This quasi-experimental study examined the benefit of intervention focusing on awareness and flexible use of strategies in arithmetic and reading among Finnish children with comorbid arithmetic and reading fluency problems (Grades 2-4). Children participated either in a calculation intervention (n = 45) or a reading intervention (n = 51) or received business-as-usual support at school (n = 47). Both domain-specific and cross-domain effects were investigated. The calculation group improved in single- and multi-digit addition fluency significantly more than the other two groups, while the progress in sentence and text reading fluency was not different in the reading intervention group compared with the other two groups. Also, neither intervention showed cross-domain effects. The results of this study add to the existing knowledge of pedagogical practices to support arithmetic and reading fluency in children with comorbid difficulties and lead us to consider the developmental and instructional differentiations between the skills.
Problematic smartphone use is a prevalent behavioral issue in the digital age and is frequently associated with sleep disturbances. However, evidence on how different sleep domains respond to short-term behavioral restriction under natural conditions remains limited. This study aimed to examine smartphone use patterns in young adult males, evaluate their relationship with problematic smartphone use risk, and assess changes in sleep-related outcomes following short-term, institutionally mandated smartphone restriction. This prospective pre-post observational study was conducted at a male police college during a 10-day institution-mandated smartphone restriction. Participants (n = 254) were classified into low-risk and high-risk problematic smartphone use groups based on the Smartphone Addiction Scale-Short Version (SAS-SV). Sleep quality, sleep hygiene, insomnia severity, and daytime sleepiness were measured before and after the restriction period. Associations between smartphone use characteristics (daily duration, timing of use, and usage purposes) and sleep outcomes were examined using group comparisons and multivariate analyses. At baseline, individuals classified as high-risk reported longer overall smartphone use, particularly during evening hours, together with poorer sleep hygiene, lower perceived sleep quality, and greater daytime sleepiness. After the restriction period, improvements were mainly observed in behaviorally related sleep measures, including sleep hygiene and subjective sleep quality. In contrast, insomnia severity and daytime sleepiness showed limited change and did not demonstrate a significant group-by-time interaction. The findings suggest that intensive evening smartphone use may be associated with sleep difficulties that are largely behaviorally mediated. Improvements in sleep-related behaviors accompanied short-term reductions in device exposure, whereas sleep parameters linked to more stable physiological regulation appeared less responsive over this brief interval. Addressing the timing and intensity of smartphone use is a relevant behavioral target in strategies to improve sleep health in young adults.
The primary objective of this study was to investigate the relationship between different types of sleep problems and specific behavioural difficulties in children and adolescents with autism spectrum disorder (ASD), compared with typically developing children (TDC). We compared 40 children and adolescents with ASD and normal intellectual functioning with 50 TDC using the Sleep Disturbance Scale for Children (SDSC), the Conners' Parent Rating Scale-Revised Short (CPRS-RS) and the Repetitive Behaviour Scale-Revised (RBS-R). Participants with ASD had significantly higher scores on CPRS-RS inattention, hyperactivity and stereotyped, self-injurious, compulsive, routine, sameness and restricted behaviours, in addition to higher RBS-R scores. The ASD group also scored higher on the SDSC initiating and maintaining sleep subscale. Correlation analyses demonstrated significant associations between repetitive behaviours and multiple domains of sleep disturbances in the ASD group, whereas no significant correlations remained after Bonferroni correction in the TDC group. Regression analyses revealed that sleep breathing problems were associated with RBS-R Total (β = 0.590, p = 0.001); arousal/waking with compulsive behaviours (β = 0.394, p = 0.014); and sameness behaviours with both timing (β = 0.542, p = 0.012) and overall sleep problems (β = 0.516, p = 0.002) in the ASD group. In this study, sameness behaviours, compulsive behaviours and total RBS-R scores were significantly associated with several sleep problems in children and adolescents with ASD. These findings add to the literature demonstrating robust associations between specific types of sleep problems and particular behavioural difficulties in this population.
