Longitudinal Study Research Articles

TEMPTED: time-informed dimensionality reduction for longitudinal microbiome studies

Longitudinal studies are crucial for understanding complex microbiome dynamics and their link to health. We introduce TEMPoral TEnsor Decomposition (TEMPTED), a time-informed dimensionality reduction method for high-dimensional longitudinal data that treats time as a continuous variable, effectively characterizing temporal information and handling varying temporal sampling. TEMPTED captures key microbial dynamics, facilitates beta-diversity analysis, and enhances reproducibility by transferring learned representations to new data. In simulations, it achieves 90% accuracy in phenotype classification, significantly outperforming existing methods. In real data, TEMPTED identifies vaginal microbial markers linked to term and preterm births, demonstrating robust performance across datasets and sequencing platforms.

Impact of anxiety symptoms on dialysis adherence and complication rates: A longitudinal observational study

BACKGROUND Anxiety is a common psychological comorbidity in patients undergoing dialysis, yet its impact on treatment adherence and complication rates remains understudied. We designed a longitudinal observational study to investigate these relationships, based on the hypothesis that higher anxiety symptoms would be associated with increased complication rates and negatively associated with adherence to the dialysis regimen. AIM To investigate the relationship between anxiety symptoms, dialysis adherence, and complication rates in patients undergoing dialysis over a 24-month period. METHODS This observational study analyzed data from 250 adult patients who underwent hemodialysis or peritoneal dialysis at three Affiliated Hospitals of Youjiang Medical University for Nationalities over a period of 24 months. Anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale-Anxiety subscale at baseline and every 6 months. Dialysis adherence was evaluated through attendance records, interdialytic weight gain, and patient-reported medication adherence. We recorded complications (infections, cardiovascular events, and hospitalizations) and used mixed-effects models and survival analyses to infer associations between anxiety symptoms, adherence measures, and complication rates. RESULTS Higher anxiety symptoms were significantly associated with poorer dialysis adherence, including increased missed sessions [incidence rate ratio = 1.32, 95% confidence interval (CI): 1.18-1.47, P < 0.001], greater interdialytic weight gain (β = 0.24, 95%CI: 0.15-0.33, P < 0.001), and lower medication adherence (odds ratio = 0.85, 95%CI: 0.78-0.93, P < 0.001). Patients with clinically significant anxiety (Hospital Anxiety and Depression Scale-Anxiety subscale ≥ 8) had a higher risk of complications [hazard ratio (HR) = 1.68, 95%CI: 1.32-2.14, P < 0.001], particularly infections (HR = 1.89, 95%CI: 1.41-2.53, P < 0.001) and cardiovascular events (HR = 1.57, 95%CI: 1.18-2.09, P = 0.002). The relationship between anxiety and complications was partially mediated by adherence measures. CONCLUSION Anxiety symptoms in patients undergoing dialysis are associated with poorer treatment adherence and increased complication rates. Regular screening and targeted interventions to address symptoms may improve adherence and clinical outcomes.

Dynamic mitophagy trajectories hallmark brain aging.

Studies using mitophagy reporter mice have established steady-state landscapes of mitochondrial destruction in mammalian tissues, sparking intense interest in basal mitophagy. Yet how basal mitophagy is modified by healthy aging in diverse brain cell types has remained a mystery. We present a comprehensive spatiotemporal analysis of mitophagy and macroautophagy dynamics in the aging mammalian brain, reporting critical region- and cell-specific turnover trajectories in a longitudinal study. We demonstrate that the physiological regulation of mitophagy in the mammalian brain is cell-specific, dynamic and complex. Mitophagy increases significantly in the cerebellum and hippocampus during midlife, while remaining unchanged in the prefrontal cortex (PFC). Conversely, macroautophagy decreases in the hippocampus and PFC, but remains stable in the cerebellum. We also describe emergent lysosomal heterogeneity, with subsets of differential acidified lysosomes accumulating in the aging brain. We further establish midlife as a critical inflection point for autophagy regulation, which may be important for region-specific vulnerability and resilience to aging. By mapping in vivo autophagy dynamics at the single cell level within projection neurons, interneurons and microglia, to astrocytes and secretory cells, we provide a new framework for understanding brain aging and offer potential targets and timepoints for further study and intervention in neurodegenerative diseases.

Triglyceride glucose index is associated with vertebral fracture in older adults: a longitudinal study.

