate the clinical efficacy of a combined rTMS and AIT intervention compared to rTMS alone and sham stimulation in children with ASD.

METHODS: This is a randomized, sham-controlled trial that will recruit 80 children aged 2 to 6 years with a confirmed ASD diagnosis. The randomization of the first 8 participants in this study used a 1:1:1 ratio. To more effectively test the core hypothesis (ie, the efficacy of the combined intervention), greater statistical power will be concentrated on the intervention group (rTMS+AIT), and the randomization ratio was ultimately adjusted to 2:1:1-specifically, (1) rTMS combined with AIT (n=40), (2) rTMS alone (n=20), or (3) sham rTMS (n=20). Primary outcome measures include the Autism Behavior Checklist and Childhood Autism Rating Scale. Secondary outcomes are the Strengths and Difficulties Questionnaire and Repetitive Behavior Scale-Revised. Assessments will be conducted at baseline, an interim time point, and immediately after the intervention. Data will be analyzed using SPSS (version 25.0; IBM Corp).

RESULTS: This study has received funding, with data collection commencing in April 2024. Due to the small initial sample size of 8 participants (5 male and 3 female), no formal statistical comparisons of baseline characteristics between groups have been conducted at this time. It is anticipated that the rTMS combined with AIT intervention will exhibit superior efficacy compared to rTMS only.

CONCLUSIONS: This will be the first sham-controlled trial to systematically investigate the potential synergistic effects of a combined rTMS and AIT intervention in children with ASD. The results will provide valuable insights into the neurotherapeutic potential of this combined approach and contribute to the development of evidence-based interventions for ASD.

PMID:41671470 | DOI:10.2196/80243

Turk J Gastroenterol. 2025 Oct 12;37(2):251-259. doi: 10.5152/tjg.2025.25248.

ABSTRACT

BACKGROUND/AIMS: Persistent dyspeptic symptoms are common during the proton pump inhibitor (PPI) washout period before Helicobacter pylori (H. pylori) testing. However, the role of rebamipide in symptom management during this interval remains unclear.

MATERIALS AND METHODS: This double-blind, randomized controlled trial enrolled 65 patients with H. pylori-associated dyspepsia or gastritis, randomized (1:1) to receive rebamipide (100 mg 3 times daily) or placebo for 4 weeks, following a 14-day eradication regimen. The primary outcome was the proportion of responders achieving a ≥25% reduction in pain symptom scores on the Severity of Dyspepsia Assessment scale at week 6. Secondary outcomes included changes in pain symptoms, non-pain symptoms, and dyspepsia-related health scores, as well as eradication rates and safety.

RESULTS: All patients completed the trial. Although the proportion of responders was higher in the rebamipide group (18 patients, 56.3% vs. 13 patients, 39.4%), this difference was not statistically significant (P = .17). Scores for pain, non-pain, and dyspepsia-related health improved similarly in both groups. Eradication rates were comparable (87.5% vs. 90.0%), and no serious adverse events were reported.

CONCLUSION: The responder rate was higher in the rebamipide group, but the difference did not reach statistical significance. The poten tial benefit of rebamipide as a rescue therapy during the PPI washout period before H. pylori testing warrants further investigation in larger trials. Cite this article as: Suksai N, Chueansuwan R, Yongsiri S, Witoon R, Juttuporn A. Rebamipide for managing dyspeptic symptoms during proton-pump inhibitor washout before Helicobacter pylori testing: A randomized, double-blind, placebo-controlled trial. Turk J Gastroenterol. 2026;37(2):251-259.

PMID:41669931 | DOI:10.5152/tjg.2025.25248

Turk J Gastroenterol. 2025 Aug 25;37(2):208-214. doi: 10.5152/tjg.2025.25265.

ABSTRACT

BACKGROUND/AIMS: This study aimed to compare the efficacy of bolus versus infusion administration of terlipressin in patients with acute esophageal variceal bleeding and to elucidate any differences in clinical outcomes between the 2 approaches.

MATERIALS AND METHODS: This prospective study included patients divided into 2 groups. Group 1 received a 2 mg intravenous (IV) bolus followed by 1 mg IV every 4 hours. Group 2 received a 1 mg IV bolus followed by a 4 mg terlipressin infusion over 24 hours. Clinical and laboratory parameters, hospitalization duration, need for blood product transfusion, rebleeding or mortality within 6 weeks, and drug related side effects were evaluated.

RESULTS: Among the 46 patients, 23 (50%) received terlipressin as an IV bolus (group 1), and 23 (50%) received it as an infusion (group 2). Treatment failure occurred in 4 patients (8.7%), all from group 1, though the difference was not statistically significant (P = .109). Six patients (13%) experienced rebleeding and death within 6 weeks, with no significant differences in clinical outcomes between the groups. No significant differences in creatinine and sodium levels were observed between the groups at baseline or at the end of treat ment (P = .654). Additionally, no difference in the incidence of portal vein thrombosis was noted between survivors and non-survivors (P = 1.000).

