Category: Nevin Manimala

Indian J Tuberc. 2025 Oct;72(4):455-459. doi: 10.1016/j.ijtb.2025.09.001. Epub 2025 Sep 2.

ABSTRACT

BACKGROUND: Tuberculosis (TB) remains a major public health challenge, especially in low- and middle-income countries. Operational Research (OR), supported by robust statistical methods, plays a critical role in optimizing TB control strategies.

OBJECTIVE: This review highlights the statistical tools applied in TB Operational Research, their applications, and the emerging role of Artificial Intelligence (AI) in strengthening data-driven decision-making.

METHODS: We examine classical statistical approaches alongside predictive modeling, cost-effectiveness analysis, and AI-based frameworks. Case examples from diverse settings illustrate their practical impact.

FINDINGS: Statistical methods underpin surveillance, diagnosis, treatment evaluation, and policy modeling in TB programs. AI-driven techniques, such as machine learning and deep learning, are expanding the analytical landscape by enhancing prediction, identifying high-risk populations, and enabling real-time program monitoring.

CONCLUSION: Statistical tools from traditional inference to AI-modeling are essential for advancing TB control. Strengthening methodological rigor, reporting standards and interdisciplinary collaboration will be pivotal in harnessing data for effective TB elimination strategies.

PMID:40975573 | DOI:10.1016/j.ijtb.2025.09.001

Radiologia (Engl Ed). 2025 Sep-Oct;67(5):101576. doi: 10.1016/j.rxeng.2025.101576. Epub 2025 Aug 5.

ABSTRACT

INTRODUCTION: Scientific journals are a fundamental tool for the dissemination of evidence-based medicine. The scientific quality of a journal is related to the level of evidence of its publications. The aim of our study is to analyse and quantify changes in the levels of evidence assigned to articles published in the Radiología journal over the last six years.

MATERIAL AND METHODS: We evaluated articles published in Radiología from 2018 to 2023. A critical reading of the selected articles was carried out and a level of evidence was assigned using two scales that are specific to the field of radiology (Insights into Imaging and the 2011 Oxford Center Evidence Based Medicine). Pearson residuals were used to establish differences in the level of evidence over the years, with a p-value < 0.05 being considered statistically significant. The level of agreement between the two scales for assessing levels of evidence was also compared using the Kappa coefficient.

RESULTS: Of the total 404 publications in Radiología from 2018 to 2023, 275 articles were included for analysis. There was evidence of a progressive increase in the level of evidence for the publications, with a peak in 2023, consistently on both scales (p = 0.043). A Kappa coefficient of 0.92 was obtained in the analysis of agreement between scales (almost perfect agreement).

CONCLUSION: The level of evidence for publications in the Radiología journal has significantly increased in 2023.

PMID:40975552 | DOI:10.1016/j.rxeng.2025.101576

Cardiovasc Pathol. 2025 Sep 18:107782. doi: 10.1016/j.carpath.2025.107782. Online ahead of print.

ABSTRACT

Aortic valve (AV) malformation and AV malfunction have been linked to aortic wall degeneration. Studies concomitantly assessing AV morphology, AV function, age, ascending aortic dilatation, and aortic biomechanical properties are lacking. This exploratory study aims to close this gap. Surgical samples of the ascending aorta (n=102) were histologically assessed. Based on echocardiographic studies, the elastic modulus (slope stress-strain curve) was calculated. Patient characteristics were collected from the patient charts. Samples obtained during autopsy (n=10) served as reference for the microscopic analysis. The patient characteristics, structural aortic wall changes, and biomechanical wall properties were statistically explored using comparative analyses and a Spearman correlation matrix. Marked medial degeneration was found significantly earlier in life for unicuspid AV morphology compared to bicuspid and tricuspid AV. Significantly fewer lamellar units and thinner aortic walls were found in surgical samples compared to the reference group regardless of AV morphology, AV function, age, and aortic dilatation. Adventitial structural impairment was associated with stiffer aortic walls. Hints were found that AV morphology (rather than AV function, age, and presence/absence of aortic dilatation) affects structural and functional ascending aortic wall properties. Additionally, the observations suggest more advanced aortic degeneration in association with unicuspid AV, underpin the need for non-surgical control samples in surgical pathological studies, and highlight the importance of the adventitial layer for aortic biomechanics.

