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Nevin Manimala Statistics

Noninvasive MRI assessment of cerebrospinal fluid pressure in different phases of Ménière’s disease: a prospective study

Eur J Radiol. 2026 Jan 6;195:112658. doi: 10.1016/j.ejrad.2026.112658. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to determine whether there are differences of cerebrospinal fluid pressure (CSF-P) on patients with Ménière’s disease (MD) during different phases.

METHODS: Noninvasive CSF-P measurement was performed using MRI with a fat-suppressed fast recovery fast spin echo T2-weighted sequence, with the optic nerve subarachnoid space width (ONSASW) posterior to the globe serving as an indicator. Endolymphatic hydrops (EH) grades and hearing thresholds were analysed to investigate the potential correlations with CSF-P.

RESULTS: A total of 66 participants were included. At the location of 3 mm behind the globe, the ONSASW and CSF-P were significantly smaller in the acute phase of MD group compared to both the remission phase of MD group (p < 0.001, p = 0.005, respectively) and control group (p < 0.001, p = 0.043, respectively). No statistically significant differences were found between the remission phase of MD group and the control group (both p > 0.05). Statistically significant correlation between CSF-P and hearing threshold was exclusively observed during the acute phase, with a correlation coefficient of 0.479 (p = 0.024). No significant associations between CSF-P and EH grades in both the two MD groups (all p > 0.05).

CONCLUSION: The study suggests that patients with MD experience a reduction in intracranial pressure during acute episodes, and these fluctuations may indicate hearing threshold variations in early-stage of patients.

PMID:41512363 | DOI:10.1016/j.ejrad.2026.112658

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Head position matters: Position‑dependent vestibular flow void artifacts in inner ear MRI and their clinical implications

Eur J Radiol. 2025 Dec 31;195:112638. doi: 10.1016/j.ejrad.2025.112638. Online ahead of print.

ABSTRACT

It has been shown that static magnetic fields from high-strength magnetic resonance imaging (MRI) machines induce nystagmus in all humans with intact inner ear function. This effect can be explained by the magneto-hydrodynamic Lorentz force, which arises from the interaction of endolymphatic ionic currents and the strong static magnetic field of an MRI machine. Prior experiments demonstrated that MRI-induced nystagmus and vertigo vary with head pitch relative to the magnetic field, being reduced when the head is pitched forward and increased when extended. In another study it has been suggested that signal void artefacts reflected Lorentz-force-induced endolymph movement caused by the interaction between ionic currents flowing through the utricular macula and the static magnetic field of the MRI scanner. Based on these findings the present authors proposed that if the hypointensities are flow voids caused by Lorentz forces, their visibility should also vary with head pitch. In this case, both nystagmus and vestibular hypointensities would share a common mechanism. Twenty healthy volunteers (8 males and 12 females) were recruited to undergo a non-contrast 3 Tesla (T) MRI scan in one of two head pitch positions: chin up (head extension, pitched backward) and chin down (head flexion, pitched forward). A statistically significant increase in hypointensities was observed between the pitched forward and pitched backward positions for both ears (p < 0.01), while no significant differences were detected between corresponding positions of the left and right ears. These findings not only support a Lorentz‑force origin of vestibular hypointensities but also have immediate clinical applicability, with direct implications for radiological interpretation and protocol design to reduce misinterpretation and patient vertigo.

PMID:41512362 | DOI:10.1016/j.ejrad.2025.112638

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From uncertainty to confidence: Standardizing team approach to physical restraint (TAPR) for safer emergency care. A pre-post intervention quality improvement project

Int Emerg Nurs. 2026 Jan 8;84:101743. doi: 10.1016/j.ienj.2026.101743. Online ahead of print.

ABSTRACT

BACKGROUND: Managing violent and disruptive patients in emergency care remains a critical challenge, placing both staff and patient at risk. A multidisciplinary team developed the Team Approach to Physical Restraint (TAPR) intervention to offer a collaborative, role-based framework for safely managing these situations through interdisciplinary coordination.

AIM: This study aimed to evaluate TAPR’s effectiveness in promoting safety and team-based preparedness in the emergency department.

METHODS: A pre- and post-intervention survey design was used to assess the impact of TAPR among emergency department clinicians across multiple roles. The survey included 8 pre-interventions and 12 post-interventions, utilizing Likert-type scales to measure outcomes related to role clarity, perceived injury prevention, confidence in protocol use, and overall effectiveness. Descriptive statistics were used to analyze participant responses.

RESULTS: Following the intervention, 92.5 % of participants reported clarity and applicability in role assignments. Additionally, 77.5 % believed TAPR reduced the likelihood of injuries during restraints, and 90% expressed confidence in initiating the protocol. Overall, 87.5 % agreed that TAPR effectively reduced risks during violent patient encounters.

