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Nevin Manimala Statistics

Prolonged feedback duration does not affect implicit recalibration in a visuomotor rotation task

eNeuro. 2022 Apr 4:ENEURO.0447-21.2022. doi: 10.1523/ENEURO.0447-21.2022. Online ahead of print.

ABSTRACT

Visuomotor rotations are frequently used to study cognitive processes underlying motor adaptation. Explicit aiming strategies and implicit recalibration are two of these processes. A large body of literature indicates that both processes are in fact dissociable and mainly independent components that can be measured using different manipulations in visuomotor rotation tasks. Visual feedback is a crucial element in these tasks, and it therefore plays an important role when assessing explicit re-aiming and implicit recalibration. For instance, researchers have found timing of visual feedback to affect the contribution of implicit recalibration to learning: if feedback is shown only at the end of the movement (instead of continuously), implicit recalibration decreases. Similarly, participants show lower levels of implicit recalibration if visual feedback is presented with a delay (instead of immediately). We thus hypothesized that the duration of feedback availability might also play a role. The goal of this study was thus to investigate the effect of longer versus shorter feedback durations on implicit recalibration in human participants. To this end, we compared three feedback durations in a between-subject design: 200ms, 600ms and 1200ms. Using a large sample size, we found differences between groups to be quite small, to the point where most differences indicated statistical equivalence between group means. We therefore hypothesize that feedback duration, when only endpoint feedback is presented, has a negligible effect on implicit recalibration. We propose that future research investigate the effect of feedback duration on other parameters of adaptation, so as proprioceptive recalibration and explicit re-aiming.Significance statementKnowledge about explicit and implicit processes in motor adaptation forms a crucial aspect in our understanding of motor learning in general. We know that the smallest changes in visual feedback might lead to more or less implicit recalibration, which in turn can lead to changes in performance. One aspect, that has not yet been tested, is whether duration of visual feedback affects implicit recalibration. We find that changes implicit recalibration are very small, if they exist at all. This is an important finding which extends our knowledge about the factors that do or don’t influence implicit recalibration.

PMID:35383109 | DOI:10.1523/ENEURO.0447-21.2022

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Nevin Manimala Statistics

Using human-centred design to tackle COVID-19 vaccine hesitancy for children and youth: a protocol for a mixed-methods study in Montreal, Canada

BMJ Open. 2022 Apr 5;12(4):e061908. doi: 10.1136/bmjopen-2022-061908.

ABSTRACT

INTRODUCTION: To successfully combat COVID-19 vaccine hesitancy and increase uptake, research has demonstrated that interventions are most effective when tailored to meet local needs through active engagement and co-development with communities. This mixed-methods project uses a human-centred design (HCD) approach to understand local perspectives of COVID-19 vaccine hesitancy and develop strategies to enhance vaccine confidence for children and adolescents.

METHODS AND ANALYSIS: Project ECHO (Étude Communautaire sur l’Hésitation vaccinale contre la COVID-19) combines population-based surveys of parents and adolescents with community-based participatory action research to design and pilot strategies to enhance COVID-19 vaccine confidence in two underserved and ethnoculturally diverse neighbourhoods of Montreal, Canada. Two surveys conducted 6 months apart through primary and secondary schools are used to monitor vaccine acceptance and its social determinants among children and youth. Analyses of survey data include descriptive and inferential statistical approaches. Community-led design teams of parents and youth from the two participating neighbourhoods, supported by academic researchers, design thinking experts and community partners, use an HCD approach to: (1) gather data to understand COVID-19 vaccine decision-making among parents and youth in their community and frame a design challenge (inspiration phase); (2) develop an intervention to address the design challenge (ideation phase) and (3) pilot the intervention (implementation phase). Strategies to evaluate the community-led interventions will be co-developed during the implementation phase.

