Tag: pubmed

J Trop Pediatr. 2025 Feb 5;71(2):fmaf007. doi: 10.1093/tropej/fmaf007.

ABSTRACT

To estimate the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection among hospitalized children aged between 1 and 12 years. A cross-sectional study was conducted to determine the seroprevalence of SARS-CoV-2 antibodies among hospitalized children at a tertiary care hospital in the North-East region of India for a period of 13 months (October 2022-November 2023). The presence of SARS-CoV-2 antibodies was estimated using enzyme-linked immunosorbent assay method. Sociodemographic characteristics and clinical profile of the participants were analyzed. The seroprevalence of SARS-CoV-2 infection among hospitalized children aged between 1 and 12 years was estimated to be 98.4%. This was comparable for children between the age groups 1-5 years (97.9%) and 6-12 years (99.1%) (P-value = .478). The most commonly reported symptoms among the seropositive children were fever (76.8%), nasal stuffiness (69.5%), cough (67.8%), diarrhea (23.6%), and nausea/vomiting (23.2%). None of the study participants had a prior history of laboratory confirmed coronavirus disease (COVID-19) infection in the past and none were vaccinated against COVID-19. Results of the univariate analysis showed that there was no significant difference between the seropositive and seronegative children in the distribution of sociodemographic characteristics, clinical profile, and laboratory findings. Our study observed a remarkably high anti-SARS-CoV-2 seropositivity rate of 98.4%, suggesting a significant under-recognized burden of COVID-19 in the pediatric population. The findings highlight the need for continued preventive measures and the development of age-appropriate vaccination strategies, particularly in tropical settings.

PMID:39965169 | DOI:10.1093/tropej/fmaf007

J Speech Lang Hear Res. 2025 Feb 18:1-14. doi: 10.1044/2024_JSLHR-24-00419. Online ahead of print.

ABSTRACT

PURPOSE: This study uses a voice production model to estimate muscle activation levels and subglottal pressure (P_S) in patients with phonotraumatic vocal hyperfunction (PVH), based on ambulatory measurements of sound pressure level (SPL) and spectral tilt (H₁-H₂). In addition, variations in these physiological parameters are evaluated with respect to different values of the Daily Phonotrauma Index (DPI).

METHOD: The study obtained ambulatory voice data from patients diagnosed with PVH and a matched control group. To infer physiological parameters, ambulatory data were mapped onto synthetic data generated by a physiologically relevant voice production model. Inverse mapping strategies involved selecting model simulations that represented ambulatory distributions using stochastic (random) sampling weighted by probability with which different vowels occur in English. A categorical approach assessed the relationship between different values of DPI and changes in estimated physiological parameters.

RESULTS: Results showed significant differences between the PVH and control groups in key parameters, including statistical moments of H₁-H₂, SPL, P_S, and muscle activity of lateral cricoarytenoid (LCA) and cricothyroid (CT) muscles. Higher DPI values, reflecting more severe PVH, were associated with increased mean LCA activation and decreased LCA variability, along with decreased mean CT activation and increased median P_S. These findings highlight the relationship between muscle activation patterns, P_S, and the severity of vocal pathology as indicated by the DPI. It is hypothesized that a major driver of muscle activation and P_S changes is the variation in maladaptive adjustments (vocal effort) when compensating for the presence of vocal pathology.

CONCLUSIONS: This study demonstrated that noninvasive ambulatory voice data could be used to drive a voice production modeling process, providing valuable insights into underlying physiological parameters associated with PVH. Future research will focus on refining the predictive power of the modeling process and exploring the implications of these findings in further delineating the etiology and pathophysiology of PVH, with the ultimate goal to develop improved methods for the prevention, diagnosis, and treatment of PVH.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.28352720.

PMID:39965156 | DOI:10.1044/2024_JSLHR-24-00419

J Speech Lang Hear Res. 2025 Feb 18:1-24. doi: 10.1044/2024_JSLHR-24-00203. Online ahead of print.

ABSTRACT

PURPOSE: Transgender and gender-diverse (TGD) people and their communication wishes are diverse and heterogeneous, so it is important to understand the situation and goals of each person individually when they arrive for professional interventions. This article describes the development and content validation of the Voice and Communication Situation Questionnaire developed with and for TGD people presumed female at birth (VCSQ^PFAB).

