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Nevin Manimala Statistics

Longitudinal actigraphy study on sleep patterns under reduced social restrictions in Japanese university students

J Physiol Anthropol. 2025 Jun 10;44(1):17. doi: 10.1186/s40101-025-00397-4.

ABSTRACT

BACKGROUND: Sleep deprivation and irregular sleep patterns can adversely affect physical and mental health. The COVID-19 pandemic presented a naturalistic opportunity to examine how reduced social time restrictions influence sleep behavior. This study aimed to investigate both group-level and individual-level changes in sleep patterns among Japanese university students before and during the pandemic and to explore how individual characteristics may contribute to these changes.

METHODS: Twenty-two female university students wore waist-worn actigraphy devices for approximately 16 weeks in both 2019 and 2020. Objective sleep data were collected alongside questionnaire assessments of chronotype, personality traits, and subjective sleep feeling.

RESULTS: In total, 4,432 valid days of actigraphy data were analyzed. Compared with the pre-pandemic year, sleep timing was delayed by approximately 20 min for bed-in time and 40 min for bed-out time in 2020. Time in bed (TIB) increased by about 20 min, while total sleep time (TST) remained largely unchanged. Sleep efficiency declined, but subjective sleep feeling remained stable. Individual-level analyses revealed substantial variability: 9 of 22 participants showed significant changes in TST, with both increases and decreases observed. Increased TIB was associated with later bed-out time, shorter baseline sleep duration, and lower neuroticism. A later bed-in time was associated with reduced TST.

CONCLUSIONS: These findings suggest that while social time restrictions can influence sleep timing and duration, the effects vary considerably across individuals. Earlier bedtimes may be more effective than simply extending TIB in promoting adequate sleep. Furthermore, individual characteristics such as personality traits may play a role in sleep adaptation under changing social contexts. Given the diversity of responses observed, both group- and individual-level perspectives are essential for understanding sleep behavior in real-world settings.

PMID:40495174 | DOI:10.1186/s40101-025-00397-4

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Seasonal variations in public perceptions of diphtheria in Northern Nigeria

BMC Public Health. 2025 Jun 10;25(1):2146. doi: 10.1186/s12889-025-23427-3.

ABSTRACT

BACKGROUND: Diphtheria remains a significant public health concern in Nigeria, with over 20,000 suspected cases and more than 500 deaths reported during the 2022-2023 outbreak period, particularly concentrated in the northern regions. Understanding public perceptions and behavior regarding diphtheria, including symptoms, transmission, and vaccination across different seasons, is vital for developing effective interventions. This study aimed to evaluate seasonal variations in public awareness of diphtheria, including knowledge of its symptoms and information sources. Additionally, it sought to assess the perceived at-risk groups and attitudes toward diphtheria vaccination in the country.

METHODS: A cross-sectional survey was conducted among residents aged 18 years and older in Kano, Katsina, Bauchi, Yobe, Borno, Kaduna, Jigawa, Kebbi, and the Federal Capital Territory (FCT). Data were collected by trained fieldworkers over 12 months via structured questionnaires divided into four sections: demographics, public awareness, perceived risk, and vaccination attitudes. Ethical approval was obtained, and verbal informed consent was secured from all participants. Data analysis involved descriptive statistics and statistical tests to examine associations between variables.

RESULTS: A total of 3,070 respondents participated in the study. Public awareness of common diphtheria symptoms such as fever (68.0%) and sore throat (60.5%) was high, whereas awareness of conjunctivitis (23.9%) was lower. Children under 5 years of age were consistently perceived as the most at-risk group (80.5%). The willingness to vaccinate against diphtheria remained high at 94.4%, with no significant seasonal variation (p-value 0.894; Chi-square test). Radio (53.1%) was identified as the primary information source, especially during the rainy season (54.6%). Seasonal variations in preventive and vaccination practices were minimal, indicating consistent public health behaviors throughout the year.

