Tag: pubmed

J Clin Psychiatry. 2021 Aug 24;82(5):20m13723. doi: 10.4088/JCP.20m13723.

ABSTRACT

Objective: Insomnia is prevalent and is associated with a range of negative sequelae. Cognitive behavioral treatment for insomnia (CBT-I) is the recommended intervention, but availability is limited. Telehealth provides increased access, but its efficacy is not certain. The objective of this study was to compare the efficacy of CBT-I delivered by telehealth to in-person treatment and to a waitlist control.

Methods: Individuals with DSM-5 insomnia disorder (n = 60) were randomized to telehealth CBT-I, in-person CBT-I, or 8-week waitlist control. CBT-I was delivered over 6-8 weekly sessions by video telehealth or in-person in an outpatient clinic. Follow-up assessments were at 2 weeks and 3 months posttreatment. The Insomnia Severity Index (ISI) was the primary outcome. Change in ISI score was compared between the CBT-I group in an intent-to-treat, noninferiority analysis using an a priori margin of -3.0 points. All analyses were conducted using mixed-effects models. Data collection occurred from November 2017-July 2020.

Results: The mean (SD) change in ISI score from baseline to 3-month follow-up was -7.8 (6.1) points for in-person CBT-I, -7.5 (6.9) points for telehealth, and -1.6 (2.1) for waitlist, and the difference between the CBT-I groups was not statistically significant (t₂₈ = -0.98, P = .33). The lower confidence limit of this between-group difference in the mean ISI changes was greater than the a priori margin of -3.0 points, indicating that telehealth treatment was not inferior to in-person treatment. There were significant improvements on most secondary outcome measures but no group differences.

Conclusions: Telehealth CBT-I may produce clinically significant improvements in insomnia severity that are noninferior to in-person treatment. CBT-I is also associated with significant gains across a range of domains of functioning. Telehealth is a promising option for increasing access to treatment without loss of clinical gains.

Trial Registration: ClinicalTrials.gov identifier: NCT03328585.

PMID:34428360 | DOI:10.4088/JCP.20m13723

J Basic Clin Physiol Pharmacol. 2021 Jun 22. doi: 10.1515/jbcpp-2020-0183. Online ahead of print.

ABSTRACT

OBJECTIVES: There is extensive data pointing to offspring outcomes related to maternal life incidents, but there is less research concerning the association between paternal life events and progeny brain development and behaviour. As male gametogenesis is a continuous process, the incidences happening in life can modify the epigenetic regulation, altering the offspring’s development and behaviour. The present study evaluates the effects of paternal stress during different life periods on their offspring’s learning ability, memory, morphological and biochemical changes in the prefrontal cortex and hippocampus in the rat model.

METHODS: Four weeks’ old male rats were subjected to five variable stressors at the rate of one per day. Stress received male rats were bred with naive female rats for 1 to 3 nights. The offspring’s learning and memory were assessed by the Morris water maze test and automated Y maze. Following behavioural studies, offspring were euthanized to examine global DNA methylation, neurotransmitter levels, namely acetylcholine, glutamate in the hippocampus and frontal cortex.

RESULTS: The offspring of stress-induced animals exhibited a delay in acquiring learning and defect in memory and altered global DNA methylation in the hippocampus (p=0.000124). There was significant reduction of acetylcholine and glutamate levels in hippocampus (p=0.000018, p=0.00001, respectively) and in prefrontal cortex (p=0.00001, p=0.00001, respectively). HPA axis of offspring was altered considerably (p=0.00001). The histomorphometry of the prefrontal cortex and different hippocampal regions revealed a statistically significant (p<0.05) reduction in neuronal numbers in the offspring of stressed animals compared to that of control. These impacts were markedly high in the offspring of fathers who received stress during both pubertal and adult periods.

CONCLUSIONS: The findings of this study demonstrate that paternal stress can impact offspring learning and memory.

PMID:34428362 | DOI:10.1515/jbcpp-2020-0183

PLoS One. 2021 Aug 24;16(8):e0256636. doi: 10.1371/journal.pone.0256636. eCollection 2021.

