Tag: nevin manimala

Clin Child Psychol Psychiatry. 2025 Jan 13:13591045251314906. doi: 10.1177/13591045251314906. Online ahead of print.

ABSTRACT

OBJECTIVE: Anxiety rates amongst autistic youth range from 11% to 84%. While Cognitive Behavioural Therapy (CBT) is an effective treatment of anxiety in neurotypical youth, there are concerns autistic youth lack the cognitive resources necessary to effectively engage with CBT. It is also unclear whether standard or adapted CBT is more effective. This review aims to compare the effects of standard and adapted CBT in the treatment of anxiety in autistic youth.

METHODS: Articles were searched across three online databases. 24 articles were selected for final review. All articles were published between 2008 and 2024. Total sample size was 1,140 and participant age ranged from 4-18 years. Various designs, settings, and CBT formats were incorporated.

RESULTS: When treating anxiety in autistic youth, standard CBT is effective although CBT adapted to accommodate the autism-related needs of the youth appears more effective, with gains maintained up to 26 months post-treatment. Statistical analysis was not significant.

CONCLUSIONS: Standard and adapted CBT are effective treatments of anxiety in autistic youth. To optimise outcomes, it may be important to consider the common cognitive styles associated with autism and adapt the therapeutic intervention accordingly. However, there is not yet statistical evidence for this hypothesis.

PMID:39805042 | DOI:10.1177/13591045251314906

Am J Speech Lang Pathol. 2025 Jan 13:1-33. doi: 10.1044/2024_AJSLP-24-00126. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to gauge the impacts of cognitive empathy training experiential learning on traumatic brain injury (TBI) knowledge, awareness, confidence, and empathy in a pilot study of speech-language pathology graduate students.

METHOD: A descriptive quasi-experimental convergent parallel mixed methods design intervention pilot study (QUAL + QUANT) was conducted with a diverse convenience sample of 19 first- and second-year speech-language pathology graduate students who engaged in a half-day TBI point-of-view simulation. The simulation was co-constructed through a participatory design with those living with TBI based on Kolb’s experiential learning model and followed the recommendations for point-of-view simulation ethics. After setting goals, participants engaged in four station activities completing cognitive communication activities of daily living, while experiencing manipulations to their sensory systems. Activities included reading while wearing goggles with blurred or double vision, listening with tinnitus and auditory processing disorder, and taking notes during a manipulated college lecture. Participants also interacted with an individual living with TBI and responded to targeted prompts throughout the day. Quantitative outcomes were measured using published TBI knowledge and empathy scales and analyzed with descriptive, parametric and nonparametric statistics, while qualitative data were analyzed through thematic analysis. Data were then triangulated through mixed methods. Mixed methods design quality was ensured by following the Mixed Methods Appraisal Tool (Hong et al., 2018).

RESULTS: After experiential learning, significant increases in speech-language pathologist (SLP) TBI knowledge, empathy, and awareness of TBI symptom and symptom impacts were found. Many, but not all, participants also reported changes in clinical confidence.

CONCLUSIONS: Cognitive empathy training using experiential learning appears to be a viable method to increase SLP knowledge, empathy, and symptom awareness for TBI clinical care. Future research should replicate the study with different types and locations of speech-language pathology graduate programs to consider TBI empathy training as a standard training method to improve both individual and provider outcomes.

PLAIN LANGUAGE SUMMARY: Individuals and families living with traumatic brain injury (TBI) say their providers lack necessary knowledge; do not seem to understand what living with TBI is like; and can be dismissive, uncaring, and lacking empathy. Health care providers do not automatically imagine the world from the patient’s perspectives, to “walk in another’s shoes”; it takes intentional effort and training. This project attempted to train those specific empathy skills for speech-language pathology graduate students through experiential learning. Experiential learning is a process where people engage in meaningful activities and spend lots of time reflecting on their experiences. Working with people living with TBI, we built a half-day workshop where 19 graduate students completed normal daily activities (such as texting, reading) through different stations that provided insights into what it may be like to have a TBI, such as wearing goggles to induce blurred or double vision, having ringing in their ears (tinnitus), and watching an overwhelming manipulated college video lecture. Afterward, participants listened to a person living with TBI and asked questions. This was important because engaging in activities without interacting with someone living with TBI misses a key idea about listening to and learning from individuals and families. We measured TBI knowledge, empathy, and confidence by looking at surveys pre- and posttraining and reading students’ written reflections. Participants reported significant changes in how they think about brain injury and how they will provide clinical care for people living with TBI in the future.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.28098254.

PMID:39804970 | DOI:10.1044/2024_AJSLP-24-00126

Environ Health Perspect. 2025 Jan;133(1):17003. doi: 10.1289/EHP13875. Epub 2025 Jan 13.