Bullying may have a considerable negative impact on health and well-being. Nevertheless, there is a lack of studies investigating exposure to bullying in the general population. Thus, we aimed to assess the prevalence of lifetime exposure to bullying in the adult Norwegian population and to compare health-related quality of life (HRQoL), and physical and psychological health problems between bullied and non-bullied. We measured lifetime exposure to bullying in the general Norwegian population using a self-report questionnaire. The study was part of a cross-sectional national health survey (n = 1733) conducted in 2014-2015, to which a probability sample of people in the general population was recruited. Reports on socio-demographic data, HRQoL and a wide range of mental and somatic health problems provided the basis for a comparison of those who were bullied with those who were not. Chi square tests and logistic regression analyses were used to assess associations with lifetime exposure to bullying. Across age groups, 28.2% reported exposure to bullying during their lifespan. Adjusted for other variables, the odds of bullying were higher in younger age groups, for those who lived as singles, and for those who were not working or in education. Respondents who had been bullied reported more mental problems such as depression, anxiety, insomnia, eating disorder, psychosis, self-harm, and suicide attempts, and they had lower HRQoL. They also reported more chronic pain, fibromyalgia, rheumatoid arthritis, diabetes mellitus, obesity, and musculoskeletal-, respiratory- and gastrointestinal diseases than people who had not been exposed to bullying. Bullying is common in the general Norwegian population, where more than a quarter of respondents had experienced exposure to bullying during their lifespan. Substantial more mental and somatic health problems among those exposed to bullying require a broad effort against bullying in central arenas in society.
Adolescents with overweight/obesity have an elevated risk of mental health and behavioral difficulties. Exercise has been shown to impart psychological benefits to these individuals; however, whether the effects of moderate-to-vigorous physical activity (MVPA) delivery differ between weekdays and weekends is limited. Therefore, this study aimed to examine the effects of weekday and weekend MVPA at age 14 on internalizing and externalizing problems at age 17 among adolescents with overweight/obesity. We analyzed data from two assessment waves of the UK Millennium Cohort Study (MSC): MCS6 (2015-2016; age ∼14) and MCS7 (2018-2019; age ∼17). Data were restricted to adolescents classified as overweight/obesity at MCS6 using the UK90 thresholds. Weekday and weekend MVPA were measured at age 14 using the wrist-worn GENEActiv accelerometer, including one pre-specified weekday and one weekend day. Outcomes at age 17 were parent-reported Strengths and Difficulties Questionnaire (SDQ) internalizing (emotional + peer problems) and externalizing (conduct + hyperactivity/inattention) composites. We estimated average treatment effects (ATEs) and conditional average treatment effect (CATEs, heterogeneous effects) using a causal forest framework (EconML) and adjusted for pre-exposure covariates (age, sex, body mass index, ethnicity, cognitive decision-making, household income, parental education, and parental mental health). Missing data were treated via K-Nearest Neighbors imputation. The analytic sample included 1,238 adolescents (mean age 14.25 years). Mean MVPA was higher on weekdays than weekends (135.74 ± 62.08 vs 113.80 ± 64.37 min/day). Covariate-adjusted average treatment effects (ATEs; per 1 min/day MVPA) were small and not statistically significant for internalizing or externalizing problems. Weekday MVPA ATEs were -0.0025 (95% CI -0.0062 to 0.0012) for internalizing and 0.0003 (-0.0027 to 0.0033) for externalizing; weekend MVPA ATEs were -0.0008 (-0.0051 to 0.0035) and 0.0005 (-0.0026 to 0.0037), respectively. Heterogeneity was evident only for weekday MVPA effects on internalizing (22.98% with significant individual effects), with height as the strongest moderator (β = 0.0002; p < 0.001; R² = 0.519) and more negative CATEs among shorter adolescents (Q1 -0.004994 vs Q4 -0.001903; ANOVA F = 106.741, p < 0.001). In adolescents with overweight/obesity, estimated average effects of weekday and weekend MVPA at the age of 14 on parent-reported internalizing and externalizing problems at age 17 were close to zero under a selection-on-observables framework. Any potential benefits may be subgroup-specific and context-dependent; the observed weekday-specific heterogeneity warrants replication with more reliable exposure measurement and a richer set of contextual covariates.