PMID:40975478 | DOI:10.1016/j.carpath.2025.107782

Comput Assist Surg (Abingdon). 2025 Dec;30(1):2562871. doi: 10.1080/24699322.2025.2562871. Epub 2025 Sep 20.

ABSTRACT

High-quality intraoperative video documentation is increasingly valued in surgery for its role in surgical evaluation, procedural archiving, and education. However, the comparative advantages of different recording methods have not been thoroughly examined. In this prospective, double-blinded study, 44 experienced orthopedic surgeons evaluated posterior total hip arthroplasty videos recorded using three techniques: a head-mounted camera, a light-handle-mounted camera, and an externally operated camera. All videos were captured by the same surgeon using standardized hardware and settings. Participants assessed video quality and educational value using a structured questionnaire. Data were analyzed using ANOVA and chi-square testing. The light-handle-mounted camera received the highest mean scores across all five evaluation domains, including visual clarity, image stability, and overall quality (mean scores ranging from 6.91 to 7.98). Repeated measures ANOVA confirmed statistically significant differences among the three camera techniques for all five questions (p = 0.022-0.043). Post hoc analysis revealed that the light-handle-mounted camera significantly outperformed the head-mounted system (p < 0.05 for all comparisons), while the external camera also demonstrated superiority over the head-mounted method. Chi-square testing showed a significant difference in educational suitability ratings (Question 6), with the light-handle-mounted system receiving the highest percentage of affirmative responses (79.5%) compared to the head-mounted (50.0%) and external cameras (31.8%) (p < 0.001). The light-handle-mounted system offered the most balanced solution, providing stable, high-quality recordings without disrupting sterility or workflow. While head-mounted and external methods have niche applications, their practical limitations reduce their suitability for routine documentation in procedures.

PMID:40974608 | DOI:10.1080/24699322.2025.2562871

J Clin Ultrasound. 2025 Sep 20. doi: 10.1002/jcu.70086. Online ahead of print.

ABSTRACT

PURPOSE: To study the diagnostic performance of ultrasound (US) in mild hip osteoarthritis (HOA) compared to conventional radiography (CR) and magnetic resonance imaging (MRI).

METHODS: Fifty-eight patients referred to CR for suspected HOA with at least unilateral Kellgren-Lawrence (KL) 2 change in the CRs were recruited. Bilateral hip US and MRI (n = 116) were performed, and patients filled the Visual Analog Scale (VAS) bilaterally. A sum US score was formed, and its correlation to KL grades and VAS scores was tested. Descriptive statistics, Chi square and McNemar’s test, Spearman correlation, and linear regression analysis were applied as statistical techniques.

RESULTS: US and CR showed similar moderate diagnostic performance compared to MRI with moderate correlation (r = 0.449) between US sum score and KL grades. With pain associations, US sum score showed an OR = 1.725 (CI 1.169-2.546) and KL grades an OR = 2.058 (CI 1.038-4.082).

CONCLUSION: US and CR demonstrated similar moderate diagnostic capability in detecting mild HOA compared to MRI, and both the US sum score and KL grades were associated with increased hip pain. With US and CR demonstrating different aspects of HOA, our findings support the complementary role of US in evaluating patients with suspected HOA.

PMID:40974584 | DOI:10.1002/jcu.70086

Epilepsia Open. 2025 Sep 20. doi: 10.1002/epi4.70150. Online ahead of print.

ABSTRACT

OBJECTIVE: Alterations to brain structures and networks involved in central autonomic and respiratory control are possible biomarkers of SUDEP, but were mainly demonstrated in people at high risk. Postictal generalized EEG suppression (PGES) has been recorded in every case of near or confirmed SUDEP. The structural alterations underpinning PGES are not known.

METHODS: This retrospective study included the brain MRIs of 100 patients with focal and generalized epilepsy who had experienced at least one generalized tonic-clonic seizure (GTCS) documented through long-term video-EEG monitoring, with PGES defined as postictal EEG activity below 10 microvolts lasting at least 20 s. Brain MRIs were parcellated into cortical and subcortical volumes, with further parcellation of thalamic subfields, and univariate and multivariate logistic regression models were applied to identify brain regions associated with PGES.

