Category: Nevin Manimala

Sci Rep. 2025 Jan 4;15(1):834. doi: 10.1038/s41598-024-84522-w.

ABSTRACT

In modern knee arthroplasty, surgeons increasingly aim for individualised implant selection based on data-driven decisions to improve patient satisfaction rates. The identification of an implant design that optimally fits to a patient’s native kinematic patterns and functional requirements could provide a basis towards subject-specific phenotyping. The goal of this study was to achieve a first step towards identifying easily accessible and intuitive features that allow for discrimination between implant designs based on kinematic data. A squat-cycle was simulated on eight fresh frozen specimens mounted in a weight-bearing knee rig, each initially tested under native conditions, and then after implantation with four different implant types (CR/CS, MS, LS, and PS). The kinematic signals of these five configurations were compared to determine whether key differences between implants could be detected leveraging two methodological approaches: (1) statistical parametric mapping to directly compare waveforms and (2) simple paired t-tests to compare the three-dimensional coordinates of the functional centres of rotation determined using a previously published REference FRame Alignment Method (REFRAME). While statistical parametric mapping of the kinematic data revealed only small differences in certain comparisons (e.g. LS vs. PS, and MS vs. LS) under lenient statistical testing conditions, the application of REFRAME showed clear differences between implants (for all implant combinations except for CR/CS vs. LS), even under conservative statistical testing. Since for most implant combinations, significant differences in the centres of rotation were found using REFRAME, this approach could present a suitable tool for discriminating between the kinematics of different implant types. Preoperative assessment of joint kinematics, combined with this REFRAME application, could therefore provide a key approach for improved clinical selection of implant type.

PMID:39755774 | DOI:10.1038/s41598-024-84522-w

Sci Rep. 2025 Jan 4;15(1):820. doi: 10.1038/s41598-024-84422-z.

ABSTRACT

Cervical cancer remains a major global health concern, with a specially alarming incidence in younger women. Traditional detection techniques such as the Pap smear and colposcopy often lack sensitivity and specificity and are highly dependent on the experience of the gynaecologist. In response, this study proposes the use of Hyperspectral Imaging, a pioneering technology that combines traditional imaging with spectroscopy to provide detailed spatial and spectral information. Over a period of six-months, our custom-designed hyperspectral colposcope was used on 62 patients. The gathered data underwent a specialized preprocessing workflow using a PCA-based strategy for unsupervised segmentation of the cervical region. This process extracted spectral signatures from various tissue types, and our subsequent statistical analysis highlighted its ability to detect differences and alterations in the cervical tissue. This offers a promising avenue for improving the precision of cervical lesion diagnosis.

PMID:39755771 | DOI:10.1038/s41598-024-84422-z

CJEM. 2025 Jan 4. doi: 10.1007/s43678-024-00843-9. Online ahead of print.

ABSTRACT

OBJECTIVES: Fundoscopy is crucial in the emergency department to identify or rule out serious ocular and neurological conditions. Despite its clinical importance, fundoscopy is often omitted due to the technical challenges associated with traditional direct ophthalmoscopy, particularly for non-ophthalmologists. This study examines emergency physicians’ practices, confidence levels, and training related to various modalities of fundoscopy including traditional direct ophthalmoscopes, binocular indirect ophthalmoscopes, panoptic ophthalmoscopes, slit lamp fundoscopy and fundus cameras; and explores the potential role of alternative modalities, such as fundus cameras, in Canadian emergency departments.

METHODS: A cross-sectional survey was distributed to approximately 1000 emergency physician members of the Canadian Association of Emergency Physicians between March 4 and April 10, 2024. The survey, developed with ophthalmology and emergency medicine experts, included Likert scales and multiple-choice questions addressing confidence, practices, training, and experience with various fundoscopy modalities. Demographic data and responses were analyzed using descriptive statistics. Surveys were anonymous and available in English and French.

RESULTS: Seventy-four emergency physicians participated (mean experience 17.8 years), representing all Canadian provinces and territories. Most reported experience with traditional direct ophthalmoscopes (97.3%), slit lamp fundoscopy (82.2%) and panoptic ophthalmoscopes (58.9%). Only 1.4% had used binocular indirect ophthalmoscopes. No participant had experience with fundus cameras. Confidence in identifying fundus findings was low across all modalities, with only 13.7% reporting confidence using traditional ophthalmoscopes. Fundoscopy was performed frequently or always by 57.5% of the respondents, yet only 6.8% routinely used pupil dilation. Only 35.6% of the respondents felt their training in fundoscopy was adequate.