Diabetes is a risk factor for bone fractures. However, the association between insulin resistance and the risk of fracture has not been well studied. In the present study, we explored the association of the triglyceride glucose index as a measure of insulin resistance with the risk of vertebral fracture in older adults. A total of 1995 subjects aged 50 years or older who underwent computed tomography (CT) for lung cancer screening from 2016-2021 were included in this study. They were followed until July 2023. Demographic information and laboratory test data were collected from the electronic medical system. Vertebral fractures were evaluated on the basis of sagittal CT images of the spine. The triglyceride glucose (TYG) index was calculated via the following equation: Ln [fasting glucose (mg/dl)×fasting triglyceride (mg/dl)/2]. The association between the TYG index and vertebral fracture incidence was evaluated via a multivariable Cox proportional hazards model. Ninety-five cases of fracture were observed during the 60 months of follow-up. The incidence of fracture was lower for the fourth TYG index than for the first TYG index (3.26% vs. 6.00%, P = 0.04). The risk of vertebral fracture decreased with increasing TYG index (adjusted hazard ratio (aHR): 0.56, 95% confidence interval (CI): 0.35-0.90). Fracture risk was significantly lower in subjects with the highest TYG (the fourth quartile) than in those with the first quartile (aHR: 0.46, 95% CI: 0.22-0.96) according to the fully adjusted model. A similar association was observed in subjects without diabetes (aHR = 0.44, 95% CI: 0.21-0.95). Restricted cubic splines further revealed that the risk of vertebral fracture decreased with increasing TYG index. A greater TYG index was associated with a lower risk of vertebral fracture, independent of body mass index and bone mass.

Association of aortic root diameter and vascular function with an exaggerated blood pressure response to exercise among elite athletes.

The systolic blood pressure/workload (SBP/MET) slope was recently reported to reliably identify an exaggerated blood pressure response (eBPR) in the normal population and in athletes. We investigated whether the aortic root diameter (AoD) also correlates with an eBPR and vascular function in elite athletes. We examined 652 healthy male elite athletes (age 25.8 ± 5 years) of mixed sports with a standardized maximum exercise test. Central blood pressure and vascular function were measured non-invasively with a validated oscillometric device. The SBP/MET slope was calculated and the threshold for an eBPR was set at > 6.2mmHg/MET. Two groups were defined (≤ 6.2 and > 6.2mmHg/MET), and an association between AoD and vascular function with the SBP/MET slope was evaluated for each group. Athletes with an eBPR (n = 191, 29%) displayed a higher systolic central BP (103 ± 7.7 vs. 101 ± 9.2mmHg, p = 0.004), larger AoD (32.8 ± 3.3 vs. 31.9. ± 3.2mm, p < 0.001), a higher AoD/left ventricular end-diastolic diameter (LVEDD) ratio (0.62 ± 0.061 vs. 0.59. ± 0.056, p < 0.001), a lower LVEDD/AoD ratio (1.64 ± 0.16 vs. 1.69. ± 0.16, p < 0.001), and a lower absolute (299 ± 59 vs. 379 ± 65 W, p < 0.001) and relative workload (3.17 ± 0.55 vs. 4.05 ± 1.2 W/kg, p < 0.001) vs. athletes with a normal SBP/MET slope (n = 461, 71%). No differences between the two groups were found after indexing AoD to body surface area (BSA) (14.76 ± 1.36 vs. 14.73 ± 1.41, p = 0.772). Athletes with eBPR displayed altered AoD/LVEDD and LVEDD/AoD ratios, whereas AoD/BSA indexing was not different. Further longitudinal studies are encouraged to explore these metrics and their role in aortic remodeling of athletes.

Exposure to violence and psychosocial trauma among Sudanese survivors

Purpose This paper aims to investigates the experiences of violence among Sudanese survivors and the associated mental health outcomes, including posttraumatic stress disorder (PTSD) and anxiety disorders. It highlights the variety, frequency and severity of political violence exposure and its impact on psychological trauma. Design/methodology/approach A cross-sectional quantitative study used data from 324 Sudanese youth exposed to violence. A self-rated 17-item questionnaire assessed violence exposure types and frequency. The General Health Questionnaire and the Davidson Trauma Scale evaluated mental health. Findings High levels of PTSD and poor general mental health were found in 60% of the youth. Exposure included brutal beatings (47%), physical torture (17%) and sexual violence (2%), with 47% enduring hours of torture. Research limitations/implications The cross-sectional design limits causal inferences, and self-reported data may introduce biases. Future studies should use longitudinal designs and consider cultural factors to better understand the long-term effects of political violence. Practical implications The study highlights the need for systematic trauma screening and targeted psychosocial support programs for Sudanese youth, particularly for underrepresented young adult males, to address significant trauma effectively. Originality/value This research provides novel insights into the mental health impact of political violence on Sudanese youth, offering valuable evidence to inform policies and programs aimed at supporting this vulnerable population.

