Category: Nevin Manimala

PLoS One. 2025 Feb 4;20(2):e0317456. doi: 10.1371/journal.pone.0317456. eCollection 2025.

ABSTRACT

BACKGROUND: Suicide is recognized as a major problem worldwide and is particularly prevalent among specific groups, including individuals with substance use disorders (SUDs). The present study aimed to investigate alcohol consumption as a risk factor for suicidal ideation and attempts among those with substance use disorders (SUDs) in western Iran.

METHODS: This is a cross-sectional study, involving 1,112 individuals with SUDs who sought treatment at Farabi Hospital in Kermanshah, Iran, between the years 2019 and 2021. These participants were included in the study through a convenient sampling method as part of an interview-based assessment study.

RESULTS: The participant’s average age was 37.97 years, and 982 were male (94.7%). Overall, 285 (27.5%) individuals had a history of suicide attempts, 316 (30.5%) individuals reported suicidal ideation, and 463 (41.6%) were alcohol users. In individuals who consumed alcohol, the prevalence of suicidal ideation (172 (37.2%) individuals), and a history of suicide attempts (156 (33.8%) individuals) was significantly higher compared to non-alcohol users. There was a statistically significant relationship between alcohol consumption and a history of suicide attempts (p < 0.05). The probability of suicide attempted in people with a history of alcohol consumption was 1.5 times, and in patients with a history of simultaneous substance use, it was 1.4 times that of other patients (all Ps < 0.05).

CONCLUSION: Our study results revealed that alcohol consumption among individuals with SUDs is associated with increased rates of suicidal ideation, attempts, and death. Therefore, clinicians should consider it as a separate suicide risk factor.

PMID:39903791 | DOI:10.1371/journal.pone.0317456

PLoS One. 2025 Feb 4;20(2):e0317797. doi: 10.1371/journal.pone.0317797. eCollection 2025.

ABSTRACT

Studies evaluating the effects of interdisciplinary treatment (IDT) on sickness absence and disability pension (SA/DP) have yielded contradictory findings. Evidence indicates that positive treatment effects are restricted to patients with a poor SA/DP prognosis. This study therefore analyzed the effect of IDT in working age patients on partial disability pension, which is a group with a particularly poor prognosis. With data from 479 patients on partial disability pension, this register-based cohort study compared the effects of IDT to those of unspecified interventions. We considered two response variables: total net SA/DP days across the span of three years from the first visit to a Swedish specialist pain clinic, and the risk of having the maximum possible 1096 SA/DP days over the same period. Our results showed that both the total net SA/DP days (mean difference: 11; 95% confidence interval: -30 to 51) and the risk of 1096 SA/DP days (risk ratio: 1.0; 95% confidence interval: 0.6 to 1.4) were similar irrespective of intervention type. Under our theoretical model, we thereby found no support in favor of IDT over less intensive interventions in working age patients with partial DP. This raises questions about the specific criteria under which IDT proves effective.

PMID:39903783 | DOI:10.1371/journal.pone.0317797

PLoS One. 2025 Feb 4;20(2):e0317833. doi: 10.1371/journal.pone.0317833. eCollection 2025.

ABSTRACT

BACKGROUND: Dating violence (DV) is a major public health problem with serious consequences for the young population. The Conflict in Adolescent Dating Relationship Inventory (CADRI) is the most internationally used tool to measure DV. However, no tool has been translated, culturally adapted, or validated in the Greek context to assess the prevalence of DV in the Greek population.

AIM: To culturally adapt, validate, and translate the Conflict in Adolescent Dating Relationship Inventory (CADRI) in the Greek language to ensure its reliability and cultural and linguistic validity in the Greek population.

METHODS: A cross-cultural adaptation process and cross-sectional study were carried out. There were two phases in the research. First, face validity was assessed after the first phase of translation, which included cross-cultural item adaptation, content validation and expert review of the instrument. In the second stage, the scale’s psychometric qualities were assessed on a sample of nursing college students. A CADRI instrument was used to assess DV.

RESULTS: The final sample comprised a total of 177 university students. The internal consistency and reliability were good (>0.7), with a Cronbach’s alpha of 0.889 for the violence perpetrated subscale and 0.925 for the violence suffered subscale, indicating strong correlations between the total item scores. After exploratory factor analysis was performed, the structure obtained was similar to the original structure. Furthermore, 88.7% of university students perpetrated DV in the last year on their partners, and 90.7% suffered DV, with verbal and emotional violence the most common types.

CONCLUSION: This study provides robust evidence of the validity and reliability of the CADRI for measuring DV in the Greek university population. Additionally, the high prevalence makes it necessary to create DV prevention plans and further research, especially among nursing students.

