Category: Nevin Manimala

Facial Plast Surg Aesthet Med. 2025 Apr 24. doi: 10.1089/fpsam.2024.0250. Online ahead of print.

ABSTRACT

Background: Chemodenervation is a mainstay in the treatment of nonflaccid facial paralysis (NFFP). This study investigates how electromyography (EMG) guidance during chemodenervation may allow for more accurate needle placement. Study Objective: To compare the accuracy with needle EMG chemodenervation compared with standard non-EMG approaches in patients receiving treatment for NFFP with botulinum toxin (BT) as measured by physician and EMG verification. Methods: The use of needle EMG across three surgeons was recorded to determine if the use of EMG changed the location, angle, or depth of needle insertion into the targeted facial muscle. The determination of accurate needle placement was self-reported by the physician coupled with the physician assessment of muscle EMG activity. Accuracy was determined as the ratio of the number of successful EMG needle insertions (placed within muscle with adequate signal) over the total number of EMG needle insertions. Results: A total of 137 patients underwent treatment for NFFP, with an average age of 54 (interquartile range [IQR]: 44-65) and weight of 73 kg (IQR: 64-90). Of the 14 facial mimetic muscles, the posterior belly of digastric (accuracy = 19%, standard deviation [SD] 0.4), risorius (accuracy = 46%, SD 0.5), and zygomaticus (accuracy = 47%, SD 0.5) had the lowest accuracy in BT placement (Table 3). Of all the muscles included, only the buccinator (p = 0.015), platysma (p = 0.0093), and zygomaticus (p = 0.024) had statistically significant variation in the accuracy of BT placement between surgeons. Conclusions: EMG guidance for the treatment of NFFP may improve the precision of needle placement and BT delivery, particularly in the mid and lower facial muscles.

PMID:40272786 | DOI:10.1089/fpsam.2024.0250

J Racial Ethn Health Disparities. 2025 Apr 24. doi: 10.1007/s40615-025-02424-7. Online ahead of print.

ABSTRACT

Discrepancies in healthcare outcomes and quality of treatment between White people and people of color are known and statistically relevant in the USA. The possible root causes of this issue, however, are not discussed enough, further enhancing an unequal access to proper healthcare and not acknowledging the role of racism and White supremacy in the consolidation of the medical field in the country. This article used discourse and document analysis to understand the role in which racism and narratives regarding Black bodies during the consolidation of medicine and gynecology had in the USA during the nineteenth century to create discrepancies in access and quality of care for Black patients today. The findings suggest that the dehumanizing narratives of Black patients in the past still impact the quality of care, creating higher mortality rates, worse prognosis, and lack of proper pain management, reinforcing health disparities.

PMID:40272774 | DOI:10.1007/s40615-025-02424-7

J Cancer Educ. 2025 Apr 24. doi: 10.1007/s13187-025-02630-1. Online ahead of print.

ABSTRACT

Esophageal cancer is a prevalent cancer worldwide, with incidence rates rising significantly in recent years, particularly in high-risk regions where case numbers continue to escalate. As one of the most visited social media platforms globally, TikTok has emerged as a key source for health information. This study aims to evaluate Chinese TikTok videos on esophageal cancer, focusing on content integrity, informational quality, source credibility, usefulness, and reliability.: We assessed 246 esophageal cancer-related videos using the Content Integrity Score based on Goobie’s coding scheme for content evaluation and the DISCERN instrument for assessing information reliability and treatment guidance. Videos were categorized by duration, source, publication year, and user engagement metrics (likes, comments, favorites, shares). Statistical analysis was conducted using Shapiro-Wilk, Kruskal-Wallis and post hoc Bonferroni tests. Additionally, Spearman’s correlation analysis was applied to explore relationships between key quantitative variables. Of the videos analyzed, 212(86.2%) were uploaded by doctors, and 168(68.3%) lacked content related to risk factors. and 217(88.2%) had a quality score rated as poor or below. User engagement metrics, including likes, comments, saves, and shares, exhibited strong intercorrelations. However, only shares showed a weak correlation with DISCERN scores (R = 0.134, p = 0.036). Additionally, DISCERN scores were positively correlated with video duration (R = 0.352, p < 0.001). Chinese TikTok videos on esophageal cancer generally offer low-quality information that lacks accuracy and is insufficient for guiding patients in making informed health decisions. Given the low quality and reliability of such content, TikTok is not a suitable source for patient education.