METHOD: Phase 1 included a transdisciplinary literature review and an initial draft of a questionnaire designed to collect self-reports of sociocultural positioning, voice and communication function, and well-being of TGD people presumed female at birth (PFAB). Phase 2 involved collection of information and feedback on the draft questionnaire via focus groups of 31 members of the PFAB community in Germany, Sweden, and the United States.

RESULTS: Revisions were based on the feedback from all focus groups and consensus within the research team. Feedback highlighted the need to develop a clear approach to introducing the questionnaire to respondents and to provide support during its completion so that self-ratings and descriptions capture the client perspective regarding categories built into the questionnaire.

CONCLUSIONS: The final draft of the VCSQ^PFAB provides an adequate framework for a person-centered and culturally responsive approach to working with TGD people PFAB. The tool is now ready to be piloted in clinical settings and statistically analyzed for further psychometric properties.

PMID:39965155 | DOI:10.1044/2024_JSLHR-24-00203

Ann Am Thorac Soc. 2025 Feb 18. doi: 10.1513/AnnalsATS.202406-603OC. Online ahead of print.

ABSTRACT

RATIONALE: Continuity of nursing care is highly valued in the intensive care unit (ICU), but its impact on patient outcomes remains unclear.

OBJECTIVES: To investigate the relationship between nurse continuity and mortality among ICU patients.

METHODS: We performed a retrospective cohort study using electronic health records from 38 ICUs across eighteen hospitals between 2018 and 2020. Cumulative nurse continuity was defined at the shift level as the proportion of 12-hour shifts in which the patient received care from a nurse that had previously provided care to them, up to and including the present shift. Employing a landmark analysis framework, we used logistic regression to assess the relationship between in-hospital mortality and cumulative nurse continuity at each shift, adjusting for potential confounders.

MEASUREMENTS AND MAIN RESULTS: The study included 47,564 ICU patients. In-hospital mortality was 10.4%. Average cumulative nurse continuity increased from 10.2% at shift three to 34.2% at shift 14. In the regression models, increasing cumulative nurse continuity was associated with a modest but statistically significant increase in mortality in some but not all shifts. The results were robust to sensitivity analyses including limiting the cohort to patients receiving mechanical ventilation, excluding patients admitted during the COVID-19 pandemic, using different measures of continuity, and treating continuity as a time-varying covariate using proportional hazards regression.

CONCLUSIONS: Nurse continuity was not associated with lower mortality and may lead to increased mortality in some settings. Further research is needed to understand the mechanisms underlying the association between nurse continuity and ICU outcomes.

PMID:39965150 | DOI:10.1513/AnnalsATS.202406-603OC

MSMR. 2025 Jan 20;32(1):11-17.

ABSTRACT

This retrospective cohort study examined ovarian dysfunction diagnosis incidence among female active component service members in the U.S. military from 2014 to 2023 using medical encounter data from the Defense Medical Surveillance System. Ovarian dysfunction diagnosis incidence gradually increased during this period, driven almost entirely by polycystic ovary syndrome (PCOS), of which the incidence increased from 32.0 cases per 10,000 person-years in 2014 to 60.3 cases per 10,000 person-years in 2023. Increases occurred among all demographic subcategories. This study also assessed independent association between ovarian dysfunction and socio-demographic and medical covariates, including COVID-19 infection and vaccination status. History of obesity had the strongest association with PCOS incidence, with an adjusted incident rate ratio (aIRR) of 2.5 and 95% confidence interval (CI) of 2.3-2.6. COVID-19 infection was modestly associated with PCOS incidence (aIRR 1.2; 95% CI, 1.1-1.3). COVID-19 vaccination status was not independently associated with increased PCOS incidence. A potential contributing factor of increased PCOS diagnosis incidence is that recent updates to the diagnostic criteria enabled more clinical and telehealth diagnoses. The increased incidence may also reflect the increasing rate of obesity and other related health burdens in the U.S. military. Incidence of diagnosis of ovarian dysfunction, driven almost entirely by PCOS, increased steadily among female active component service members from 2014 to 2023. This increase in incidence was observed in all demographic subgroups and had the strongest independent association with pre-existing obesity.

