Category: Nevin Manimala

Acta Neurochir (Wien). 2025 Dec 20. doi: 10.1007/s00701-025-06737-8. Online ahead of print.

ABSTRACT

PURPOSE: to comprehensively and hierarchically assess risk factors for recurrence requiring reoperation (RrR) in chronic subdural hematoma (cSDH) in the era of middle meningeal artery embolization (MMAE).

METHODS: Patients treated for a cSDH from January 2019 to October 2024 at Fondazione Gemelli research hospital were considered for inclusion. Clinical, coagulation, radiological, and treatment factors were recorded. MMAE was performed systematically from October 2022, using polyvinyl alcohol (PVA) particles injected directly from the main trunk of MMA. The dataset comprised 45 quantitative and qualitative variables for each cSDH. Variables showing statistical significance (p-value < 0.05) were selected as covariates in two supervised learning frameworks to predict the RrR (outcome, Y): (i) Classification and Regression Tree (CART) and (ii) Random Forest (RF) classifier.

RESULTS: 500 patients were eligible and 233 were included, resulting in 283 treated cSDHs (mean follow-up: 119 days); 129 underwent adjuvant MMAE. 50 cSDH had a RrR (mean time to recurrence: 47 days), of which 41 (82%) in the non-embolized group and 9 (18%) in the embolized group (p-value < 0.001). Adjuvant embolization was the strongest factor associated with RrR, significantly reducing the risk for reintervention. Markwalder grading scale, preoperative cSDH volume, and platelet count (PLT) are strong predictors in non-embolized patients. A critical PLT cut-off of 229 × 10⁹/L strongly impacts RrR risk for substantial cSDH volumes.

CONCLUSIONS: The present results support the routine use of MMAE and the correction of PLT in relation to cSDH volume.

PMID:41420704 | DOI:10.1007/s00701-025-06737-8

Aging Clin Exp Res. 2025 Dec 20. doi: 10.1007/s40520-025-03294-z. Online ahead of print.

ABSTRACT

BACKGROUND: Life-space mobility (LSM) is a critical health indicator in older adults, the mechanisms underlying the relationship between subjective cognitive decline (SCD) and LSM remain unclear.

AIMS: This study examined depression as a mediator between SCD and LSM, and assessed whether perceived social support (PSS) moderates the relationship between SCD and depression among Chinese community-dwelling older adults.

METHODS: We seek to elucidate psychosocial mechanisms of the SCD-LSM link and inform targeted intervention strategies. Drawing on a face-to-face interview sample of 287 community-dwelling aged, this cross-sectional study utilised a moderated mediation analysis. Key constructs were evaluated by the Subjective Cognitive Decline Questionnaire-9, 15-item geriatric depression scale, Perceived Social Support Scale, the Life Space Assessment, respectively.

RESULTS: The results showed that SCD was negatively associated with LSM (β = -0.213, p < 0.001). Mediation analysis indicated an indirect association between SCD and LSM through depression (indirect effect = -1.868, 95% CI [-2.825, -1.029]), accounting for 41.6% of the total association. Furthermore, PSS was identified as a significant moderator in the relationship between SCD and depression (β = -0.088, p < 0.05), with a stronger association observed among older adults with lower PSS levels. The interaction term contributed a unique incremental variance of ΔR² = 0.0086 to the model.

DISCUSSION: Establishing a social support system holds promise for improving life-space mobility and alleviating depression among community-dwelling older adults with subjective cognitive decline, thereby enhancing their well-being.

CONCLUSION: A negative association between SCD and LSM was observed, with depression partially mediating this relationship. Importantly, PSS demonstrated a statistically significant moderating effect on the relationship between SCD and depression, although the effect size was small.

PMID:41420691 | DOI:10.1007/s40520-025-03294-z

J Racial Ethn Health Disparities. 2025 Dec 20. doi: 10.1007/s40615-025-02773-3. Online ahead of print.

