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An evaluation of menstrual health apps' functionality, inclusiveness, and health education information
No full textBackground: Menstrual health apps have become increasingly popular, providing users with a tool to monitor and learn about menstrual cycles, symptoms, and management. While previous research examined different aspects of menstrual health apps (e.g., fertility tracking), few examined menstrual health apps comprehensively to examine the menstrual health apps' functionality, inclusiveness, and health education information. The purpose of this study was to evaluate menstrual health apps' functionality, inclusiveness, and health education information.
Methods: In this descriptive study, two reviewers independently searched, screened, and evaluated each app using a standardized tool. Three terms (i.e., "period pain," "period app," and "menstrual cramp") were used to search the Apple App Store. Apps were also cross-searched on the Google Play Store. We screened 60 apps. After excluding duplicates and apps that did not meet the inclusion criteria, 14 apps were evaluated on their functionality (user experience, internet and language accessibility, privacy, cycle-prediction, and symptom-tracking ability), inclusiveness (cycle lengths and regularities, fertility goals, and gender expressions and sexualities), and menstrual health education information (credibility and comprehensiveness, presence of additional health information, and information on when to seek care). We used a modified version of the Mobile App Rating Scale to score each app.
Results: For functionality, half of the apps had third-party advertisements. Most (71.4%) did not require cellular connection to utilize menstrual symptom-tracking, and 71.4% shared user data with third parties. All had cycle-prediction and symptom-tracking functions. The mean number of relevant symptoms tracked was 17.5 (SD = 5.44). None of the apps used or cited validated symptom measurement tools. For inclusiveness, all apps could be tailored to cycle lengths other than 28 days, 85.7% had ovulation prediction functions, 50% had neutral or no pronouns, and 92.9% allowed users to input at least one contraceptive type. For health education information, 42.9% cited medical literature.
Conclusion: This study suggests a lack of professional involvement and gender inclusivity in menstrual health app development. Healthcare professionals should educate themselves on apps' functionality, inclusiveness, and health education information before recommending apps. Additional research is needed to understand diverse users' perspectives on menstrual health apps
The prevalence of neuropathic pain pathophysiology associated with ankle fracture: A study protocol
No full textChronic pain is prevalent among U.S. military personnel and often accompanied by comorbid behavioral health disorders and other medical conditions that further complicate its management. According to the Centers for Disease Control and Prevention, the prevalence of chronic pain among active-duty Service members is 1.5 to 2 times higher than the 20% of American adults who live with chronic pain. Recent report findings determined that Service members make up a large population within the Military Health Systems (MHS), and that this population is disproportionately affected by lost duty days, early retirement, loss of readiness, and increased burden to the MHS. To date, the Department of Defense (DOD) and MHS have emphasized multimodal, multidisciplinary, stepped treatment for chronic pain that prioritizes nonpharmacologic therapies and non-opioid pain medications. Though the DOD and MHS have invested in several pain treatment types, our level of understanding needs to better distinguish between acute and chronic pain and identify risk factors and mechanisms responsible for the chronification of pain, as it is the chronic pain which compromises functioning and readiness to a greater degree across the force. The novel information generated by this study will enhance our understanding of how ankle fracture elicits pathological risk factors for bone fracture associated neuropathic pain (BFNP), which ultimately impairs health-related quality of life. Due to the high prevalence of ankle fractures and the subsequent risk of developing chronic pain after ankle fracture, we will utilize this patient population to provide the preliminary evidence on whether bone fracture and subsequent BFNP phenotypes are reflected in specific genetic profiles and activated states of immune cells
Rates of retear following rotator cuff repair are similar between men and women
No full textHypothesis: A systematic review and meta-analysis was conducted investigating sex-based differences in retear rate after arthroscopic rotator cuff repair (RCR). It is hypothesized that females experience a higher rate of retear than males.
Methods: We performed a systematic review of 3 databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they were written in English, published in a peer-reviewed journal, included patients with a history of arthroscopic RCR, reported failure rate based on sex, and had level of evidence 3 or higher. To assess failure, we used retear as our primary outcome, defined as a loss of structural integrity of the rotator cuff after primary repair, confirmed by imaging. Complications, reoperation, and patient-reported outcomes (PRO) were secondary outcomes.