A systematic review of parent-child communication in pediatric asthma.

Parent-child communication is integral to pediatric asthma management. This review evaluates parent-child communication among youth with asthma and their caregivers. It aims to characterize the type of communication according to a unifying framework (Murphy, L. K., Murray, C. B., & Compas, B. E., Guest Editors: Cynthia A. Gerhardt, Cynthia A. Berg, Deborah J. Wiebe and Grayson N. Holmbeck (2017). Topical review: Integrating findings on direct observation of family communication in studies comparing pediatric chronic illness and typically developing samples. Journal of Pediatric Psychology, 42, 85-94. https://doi.org/10.1093/jpepsy/jsw051), assess sociodemographic factors associated with communication, and examine the relationship between parent-child communication and youth psychosocial and health-related outcomes. A systematic literature search was conducted using PubMed, PsycINFO, CINAHL, Web of Science, Cochrane Library, and Embase databases (June 2021; updated May 2024). Included studies reported original, peer-reviewed research on the relationship between parent-child communication and youth psychosocial or health outcomes among pediatric patients (mean age <18 years) with asthma and their primary caregiver(s). Study quality was evaluated using the Study Quality Assessment Tools of the NHLBI. Sixty-six articles were included with data from 5,373 youth with asthma. Studies assessed both positive (warm and structured) and negative (hostile/intrusive and withdrawn) communication. Most studies used questionnaires and cross-sectional designs. Associations between sociodemographic and communication variables were largely nonsignificant. Greater positive and less negative communication was associated with better youth psychosocial and asthma outcomes overall. Parent-child communication may be an important target for interventions aimed at improving youth outcomes. More research is needed to develop communication-focused interventions that aim to enhance parents' and youths' communication skills (i.e., increase their use of positive communication approaches and/or reduce their use of negative communication approaches) and evaluate their impact on youth outcomes. Future research should also use more discussion tasks and longitudinal designs.

Cognitive function and its longitudinal predictability by intensity of physical activity in Chinese middle-aged and older adults.

The aging population faces several health problems, including cognitive decline that can progress to Alzheimer's disease. Regular physical activity is widely recognized for its extensive benefits, including physical and mental health improvements especially for older adults. This study aimed to examine the prediction of physical activity intensities on cognitive function of older adults. Data from 8 years prospective survey among Chinese population aged 45 years and older is used. Cognitive function was measured by word recall, orientation, numeric subtraction, and copying a picture. Physical activity was assessed with three intensity levels. General estimating equations (GEE) with unstructured correlation matrix is used to test the prediction of physical activity intensity on cognitive function. Cognitive function of participants significantly declined from 9.81 at baseline to 8.81 after 8 years. Moderate-intensity physical activity for 3 days/week was strongest positive predictor of cognitive function with a betta coefficient of 0.64. Light-intensity physical activity also positively predicted cognitive function, however vigorous physical activity for more than 3 days/week negatively predicted cognitive function. Cognitive function of the Chinese population is found to continuously decline after 60 years old age. Fortunately, this decline can be delayed with age-tolerable light to moderate-intensity physical activities.

Impact of glycemic treatment and blood glucose monitoring on outcomes in patients with acute ischemic stroke without prior diabetes: a longitudinal cohort study

ObjectivesTo explore the short- and long-term effects of glycemic management—through glycemic treatment and blood glucose monitoring (BGM)—on stroke recurrence and mortality specifically in patients experiencing a first-ever ischemic stroke (FIS) with hyperglycemia (FISHG) who have not previously been diagnosed with diabetes mellitus (DM).MethodsWe gathered data on patients who were registered on Taiwan’s National Health Insurance Research Database from 2000 to 2015. We one-fold propensity-score-matched (by sex, age, and index date) 207,054 patients into 3 cohorts: those with FIS (1) without hyperglycemia, (2) hyperglycemia without glycemic treatment, and (3) hyperglycemia with glycemic treatment. We used Cox proportional hazard regression to evaluate the short- (within 1 year after FIS) and long-term (9.3 ± 8.6 years after FIS) prognostic effects of glycemic management on stroke recurrence and mortality of FISHG.ResultsStroke recurrence and mortality were significantly more likely in the patients with FISHG than their counterparts without hyperglycemia (p < 0.05). Under glycemic treatment, patients with FISHG demonstrated lower risk of mortality at every follow-up than those without (p < 0.001) but were not less likely to have stroke recurrence (p > 0.05). Integrating BGM with glycemic treatment in the FISHG cohort significantly reduced the risk of stroke recurrence compared to patients receiving only glycemic treatment at 1-month, 3-month, 6-month, and 1-year post-stroke follow-ups (adjusted hazard ratios = 0.84, 0.90, 0.88, and 0.92, respectively); additionally, this approach significantly decreased mortality risk at each post-stroke follow-up period (p < 0.05).ConclusionsBGM combined with glycemic treatment significantly improves prognosis in patients with FISHG who have not been previously diagnosed with DM, reducing the risks of stroke recurrence and mortality.