CONCLUSION: TAPR enhanced preparedness, improved interprofessional collaboration and increased staff confidence in managing violent patients. These findings suggest that TAPR may serve as standardized approach for promoting safety and consistency in emergency care environments.

PMID:41512360 | DOI:10.1016/j.ienj.2026.101743

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Sex-related differences in infective endocarditis. A retrospective study in a high-volume surgical centre

Heart Lung. 2026 Jan 8;78:102715. doi: 10.1016/j.hrtlng.2025.102715. Online ahead of print.

ABSTRACT

BACKGROUND: Despite advancements in diagnostic and therapeutic strategies, infective endocarditis (IE) remains associated with high morbidity and mortality rates. Recent studies have highlighted significant sex-related differences in the clinical presentation, management, and outcomes of IE, reporting conflicting results.

OBJECTIVES: identifying the sex-related differences of patients with IE in clinical presentation and predictors of all-cause mortality.

METHODS: We conducted a retrospective study at a high-volume surgical centre, examining 687 new cases of non-device-related IE admitted between January 2013 and November 2023. Data were collected from anonymized electronic hospital records, including demographic, clinical, echocardiographic, and microbiologic characteristics. Statistical analyses were performed to identify sex-related differences in clinical presentation and predictors of all-cause mortality.

RESULTS: Female patients represented 34% of the cohort and were significantly older than males (69.6 vs. 63.9 years, p < 0.001). Females had higher prevalence of diabetes (24.8% vs. 18.1%, p = 0.039) and hypertension (65.8% vs. 57%, p = 0.025). Mitral valve IE was more common in females (46.6% vs. 36%, p = 0.023), while males had higher incidence of spondylodiscitis (10.2% vs. 3.4%, p = 0.002). Overall mortality was higher in females, but sex was not an independent predictor of mortality at multivariable analysis.

CONCLUSION: Our study highlights important sex-based differences in IE, emphasizing the need for sex-specific approaches to diagnosis, treatment, and management. Recognizing and addressing these differences can improve outcomes for both male and female patients with IE.

PMID:41512348 | DOI:10.1016/j.hrtlng.2025.102715

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Cardiovascular disease-associated admissions in patients with Cystic Fibrosis: A 7-Year U.S. National Inpatient Sample Analysis

Heart Lung. 2026 Jan 8;78:102701. doi: 10.1016/j.hrtlng.2025.102701. Online ahead of print.

ABSTRACT

BACKGROUND: As survival improves for people with cystic fibrosis (PwCF) in the era of CFTR modulators, cardiovascular (CV) diseases are emerging as clinically important comorbidities. Beyond age-related risks, mechanistic pathways such as systemic inflammation, chronic hypoxia, CF-related diabetes, and CFTR-related endothelial dysfunction may contribute to CV injury. However, national-level data on CV outcomes in PwCF remain limited.

OBJECTIVES: We hypothesized that primary cardiac admissions in PwCF are increasing over time and associated with worse in-hospital outcomes compared to non-cardiac admissions.

METHODS: We retrospectively analyzed adult (≥18 years) PwCF hospitalizations in the U.S. National Inpatient Sample (2016-2022). Primary cardiac admissions were defined by a principal diagnosis of atrial fibrillation (AF), heart failure (HF), or myocardial infarction (MI) using ICD-10 codes. Outcomes included in-hospital mortality, length of stay (LOS), charges, and discharge disposition. Temporal trends in cardiac admissions were modeled using negative binomial regression with an offset for total CF hospitalizations; Joinpoint regression was performed as a complementary method. Descriptive statistics and multivariable regression models adjusted for age, sex, and race were used. A p-value <0.05 was considered statistically significant.

RESULTS: Among 121,290 PwCF hospitalizations, 520 (0.43%) were for cardiac causes. PwCF with cardiac admissions were older (median 62 vs. 29 years, p < 0.001) and had more traditional CV comorbidities. Cardiac admission rates increased by 16.4% per year from 2016 to 2022 (IRR 1.16 [1.04-1.29], p = 0.009) in negative binomial regression. Joinpoint regression detected no significant inflection points and estimated a non-significant APC of 16.4% per year (95% CI 10.9-57.4, p = 0.214). Unadjusted mortality was higher for cardiac vs. non-cardiac admissions (OR 3.70, 95% CI 1.61-8.53, p = 0.002), but not significant after adjustment (OR 1.36, 95% CI 0.55-3.34, p = 0.468).

CONCLUSION: Our findings indicated higher in-hospital mortality among PwCF admitted for cardiac causes, and more discharge to nursing facilities among PwCF admitted for cardiac causes. There is a need for greater CV screening, and geriatric care in PwCF.

