Nicholas I Goldenson, Saul Shiffman, Mark A Sembower, Arielle Selya, Steve Pype, Ryan A Black
{"title":"Evaluating the Effect of the JUUL2 System With 5 Flavors on Cigarette Smoking and Tobacco Product Use Behaviors Among Adults Who Smoke Cigarettes: 6-Week Actual Use Study.","authors":"Nicholas I Goldenson, Saul Shiffman, Mark A Sembower, Arielle Selya, Steve Pype, Ryan A Black","doi":"10.2196/60620","DOIUrl":"10.2196/60620","url":null,"abstract":"<p><strong>Background: </strong>Adults who switch completely from smoking cigarettes to using electronic nicotine delivery systems (ENDS) substantially reduce their exposure to toxicants and carcinogens that are associated with smoking-related diseases.</p><p><strong>Objective: </strong>This 6-week actual use study-a prospective uncontrolled real-world study designed to evaluate quasi-naturalistic product use-aimed to assess switching behavior among US adults who smoked cigarettes and were provided with JUUL2 ENDS products.</p><p><strong>Methods: </strong>US adults who smoked cigarettes every day but were predominantly not ready to quit (N=1160; mean age 39.42, SD 11.03 years; 641/1160, 55.26% female participants; 667/1160, 57.5% non-Hispanic White; mean cigarettes per day 14.11, SD 8.96; only 1% [11/1160] planning to stop smoking within 30 days; and 481/1160, 41.47% dual users) were recruited to use JUUL2 ENDS products (18 mg/mL nicotine) in 1 of 5 flavors in real-world environments for 6 weeks. Participants who expressed sufficient interest in using JUUL2 products were enrolled at 24 different consumer research sites across the United States into one of the two following study arms: (1) traditional flavors (Virginia Tobacco and Polar Menthol, 10 sites); or (2) complex flavors (Autumn Tobacco, Summer Menthol, and Ruby Menthol, 14 sites). No instructions regarding JUUL2 product use or cigarette smoking were provided. After a 1-week trial period, participants were provided with their preferred flavor for 6 weeks of ad libitum use (10 pods per week). In total, 6 weekly web-based surveys were used to assess switching (smoking abstinence) and smoking reduction; dependence and respiratory symptoms were assessed at baseline and week 6.</p><p><strong>Results: </strong>Across the 5 flavor groups at week 6, the rates of complete past-7-day switching away from cigarettes ranged from 38.2% (79/207) to 47.3% (95/201), and 24.3% (55/226) to 33.9% (74/218) of participants reported complete past-30-day switching. Participants who used the 3 menthol-flavored (vs 2 tobacco-flavored) JUUL2 products had significantly higher rates of past-30-day switching at week 6 (odds ratio 1.36, 95% CI 1.04-1.78). Compared to their baseline values when they were smoking, the past-30-day switchers at week 6 had significantly reduced their dependence (mean differences in dependence, cigarettes - JUUL2: 0.57-0.99; P<.001) and self-reported frequency of respiratory symptoms (P<.05). Among participants who continued to smoke at week 6, 50.9% (59/116) to 62.9% (73/116) reduced their daily cigarette consumption by at least 50% from baseline.</p><p><strong>Conclusions: </strong>Adoption of JUUL2 ENDS products can likely help substantial proportions of US adults who smoke to switch completely away from cigarettes or meaningfully reduce their cigarette consumption, thereby reducing their dependence on tobacco products and improving their respiratory symptoms.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e60620"},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jill Inderstrodt, Julia C Stumpff, Rebecca C Smollen, Shreya Sridhar, Sarah A El-Azab, Opeyemi Ojo, Brendan Bowns, David A Haggstrom
{"title":"Informatics Interventions for Maternal Morbidity: Scoping Review.","authors":"Jill Inderstrodt, Julia C Stumpff, Rebecca C Smollen, Shreya Sridhar, Sarah A El-Azab, Opeyemi Ojo, Brendan Bowns, David A Haggstrom","doi":"10.2196/64826","DOIUrl":"10.2196/64826","url":null,"abstract":"<p><strong>Background: </strong>Women have been entering pregnancy less healthy than previous generations, placing them at increased risk for pregnancy complications. One approach to ensuring effective monitoring and treatment of at-risk women is designing technology-based interventions that prevent maternal morbidities and treat perinatal conditions.</p><p><strong>Objective: </strong>This scoping review evaluates what informatics interventions have been designed and tested to prevent and treat maternal morbidity.