The evolution of academic advisor and resident dyadic coaching relationships: a two-year longitudinal qualitative study.

Implementing competency based medical education (CBME) has generated enormous amounts of assessment data. To help residents synthesize and use these data, some programs have appointed academic advisors (AA) to 'coach over time'. This study explored how resident and faculty AA dyads perceived their relationship developing and evolving, and the extent to which it aligned with 'coaching over time'. Over a two-year period at four separate time-points, we conducted longitudinal qualitative interviews with nine dyads of Internal Medicine residents (32 interviews) and their paired AA (27). We used constructivist grounded theory to develop a conceptual understanding of how AA-resident relationships evolved. Three major themes were identified. 'Building the Relationship' included elements perceived to facilitate or impede growth of the relationship. Most relationships flourished, facilitated by passage of time, 'fit' between the two, and often by working together clinically. Still, many residents perceived the need to 'save face' with their AAs. 'Enacting the AA Role' had features that appeared to align more with mentorship than coaching. 'Finding Meaning in the Relationship' underscored the perceived value fostered by the longitudinal pairing. The relationships often, but not always, achieved far-reaching benefits, though not necessarily limited to those intended by the program. Our study helps us understand what 'coaching over time' might look like for large residency programs wherein residents rotate through many sites and services. The dyads created an opportunity for a coaching relationship to form and develop in beneficial ways, though it was different to and went beyond the narrower focus on meeting CBME requirements.

Covered Stent Correction for Sinus Venosus Atrial Septal Defects, an Emerging Alternative to Surgical Repair: Results of an International Registry.

Covered stent correction for a sinus venosus atrial septal defect (SVASD) was first performed in 2009. This innovative approach was initially viewed as experimental and was reserved for highly selected patients with unusual anatomic variants. In 2016, increasing numbers of procedures began to be performed, and in several centers, it is now offered as a standard of care option alongside surgical repair. However, covered stent correction for SVASD is not recognized by regulatory authorities, and in the minds of many pediatric and adult congenital cardiologists and surgeons, the condition is viewed as treatable only by cardiac surgery with cardiopulmonary bypass. In April 2023, all centers identified from international conferences, publications, and colleague networks to be undertaking covered stent correction for SVASD were invited to participate in a retrospective audit of their procedures. Data were received on 381 patients from 54 units over a 12-year period with 90% of procedures being performed over the past 5 years. Balloon-expandable stents (8 types) were used in the majority; self-expanding stents (4 types) were used in 4.5%. The commonest stent was the 10-zig covered Cheatham Platinum stent in 62% of cases. In 10 procedures, the stent embolized requiring surgical retrieval and repair of the defect, resulting in technically successful implantation in 371 of 381 (97.4%). Major complications (surgical drainage of tamponade, pacemaker implantation, surgery for pulmonary vein occlusion, and late stent removal) occurred in 5 patients (1.3%). Repeat catheterization to correct residual leaks was required in 7 patients (1.8%). Thus, 359 of 381 patients (94.2%) had successful correction without major complications or additional catheter interventions. This article details the exponential uptake of covered stent correction for SVASD during the past 5 years. Cardiopulmonary bypass was avoided in the majority of patients, and major complications were infrequent. Prospective registries with standardized definitions, inclusion criteria, and follow-up and comparative studies with surgery are now required to help support the extension of covered stent correction as an alternative standard-of-care option for patients with an SVASD.