RESULTS: PGES was observed in 52 of 100 patients. Patients with PGES were older and had a slower heart rate before and after seizures compared to those without PGES. The tonic phase of GTCS was longer in patients with PGES. Univariate logistic regression analysis identified significant associations between PGES and six brain regions: the left and right lateral occipital cortices, left and right precuneus, and left and right thalamus. Multivariate analysis revealed that the right thalamus and both precuneus were independent predictors of PGES. Further analysis of thalamic subfields showed an increased volume of the ventral anterior nucleus of the right thalamus in patients with PGES.

SIGNIFICANCE: Structural alterations in the right thalamus and precuneus are significantly associated with the presence of PGES in epilepsy patients.

PLAIN LANGUAGE SUMMARY: Some people with epilepsy show a period of very low brain activity after a seizure, called PGES, which may be linked to a higher risk of sudden death. We analyzed brain scans from 100 people with epilepsy and found that two brain regions-the right thalamus and the precuneus-were different in those with PGES. These findings may help doctors understand which patients are more at risk after seizures and how to better protect them.

PMID:40974544 | DOI:10.1002/epi4.70150

J Autism Dev Disord. 2025 Sep 20. doi: 10.1007/s10803-025-07040-2. Online ahead of print.

ABSTRACT

PURPOSE: Extended reality (XR) technology has emerged as a promising tool for vocational training by providing controlled, customizable learning environments. This study aimed to evaluate the effectiveness of XR-based interventions in improving vocational skills for individuals with autism spectrum disorder (ASD) and intellectual disability (ID).

METHOD: A meta-analysis was conducted on 26 eligible studies (N = 642) employing pre-post experimental or controlled experimental designs, selected from an initial pool of 3,52 articles. Moderators included: (1) participants’ characteristics (disorder type, age, intelligence quotient, and co-occurring conditions), (2) technical characteristics (level of immersion and human-computer interaction), (3) intervention characteristics (assistance from human interventionist, intervention form, intervention intensity, including frequency, single-session duration, intervention period, total sessions, total duration), (4) target skills, and (5) measurement characteristics (evaluation methods and measurement tools).

RESULTS: We found: (1) XR-based interventions demonstrated a medium overall effect size (SMD = 0.73, 95% CI [0.59, 0.87]) for vocational skills training among individuals with ASD and ID. (2) Based on the results of statistical power analysis, subgroup analyses were conducted for target skill types. We found interventions targeting employment outcomes showed significantly lower effect sizes than those targeting job hard skills, job soft skills, and adaptive psychological traits. Additionally, interventions targeting maladaptive psychological traits were significantly less effective than those targeting job soft skills. (3) Based on results of statistical power analysis, meta-regression was conducted for single-session duration and revealed no significant moderating effect.

CONCLUSION: XR-based interventions show promise for improving vocational skills among individuals with ASD and ID, with effectiveness moderated by target skills. This meta-analysis highlights that improving employment for individuals with ASD and ID requires a multi-layered approach. We need to integrate technology optimization with inclusive policies and employment support.

PMID:40974514 | DOI:10.1007/s10803-025-07040-2

J Autism Dev Disord. 2025 Sep 20. doi: 10.1007/s10803-025-07043-z. Online ahead of print.

ABSTRACT

PURPOSE: Parents of children with autism are exposed to stressors associated with the daily care of raising a child with a developmental disability, which may negatively impact parental quality of life (QOL). The specific aim of this study was to examine the relationships between demographic factors, stress, and coping among parental caregivers of children with autism to determine whether predictors of QOL exist.

METHODS: This study was descriptive, and an electronic survey was distributed to parents of children, age 3-21 years old, diagnosed with autism. The survey measured parent-reported demographic factors, severity of the child’s diagnosis of autism, parental stress, coping, and QOL. Data were analyzed using multiple regression.

RESULTS: Study findings suggest that, in parental caregivers of children with autism in (N = 152) daily stressors, coping self-efficacy, and household income were predictors for physical QOL; daily stressors and coping self-efficacy were predictors of psychological QOL, and coping-self efficacy, household income, and severity of the diagnosis of the child were predictors for environmental QOL.

