Category: Nevin Manimala

Acta Ophthalmol. 2025 Feb 6. doi: 10.1111/aos.17459. Online ahead of print.

ABSTRACT

Pregnancy induces a variety of changes in the eye. Mapping these changes provides a pathophysiological basis for understanding pregnancy-associated ocular disorders. In this systematic review and meta-analysis, our aim was to determine how pregnancy affects subfoveal choroidal thickness and to explore temporal changes in subfoveal choroidal thickness during pregnancy and postpartum. On April 7, 2024, we searched eight literature databases for studies which used macular optical coherence tomography to evaluate subfoveal choroidal thickness in healthy pregnant women. We identified 26 studies summarizing data from 1935 healthy women, of which 1096 were pregnant and 839 non-pregnant. We found that pregnant women had a subfoveal choroidal thickness which was 31.1 μm (95% CI: 19.4-42.7 μm) thicker than non-pregnant women. No statistically significant changes were observed throughout trimesters. From the 3rd trimester to postpartum, we found a reduction in the subfoveal choroidal thickness at -41.9 μm (95% CI: -68.5 to -15.2 μm). In conclusion, in healthy women without ocular disease, pregnancy is associated with a thicker subfoveal choroid indicating a higher choroidal perfusion. Choroidal thickness remains stable across trimesters and is reduced postpartum, indicating a temporary physiological adaptation during pregnancy.

PMID:39912315 | DOI:10.1111/aos.17459

J Neurosurg Anesthesiol. 2025 Feb 6. doi: 10.1097/ANA.0000000000001029. Online ahead of print.

ABSTRACT

There is still no clear evidence of the efficacy of the application of neuroprotective agents (NPAs) for acute ischemic stroke (AIS) patients receiving reperfusion therapies. This meta-analysis aimed to determine the effects of NPAs versus placebo on functional and safety outcomes as an adjunctive treatment to intravenous thrombolysis (IVT) or endovascular therapy (EVT) in AIS patients. The primary outcome was neurological functional independence, as evaluated by the proportion of patients whose modified Rankin Scale scores were 0 to 2 at 90 days after treatment. Thirteen randomized controlled trials with a total of 3736 patients were included. The application of NPAs was associated with greater odds of functional independence (odds ratio [OR]: 1.28; 95% CI: 1.12 to 1.46; P < 0.001; I2 = 0.0%) within 90 days. However, subgroup analysis of reperfusion therapy type (IVT, EVT, or both) revealed that only the EVT subgroup showed a significant association between NPAs or placebo and functional independence at 90 days (EVT group, OR: 1.43; 95% CI: 1.05 to 1.94; P = 0.022; I2 = 0.0%; IVT group, OR: 1.51; 95% CI: 0.93 to 2.46; P = 0.099; I2 = 39.8%; IVT plus EVT group, OR: 1.17; 95% CI: 0.94 to 1.45; P = 0.157; I2 = 16.0%). This meta-analysis revealed that NPAs could increase the possibility of AIS patients undergoing reperfusion therapies achieving functional independence within 90 days of onset; however, with the limited number of studies on each drug, further evidence is still needed to demonstrate the efficacy of each individual agent as an adjunctive therapy for different means of reperfusion.

PMID:39912307 | DOI:10.1097/ANA.0000000000001029

Stat Med. 2025 Feb 28;44(5):e10334. doi: 10.1002/sim.10334.

ABSTRACT

High-throughput single-cell RNA-seq (scRNA-seq) data contains an excess of zero values, which can be contributed by unexpressed genes and detection signal dropouts. Existing imputation methods fail to distinguish between these two types of zeros. In this study, we introduce a statistical framework that effectively differentiates true zeros (lack of expression) from false zeros (dropouts). By focusing only on imputing the dropout zeros, we developed a new imputation tool, scRecover. Our approach utilizes a zero-inflated negative binomial framework to model the gene expression of each gene in each cell, enabling the estimation of zero-dropout probability. Additionally, we employ a modified version of the Good and Toulmin model to identify true zeros for each gene. To achieve imputation, scRecover is combined with other imputation methods such as scImpute, SAVER and MAGIC. Down-sampling experiments show that it recovers dropout zeros with higher accuracy and avoids over-imputing true zero values. Experiments conducted on real world data highlight the ability of scRecover to enhance downstream analysis and visualization.