</p><p><strong>Methods: </strong>MEDLINE, Embase, and Cochrane Library were searched to identify relevant studies. The inclusion criteria were studies that tested a medical or clinical informatics intervention; enrolled adult women; and addressed preeclampsia, gestational diabetes mellitus (GDM), preterm birth, Centers for Disease Control and Prevention-defined severe maternal morbidity, or perinatal mental health conditions. Demographic, population, and intervention data were extracted to characterize the technologies, conditions, and populations addressed.</p><p><strong>Results: </strong>A total of 80 studies were identified that met the inclusion criteria. Many of the studies tested for multiple conditions. Of these, 73% (60/82) of the technologies were tested for either GDM or perinatal mental health conditions, and 15% (12/82) were tested for preeclampsia. For technologies, 32% (28/87) of the technologies tested were smartphone or tablet applications, 26% (23/87) were telehealth interventions, and 14% (12/87) were remote monitoring technologies. Of the many outcomes measured by the studies, almost half (69/140, 49%) were patient physical or mental health outcomes.</p><p><strong>Conclusions: </strong>Per this scoping review, most informatics interventions address three conditions: GDM, preeclampsia, and mental health. There may be opportunities to treat other potentially lethal conditions like postpartum hemorrhage using proven technologies such as mobile apps. Ample gaps in the literature exist concerning the use of informatics technologies aimed at maternal morbidity. There may be opportunities to use informatics for lesser-targeted conditions and populations.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e64826"},"PeriodicalIF":1.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chih-Yuan Lin, Chih-Ching Liu, Yu-Tung Huang, Yue-Chune Lee
{"title":"Policy Spotlight Effects on Critical Time-Sensitive Diseases: Nationwide Retrospective Cohort Study on Taiwan's Hospital Emergency Capability Categorization Policy.","authors":"Chih-Yuan Lin, Chih-Ching Liu, Yu-Tung Huang, Yue-Chune Lee","doi":"10.2196/54651","DOIUrl":"10.2196/54651","url":null,"abstract":"<p><strong>Background: </strong>Taiwan's categorization of hospital emergency capability (CHEC) policy is designed to regionalize and dispatch critical patients. The policy was designed in 2009 to improve the quality of emergency care for critical time-sensitive diseases (CTSDs). The CHEC policy primarily uses time-based quality surveillance indicators.</p><p><strong>Objective: </strong>We aimed to investigate the impact of Taiwan's CHEC policy on CTSDs.</p><p><strong>Methods: </strong>Using Taiwan's 2005 Longitudinal Health Insurance Database, this nationwide retrospective cohort study examined the CHEC policy's impact from 2005 to 2011. Propensity score matching and difference-in-differences analysis within a generalized estimating equation framework were used to compare pre- and postimplementation periods. The study focused on acute ischemic stroke (AIS), ST-segment elevation myocardial infarction (STEMI), septic shock, and major trauma. AIS and STEMI cases, monitored with time-based indicators, were evaluated for adherence to diagnostic and treatment guidelines as process quality measures. Mortality and medical use served as outcome indicators. Major trauma, with evolving guidelines and no time-based monitoring, acted as a control to test for policy spotlight effects.</p><p><strong>Results: </strong>In our cohort of 9923 patients, refined through 1:1 propensity score matching, 5566 (56.09%) were male and were mostly older adults. Our analysis revealed that the CHEC policy effectively improved system efficiency and patient outcomes, resulting in significant reductions in medical orders (-7.29 items, 95% CI -10.09 to -4.48; P<.001), short-term mortality rates (-0.09%, 95% CI -0.17% to -0.02%; P=.01) and long-term mortality rates (-0.09%, 95% CI -0.15% to -0.04%; P=.001), and total medical expenses (-5328.35 points per case, 95% CI -10,387.10 to -269.60; P=.04), despite a modest increase in diagnostic fees (376.37 points, 95% CI 92.42-660.33; P=.01). The CHEC policy led to notable increases in diagnostic fees, major treatments, and medical orders for AIS and STEMI cases. For AIS cases, significant increases were observed in major treatments (β=0.77; 95% CI 0.21-1.33; P=.007) and medical orders (β=15.20; 95% CI 5.28-25.11; P=.003) compared to major trauma. In STEMI cases, diagnostic fees significantly increased (β=1983.75; 95% CI 84.28-3883.21; P=.04), while upward transfer rates significantly decreased (β=-0.59; 95% CI -1.18 to -0.001; P=.049). There were also trends toward increased major treatments (β=0.30; 95% CI -0.03 to 0.62, P=.07), medical orders (β=11.92; 95% CI -0.90 to 24.73; P=.07), and medical expenses (β=24,275.54; 95% CI -640.71 to 4,991,991.78; P=.06), although these were not statistically significant. In contrast, no significant changes were identified in process or outcome quality indicators for septic shock. These findings suggest policy spotlight effects, reflecting a greater emphasis on diseases directly prioritized under the","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e54651"},"PeriodicalIF":1.