IMPACT: Validation of the CADRI in Greece will increase the knowledge of DV in this population, which lacks validated instruments.

PUBLIC CONTRIBUTION: The results obtained with the CADRI can be applied to the prevention of DV in young people.

PMID:39903781 | DOI:10.1371/journal.pone.0317833

J Clin Nurs. 2025 Feb 4. doi: 10.1111/jocn.17674. Online ahead of print.

ABSTRACT

AIMS AND OBJECTIVES: To systematically assess the effects of massage and touch on agitation in patients with dementia and to determine the optimal intervention design.

BACKGROUND: Agitated behaviour is the most common behavioural symptom in patients with dementia and can seriously affect the health status and quality of life of individuals with dementia and their caregivers. Massage and touch have been widely used as a non-pharmacological intervention to address the behavioural issues of dementia. However, current research findings on the effects of massage and touch on agitation in people with dementia are inconsistent.

DESIGN: A meta-analysis of randomised controlled trials.

METHODS: This meta-analysis complied with PRISMA guidelines, and relevant literature up to January 2024 was systematically retrieved from PubMed, Embase, Web of Science, the Clinical Trials Registry, Cochrane Library and four Chinese databases. Statistical evaluations were performed utilising Review Manager 5.4, and the included studies’ bias risks were assessed with the Cochrane Collaboration tool.

RESULTS: Seventeen randomised controlled trials involving 980 patients with dementia were included. The results of the meta-analysis showed that massage and touch could ameliorate agitation and behaviour problems in dementia. Subgroup analyses based on massage type showed that hand, head and foot massage significantly improved agitation. Massage and touch for ≤ 4 weeks were more effective in reducing agitated behaviour than those for > 4 weeks. Furthermore, subgroup analysis revealed that massages and touch were more effective for individuals with less severe dementia.

CONCLUSIONS: Massage and touch in the short term can effectively improve agitation in dementia patients, while hand, head and foot massage can effectively reduce agitation. Thus, clinical nursing staff and caregivers of individuals should be actively helped to apply massage and touch to their patients. However, more studies are needed to validate our results before we can give a more definitive recommendation.

RELEVANCE TO CLINICAL PRACTICE: This study suggests that massage and touch can be used as complementary treatments for agitation in people with dementia and encourages nursing staff and caregivers to apply massage and touch to better cope with the agitated behaviour of older adults with dementia.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

TRIAL REGISTRATION: PROSPERO registration number: CRD42024507133.

PMID:39902611 | DOI:10.1111/jocn.17674

Magn Reson Med. 2025 Feb 4. doi: 10.1002/mrm.30462. Online ahead of print.

ABSTRACT

PURPOSE: Accurate analysis of metabolite levels from ¹H MRS data is a significant challenge, typically requiring the estimation of approximately 100 parameters from a single spectrum. Signal overlap, spectral noise, and common artifacts further complicate the analysis, leading to instability and reports of poor agreement between different analysis approaches. One inconsistently used method to improve analysis stability is known as regularization, where poorly determined parameters are partially constrained to take a predefined value. In this study, we examine how regularization of frequency and linewidth parameters influences analysis accuracy.

METHODS: The accuracy of three MRS analysis methods was compared: (1) ABfit, (2) ABfit-reg, and (3) LCModel, where ABfit-reg is a modified version of ABfit incorporating regularization. Accuracy was assessed on synthetic MRS data generated with random variability in the frequency shift and linewidth parameters applied to each basis signal. Spectra ( N = 1000 $$ N=1000 $$ ) were generated across a range of SNR values (10, 30, 60, 100) to evaluate the impact of variable data quality.

RESULTS: Comparison between ABfit and ABfit-reg demonstrates a statistically significant (p < 0.0005) improvement in accuracy associated with regularization for each SNR regime. An approximately 10% reduction in the mean squared metabolite errors was found for ABfit-reg compared to LCModel for SNR >10 (p < 0.0005). Furthermore, Bland-Altman analysis shows that incorporating regularization into ABfit enhances its agreement with LCModel.

CONCLUSION: Regularization is beneficial for MRS fitting and accurate characterization of the frequency and linewidth variability in vivo may yield further improvements.

PMID:39902605 | DOI:10.1002/mrm.30462

Afr J Reprod Health. 2025 Jan 31;29(1):15-24. doi: 10.29063/ajrh2025/v29i1.2.

