Category: Nevin Manimala

Circ Arrhythm Electrophysiol. 2025 May 20:e013647. doi: 10.1161/CIRCEP.124.013647. Online ahead of print.

ABSTRACT

BACKGROUND: We have previously reported a novel clinical risk score (risk prediction score for shockable sudden cardiac arrest [VFRisk]) for the prediction of shockable sudden cardiac arrest, discovered and validated in 2 US west coast communities. We hypothesized that VFRisk predicts sudden cardiac death (SCD) risk in the geographically distinct FHS (Framingham Heart Study).

METHODS: We performed a nested case-referents study in the FHS to test VFRisk. Cases were participants who experienced SCD among the original and offspring FHS cohorts. Referents were randomly selected from FHS participants frequency-matched (ratio of 1:3) to cases on age, sex, cohort, and exam. VFRisk was the sum of 12 risk factors, each multiplied by its respective points.

RESULTS: Among 312 cases and 935 referents, mean ages were 69.5 and 69.7 years with 70.8% male in both groups. SCD cases had significantly higher prevalence of diabetes, heart failure, stroke, atrial fibrillation, and myocardial infarction compared with the referents group. The VFRisk score was validated with good discrimination (C-statistic, 0.71 [95% CI, 0.66-0.77]) for SCD. Cases had higher VFRisk scores than referents (3.8±2.8 versus 1.8±1.7; P<0.001). A 1-unit increase in VFRisk score was associated with a 48% increase in odds of SCD (odds ratio, 1.48 [95% CI, 1.34-1.64]). The highest VFRisk quartile had 7.8-fold higher odds of SCD than the lowest quartile.

CONCLUSIONS: The VFRisk score successfully predicted SCD in the FHS. The differences in discrimination between the 2 studies could partially be explained by the inability to distinguish shockable versus nonshockable events in the FHS.

PMID:40391444 | DOI:10.1161/CIRCEP.124.013647

Nutr Diet. 2025 May 20. doi: 10.1111/1747-0080.70021. Online ahead of print.

ABSTRACT

AIMS: The aim of this study is to explore the occurrence of food insecurity among pregnant women in Australia.

METHODS: This cross-sectional, self-reported study included two measures of food insecurity (the US Department of Agriculture Household Food Security Survey Module and single item measure), use of emergency and community food assistance, health conditions, eating habits during pregnancy, and professional nutritional advice and health seeking behaviours. Participants were recruited using (1) an advertisement posted on social media and (2) flyers with a QR code linked to the online survey, made available for women to take from clinic rooms at a hospital in Melbourne, Victoria. Data were analysed using basic statistics, spearman’s rho correlation coefficients, and linear regression to identify factors that may be associated with food insecurity among pregnant women in Australia; the study was open between May 2021 and March 2022.

RESULTS: Three hundred and three valid responses were received from pregnant women in Australia. Food insecurity was determined to be 14.5% (US Department of Agriculture Household Food Security Survey Module) and 6.3% (single item used). Food insecurity was significantly associated with income, education level and age.

CONCLUSIONS: Results indicate a high prevalence of food insecurity among pregnant women. Routine screening and referral of food insecure pregnant women should be considered in antenatal care settings.

PMID:40391424 | DOI:10.1111/1747-0080.70021

Nurs Health Sci. 2025 Jun;27(2):e70137. doi: 10.1111/nhs.70137.

ABSTRACT

This cross-sectional study aimed to investigate dyadic effects of micro-level (physical [PCS]/mental [MCS] health) and meso-level (dyadic coping/social support) factors on both subjective and objective social isolation in patient-spousal caregiver dyads with colorectal cancer (CRC), with hypothesized actor-partner interdependence effects. Data from 220 patient-caregiver dyads with CRC collected using validated instruments (General Alienation Scale, Lubben Social Network Scale-6, Medical Outcomes Study 12-item Short-Form version 2, Dyadic Coping Inventory, and Perceived Social Support Scale) were analyzed using the Actor-Partner Interdependence Model. Findings substantiated dyadic interdependence between subjective/objective social isolation and variables within dyads across micro- and meso-levels. Both micro-level (PCS/MCS) and meso-level (dyadic coping/social support) factors demonstrated significant actor effects on both subjective and objective social isolation experienced by patients and their partners. Patients’ both micro-level (PCS/MCS) and meso-level (dyadic coping/social support) factors negatively influenced their partners’ subjective and objective social isolation. No partner effect was identified from variables associated with spousal caregivers on patients’ social isolation. These findings suggest that interventions targeting these variables could be effectively designed for patient-spousal caregiver dyads with CRC to address social isolation.