PMID:39912305 | DOI:10.1002/sim.10334

JMIR Mhealth Uhealth. 2025 Feb 5;13:e56185. doi: 10.2196/56185.

ABSTRACT

BACKGROUND: Digital phenotyping provides insights into an individual’s digital behaviors and has potential clinical utility.

OBJECTIVE: In this observational study, we explored digital biomarkers collected from wrist-wearable devices and smartphones and their associations with clinical symptoms and functioning in patients with schizophrenia.

METHODS: We recruited 100 outpatients with schizophrenia spectrum disorder, and we collected various digital data from commercially available wrist wearables and smartphones over a 6-month period. In this report, we analyzed the first week of digital data on heart rate, sleep, and physical activity from the wrist wearables and travel distance, sociability, touchscreen tapping speed, and screen time from the smartphones. We analyzed the relationships between these digital measures and patient baseline measurements of clinical symptoms assessed with the Positive and Negative Syndrome Scale, Brief Negative Symptoms Scale, and Calgary Depression Scale for Schizophrenia, as well as functioning as assessed with the Social and Occupational Functioning Assessment Scale. Linear regression was performed for each digital and clinical measure independently, with the digital measures being treated as predictors.

RESULTS: Digital data were successfully collected from both the wearables and smartphones throughout the study, with 91% of the total possible data successfully collected from the wearables and 82% from the smartphones during the first week of the trial-the period under analysis in this report. Among the clinical outcomes, negative symptoms were associated with the greatest number of digital measures (10 of the 12 studied here), followed by overall measures of psychopathology symptoms, functioning, and positive symptoms, which were each associated with at least 3 digital measures. Cognition and cognitive/disorganization symptoms were each associated with 1 or 2 digital measures.

CONCLUSIONS: We found significant associations between nearly all digital measures and a wide range of symptoms and functioning in a community sample of individuals with schizophrenia. These findings provide insights into the digital behaviors of individuals with schizophrenia and highlight the potential of using commercially available wrist wearables and smartphones for passive monitoring in schizophrenia.

PMID:39912304 | DOI:10.2196/56185

JMIRx Med. 2025 Feb 5;6:e57597. doi: 10.2196/57597.

ABSTRACT

BACKGROUND: Routine periodic health examinations (PHEs) for adults who are asymptomatic are included in clinical preventive services. They aim to prevent morbidity and mortality by identifying modifiable risk factors and early signs of treatable diseases. PHEs are a standard procedure in primary health care worldwide, including in Jordan. The country is undergoing an epidemiological transition toward noncommunicable diseases, which are the leading causes of morbidity and mortality. The prevalence of smoking is among the highest in the world, with escalating rates of obesity and physical inactivity. Notably, hypertension and diabetes are the most prevalent diseases.

OBJECTIVE: This study aims to determine the extent to which individuals in Jordan participate in PHEs and to evaluate the various factors related to sociodemographics, health, knowledge, and behavior that influence this participation.

METHODS: This study used a cross-sectional design and includes 362 participants 18 years or older residing in Jordan. A convenience sampling method was used, and data were collected through a hybrid web-based and face-to-face questionnaire. The analysis involved the application of logistic regression through SPSS to investigate the relationship between various influencing factors and the uptake of PHEs.

RESULTS: Our study indicated that only 98 of the 362 (27.1%, 95% CI 22.8%-31.9%) participants underwent PHEs within the last 2 years. Noteworthy predictors of PHE uptake among Jordanians included recent visits to a primary health care facility within the previous year (adjusted odds ratio [AOR] 4.32, 95% CI 2.40-7.76; P<.001), monthly income (P=.02; individuals with a monthly income of 1500-2000 JD displayed more than five times the odds of undertaking PHEs than those with a monthly income <500 JD; AOR 5.74, 95% CI 1.32-24.90; P=.02; those with a monthly income of more than 2000 JD exhibited even higher odds; AOR 9.81, 95% CI 1.73-55.55; P=.02; a currency exchange rate of 1 JD=US $1.43 is applicable), and knowledge levels regarding PHEs and preventive health measures (AOR 1.23, 95% CI 1.03-1.47; P=.007). These variables emerged as the strongest predictors in our analysis, shedding light on key factors influencing PHE uptake in the population. Contrary to other research, our study did not find any statistically significant association between gender (P=.33), smoking status (P=.76), marital status (P=.52), health status self-evaluation (P=.18), seasonal influenza vaccination (P=.07), combined health behavior factors (P=.34), and BMI (P=.76) and PHE uptake.