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sari Reisner, Yuxin Liu, Regina Tham, Kaiden Kane, S Wilson Cole, Elizabeth R Boskey, Sabra L Katz-Wise, Alex S Keuroghlian, Rena Xu
{"title":"Prevalence and Correlates of Clinically Elevated Depressive Symptoms in a Nationwide Sample of Transgender, Nonbinary, and Gender Diverse Young Adults in the United States: Cross-Sectional Survey Study.","authors":"Sari Reisner, Yuxin Liu, Regina Tham, Kaiden Kane, S Wilson Cole, Elizabeth R Boskey, Sabra L Katz-Wise, Alex S Keuroghlian, Rena Xu","doi":"10.2196/66630","DOIUrl":"10.2196/66630","url":null,"abstract":"<p><strong>Background: </strong>In the United States, transgender, nonbinary, and gender diverse (TGD) young adults experience a higher risk of depression compared to their cisgender peers. Understanding factors associated with increased risk of depression within the TGD young adult population is important to guide clinical care as well as inform the development of interventions to reduce mental health disparities.</p><p><strong>Objective: </strong>This exploratory study investigated the prevalence and correlates of positive screening for depressive symptoms among TGD young adults to inform the design, development, and implementation of national interventions aimed at improving mental health in this at-risk population.</p><p><strong>Methods: </strong>In August 2022, a cross-sectional, nationwide online survey was conducted among TGD young adults aged 18-25 (N=104) in the United States. Measures included sociodemographic variables, family characteristics, mental health care utilization, and the two-item Patient Health Questionnaire-2 (PHQ-2) screener for depression. Poisson regression models with robust variance estimation were fitted to estimate adjusted prevalence ratios (aPR) and 95% CI for correlates of PHQ-2 depression (score ≥3).</p><p><strong>Results: </strong>The study sample had a mean age of 22 (SD 2) years; 48/104 (46%) individuals identified as Black, Indigenous, or other People of Color, and 69/104 (66%) were nonbinary. Overall, 44 (42%) individuals screened positive for depression using PHQ-2. In a multivariable model adjusted for age, race and ethnicity, US census region, and health insurance status, factors associated with increased depression prevalence using PHQ-2 included low versus high family support (aPR 1.54, 95% CI 1.05-2.27) and identifying with a nonChristian religion versus being unaffiliated (aPR 1.66, 95% CI 1.04-2.63). Factors associated with reduced depression prevalence included living in a rural versus suburban area (aPR 0.48, 95% CI 0.26-0.92) and receiving mental health therapy versus not (aPR 0.71, 95% CI 0.53-0.97).</p><p><strong>Conclusions: </strong>The high prevalence of depressive symptoms among TGD young adults in this study sample highlights the need for comprehensive mental health evaluation and support in this population. Depression risk is increased among certain subgroups, such as those with low family support. These findings are valuable in informing the development of interventions that aim to improve mental health outcomes among TGD young people.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e66630"},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long-Term Engagement of Diverse Study Cohorts in Decentralized Research: Longitudinal Analysis of \"All of Us\" Research Program Data.","authors":"Vijay Yadav, Elias Chaibub Neto, Megan Doerr, Abhishek Pratap, Larsson Omberg","doi":"10.2196/56803","DOIUrl":"10.2196/56803","url":null,"abstract":"<p><strong>Background: </strong>The generalizability of clinical research hinges on robust study designs, which include the recruitment and maintenance of a representative study population. This study examines the evolution of the demographic characteristics of 329,038 participants who enrolled and participated in The All of Us Research Program (AoURP), a decentralized study aimed at representing the diversity of the United States.