Tag: nevin manimala

Psychol Trauma. 2024 Jun 20. doi: 10.1037/tra0001684. Online ahead of print.

ABSTRACT

OBJECTIVE: A better understanding of the development of prolonged grief disorder can help professionals identify bereaved in need of intervention efforts and improve the efficiency of services. We aimed to examine the prevalence of and risk factors for prolonged grief disorder in a sample of young, bereaved terrorist attack survivors almost a decade postloss.

METHOD: In total, 165 bereaved survivors (M_age = 27.75, SD = 4.27; 45.5% females) of the 2011 terror attack on Utøya island, Norway, participated in face-to-face, semistructured interviews. At 4-5 months after the attack, early posttraumatic reactions were measured using the Brief Grief Questionnaire, University of California at Los Angeles PTSD Reaction Index, the Hopkins Symptom Checklist-8, and the eight-item Children’s Somatic Symptoms Inventory. At 8.5 years postloss, the Traumatic Grief Inventory-Self Report Plus was used to assess prolonged grief disorder. To explore the association between participants’ sociodemographic characteristics, early postloss clinical characteristics, and later prolonged grief reactions, we used multiple linear regression analyses.

RESULTS: We found that 4.8% of the participants fulfilled the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision diagnostic criteria for prolonged grief disorder 8.5 years after their traumatic loss. Lower age and high levels of early somatic complaints predicted higher prolonged grief reactions almost a decade postloss.

CONCLUSIONS: Young, bereaved survivors may be at particularly high risk of experiencing persistent grief reactions following the traumatic loss of a peer. Pending replication of our findings, professionals should focus on identifying bereaved who experience intense somatic symptoms early after a traumatic loss. Targeting these symptoms may alleviate the exacerbation of persistent grief reactions several years after a traumatic loss. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:38900511 | DOI:10.1037/tra0001684

J Glob Health. 2024 Jun 21;14:05020. doi: 10.7189/jogh.14.05020.

ABSTRACT

BACKGROUND: The reallocation of health care services during the coronavirus disease 2019 (COVID-19) pandemic disrupted the continuity of primary care. This study examines the repercussions of the COVID-19 pandemic on clinical indicators within the Catalan population, emphasising individuals with chronic conditions. It provides insights into mortality and transfer rates considering intersectional perspectives.

METHODS: We designed a retrospective, observational population-based cohort study based on routinely collected data from January 2015 to June 2021 for all individuals available in the Information System for Research in Primary Care (Sistema d’Informació per al Desenvolupament de la Investigació en Atenció Primària (SIDIAP)), the largest public primary care database in Catalonia, Spain. We included 6 301 095 individuals, constituting 81.6% of Catalonia’s population in 2020. To perform a repeated measurements analysis of the indicators, we focussed on individuals who had one or more indicators in both the pre-pandemic (January 2015 to March 2020) and pandemic periods (March 2020 to June 2021), and those diagnosed with type 2 diabetes mellitus (T2D), high blood pressure, and heart failure. We selected key clinical indicators for analysis, including systolic and diastolic blood pressure, body mass index (BMI), cholesterol (total, high, and low-density lipoprotein), triglycerides, glycosylated haemoglobin, the Barthel index, and cardiovascular risk (Registre Gironí del cor (REGICOR) index).

RESULTS: Mortality and transfer rates increased during the pandemic, contributing to a decline in the active population in the public health system. We also observed a reduction in pandemic period prevalence of patients with chronic conditions: -26.7% for heart failure, -15.1% for high blood pressure, and -14.6% for T2D. In both pre-pandemic and pandemic periods, 1 632 013 subjects had at least one clinical indicator record. Clinical indicators worsened in patients diagnosed with chronic conditions during the pandemic. Most indicators worsened, with differences between men and women (+9.4% vs +3.7% for the REGICOR index and -14.1% vs -16.6% for the Barthel index in men and in women, respectively), and to a similar extent (or greater in some cases) in individuals without these conditions.

CONCLUSIONS: We used longitudinal data to assess the repercussions of the COVID-19 pandemic on population health while considering a wide range of clinical indicators and socioeconomic determinants. Our analysis shows a deterioration in clinical indicators during the pandemic, particularly in cardiometabolic factors, underscoring the importance of continuous primary care for individuals with chronic conditions.