PMID:40391397 | DOI:10.1111/nhs.70137

Stat Comput. 2025;35(4):97. doi: 10.1007/s11222-025-10624-8. Epub 2025 May 17.

ABSTRACT

Individual treatment effect estimation has gained significant attention in recent data science literature. This work introduces the Double Neural Network (Double-NN) method to address this problem within the framework of extended fiducial inference (EFI). In the proposed method, deep neural networks are used to model the treatment and control effect functions, while an additional neural network is employed to estimate their parameters. The universal approximation capability of deep neural networks ensures the broad applicability of this method. Numerical results highlight the superior performance of the proposed Double-NN method compared to the conformal quantile regression (CQR) method in individual treatment effect estimation. From the perspective of statistical inference, this work advances the theory and methodology for statistical inference of large models. Specifically, it is theoretically proven that the proposed method permits the model size to increase with the sample size n at a rate of $O\left(n^{\zeta }\right)$ for some $0\le \zeta <1$ , while still maintaining proper quantification of uncertainty in the model parameters. This result marks a significant improvement compared to the range $0\le \zeta <\frac{1}{2}$ required by the classical central limit theorem. Furthermore, this work provides a rigorous framework for quantifying the uncertainty of deep neural networks under the neural scaling law, representing a substantial contribution to the statistical understanding of large-scale neural network models.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11222-025-10624-8.

PMID:40391382 | PMC:PMC12085359 | DOI:10.1007/s11222-025-10624-8

Curr Res Food Sci. 2025 Apr 27;10:101060. doi: 10.1016/j.crfs.2025.101060. eCollection 2025.

ABSTRACT

Health effects associated with microbial metabolites are influenced by dietary compounds and other environmental factors. Polyphenols derived from plant-based foods reach the large intestine mostly undigested, where they can interact with the gut microbiota. This explorative study investigated the metabolic responses of gut microbiota to the polyphenols rutin and genistein. Ex vivo anaerobic incubations with pooled fecal samples from volunteers with a BMI <25 (n = 7) and a BMI >40 (n = 7) were analyzed by ESI DI-FT-ICR-MS. Differences in metabolic diversity were observed between the two BMI groups, with the obese group showing a less diverse metabolic response. Metabolomic profiling identified 361 metabolites in 35 substance classes, with notable effects of the polyphenols on amino acid, carbohydrate, nucleotide, and lipid metabolism. Both BMI groups showed increased levels of dipeptides and amino acids and decreased levels of biogenic amines. Among the key findings, glutamine levels increased, which has been associated with obesity-related metabolic processes, while tryptophan levels were also elevated, a factor previously associated with obesity-related pathways. Glycine levels increased in both groups. Additionally, histamine, cadaverine, putrescine, and trimethylamine were reduced after exposure to the polyphenols. Changes in metabolites related to carbohydrate metabolism suggest an influence of rutin and genistein on sugar transport and cell wall synthesis. Furthermore, in the obese group, rutin exposure was associated with increased butyrate levels and decreased lactate levels. These findings contribute to a better understanding of how rutin and genistein interact with the gut microbiota metabolome, with potential implications for metabolic health and obesity-related research.

PMID:40391378 | PMC:PMC12088750 | DOI:10.1016/j.crfs.2025.101060

J Res Med Sci. 2025 Apr 30;30:22. doi: 10.4103/jrms.jrms_154_24. eCollection 2025.

ABSTRACT

BACKGROUND: To evaluate the safety of propofol and sevoflurane for general anesthesia in elderly.

MATERIALS AND METHODS: All studies on sevoflurane, propofol, and hyperamylasemia from the establishment of Embase, Ovid, Cochrane Library, and Google Scholar from database establishment to December 2024 were searched. Literatures were screened, and data were extracted on the grounds of inclusion and exclusion criteria. Review Manager (RevMan) (Version 5.4. The Cochrane Collaboration.) was used for statistical analysis. Outcomes assessed included time to spontaneous eye opening, extubation time, incidence rate of postoperative cognitive dysfunction (POCD), postoperative delirium, agitation, nausea and vomiting.