ABSTRACT

INTRODUCTION/BACKGROUND: Dengue fever remains a public health threat despite being preventable. A solution to the constant problem of dengue infection will require active intervention and a paradigm shift. Assessing perceived risk and correlating it with the attitude and practice of the community will help in designing appropriate measures. However, possible instruments for these assessments come with limitations.

OBJECTIVE: The aim is to develop and validate a new scoring-based questionnaire, using dual statistical approaches to measure risk perception, attitude, and practices (RPAP) related to dengue in the community.

METHODS: The RPAP questionnaire was developed bilingually using the International Society for Pharmacoeconomics and Outcome Research (ISPOR) guidelines. Content analysis was reviewed scrupulously by four expert panels. The initial 35-item scale was tested among 253 Malaysian respondents recruited non-probabilistically via multiple online platforms. Two statistical methods were employed to measure the construct validity: Exploratory Factor Analysis (EFA) as part of the Classical Test Theory (CTT) measurement, while Rasch Measurement Analysis (Rasch) was performed for the Item Response Theory (IRT) measurement. All results were cross-validated with their counterpart to ensure stability. Confirmatory Factor Analysis (CFA) was used to obtain a model fit index.

RESULTS: 29 questions were retained after the final analysis. Both EFA and Rasch analysis detect multidimensionality. Nine latent factors were extracted from EFA, while only eight factors remained in the final model following CFA: 1) perceived susceptibility; 2) perceived severity; 3) perceived barrier; 4) perceived benefit; 5) cues to action; 6) self-efficacy; 7) attitude; and 8) practice. All items had adequate factor loadings and showed good internal consistency. The final model after CFA achieved a good fit with an RMSEA value of 0.061, SRMR of 0.068, PNFI of 0.649, and GFI of 0.996.

CONCLUSION: The RPAP questionnaire contains 29 items and is a reliable and accurate psychometric instrument for measuring the risk perception of dengue fever, attitude, and practice of the community in dengue prevention. The Rasch measurement provides additional rigour to complement the CTT analysis. This RPAP questionnaire is suitable for use in studies related to dengue prevention in the community.

PMID:34428257 | DOI:10.1371/journal.pone.0256636

J Community Psychol. 2021 Aug 24. doi: 10.1002/jcop.22697. Online ahead of print.

ABSTRACT

A comprehensive community status assessment of an Ohio urban county’s crisis response (CR) system explored the experiences of its behavioral health services’ clients and providers to surface themes characterizing the system’s responsiveness and identifying opportunities for improvements. Forty-eight focus groups and two online surveys were conducted. Data were analyzed using qualitative content analysis and descriptive statistics. The greatest areas of needed improvement ascertained by this effort are in increased CR system resources, more efficient use of resources, and capacity enhancements in nine areas: the mobile crisis team, CR protocols, psychiatric inpatient and crisis stabilization beds, stabilization admission for eligible persons, stabilization services for in-crisis but admission-ineligible persons, continuity of care, research into child versus adult CR systems, Provider Emergency Support Program, and first responder crisis intervention training. The assessment provides a foundation for the county to identify further opportunities for system scale-up.

PMID:34428323 | DOI:10.1002/jcop.22697

Health Econ. 2021 Aug 24. doi: 10.1002/hec.4413. Online ahead of print.

ABSTRACT

The classic “logistic” model has provided a realistic model of the behaviour of Covid-19 in China and many East Asian countries. Once these countries passed the peak, the daily case count fell back, mirroring its initial climb in a symmetric way, just as the classic model predicts. However, in Italy and Spain and most other Western countries, the first wave of the epidemic was very different. The daily count fell back gradually from the peak but remained stubbornly high. The reason for the divergence from the classical model remain unclear. We take an empirical stance on this issue and develop a model framework based upon the statistical characteristics of the time series. With the possible exception of China, the workhorse logistic model is decisively rejected against more flexible alternatives.