CONCLUSION: Emergency physicians in Canada report low confidence in fundoscopy despite its critical role in identifying vision- or life-threatening conditions. Traditional modalities are widely used but remain challenging for non-ophthalmologists. Fundus cameras, which offer ease of use and higher diagnostic accuracy, are underutilized.

PMID:39755766 | DOI:10.1007/s43678-024-00843-9

Sci Rep. 2025 Jan 4;15(1):840. doi: 10.1038/s41598-024-84565-z.

ABSTRACT

While recent studies have indicated a potential link between incense burning and respiratory diseases, there is a lack of data specifically focused on diabetic patients. To explore the relationship between indoor incense burning and impaired lung function among Chinese individuals with diabetes, a comprehensive cross-sectional study was undertaken, enrolling 431 adults diagnosed with diabetes. Information on incense burning and characteristics was collected using a structured questionnaire. The outcome of the study, impaired lung function, was assessed using spirometry. Multivariable logistic regression models were employed. In the fully adjusted model, participants exposed to indoor incense burning exhibited 130% higher odds of impaired lung function compared to those not exposed, as indicated by an odds ratio (OR) of 2.3 (95% confidence interval [CI]: 0.97, 5.16; P = 0.05). Notably, this association was statistically significant only in men (OR = 3.39; 95%CI: 1.07, 9.82; P = 0.03). Our study has elucidated an association between exposure to indoor incense burning and impaired lung function in individuals with diabetes, independently of demographic factors. These findings underscore the importance of considering indoor environmental factors, such as incense burning, in the comprehensive management and care of diabetic individuals.

PMID:39755765 | DOI:10.1038/s41598-024-84565-z

Sci Rep. 2025 Jan 4;15(1):844. doi: 10.1038/s41598-024-85010-x.

ABSTRACT

China has implemented the “tiered medical services” policy since 2015, while there is a paucity of data evaluating the the current status of chronic obstructive pulmonary disease (COPD) management under the system. Characteristics and treatments from 11,905 COPD patients in 88 hospitals across different tiers in China were included and analyzed. We assessed the statistical significance of differences by one way analysis of variance (ANOVA) for continuous variables and with the chi-squared test for categorical variables. Patients in primary hospitals (Tier1) exhibited heightened exposure to risk factors including smoking, household biofuel, and family history of respiratory diseases, and displayed elevated COPD assessment test (CAT) and modified Medical Research Council (mMRC) dyspnea scale scores, and worse lung function, in comparison to tertiary (Tier3) hospitals (P < 0.001). However, the utilization of inhaled maintenance treatments in Tier1 hospitals is markedly lower than that in Tier3 hospitals (54.8% vs. 81.3%, P < 0.001). At odds with the patients with more severer symptoms (as indicated by CAT ≥ 10 or mMRC ≥ 2), a higher proportion relied exclusively on single bronchodilators in Tier1 hospitals was observed compared to secondary (Tier2) and Tier3 hospitals (37.7% vs. 32.1% vs. 26.3%, 40.0% vs. 29.8% vs. 25.6%, P<0.001). Dual bronchodilators (long-acting β2-agonists /long-acting muscarinic antagonist, LABA/LAMA) represented the least common medication regimen across all tiers of hospitals, albeit their usage rates increased in tandem with hospital tier (0.7% vs. 7.2% vs. 10.4%, P < 0.001). In addition, the use of inhalation therapies containing inhaled corticosteroids (ICS) in China’s primary care is notably lower (16.9%) than the United States, the United Kingdom, and other middle-to-high-income countries (29.5-57.0%). There was compelling evidence pointing to greater disease severity in Tier1 hospitals, attributable to the lower and inappropriate utilization of inhaled maintenance treatments. This underscores the necessity for enhanced availability of medications and educational initiatives aimed at both physicians and patients within Tier1 hospitals.

PMID:39755745 | DOI:10.1038/s41598-024-85010-x

Sci Rep. 2025 Jan 4;15(1):761. doi: 10.1038/s41598-024-81271-8.