ETHICS AND DISSEMINATION: This study has been approved by the research ethics boards of the Sainte-Justine University Hospital Centre and the University of Montreal. Community design teams will be involved in the dissemination of findings and the design of knowledge translation initiatives that foster dialogue related to COVID-19 vaccination for children and adolescents among community, school and public health stakeholders. Findings will be disseminated through peer-reviewed publications, conference presentations, community forums, policy briefs, and social media content.

PMID:35383090 | DOI:10.1136/bmjopen-2022-061908

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Nevin Manimala Statistics

Exploring how and why social prescribing evaluations work: a realist review

BMJ Open. 2022 Apr 5;12(4):e057009. doi: 10.1136/bmjopen-2021-057009.

ABSTRACT

OBJECTIVE: The evidence base for social prescribing is inconclusive, and evaluations have been criticised for lacking rigour. This realist review sought to understand how and why social prescribing evaluations work or do not work. Findings from this review will contribute to the development of an evidence-based evaluation framework and reporting standards for social prescribing.

DESIGN: A realist review.

DATA SOURCES: ASSIA, CINAHL, Embase, Medline, PsycINFO, PubMed, Scopus Online, Social Care Online, Web of Science and grey literature.

ELIGIBILITY CRITERIA: Documents reporting on social prescribing evaluations using any methods, published between 1998 and 2020 were included. Documents not reporting findings or lacking detail on methods for data collection and outcomes were excluded.

ANALYSIS: Included documents were segregated into subcases based on methodology. Data relating to context, mechanisms and outcomes and the programme theory were extracted and context-mechanism-outcome configurations were developed. Meta-inferences were drawn from all subcases to refine the programme theory.

RESULTS: 83 documents contributed to analysis. Generally, studies lacked in-depth descriptions of the methods and evaluation processes employed. A cyclical process of social prescribing evaluation was identified, involving preparation, conducting the study and interpretation. The analysis found that coproduction, alignment, research agency, sequential mixed-methods design and integration of findings all contributed to the development of an acceptable, high-quality social prescribing evaluation design. Context-mechanism-outcome configurations relating to these themes are reported.

CONCLUSIONS: To develop the social prescribing evidence base and address gaps in our knowledge about the impact of social prescribing and how it works, evaluations must be high quality and acceptable to stakeholders. Development of an evaluation framework and reporting standards drawing on the findings of this realist review will support this aim.

PROSPERO REGISTRATION NUMBER: CRD42020183065.

PMID:35383075 | DOI:10.1136/bmjopen-2021-057009

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Children with cancer and their families after active treatment: analyses of biopsychosocial needs and implications for healthcare – a study protocol

BMJ Open. 2022 Apr 5;12(4):e055633. doi: 10.1136/bmjopen-2021-055633.

ABSTRACT

INTRODUCTION: Patients and families affected by paediatric cancer experience psychosocial burden not only during active treatment but also during follow-up care. Use of health services during follow-up treatment should be organised according to patients’ and family members’ needs with regard to their physical and mental situation. This study aims (1) at analysing healthcare use (medical and psychosocial) and associated factors in follow-up care of paediatric cancer patients and (2) at investigating the psychosocial situation and support needs of children and their families during follow-up care. Based on the results, recommendations for healthcare planning and for the development of new and the optimisation of existing support offers will be derived.

METHODS AND ANALYSIS: We will conduct a prospective observational study using a naturalistic explorative design with quantitative and qualitative methods. Paediatric cancer patients in follow-up care, their parents and siblings will be invited to fill out a questionnaire at three measurement points (baseline, 6 months follow-up, 12 months follow-up; target n=252 complete data sets over all measurement points). Additionally, parents will be interviewed using a semistructured interview guideline (target n=15-20) at baseline. Quantitative data will be analysed using descriptive statistics, linear mixed models and regression models. Moreover, explorative analyses will be conducted. Qualitative data will be analysed using qualitative content analyses.