Prevalence and associated body composition factors of sarcopenia in community-dwelling older adults

BackgroundThe objective of this investigation was to examine the frequency and determinants related to body composition of sarcopenia among aging individuals residing in the Beijing community through implementation of the diagnostic criteria for sarcopenia outlined by the 2019 Asian Working Group for Sarcopenia (AWGS).MethodsA cross-sectional examination employing multistage cluster sampling was conducted on a sample consisting of 933 individuals aged 50 years or above. The study utilized the AWGS 2019 criteria for muscle mass, muscle strength, and physical function to gauge sarcopenia. In addition, data on demographic characteristics, anthropometry, and body composition were collected. Logistic regression analysis was carried out to ascertain the relationships between sarcopenia and correlated factors.ResultsThe study found that the overall prevalence of sarcopenia was 8.3%. Sex (p < 0.001) and body mass index (BMI p < 0.001) were determined to have a significant association with the occurrence of sarcopenia. The adjusted analyses demonstrated that with each standard deviation increase in fat-free mass index (OR = 0.02 (0.01–0.05), of 95%), skeletal muscle mass (OR = 0.17 (0.12–0.25), of 95%), and other body composition indicators (including total body water 0.26 (0.2–0.35), intracellular water 0.1 (0.06–0.17), protein 0.01 (0–0.02), soft lean mass 0.35 (0.28–0.44), BMI 0.58 (0.51–0.67), body cell mass 0.21 (0.15–0.29), OR < 0.60, of 95%), the risk of sarcopenia decreased by more than 40%. Certain straightforwardly accessible anthropometric indices such as upper arm circumference (correlation coefficient 0.94 (0.9–0.97), 0.97 (0.95–1), 1.01 (0.99–1.03), respectively, of 95%), waist circumference (0.94(0.92–0.96), 1.01 (0.99–1.03), 1.02 (1–1.03), of 95%), hip circumference (0.93 (0.9–0.96), 0.99 (0.97–1.02), 1.02 (1–1.04), of 95%), waist-to-hip ratio (0.93 (0.87–1), 1.04 (1–1.08), 1 (0.97–1.03), of 95%), body fat percentage (1 (0.98–1.02), 1.02(1–1.04), 1.01 (0.99–1.02), of 95%), and phase angle (0.91 (0.89–0.93), 0.96 (0.94–0.98), 0.99 (0.98–1), of 95%) exhibited substantial correlation with skeletal muscle index, muscle strength or physical performance. However, no noteworthy link between sarcopenia and most variables associated with physical function was discovered.ConclusionsThe findings of the study highlight the prevalence of sarcopenia among the aging residents of Beijing. Certain easily measured anthropometric indices demonstrated strong correlation with muscle strength or physical performance, thereby providing an avenue for screening and diagnosing sarcopenia in older people who may not be able to undergo grip strength or physical function assessments. To investigate causal relationships, future studies employing longitudinal or interventional designs with a more comprehensive population are warranted.

Five-Year Outcomes of Lenadogene Nolparvovec Gene Therapy in Leber Hereditary Optic Neuropathy.

Limited studies have assessed the long-term benefit/risk of gene therapy for Leber hereditary optic neuropathy (LHON). To determine the safety and efficacy of lenadogene nolparvovec in patients with LHON due to the MT-ND4 gene variant for up to 5 years after administration. The RESCUE and REVERSE Long-Term Follow-up Study (RESTORE), conducted from 2018 to 2022, is the 5-year follow-up study of the 2 phase 3 clinical studies RESCUE (Efficacy Study of Lenadogene Nolparvovec for the Treatment of Vision Loss Up to 6 Months From Onset in LHON Due to the MT-ND4 Mutation) and REVERSE (Efficacy Study of Lenadogene Nolparvovec for the Treatment of Vision Loss From 7 Months to 1 Year From Onset in LHON Due to the MT-ND4 Mutation). At the end of each study, ie, 2 years after gene therapy administration, patients were offered enrollment in the RESTORE trial, a multinational, multicenter, prospective study, for an additional 3 years of follow-up. Patients with LHON due to the MT-ND4 gene variant received lenadogene nolparvovec in 1 eye and a sham injection in the other eye. Lenadogene nolparvovec was administered as a single intravitreal injection in the RESCUE/REVERSE studies. Measures included best-corrected visual acuity (BCVA), quality of life using the National Eye Institute visual functioning questionnaire 25 (NEI VFQ-25), and adverse events. Among the 76 patients who received gene therapy in the RESCUE (n = 39) and REVERSE (n = 37) studies, 72 (94.7%) completed these studies; 62 patients (81.6%) participated in the RESTORE trial, and 55 patients (72.4%) completed the 5-year follow-up. Participants were mostly male (49 [79.0%]) with a mean (SD) age of 35.9 (15.3) years at treatment. At baseline, the mean (SD) BCVA was 1.5 (0.5) logMAR (20/600 Snellen) in eyes to be treated with lenadogene nolparvovec and 1.4 (0.5) logMAR (20/500) in sham eyes. At the end of the RESCUE/REVERSE trials, ie, 2 years after treatment, eyes treated with lenadogene nolparvovec and eyes treated with sham reached a mean BCVA value of 1.4 (0.6) logMAR (20/500). The mean (SD) change from baseline to year 2 was -0.05 (0.6) logMAR (+1 line) and 0.01 (0.6) logMAR (-0 line) in gene therapy-treated and sham eyes, respectively (difference, -0.03; 95% CI, -0.16 to 0.09; P = .60). Five years after treatment, the bilateral improvement from nadir was similar to that observed at 2 years, with a mean (SD) change in BCVA of -0.4 (0.5) logMAR (more than +4 lines) for eyes treated with lenadogene nolparvovec and -0.4 (0.4) logMAR (+4 lines) for eyes treated with sham (difference, -0.05; 95% CI, -0.15 to 0.04; P = .27). An improvement of at least -0.3 logMAR (+3 lines) from the nadir in at least 1 eye was observed in 66.1% of participants (41 of 62). Between 2 and 5 years, intraocular inflammation was noted in 4 participants with 8 events in eyes treated with lenadogene nolparvovec and 1 event in an eye treated with sham. In this analysis of the RESTORE trial, follow-up of patients with LHON due to the MT-ND4 gene variant unilaterally treated with lenadogene nolparvovec demonstrated a sustained bilateral improvement in BCVA and a good safety profile up to 5 years after treatment. This evidence of persistent benefit over time is promising for the use of gene therapy in these patients. ClinicalTrials.gov Identifier: NCT03406104.