PMID:38900506 | DOI:10.7189/jogh.14.05020

JAMA Netw Open. 2024 Jun 3;7(6):e2417122. doi: 10.1001/jamanetworkopen.2024.17122.

ABSTRACT

IMPORTANCE: Cancer survivors experience accelerated functional decline that threatens independence and quality of life. Previous studies have suggested that vegetable gardening may improve diet, physical activity, and physical function in this vulnerable population, which comprises more than 5% of the US population.

OBJECTIVE: To assess whether diet, physical activity and functioning, and other outcomes improved in older cancer survivors assigned to a vegetable gardening intervention compared with a waitlist.

DESIGN, SETTING, AND PARTICIPANTS: From May 11, 2016, to May 2, 2022, a 2-arm, assessor-blinded, crossover-designed, intent-to-treat, randomized clinical trial was conducted at cancer survivors’ homes across Alabama. Medicare-eligible survivors of cancers with 5-year survival of 60% or more were registry ascertained and screened for suboptimal vegetable and fruit consumption (<5 servings per day), physical activity (<150 moderate-to-vigorous minutes per week), and physical function (36-Item Short Form Health Survey [SF-36] subscale score ≤90). Consented participants underwent baseline assessments, were randomly assigned to intervention or waitlisted arms, and were reassessed at 1-year follow-up.

INTERVENTION: One-year, home-based vegetable gardening intervention providing gardening supplies and mentorship by cooperative extension-certified master gardeners to plant and maintain spring, summer, and fall gardens. Waitlisted participants received the identical intervention after 12 months.

MAIN OUTCOMES AND MEASURES: The main outcome was a composite index of improvements in self-reported vegetable and fruit consumption, physical activity, and physical function corroborated by plasma α-carotene levels, accelerometry, and physical performance assessments, respectively.

RESULTS: Of 381 enrolled participants (mean [SD] age, 69.8 [6.4] years; range, 50-95 years; 263 [69.0%] female), 194 were assigned to the gardening intervention and 187 were waitlisted (attrition rates, 7.2% and 7.0%, respectively). Intent-to-treat analyses did not detect a significant improvement in the composite index of vegetable and fruit intake, moderate-vigorous physical activity, and physical function (intervention arm vs waitlisted arm, 4.5% vs 3.1%; P = .53) or between-arm differences in vegetable and fruit intake (mean difference, 0.3 [95% CI, -0.1 to 0.7] servings per day; P = .10). The intervention arm experienced a significant improvement in vegetable and fruit intake (mean increase, 0.3 [95% CI, 0.0-0.6] servings per day; P = .04). Significant improvements also were observed in the intervention arm vs waitlisted arm in physical performance (mean difference for 2-minute step test, 6.0 [95% CI, 0.8-11.2] steps; P = .03; for 30-second chair stand, 0.8 [95% CI, 0.1-1.5] repetitions; P = .02), perceived health (8.4 [95% CI, 3.0-13.9] points on a 100-point scale [higher scores indicate better health]; P = .003), and gut microbiome alpha diversity (84.1 [95% CI, 20.5-147.6] more observed species; P = .01). The COVID-19 pandemic significantly moderated effects (eg, odds of improvement in self-reported physical functioning were greater before vs during the pandemic: odds ratio, 2.17; 95% CI, 1.12-4.22; P = .02).

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial including older cancer survivors, a vegetable gardening intervention did not significantly improve a composite index of diet, physical activity, and physical function; however, survivors assigned to the intervention had significantly increased vegetable and fruit consumption and, compared with waitlisted survivors, experienced significant improvements in perceived health and physical performance. Further study in broader populations and during pandemic-free periods is needed to determine definitive benefits.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02985411.

PMID:38900426 | DOI:10.1001/jamanetworkopen.2024.17122

JAMA Netw Open. 2024 Jun 3;7(6):e2417770. doi: 10.1001/jamanetworkopen.2024.17770.

ABSTRACT

IMPORTANCE: Although several interventions have been shown to be effective in preventing suicide at high-risk locations, the potential for these interventions to be deployed is limited by a lack of knowledge about where high-risk locations are and the factors associated with choosing these locations.