ETHICS AND DISSEMINATION: The study was approved by the Local Psychological Ethics Committee (LPEK-0281). Our findings will be published in scientific, peer-reviewed journals and presented to clinicians and researchers on conferences. To assure that results will be available to affected patients and families, a lay summary will be written and disseminated using several ways (upload on the homepage of the research group, upload on the homepage of the psychosocial working group in the Society for Paediatric Oncology/Haematology in Germany, sending to relevant patient organisations).

TRIAL REGISTRATION NUMBER: DRKS00025289.

PMID:35383068 | DOI:10.1136/bmjopen-2021-055633

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Improving Outcomes through a Neonatal Abstinence Syndrome Collaborative in Maryland

Am J Perinatol. 2022 Apr 5. doi: 10.1055/a-1817-5522. Online ahead of print.

ABSTRACT

OBJECTIVES: A statewide Maryland Perinatal Neonatal Quality Collaborative, facilitated by the Maryland Patient Safety Center (MPSC), identified the three specific, measurable, attainable, relevant, and time-limited (SMART) aims to improve outcomes of NAS care: (1) to reduce hospital length of stay (LOS), (2) to reduce interhospital transfers, and (3) to reduce 30-day readmission rates of infants with neonatal abstinence syndrome (NAS).

STUDY DESIGN: The Maryland collaborative developed a bundle of best practices for care of infants with NAS. MPSC partnered with Vermont Oxford Network (VON) to utilize the VON NAS toolkit and provide its standardized NAS educational curriculum to address the three objectives for participating birthing hospitals. Efforts began in quarter 4 (Q4) 2016 and continued for two years. Thirty-one of Maryland’s 32 delivery hospitals (97%) participated in the two-year collaborative. Additionally, one specialty pediatric hospital with a NAS unit participated in the group learnings. Participating facilities implemented components of the MPSC NAS bundle and provided their staff caring for infants with NAS and their mothers access to the VON standardized educational curriculum. MPSC partnered with VON to conduct two audits of implementation of policies and procedures in Q1 2016 and Q3 2018. The Maryland Department of Health supplied quarterly aggregate hospital information on LOS, interhospital transfers, and 30-day readmissions of infants with a discharge diagnosis of ICD-10 P96.1.

RESULTS: Among term infants with NAS with total hospital stay greater than 5 days, we observed a non-significant reduction in both mean and median LOS of 1.5 days. In this same group, the rate of interhospital transfers fell significantly from 20.1% in 2016 to 13.8% in 2017 and to 11.0% in 2018.

CONCLUSION: The best practice bundle created by the Maryland collaborative was associated with a reduction in the percentage of infants with NAS who required interhospital transfer, thereby reducing family disruption.

PMID:35381608 | DOI:10.1055/a-1817-5522

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The Effect of Multichannel and Channel-free Hearing Aids on Spectral-Temporal Resolution and Speech Understanding in Noise

J Am Acad Audiol. 2022 Apr 5. doi: 10.1055/a-1817-6840. Online ahead of print.

ABSTRACT

BACKGROUND: Identifying and understanding speech is difficult for individuals with sensorineural hearing loss, especially in noisy environments. Possible causes include less audibility of the signal, impaired temporal resolution and low selectivity of frequency. The hearing aid is the most common option used to minimize the problems faced by individuals with sensorineural hearing loss.

PURPOSE: To investigate the effects of multichannel and channel-free hearing aid signal processing techniques on spectral-temporal resolution and speech understanding in noise.

RESEARCH DESIGN: A experimental study was used in which the determined tests were applied to the participants.

STUDY SAMPLE: Thirty-four individuals with bilateral symmetrical sensorineural hearing loss between the ages of 18-70 were included in our study.

DATA COLLECTION AND ANALYSIS: Spectral-temporally modulated ripple test, random gap detection test (RDGT) and Turkish matrix test were applied to the participants using multichannel and channel-free hearing aids. All the data obtained were compared statistically in terms of the performances of the hearing aids.