Cognitive factors underlying mathematical skills: A systematic review and meta-analysis.

In understanding the nature of mathematical skills, the most influential theories suggest that mathematical cognition draws on different systems: numerical, linguistic, spatial, and general cognitive skills. Studies show that skills in these areas are highly predictive of outcomes in mathematics. Nonetheless, the strength of these relations with mathematical achievement varies, and little is known about the moderators or relative importance of each predictor. Based on 269 concurrent and 174 longitudinal studies comprising 2,696 correlations, this meta-analysis summarizes the evidence on cognitive predictors of mathematical skills in children and adolescents. The results showed that nonsymbolic number skills (often labeled approximate number sense) correlate significantly less with mathematical achievement than symbolic number skills and that various aspects of language relate differently to mathematical outcomes. We observed differential predictive patterns for arithmetic and word problems, and these patterns only partly supported the theory of three pathways-quantitative, linguistic, and spatial-for mathematical skills. Concurrently, nonsymbolic number and phonological skills were weak but exclusive predictors of arithmetic skills, whereas nonverbal intelligence quotient (IQ) predicted word problems only. Only symbolic number skills predicted both arithmetic and word problems concurrently. Longitudinally, symbolic number skills, spatial ability, and nonverbal IQ predicted both arithmetic and word problems, whereas language comprehension was important for word problem solving only. As in the concurrent data, nonsymbolic number skill was a weak longitudinal predictor of arithmetic skills. We conclude that the candidates to target in intervention studies are symbolic number skills and language comprehension. It is uncertain whether the two other important predictors, nonverbal IQ and spatial skills, are actually malleable. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Life-course perspective on the causal mechanism of social functioning in schizophrenia spectrum disorder.

Due to prior emphasis on clinical recovery in Schizophrenia Spectrum Disorder (SSD), improving social functioning (SF) was oftentimes neglected, with ⩽15% of patients achieving social recovery. Priorly, we and others have shown that life-course factors, including childhood adversities, play a role in the occurrence and severity of postmorbid SF impairments, highlighting the need to understand these factors for effective interventions. This study investigates the mechanisms influencing SF in SSD and examines the causal roles of childhood trauma, premorbid adjustment, perceived stigma, self-esteem, and quality of life. This longitudinal study utilized data of 1,057 SSD patients, with measures at baseline, 3 and 6-year follow-up, from the Genetic Risk and Outcome of Psychosis cohort, to unravel the causal mechanism underlying SF utilizing Structural Equation Modeling. Determinants were assessed using validated retrospective and self-report questionnaires. Model development and testing involved a multistage process, encompassing relationships exploration, fit evaluation and model comparison. We developed a probable causal model. Impaired premorbid adjustment emerged as a crucial factor, exerting negative influence on long-term SF, with a direct effect of β = -.252, p < .001 on SF at 3-year follow-up and β = -.056, p = .073 at 6-year follow-up. Childhood trauma exhibited a negative direct effect on SF at 3-year follow-up (β = -.087, p = .039), while demonstrating a substantial carry-over, indirect effect. Elevated perceived stigma negatively affected SF at 3-year follow-up (β = -.112, p = .008). The model explained 9.9% of SF variation at the 3-year follow-up and 54.3% at the 6-year follow-up. While validation is necessary, we found a foundational basis for causal interpretation. Premorbid adjustment, childhood trauma, and perceived stigma are essential life-course factors shaping postmorbid SF in SSD. We recommend interventions covering both prevention and treatment for individuals with established symptoms-addressing childhood trauma, premorbid adjustment, and perceived stigma-to enhance long-term social outcomes and offer actionable insights for clinicians.