PMID:34428329 | DOI:10.1002/hec.4413

PLoS One. 2021 Aug 24;16(8):e0255856. doi: 10.1371/journal.pone.0255856. eCollection 2021.

ABSTRACT

Collision of falling in the mechanical harvesting process of sweet potato is one of the main causes of epidermal destruction and damage to sweet potato tubers. Therefore, a sweet potato mechanical characteristic test and a full-factor sweet potato drop test were designed. Based on the analysis of the fitting mathematical model, the impact of the drop height, collision material and sweet potato chunk size on the damage of the sweet potato were studied. The mathematical models were established by fitting analysis of the IBM SPSS Statistics 22 software between the drop height and the sweet potato chunk size with each test index (impact force, impact stress, broken skin area and damaged area). The critical epidermal destruction height and the critical damage height of a certain size of sweet potato when it collides with a collision material can be calculated by the mathematical model, and the critical epidermal destruction mass and critical damage mass of sweet potato when it falls from a certain height and collides with a collision material can also be calculated. Then a series of critical values (including critical epidermal destruction force value, critical epidermal destruction impact stress, critical damage force value, critical damage impact stress) of mechanical properties of sweet potato were obtained. The results show that the impact deformation of sweet potato includes both elastic and plastic ones, and has similar stress relaxation characteristics. The critical damage impact stress of sweet potato is that the average value of the impact stress on the contact surface is less than it’s Firmness. The results provided a theoretical basis for understanding the collision damage mechanism of sweet potato and how to reduce the damage during harvest.

PMID:34428245 | DOI:10.1371/journal.pone.0255856

PLoS One. 2021 Aug 24;16(8):e0256577. doi: 10.1371/journal.pone.0256577. eCollection 2021.

ABSTRACT

BACKGROUND: Since 2008, the Canadian Institutes of Health Research (CIHR) has mandated that studies it funds either in whole or in part are required to publish their results as open access (OA) within 12 months of publication using either online repositories and/or OA journals. Yet, there is evidence that authors are poorly compliant with this mandate. Specifically, there has been an apparent decrease in OA publication after 2015, which coincides with a change in the OA policy during the same year. One particular policy change that may have contributed to this decline was lifting the requirement that authors deposit their article in an OA repository immediately upon publication. We investigated the proportion of OA compliance of CIHR-funded studies in the period before and after the policy change of 2015 with manual confirmation of both CIHR funding and OA status.

METHODS AND FINDINGS: We identified CIHR-funded studies published between the years 2014 to 2017 using a comprehensive search in the Web of Science (WoS). We took a stratified random sample from all four years (i.e. 2014 to 2017), with 250 studies from each year. Two authors independently reviewed the final full-text publications retrieved from the journal web page to determine to confirm CIHR funding, as indicated in the acknowledgements or elsewhere in the paper. For each study, we also collected bibliometric data that included citation count and Altmetric attention score Statistical analyses were conducted using two-tailed Fisher’s exact test with relative risk (RR). Among the 851 receiving CIHR funding published from 2014 to 2017, the percentage of CIHR-funded studies published as OA significantly decreased from 79.6% in 2014 to 70.3% in 2017 (RR = 0.88, 95% CI: 0.79-0.99, P = 0.028). When considering all four years, there was no significant difference in the percentage of CIHR-funded studies published as OA in both 2014 and 2015 compared to both 2016 and 2017 (RR = 0.97, 95% CI: 0.90-1.05, P = 0.493). Additionally, OA publications had significantly higher citation count (both in year of publication and in total) and higher attention scores (P<0.05).

CONCLUSIONS: Overall, we found that there was a significant decrease in the proportion of CIHR funded studies published as OA from 2014 compared to 2017, though this difference did not persist when comparing both 2014-2015 to 2016-2017. The primary limitation was the reliance of self-reported data from authors on CIHR funding status. We posit that this decrease may be attributable to CIHR’s OA policy change in 2015. Further exploration is warranted to both validate these studies using a larger dataset and, if valid, investigate the effects of potential interventions to improve the OA compliance, such as use of a CIHR publication database, and reinstatement of a policy for authors to immediately submit their findings to OA repositories upon publication.