OBJECTIVE: To identify high-risk suicide locations in Australia and the factors associated with choosing these locations.

DESIGN, SETTING, AND PARTICIPANTS: This case-control study included data on individuals who died by suicide in Australia between January 2001 and December 2017, obtained from the National Coronial Information System. Data analysis was conducted from February to December 2021.

EXPOSURES: Sociodemographic, residential, incident time, and incident location variables.

MAIN OUTCOMES AND MEASURES: The scan statistic was used to detect spatial clusters of suicides in public locations. Suicide locations within significant clusters with at least 0.5 suicides per year were defined as high-risk locations. Multivariable logistic regression analyses were performed to examine the factors associated with choosing a high-risk location.

RESULTS: Over the study period, 10 701 suicides took place in public places. The individuals who died of suicide in public places included 8602 (80.4%) male individuals, and most were aged 25 to 49 years (5825 [54.5%]). A total of 17 high-risk suicide locations in Australia were detected. These involved 495 suicides, which accounted for 4.6% of suicides in public locations. For suicides at high-risk locations, 82.2% (407 of 495) occurred at cliffs and bridges. Being female (adjusted odds ratio [aOR], 1.73; 95% CI, 1.41-2.13), employed (aOR, 1.57; 95% CI, 1.20-2.04), never married (aOR, 1.64; 95% CI, 1.26-2.13), and from a major city (aOR, 3.94; 95% CI, 2.94-5.28) were associated with the choice of a high- over low-risk suicide location. High-risk locations tended to be in major cities.

CONCLUSIONS AND RELEVANCE: This case-control study found 17 high-risk suicide locations in Australia and the factors associated with the choice of these locations. Actions should be taken to prevent suicide at these locations where possible.

PMID:38900425 | DOI:10.1001/jamanetworkopen.2024.17770

Pain Ther. 2024 Jun 20. doi: 10.1007/s40122-024-00621-6. Online ahead of print.

ABSTRACT

INTRODUCTION: Sodium pentobarbital (SP), a short- to intermediate-acting barbiturate, has limited information in the existing literature. The objectives of this study are to describe (a) the effect of intravenous (IV) SP infusion on pain and sensory abnormalities, and (b) its utility in the diagnosis and management of patients with chronic pain.

METHODS: A narrative review of barbiturate applications for chronic pain was followed by a pragmatic study of 176 consecutive patients admitted to an inpatient pain unit (2004-2009). We collected demographic information upon admission, diagnoses retrieved from chart review, and pain ratings and sensory abnormalities at baseline and after blinded infusion of normal saline (NS) followed by SP.

RESULTS: The study group consisted of 83 men and 93 women (mean age 41 ± 11 years); the mean NS dose was 7.8 ± 2.3 (range 2-10 ml), the SP dose was 223.8 ± 88 mg (range 40-420), and the numeric rating scale (NRS) baseline pain score was 6.0 ± 2. The mean reduction in NRS reached both statistical and clinical significance in 150 responders to either NS/SP or SP only. Collectively, we found (a) an extremely high rate of response to IV SP irrespective of the underlying pathology, (b) greater response for pain than for sensory abnormalities (sensory gains or deficits), (c) greater response for sensory gain than for sensory deficit, and (d) greater response for allodynia than for pinprick hyperalgesia. Illustrative case reports are also presented.

DISCUSSION: IV SP infusion is a diagnostic tool that assists in elucidating pain generators and the nature of sensory abnormalities (central vs. peripheral), with effects similar to those of IV sodium amytal. The test cannot be viewed as a tell-all diagnostic modality and must be used in conjunction with clinical judgment, investigations, and psychological reports.

PMID:38900409 | DOI:10.1007/s40122-024-00621-6

Spine Deform. 2024 Jun 20. doi: 10.1007/s43390-024-00918-8. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the association and evaluate the characteristics between different types of anterior chest wall and spinal deformities.

METHODS: A total of 548 patients with anterior chest wall deformities were included in this study. Clinical and radiological examinations were performed to determine spinal deformities. The type and severity of the spinal deformities were evaluated and their relationships with chest wall deformity subtypes were statistically analyzed.