</p><p><strong>Objective: </strong>The primary objectives of this study were to assess alterations in the demographic composition of the cohort at different protocol stages within AoURP, while analyzing completion rates and timeframes for survey and substudy completion. Additionally, we examined how participant interactions with the program impacted engagement and survey responses.</p><p><strong>Methods: </strong>We conducted a longitudinal analysis of the AoURP data, tracking changes in demographic composition, completion rates, and completion times for surveys and substudies. Comparative analyses were performed to assess differences in engagement and survey completion based on sociodemographic characteristics of participants involved in postenrollment study components.</p><p><strong>Results: </strong>The sociodemographic composition of the cohort that participated in the postenrollment study (eg, optional components) differed significantly from that of the recruited population. The proportion of self-identified White participants increased by 21.2%, whereas the proportion of Black or African American participants decreased by 12.18% (P=.02). Participants who identified as White (n=93,614, 52.7%) and NonHispanic (n=109,279, 42.21%) were more engaged compared to those identifying as Black or African American (n=10,887, 15.76%), Asian (n=4274, 38.72%), or Hispanic (n=12,530, 20.7%; P=.006). Participants' response times to study surveys and completeness varied across all demographic groups (P<.001). Furthermore, those identifying as White skipped fewer survey questions (1.19) compared to those identifying as Black or African American (1.40) or other racial and ethnic identities (P<.001).</p><p><strong>Conclusions: </strong>The AoURP dataset serves as an exceptional resource for investigating diverse public health concerns. However, the longitudinal analysis of participant-level data underscores a significant skew in population diversity, suggesting the need for targeted strategies to enhance engagement and retention across all groups. Ensuring diversity in the cohort is essential for maintaining the study's representativeness and the broad applicability of its findings.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e56803"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liesje Donkin, Nathan Henry, Amy Kercher, Mangor Pedersen, Holly Wilson, Amy Hai Yan Chan
{"title":"Effective Recruitment or Bot Attack? The Challenge of Internet-Based Research Surveys and Recommendations to Reduce Risk and Improve Robustness.","authors":"Liesje Donkin, Nathan Henry, Amy Kercher, Mangor Pedersen, Holly Wilson, Amy Hai Yan Chan","doi":"10.2196/60548","DOIUrl":"10.2196/60548","url":null,"abstract":"<p><p>Internet-based research has exploded in popularity in recent years, enabling researchers to offer both investigations and interventions to broader participant populations than ever before. However, challenges associated with internet-based research have also increased-notably, difficulties verifying participant data and deliberate data manipulation by bot and spam responses. This study presents a viewpoint based on 2 case studies where internet-based research was affected by bot and spam attacks. We aim to share the learnings from these experiences with recommendations for future research practice that may reduce the likelihood or impact of future attacks. The screening and verification processes used are presented and discussed, including the limitations of these. Based on our experience, security and screening within internet-based research platforms are partly effective, but no solution is available to protect researchers completely against bot attacks. Implications for future research and advice for health researchers are discussed.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e60548"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Understanding Loneliness Through Analysis of Twitter and Reddit Data: Comparative Study.","authors":"Hurmat Ali Shah, Mowafa Househ","doi":"10.2196/49464","DOIUrl":"10.2196/49464","url":null,"abstract":"<p><strong>Background: </strong>Loneliness is a global public health issue contributing to a variety of mental and physical health issues. It increases the risk of life-threatening conditions and contributes to the burden on the economy in terms of the number of productive days lost. Loneliness is a highly varied concept, which is associated with multiple factors.