CONCLUSIONS: PHE uptake is notably low in Jordan. Critical determinants of this uptake include recent visits to a primary health care facility within the previous year, monthly income, and knowledge levels regarding PHEs and preventive health services. To enhance PHE uptake, there is a critical need to integrate PHEs with primary health care services, increase awareness about PHEs, and offer free preventive services, particularly for those at high risk.

PMID:39912301 | DOI:10.2196/57597

JMIR Serious Games. 2025 Feb 5;13:e57443. doi: 10.2196/57443.

ABSTRACT

BACKGROUND: Current telemedicine technologies are not fully optimized for conducting physical examinations. The Virtual Remote Tele-Physical Examination (VIRTEPEX) system, a novel proprietary technology platform using a Microsoft Kinect-based augmented reality game system to track motion and estimate force, has the potential to assist with conducting asynchronous, remote musculoskeletal examinations.

OBJECTIVE: This pilot study evaluated the feasibility of the VIRTEPEX system as a supplement to telehealth musculoskeletal strength assessments.

METHODS: In this cross-sectional pilot study, 12 study participants with upper extremity pain and/or weakness underwent strength evaluations for four upper extremity movements using in-person, telehealth, VIRTEPEX, and composite (telehealth plus VIRTEPEX) assessments. The evaluators were blinded to each other’s assessments. The primary outcome was feasibility, as determined by participant recruitment, study completion, and safety. The secondary outcome was preliminary evaluation of inter-rater agreement between in-person, telehealth, and VIRTEPEX strength assessments, including κ statistics.

RESULTS: This pilot study had an 80% recruitment rate, a 100% completion rate, and reported no adverse events. In-person and telehealth evaluations achieved highest overall agreement (85.71%), followed by agreements between in-person and composite (75%), in-person and VIRTEPEX (62.5%), and telehealth and VIRTEPEX (62.5%) evaluations. However, for shoulder flexion, agreement between in-person and VIRTEPEX evaluations (78.57%; κ=0.571, 95% CI 0.183 to 0.960) and in-person and composite evaluations (78.57%; κ=0.571, 95% CI 0.183 to 0.960) was higher than that between in-person and telehealth evaluations (71.43%; κ=0.429, 95% CI -0.025 to 0.882).

CONCLUSIONS: This study demonstrates the feasibility of asynchronous VIRTEPEX examinations and supports the potential for VIRTEPEX to supplement and add value to standard telehealth platforms. Further studies with an additional development of VIRTEPEX and larger sample sizes for adequate power are warranted.

PMID:39912298 | DOI:10.2196/57443

Stat Med. 2025 Feb 28;44(5):e10329. doi: 10.1002/sim.10329.

ABSTRACT

The high-throughput biomedical technology enables measurement of thousands of gene expression levels contemporaneously. A major task in analyzing these gene expression data is to identify both over-expressed and under-expressed genes. The popular two-group models select the non-null genes without further classifying them as overexpression or underexpression. Consequently, two-group decision rules are unable to constrain the numbers of falsely discovered over-expressed or under-expressed genes respectively. We propose a general three-group model that allows dependence between the test statistics and develop a decision rule that separately controls the two types of false discoveries. We show that the optimal decision rule in our three-group model has a special monotonic structure. By making use of this monotonic structure, we can linearize the two-directional false discovery rate constraints. We prove that our decision rule optimizes the expected number of true discoveries while controlling the proportions of falsely discovered over-expressed and under-expressed genes at desired levels simultaneously. The data-driven versions of the proposed procedures are suggested, and their consistency is established. Comparisons with state-of-the-art approaches and applications to genomic studies show that our procedures work well.

PMID:39912293 | DOI:10.1002/sim.10329

J Anat. 2025 Feb 6. doi: 10.1111/joa.14227. Online ahead of print.