PMID:34428248 | DOI:10.1371/journal.pone.0256577

PLoS One. 2021 Aug 24;16(8):e0255888. doi: 10.1371/journal.pone.0255888. eCollection 2021.

ABSTRACT

OBJECTIVES: Several systematic reviews and meta-analyses on short-term outcomes between total hip arthroplasty (THA) through direct anterior approach (DAA) compared to THA through conventional (including anterior, anterolateral, lateral transgluteal, lateral transtrochanteric, posterior, and posterolateral) approaches (CAs) in treatment of hip diseases and fractures showed contradicting conclusions. Our aim was to draw definitive conclusions by conducting both a fixed and random model meta-analysis of quality randomized controlled trials (RCTs) and by comparison with related meta-analyses.

DESIGN: We performed a systematic literature search up to May 2020 to identify RCTs, comparing THA through DAA with THA through CAs and related meta-analyses. We conducted risk of bias and level of evidence assessment in accordance with the Cochrane’s Risk of Bias 2 tool and with the guidelines of the Centre for Evidence-Based Medicine. We estimated mean differences (MD) with 95% confidence intervals (CI) through fixed and random effects models, using the DerSimonian and Laird method. Heterogeneity was assessed using tau-square (τ2). Our conclusions take into account the overall results from related meta-analyses.

RESULTS: Nine studies on THA through DAA met the criteria for final meta-analysis, involving 998 patients. Three studies were blinded RCTs with a level I evidence, the other 6 studies were non-blinded RCTs with a level II evidence. We came to the following results for THA through DAA compared to THA through CAs: operation time (I2 = 92%, p<0.01; fixed: MD = 15.1, 95% CI 13.1 to 17.1; random: MD = 18.1, 95% CI 8.6 to 27.5); incision length (I2 = 100%, p<0.01; fixed: MD = -2.9, 95% CI -3.0 to -2.8; MD = -1.1, 95% CI -4.3 to 2.0); intraoperative blood loss (I2 = 87%, p<0.01; fixed: MD = 51.5, 95% CI 34.1 to 68.8; random: MD = 51.9, 95% CI -89.8 to 193.5); VAS 1 day postoperatively (I2 = 79%, p = 0.03; fixed: MD = -0.8, 95% CI -1.2 to -0.4; random: MD = -0.9, 95% CI -2.0 to 0.15); HHS 3 months postoperatively (I2 = 52%, p = 0.08; fixed: MD = 2.8, 95% CI 1.1 to 4.6; random: MD = 3.0, 95% CI -0.5 to 6.5); HHS 6 months postoperatively (I2 = 0%, p = 0.67; fixed: MD = 0.9, 95% CI -1.1 to 2.9; random: MD = 0.9, 95% CI -1.1 to 2.9); HHS 12 months postoperatively (I2 = 0%, p = 0.79; fixed: MD = 0.7, 95% CI -0.9 to 2.4; random: MD = 0.7, 95% CI -0.9 to 2.4). We compared our findings with 7 related meta-analyses.

CONCLUSIONS: Considering the results of our meta-analysis and the review of related meta-analyses, we can conclude that short-term outcomes of THA through DAA were overall better than THA through CAs. THA through DAA had a shorter incision length, a tendency towards a lower pain VAS 1 day postoperatively and better early postoperative functional outcome than THA through CAs. The intraoperative blood loss showed indifferent results. THA through DAA had a longer operation time than THA through CAs.

PMID:34428236 | DOI:10.1371/journal.pone.0255888

PLoS One. 2021 Aug 24;16(8):e0256256. doi: 10.1371/journal.pone.0256256. eCollection 2021.

ABSTRACT

INTRODUCTION: A family-centered care model (FCCM) providing family-based HIV services, rather than separate adult/pediatric services, has been proposed to increase pediatric retention and treatment adherence.