Results: In 11 eligible studies, there were 3134 patients, 1787 female (57%) and 1476 male (43%). Of 11 studies, 10 reported sex-specific rates of retear, 3 reported complications by sex, 3 reported reoperation by sex, and 2 reported PROs by sex. A random-effects model demonstrated no significant difference in retear rates between females and males (mean difference, .010 [95% CI, -.068 to .087]; P = .81). Limited reporting prevented analysis for complication or reoperation rates. One study found significantly higher American Shoulder and Elbow Surgeons scores (92.2 vs. 88.2, P = .002), Constant-Murley Score scores (92.2 vs. 81.8, P < .001) and significantly lower visual analog scale pain scores (.75 vs. 1.39, P < .001) for males compared with females. No other significant differences in PROs were found. A random-effects model showed a significant difference in age between patients with and without retear (mean difference, 4.38 years [95% CI, 1.81-6.95]; P < .001).
Conclusion: Female and male patients showed no significant difference in retear rate following arthroscopic RCR. Retears were associated with increased age, which aligns with previous findings in the existing literature. Since many studies reported only one or a few of the desired outcomes, increasing the uniformity of outcome reporting related to RCR failure may be beneficial
How We Monitor Cardiac Health in Breast Cancer Survivors
No full textThe Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice
Establishing group-level brain structural connectivity incorporating anatomical knowledge under latent space modeling
No full textBrain structural connectivity, capturing the white matter fiber tracts among brain regions inferred by diffusion MRI (dMRI), provides a unique characterization of brain anatomical organization. One fundamental question to address with structural connectivity is how to properly summarize and perform statistical inference for a group-level connectivity architecture, for instance, under different sex groups, or disease cohorts. Existing analyses commonly summarize group-level brain connectivity by a simple entry-wise sample mean or median across individual brain connectivity matrices. However, such a heuristic approach fully ignores the associations among structural connections and the topological properties of brain networks. In this project, we propose a latent space-based generative network model to estimate group-level brain connectivity. Within our modeling framework, we incorporate the anatomical information of brain regions as the attributes of nodes to enhance the plausibility of our estimation and improve biological interpretation. We name our method the attributes-informed brain connectivity (ABC) model, which compared with existing group-level connectivity estimations, (1) offers an interpretable latent space representation of the group-level connectivity, (2) incorporates the anatomical knowledge of nodes and tests its co-varying relationship with connectivity and (3) quantifies the uncertainty and evaluates the likelihood of the estimated group-level effects against chance. We devise a novel Bayesian MCMC algorithm to estimate the model. We evaluate the performance of our model through extensive simulations. By applying the ABC model to study brain structural connectivity stratified by sex among Alzheimer's Disease (AD) subjects and healthy controls incorporating the anatomical attributes (volume, thickness and area) on nodes, our method shows superior predictive power on out-of-sample structural connectivity and identifies meaningful sex-specific network neuromarkers for AD
Race- and Gender-Based Oppression Increase Black Women's Vulnerability to Posttraumatic Stress: The Psychology of Radical Healing Fosters Posttraumatic Growth
No full textThe Neighborhoods Study: Examining the social exposome in Alzheimer's disease and related dementias
No full textIntroduction: The Neighborhoods Study (TNS) is a novel investigation of adverse social exposome and brain health leveraging 22 Alzheimer's Disease Research Centers (ADRCs). TNS aims to understand if the adverse social exposures increase Alzheimer's disease and related dementias (ADRD) risk.
Methods: TNS uses innovative methods to determine lifetime addresses of living (n = ≈ 3116) and brain bank cohorts (n = ≈ 8637). Addresses are linked to time-concordant adverse social exposome using the Area Deprivation Index (ADI) and summarized over time. Brain health measures are provided by the National Alzheimer's Coordinating Center.
Results: We highlight a general overview and methodology of TNS. Data collection is ongoing; however, preliminary findings indicate that the adverse social exposome is related to ADRD biomarkers, neuropathology, and cognitive function.
Discussion: TNS is the largest study of adverse social exposome and ADRD, using the ADRC network to build robust scientific consortia. Its findings will inform ADRD interventions, precision medicine, and policy.
Highlights: The Neighborhoods Study (TNS) investigates adverse social exposome and brain health. TNS is a collaboration among 22 Alzheimer's Disease Research Centers. TNS will give insight on environmental and exposomal factors which may be modifiable. Participant lifetime addresses are linked to temporal adverse social exposome metrics. This study's findings will inform precision approaches to mitigate dementia risk