PMID:39965137

Ann Am Thorac Soc. 2025 Feb 18. doi: 10.1513/AnnalsATS.202408-863OC. Online ahead of print.

ABSTRACT

RATIONALE: Randomized controlled trials (RCT) of lung cancer screening (LCS) using computed tomography (CT) documented lung cancer mortality reductions between 7.2%-29.2% compared to chest radiograph (CXR). Women appear to have a greater reduction than men.

OBJECTIVE: To determine why women appear to have better outcomes from LCS compared to Men.

METHODS: Secondary analysis of the National Lung Screening Trial (NLST), a RCT comparing CXR with CT among screen eligible individuals aged 55-74 years. Descriptive statistics and a competing risk proportional hazards model that included an interaction between sex and screening arm were used to examine differences in screening outcomes by sex.

RESULTS: Of 31,530 men and 21,922 women, 648 (2. 1%) and 373 (1.7%) died of lung cancer during the study, respectively. Overall mortality was higher in men: 2771 (8.8%) vs 1198 (5.5%). In an adjusted competing cause of death analysis, the LC mortality subdistribution hazard ratio (sHR) favoring CT was significant in women (sHR=0.74, 95% CI: 0.6, 0.9, p=0.003) but not men (sHR=0.91, 95% CI: 0.78, 1.06, p=0.24). The interaction between screening arm and sex was not significant (p=0.1). COPD and heart disease, more prevalent in men, were independently associated with LC death. LC deaths were consistently greater in the CT arm (vs CXR), for pre-existing COPD and DM in men but not women. Of those with lung cancer, women in the CT arm had 53.7% prevalence of adenocarcinoma (AD) histology, while women in the CXR arm and men in both arms had approximately 36-41% AD prevalence. However, there was no overall difference between sexes in the screening difference for AD lethality.

CONCLUSION: Women in the NLST had a greater reduction in LC mortality, that while not statistically significant, could be the result of more prevalent comorbid disease in men which contributed to greater all-cause and LC mortality. .

PMID:39965131 | DOI:10.1513/AnnalsATS.202408-863OC

MSMR. 2025 Jan 20;32(1):7-10.

ABSTRACT

The Armed Forces Health Surveillance Division (AFHSD) uses a surveillance case definition to identify malignant brain tumors among U.S. active service members. This case definition was applied to the dependent pediatric population of the active component of the Department of the Air Force, which identified 179 malignant brain cancer cases. Those identified pediatric cases were reviewed using multiple data sources. The positive predictive value (PPV) of the AFHSD case definition was found to be 64.5% (95% confidence interval [CI], 55.9-72.5%). In 2019, Webber et al. reported a PPV of 84.3% for brain and other nervous system cancers among U.S. active component officers. The current pediatric study’s lower PPV suggests the case definition may be less effective for pediatric populations, indicating a need for refining surveillance methods for dependent populations. The AFHSD case definition was less effective at identifying malignant brain tumors in the active component Air Force pediatric dependent population, with a lower PPV compared to previous studies of the active component Air Force adult population. In addition, several cases were missed by the AFHSD rules. The PPV of the AFHSD case definition was lower when applied to the Air Force pediatric dependent population (64.5%; 95% CI, 55.9-72.5%) compared to the previously published PPV in the adult population (84.3%). There were an additional 16 cases of malignant brain tumors missed by initial screening utilizing AFHSD incidence rules.

PMID:39965130

MSMR. 2025 Jan 20;32(1):2-6.

ABSTRACT

Traumatic brain injury (TBI) has been a major source of morbidity within military forces during the last 2 decades, but research on the relationship between TBI and medical readiness is limited. This study population included 41,442 service members from the U.S. Navy and Marine Corps who completed a Post-Deployment Health Assessment (PDHA) and a Periodic Health Assessment (PHA). Presence of TBI was ascertained from a screening instrument on the PDHA, and provider determination of medical readiness was abstracted from the PHA. Multivariable logistic regression assessed the association between probable TBI and ‘not medically ready’ (NMR) service member disposition while adjusting for covariates. Overall, 1.8% of the study population screened positive for TBI, and individuals with TBI had a significantly higher prevalence of NMR disposition (7.8%) than those without (3.7%). After adjusting for all covariates, TBI was associated with higher odds of post-deployment NMR disposition (odds ratio 1.5; 95% confidence interval, 1.2-2.0). Deployment-related TBI is associated with medical readiness. Future studies are needed to elucidate the TBI sequelae that may lead to NMR disposition as well as the impact of repeated TBIs. This study identified 54% increased odds of NMR disposition for military personnel with probable TBI following deployment, after adjusting for post-traumatic stress disorder and other covariates.