ABSTRACT

BACKGROUND: Coccidioidomycosis, caused by inhalation of Coccidioides spp. spores, is an emerging infectious disease that is increasing in incidence throughout the southwestern US. The pathogen is soil-dwelling, and spore dispersal and human exposure are thought to co-occur with airborne mineral dust exposures, yet fundamental exposure-response relationships have not been conclusively estimated.

OBJECTIVES: We estimated associations between fine mineral dust concentration and coccidioidomycosis incidence in California from 2000 to 2017 at the census tract level, spatiotemporal heterogeneity in exposure-response, and effect modification by antecedent climate conditions.

METHODS: We acquired monthly census tract-level coccidioidomycosis incidence data and modeled fine mineral dust concentrations from 2000 to 2017. We fitted zero-inflated distributed-lag nonlinear models to estimate overall exposure-lag-response relationships and identified factors contributing to heterogeneity in exposure-responses. Using a random-effects meta-analysis approach, we estimated county-specific and pooled exposure-responses for cumulative exposures.

RESULTS: We found a positive exposure-response relationship between cumulative fine mineral dust exposure in the 1-3 months before estimated disease onset and coccidioidomycosis incidence across the study region [incidence rate ratio (IRR) for an increase from 0.1 to $1.1{\mu g/m}^3=1.60$; 95% CI: 1.46, 1.74]. Positive, supralinear associations were observed between incidence and modeled fine mineral dust exposures 1 [$\text{IRR}=1.13$ (95% CI: 1.10, 1.17)], 2 [$\text{IRR}=1.15$ (95% CI: 1.09, 1.20)] and 3 [$\text{IRR}=1.08$ (95% CI: 1.04, 1.12)] months before estimated disease onset, with the highest exposures being particularly associated. The cumulative exposure-response relationship varied significantly by county [lowest IRR, western Tulare: 1.05 (95% CI: 0.54, 2.07); highest IRR, San Luis Obispo: 3.01 (95% CI: 2.05, 4.42)]. Season of exposure and prior wet winter were modest effect modifiers.

DISCUSSION: Lagged exposures to fine mineral dust were strongly associated with coccidioidomycosis incidence in the endemic regions of California from 2000 to 2017. https://doi.org/10.1289/EHP13875.

PMID:39804964 | DOI:10.1289/EHP13875

PLoS Comput Biol. 2025 Jan 13;21(1):e1012143. doi: 10.1371/journal.pcbi.1012143. Online ahead of print.

ABSTRACT

High-dimensional mixed-effects models are an increasingly important form of regression in which the number of covariates rivals or exceeds the number of samples, which are collected in groups or clusters. The penalized likelihood approach to fitting these models relies on a coordinate descent algorithm that lacks guarantees of convergence to a global optimum. Here, we empirically study the behavior of this algorithm on simulated and real examples of three types of data that are common in modern biology: transcriptome, genome-wide association, and microbiome data. Our simulations provide new insights into the algorithm’s behavior in these settings, and, comparing the performance of two popular penalties, we demonstrate that the smoothly clipped absolute deviation (SCAD) penalty consistently outperforms the least absolute shrinkage and selection operator (LASSO) penalty in terms of both variable selection and estimation accuracy across omics data. To empower researchers in biology and other fields to fit models with the SCAD penalty, we implement the algorithm in a Julia package, HighDimMixedModels.jl.

PMID:39804942 | DOI:10.1371/journal.pcbi.1012143

PLoS One. 2025 Jan 13;20(1):e0315794. doi: 10.1371/journal.pone.0315794. eCollection 2025.

ABSTRACT

BACKGROUND: Sepsis is one of the leading causes of mortality and morbidity among neonates. An estimated 5.29-8.73 million Disability-adjusted life years (DALYs) are lost annually in SSA due to neonatal sepsis (NS). Uganda registered stagnated neonatal mortality of 27 deaths per 1000 live births in 2020 of which 12% was attributed to NS. Early risk factor identification and improved obstetric care are proven to reduce deaths due to NS, yet there is scanty literature on the LRRH. We, therefore, determined the prevalence of NS and identified its associated factors within the LRRH of northern Uganda.

METHODS: A hospital-based, cross-sectional study with a retrospective chart review was conducted in the neonatal intensive care unit (NICU) at Lira Regional Referral Hospital (LRRH), in northern Uganda. 194 records of neonates admitted to the NICU from September 2022 to February 2023 were reviewed. The participant records were selected by systematic sampling technique and a structured data extraction tool was used to collect data. Using SPSS version 25 data entry and analysis were done. The univariable analysis gave a general description of the data. Logistic regression analysis was used to show associations and the statistical significance was declared at a P value of 0.05 after multivariable analysis.