CONCLUSION: This study highlights the importance of maintaining robust public health education campaigns, leveraging both traditional and digital media to sustain high awareness and vaccination rates for public health interventions. Based on our findings, we recommend implementing targeted school-based health education programs and strengthening partnerships with community health workers to enhance diphtheria awareness, especially among caregivers of young children. Understanding sociodemographic and seasonal contexts is crucial for effective public health interventions, ensuring that at-risk groups are adequately protected.

PMID:40495171 | DOI:10.1186/s12889-025-23427-3

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Prevalence and risk factors of intestinal parasitic infections among preschool and school-aged children in Egypt: a systematic review and meta-analysis

BMC Public Health. 2025 Jun 10;25(1):2160. doi: 10.1186/s12889-025-23325-8.

ABSTRACT

INTRODUCTION: Intestinal parasitic infections (IPIs) are a major public health concern, particularly among children in low- and middle-income countries, where limited resources and data hinder effective interventions. This meta-analysis consolidates current evidence on the prevalence of IPIs among preschool and school-aged children in Egypt, identifies key risk factors, and examines trends in prevalence over time.

METHODS: Six databases (African Journals Online, African Index Medicus, PubMed, Scopus, Google Scholar, and Web of Science) were systematically searched from January 1, 2010, to January 1, 2025. Studies conducted in Egypt on apparently healthy preschool or school-aged children were included if they reported IPIs prevalence or risk factors. A random-effects model was employed to estimate pooled prevalence or risk ratios. The meta-analysis was performed using the ‘meta’ package in R (version 4.4.1), with statistical significance set at p < 0.05.

RESULTS: This meta-analysis included 21 studies conducted between 2009 and 2021, involving 54,282 school and preschooler children from both Lower and Upper Egypt. The pooled prevalence of at least one IPI was 46.5% (95% CI: 40.5-52.5). Sensitivity analyses confirmed the robustness of the finding, with no evidence of publication bias. Meta-regression analysis revealed that the prevalence of at least one IPI remained consistent from 2009 to 2021. The most prevalent parasite was Entamoeba spp. (10.9%), followed by Giardia duodenalis (7.3%) and Enterobius vermicularis (4.9%). Less common parasites included Schistosoma mansoni (1.3%), Ancylostoma duodenale (1.0%), Schistosoma haematobium (0.6%), Heterophyes heterophyes (0.7%), Trichuris trichiura (0.5%), and Fasciola spp. (0.3%). Key risk factors included age 6-10 years (RR = 1.5), rural residence (RR = 1.4), low socioeconomic status (RR = 2.4), poor handwashing practices (RR = 2.1), consuming unwashed vegetables (RR = 1.5), and low maternal education (RR = 1.62).

CONCLUSION: These findings highlight the substantial burden of IPIs among Egyptian preschool and school-aged children, with nearly half infected by at least one parasite. The consistently high prevalence from 2009 to 2021 underscores the urgent need to reevaluate current control measures and prioritize interventions targeting the high-risk groups identified in this study.

PMID:40495169 | DOI:10.1186/s12889-025-23325-8

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Use of Intramuscular Midazolam, Diphenhydramine, and Haloperidol in Acute Agitation Management in a Psychiatric Emergency Department

J Clin Psychopharmacol. 2025 Jun 6. doi: 10.1097/JCP.0000000000002027. Online ahead of print.

ABSTRACT

PURPOSE/BACKGROUND: Intramuscular (IM) lorazepam is administered to acutely agitated patients. During a lorazepam shortage, midazolam was selected as the IM benzodiazepine of choice at this study location. This study aims to explore the efficacy and safety of IM haloperidol, diphenhydramine, and midazolam in treating acutely agitated patients.