PMID:40272765 | DOI:10.1007/s13187-025-02630-1

Cancer Causes Control. 2025 Apr 24. doi: 10.1007/s10552-025-01998-1. Online ahead of print.

ABSTRACT

PURPOSE: Acute leukemia is the most common childhood malignancy, with suspected contributions from environmental factors and immune responses to common pathogens. A recent meta-analysis indicated possible spatiotemporal clustering, though the findings were hindered by data quality limitations. We investigated spatial and spatiotemporal clustering of childhood leukemia using advanced methods and complete residential histories.

METHODS: We included patients aged 0-17 years diagnosed in 1990-2019, using data from the Finnish Cancer Registry. A 1:3 age- and sex-matched case-control design was employed and residential history data with exact coordinates was collected. Clustering was evaluated using the Cuzick-Edwards test, Knox test, Kulldorff’s scan statistic, and Jacquez’s Q statistic.

RESULTS: The dataset included 1,626 childhood leukemia cases (median age 5.0 years, 54% male). The Knox test revealed no evidence of spatiotemporal clustering. However, the Cuzick-Edwards test revealed spatial clustering at diagnosis addresses for children under 1 year (OR 1.35, 95% CI 1.14-1.57). Further analysis with Jacquez’s Q test using complete residential histories identified significant spatiotemporal clustering in young children (ages 1.5-5.99 years) with acute lymphoblastic leukemia (ALL, p = 0.037). We also tested for co-incidence between leukemia and type 1 diabetes but found no clustering.

CONCLUSION: Overall, we found limited evidence for clustering. In the subgroup analyses, significant spatiotemporal clustering in acute lymphoblastic leukemia cases among children aged 1.5-5.99 years was observed, coinciding with the peak incidence in early childhood. Previous research has shown that this age group has distinct genetic characteristics and may possess a unique etiology.

PMID:40272762 | DOI:10.1007/s10552-025-01998-1

CJEM. 2025 Apr 24. doi: 10.1007/s43678-025-00906-5. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to assess the efficacy of a single dose of nebulized glucocorticoids (dexamethasone or budesonide) compared to a placebo in relieving sore throat symptoms. The primary outcome was complete symptom resolution at 24 h. Secondary objectives included evaluating pain scores at 48 h, time to pain relief within 7 days, absenteeism, and ED visits or hospital admissions for acute pharyngitis (AP) symptoms or complications within 7 days.

METHODS: This multicenter, double-blind, randomized controlled trial was conducted across three EDs targeting patients over 5 years old with acute pharyngitis, excluding those with recent steroid or antibiotic use, adenotonsillectomy, or pregnancy. Participants were randomly assigned to one of three groups: nebulized dexamethasone, budesonide, or placebo. Pain severity was assessed using a numeric rating scale from 0 to 10. Analysis involved descriptive statistics and Chi-square tests to compare outcomes across treatment groups.

MAIN RESULTS: A total of 163 patients with AP were enrolled. No significant difference in the primary outcome, complete symptom resolution at 24 h, was observed between the glucocorticoids (dexamethasone, budesonide) and placebo groups, with relative risks of 2.2 (95% confidence interval [CI] 0.8-5.1) and 1.1 (95% CI 0.9-1.2), respectively. Among secondary outcomes, time to pain relief was significantly shorter in the glucocorticoid groups (mean onset: 2.6 h for dexamethasone, 3.1 h for budesonide) compared to the placebo group (4.1 h; p = 0.003). There were no significant differences in pain scores at 48 h, ED re-attendance, hospital admissions, or absenteeism. All treatments were well-tolerated, with no significant adverse events reported.

CONCLUSION: Despite a statistically significant earlier onset of pain relief, the study found no significant difference in complete resolution of sore throat at 24 or 48 h between glucocorticoids and placebo groups. Therefore, the routine use of nebulized steroids for managing acute pharyngitis may not be warranted, emphasizing the importance of maintaining standard care practices and considering alternative adjunct therapies.

