Tag: nevin manimala

JMIR Aging. 2024 Dec 4;7:e55681. doi: 10.2196/55681.

ABSTRACT

BACKGROUND: Falls pose a significant public health concern, with increasing occurrence due to the aging population, and they are associated with high mortality rates and risks such as multimorbidity and frailty. Falls not only lead to physical injuries but also have detrimental psychological and social consequences, negatively impacting quality of life. Identifying individuals at high risk for falls is crucial, particularly for those aged ≥60 years and living in residential care settings; current professional guidelines favor personalized, multifactorial fall risk assessment approaches for effective fall prevention.

OBJECTIVE: This study aimed to explore the prognostic validity of the Fall Risk Score (FRS), a multifactorial-based metric to assess fall risk (using longitudinal real-world data), and establish the clinical relevance of the FRS by identifying threshold values and the minimum clinically important differences.

METHODS: This retrospective cohort study involved 617 older adults (857 observations: 615 of women, 242 of men; mean age 83.3, SD 8.7 years; mean gait speed 0.49, SD 0.19 m/s; 622 using walking aids) residing in German residential care facilities and used the LINDERA mobile health app for fall risk assessment. The study focused on the association between FRS at the initial assessment (T1) and the normalized number of falls at follow-up (T2). A quadratic regression model and Spearman correlation analysis were utilized to analyze the data, supported by descriptive statistics and subgroup analyses.

RESULTS: The quadratic model exhibited the lowest root mean square error (0.015), and Spearman correlation analysis revealed that a higher FRS at T1 was linked to an increased number of falls at T2 (ρ=0.960, P<.001). Subgroups revealed significant strong correlations between FRS at T1 and falls at T2, particularly for older adults with slower gait speeds (ρ=0.954, P<.001) and those using walking aids (ρ=0.955, P<.001). Threshold values revealed that an FRS of 45%, 32%, and 24% corresponded to the expectation of a fall within 6, 12, and 24 months, respectively. Distribution-based minimum clinically important difference values were established, providing ranges for small, medium, and large effect sizes for FRS changes.

CONCLUSIONS: The FRS exhibits good prognostic validity for predicting future falls, particularly in specific subgroups. The findings support a stratified fall risk assessment approach and emphasize the significance of early and personalized intervention. This study contributes to the knowledge base on fall risk, despite limitations such as demographic focus and potential assessment interval variability.

PMID:39631046 | DOI:10.2196/55681

Dev Med Child Neurol. 2024 Dec 4. doi: 10.1111/dmcn.16199. Online ahead of print.

ABSTRACT

AIM: To extend the findings of a previous clinical trial suggesting combined abacavir (ABC), lamivudine (3TC), and zidovudine (AZT) reduces type I interferon (IFN) signalling in Aicardi-Goutières syndrome (AGS).

METHOD: This was an open label, non-placebo-controlled phase II clinical trial (NCT04731103) in patients less than 16 years with any of five AGS genotypes. The effect of ABC or 3TC individually, or of combined ABC + 3TC + AZT, on IFN-stimulated gene (ISG) expression (primary outcome) and IFN-alpha protein (secondary outcome) in blood was assessed.

RESULTS: Thirteen patients were recruited. Compliance was poor in the ABC + 3TC + AZT arm. No statistically significant effects were observed with ABC or 3TC, or with ABC + 3TC + AZT over 6 weeks. A statistically significant reduction of ISG expression was recorded after 3 weeks of ABC + 3TC + AZT, which was not mirrored by changes in IFN-alpha protein.

INTERPRETATION: There is insufficient evidence that ABC or 3TC is either effective or ineffective in reducing type I IFN signalling in AGS over 6 weeks. The effect of ABC + 3TC + AZT at 3 weeks supports data from a previous clinical trial of the effect of ABC + 3TC + AZT in reducing type I IFN signalling, although there was insufficient evidence of an effect at 6 weeks. Time to local research and development (R&D) approval, and to sponsor authorization after R&D approval, severely limited patient recruitment.

PMID:39630935 | DOI:10.1111/dmcn.16199

J Am Acad Orthop Surg. 2024 Nov 26. doi: 10.5435/JAAOS-D-24-00473. Online ahead of print.

NO ABSTRACT

PMID:39630934 | DOI:10.5435/JAAOS-D-24-00473

Sci Adv. 2024 Dec 6;10(49):eadp8915. doi: 10.1126/sciadv.adp8915. Epub 2024 Dec 4.