ABSTRACT

Active transportation, such as cycling, improves mobility and general health. However, statistics reveal that in low- and middle-income countries, male and female cycling participation rates differ significantly. Existing literature highlights that women’s willingness to use bicycles is significantly influenced by their perception of security. This study employs virtual reality (VR) cycling simulation and electroencephalography (EEG) analysis to investigate factors influencing female cyclists’ perceptions of security in Tehran. A total of 52 female participants took part in four scenarios within a VR bicycle simulator, which simulates various environmental settings. In this experiment, participants’ brainwave signals are gathered through an EEG device, and a questionnaire with their stated preferences is filled out. The Gaussian mixture approach is used to cluster brainwave patterns based on security perception from EEG data. Subsequently, four supervised machine learning methods, random forest, support vector machine, logistic regression, and multilayer perceptron, are utilized to classify influential factors on security perception using clustered EEG data. Consequently, the support vector machine model, with an F1 score of 0.74, appears to be the most effective technique for the classification of environmental and surveillance factors. Furthermore, the SelectKBest algorithm determines that factors such as the presence of obstacles like kiosks, cycling routes passing through tunnels and underpasses, the level of incivility in the urban cycling environment, and the presence of informal surveillance have the biggest impact on female cyclists’ security perception.

PMID:39755730 | DOI:10.1038/s41598-024-81271-8

Sci Rep. 2025 Jan 4;15(1):802. doi: 10.1038/s41598-024-79424-w.

ABSTRACT

Children are highly sensitive to toxins which can damage their organs and lead to death. Investigating the main causes of intoxication could reduce mortality and morbidity in children. In this cross-sectional study, the documents of all poisoned patients (214 cases) admitted to the emergency department of Taleghani children`s Hospital between April 2020 and 2023 were investigated. Approximately 51% of them were females. There were 87 cases (45.3%) of illicit drug poisoning, which included methadone 43.8%, opium 41.4%, amphetamine 8.2%, cannabis 3.3%, buprenorphine 2.2%, and tramadol 1.1%. Children who were poisoned by illicit drugs presented with impaired level of consciousness (92.5%), unstable vital signs and abnormal laboratory results. The level of serum glucose was higher in methadone toxicity. Three and two cases, due to methadone and opium poisoning died. Children with illicit drugs poisoning in terms of vital signs and laboratory data were worse compared to other poisonings and mortality is high in this group. In this study, the blood sugar in methadone poisoning cases was statistically significantly different from other drugs, and it is suggested that in cases of children suspected of poisoning with illicit drugs and high blood sugar, methadone poisoning should be considered in the differential diagnosis.

PMID:39755707 | DOI:10.1038/s41598-024-79424-w

Transl Psychiatry. 2025 Jan 4;15(1):1. doi: 10.1038/s41398-024-03197-z.

ABSTRACT

Experiencing a traumatic event may lead to Posttraumatic Stress Disorder (PTSD), including symptoms such as flashbacks and hyperarousal. Individuals suffering from PTSD are at increased risk of cardiovascular disease (CVD), but it is unclear why. This study assesses shared genetic liability and potential causal pathways between PTSD and CVD. We leveraged summary-level data of genome-wide association studies (PTSD: N = 1,222,882; atrial fibrillation (AF): N = 482,409; coronary artery disease (CAD): N = 1,165,690; hypertension (HT): N = 458,554; heart failure (HF): N = 977,323). First, we estimated genetic correlations and utilized genomic structural equation modeling to identify a common genetic factor for PTSD and CVD. Next, we assessed biological, behavioural, and psychosocial factors as potential mediators. Finally, we employed multivariable Mendelian randomization to examine causal pathways between PTSD and CVD, incorporating the same potential mediators. Significant genetic correlations were found between PTSD and CAD, HT, and HF (r_g = 0.21-0.32, p ≤ 3.08 · 10^-16), but not between PTSD and AF. Insomnia, smoking, alcohol dependence, waist-to-hip ratio, and inflammation (IL6, C-reactive protein) partly mediated these associations. Mendelian randomization indicated that PTSD causally increases CAD (IVW OR = 1.53, 95% CIs = 1.19-1.96, p = 0.001), HF (OR = 1.44, CIs = 1.08-1.92, p = 0.012), and to a lesser degree HT (OR = 1.25, CIs = 1.05-1.49, p = 0.012). While insomnia, smoking, alcohol, and inflammation were important mediators, independent causal effects also remained. In addition to shared genetic liability between PTSD and CVD, we present strong evidence for causal effects of PTSD on CVD. Crucially, we implicate specific lifestyle and biological mediators (insomnia, substance use, inflammation) which has important implications for interventions to prevent CVD in PTSD patients.