RESULTS: There was no significant difference between multichannel and channel-free hearing aids for spectral resolution and speech understanding in noise tests (p>0.05). While there was no significant difference between the two hearing aids for 500 Hz and 4000 Hz RGDT in temporal resolution measurement (p>0.05); for 1000 Hz (p=.045), 2000 Hz (p=.046) and composite RGDT (p=.001), statistically significant better performances were obtained with the channel-free hearing aids.

CONCLUSIONS: It is thought that faster processing of the incoming signal in the channel-free hearing aids improves the temporal resolution performance. It is predicted that our study findings might help to determine the signal processing technique that will maximize the communication skills of the patients in various conditions.

PMID:35381603 | DOI:10.1055/a-1817-6840

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Disclosure and help-seeking behaviors related to sexual and physical violence in childhood and adolescence: Results from the Namibia Violence Against Children and Youth Survey

Child Abuse Negl. 2022 Apr 2;128:105624. doi: 10.1016/j.chiabu.2022.105624. Online ahead of print.

ABSTRACT

BACKGROUND: Violence disclosure and help-seeking can mitigate adverse health effects associated with childhood violence, but little is known about facilitators and barriers of disclosure and help-seeking behaviors in sub-Saharan Africa.

OBJECTIVE: To understand factors associated with disclosure and help-seeking to inform care.

PARTICIPANTS AND SETTING: Participants aged 13-24 years old in the 2019 Namibia Violence Against Children and Youth Survey (VACS).

METHODS: We assessed the prevalence of victimization, disclosure, and help-seeking and examined factors associated with violence disclosure and help-seeking, separately, by gender.

RESULTS: 4211 girls and 980 boys participated in the Namibia VACS. The prevalence of childhood sexual violence differed significantly by gender (15.7% among girls, 9.8% among boys), but physical violence prevalence did not differ by gender. Among victims of sexual violence, 57.3% of girls disclosed and 10.4% sought help, compared with only 30.7% and 3.2% of boys. Among victims of physical violence, 61.1% of girls and 53.4% of boys disclosed, and 16.9% of girls and 17.7% of boys sought help. Older age, social support, and experiencing more types of violence were associated with sexual violence disclosure among boys, but none of these factors were associated with sexual violence disclosure among girls. Lower education, perpetrator type, and witnessing violence were associated with physical violence disclosure among girls, while peer support and perpetrator type were associated with physical violence disclosure among boys.

CONCLUSIONS: Factors associated with childhood violence differed by gender and violence type in Namibia, highlighting a need for gender-specific violence services to facilitate violence disclosure and help-seeking.

PMID:35381545 | DOI:10.1016/j.chiabu.2022.105624

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Nevin Manimala Statistics

Complications, readmission rates, and in-hospital lengths-of-stay in octogenarian vs. non-octogenarians following total knee arthroplasty: An analysis of over 1.7 million patients

Knee. 2022 Apr 2;35:213-219. doi: 10.1016/j.knee.2022.03.012. Online ahead of print.

ABSTRACT

INTRODUCTION: Studies investigating complications between octogenarians and non-octogenarians undergoing primary total knee arthroplasty (TKA) are limited. Therefore, we investigated whether octogenarians are at greater odds of: (1) in-hospital lengths of stay (LOS) (2) readmission rates, (3) medical complications, and (4) hardware complications compared to non-octogenarians following TKA.

METHODS: A retrospective query of the PearlDiver database isolated 1,775,460 patients who underwent primary TKA from 2005 to 2014. Patients aged 80 and above represented the study cohort (n = 295,908) and patients 65 to 79 represented the control cohort (n = 1,479,552). Study group patients were matched to controls in a 1:5 ratio according to gender and medical comorbidities. Pearson’s Chi Square and logistic regression were used to analyze the primary outcomes of the study which included 90-day medical complications, 90-day readmission rates, 2-year implant-related complications, and in-hospital LOS. A p-value less than 0.001 was statistically significant.