PMID:39965127

Eur J Cardiothorac Surg. 2025 Feb 18:ezaf050. doi: 10.1093/ejcts/ezaf050. Online ahead of print.

ABSTRACT

OBJECTIVES: Surgical edge-to-edge repair has been proposed to treat tricuspid regurgitation with various etiologies. Two techniques can be used for this repair: the “double-orifice” and the “clover” repairs. This study compares the clinical outcomes of these two techniques.

METHODS: The study enrolled 258 patients who underwent tricuspid edge-to-edge repair out of 2,257 tricuspid valve repairs between January 2001 and December 2021. Patients were categorised into two groups (double-orifice and clover repairs) and analysed using propensity score matching.

RESULTS: The mean age of the 258 patients was 60.8 ± 12.4 years, with 190 females (73.6%) and a mean EuroScore II of 4.6 ± 5.5. Of these, 169 underwent double-orifice repair and 89 clover repair, adjusted to 118 and 66 after matching, respectively. Using the reverse Kaplan-Meier method to account for censored data, the median follow-up duration[Q1-Q3] was 169[76-229] months. Early mortality and morbidity did not differ significantly between the groups. Survival analysis did not show statistical differences in overall mortality and late severe tricuspid regurgitation recurrence between the groups. Similarly, freedoms from late significant tricuspid stenosis (trans-tricuspid pressure gradient ≥5 mmHg) and tricuspid reoperations (8[4.7%] in the double-orifice repair group and 2[2.2%] in the clover repair group) were not significantly different between the groups. The sensitivity analysis, which included the inverse probability of treatment weighting analysis, produced consistent results.

CONCLUSIONS: The surgical outcomes of tricuspid edge-to-edge repair were not statistically significantly different, regardless of the repair techniques. Both methods can be valuable options for tricuspid regurgitation repair.

PMID:39965096 | DOI:10.1093/ejcts/ezaf050

J Am Med Inform Assoc. 2025 Feb 18:ocaf035. doi: 10.1093/jamia/ocaf035. Online ahead of print.

ABSTRACT

OBJECTIVE: This study addresses the significant challenges posed by emerging SARS-CoV-2 variants, particularly in developing diagnostics and therapeutics. Drug repurposing is investigated by identifying critical regulatory proteins impacted by the virus, providing rapid and effective therapeutic solutions for better disease management.

MATERIALS AND METHODS: We employed a comprehensive approach combining mathematical modeling and efficient parameter estimation to study the transient responses of regulatory proteins in both normal and virus-infected cells. Proportional-integral-derivative (PID) controllers were used to pinpoint specific protein targets for therapeutic intervention. Additionally, advanced deep learning models and molecular docking techniques were applied to analyze drug-target and drug-drug interactions, ensuring both efficacy and safety of the proposed treatments. This approach was applied to a case study focused on the cytokine storm in COVID-19, centering on Angiotensin-converting enzyme 2 (ACE2), which plays a key role in SARS-CoV-2 infection.

RESULTS: Our findings suggest that activating ACE2 presents a promising therapeutic strategy, whereas inhibiting AT1R seems less effective. Deep learning models, combined with molecular docking, identified Lomefloxacin and Fostamatinib as stable drugs with no significant thermodynamic interactions, suggesting their safe concurrent use in managing COVID-19-induced cytokine storms.

DISCUSSION: The results highlight the potential of ACE2 activation in mitigating lung injury and severe inflammation caused by SARS-CoV-2. This integrated approach accelerates the identification of safe and effective treatment options for emerging viral variants.

CONCLUSION: This framework provides an efficient method for identifying critical regulatory proteins and advancing drug repurposing, contributing to the rapid development of therapeutic strategies for COVID-19 and future global pandemics.

PMID:39965087 | DOI:10.1093/jamia/ocaf035