Dysphagia in Progressive Supranuclear Palsy (PSP) has devastating consequences, including pneumonia and death; however, no studies have described its impact on quality of life (QOL), limiting the degree to which management approaches align with patient needs. Therefore, in this cross-sectional retrospective analysis we characterized swallowing-related QOL (SWAL-QOL) in PSP and assessed its relationship with demographic and clinical characteristics. Consecutive outpatients completed an assessment of swallowing including the SWAL-QOL questionnaire. Correlations and Wilcoxon sum-rank tests were used to examine whether SWAL-QOL total score (primary analysis) and domain scores (exploratory analysis) differed by demographic variables (age, sex, disease duration), diet status, cognition (MoCA), and swallowing safety. Thirty-five patients with PSP were included (mean age 71, 14F). Median SWAL-QOL total score was 72.1 [IQR 52.6, 82.8]. The most impaired domains were eating duration, fatigue, and communication (M = 50). Those on modified diets had significantly lower total scores (M = 44.1) than those on regular diets (M = 79.8) (W = 22; p = .003). No relationship between total score and age (ρ = 0.30; p = .079), sex (W = 126; p = 0.495), disease duration (ρ = -0.161; p = .354), cognition (ρ=0.207; p = .273), or swallowing safety (χ2 = 1.89; p = .389) was found. SWAL-QOL is reduced in PSP and findings suggest that attention to eating duration and diet modification may inform person-centered care. Purpose People with Progressive Supranuclear Palsy (PSP) often develop problems with swallowing, known as dysphagia, which can lead to serious problems like poor nutrition, pneumonia, or even death. This study aimed to understand how swallowing difficulties impact quality of life (QOL) for people with PSP and whether swallowing-related QOL is associated with things like age, disease severity, thinking ability, diet, or swallowing safety.What we did We looked at a group of 35 patients with PSP who came for clinic visits and completed a questionnaire about how swallowing affects their life, called the swallowing-related quality of life questionnaire (SWAL-QOL).What we found We found that overall, people with PSP had reduced quality of life related to swallowing, with the biggest challenge being how long it takes to eat. We also found that those who were on modified diets (e.g. eating softer/pureed foods) had worse SWAL-QOL scores than those on regular diets. QOL was not related to age, sex, disease duration, thinking ability, or swallowing safety.What it means Swallowing problems impact QOL and mealtime experiences for people with PSP. Considering how long it takes to eat and diet changes may be especially important aspects of swallowing care in PSP.
Many inverse problems and signal processing problems involve low-rank regularizers based on the nuclear norm. Commonly, proximal gradient methods (PGM) are adopted to solve this type of non-smooth problems as they can offer fast and guaranteed convergence. However, PGM methods cannot be simply applied in settings where low-rank models are imposed locally on overlapping patches; therefore, heuristic approaches have been proposed that lack convergence guarantees. In this work we propose to replace the nuclear norm with a smooth approximation in which a Huber-type function is applied to each singular value. By providing a theoretical framework based on singular value function theory, we show that important properties can be established for the proposed regularizer, such as: convexity, differentiability, and Lipschitz continuity of the gradient. Moreover, we provide a closed-form expression for the regularizer gradient, enabling the use of standard iterative gradient-based optimization algorithms (e.g., nonlinear conjugate gradient) that can easily address the case of overlapping patches and have well-known convergence guarantees. In addition, we provide a novel step-size selection strategy based on a quadratic majorizer of the line-search function that leverages the Huber characteristics of the proposed regularizer. Finally, we assess the proposed optimization framework by providing empirical results in dynamic magnetic resonance imaging (MRI) reconstruction in the context of local low-rank models with overlapping patches.
Childhood material hardship, including insecurity in housing, utilities, food, and medical care, is a critical factor influencing cognitive functioning and mental health outcomes. However, past research on material hardship is limited by cross-sectional data and reliance on conventional behavioral measures of cognitive functioning that suffer from poor reliability and lack of specificity. To address these gaps, this study used a well-validated computational model of cognition to examine individuals' drift rate, which is hypothesized to be driven by the efficiency of evidence accumulation (EEA) for decision-relevant information, a key process that supports higher-order cognitive functioning. Here, we examined how material hardship during childhood was associated with adolescent drift rate, and whether drift rate was linked with attention difficulties. 187 adolescents recruited from the Future of Families and Child Wellbeing Study were included in the analyses. Adolescents exposed to greater material hardship showed lower drift rate, suggesting less effective processing. Growth curve modeling revealed that initial exposure to material hardship, but not changes across childhood, was associated with drift rate in adolescence. Lower drift rate was also associated with concurrent attentional problems and served as a significant indirect pathway linking material hardship to adolescent attention. This is the first longitudinal study that examined the associations among childhood material hardship exposure, adolescent drift rate, and attentional difficulties. Our results suggest that challenges to essential living conditions in childhood may impact cognitive processes underlying goal-directed behavior in adolescents. These findings highlight the application of computational models to reveal specific cognitive processes impacted by adversity. SUMMARY: Existing research on material hardship and cognitive functioning is limited by reliance on cross-sectional task-based performance, resulting in inconsistent findings. We applied the diffusion-decision model to decompose trial-wise performance into underlying cognitive processes, including drift rate, a key evidence accumulation process underlying goal-directed behavior. Greater cumulative childhood material hardship, beyond exposure to other adversity, is associated with lower drift rate, which is linked with greater attentional problems in adolescents. Findings were specific to drift rate, not average response time or accuracy, emphasizing the value of computational methods in capturing cognitive changes associated with material hardship.