TRIAL REGISTRATION NUMBER: Clinicaltrial.com NCT04027322. Date: 07/18/2019.

PMID:40272745 | DOI:10.1007/s43678-025-00906-5

AIDS Behav. 2025 Apr 24. doi: 10.1007/s10461-025-04744-5. Online ahead of print.

ABSTRACT

The Ending the HIV Epidemic (EHE) initiative aims to reduce new HIV infections by 90% by 2030 in the United States (US). However, rising sexually transmitted infection (STI) rates exacerbate the bidirectional infection risk between HIV and STIs. Most research on STIs among people with HIV (PWH) has focused on high-risk groups, resulting in limited data on broader populations. This study addresses that gap by examining the incidence and risk factors for gonorrhea, chlamydia, and syphilis in a statewide cohort of PWH in South Carolina. Data from South Carolina’s HIV and STI surveillance systems were linked, and all PWH aged 18 and older who were diagnosed with HIV between 2007 to April 2018 were included. Cohort demographics were analyzed using descriptive statistics and chi-squared tests, and a Cox Proportional Hazards model examined time to first STI after HIV diagnosis. The study found an increase in the incidence of gonorrhea, chlamydia, and syphilis over the study period. Young adults, men, Black individuals, MSM, and urban residents were found to be at increased risk for STI diagnosis. Clinical risk factors associated with increased STI risk included lower initial CD4 counts, and higher initial viral loads. The findings underscore a considerable STI burden among PWH in South Carolina. To mitigate STI transmission in the context of HIV, targeted interventions for high-risk populations are needed.

PMID:40272742 | DOI:10.1007/s10461-025-04744-5

J Mol Neurosci. 2025 Apr 24;75(2):56. doi: 10.1007/s12031-025-02354-3.

ABSTRACT

Emerging evidence suggests that sleep deprivation may contribute to cancer risk. However, the genetic association between sleep deprivation and glioblastoma (GBM) remains unexplored. This study aimed to investigate the causal relationship between sleep traits and GBM using genome-wide association study (GWAS) data of sleep duration, sleeplessness, GBM, and immune cell traits from the UK Biobank and FinnGen databases. Mendelian randomization (MR) analyses were conducted to assess potential causal links between sleep traits and GBM risk. Mediation analysis was performed to identify immune mediators affected by sleep duration that might influence GBM development. Single-nucleus RNA sequencing (snRNA-seq) was utilized to examine cellular subpopulation changes in brain tissue from sleep-deprived (SD) and ad libitum sleep mice. Additionally, a mouse model of sleep deprivation was established for transcriptomic analysis. We found a significant causal association between reduced sleep duration and increased GBM risk (IVW OR = 6.000 × 10^-5, P = 0.003, Bonferroni P = 0.025). Sleeplessness also emerged as a potential risk factor for GBM (OR-IVW = 20.221, P = 0.038). Mediation analysis identified CD80 expression on plasmacytoid dendritic cells (pDCs) as a mediator in the association between sleep duration and GBM, with a mediation effect of 0.256. SnRNA-seq confirmed significant alterations in CD80 + pDCs in sleep-deprived mice. Transcriptomic analysis of SD mice demonstrated upregulation of GBM-related markers (Egfr, Tert, and Mgmt) and associated signaling pathways. These findings suggest a potential causal link between insufficient sleep and increased GBM risk, highlighting the importance of sleep management for GBM patients.

PMID:40272711 | DOI:10.1007/s12031-025-02354-3

Atten Percept Psychophys. 2025 Apr 24. doi: 10.3758/s13414-025-03062-1. Online ahead of print.

ABSTRACT

In action control research, stimulus features are assumed to get bound to response features and integrated into an event file. Repetition of any feature leads to retrieval of this event file, causing interference with the current action, depending on whether features repeat or change. It is known that the location of a stimulus works as a feature in these processes. Location is usually operationalized as the absolute position of the stimulus; however, the significance of a particular stimulus location is often only revealed when its position relative to other context stimuli is considered as well. In two experiments (N_total = 100), we investigated under which conditions which form of location-absolute or relative-is used for binding and retrieval processes. It was shown that solely absolute stimulus location is used when there is a unique absolute target stimulus position for each possible relative target stimulus location. As soon as the target stimulus’ locations can no longer be conclusively defined by its absolute position, relative stimulus locations are used in binding and retrieval processes as well. Results are discussed in terms of prioritization processes and the idea of context-dependent processing of position deviances. Taken together, this reveals a flexible use of location as a feature in action control processes.