</p><p><strong>Objective: </strong>This study aimed to understand loneliness through a comparative analysis of loneliness data on Twitter and Reddit, which are popular social media platforms. These platforms differ in terms of their use, as Twitter allows only short posts, while Reddit allows long posts in a forum setting.</p><p><strong>Methods: </strong>We collected global data on loneliness in October 2022. Twitter posts containing the words \"lonely,\" \"loneliness,\" \"alone,\" \"solitude,\" and \"isolation\" were collected. Reddit posts were extracted in March 2023. Using natural language processing techniques (valence aware dictionary for sentiment reasoning [VADER] tool from the natural language toolkit [NLTK]), the study identified and extracted relevant keywords and phrases related to loneliness from user-generated content on both platforms. The study used both sentiment analysis and the number of occurrences of a topic. Quantitative analysis was performed to determine the number of occurrences of a topic in tweets and posts, and overall meaningful topics were reported under a category.</p><p><strong>Results: </strong>The extracted data were subjected to comparative analysis to identify common themes and trends related to loneliness across Twitter and Reddit. A total of 100,000 collected tweets and 10,000 unique Reddit posts, including comments, were analyzed. The results of the study revealed the relationships of various social, political, and personal-emotional themes with the expression of loneliness on social media. Both platforms showed similar patterns in terms of themes and categories of discussion in conjunction with loneliness-related content. Both Reddit and Twitter addressed loneliness, but they differed in terms of focus. Reddit discussions were predominantly centered on personal-emotional themes, with a higher occurrence of these topics. Twitter, while still emphasizing personal-emotional themes, included a broader range of categories. Both platforms aligned with psychological linguistic features related to the self-expression of mental health issues. The key difference was in the range of topics, with Twitter having a wider variety of topics and Reddit having more focus on personal-emotional aspects.</p><p><strong>Conclusions: </strong>Reddit posts provide detailed insights into data about the expression of loneliness, although at the cost of the diversity of themes and categories, which can be inferred from the data. These insights can guide future research using social media data to understand loneliness. The findings provide the basis for further comparative investigation","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e49464"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mert Marcel Dagli, Ryan William Turlip, Felix C Oettl, Mohamed Emara, Jaskeerat Gujral, Daksh Chauhan, Hasan S Ahmad, Gabrielle Santangelo, Connor Wathen, Yohannes Ghenbot, John D Arena, Joshua L Golubovsky, Ben J Gu, John H Shin, Jang Won Yoon, Ali K Ozturk, William C Welch
{"title":"Comparison of Outcomes Between Staged and Same-Day Circumferential Spinal Fusion for Adult Spinal Deformity: Systematic Review and Meta-Analysis.","authors":"Mert Marcel Dagli, Ryan William Turlip, Felix C Oettl, Mohamed Emara, Jaskeerat Gujral, Daksh Chauhan, Hasan S Ahmad, Gabrielle Santangelo, Connor Wathen, Yohannes Ghenbot, John D Arena, Joshua L Golubovsky, Ben J Gu, John H Shin, Jang Won Yoon, Ali K Ozturk, William C Welch","doi":"10.2196/67290","DOIUrl":"10.2196/67290","url":null,"abstract":"<p><strong>Background: </strong>Adult spinal deformity (ASD) is a prevalent condition often treated with circumferential spinal fusion (CF), which can be performed as staged or same-day procedures. However, evidence guiding the choice between these approaches is lacking.</p><p><strong>Objective: </strong>This study aims to compare patient outcomes following staged and same-day CF for ASD.</p><p><strong>Methods: </strong>Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was conducted in PubMed, MEDLINE, Embase, Cochrane CENTRAL, Web of Science, and Scopus. Eligibility criteria included studies comparing outcomes following staged and same-day CF in adults with ASD. Searches were exported to Covidence, and records were deduplicated automatically. Title and abstract screening, full-text review, and data extraction were performed by two independent reviewers, with all conflicts being resolved by a third reviewer. A meta-analysis was conducted for outcomes reported in 3 or more studies.