Pregnant women need enough vitamin D for healthy pregnancies, but many women in Iran's Khuzestan province don't get sufficient sunlight to produce vitamin D naturally. In this study, we aimed to determine how many pregnant women have low vitamin D levels and to test different methods of providing vitamin D supplements. We also sought to assess whether our new algorithm model, called Irregular Fuzzy Cellular Automata (IFCA), performs better than older methods for predicting pregnancy complications. We examined 2,481 pregnant women who participated in this study in two Iranian cities between 2014 and 2016. Women with vitamin D blood levels below 20 ng/mL were considered to have low vitamin D. We selected 800 women with moderate or severe vitamin D deficiency (25(OH)D < 50 nmol/L) and assigned them to eight groups receiving different combinations of injectable and oral supplementation regimens. We assessed maternal complications such as gestational hypertension, diabetes, preterm birth, and premature rupture of membranes. For babies, we evaluated their weight, length, head size, and vitamin D levels in their cord blood. We compared how well our new IFCA model worked against older methods by evaluating its accuracy compared to them. Our results indicate that 85% of the women had low vitamin D levels, with approximately 38% exhibiting severe deficiency. After taking supplements, the average vitamin D level in mothers went up to 24.1 ± 3.2 ng/mL (p < 0.001). Mothers' vitamin D levels matched closely with their babies' levels (r = 0.82, p < 0.001). Only 0.6% of women developed high blood pressure during pregnancy, but we found that being overweight and having high blood pressure were bigger problems (OR = 2.3, p = 0.032) than low vitamin D alone. Our IFCA model worked better than older methods, achieving an accuracy of 89% with an AUC of 0.92 (p < 0.01). Low vitamin D is very common in pregnant women who don't get much sunlight, but providing them with supplements can address this issue. Both injection and pill forms of vitamin D helped bring levels back to normal. Our new IFCA model was better at finding women who might have pregnancy problems than older methods. Doctors should monitor vitamin D levels early in pregnancy and utilize improved tools to help ensure the health of mothers and babies. This study was registered in the Iranian Registry of Clinical Trials (IRCT) under the code IRCT2014102519660N1. Registered on 15 January 2014 at www.irct.ir.
Protein purification is required for many experimental assays in molecular biology. However, this is a laborious procedure that can be challenging and prone to several problems (degradation, aggregation, contamination etc.). These issues can jeopardize the quality of the samples and the reliability of the research tests. This article describes four protocols that can be used for the purification of human Staufen1 (and several mutants), an important protein capable of binding RNA and inducing a variety of phenomena crucial for cell biology, including Staufen-mediated mRNA decay (SMD). SMD dysregulation is reported to be involved in tumorigenesis, adipogenesis, neurodegeneration, and cell cycle regulation. The data presented here show that EDTA reduces protein degradation. These protocols can minimize Staufen degradation and aggregation; therefore, they have proven to be efficient and reliable. This article also provides a table of potential problems and their corresponding solutions. Moreover, this work shows that the removal of a Staufen domain (Staufen-Swapping Motif, SSM) highly increases the degradation of this protein. This suggests that SSM plays a role in Staufen integrity. Fast, reliable purification protocols, ideal for Staufen and other water-soluble proteins Staufen purification troubleshooting SSM deletion increases Staufen degradation.