ABSTRACT

The scientific literature continues to recognize the changing health status of migrants residing in geographic destinations outside their homeland. However, very little research has compared the health of Caribbean residents within their homeland with those across various diasporic destinations. This five-country study examined the physical and mental health of Caribbeans within the region and those in host countries, and whether the length of time in host countries is associated with declining health. We analyzed population-based data collected in Jamaica (2005), Guyana (2005), Canada (2000/2001, 2003, and 2005), the United States (2001-2003), and England (1998-2000). Parallel descriptive statistics and multivariate logistic regression were used to assess the health status of first-generation Caribbeans. The study revealed that Caribbean people within the region generally maintained a higher degree of health advantage compared to Caribbean migrants in North America and England. Length of time was associated with physical and mental health problems within certain host countries. Sociodemographic factors contribute to health. The findings suggest that first-generation Caribbeans might initially lose certain health benefits in host countries, although we find trends for improved cardiovascular health over time in Canada. Further exploration of other influences on health among Caribbeans across the diaspora is needed.

PMID:41420681 | DOI:10.1007/s40615-025-02773-3

Environ Monit Assess. 2025 Dec 20;198(1):59. doi: 10.1007/s10661-025-14927-1.

ABSTRACT

Research on the segmentation and analysis of forest canopy gaps (CGs) is important for understanding forest dynamics, biodiversity, and ecosystem resilience. In this study, seasonal changes in CGs over a five-year period were analyzed using unmanned aerial vehicle (UAV) RGB imagery, satellite multispectral imagery, Synthetic Aperture Radar (SAR), and Light Detection and Ranging (LiDAR) data. The aerial LiDAR achieved the highest segmentation accuracy (87%) for smaller gaps, followed by UAV RGB imagery (84%) and satellite-based observations (70%). Statistical models, including the Weibull Distribution and the Markov Chain, were used for spatial and temporal modeling of CGs. Gap size distribution over the five years showed that smaller CGs (< 100 m²) were more common in the early years, while larger gaps increased in later years, particularly in spring and autumn. This research supports CG segmentation and analysis by combining multi-source data and statistical modeling. Providing a flexible solution for monitoring forest ecosystems and promoting sustainable management practices.

PMID:41420677 | DOI:10.1007/s10661-025-14927-1

Biogerontology. 2025 Dec 20;27(1):25. doi: 10.1007/s10522-025-10372-2.

ABSTRACT

BACKGROUND: Epigenetic age acceleration (EAA) is a biomarker of biological aging associated with multiple diseases. Plasma metabolites are potential targets for disease prevention. Therefore, our study aims to investigate the association between plasma metabolites and EAA.

METHODS: Statistics of plasma metabolites and EAA were obtained from the GWAS database. After rigorously screening the instrumental variables, we applied five Mendelian randomization methods to evaluate the relationship between each metabolite and the EAA. The robustness of the results was verified by a series of sensitivity analyses, and metabolic pathway enrichment analysis was performed for significantly associated metabolites.

RESULTS: Our analysis identified 149 plasma metabolites associated with EAA (p < 0.05), including 46 metabolites associated with IEAA, 47 with HannumAge, 38 with GrimAge, and 41 with PhenoAge. Among these, palmitoylcarnitine levels remained correlated with EAA after multiple testing correction (P_FDR < 0.05). In the enrichment analysis, 13 metabolic pathways were associated with EAA. Among them, “cysteine and methionine metabolism” was identified as the most significantly enriched pathway (P_FDR < 0.1), and 3 metabolites in this pathway were correlated with EAA.

CONCLUSION: These results demonstrated that plasma metabolomics, particularly amino acid and lipid metabolism, were associated with EAA and aging. The “cysteine and methionine metabolism” pathway emerged as a potential mechanism of aging, and may underpin metabolic alterations during the aging process, and its metabolites, such as methionine, 5-methylthioadenosine, and α-ketobutyrate, may serve as intervention targets.

PMID:41420675 | DOI:10.1007/s10522-025-10372-2

Psychol Rep. 2025 Dec 20:332941251409066. doi: 10.1177/00332941251409066. Online ahead of print.