ABSTRACT

Most homicides in the United States are committed using a handgun, but little research examines gun carrying over critical stages of the life course and changing contexts of violence. Notably, although most of the handgun homicides are committed by adults, most research on concealed gun carrying focuses on adolescents in single cohort studies. Using more than 25 years of longitudinal multicohort data from Chicago, 1994-2021, we show that pathways of concealed gun carrying are distinct between adolescence and adulthood. Adolescent carrying is often age-limited and responsive to direct exposure to gun violence (witnessing and victimization), while adult carrying is a persistent behavior that is less tied to direct exposure. The onset of concealed carry is also a strong predictor of later gun use (shooting or brandishing), and we find distinct patterns of gun use between individuals who first carry in adolescence versus adulthood. We discuss the implications of these dual pathways for research and policies on firearm use.

PMID:39630904 | DOI:10.1126/sciadv.adp8915

Proc Natl Acad Sci U S A. 2024 Dec 10;121(50):e2403327121. doi: 10.1073/pnas.2403327121. Epub 2024 Dec 4.

ABSTRACT

Dirac fluids-interacting systems obeying particle-hole symmetry and Lorentz invariance-are among the simplest hydrodynamic systems; they have also been studied as effective descriptions of transport in strongly interacting Dirac semimetals. Direct experimental signatures of the Dirac fluid are elusive, as its charge transport is diffusive as in conventional metals. In this paper, we point out a striking consequence of fluctuating relativistic hydrodynamics: The full counting statistics (FCS) of charge transport is highly non-Gaussian. We predict the exact asymptotic form of the FCS, which generalizes a result previously derived for certain interacting integrable systems. A consequence is that, starting from quasi-one-dimensional nonequilibrium initial conditions, charge noise in the hydrodynamic regime is parametrically enhanced relative to that in conventional diffusive metals.

PMID:39630864 | DOI:10.1073/pnas.2403327121

PLoS Negl Trop Dis. 2024 Dec 4;18(12):e0012596. doi: 10.1371/journal.pntd.0012596. Online ahead of print.

ABSTRACT

Amid profound climate change, incidence of dengue continues to rise and expand in distribution across the world. Here, we analysed dengue in three coastal departments of Peru which have recently experienced public health emergencies during the worst dengue crises in Latin American history. We developed a climate-based spatiotemporal modelling framework to model monthly incidence of new dengue cases in Piura, Tumbes, and Lambayeque over 140 months from 2010 to 2021. The framework enabled accurate description of in-sample and out-of-sample dengue incidence trends across the departments, as well as the characterisation of the timing, structure, and intensity of climatic relationships with human dengue incidence. In terms of dengue incidence rate (DIR) risk factors, we inferred non-linear and delayed effects of greater monthly mean maximum temperatures, extreme precipitation, sustained drought conditions, and extremes of a Peruvian-specific indicator of the El Niño Southern Oscillation. Building on our model-based understanding of climatic influences, we performed climate-model-based forecasting of dengue incidence across 2018 to 2021 with a forecast horizon of one month. Our framework enabled representative, reliable forecasts of future dengue outbreaks, including correct classification of 100% of all future outbreaks with DIR ≥ 50 (or 150) per 100,000, whilst retaining relatively low probability of 0.12 (0.05) for false alarms. Therefore, our model framework and analysis may be used by public health authorities to i) understand climatic drivers of dengue incidence, and ii) alongside our forecasts, to mitigate impacts of dengue outbreaks and potential public health emergencies by informing early warning systems and deployment of vector control resources.

PMID:39630856 | DOI:10.1371/journal.pntd.0012596

PLoS Negl Trop Dis. 2024 Dec 4;18(12):e0011835. doi: 10.1371/journal.pntd.0011835. Online ahead of print.

ABSTRACT

BACKGROUND/METHODOLOGY: Despite progress using mass drug administration (MDA), lymphatic filariasis (LF) remains a major public health issue in India. Vector control could potentially augment MDA towards LF elimination. We conducted a cost-effectiveness analysis of MDA alone and MDA together with vector control single (VCS) modality or vector control integrated (VCI) modalities. Data came from historical controls and a three-arm cluster randomized trial of 36 villages at risk of LF transmission in Tamil Nadu, India. The arms were: MDA alone (the standard of care); MDA plus VCS (expanded polystyrene beads covering the water surface in wells and cesspits to suppress the filariasis vector mosquito Culex quinquefasciatus); and MDA plus VCI (VCS plus insecticidal pyrethroid-impregnated curtains [over windows, doors, and eaves). Economic costs in 2010 US$ combined government and community inputs from household to state levels. Outcomes were controlled microfilaria prevalence (MfP) and antigen prevalence (AgP) to conventional elimination targets (MfP<1% or AgP<2%) from 2010 to 2013, and modeled disability adjusted life years (DALYs) averted.

