Increased vascular deposition of oxidized LDL in untreated juvenile dermatomyositis

Background: Juvenile dermatomyositis (JDM) is a systemic vasculopathy associated with metabolic derangements and possible increased risk for premature atherosclerosis. Oxidation of low-density lipoprotein (LDL) in the endothelium is an early step in atherosclerotic plaque formation. It is not known if oxidized LDL is altered in children with untreated JDM. The deposition of oxidized LDL in the vasculature of muscle biopsies (MBx) from patients with untreated JDM and pediatric controls was assessed. Findings: Frozen tissue sections of MRI-directed MBx from 20 female children with untreated JDM and 5 female controls were stained with DAPI and fluorescently labeled antibodies against von Willebrand factor (vWF) and LDL oxidized by copper (oxLDL). Blood vessels were identified by positive vWF staining, and total fluorescence of oxLDL within the vessel walls was measured. Children with untreated JDM had increased deposition of oxLDL in the walls of muscle vasculature compared to healthy children (difference in means ± SEM = 19.86 ± 8.195, p = 0.03). Within the JDM cohort, there was a trend towards increased oxLDL deposition with longer duration of untreated disease (r = 0.43, p = 0.06). There was no significant correlation found between oxLDL deposition and markers of acute JDM disease activity including disease activity scores or muscle enzymes. Conclusions: This study found increased deposition of oxLDL within blood vessels of children with untreated JDM supporting the concern that these children are at increased risk for premature atherosclerosis from chronic exposure to vascular oxLDL. This study highlights the importance of early diagnosis and treatment initiation to ameliorate cardiovascular damage

Identification of Myths and Misinformation About Treatment for Opioid Use Disorder on Social Media: Infodemiology Study

BackgroundHealth misinformation and myths about treatment for opioid use disorder (OUD) are present on social media and contribute to challenges in preventing drug overdose deaths. However, no systematic, quantitative methodology exists to identify what types of misinformation are being shared and discussed. ObjectiveWe developed a multistage analytic pipeline to assess social media posts from Twitter (subsequently rebranded as X), YouTube, Reddit, and Drugs-Forum for the presence of health misinformation about treatment for OUD. MethodsOur approach first used document embeddings to identify potential new statements of misinformation from known myths. These statements were grouped into themes using hierarchical agglomerative clustering, and public health experts then reviewed the results for misinformation. ResultsWe collected a total of 19,953,599 posts discussing opioid-related content across the aforementioned platforms. Our multistage analytic pipeline identified 7 main clusters or discussion themes. Among a high-yield data set of posts (n=303) for further public health expert review, these included discussion about potential treatments for OUD (90/303, 29.8%), the nature of addiction (68/303, 22.5%), pharmacologic properties of substances (52/303, 16.9%), injection drug use (36/303, 11.9%), pain and opioids (28/303, 9.3%), physical dependence of medications (22/303, 7.2%), and tramadol use (7/303, 2.3%). A public health expert review of the content within each cluster identified the presence of misinformation and myths beyond those used as seed myths to initialize the algorithm. ConclusionsIdentifying and addressing misinformation through appropriate communication strategies could be an increasingly important component of preventing overdose deaths. To further this goal, we developed and tested an approach to aid in the identification of myths and misinformation about OUD from large-scale social media content

The Risk of A Child Neglect and Intellectual Disability of A Parent

Kontekst: Chociaż zaniedbywanie dzieci jest najczęściej zgłaszaną formą krzywdzenia, to jest stosunkowo słabo zbadane. Cel: Zebranie szacunkowych danych dotyczących podtypów zaniedbywania i różnic demograficznych w zakresie ekspozycji na poszczególne z nich, a także informacji o skutkach psychologicznych tego zjawiska. Osoby badane: Dane zbiorcze z dwóch reprezentatywnych prób z ogólnoamerykańskich badań ekspozycji dzieci na przemoc (National Surveys of Children’s Exposure to Violence, NatSCEV), przeprowadzonych w latach 2011 i 2014, dotyczących doświadczeń dzieci oraz nastolatków w wieku od miesiąca do 17 lat (N = 8503). Metody: Przeprowadzono ankiety telefoniczne, aby uzyskać dane socjodemograficzne, sześć miar doświadczeń zaniedbywania w roku poprzedzającym badanie i w ciągu całego życia oraz ocenę objawów traumy, myśli samobójczych, używania alkoholu i narkotyków. Wyniki: Ponad jedno na 17 amerykańskich dzieci (6,07%) doświadczyło jakiejś formy zaniedbywania w roku poprzedzającym badanie, a ponad jedno na siedmioro (15,4%) doświadczyło zaniedbywania w którymś momencie życia. Najczęstszym typem zaniedbywania jest zaniedbanie nadzoru nad dzieckiem (supervisory neglect) spowodowane niewydolnością opiekuńczą rodziców lub ich nieobecnością. W rodzinach z dwojgiem rodziców biologicznych zjawisko to występowało rzadziej (4,29% w poprzednim roku) niż w rodzinach o innej strukturze (7,95–14,10%; p <0,05). Wszystkie typy zaniedbywania były związane z nasileniem symptomów traumy i myśli samobójczych (w grupie dzieci i nastolatków w wieku 10–17 lat), a niektóre formy wiązały się z podwyższonym ryzykiem picia alkoholu i używania narkotyków przed osiągnięciem pełnoletniości. Wniosek: Należy poświęcić więcej uwagi skutkom zaniedbywania dzieci. Otrzymane wyniki podkreślają wagę działań profilaktycznych, zapewniających wsparcie niezbędne do budowania bezpiecznych, stabilnych, troskliwych relacji oraz środowisk wspomagających prawidłowy rozwój dziecka.Background: Childhood neglect is an understudied form of childhood maltreatment despite being the most commonly reported to authorities. Objective: This study provides national estimates of neglect subtypes, demographic variations in exposure to neglect subtypes, and examines the psychological impact. Participants and Setting: Pooled data from two representative U.S. samples from the National Surveys of Children’s Exposure to Violence (NatSCEV) survey conducted in 2011 and 2014, representing the experiences of children and youth aged 1 month to 17 years (N=8503). Methods: Telephone surveys were used to obtain sociodemographic characteristics, six measures of past year and lifetime exposure to neglect, and assessments of trauma symptoms, suicidal ideation, alcohol use, and illicit drug use. Results: More than 1 in 17 U.S. children (6.07%) experienced some form of neglect in the past year, and more than 1 in 7 (15.14%) experienced neglect at some point in their lives. Supervisory neglect, due to parental incapacitation or parental absence, was most common. Families with two biological parents had lower rates (4.29% in the past year) than other household configurations (range from 7.95% to 14.10%; p < .05). All types of neglect were associated with increased trauma symptoms and suicidal ideation (for 10–17 year olds), and several were associated with increased risk of underage alcohol and illicit drug use. Conclusion: More attention needs to be paid to the impact of supervisory neglect. These results underscore the importance of prevention strategies that provide the supports necessary to build safe, stable, and nurturing relationships and environments that help children thrive