ABSTRACT

Psychological research increasingly relies on high-dimensional data, yet it remains challenging to determine whether patterns of representation are independent across experimental contexts. Traditional multivariate approaches, such as decoding, are sensitive to pattern differences but do not directly test factorial hypotheses. In contrast, analysis of variance (ANOVA) provides inferential clarity but is limited to univariate measures. To address this gap, we introduce Multivariate Interaction Classification (MIC), a framework that combines the logic of factorial interaction tests with the sensitivity of multivariate pattern analysis. MIC evaluates representational independence by comparing within-context and cross-context decoding performance. Through simulation studies, we show that MIC reliably distinguishes modality-specific, modality-general, and hybrid representational structures. We then validate the method with affective ratings of gustatory and auditory stimuli, demonstrating how MIC can reveal the coexistence of specific and general codes. By providing a statistically grounded and easily implemented tool, MIC enables researchers to move beyond descriptive decoding toward confirmatory tests of representational hypotheses. All code and materials are openly available to ensure transparency and reproducibility.

PMID:41420430 | DOI:10.1177/00332941251409066

Vasc Endovascular Surg. 2025 Dec 20:15385744251410019. doi: 10.1177/15385744251410019. Online ahead of print.

ABSTRACT

BackgroundCarotid endarterectomy (CEA) remains the standard surgical intervention for carotid stenosis. While the conventional CEA (cCEA) and eversion techniques have been widely investigated, data on the clinical implications of modified eversion CEA (meCEA), which employs a limited arteriotomy of the carotid bulb, remain scarce. This study aimed to compare the early and mid-term outcomes of meCEA with those of cCEA using adjusted analyses.MethodsIn this retrospective study, 206 patients who underwent CEA between 2015 and 2025 at Daegu Catholic University Hospital were included. Patients were divided into the cCEA (n = 170) and meCEA (n = 36) groups. Baseline characteristics, operative profiles, and postoperative complications were compared using propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) to adjust for potential confounding. Overall survival (OS) and event-free survival (EFS) were evaluated using IPTW-adjusted Kaplan-Meier and Cox proportional hazards models.ResultsThe meCEA group showed marked intraoperative advantages, including a significantly lower rate of patch angioplasty (25.0% vs 87.1%), shorter operative time (94.3 ± 24.5 vs 139.8 ± 43.7 min), and reduced internal carotid artery clamp time (35.0 ± 12.7 vs 48.5 ± 12.5 min; all P < 0.001). No significant differences were observed in postoperative stroke, transient ischemic attack, or in-hospital mortality after PSM adjustment. IPTW-adjusted survival analysis revealed no statistically significant differences in OS (HR: 1.09, 95% CI: 0.38-3.14, P = 0.87) or EFS (HR: 1.29, 95% CI: 0.52-3.23, P = 0.581) between the groups. However, interpretation of long-term outcomes was limited by a shorter follow-up duration in the meCEA group (22.7 vs 63.9 months).ConclusionsThe meCEA technique offers significant operative benefits while demonstrating comparable early and mid-term safety profiles to conventional CEA. Although no significant survival difference was observed after adjustment, the results suggest that meCEA may serve as an effective alternative to cCEA. Further prospective studies with longer follow-up are needed to validate these findings.

PMID:41420426 | DOI:10.1177/15385744251410019

J Geriatr Psychiatry Neurol. 2025 Dec 20:8919887251409415. doi: 10.1177/08919887251409415. Online ahead of print.