ABSTRACT

This study evaluated the effectiveness of the open glottis breathing technique during the second stage of labor among 600 primigravida women, randomly assigned to either an open glottis group (n=300) or a closed glottis group (n=300). Participants in the open glottis group received training via 3D animated videos. Results demonstrated a significant impact on perineal integrity, with 20.7% of women in the experimental group reporting an intact perineum compared to just 1.7% in the control group. Additionally, the open glottis group experienced shorter labor durations and a decrease in severe neonatal asphyxia, as indicated by improved APGAR scores compared to the closed glottis group. Statistical analysis using the χ² test revealed a highly significant difference in perineal conditions between the two groups, with a χ² value of 65.7 (p < 0.000). The study also identified a significant association between maternal age, residence, and income with the reduction of perineal tears (p < 0.000). Overall, the findings suggest that the modified open glottis breathing technique effectively prevents perineal trauma, shortens the duration of the second stage of labor, and enhances neonatal outcomes. These results highlight the potential benefits of integrating this technique into labor management practices to improve maternal and neonatal health.

PMID:39902604 | DOI:10.29063/ajrh2025/v29i1.2

Circ Cardiovasc Imaging. 2025 Feb 4:e017156. doi: 10.1161/CIRCIMAGING.124.017156. Online ahead of print.

ABSTRACT

BACKGROUND: Infective endocarditis (IE) can be challenging to diagnose. Positron emission tomography/computed tomography (PET/CT) with 2-deoxy-2-[¹⁸F]-fluoro-d-glucose ([¹⁸F]FDG) is recommended as a diagnostic tool in the guidelines, but holds limitations. The aim of this study was to compare the tracer uptake between the novel [⁶⁴Cu]Cu-DOTATATE, which has low cardiac uptake and does not require fasting or dietary restrictions, and [¹⁸F]FDG in patients with IE and examine the sensitivity and specificity.

METHODS: The CuDOS study (Cu-Dotatate Positron Emissions Tomography in Infective Endocarditis) was a prospective study including 20 patients with IE (10 with prosthetic valve endocarditis and 10 with native valve endocarditis) and 20 controls. All participants underwent [⁶⁴Cu]Cu-DOTATATE and [¹⁸F]FDG PET/CT. Scans were read blinded to clinical data. Tracer uptakes were measured as maximum standardized uptake values in each heart valve. Differences were tested with Wilcoxon rank tests.

RESULTS: The median age of the cases and controls was 68 years (interquartile range [IQR], 55.0-75.5) and 61 years (IQR, 57.0-69.5), respectively. [⁶⁴Cu]Cu-DOTATATE uptake (median maximum standardized uptake value [IQR]) in patients with IE was higher than in controls (2.34 [1.40-3.23] versus 1.44 [1.21-1.60]; P =0.008), although this difference was mainly driven by prosthetic valve endocarditis cases (3.23 [2.02-3.86]; P <0.001) and not between native valve endocarditis cases and controls (1.51 [1.23-2.58]; P=0.428). The sensitivity of [⁶⁴Cu]Cu-DOTATATE and [¹⁸F]FDG PET/CT in 20 cases versus 20 controls were equal, and the specificity was 90% and 75%, respectively. The analysis of prosthetic valve endocarditis versus the 20 controls showed equal sensitivity (80%), and a specificity of 90% and 75%, respectively (P =0.38). In addition, a greater proportion of scans achieved diagnostic certainty with [⁶⁴Cu]Cu-DOTATATE PET/CT compared with [¹⁸F]FDG PET/CT for native valve endocarditis, prosthetic valve endocarditis, and controls.

CONCLUSIONS: [⁶⁴Cu]Cu-DOTATATE PET/CT showed uptake in the infected valve in patients with IE, and has major advantage as it does not require any preparation compared with [¹⁸F]FDG. [⁶⁴Cu]Cu-DOTATATE had a numerically higher specificity than [¹⁸F]FDG, although the difference was not statistically significant. Both tracers were limited in the detection of native valve endocarditis.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05432427. www.clinicaltrialsregister.eu; Unique identifier: 2021-005501-27.

PMID:39902600 | DOI:10.1161/CIRCIMAGING.124.017156

Proc Inst Mech Eng H. 2025 Feb 4:9544119251315877. doi: 10.1177/09544119251315877. Online ahead of print.

ABSTRACT

Generative deep learning has emerged as a promising data augmentation technique in recent years. This approach becomes particularly valuable in areas such as motion analysis, where it is challenging to collect substantial amounts of data. The objective of the current study is to introduce a data augmentation strategy that relies on a variational autoencoder to generate synthetic data of kinetic and kinematic variables. The kinematic and kinetic variables consist of hip and knee joint angles and moments, respectively, in both sagittal and frontal plane, and ground reaction forces. Statistical parametric mapping (SPM) did not detect significant differences between real and synthetic data for each of the biomechanical variables considered. To further evaluate the effectiveness of this approach, a long-short term model (LSTM) was trained both only on real data (R) and on the combination of real and synthetic data (R&S); the performance of each of these two trained models was then assessed on real test data unseen during training. The principal findings included achieving comparable results in terms of nRMSE when predicting knee joint moments in the frontal (R&S: 9.86% vs R: 10.72%) and sagittal plane (R&S: 9.21% vs R: 9.75%), and hip joint moments in the frontal (R&S: 16.93% vs R: 16.79%) and sagittal plane (R&S: 13.29% vs R: 14.60%). The main novelty of this study lies in introducing an effective data augmentation approach in motion analysis settings.