ABSTRACT

Cortical bone and dentine are two mineralized tissues sharing a common embryological origin, developmental, and genetic background, distinct from those of enamel. Understanding their relationship is crucial to decipher the factors acting on their postnatal development, and shedding light on the evolutionary patterns of tissue proportions. Here, we investigate the coordinated variation between cortical bone and dentine volumes measured from arm and forearm bones (humeri, ulnae, radii) and upper anterior teeth (central incisors, lateral incisors, canines) of modern humans. Given the shared characteristics of cortical bone and dentine, we expect similarities in their postnatal development, which may lead to covariation between their volumes. The degree of bone-dentine covariation may be influenced by the physiological response of upper limb bones to mechanical loading. No such covariation is expected with enamel volumes, due to the greater developmental independence of bone and enamel. Our sample includes 55 adults of African and European ancestries from South African osteological collections. Principal component analysis of cortical thickness variation along the shafts of paired humeri, ulnae, and radii is used to assess asymmetry. Bone regions with bilateral asymmetry in cortical bone thickness are considered sensitive to functional loads, while regions with minimal bilateral variation likely reflect genetic influences during bone postnatal development. Statistical analyses reveal strong positive correlations between cortical bone and dentine volumes across all bones and teeth, and weaker correlations between cortical bone and enamel. We outline a complex pattern of bone-dentine covariation that varies by skeletal location and tooth type. Contrary to our expectations, the presumed functional sensitivity of bone regions does not influence the covariation signal. Additionally, the strength of the covariation appears to align with the developmental sequence of the anterior teeth, with the upper canines showing the strongest correlation with cortical bone volumes, followed by lateral and central incisors. These results provide insights into the functional and biological factors influencing the coordinated variation of cortical bone and dentine volumes during postnatal development. Further research on the cortical bone-dentine covariation across different skeletal parts, including lower limb elements, would enhance our understanding of the effects of both endogenous and exogenous factors on the development of the mineralized tissues.

PMID:39912285 | DOI:10.1111/joa.14227

Indian Pediatr. 2025 Feb 15;62(2):148-150. doi: 10.1007/s13312-025-3381-7.

ABSTRACT

The management of high-risk neuroblastoma has dismal outcomes in low-and-middle-income countries (LMICs). There is limited data on post transplant outcomes of high-risk neuroblastoma from LMICs. We report the outcomes of twelve patients with high-risk neuroblastoma who underwent autologous stem cell transplanatation (ASCT) at a single tertiary care center in Northen India. At a median follow-up of 25.5 months, the event-free survival was 63.6%. Relapse occurred in four patients (33.3%), who subsequently died. All patients had febrile neutropenia; there was no ASCT-related mortality. Multidisciplinary therapy even with omission of dinutuximab in our cohort had acceptable outcomes.

PMID:39912276 | DOI:10.1007/s13312-025-3381-7

Indian Pediatr. 2025 Feb 15;62(2):143-147. doi: 10.1007/s13312-025-3380-8.

ABSTRACT

OBJECTIVE: To describe the clinical profile, etiology and outcome of children with hospital-onset seizures (HOS) in a tertiary care public hospital.

METHODS: In this prospective study, consecutive children aged 3 months to 12 years admitted for at least 24 hours in the Department of Pediatrics of a tertiary care public hospital between 1 February, 2021 and 15 September, 2021, were followed-up during hospital stay till death/discharge. Any child admitted within 7 days following head trauma, or admitted for seizure control during the current illness was excluded. All patients were followed up daily for the occurrence of seizures during hospital stay. Outcomes were assessed using Glasgow Outcome Scale (GOS).

RESULTS: Out of the 1050 children (635 boys), 25 (2.38%) children with a median (IQR) age of 12 (4,60) months developed seizures during the hospital stay. Seizures occurred at a median (IQR) interval of 21 hour (8 hour, 5 days) from admission; seizures progressed to status epilepticus in 3 (12%) children. Majority of those with seizures had an underlying neurological disorder/disease at admission. Majority of patients (68%) had generalized tonic-clonic seizures. After neuro-infections, metabolic derangements were the second most common etiological group for HOS (32%). A poor outcome, defined as death/severe disability as per GOS, was seen in 8 (32%) children with HOS. Children with HOS had a 2.76 times higher risk of a poor outcome as compared to those with no seizures during the hospital stay [RR (95% CI) 2.76 (1.07, 7.11), P = 0.035].

CONCLUSION: Physicians need to be aware of the risk factors for HOS in children so as to provide adequate monitoring and emergent treatment.

PMID:39912275 | DOI:10.1007/s13312-025-3380-8