RESULTS: Octogenarians were found to have significantly higher incidence and odds of 90-day readmission rates (10.59 vs. 9.35%; OR: 1.15, p < 0.0001) and significantly longer in-hospital LOS (3.69 days ± 1.95 vs. 3.23 days ± 1.83, p < 0.0001) compared to controls. Octogenarians also had equal incidence and odds of developing any medical complication (1.26 vs. 1.26%; OR: 0.99, p = 0.99) and lower incidence and odds (1.67 vs. 1.93%; OR: 0.86, p < 0.001) of implant-related complications compared to controls.

CONCLUSION: Octogenarians undergoing primary TKA have similar odds of medical related complications and lower odds of implant-related complications compared to non-octogenarian patients, whereas readmission rates and in-hospital LOS are greater.

PMID:35381573 | DOI:10.1016/j.knee.2022.03.012

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3D patient-derived tumor models to recapitulate pediatric brain tumors In Vitro

Transl Oncol. 2022 Apr 2;20:101407. doi: 10.1016/j.tranon.2022.101407. Online ahead of print.

ABSTRACT

Brain tumors are the leading cause of cancer-related deaths in children. Tailored therapies need preclinical brain tumor models representing a wide range of molecular subtypes. Here, we adapted a previously established brain tissue-model to fresh patient tumor cells with the goal of establishing3D in vitro culture conditions for each tumor type.Wereported our findings from 11 pediatric tumor cases, consisting of three medulloblastoma (MB) patients, three ependymoma (EPN) patients, one glioblastoma (GBM) patient, and four juvenile pilocytic astrocytoma (Ast) patients. Chemically defined media consisting of a mixture of pro-neural and pro-endothelial cell culture medium was found to support better growth than serum-containing medium for all the tumor cases we tested. 3D scaffold alone was found to support cell heterogeneity and tumor type-dependent spheroid-forming ability; both properties were lost in 2D or gel-only control cultures. Limited in vitro models showed that the number of differentially expressed genes between in vitro vs. primary tissues, are 104 (0.6%) of medulloblastoma, 3,392 (20.2%) of ependymoma, and 576 (3.4%) of astrocytoma, out of total 16,795 protein-coding genes and lincRNAs. Two models derived from a same medulloblastoma patient clustered together with the patient-matched primary tumor tissue; both models were 3D scaffold-only in Neurobasal and EGM 1:1 (v/v) mixture and differed by a 1-mo gap in culture (i.e., 6wk versus 10wk). The genes underlying the in vitrovs. in vivo tissue differences may provide mechanistic insights into the tumor microenvironment. This study is the first step towards establishing a pipeline from patient cells to models to personalized drug testing for brain cancer.

PMID:35381525 | DOI:10.1016/j.tranon.2022.101407

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Pivot shift and Lachman test simulation-based exploration in juvenile populations for accurately predicting anterior tibial translation

J Biomech. 2022 Mar 29;136:111069. doi: 10.1016/j.jbiomech.2022.111069. Online ahead of print.

ABSTRACT

Advancements in technology and finite element software have made it possible to develop simulation-based exploration of subject-specific tibiofemoral joint kinematics. In this study, the goal was to develop baseline knee models that accurately predict anterior tibial displacement when undergoing a Lachman and pivot shift test. A total of 22 subject-specific adolescent tibiofemoral joint finite element representations were developed using FEBio. The models were subject to loading conditions established in the literature to simulate the two clinical tests. Anterior tibial translations that were measured through clinical, historical controls were used to validate the proposed models. A 95% confidence interval showed that the simulated Lachman and pivot shift tests of the juvenile knee models were not statistically different from the historical controls and were in accordance with the anterior tibial translations that were measured experimentally. Clinically, simulations are important in advancing the field of knee finite element modeling, particularly in pediatric applications where the surgeon must balance restoring full function in a patient who is skeletally immature and where the growth plate is vulnerable. The methodologies created in developing these foundational models can be utilized to build more anatomically complex finite element representations that can both predict ligament stresses in response to dynamic activities and analyze the effects of different insertion sites.

PMID:35381503 | DOI:10.1016/j.jbiomech.2022.111069