Mega-analysis methods in ENIGMA: The experience of the generalized anxiety disorder working group.

The ENIGMA group on Generalized Anxiety Disorder (ENIGMA-Anxiety/GAD) is part of a broader effort to investigate anxiety disorders using imaging and genetic data across multiple sites worldwide. The group is actively conducting a mega-analysis of a large number of brain structural scans. In this process, the group was confronted with many methodological challenges related to study planning and implementation, between-country transfer of subject-level data, quality control of a considerable amount of imaging data, and choices related to statistical methods and efficient use of resources. This report summarizes the background information and rationale for the various methodological decisions, as well as the approach taken to implement them. The goal is to document the approach and help guide other research groups working with large brain imaging data sets as they develop their own analytic pipelines for mega-analyses.

Community voices on factors influencing COVID-19 concerns and health decisions among racial and ethnic minorities in the school setting.

Racial and ethnic minority communities have been disproportionately affected by COVID-19, but the uptake of COVID-19 mitigation strategies like vaccination and testing have been slower in these populations. With the continued spread of COVID-19 while in-person learning is a priority, school-aged youth and their caregivers must make health-related decisions daily to ensure health at school. It is critical to understand factors associated with COVID-related health decisions such as vaccination, testing, and other health behaviors (e.g., wearing masks, hand washing). Community-engaged campaigns are necessary to overcome barriers to these health behaviors and promote health equity. The aim of this study was to examine COVID-19-related concerns and influences on health decisions in middle and high schools serving primarily racial and ethnic minority, low-income families. Seven focus groups were conducted with school staff, parents, and students (aged 16 years and older). Qualitative data were analyzed using a general inductive approach. Factors related to COVID-19 concerns and health decisions centered on (1) vaccine hesitancy, (2) testing hesitancy, (3) developmental stage (i.e., ability to engage in health behaviors based on developmental factors like age), (4) cultural and family traditions and beliefs, (5) compatibility of policies and places with recommended health behaviors, (6) reliability of information, and (7) perceived risk. We explore sub-themes in further detail. It is important to understand the community's level of concern and identify factors that influence COVID-19 medical decision making to better address disparities in COVID-19 testing and vaccination uptake.

In vivo measurements of medial branch nerve depth and adjacent osseous structures for ablation of facet-related back pain: Predictors for patient candidacy.

BACKGROUND: Medial branch (MB) targeting during RF ablation for facetogenic back pain is usually performed with flouroscopic guidance yet no specific measurements on the target depth have been published. In order to understand candidacy for other potential ablation methods, we sought to determine the actual MB depth and measurements of adjacent osseous structures. METHODS: CT scans without contrast of the lumbar spine performed in the supine position were retrospectively analyzed in 100 patients. Axial slices less than or equal to 2.5 mm with sagittal and coronal reformations were evaluated. The following distances were measured bilaterally at the L2-L5 levels: The depth from the skin to the MB nerve (anatomic target for RF ablation) at a 15° angulation, the smallest width of the pedicle, and the length, height and width of the transverse process. Age, gender, weight, height, and BMI were correlated with the above measurements. RESULTS: The average distance and 95% CI from skin-to-MB in mm at a 15°angle to the skin increased as the lumbar level increased measuring 64.4 (62.4-66.5) at L2, 72.0 (69.7-74.3) at L3, 79.2 (76.9-81.6) at L4, and 79.1 (76.7-81.5) at L5. The average thickness of the pedicles also increased as the lumbar level increased measuring 9.2 mm at L2 and 16.1 mm at L5. Body weight, lumbar level, and female gender were associated with increased MB depth. Taller stature was associated with more superficial MB depth. We eliminated mild interaction effects between height, weight, and gender by substituting BMI for height and weight without affecting r2. Linear regression revealed the following equation: MB Depth (mm) = 2.2*BMI + 4.9*lumbar vertebral level + 3.6 (if female) - 5.4, which fit the data well (P<0.001, r2 = 0.60). CONCLUSIONS: Our results demonstrate that the MB resides 107 mm or less in depth when measured at a 15° angulation from the skin in > 95% of patients and the distance increases as the lumbar level increases.