RESULTS: Among a total of 194 neonates whose charts were reviewed, 80 neonates had neonatal sepsis, giving a proportion of 0.412 and then prevalence of 41.2%. Age in days of the neonate (AOR = 4.212, 95% CI: [1.627-10.903]) for neonates of 1-3days of age, sex where males (AOR = 2.09, 95% CI: [1.123-3.887]), an APGAR score of 1-4 at birth (AOR = 0.309, 95% CI: [0.115-0.831]) and weight at birth <2500g (AOR = 2.543, 95% CI: [1.381-4.683]) were significantly related to it.

CONCLUSIONS AND RECOMMENDATIONS: The results found the prevalence of NS among neonates admitted to the NICU of LRRH high at 41.2%. Factors 1-3 days of age, male sex, a birth weight of <2500g, and an Apgar score of 1-4 at birth among all neonates were significant. Therefore, it was suggested that caregivers ensure safe newborn care, detect infections early, and use prophylactic antibiotics for high-risk babies after birth, to reduce NS. Further research will be conducted on the major causative agents and outcomes of NS in the NICU of LRRH.

PMID:39804938 | DOI:10.1371/journal.pone.0315794

PLOS Digit Health. 2025 Jan 13;4(1):e0000670. doi: 10.1371/journal.pdig.0000670. eCollection 2025 Jan.

ABSTRACT

Epidemiology and Public Health have increasingly relied on structured and unstructured data, collected inside and outside of typical health systems, to study, identify, and mitigate diseases at the population level. Focusing on infectious diseases, we review the state of Digital Epidemiology at the beginning of 2020 and how it changed after the COVID-19 pandemic, in both nature and breadth. We argue that Epidemiology’s progressive use of data generated outside of clinical and public health systems creates several technical challenges, particularly in carrying specific biases that are almost impossible to correct for a priori. Using a statistical perspective, we discuss how a definition of Digital Epidemiology that emphasizes “data-type” instead of “data-source,” may be more operationally useful, by clarifying key methodological differences and gaps. Therefore, we briefly describe some of the possible biases arising from varied collection methods and sources, and offer some recommendations to better explore the potential of Digital Epidemiology, particularly on how to help reduce inequity.

PMID:39804936 | DOI:10.1371/journal.pdig.0000670

PLoS Negl Trop Dis. 2025 Jan 13;19(1):e0012783. doi: 10.1371/journal.pntd.0012783. Online ahead of print.

ABSTRACT

INTRODUCTION: Visceral leishmaniasis (VL) also known as Kala-azar is one of the neglected tropical diseases (NTD) of public health importance. Despite being a disease of a long history, the condition remains poorly studied especially in East Africa. For instance, whereas, the geographical location of the disease is known, there is a stark paucity of data on the burden, risk factors and clinical outcomes of this contribution in Northeastern Uganda. Therefore, the disease picture in these settings is incomplete. The overarching aim for this study was to describe pre-elimination prevalence, associated factors and treatment outcomes of VL in Moroto District.

METHODS: We conducted a cross-sectional study in which community cases were identified at baseline. They were followed up at Amudat Hospital Kala-azar Treatment Centre for the treatment outcomes. We used a customized data collection tool to elicit data on demographic characteristics, socio-economic and anthropometry. Data were entered on excel database and exported to Stata software for analyses. Proportions and measures of central tendency were computed. Binary associations were determined using Chi-square statistical test. In addition, variables independently associated with VL were determined via logistic regression analyses. At follow up stage, the outcomes were determined.

RESULTS: The overall prevalence of VL infection in Moroto district was 5.21% (95%CI: 3.15% – 8.48%) with varying county level prevalence at Matheniko, Tepeth and Mororo at 6.90%, 4.49% and 3.61%; respectively. The common risk factors for VL infection included lack of knowledge of habitat for Sand flies, AOR 5.33 (95%CI: 1.69-16.82). Patients with VL presented with fever, headache, abdominal pain and swelling, coughing, night sweats, diarrhea, fatigue, breathlessness, and nose bleeding. The average hospitalization for VL was 17 days. All the patients who were treated at the hospital cured.

CONCLUSION: The prevalence of VL in Moroto district was 5.21% and within elimination threshold. The high-risk factors for VL infection included lack of knowledge about the habitat for Sand flies. The average hospitalization for VL was 17 days.

PMID:39804935 | DOI:10.1371/journal.pntd.0012783

PLoS One. 2025 Jan 13;20(1):e0316445. doi: 10.1371/journal.pone.0316445. eCollection 2025.

ABSTRACT

BACKGROUND: The July effect in US teaching hospitals has been studied with conflicting results. We aimed to evaluate the effect of physician turnover in July on the clinical outcomes of patients hospitalized with cirrhosis.