Tissue damage from an electrical burn could result from either direct electrical current and/or its conversion from electric to thermal energy. Although loss of consciousness, altered mentation, and peripheral neuropathy are the common neurologic sequelae of electrical burns, spinal cord injury can also be the only neurological complication of high-voltage electrical burn injuries. In this case report we present scalp soft tissue defect and acute spinal cord injury following high voltage electrical burn in a 35 years old male patient. We aim to emphasize the importance of multidisciplinary management in improving patient outcomes. A 35-year-old soldier experienced a high-voltage power live burn injury to the right frontal area of the head. Eight hours after the injury, he developed bilateral lower-extremity weakness and a tingling sensation. Basic investigations like CBC, renal function test, and ECG readings were normal. Both brain CT and spinal MRI studies reveal normal. Concomitant with wound management, physiotherapy was initiated, and he had significant improvement in his weakness by the end of the third week. Despite accounting for less than 4% of burn case, electrical burn have special concerns including the potential for cardiac arrhythmias and compartment syndromes with concurrent rhabdomyolysis. Other types of burns include flame burn and scald burn. High-voltage electrical burn injuries are serious problems causing variable degrees and types of neurologic impairments. Acute spinal cord injuries are among the less commonly reported problems. Given the limited effective treatment options for neurologic complications, appropriate preventive measures, multidisciplinary management, and long-term neurologic follow-up are important.
Little is known about cardiac troponin T (cTnT) release during transvenous lead extraction (TLE). The aim of the study was to identify factors influencing the intensity of cTnT release during TLE and to investigate whether the increase in cTnT levels after TLE has any prognostic significance for medium-term survival. Retrospective analysis of a TLE database. In 166 consecutive patients who underwent the TLE procedure, an elevated hs cTnT level > 0.014 µg/l was present in almost 100%. The increase in troponin level 8 h after TLE (DcTnT8) was 900% of average and 400% of the median initial concentration. The factors most strongly associated with cTnT release during TLE were the age of the oldest extracted leads and the number of points on the Complex Indicator of Difficulty (CID) score. Additional procedural factors included the occurrence of technical problems, the need for second-line tools, hypotension > 1 min appearance, and traction on cardiac structures visible on transoesophageal echocardiography. Elevated cTnT levels are observed following nearly all TLE procedures; however, they do not impact the incidence of major complications, perioperative mortality, or long-term survival rates. Longer dwelling time of the extracted leads and the procedural complexity of TLE are the primary determinants of the magnitude of cardiac troponin release.
Infertility is a medical condition with associated psychosocial problems on couple's life that requires employing coping strategies using a couple-based approach. Therefore, the aim of the present study was to explore coping strategies using a couple-based approach. This study used a qualitative content analysis approach and semi-structured interviews with 36 Iranian individuals, selected through the purposeful method and considering maximum diversity in terms of age and cause, type, and duration of infertility, 10 of which couples were conducted in pairs interview. Content analysis was performed using the Granheim and Ludman method. Three main categories were extracted from data analysis: "coexistence with infertility," "emotional relief," and "consolidating couples' relationships." The coexistence with the infertility category was deduced from consolidating couples' relationships, participation in accepting the responsibility of fertility, and reorganizing married life themes; the emotional relief category was extracted from the spiritual intimacy, the value of married life, and scenario planning themes, and consolidating couples' relationships category was obtained from the dynamic interaction and emotional intimacy themes. The study results showed that coping strategies could be investigated in three general categories: coexistence with infertility, emotional relief, and consolidating couples' relationships. Therefore, it is recommended to consider these coping strategies in designing and providing counseling services to infertile couples. The results of the present study expanded our understanding of adaptive coping strategies, recommending these strategies in counseling programs requires a study with a quantitative approach. But the findings are limited in generalizability to Iranian infertile couples actively seeking fertility treatment.