PMID:39902572 | DOI:10.1177/09544119251315877

Circ Cardiovasc Imaging. 2025 Feb 4:e016851. doi: 10.1161/CIRCIMAGING.124.016851. Online ahead of print.

ABSTRACT

BACKGROUND: Immune checkpoint inhibitors (ICIs), though revolutionary in cancer treatment, may accelerate atherosclerosis by inducing arterial inflammation. Due to a lack of controlled studies, the capacity of arterial 2-deoxy-2-[¹⁸F]fluoro-D-glucose ([¹⁸F]FDG) uptake in patients with cancer to detect this arterial inflammation remains unclear.

METHODS: Arterial [¹⁸F]FDG uptake at 6 anatomic landmarks was assessed on serial positron emission tomography scans in patients with cancer treated at a German University Hospital between January 2010 and May 2023. Patients aged ≥65 years with at least 4 sequential scans within 30 months were included. Linear mixed regression analyses were used to evaluate the change in arterial tracer uptake in patients who received ICI or not.

RESULTS: Of the 156 patients included, 50 (30.1%) received ICIs after the baseline scan. Baseline arterial [¹⁸F]FDG uptake correlated with traditional cardiovascular risk factors, such as body mass index and male sex. Cross-sectional analyses suggested a negative effect of cholesterol-lowering medication on arterial [¹⁸F]FDG uptake at follow-up. In a time-dependent interaction analysis, arterial [¹⁸F]FDG uptake increased by 0.8% annually in patients without ICIs (95% CI, 0.2%-1.4%), potentially reflecting the background progression of arterial inflammation in patients with cancer. In ICI users, [¹⁸F]FDG uptake increased by 2.5% annually (95% CI, 1.7%-3.3%; P=0.001 for interaction with no ICI). Higher annual increase rates in ICI users were consistent across several anatomic landmarks, preexisting cardiovascular disease status, arterial calcification status, and concomitant chemotherapy or steroid use. However, this effect did not reach statistical significance in patients with melanoma and those with prior irradiation therapy.

CONCLUSIONS: This is the first controlled clinical study supporting the role of ICIs in accelerating atherosclerosis through low-grade arterial inflammation. However, although detectable by repeated [¹⁸F]FDG scans, the increase in tracer uptake associated with ICI use was modest compared with individual variability, questioning whether [¹⁸F]FDG captures the full pathophysiological process of ICI-induced, lymphocyte-driven inflammation.

PMID:39902567 | DOI:10.1161/CIRCIMAGING.124.016851

Ann Surg. 2025 Feb 4. doi: 10.1097/SLA.0000000000006645. Online ahead of print.

ABSTRACT

OBJECTIVE: Although pancreatic ductal adenocarcinoma (PDAC) is still a devastating disease, the survival rate for surgically removed PDACs has significantly improved in recent years. Early detection is essential in managing PDAC.

SUMMARY BACKGROUND DATA: The presence of KRAS mutations in PDAC leads to the initial genetic abnormality and offers a significant timeframe for identifying resectable PDACs. A minimally invasive and highly specific PDAC screening test is necessary to prevent the need for invasive follow-up tests.

METHODS: Between July 2021 and March 2023, 169 cases were enrolled in 7 institutions. By administering secretin before esophagogastroduodenoscopy (EGD), the excretion of pancreatic juice into the papillary fluid can be stimulated, creating a resource for testing. Washing fluid was collected using a specialized catheter from control individuals (n=75) and patients with resectable PDAC (n=89) at the initial diagnosis. A highly sensitive technique was employed to study KRAS gene mutations.

RESULTS: This study obtained an AUC of 0.934 [95%CI: 0.904, 0.964] when using KRAS mutations in duodenal lavage fluid to differentiate between patients with resectable PDAC and healthy controls. The estimated sensitivities were calculated with specificity set at 100%, resulting in a sensitivity of 83.1% [95%CI: 71.7%, 91.2%]. The McNemer test showed a significantly higher sensitivity for KRAS mutations than serum CEA and CA19-9 (P<0.0001).

CONCLUSIONS: We created a method to identify resectable PDACs by analyzing KRAS mutation levels in duodenal fluid collected during EGD with secretin stimulation of pancreatic juice secretion.

PMID:39902566 | DOI:10.1097/SLA.0000000000006645