RESULTS: Fourteen trials were identified and included in this meta-analysis. The results showed no significant difference in time to spontaneous eye opening (P = 0.54), the incidence of POCD (P = 0.07), postoperative delirium (P = 0.37), and postoperative nausea and vomiting (P = 0.8) between the sevoflurane and propofol groups. Compared with propofol groups, extubation time (P < 0.0001) was significantly shortened by sevoflurane groups. Conversely, compared with sevoflurane, the incidence of postoperative agitation in the propofol group was significantly reduced (P = 0.04).

CONCLUSION: There was no difference in time to spontaneous eye-opening, the incidence of POCD, postoperative delirium, postoperative nausea, and vomiting between the sevoflurane and propofol groups. However, compared with propofol, sevoflurane can significantly shorten intubation time. The incidence of postoperative agitation (P = 0.04) was significantly lower in the propofol group compared with sevoflurane.

PMID:40391341 | PMC:PMC12087908 | DOI:10.4103/jrms.jrms_154_24

J Diabetes Res. 2025 May 12;2025:3148242. doi: 10.1155/jdr/3148242. eCollection 2025.

ABSTRACT

Background: Elderly patients with Type 2 diabetes mellitus (T2DM) often experience prolonged length of stay (LOS) and 30-day readmission. This study was aimed at identifying factors influencing these outcomes and develop predictive models for them. Methods: The least absolute shrinkage and selection operator (LASSO) combined with logistic regression was utilized to construct the prediction models, which were subsequently visualized through nomograms. The performance of these models was comprehensively evaluated in terms of discrimination, calibration, and clinical utility. Specifically, the discrimination capacity was assessed using the area under the receiver operating characteristic curve (AUROC), while calibration was evaluated via calibration curves and the Brier score. Clinical utility was examined through decision curve analysis (DCA) and clinical impact curve (CIC). Additionally, to verify the robustness and generalizability of the developed prediction models, subgroup analyses were conducted across various strata of the study population. Results:A total of 24 variables for 8800 patients were included for predicting prolonged LOS, and 38 variables were used for 30-day readmission prediction. In the training set, 28.42% of patients had prolonged LOS and 13.68% were readmitted within 30 days. The prolonged LOS model had an AUROC of 0.720 (95% CI: 0.703-0.737), while the 30-day readmission model achieved 0.766 (95% CI: 0.745-0.787). The Brier scores were 0.174 (95% CI: 0.168-0.180) and 0.102 (95% CI: 0.096-0.108), respectively. Both models showed good clinical utility in DCA and CIC analyses. Subgroup validation across different age groups showed consistent performance, with all AUROCs above 0.60. Albumin was identified as the most significant predictor in both models. Conclusion: The predictive models developed in this study demonstrated robust performance in forecasting common outcomes in elderly patients with T2DM. Moreover, albumin level was strongly associated with both prolonged LOS and 30-day readmission, making it a key factor in patient management.

PMID:40391336 | PMC:PMC12088840 | DOI:10.1155/jdr/3148242

J Caring Sci. 2024 Sep 29;14(1):42-51. doi: 10.34172/jcs.025.33745. eCollection 2025 Feb.

ABSTRACT

INTRODUCTION: Internet addiction is a growing phenomenon that has harmful psychological-behavioral effects on users. The present study was conducted with the aim of investigating the relationship between moral intelligence and communication skill s with the mediation of psychological distress in secondary school students of Tabriz city.

METHODS: In this descriptive cross-sectional correlational study, 431 adolescents (female=227, male=204) in Tabriz, Iran schools were selected using cluster sampling and responded to psychological distress questionnaires DASS21, Internet addiction KDAI, communication skill s of Queen dam and moral intelligence of Lenik Vakil. Structural equation modeling (SEM) was used to analyze the data. SPSS 26 and LISREL 8.80 statistical software were used to classify, process and analyze data and test research hypotheses.

RESULTS: The fit indices of the proposed model show its optimal fit (χ²/df=2.93, CFI=0.97, GFI=0.91, AGFI=0.88, RMSEA=0.06, RMR=0.03). The results showed that moral intelligence (β=-0.167, P<0.001) and communication skill s (β=-0.525, P<0.001) have a significant indirect relationship with Internet addiction.

CONCLUSION: The present study showed that healthcare organizations should take preventive interventions more seriously to reduce the possibility of Internet addiction and pay attention to the issue of increasing the level of moral intelligence and communication skill s with regard to the mediating role of psychological distress in order to reduce psychological distress. We can reduce the increasing prevalence of internet addiction.