Long-term courses in schizophrenia : Areview of current results and developments

Despite classical conceptions of schizophrenia as aprogressive illness with a high chronification, current long-term follow-up studies show a higher proportion of remission, possibly also a higher proportion of recovery than previously assumed. The heterogeneity of clinical courses is also reflected in different trajectories of cognitive and biological (e.g., imaging) variables, in which many of those affected show remission. Early clinical intervention during the first weeks and months following the onset of psychosis are decisive not only for early remission but also possibly for the long-term outcome. The treatment and reduction of somatic comorbidities are promising approaches in addition to a differentiated core treatment to positively influence the course of the illness even years after the disease. The identification of additional predictors, e.g., based on biological parameters, can together with machine learning approaches contribute to optimization of an individualized core treatment.

Safety and Efficacy of Novel Cost-Effective EUS Coiling and Glue Technique for the Management of Large Gastric Varices: A Long-Term Follow-up Study

Abstract Aims and Objective Mortality by gastric variceal bleeding can reach up to 30%. Gastric varices can be treated by either direct endoscopic glue or endoscopic ultrasound (EUS) coiling + glue injection. Now, enough data show that EUS coil + glue is an effective option for large varices. However, it is a costlier option than direct endoscopic glue injection. In our study, after putting the coil under EUS guidance, direct endoscopic glue injection is done with a 21G sclerotherapy needle. Since the EUS needle was not used for the glue injection, it can be reused for up to three cases for deployment of the EUS coil, hence reducing the cost of the whole procedure. In short, our study aims to find the safety and efficacy of a cost-effective method of EUS coiling + glue injection in a cohort of the Indian population. Material and Methods Retrospective review of prospectively collected data on EUS coiling + direct endoscopic glue injection over a period spanning from July 2017 to December 2023 from a tertiary care center in North India. Results A total of 103 patients (gastroesophageal varices type 2, GOV2 [n = 82] and isolated gastric varices type 1, IGV1 [n = 21]) were taken up for the study. Among the 103 patients, 74 patients were males and 29 were females. The mean follow-up duration of the study population was 34.2 ± 21 months. The average size of the varix was 2.3 cm. The average number of coils was 3.3 and the volume of injected glue was 3.1 mL. In our study, 4 out of 103 patients had rebleeding, but the cause of rebleeding turned out to be nonvariceal. Regarding the intraprocedural and postprocedural adverse events, 1 out of 103 patients in our study experienced abdominal pain and fever, which responded to oral analgesics and antipyretics. There was no active bleeding from the puncture site or evidence of systemic embolization. Technical success was 100% in our study. Reuse of needles was not associated with any increment in risk of infection. Conclusion EUS coiling + direct endoscopic glue injection is a safe and effective endoscopic therapy for large gastric varices with sustainable long-term beneficial effects with a negligible amount of rebleeding. Direct endoscopic injection of glue following EUS coiling with a 21G sclerotherapy needle can significantly reduce the cost of the procedure without any risk of infection.

From applause to disappointment – appreciation among healthcare providers that provided end-of-life care during the COVID-19 pandemic and its impact on well-being – a longitudinal mixed methods study (the CO-LIVE study)