METHODS/PROCEDURES: A single center, retrospective chart review was conducted in adult patients who received IM diphenhydramine and haloperidol in combination with either midazolam (midazolam+) or lorazepam (lorazepam+) in a psychiatric emergency department (ED) during 2 identified lorazepam shortage periods. Multivariate ordinary least squares and logistic regression analyses were used to evaluate post-IM patients’ conditions in behavioral activity rating scale (BARS) scores and the safety and tolerability of IM administrations.

FINDINGS/RESULTS: A total of 174 patients met inclusion criteria, with 87 patients in the midazolam+ group (treatment) and 87 patients in the lorazepam+ group (control). Lorazepam+ was associated with a 9.4% greater decrease in BARS score than midazolam+ (P<0.01). Midazolam+ administrations achieved a goal BARS score of 4 more frequently than lorazepam+ (P<0.05). 18.4% more patients received a BARS score of 2, oversedation with lorazepam+ (P<0.05). Lorazepam+ patients took nearly 3 hours (176 min) longer than midazolam+ to return to “normal” baseline behavior (P<0.001). No statistically significant differences were detected in the incidence of hypotensive episodes or oxygen desaturation between groups.

IMPLICATIONS/CONCLUSIONS: This is the first study to examine coadministration of intramuscular midazolam with haloperidol and diphenhydramine. Midazolam+ was effective at managing agitation and may be an alternative to lorazepam+.

PMID:40493972 | DOI:10.1097/JCP.0000000000002027

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Emergency Department Visits With an Influenza Test Ordered or Provided: United States, 2013-2022

NCHS Data Brief. 2024 Dec;(517):1. doi: 10.15620/cdc/168516.

ABSTRACT

INTRODUCTION: Influenza, also known as flu, is a viral respiratory infection. In the 2022-2023 flu season, an estimated 31 million people developed influenza, 360,000 were hospitalized with influenza, and 21,000 died from influenza. To prevent more serious illness, early identification and treatment of influenza is important. This report uses data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to study trends in the use of influenza testing at hospital emergency department (ED)visits from 2013 through 2022.

METHODS: Data in this report are from NHAMCS, a nationally representative annual survey of nonfederal general and short-stay hospitals. Results are presented from 2013 to 2022. Estimates and their corresponding variances were calculated using SAS-callable SUDAAN software. Differences between percentages were evaluated using two-sided significance t tests at the 0.05 level. Linear regression was used to test the significance of slope.

KEY FINDINGS: ED visits by children ages 0-5 years had the highest percentage of influenza tests ordered or provided in 2013 and 2022. Percentages of ED visits with an influenza test ordered or provided increased between 2013 and 2022 for all age groups. Fever and cough were the most frequent first-listed reasons for ED visits at which an influenza test was ordered or provided in both 2013 and 2022. Percentages of ED visits with an influenza test ordered or provided increased within each region of the United States (Northeast, Midwest, South, and West) between 2013 and 2022.

PMID:40493962 | DOI:10.15620/cdc/168516

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Discussion

NCHS Data Brief. 2025 Apr;(212):1.

ABSTRACT

BACKGROUND: Synthetic data has been gaining popularity in many fields as an approach to retain data utility (the validity of inference using synthetic data) and protect confidentiality. However, creating synthetic data for complex surveys remains a challenge.

METHODS: This research compared three approaches to incorporate survey design information (stratification, clustering, and sampling weights) during the synthetic data-generating process using the Research and Development Survey (RANDS), a series of primarily web surveys conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention. Both parametric (logistic and linear regression models) and nonparametric (classification and regression trees [CART]) methods were used to create synthetic data. Data utility and disclosure risk were evaluated via confidence interval overlap, propensity score measurement, and average matching probability for re-identification.

RESULTS: Using the original survey design information as predictors during the synthesis process improved data utility for the parametric method. However, the nonparametric method yielded results with better data utility but slightly higher disclosure risk.

PMID:40493961

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Change in the Primary Measure of Perinatal Mortality for Vital Statistics

Natl Vital Stat Rep. 2025 May 20;(5):1. doi: 10.15620/cdc/174590.