PMID:39755697 | DOI:10.1038/s41398-024-03197-z

Sci Rep. 2025 Jan 4;15(1):824. doi: 10.1038/s41598-024-79600-y.

ABSTRACT

Real-world data on treatment outcomes or the quality of large-scale chronic hepatitis B (CHB) treatment programs in sub-Saharan Africa (SSA) is extremely difficult to obtain. In this study, we aimed to provide data on the prevalence and incidence of mortality, loss to follow-up (LFTU), and their associated factors in patients with CHB in three treatment centres in Eritrea. Additional information includes baseline clinical profiles of CHB patients initiated on nucleos(t)ide analogue (NUCs) along with a comparison of treatment with Tenofovir disoproxil fumarate (TDF) vs. TDF + Lamuvudine (LAM) using specific biochemical, haematological and virologic parameters. A multicenter retrospective cohort study was conducted on CHB patients in Asmara, Eritrea (2018-2021). Demographic, clinical, and laboratory information was collected from medical records using a structured checklist. Relevant parametric and nonparametric statistics were employed to explore treatment outcomes and to evaluate differences between groups. Where appropriate, Kaplan-Meier (KM) curves and univariate and multivariate Cox regression models were implemented. A two-sided p-value < 0.05 was considered significant. A total of 413 patients with HBV (median age (IQR) at diagnosis: 39 (IQR: 28-50 years; females: 118(28.6%); followed for a total of 22,921 person days) were studied. HBV/HIV co-infection was observed in 15(3.6%) and baseline ALT and AST were elevated in 99(31.2%) and 101(32.8%), respectively. The Fibrosis-4 (FIB-4) index estimates suggested that cirrhosis was highly likely in 33 (14%) patients with 49 (20.8%) patients in the indeterminate FIB-4 score category. During the follow-up period, 4.6% (95% CI: 2.5-6.6%) died, while 23.9% (95% CI: 19.8-28%) were LTFU. In the adjusted Cox proportional hazards model, LTFU were independently associated with baseline serum HBV DNA (IU/mL) (aHR = 1.3, 95% CI 1.04-1.7; p-value = 0.02); Not initiated on NUC (aHR = 3.9, 95% CI: 1.1-13.7, p-value = 0.02); and FIB-4 Score (aHR = 1.05, 95% CI: 1-1.1; p-value = 0.01). Of the 413 patients enrolled in the study, 98 cases (23.73%) were initiated on treatment. In the head-to-head comparison of the results in TDF and TDF + LAM after 12 weeks of treatment, VR was observed in 14(45.2%) vs. 17(54.8%), respectively, translating into an overall VR of 60.7% (95% CI 46.9-74.6). Furthermore, VR in TDF vs. TDF + LAM were similar, 14(45.2%) vs. 17(54.4%) respectively, p-value = 0.3). This study uncovered multiple systems- and patient-centered gaps in the three HBV treatment programs in Asmara, Eritrea. These include late presentation, high incidence of LTFU, inconsistencies in routine data, and poor data management. Interventions should target improvements in laboratory infrastructure, adherence to patient monitoring guidelines, HBV literacy, better tracking of patients, and documentation of patient’s information.

PMID:39755688 | DOI:10.1038/s41598-024-79600-y

Nat Commun. 2025 Jan 4;16(1):389. doi: 10.1038/s41467-024-55214-w.

ABSTRACT

Spatial protein expression technologies can map cellular content and organization by simultaneously quantifying the expression of >40 proteins at subcellular resolution within intact tissue sections and cell lines. However, necessary image segmentation to single cells is challenging and error prone, easily confounding the interpretation of cellular phenotypes and cell clusters. To address these limitations, we present STARLING, a probabilistic machine learning model designed to quantify cell populations from spatial protein expression data while accounting for segmentation errors. To evaluate performance, we develop a comprehensive benchmarking workflow by generating highly multiplexed imaging data of cell line pellet standards with controlled cell content and marker expression and additionally established a score to quantify the biological plausibility of discovered cellular phenotypes on patient-derived tissue sections. Moreover, we generate spatial expression data of the human tonsil-a densely packed tissue prone to segmentation errors-and demonstrate cellular states captured by STARLING identify known cell types not visible with other methods and enable quantification of intra- and inter- individual heterogeneity.

PMID:39755686 | DOI:10.1038/s41467-024-55214-w