ABSTRACT

ObjectivesThis study aimed to compare the effects of different exercise interventions on brain-derived neurotrophic factor (BDNF) levels in patients with neurodegenerative diseases and to explore regulatory factors.MethodsSearched PubMed, Scopus, Web of Science Core Collection, CNKI and Cochrane Library databases up to March 15, 2025. Bayesian network meta-analysis was conducted using R software, and meta-regression analyzed the moderating effects of training period and frequency.Results42 randomized controlled trials covering 1482 patients were included. The Surface Under the Cumulative Ranking (SUCRA) indicated that stretching training (SUCRA = 78.92) and high-intensity interval training (SUCRA = 69.73) were ranked higher than other exercise modalities and exhibited more favorable effect on BDNF enhancement, although neither demonstrated statistically significant superiority over the blank control. In contrast, combined training (SUCRA = 35.58), aerobic training (SUCRA = 35.17), and resistance training (SUCRA = 12.98) showed relatively lower potential for BDNF enhancement (blank control SUCRA = 67.62). Meta-regression analysis showed that the effect of combined training was significantly and positively correlated with intervention period (P < 0.01).ConclusionsStretching training and high-intensity interval training appear promising for enhancing BDNF level in neurodegenerative diseases, while isolated aerobic or resistance training show relatively lower potential on improving BDNF. Combined training requires sustained implementation for significant benefits. These findings highlight the importance of tailored exercise prescription for improving BDNF levels.

PMID:41420424 | DOI:10.1177/08919887251409415

Psychol Rep. 2025 Dec 20:332941251409157. doi: 10.1177/00332941251409157. Online ahead of print.

ABSTRACT

The current progressive adoption of online platforms and web-based interventions, within the context of Cognitive Behavioral Therapy (CBT) services, offers a novel opportunity to scale evidence-based psychotherapy. In the present work, we depict the development of a web and native application within the Italian landscape, GRETA (Graphic Robotic Engine for Therapy Automation). GRETA provides the following functions: (a) Management of therapy appointments and payments; (b) Clinical data, therapy progress, and sessions summary between professionals; (c) Production of the medical report and notes for external institutions; (d) Homework, materials, psychometric measures, progress reports, and therapy notes; (e) Systematic monitoring of the therapeutic process and outcomes; (f) Ensuring confidentiality, security, and integrity of patient information; (g) Collection, aggregation, and analysis of anonymized patient data through statistical reports and graphical dashboards. Beyond the technological implementation, this study also assesses the effectiveness of therapy delivered through GRETA. Pre-post treatment comparisons were conducted on a sample of 442 patients discharged for any reason by the CBT service, categorized into three diagnostic groups: anxiety disorder, depressive disorder, and comorbid anxiety and depressive disorder. Results revealed significant improvements in symptom severity and functional adjustment across all groups. Future developments of GRETA will involve integrating Artificial Intelligence-based features, such as predictions of clinical outcomes.

PMID:41420419 | DOI:10.1177/00332941251409157

Orthod Craniofac Res. 2025 Dec 20. doi: 10.1111/ocr.70076. Online ahead of print.

ABSTRACT

OBJECTIVE: This cross-sectional study examined differences in orofacial features and oral health-related quality of life in previously treated young adults with either idiopathic condylar resorption (ICR) or TMJ involvement from juvenile idiopathic arthritis (JIA).

MATERIAL AND METHODS: The study included 17 patients with ICR and 15 patients with JIA-related TMJ involvement, all treated at the Section for Orthodontics, Aarhus University Craniofacial Clinic, Denmark and the Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Denmark. Data compared came from a standardised radiological examination with cone-beam computed tomography, a standardised clinical orofacial examination and a completed oral health-related quality of life questionnaire (OHIP-14). Validated methodologies were used to evaluate TMJ and dentofacial morphology.

RESULTS: The ICR patients reported a markedly higher number of TMJ pain symptoms, affected jaw function and difficulties in chewing food. The ICR group showed significantly more pronounced aberrant dentofacial morphology in relation to mandibular inclination, anterior/posterior face height ratio and mandibular sagittal position. No statistically significant differences were detected in the severity of condylar deformity between ICR and JIA patients. The oral health-related quality of life was significantly more negatively affected in the ICR group compared to the JIA group in the following domains: physical pain, psychological discomfort and psychological disability.

CONCLUSION: The present study illustrates more severe TMJ signs and symptoms, a greater degree of dentofacial deformity and negatively affected oral health-related quality of life in the ICR group when compared with the JIA group. The same degree of TMJ deformity was found in both groups. Our findings contribute valuable insights towards establishing diagnostic criteria for ICR patients and improving the differential diagnosis of JIA-related TMJ involvement.

PMID:41420415 | DOI:10.1111/ocr.70076