ABSTRACT

BACKGROUND AND OBJECTIVES: Beginning with the 2023 data year, the National Center for Health Statistics (NCHS) will use a different, expanded measure of perinatal mortality for standard publications. This measure, Definition III, includes fetal deaths at 20 weeks of gestation or more and infant deaths younger than 7 days. Definition III replaces Definition I (fetal deaths at 28 weeks of gestation or more and infant deaths younger than 7 days), which has been used in NCHS reports since the 1980s. This change is being made due to the implementation of national reporting of all fetal deaths at 20 weeks of gestation or more as of 2014, allowing for the use of Definition III, which more fully represents the perinatal events most likely to be affected by similar factors. This report describes the reason for this change and compares trends in perinatal mortality rates based on Definition I and Definition III from 2014 to 2022 and differences in the two measures by maternal race and Hispanic origin, age, and state of residence for 2022.

METHODS: Data for perinatal mortality are derived from NCHS’s National Vital Statistics System’s fetal death, birth, and period linked birth/infant death files. Perinatal mortality rates for Definition III are compared with those for Definition I.

RESULTS: In 2022, Definition III comprised 91.4% of perinatal deaths (fetal deaths at 20 weeks of gestation or more and infant deaths younger than 28 days) compared with 60.7% of perinatal deaths captured by Definition I. The perinatal mortality rate for Definition III was about 50% higher than that for Definition I (8.27 and 5.51, respectively, in 2022). Trends in perinatal mortality were similar for both measures during 2014-2022; rates were stable from 2014 through 2016 and then declined from 2016 through 2022. For 2022, patterns by maternal race and Hispanic origin and age were also similar, but more variation in patterns was observed by state.

PMID:40493960 | DOI:10.15620/cdc/174590

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Evaluation of velopharyngeal morphology and surgical recovery in cleft palate patients with different types of velopharyngeal functions

Plast Reconstr Surg. 2025 Jun 10. doi: 10.1097/PRS.0000000000012244. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate key factors related to the velopharyngeal insufficiency (VPI) by evaluating velopharyngeal morphology, soft palate mobility and surgical recovery in cleft palate patients with different types of velopharyngeal function.

METHODS: CT data was used to compare morphology in 49 postoperative velopharyngeal competence (VPC), 39 VPI, and 49 non-cleft individuals. Ultrasound assessed surgical recovery in 87 VPC, 77 VPI, and 75 non-cleft individuals. Soft palate mobility was evaluated in 20 VPC and 17 VPI patients through cephalometric X-rays.

RESULTS: In terms of velopharyngeal morphology, both VPC and VPI groups exhibited shorter velar and hard palate ratios, longer pharyngeal ratio, and lower VP ratio compared to the non-cleft group (p < 0.05), but there were no significant differences between VPC and VPI (p > 0.05). Both groups exhibited significantly lower echo intensity (EI), higher intensity dispersion index (IDI) and lower logarithm unit color velocity (LUCV) values compared to the non-cleft group (p < 0.05). However, the differences in EI, IDI and LUCV between the VPC and VPI groups were not statistically significant (p > 0.05). In contrast, VPC group showed significantly better soft palate mobility compared to VPI, with greater elevation angle (p = 0.042) and higher closure rate (p = 0.001) during speech.

CONCLUSION: The VPC group showed significantly improved soft palate mobility compared to the VPI group; however it was interesting to note the lack of significant differences in velopharyngeal morphology and surgical recovery in postoperative cleft palate patients with VPC and VPI.

PMID:40493959 | DOI:10.1097/PRS.0000000000012244

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Predictors of insulin adherence among patients with Type 2 diabetes: a cross-sectional study

Curr Med Res Opin. 2025 Jun 10:1-18. doi: 10.1080/03007995.2025.2517697. Online ahead of print.