BackgroundThe healthcare sector is facing increasing work pressure, making a healthy workforce essential. Appreciation is a factor influencing well-being, and the COVID-19 pandemic offers valuable insights into this. This study aims to: 1) describe to what extent end-of-life care providers felt appreciated and understood during the first 18 months of the pandemic, 2) examine the impact of appreciation on their well-being, and 3) explore their perceptions of what appreciation should look like.MethodsA longitudinal mixed methods study among healthcare providers in the Netherlands delivering end-of-life care during the COVID-19 pandemic. Surveys were conducted at four timepoints (n = 302), and interviews were conducted at three timepoints (n = 17) during the first 18 months of the pandemic. Generalized Estimating Equations analysis was performed on the quantitative data and thematic analysis was conducted on the interview data.ResultsThis study shows that feeling of appreciation among healthcare providers peaked in the first wave of the pandemic, but significantly dropped in the second wave, with only about half of the healthcare providers feeling appreciated. This slightly improved afterwards. Furthermore, nearly half of healthcare providers felt misunderstood during the first 18 months of the pandemic. Additionally, this study shows that between September 2020 and September 2021 about 1 in 3 healthcare providers had a score on the Well-Being Index indicating higher risk for burnout. Feeling appreciated and not feeling understood were both significantly associated with worse well-being. Interviews revealed that nurses did not always feel understood and appreciated by society, employers, patients and their families, as well as their own friends and family, leading to feelings of sadness, anger, and frustration. Three major themes emerged: ‘recognizing real needs, ‘we are not in this together’ and ‘short-lived appreciation that failed to lead to structural changes’.ConclusionsThis study shows that during the COVID-19 pandemic, healthcare providers often felt neither appreciated nor understood, which is associated with lower scores of well-being. The expressed appreciation often did meet their needs or expectations, from both employers and society. With healthcare provider well-being still under strain, sustained attention to appreciation and understanding is important for retaining the workforce.

The effect of digital obesity and phubbing level on life satisfaction: latent profile analysis

BackgroundIn this study, the effects of individuals’ digital obesity and phubbing behaviors on their life satisfaction were investigated by latent profile analysis (LPA) method. LPA is a statistical technique used to identify unobserved subgroups within a population based on individuals’ responses to various observed variables.MethodsThe present study was conducted in a correlational cross-sectional descriptive design between November 2023- January 2024. Digital obesity scale, phubbing scale, life satisfaction scale were used in this study.ResultsAs a result of LPA, Class 1 (Low Digital Addicts) has the lowest arithmetic mean in all indicators. When life satisfaction was analyzed on the basis of the classes, it was found out that Class 2 (High Digital Addicts), which was collected in the group with high levels of digital obesity and phubbing, had lower life satisfaction. Considering the demographic levels of individuals according to class level, it was concluded that high digital addiction was more common among individuals with secondary and postgraduate education.ConclusionsIn the present study, two classes were found as a result of LPA. In the analysis, Class 1(Low Digital Addicts) was found to have the lowest arithmetic mean in all indicators. On the other hand, when life satisfaction was analyzed according to the classes, it was detected that Class 2 (High Digital Addicts) life satisfaction was lower in the group with high levels of digital obesity and phubbing. In the study, the life satisfaction of class 1, which is characterized as low digital addicts, was found to be higher. Longitudinal studies on digital addictions affecting life satisfaction are recommended.

Pooled prevalence and associated factors of depression among high school students in Ethiopia

BackgroundDepression among high school students is a public health concern in Ethiopia. Studies have indicated that estimates of the prevalence of depression and its predicting factors among high school students are inconsistent. A systematic review and meta-analysis are essential to determine the pooled prevalence of depression and associated factors among high school students to help health care managers design appropriate interventions.MethodsA wide-ranging search was used in international databases, such as PubMed, Scopus, Web of Science, EMBASE, Google Scholar, and Advanced Google. Observational studies (with cross-sectional study designs and case‒control, cohort and longitudinal studies) that reported the proportion of depression and associated factors in Ethiopia were included. In this study, unpublished and published primary studies were included. Two reviewers autonomously extracted all essential data elements using the Microsoft Excel worksheet and transferred them to Stata V.18 for analysis. The I2 statistic test was determine the presence of heterogeneity among included studies and Egger’s regression test and funnel plot checked the publication bias.ResultsIn this review, a total of 10 primary studies with 6988 participants were included to estimate the combined prevalence. The pooled prevalence of depression among high school students in Ethiopia was 30% (26%, 34%). The subgroup analysis showed that the pooled prevalence of depression was higher in Tigray 35% (95% CI 33%, 38%) and a lower prevalence of depression was observed in Oromia 28% (95% CI 25%, 31%) and Amhara 28% (95% CI 18%, 37%). The results of the meta-analysis showed that being female (OR = 1.98; 95% CI 1.34, 2.61), alcohol use (OR = 2.59, 95% CI 1.64, 3.55), and parental neglect (OR = 2.64; 95% CI 1.86, 3.42) were significantly associated with depression among high school students in Ethiopia.ConclusionsIn this study, the overall pooled prevalence of depression among high school students in Ethiopia was high. Being female, alcohol use and parental neglect were potential factors associated with depression among high school students in Ethiopia. Therefore, it is important to pay special attention and design interventions to address depression among high school students in Ethiopia.PROSPERO registration number: CRD42024543877.