PRINCIPAL FINDINGS: The estimated annual economic cost per resident was US$0.53 for MDA alone, US$1.02 for VCS, and US$1.83 for VCI. With MDA offered in all arms, all arms reduced LF prevalence substantially from 2010 to 2013. MDA proved highly cost effective at $112 per DALY averted, a very small (8%) share of India’s then per capita Gross Domestic Product. Progress towards elimination was comparable across all three study arms.

CONCLUSIONS: The well-functioning MDA program proved effective and very cost-effective for eliminating LF, leaving little scope for further improvement. Supplementary vector control demonstrated no statistically significant additional benefit on MfP or AgP in this trial.

PMID:39630851 | DOI:10.1371/journal.pntd.0011835

PLoS One. 2024 Dec 4;19(12):e0312271. doi: 10.1371/journal.pone.0312271. eCollection 2024.

ABSTRACT

BACKGROUND: The COVID-19 pandemic impacted the world in every aspect. Higher institutions were greatly affected because the outbreak disrupted the teaching and learning structure. Vaccines decrease the rate of infection and transmission of the virus, but the presence of some myths has led to hesitancy towards the vaccine.

OBJECTIVE: The purpose of the survey was to assess the knowledge, perception, and acceptance of the COVID-19 vaccine among undergraduate students in Enugu State, Nigeria.

METHODS: This was a cross-sectional study carried out among undergraduate students at the University of Nigeria Nsukka (UNN), the Institute of Management and Technology (IMT), and Enugu State University of Technology Enugu state (ESUT), Nigeria between March and November 2023. These institutions were chosen based on their large student populations, diverse academic offerings, and significant geographical coverage within the state. Data collection was done using a 26-item validated self-administered questionnaire. Statistical Product and Service Solutions (SPSS) version 25 with appropriate descriptive (frequency and percentage) and inferential statistics (Chi-square) were used to analyze the data.

RESULTS: 1,143 completed questionnaires were obtained. The modal age range was 18-24 years accounting for 814 (71.2%) of the participants. A total of 577 (50.5%) participants demonstrated a good level of knowledge while 685 (59.9%) showed a positive perception of the COVID-19 vaccine. Gender (p = 0.010) and institution (p < 0.001) were associated with their perception of the COVID-19 vaccine. In addition, knowledge and perception of the COVID-19 vaccine were significantly associated with its acceptance at p = 0.038 and < 0.001, respectively.

CONCLUSION: This study reveals that COVID-19 vaccine acceptance among university students in Enugu State, Nigeria, remains low despite moderate knowledge and generally positive attitudes, with perceptions playing a more significant role than knowledge. The findings highlight the need for educational interventions that not only provide accurate information but also actively address misconceptions. To improve vaccine uptake, public health campaigns should focus on shifting perceptions through culturally sensitive, institution-specific strategies.

PMID:39630847 | DOI:10.1371/journal.pone.0312271

Rev Bras Enferm. 2024 Nov 29;77Suppl 3(Suppl 3):e20230283. doi: 10.1590/0034-7167-2023-0283. eCollection 2024.

ABSTRACT

OBJECTIVE: To identify factors associated with poor sleep quality in elderly dependent individuals in social vulnerability.

METHOD: Cross-sectional study with 59 elderly dependent individuals assisted by Family Health Units in São Carlos/SP. The following tools were used: Katz Index, Lawton and Brody Scale, Pittsburgh Sleep Quality Index, Addenbrooke’s Cognitive Examination Revised, Fried’s Frailty Phenotype, Geriatric Depression Scale (15 items), Perceived Stress Scale, Family APGAR, Social Support Scale from the Medical Outcomes Study, and World Health Organization Quality of Life, abbreviated and “old” versions.

RESULTS: The majority of participants were women (52.5%), aged 60-74 years (71.1%), and had poor sleep quality (76.2%). Stress (OR=1.12; 95%CI=1.02-1.22) and polypharmacy (OR=7.39; 95%CI=1.22-44.73) increased the chances of poor sleep quality, while physical activity decreased these chances (OR=0.15; 95%CI=0.02-0.79).

CONCLUSION: Stress and polypharmacy are associated with poor sleep quality in elderly dependent individuals.

PMID:39630845 | DOI:10.1590/0034-7167-2023-0283

J Am Assoc Nurse Pract. 2024 Dec 1;36(12):674-676. doi: 10.1097/JXX.0000000000001076.

ABSTRACT

The document statistics tool, which authors use to review their work before submission, is explained. The tool yields readability statistics, which assess the document’s ease of reading. Authors are encouraged to take advantage of its features, which are described in full.

PMID:39630489 | DOI:10.1097/JXX.0000000000001076