PMID:40272710 | DOI:10.3758/s13414-025-03062-1

Head Neck Pathol. 2025 Apr 24;19(1):43. doi: 10.1007/s12105-025-01750-w.

ABSTRACT

PURPOSE: Mucoepidermoid carcinoma is the most common malignant tumor of the salivary gland. MEC harboring MAML2 rearrangement has a favorable prognosis. This study investigated the histologic and locational diversity of head and neck mucoepidermoid carcinoma, clinicopathologic characteristics, and associations with CRTC1/3::MAML2 fusion.

METHODS: Patients with head and neck mucoepidermoid carcinoma (n = 128) treated from February 2004 to December 2016 were included. Retrospective analysis encompassed clinical data, pathologic findings, and prognoses, with concurrent performance of fluorescence in situ hybridization to detect MAML2 rearrangement.

RESULTS: The 128 head and neck mucoepidermoid carcinomas comprised 76 parotid gland, 29 oral cavity, 10 submandibular/sublingual, 8 pharynx, 2 lip, 2 sinonasal cavity, and 1 larynx MEC. The parotid gland was the most common site (59%), and the classic subtype was predominant (69%). MAML2 fusion was detected in 84% of analyzed cases and was strongly associated with low-grade tumors (P < 0.001). MAML2-negative cases exhibited higher rates of lymphovascular invasion, nodal metastasis, and poorer outcomes. Tumors in the parotid, submandibular gland, sublingual gland, oral cavity, and oropharynx, showed more frequent MAML2 rearrangement, than nasopharynx, larynx, lip, and paranasal sinus origin (P < 0.001). The classic and Warthin-like subtypes showed higher MAML2 rearrangement than other subtypes (P = 0.001). MAML2 fusion status was a statistically significant predictor of overall survival by univariate (P = 0.039) and multivariate (P = 0.048) analyses.

CONCLUSION: The presence MAML2 fusion is a favorable prognostic marker in mucoepidermoid carcinoma, with its prevalence varying by location and subtype. Its varying prevalence across locations and subtypes highlights its significant prognostic relevance. These findings underscore the importance of molecular testing and histopathologic evaluation in predicting clinical outcomes.

PMID:40272673 | DOI:10.1007/s12105-025-01750-w

Int J Comput Assist Radiol Surg. 2025 Apr 24. doi: 10.1007/s11548-025-03359-4. Online ahead of print.

ABSTRACT

PURPOSE: Cerebral digital subtraction angiography (DSA) is a standard imaging technique in image-guided interventions for visualizing cerebral blood flow and therapeutic guidance thanks to its high spatio-temporal resolution. To date, cerebral perfusion characteristics in DSA are primarily assessed visually by interventionists, which is time-consuming, error-prone, and subjective. To facilitate fast and reproducible assessment of cerebral perfusion, this work aims to develop and validate a fully automatic and quantitative framework for perfusion DSA.

METHODS: We put forward a framework, perfDSA, that automatically generates deconvolution-based perfusion parametric images from cerebral DSA. It automatically extracts the arterial input function from the supraclinoid internal carotid artery (ICA) and computes deconvolution-based perfusion parametric images including cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and Tmax.

RESULTS: On a DSA dataset with 1006 patients from the multicenter MR CLEAN registry, the proposed perfDSA achieves a Dice of 0.73(±0.21) in segmenting the supraclinoid ICA, resulting in high accuracy of arterial input function (AIF) curves similar to manual extraction. Moreover, some extracted perfusion images show statistically significant associations (P=2.62e – 5) with favorable functional outcomes in stroke patients.

CONCLUSION: The proposed perfDSA framework promises to aid therapeutic decision-making in cerebrovascular interventions and facilitate discoveries of novel quantitative biomarkers in clinical practice. The code is available at https://github.com/RuishengSu/perfDSA .

PMID:40272658 | DOI:10.1007/s11548-025-03359-4