METHODS: We utilized the Nationwide Inpatient Sample database (2016-2019) to identify patients hospitalized with cirrhosis and liver-related complications (variceal bleeding, hepatorenal syndrome, acute-on-chronic liver failure). We used difference-in-differences analysis to compare teaching and non-teaching hospital differences in mortality and length of stay (LOS) in May and July, and trends in outcomes in other months before and after July.

RESULTS: We included 78,371 hospitalizations in teaching and 23,518 in non-teaching hospitals in May and July. Teaching hospital admissions had overall higher complication rates and mortality compared to non-teaching hospitals. We did not find a difference in mortality between teaching and non-teaching hospitals in all cirrhotic patients (adjusted odds ratio 1.01, 95%CI [0.88-1.16]) or in those with severe complications (0.87, [0.72-1.06]). There was greater LOS in July vs. May in teaching hospitals relative to non-teaching hospitals for all patients with cirrhosis (adjusted rate ratio 1.03, 95%CI [1.02-1.05]) and for those with severe complications (1.19, [1.17-1.21]). The months after July were associated with longer LOS in teaching hospitals, with the effect gradually diminishing over the subsequent months.

CONCLUSIONS: Our study suggests trainee turnover in July did not affect mortality, but lengthened hospital stays for patients with cirrhosis, highlighting the need for effective supervision of new trainees and strategies to mitigate operational disruptions for improved clinical management.

PMID:39804918 | DOI:10.1371/journal.pone.0316445

PLoS One. 2025 Jan 13;20(1):e0317016. doi: 10.1371/journal.pone.0317016. eCollection 2025.

ABSTRACT

INTRODUCTION: The population is heterogeneous with varying levels of healthcare needs. Clustering individuals into health segments with more homogeneous healthcare needs allows for better understanding and monitoring of health profiles in the population, which can support data-driven resource allocation.

METHODS: Using the developed criteria, data from several of Singapore’s national administrative datasets were used to classify individuals into the various health segments. Cross-sectional analysis of healthcare utilization charges was conducted. Validation was done for the framework’s prognostic ability of clinically relevant outcomes measured in the following year.

RESULTS: The framework is comprised of twelve segments classed within four broad groups. The segments comprising individuals with cancer, with transitional care needs, and in the last year of their lives had the highest mean per resident healthcare charges. The segments comprising adults and seniors with complex chronic conditions and with transitional care needs had the highest percentage of individuals historically diagnosed with obesity. The framework was able to distinguish varying tiers of healthcare utilization charges and relative risk of death in the following year.

DISCUSSION: The framework was developed using a hybrid approach, with expert input and comprehensive national data that extended beyond the usual hospital patient population. The framework can be directly applied for use in program or policy design, evaluation, and cost-effectiveness analyses.

CONCLUSION: The HealthSCOPES framework was developed to segment the entire population in Singapore with similar healthcare needs.

PMID:39804885 | DOI:10.1371/journal.pone.0317016

PLoS One. 2025 Jan 13;20(1):e0311730. doi: 10.1371/journal.pone.0311730. eCollection 2025.

ABSTRACT

BACKGROUND: Maternal mortality ratio (MMR) has decreased worldwide but Pakistan is still striving towards achieving the SDG targets for maternal health. This study highlights the trends in maternal mortality levels and risk factors in Pakistan between 2007 and 2019.

METHODS: This study compares the results of secondary data analysis of the Pakistan Maternal Mortality Survey 2019 with the Pakistan Demographic and Health Survey 2007. A nested case-control study was carved to compare maternal deaths with the women who survived a pregnancy, in the same sampling clusters during the same period. Logistic regression was used to estimate odds ratios (OR) for major risk factors of maternal mortality after adjusting for the women’s age, parity, education, and wealth quintile.

RESULTS: In 2019, Pakistan’s MMR was 186 per 100,000 live births, registering a 33% decline from 2007 (rural 42% vs. urban 11%). The leading causes of maternal mortality were postpartum hemorrhage, hypertensive disease of pregnancy, postpartum infection, and post-abortion complications. Women > 35 years and those expecting their first child were more likely to die from childbirth, while those who had ever used family planning had a lower risk according to the data for both years. In 2007, a distance of > 40 kilometers to a hospital significantly increased the risk of mortality but this association was not significant in 2019. In 2019, women who died were more likely to receive antenatal care than those who survived (adjusted OR 9.3); this association was not significant in 2007.

CONCLUSION: The modest reduction in MMR can be attributed to improved access to maternal health services in rural areas with increased antenatal care and institutional deliveries. However, most maternal deaths were caused by poor accessibility to quality emergency obstetric care. Lack of family planning remains a major risk factor for high maternal mortality in Pakistan.

PMID:39804883 | DOI:10.1371/journal.pone.0311730