Depressive symptoms during pregnancy and the postpartum period have been extensively studied; however, evidence regarding mental health in the preconception period remains limited. Women preparing for pregnancy undergo physiological changes, lifestyle adjustments, and psychosocial transitions, and emotional vulnerability may be heightened by reproductive stressors, including infertility. Nevertheless, population-based studies examining depressive symptoms and their associated lifestyle and reproductive factors during the preconception period remain scarce. This cross-sectional study included 14,004 women aged 20-45 years who participated in the Seoul Metropolitan Preconception Health Management Program between 2019 and 2021. Depressive symptoms were assessed using the Korean-validated Hospital Anxiety and Depression Scale-Depression subscale (HADS-D), with scores ≥ 11 indicating elevated risk. Sociodemographic, lifestyle, nutritional, menstrual, and reproductive factors were assessed. A multivariable logistic regression model was used to identify factors independently associated with depressive symptoms. Among the participants, 1,102 women (8.5%) exhibited elevated depressive symptoms. In a multivariable logistic regression model, depressive symptoms were independently associated with current smoking, passive smoking exposure, insomnia, binge eating, irregular menstruation, severe dysmenorrhea, infertility history, and previous pregnancy. Insomnia, binge eating, current smoking, and severe dysmenorrhea were each associated with more than twofold higher odds of depressive symptoms. In contrast, regular physical activity showed a clear dose-response association, with increasing physical activity level associated with progressively lower odds of depressive symptoms, whereas greater dysmenorrhea severity was associated with progressively higher proportions screening positive for depressive symptoms. Folic acid supplementation was also independently associated with reduced odds of depressive symptoms. Depressive symptoms were relatively common among women preparing for pregnancy and were closely associated with modifiable lifestyle factors, including smoking, sleep problems, and eating behaviors, as well as reproductive-related factors such as dysmenorrhea and infertility. These findings underscore the need to integrate systematic mental health screening and targeted lifestyle and reproductive health interventions into routine preconception and infertility care to improve women's psychological well-being and support healthier future pregnancies.
Long-term hospitalized patients with schizophrenia (SZ) often experience significant oral health problems, and oral frailty (OF) can further exacerbate the decline in their quality of life. However, the status and key influencing factors contributing to OF in this population remain insufficiently explored. Most existing studies rely on traditional regression models, which are prone to overfitting when processing high-dimensional data, making accurate risk identification difficult. This study aims to clarify the current status of OF in this population in Southwest China, identify the influencing factors, and optimize the predictive model using machine learning (ML), thereby providing a basis for clinical practice. A total of 404 long-term hospitalized patients with SZ from three psychiatric hospitals in Southwest China were enrolled in this study. The Oral Frailty Index-8 was employed to assess OF. Nine feature selection methods and five ML models were employed to optimize the model through two-stage feature selection, while Shapley Additive Explanations (SHAP) were used to analyze the model's predictive logic. The prevalence of OF in this population was determined to be 69.3%. The optimal model identified was the random forest, with the Area Under the Curve increasing to 0.779 following two-stage optimization. Compared to non-feature selection, performance improved by approximately 6.57%. SHAP analysis revealed that the Number of Teeth, Number of Psychiatric Hospitalizations, Self-discontinuation of Medication, Marital Status, and Age were core risk factors for OF. The prevalence of OF in long-term hospitalized patients with SZ is notably high. Two-stage feature selection enhances the accuracy of the predictive model, and the identified core factors can serve as a reference for developing individualized oral intervention programs in clinical practice.
Effective communication is essential for health, quality of life and social participation. Adults with communication disabilities-particularly those with intellectual disabilities-often face systemic barriers to accessing appropriate support. A retrospective audit of 497 consultations from 276 adults with intellectual disabilities living in Australian group homes (2017-2022) was conducted at a private speech pathology clinic. The audit examined the proportion of patients recommended for and receiving a full communication assessment. A mixed method analysis was conducted and identified that of the 234 patients recommended for assessment, only 93 (39.7%) received one. Thematic analysis found that facilitators included dedicated funding, carer advocacy and multiple clinical contacts. Barriers were primarily related to funding limitations, competing clinical priorities and poor service access. There is a clear gap between recommended and delivered communication assessment. Systemic reform is needed to prioritise communication through improved funding pathways, carer training and access to speech pathology services. Many adults with intellectual disability living in group homes are missing out on important communication support. Even when a speech pathologist has recommended a communication assessment, only about 4 in 10 actually receive the assessment that they need. Funding, lack of advocacy and communication being seen as a low priority are three reasons that people don't get the communication assessment that they need. This happens, even though communication problems can seriously affect health, behaviour and quality of life.