</p><p><strong>Results: </strong>Seven studies with 741 patients undergoing CF for ASD were included in the review (staged: n=331, 44.7% and same-day: n=410, 55.3%). Four studies that had comparable outcomes were merged for the quantitative meta-analysis and split based on observed measures. The meta-analysis revealed significantly shorter hospital length of stay (mean difference 3.98, 95% CI 2.23-5.72 days; P<.001) for same-day CF. Three studies compared the operative time between staged and same-day CF, with all reporting a lower mean operative time for same-day CF (mean between 291-479, SD 129 minutes) compared to staged CF (mean between 426-541, SD 124 minutes); however, inconsistent reporting of mean and SD made quantitative analyses unattainable. Of the 4 studies that compared estimated blood loss (EBL) in the relevant groups, 3 presented a lower EBL (mean between 412-1127, SD 954 mL) in same-day surgery compared to staged surgery (mean between 642, SD 550 to 1351, SD 869 mL). Both studies that reported intra- and postoperative adverse events showed more intraoperative adverse events in staged CF (10.9% and 13.6%, respectively) compared to same-day CF (9.1% and 3.6%, respectively). Four studies measuring any perioperative adverse events showed a higher incidence of adverse events in staged CF than all studies combined. However, quantitative analysis of EBL, intraoperative adverse events, and perioperative adverse events found no statistically significant difference. Postoperative adverse events, reoperation, infection rates, and readmission rates showed inconsistent findings between studies. Data quality assessment revealed a moderate degree of bias for all included studies.</p><p><strong>Conclusions: </strong>Same-day CF may offer shorter operating time and hospital stay compared to staged CF for ASD. However, there was marked heterogeneity in perioperative outcomes reporting, and co","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e67290"},"PeriodicalIF":1.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Priscila de Campos Tibúrcio, Priscila Maria Marcheti, Daniela Miori Pascon, Marco Antônio Montebello Junior, Maria Alzete de Lima, Carla Sílvia Fernandes, Célia Samarina Vilaça de Brito Santos, Maria do Perpétuo Socorro de Sousa Nóbrega
{"title":"Therapeutic Guidelines for the Self-Management of Major Depressive Disorder: Scoping Review.","authors":"Priscila de Campos Tibúrcio, Priscila Maria Marcheti, Daniela Miori Pascon, Marco Antônio Montebello Junior, Maria Alzete de Lima, Carla Sílvia Fernandes, Célia Samarina Vilaça de Brito Santos, Maria do Perpétuo Socorro de Sousa Nóbrega","doi":"10.2196/63959","DOIUrl":"10.2196/63959","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder contributes to the global burden of mental illness. Therapeutic guidelines promote treatment self-management and support caregivers and family members in this process.</p><p><strong>Objective: </strong>We aimed to identify therapeutic guidelines for the symptoms of major depressive disorder.</p><p><strong>Methods: </strong>This scoping review followed the assumptions established by the Joanna Briggs Institute and the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) protocol, carried out in 12 databases (LILACS, PubMed, SciELO, Scopus, Web of Science, b-on, BDENF, AgeLine, Cochrane, BVS, IBECS, and CINAHL) and 5 secondary gray literature sources (Google Scholar, Global ETD Search, EBSCO Open Dissertations, CAPES Catalog of Theses and Dissertations, and the Digital Library of Theses and Dissertations of the University of Sao Paulo). The eligibility criteria were based on the population, concept, and context framework: people diagnosed with major depressive disorder aged >18 years (population), therapeutic guidelines for self-management of major depressive disorder symptoms (concept), and symptoms of major depressive disorder (context). Data collection was carried out from March to July 2022 and updated in June 2024. The included studies were experimental, quasi-experimental, analytical observational, descriptive observational, qualitative, or quantitative studies; systematic reviews and meta-analyses; and scoping and literature reviews published in full without time restrictions in English, Spanish, or Portuguese. All the information, as well as the studies captured, was stored in a Microsoft Excel spreadsheet using Rayyan and the JBI Manual for Evidence Synthesis. The titles, abstracts, and full texts were carefully read and classified, extracting the results. After review by 2 independent researchers, 62 studies were selected. The results are presented descriptively, including characterization of the studies and mapping and categorization of groups and subgroups of therapeutic guidelines for self-management of major depressive disorder.