PMID:40391314 | PMC:PMC12085762 | DOI:10.34172/jcs.025.33745

J Caring Sci. 2024 Aug 6;14(1):14-24. doi: 10.34172/jcs.025.33510. eCollection 2025 Feb.

ABSTRACT

INTRODUCTION: Patients with coronary artery disease (CAD) can improve quality of life by undergoing coronary artery bypass graft (CABG), but they may face various complications. Early mobilization can help prevent these complications. This study aimed to evaluate the effects of two early mobilization protocols on pain and hemodynamic outcomes in patients who had CABG surgery.

METHODS: This was a randomized, blinded clinical trial with a three-arm parallel design, conducted on 105 patients who underwent CABG at Shahid Madani hospital in Tabriz. The patients were randomly assigned to three groups: control, first intervention, and second intervention. The control group received standard care, while two intervention groups received early mobilization based on passive and active range of motion (ROM) activities and early mobilization based on deep breathing exercises respectively. Data were collected using a questionnaire that measured pain intensity using a facial pain scale and hemodynamic indicators using a monitor device. Data analysis was performed using SPSS version 24 software and descriptive and inferential statistics methods.

RESULTS: According to the study, the second intervention group is more effective than the first intervention group. The results indicated that in both morning and evening shifts, the mean of systolic blood pressure (SBP) increased significantly in three groups. Also, the mean of diastolic blood pressure (DBP) increased significantly in both shifts in intervention group 1 and control. The mean of DBP decreased (MD=-26.0, 95% CI: -5.6 to -1.2; P=0.003) significantly among intervention group 2 compared to control group in the evening. The results also indicated that the mean of heart rate (HR) raised significantly in both shifts in all three groups. In the morning, there was a significant difference between intervention group 2 and 1 compared to control. The mean of arterial oxygen saturation was a significant difference between intervention group 2 and intervention group 1 and control group in the both shifts. The mean of pain decreased significantly in the morning in two intervention groups. Similarly, in the evening, the mean of pain decreased significantly in intervention group 1, and intervention group 2. Both in the morning and evening, there was a significant difference between intervention group 2 and intervention group 1 (P<0.001).

CONCLUSION: This study provides valuable insights into the effects of early mobilization interventions on patients after CABG, but more research is needed to determine the optimal timing and intensity of mobilization protocols for patients after CABG and to explore the long-term effects and cost-effectiveness of these interventions.

PMID:40391311 | PMC:PMC12085765 | DOI:10.34172/jcs.025.33510

J Caring Sci. 2025 Mar 9;14(1):52-57. doi: 10.34172/jcs.025.33337. eCollection 2025 Feb.

ABSTRACT

INTRODUCTION: This study aimed to investigate health anxiety and its relationships with academic performance and learning styles among nursing students during the COVID-19 pandemic.

METHODS: A cross-sectional design was employed, involving 365 participants selected through stratified random sampling in Iran in 2021. Data were collected using Health Anxiety Inventory, Visual, Aural, Reading/Writing, and Kinesthetic Learning Styles Questionnaire and students’ self-reported grade point average (GPA). Data were analyzed using descriptive and inferential statistics (independent samples t-test, one-way ANOVA, Pearson correlation coefficient and chi-square test) by SPSS version 13.

RESULTS: The mean (SD) health anxiety score among nursing students was 24.33(9.79) on a range of 0-54; and the mean (SD) of GPA was 15.60 (1.51) on a range of 0-20. The majority of students (85.8%) had a unimodal learning style, with the dominant pattern being kinetic-motor (39.7%). The study found a negative correlation between health anxiety and academic performance (r=-0.19, P≤0.05). However, no significant association was identified between health anxiety and learning style (r=-0.27, P=0.42). The analysis of health anxiety among participants indicated notable differences based on demographic factors such as sex, interest in nursing, and education level (P<0.001).

CONCLUSION: This study revealed a moderate level of health anxiety among Iranian nursing students during the COVID-19 pandemic and identified a significant negative correlation between health anxiety and academic performance. These findings underscore the need for interventions targeting health anxiety to potentially improve academic outcomes for nursing students, as reducing anxiety levels can enhance focus, learning capacity, and overall academic performance.

PMID:40391308 | PMC:PMC12085760 | DOI:10.34172/jcs.025.33337