Rising rates of mental health and substance use are significant contributors to illness and disability among adolescents, highlighting a critical area for support and intervention. Existing evidence suggests the physical environment where young people live may impact their mental health. However, research is seldom longitudinal and rarely accounts for the co-location or mixture of potential environmental influences. To assess longitudinal relationships between the physical environment in which young people reside in Aotearoa New Zealand and their mental health outcomes. This study follows a population cohort of 957,381 young people (aged 10-24 years in 2018) over six years (2013-2018), linking their mental health outcomes (emotional, externalising, substance problems, and self-harm) and individual-level characteristics derived from administrative linked microdata with environmental data represented by the Healthy Location Index. Longitudinal Generalised Estimating Equations and quantile g-computing examined longitudinal relationships between the physical environments where young people reside and their mental health. We found evidence of longitudinal associations between the mixture of physical environment and young people's mental health for emotional disorders (aORΨ = 1.09 [1.08, 1.10]), substance use (aORΨ = 1.04 [1.02, 1.05]), and self-harm (aORΨ = 1.14 [1.10, 1.17]) (but not externalising conditions (aORΨ = 1.01 [0.99, 1.02])), present even after adjusting for individual-level and socioeconomic characteristics. Modelling emphasised the importance of the mix of the environments and the combined positive influence of natural spaces (bluespace and greenspace) for mental health outcomes. This study provides longitudinal evidence of meaningful associations between exposure to the combined built and natural environment and mental health in young people. Specifically, living in predominantly health-constraining environments was associated with increased odds of emotional disorders, while greater access to and the mixture of greenspace and bluespace contributed to better mental health outcomes. Our findings are strengthened by a robust longitudinal nationwide study design and comprehensive adjustment, underscoring the significance of the environmental mix. These results extend current evidence and offer novel insights into how physical environments shape young people's mental health over time.
Prader-Willi syndrome (PWS) is a rare imprinting disorder characterized by typical dysmorphic features, lack of satiety, infantile hypotonia, and later morbid obesity with complications, short stature, hypogonadotropic hypogonadism, skeletal and psychiatric problems. From the literature, it is well known that patients with PWS have a more favorable metabolic pattern than healthy controls. The aim of the study is to assess the metabolic profile of PWS patients followed at an Expert Center for Rare Endocrine Diseases compared with healthy controls and to look for relations between components of the metabolic syndrome (MetS), adipokines, and the compartments of body composition (BC-lean and fat mass). The current study is a cross-sectional evaluation of 25 patients with Prader-Willi syndrome (mean age 11.3 ± 8.2 years), with a total of 183.6 patient-years of regular follow-up (from the first visit to the center to the data collection cutoff date), compared with 24 age-, sex-, and BMI-matched healthy controls (mean age 11.3 ± 3.9 years). Each participant underwent anthropometric measurements, physical examination, biochemical and hormonal blood sampling, and whole-body DXA scan. Statistical analysis (SPSS 15.0 statistical package, Chicago, IL, USA) was performed to assess the relations between the metrics in the PWS group compared with controls. Patients with PWS showed a better profile of glucose homeostasis with significantly lower serum insulin concentration and calculated HOMA-IR index compared with the controls (p < 0.05). Taking into consideration age, sex, and body mass index (BMI) in the PWS group, the analysis showed strong positive correlations between waist circumference (WC) and systolic blood pressure (SBP) (r = 0.864, p < 0.001), and WC and diastolic blood pressure (DBP) (r = 0.534, p = 0.033). Partial correlation analysis with respect to age, sex, and pubertal development found significant positive WC correlations with insulin (r = 0.796, p = 0.006), HOMA-IR (r = 0.697, p = 0.025), LDL-cholesterol (r = 0.735, p = 0.002), uric acid (r = 0.735, p = 0.002), CRP (r = 0.600, p = 0.023), and leptin (r = 0.730, p = 0.005). Strong negative correlations existed between WC and SHBG (r = -0.772, p = 0.002) and HMW adiponectin (r = -0.998, p = 0.044). Additionally, a negative correlation of HMW adiponectin and SBP was demonstrated. 88% of the patients were treated with recombinant human growth hormone (rhGH). Bone mineral density adjusted for height (BMD/height) was significantly lower in patients with PWS (p < 0.05) compared with healthy controls. The analysis did not reveal significant relationships between BC compartments and metabolic and auxological parameters in the PWS group. Our study confirms that patients with PWS have a favorable metabolic profile compared with healthy controls matched by age, sex, and BMI. Syndromic participants who manifest greater accumulation of abdominal adipose tissue have a higher risk of hemodynamic changes and metabolic disturbances predictive of the development of cardiovascular diseases (CVD) in adulthood. WC could serve as a predictive marker for detecting higher metabolic risk in this syndromic group of patients, and both WC and HMW adiponectin for hypertension. In the future, on this basis, we could possibly implement both of these metrics in clinical practice.