RESULTS: Spinal deformities were identified in 93 (16.97%) patients. The patients were subdivided into 71 (76.3%) male and 22 (23.7%) female patients. A spinal deformity was detected in 57 (13%) of 418 pectus excavatum (PE) patients, in 23 (19%) of 117 pectus carinatum (PC) patients, and in all patients with mixed pectus deformity (PE + PC), syndromic deformity and rib anomalies. In the PE group, scoliosis, and kyphosis were observed at 57.9 and 31.6%, respectively. In the PC group, these rates were 43.5 and 47.8%, respectively. Idiopathic scoliosis was observed in 42 (77.7%) and constituted the most common scoliosis subgroup. The main thoracic curvature was the most common curve pattern, which was observed in 15 (35.7%) patients with idiopathic scoliosis.

CONCLUSIONS: Idiopathic scoliosis with main thoracic curvature is the most common deformity in patients with anterior chest wall deformity. Spinal deformities are more common in male patients with chest deformities. Kyphosis is found in a significant number of PE and PC patients. Patients with mixed PE and PC, rib anomalies, and syndromic disease are more likely to have spinal deformities.

PMID:38900408 | DOI:10.1007/s43390-024-00918-8

Photosynth Res. 2024 Jun 20. doi: 10.1007/s11120-024-01105-6. Online ahead of print.

ABSTRACT

David Mauzerall was born on July 22, 1929 to a working-class family in the small, inland textile town of Sanford, Maine. Those humble origins instilled a lifelong frugality and an innovative spirit. After earning his PhD degree in 1954 in physical organic chemistry with Frank Westheimer at the University of Chicago, he joined The Rockefeller Institute for Medical Research (now University) as a postdoctoral fellow that summer, rose to the rank of professor, and remained there for the rest of his career. His work over more than 60 years encompassed porphyrin biosynthesis, photoinduced electron-transfer reactions in diverse architectures (solutions, bilayer lipid membranes, reaction centers, chromatophores, and intact leaves), the light-saturation curve of photosynthesis, statistical treatments of photoreactions, and “all-things porphyrins.” His research culminated in studies he poetically referred to as “listening to leaves” through the use of pulsed photoacoustic spectroscopy to probe the course and thermodynamics of photosynthesis in its native state. His research group was always small; indeed, of 185 total publications, 39 were singly authored. In brief, David Mauzerall has blended a deep knowledge of distinct disciplines of physical organic chemistry, photochemistry, spectroscopy and biophysics with ingenious experimental methods, incisive mathematical analysis, pristine personal integrity, and unyielding love of science to deepen our understanding of photosynthesis in its broadest context. He thought creatively – and always independently. His work helped systematize the fields of photosynthesis and the origin of life and made them more quantitative. The present article highlights a number of salient scientific discoveries and includes comments from members of his family, friends, and collaborators (Gary Brudvig, Greg Edens, Paul Falkowski, Alzatta Fogg, G. Govindjee, Nancy Greenbaum, Marilyn Gunner, Harvey Hou, Denise and Michele Mauzerall, Thomas Moore, and William Parson) as part of a celebration of his 95th birthday.

PMID:38900375 | DOI:10.1007/s11120-024-01105-6

Int J Comput Assist Radiol Surg. 2024 Jun 20. doi: 10.1007/s11548-024-03213-z. Online ahead of print.

ABSTRACT

PURPOSE: Medical image analysis has become a prominent area where machine learning has been applied. However, high-quality, publicly available data are limited either due to patient privacy laws or the time and cost required for experts to annotate images. In this retrospective study, we designed and evaluated a pipeline to generate synthetic labeled polyp images for augmenting medical image segmentation models with the aim of reducing this data scarcity.

METHODS: We trained diffusion models on the HyperKvasir dataset, comprising 1000 images of polyps in the human GI tract from 2008 to 2016. Qualitative expert review, Fréchet Inception Distance (FID), and Multi-Scale Structural Similarity (MS-SSIM) were tested for evaluation. Additionally, various segmentation models were trained with the generated data and evaluated using Dice score (DS) and Intersection over Union (IoU).