ABSTRACT

OBJECTIVE: Type 2 diabetes (T2D) is a chronic metabolic disorder requiring insulin therapy as β-cell function declines. Despite insulin’s proven efficacy, adherence remains a significant challenge. This study aims to identify factors influencing insulin adherence among patients with T2D to inform targeted clinical interventions.

METHODS: A cross-sectional study was conducted at a tertiary diabetes clinic, recruiting adult patients with T2D on insulin therapy for at least six months. A structured, validated questionnaire was administered in person to collect demographic, clinical, and treatment-related data, along with patient beliefs about insulin. Insulin adherence was defined as taking ≥80% of prescribed doses over the past month. Statistical analysis included univariate and multivariate logistic regression to identify independent predictors of adherence.

RESULTS: Among 111 patients, 49 (44.1%) were adherent, while 62 (55.9%) were non-adherent. Adherence was associated with male gender, higher education levels, smoking abstinence, and adherence to recommended diet and exercise regimens. Non-adherent patients had a higher prevalence of family history of diabetes, more diabetic complications, increased comorbidities, and more frequent hospitalizations. Self-injection of insulin and regular self-monitoring of blood glucose were linked to better adherence, whereas fear of injections and the use of herbal medicine were associated with lower adherence. Negative beliefs about insulin were not significantly different between groups.

CONCLUSION: Insulin adherence in T2D is influenced by lifestyle, clinical, and practical treatment factors rather than negative beliefs alone. Addressing practical barriers, such as fear of injection and alternative treatment use, through patient education and supportive interventions may improve adherence rates.

PMID:40493381 | DOI:10.1080/03007995.2025.2517697

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Social Network Exposure to Commercial Sexual Exploitation and Risk of Harm to Youths

JAMA Netw Open. 2025 Jun 2;8(6):e2513520. doi: 10.1001/jamanetworkopen.2025.13520.

ABSTRACT

IMPORTANCE: Commercial sexual exploitation (CSE) of young people (aged 6-26 years) poses a considerable public health and social challenge. Understanding how social network exposure to CSE influences CSE risk may inform targeted prevention strategies for at-risk youths.

OBJECTIVE: To examine the association between social network exposure to CSE and personal risk of experiencing CSE among youths, with a focus on how exposure interacts with childhood adversities.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data collected between January 1, 2015, and December 31, 2022, from a CSE program at a children’s advocacy center in the northeastern US. Eligibility criteria included referral for suspected or confirmed CSE risk. Social relationships with offenders, peers, and others sharing residential placements were examined as potential sources of exposure. The final analyses were completed on March 20, 2025.

EXPOSURE: Social network exposure to CSE among youths.

MAIN OUTCOMES AND MEASURES: Experiencing CSE was the main outcome. Logistic regression was used to assess associations between youth network exposure to CSE and the risk of experiencing CSE, and social network analyses were conducted to identify patterns in the connections between youths with and without CSE experiences.

RESULTS: A total of 997 youth were included in the study (mean [SD] age, 14.7 [2.1] years; 903 female [90.6%]). Youths exposed to CSE through their social networks were significantly more likely to experience CSE (adjusted odds ratio, 2.92; 95% CI, 1.91-4.47). A significant interaction between social exposure and childhood adversities revealed that social network exposure was associated with higher CSE risk among youth with fewer adversities (adjusted odds ratio, 1.45; 95% CI, 1.22-1.74). Network analyses revealed that youth experiencing CSE were more likely to be connected to one another (β [SE], 0.32 [0.14]), highlighting the clustering of CSE within social networks.

CONCLUSIONS AND RELEVANCE: These findings suggest that prevention strategies should aim to reduce unmitigated exposure to individuals experiencing CSE and focus on fostering supportive and healthy relationships. This study underscores the potential for social network modeling to identify at-risk youth and inform prevention efforts.

PMID:40493369 | DOI:10.1001/jamanetworkopen.2025.13520