To explore the prevalence of discrepancies between estimated and actual orthodontic treatment duration and identify predictors of treatment delays. A total of 96 patients (62.5% female; age = 15.6 ± 6.8 years) who completed an orthodontic treatment with pre-adjusted edgewise fixed appliances between 2015 and 2023 were retrospectively included. Differences between actual and estimated treatment duration >3 months were classified as discrepancies and categorized as "overestimation" or "underestimation." Such discrepancies were compared on demographics, COVID period, and orthodontic parameters using Student's t-tests and chi-square tests, as appropriate. Predictors of underestimated treatment duration were assessed with logistic regression analysis. Actual treatment duration significantly differed from the estimated duration (26.5 ± 9.6 vs. 21.6 ± 3.6 months; P <0.001), with 65.6% cases exhibiting treatment discrepancy (P = 0.003) and 61.5% of them being underestimated (P = 0.032). Cases with underestimated durations more commonly displayed posterior crossbite (30.9% vs. 5.4%; P = 0.004), larger SNA angle (83.7 ± 3.7 vs. 78.8 ± 3.8; P = 0.005), bracket debonding (53.4% vs. 31.4%; P = 0.039; odds ratio [OR] = 2.51, 95% confidence interval [CI] = 1.04-6.04), and were most likely conducted during COVID period (33.9% vs. 10.8%; P = 0.011; OR = 4.23, 95% CI = 1.31-13.62) compared to overestimated ones. Posterior crossbite (P = 0.006) and COVID period (P = 0.007) were significant predictors of treatment underestimation. Approximately two-thirds of orthodontic treatments showed discrepancies between estimated and actual duration, with 61.5% being underestimated especially in presence of posterior crossbite and during COVID period. Why orthodontic treatment takes longer than expected?Why was this study done? People who start orthodontic treatment with braces often want to know how long their treatment will last. Knowing the expected treatment time is important because it affects motivation, comfort, and overall satisfaction. However, orthodontic treatment does not always go as planned, and treatment may take longer than expected. When this happens, patients and families may feel frustrated or disappointed. This study aimed to understand how often orthodontic treatment lasts longer than expected and why this happens. What did the researchers want to find out? The researchers wanted to find out which factors are linked to longer-than-expected orthodontic treatment time. They expected that certain bite problems or unexpected events could increase treatment length. What did the researchers do? The research team looked at 96 patients who received orthodontic treatment at a university dental clinic. For each patient, they compared the estimated treatment time given at the start with the actual time it took to complete treatment. They also looked at common features among patients whose treatment lasted longer than expected. What did the researchers find? In approximately two out of three patients, the estimated treatment time was not accurate. In most cases, treatment lasted longer than expected by about 4 months. These patients most likely had a posterior crossbite (a problem with how the back teeth fit together) or their treatments were carried out during the COVID-19 pandemic. What do the findings mean? Estimating orthodontic treatment time in advance is challenging, even for experienced clinicians. Some factors that affect treatment length cannot be predicted at the start of care. Clear communication with patients and families about the possibility of delays is needed. Setting realistic expectations will improve patient satisfaction.
This research study constructs and examines solitary wave solutions to the Katugampola time-fractional [Formula: see text]-dimensional generalized Painlev'e-type (also known as P-type) equation with the help of the generalized [Formula: see text]-expansion method and tanh-coth method. The targeted model is extensively used to understand the dynamics of the plasma waves and instabilities in soliton theory, plasma physics and nonlinear wave theory. By offering closed form traveling solutions, the proposed methods transform the desired model into a nonlinear algebraic system. A new set of solutions in terms of trigonometric, rational and hyperbolic functions is obtained by analytically solving the resulting algebraic system using the symbolic computation tool Maple. We provide a range of 3D, density, and 2D visual representations that show the presence of bright and dark solitary wave solutions in the framework of the resulting wave profiles that illustrate the strong dynamics of the model. Also, a more dynamic and practical framework proposed by Katugampola-derivative is used to enhance the validity of the results by investigating how the time-fractional derivative affects the given model's solutions. Being the initial accounts of developing solutions of the aimed model, our comparison brings out the uniqueness of the obtained solutions. The variegated array of findings also shows that the suggested approaches are useful mathematical tools for solving nonlinear Fractional Partial Differential Equations (FPDEs), with applications in mathematical sciences such as engineering, physics, and biology, as well as in other nonlinear evolution problems.