RESULTS: Our pipeline produced images more akin to real polyp images based on FID scores. Segmentation model performance also showed improvements over GAN methods when trained entirely, or partially, with synthetic data, despite requiring less compute for training. Moreover, the improvement persists when tested on different datasets, showcasing the transferability of the generated images.

CONCLUSIONS: The proposed pipeline produced realistic image and mask pairs which could reduce the need for manual data annotation when performing a machine learning task. We support this use case by showing that the methods proposed in this study enhanced segmentation model performance, as measured by Dice and IoU scores, when trained fully or partially on synthetic data.

PMID:38900372 | DOI:10.1007/s11548-024-03213-z

Environ Monit Assess. 2024 Jun 20;196(7):635. doi: 10.1007/s10661-024-12812-x.

ABSTRACT

Detecting human impact on freshwater ecosystems is problematic without rigorous assessment of temporal changes. Assessments of mining impacts are further complicated by the strong influence of local catchment geology on surface waters even in unmined environments. Such influence cannot be effectively considered by using broad-scale reference frameworks based on regionalization and stream types. Using the BACI (Before-After Control-Impact) design, we examined the impact of mining discharges on freshwater algae and macroinvertebrate communities resulting from the rerouting of treated wastewaters through a pipeline to larger water bodies in Northern and North-Eastern Finland. Impacted sites and control sites were sampled 1 to 2 years before and 1 to 3 years after the pipelines became operational. Stream diatom communities recovered from past loadings upstream of the pipeline (which was no longer impacted by wastewaters) after rerouting of the wastewaters, while no changes downstream from the pipeline were detected. Upstream from the pipeline, diatom species richness increased and changes in relative abundances of the most common diatom taxa as well as in the overall community composition were observed. The effects of the pipeline were less evident for stream macroinvertebrate communities. There was an indication that regional reference conditions used in national biomonitoring may not represent diatom communities in areas with a strong geochemical background influence. Lake profundal macroinvertebrate communities were impacted by past loadings before the construction of the pipeline, and the influence of the pipeline was observed only as changes in the abundances of a few individual species such as phantom midges (which increased in abundance in response to discharges directed through the pipeline). Our results highlight the variable influence of mining discharges on aquatic communities. Statistically strong monitoring programmes, such as BACI designs, are clearly needed to detect these influences.

PMID:38900337 | DOI:10.1007/s10661-024-12812-x

AIDS Behav. 2024 Jun 20. doi: 10.1007/s10461-024-04412-0. Online ahead of print.

ABSTRACT

Peer advocacy can promote HIV protective behaviors, but little is known about the concordance on prevention advocacy(PA) reports between people living with HIV(PLWH) and their social network members. We examined prevalence and correlates of such concordance, and its association with the targeted HIV protective behavior of the social network member. Data were analyzed from 193 PLWH(index participants) and their 599 social network members(alters). Kappa statistics measured concordance between index and alter reports of PA in the past 3 months. Logistic and multinomial regressions evaluated the relationship between advocacy concordance and alter condom use and HIV testing behavior and correlates of PA concordance. Advocacy concordance was observed in 0.3% of index-alter dyads for PrEP discussion, 9% for condom use, 18% for HIV testing, 26% for care engagement, and 49% for antiretroviral use discussions. Fewer indexes reported condom use(23.5% vs. 28.1%;[Formula: see text]=3.7, p=0.05) and HIV testing(30.5% vs. 50.5%; [Formula: see text]=25.3, p<0.001) PA occurring. Condom advocacy concordance was higher if the index and alter were romantic partners(OR=3.50; p=0.02), and lower if the index was 10 years younger than the alter(OR=0.23; p = 0.02). Alters had higher odds of using condoms with their main partner when both reported condom advocacy compared to dyads where neither reported advocacy(OR=3.90; p<0.001) and compared to dyads where only the index reported such advocacy(OR = 3.71; p=0.01). Age difference and relationship status impact advocacy agreement, and concordant perceptions of advocacy are linked to increased HIV protective behaviors. Alters’ perceptions may be crucial for behavior change, informing strategies for improving advocacy.

PMID:38900313 | DOI:10.1007/s10461-024-04412-0