MATERIALS AND METHODS: Eight health-care facilities in the Hhohho region of Eswatini were randomized to implement FCCM (n = 4) or continue standard-of-care (SOC) separate adult/pediatric clinics (n = 4). HIV-positive children and caregivers were enrolled; caregiver interview and child/caregiver chart abstraction were done at enrollment and every three months; pediatric viral load was evaluated at enrollment and every six months through 12 months. Because of study group differences in 12-month viral load data availability (89.4% FCCM and 72.0% SOC children had 12-month viral load), we used three separate analyses to evaluate the effects of FCCM on children’s viral suppression (<1,000 copies/mL) and undetectable virus (<400 copies/mL) at 12 months. In the first analysis, all children with missing viral outcome data were excluded from the analysis (modified intent to treat, mITT). The second analysis used inverse probability of missingness weighted logistic regression to estimate the effect of FCCM on 12-month viral outcomes compared to SOC (weighted mITT). For the third approach, missing virologic outcome data were imputed as virologic failure (imputed ITT). We also examined factors associated with viral suppression at 12 months using multivariable logistic regression.

RESULTS: We enrolled 379 HIV-positive children and 363 caregivers. Among all children at enrollment, viral suppression and undetectability was 78.4% and 73.9%, respectively, improving to 90.2% and 87.3% at 12 months. In mITT and weighted mITT analyses, there was no significant difference in children’s 12-month viral suppression between FCCM and SOC groups (89.2% and 91.6%, respectively). Using imputed ITT, there was a modest increase in 12-month viral suppression in FCCM versus SOC children (79.7% and 69.8%, respectively, p = 0.051) and 12-month undetectability (78.7% and 65.7%, respectively, p = 0.015). Among the 255 children suppressed at enrollment, more FCCM versus SOC children (98.0% versus 95.3%) were suppressed at 12-months, but this was not statistically significant in mITT or weighted mITT analyses, with a marginally significant difference using imputed mITT analysis (p = 0.042). A higher proportion of children suppressed at enrollment had undetectable viral load at 12 months in FCCM versus SOC children (98.0% versus 92.5%), a statistically significant difference across analytical methods. Among the 61 children unsuppressed at enrollment, achieving suppression was higher among SOC versus FCCM children, but this difference was not statistically significant and included only 38 children; and there were no significant differences in detectable viral load at 12 months. There were no significant differences between study groups in retention or ART adherence at 12 months for children or caregivers. Factors associated with lack of viral suppression/detectability at 12 months included lack of viral suppression at enrollment and having a younger caregiver (age <25 years).

CONCLUSIONS: FCCM in Eswatini was associated with a modest increase in viral suppression/undetectability at 12-months; 12-month retention and adherence did not differ by study group for children or caregivers. High levels of suppression and retention in both groups may have limited our ability to detect a difference.

TRIAL REGISTRATION: NCT03397420; ClinicalTrials.gov.

PMID:34428241 | DOI:10.1371/journal.pone.0256256

PLoS One. 2021 Aug 24;16(8):e0255703. doi: 10.1371/journal.pone.0255703. eCollection 2021.

ABSTRACT

The distributive power of the arithmetic operators: multiplication, division, addition, and subtraction, gives the arithmetic optimization algorithm (AOA) its unique ability to find the global optimum for optimization problems used to test its performance. Several other mathematical operators exist with the same or better distributive properties, which can be exploited to enhance the performance of the newly proposed AOA. In this paper, we propose an improved version of the AOA called nAOA algorithm, which uses the high-density values that the natural logarithm and exponential operators can generate, to enhance the exploratory ability of the AOA. The addition and subtraction operators carry out the exploitation. The candidate solutions are initialized using the beta distribution, and the random variables and adaptations used in the algorithm have beta distribution. We test the performance of the proposed nAOA with 30 benchmark functions (20 classical and 10 composite test functions) and three engineering design benchmarks. The performance of nAOA is compared with the original AOA and nine other state-of-the-art algorithms. The nAOA shows efficient performance for the benchmark functions and was second only to GWO for the welded beam design (WBD), compression spring design (CSD), and pressure vessel design (PVD).

PMID:34428219 | DOI:10.1371/journal.pone.0255703