</p><p><strong>Results: </strong>In total, 62 studies published between 2011 and 2023 were included, where 44 (71%) came from indexed data sources and 18 (29%) were gray literature indexed on Google Scholar (13/62, 21%), doctoral theses (3/62, 5%), and master's dissertations (2/62, 3%). Among the therapeutic guidelines identified, mapped, and categorized, 7 major groups were identified for self-management: psychotherapy (32/62, 52%), adoption of healthy habits (25/62, 40%), integrative and complementary practices (17/62, 27%), relaxation techniques (9/62, 14%), consultation with a health professional (14/62, 22%), pharmacological therapy (9/62, 14%), and leisure or pleasurable activities (4/62, 6%).</p><p><strong>Conclusions: </strong>It was possible to identify therapeutic guidelines to promote se","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e63959"},"PeriodicalIF":1.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Associations Between Sleep Duration and Activity of Daily Living Disability Among Older Adults in China: Cross-Sectional Study.","authors":"Huimin Fan, Weijie Yu, Hongguo Rong, Xiaokun Geng","doi":"10.2196/65075","DOIUrl":"10.2196/65075","url":null,"abstract":"<p><strong>Background: </strong>China has the largest elderly population globally; the growth rate of the aged tendency of the population was higher than that of Western countries. Given the distinctions in historical, ethnic, and economic status as well as socio-cultural background, Chinese adults had different sleep patterns compared with adults in other countries. Considering the heavy disease burden caused by activities of daily living (ADL) disability, we conducted a cross-sectional analysis using data from the China Health and Retirement Longitudinal Study (CHARLS) to test the hypothesis that individuals with short and longer sleep duration are more likely to have ADL disability.</p><p><strong>Objective: </strong>ADL disability is a common condition affecting the quality of life among older people. This study aimed to explore the associations between sleep duration and ADL disability among middle-aged and older adults in China.</p><p><strong>Methods: </strong>This cross-sectional study used data from 17,607 participants from the 2018 CHARLS (from 2018 to 2020), an ongoing representative survey of adults aged 45 years or older and their spouses. Self-reported sleep duration per night was obtained from face-to-face interviews. The ADL was measured using a 6-item summary assessed with an ADL scale that included eating, dressing, getting into or out of bed, bathing, using the toilet, and continence. Multiple generalized linear regression models-adjusted for age, sex, education, marital status, tobacco and alcohol use, depression, place of residence, sensory impairment, self-reported health status, life satisfaction, daytime napping, chronic disease condition, and sample weights-were used.</p><p><strong>Results: </strong>Data were analyzed from 17,607 participants, of whom 8375 (47.6%) were men. The mean (SD) age was 62.7 (10.0) years. Individuals with 4 hours or less (odds ratio [OR] 1.91, 95% CI 1.60-2.27; P<.001), 5 hours (OR 1.33, 95% CI 1.09-1.62; P=.006), 9 hours (OR 1.48, 95% CI 1.13-1.93; P<.001), and 10 hours or more (OR 1.88, 95% CI 1.47-2.14; P<.001) of sleep per night had a higher risk of ADL disability than those in the reference group (7 hours per night) after adjusting for several covariates. Restricted cubic splines analysis suggested a U-shaped association between sleep duration and ADL disability. When sleep duration fell below 7 hours, an increased sleep duration was associated with a significantly low risk of ADL disability, which was negatively correlated with sleep duration until it fell below 7 hours (OR 0.83, 95% CI 0.79-0.87; P<.001). When sleep duration exceeded 7 hours, the risk of ADL disability would increase facing prolonged sleep duration (OR 1.19, 95% CI 1.12-1.27; P<.001). ADL disability should be monitored in individuals with insufficient (≤4 or 5 hours per night) or excessive (9 or ≥10 hours per night) sleep duration.</p><p><strong>Unlabelled: </strong>In this study, a U-shaped association between sleep duratio","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":"14 ","pages":"e65075"},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}