CONCLUSION: Coping self-efficacy and improved income can positively improve QOL, while severity of the diagnosis of autism and daily stressors can negatively impact QOL. Clinically, nurses with a better understanding of the parental stress and coping in parents of children with autism can better recommend tailored resources to improve QOL. Policies to support financial help for families may also improve QOL. Future research should focus on interventions to support caregiver health.

PMID:40974513 | DOI:10.1007/s10803-025-07043-z

Breast Cancer Res Treat. 2025 Sep 20. doi: 10.1007/s10549-025-07821-4. Online ahead of print.

ABSTRACT

PURPOSE: Knowledge of the uptake and breast and ovarian cancer-preventive and survival effects of bilateral risk-reducing mastectomy (BRRM) and salpingo-oophorectomy (RR-BSO) in female BRCA1/2 carriers is essential for optimized decision-making. This study aimed to examine time trends in the number of registered unaffected BRCA1/2 carriers, BRRM and RR-BSO uptake, and oncological effects of risk-reducing surgeries in a nationwide Danish cohort with matched controls.

METHODS: We included 3067 female BRCA1/2 carriers registered in the Hereditary Breast and Ovarian Cancer Registry and 30,652 age-matched controls between 2000 and 2022. Data were retrieved from national health registries. Uptake and oncological effects of risk-reducing surgeries were assessed using cumulative incidences and Cox proportional hazards models with 95% confidence intervals (CI).

RESULTS: Annual numbers of registered unaffected BRCA1/2 carriers, BRRM, and RR-BSO increased over time. BRRM and RR-BSO uptake 10 years after genetic test varied with the age at genetic test and parity. BRRM reduced the hazard rate of breast cancer by 94% [hazard ratio (HR) 0.06, CI 0.01-0.25]. The same pattern was not found for RR-BSO (HR = 1.31, CI 0.90-1.91). Compared to controls, BRCA1/2 carriers had an increased hazard rate for breast cancer before BRRM (HR 7.49, CI 5.81-9.42).

CONCLUSION: BRRM’s large protective effect against breast cancer in BRCA1/2 carriers was confirmed, in contrast to that of RR-BSO. There were tendencies toward a reduction in overall mortality rates after BRRM, and compared with controls, we saw tendencies toward higher mortality rates before BRRM.

PMID:40974500 | DOI:10.1007/s10549-025-07821-4

Gastric Cancer. 2025 Sep 20. doi: 10.1007/s10120-025-01662-2. Online ahead of print.

ABSTRACT

BACKGROUND: The renin-angiotensin system (RAS) has been increasingly recognized to be associated with carcinogenesis and cancer progression. There is extensive preclinical evidence suggesting the benefits of RAS-inhibiting drugs, such as angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs), in preventing the progression of gastric cancer (GC). However, clinical evidence supporting the positive effects of ARBs and ACEIs on GC prognosis is currently limited. The purpose of this study is to investigate their effects in a Finnish cohort.

METHODS: This is a retrospective national cohort study, where cancer patient registry data were linked to prescription purchase records for ARBs and ACEIs. The effect of ARB/ACEI in the post-diagnostic period on overall mortality was assessed using Cox regression analysis. Disease-specific mortality associations were evaluated with the Fine and Gray model.

RESULTS: We included 2246 histologically confirmed GC patients diagnosed between 2011 and 2016. Follow-up continued until the end of 2023. In the main analysis, a protective effect of ARB use was associated with a significant reduction in overall mortality (adjusted hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.69-0.94, p = 0.007). Furthermore, the effect was greater for those with higher ARB dosage. A similar finding was not observed with ACEI use. For disease-specific survival, both ARB and ACEI use had a significant protective effect (adjusted HR 0.75, 95% CI 0.62-0.90 p = 0.002 and adjusted HR 0.76, 95% CI 0.63-0.93, P = 0.007, respectively).

CONCLUSIONS: Our study adds to the evidence that ARB use might have a beneficial impact on survival among GC patients.

PMID:40974486 | DOI:10.1007/s10120-025-01662-2