CONCLUSION: As no significant differences in efficacy or safety were observed between bolus and infusion administration, infusion ther apy may be preferred due to its potential benefits in patient comfort and ease of administration. Cite this article as: Şenkaya A, Çelik F, Kurtulmuş Akgün İ, et al. Terlipressin treatment for acute esophageal variceal bleeding: Bolus or infusion? Turk J Gastroenterol. 2026;37(2):208-214.

PMID:41669923 | DOI:10.5152/tjg.2025.25265

J Hypertens. 2026 Jan 30. doi: 10.1097/HJH.0000000000004255. Online ahead of print.

ABSTRACT

BACKGROUND: Peripheral artery disease (PAD), assessed via the ankle-brachial index (ABI), is a recognized form of hypertension-mediated organ damage (HMOD). While alternative ABI calculations have shown improved sensitivity for PAD detection, their prognostic utility in hypertensive populations remains unclear.

METHODS: In this prospective cohort study of 21 875 hypertensive individuals (ÉRV Study), we compared the prognostic performance of three ABI-based approaches: standard ABI using the higher ankle pressure (ABI-HIGH), ABI using the lower ankle pressure (ABI-LOW), and multivessel ABI scoring (number of vessels with ABI ≤0.90). The primary endpoint was all-cause mortality, assessed over a median follow-up of 5 years using interval-censored Cox regression.

RESULTS: PAD prevalence was 14.4% using ABI-HIGH and 28.3% using ABI-LOW, with 13.9% of patients identified only by the latter. All PAD definitions were independently associated with mortality. ABI-LOW as a continuous variable demonstrated the strongest association (hazard ratio 1.87; 95% CI, 1.63-2.16). Multivessel ABI showed a dose-response relationship with mortality. However, overall discrimination was modest: time-dependent AUCs ranged from 0.608 to 0.635 for ABI-based models alone. When added to clinical predictors, ABI metrics improved the AUC to a range from 0.763 to 0.780, with added predictive value between 6 and 11%.

CONCLUSION: In hypertensive individuals, ABI-LOW and multivessel scoring identify more PAD cases and are independently associated with mortality. However, their incremental value in mortality risk prediction is limited. Alternative ABI methods may assist in identifying higher risk subgroups warranting further vascular assessment.

PMID:41669913 | DOI:10.1097/HJH.0000000000004255

Epidemiol Psychiatr Sci. 2026 Feb 11;35:e10. doi: 10.1017/S2045796026100468.

ABSTRACT

AIMS: Off-label use of antipsychotics, often at low doses, is increasing. Exploring the link between individual antipsychotic treatment patterns, including low-dose continuous use, and cardiometabolic health is crucial to prevent long-term morbidity and mortality. The current retrospective study examined the prevalence of cardiometabolic medicine use among antipsychotic-users, and its association with their past antipsychotic treatment patterns.

METHODS: Using a 10% sample of the Australian national medicine dispensing claims data from 2022, we identified individuals aged 15-64 years with ≥2 antipsychotic dispensings (antipsychotic-users) and non-users. We extracted their past 5-year antipsychotic treatment patterns (dose, duration and use of multiple agents). Using Poisson regression and accounting for age and sex, we calculated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for cardiometabolic medicine use (anti-diabetics, antihypertensives, lipid modifiers, anti-thrombotics) among antipsychotic-users versus non-users. We applied unsupervised hierarchical clustering analysis to identify common antipsychotic-cardiometabolic co-dispensing.

RESULTS: Use of any cardiometabolic medicine was more prevalent among antipsychotic-users (35.8%, n = 28,345) than non-users (26%, n = 1,106,610) yielding an aPR of 1.30 (CI 1.28-1.33). aPRs for the use of anti-diabetics, lipid modifiers and antihypertensives were the highest among the younger age groups between 20 and 49 years and among women. Clustering analysis revealed increased co-dispensing of antipsychotics and anti-diabetics including sulfonylureas, statins, platelet aggregation inhibitors and beta blockers. The prevalence of cardiometabolic medicine use was associated with higher antipsychotic doses (23-54%), treatment duration (12-37%) and use of multiple agents (51%) compared with non-users. However, the prevalence of cardiometabolic medicine use for continuous (≥1 year) low-dose use of aripiprazole, asenapine, brexpiprazole, chlorpromazine, lurasidone, olanzapine, periciazine and quetiapine was also elevated (13-43%).

CONCLUSIONS: Use of cardiometabolic medicines is increased among people on long-term antipsychotic treatment. These results highlight the need for active monitoring for cardiometabolic adverse effects, with antipsychotic cessation where possible, or timely interventions to limit morbidity.

PMID:41669909 | DOI:10.1017/S2045796026100468