PMID:41512346 | DOI:10.1016/j.hrtlng.2025.102701

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Perceived Use of Web-Based Videoconferencing for Social Connectedness Among Older Adults Living in Long-Term Care: Qualitative Study

JMIR Aging. 2026 Jan 9;9:e73213. doi: 10.2196/73213.

ABSTRACT

BACKGROUND: The COVID-19 pandemic highlighted how restrictions on in-person interactions within long-term care homes (LTCHs) severely compromised social connectedness among older adults and their families. Post pandemic, despite policy changes supporting greater in-person family engagement, frequent outbreaks continue to disrupt face-to-face interactions, and factors such as geography, life circumstances, and health can constrain family members’ ability to make regular in-person visits. Research suggests that web-based videoconferencing technology (WVT) may be a practical solution to help older adults within LTCHs to maintain social connection in the absence of physical gathering. However, increased understanding of end user experience is lacking, and more information on LTCHs’ readiness to support and sustain WVT will be needed if this modality is to be successfully and widely implemented.

OBJECTIVE: This study aimed to understand how older adults living in LTCHs, their families, and LTCH staff members perceived the use and ease of use of WVT devices for facilitating social connectedness.

METHODS: Using a qualitative description approach, in-depth semistructured interviews were conducted with 7 older adults, 22 family members, and 10 staff across 3 LTCHs via Zoom (Zoom Communications, Inc), Microsoft Teams, or phone calls. Data were analyzed using a directed content analysis informed by the technology acceptance model.

RESULTS: Findings were structured into 3 main themes: actual system use, perceived usefulness of WVT, and perceived ease of use of WVT. Participants described using a range of WVT hardware and software to promote social connection between older adults and family members. Videoconferencing had a crucial role in supporting older adults and their family members’ positive emotional state while also enabling them to maintain life and social roles such as participating in family functions. Despite the perceived use of these tools, participants were concerned about the decline in offering videoconferencing services across LTCHs post pandemic. Some participants noted shifting funding priorities toward supporting in-person recreational activities rather than diversifying web-based social connection options. In addition, factors pertaining to WVT ease of use and integration included limited staff to support older adults with different physical and cognitive needs, variability in digital literacy including knowledge about accessibility features to enhance the ease of use, and families’ lack of awareness about the availability of WVT for social connectedness.

CONCLUSIONS: Web-based videoconferencing technology has the potential to be a meaningful tool to reduce social isolation and promote a sense of social connectedness among older adults and their families and friends. Future research should explore how WVT could be integrated into care planning for this population, particularly in situations where older adults may be at heightened risk for social isolation. Resource allocation toward equipment, infrastructure, and family and staff training would be well-placed to increase engagement with WVT within LTCHs.

PMID:41512315 | DOI:10.2196/73213

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Early Prediction of Cardiac Arrest Based on Time-Series Vital Signs Using Deep Learning: Retrospective Study

JMIR Form Res. 2026 Jan 9;10:e78484. doi: 10.2196/78484.

ABSTRACT

BACKGROUND: Cardiac arrest (CA), characterized by an extremely high mortality rate, remains one of the most pressing global public health challenges. It not only causes a substantial strain on health care systems but also severely impacts individual health outcomes. Clinical evidence demonstrates that early identification of CA significantly reduced the mortality rate. However, the developed CA prediction models exhibit limitations such as low sensitivity and high false alarm rates. Moreover, issues with model generalization remain insufficiently addressed.

OBJECTIVE: The aim of this study was to develop a real-time prediction method based on clinical vital signs, using patient vital sign data from the past 2 hours to predict whether CA would occur within the next 1 hour at 5-minute intervals, thereby enabling timely and accurate prediction of CA events. Additionally, the eICU-CRD dataset was used for external validation to assess the model’s generalization capability.

METHODS: We reviewed and analyzed 4063 patients from the MIMIC-III waveform database, extracting 6 features to develop a deep learning-based CA prediction model named TrGRU. To further enhance performance, statistical features based on a sliding window were also constructed. The TrGRU model was developed using a combination of transformer and gated recurrent unit architectures. The primary evaluation metrics for the model included accuracy, sensitivity, area under the receiver operating characteristic curve (AUROC), and area under the precision-recall curve (AUPRC), with generalization capability validated using the eICU-CRD dataset.

RESULTS: The proposed model yielded an accuracy of 0.904, sensitivity of 0.859, AUROC of 0.957, and AUPRC of 0.949. The results showed that the predictive performance of TrGRU was superior to that of the models reported in previous studies. External validation using the eICU-CRD achieved a sensitivity of 0.813, an AUROC of 0.920, and an AUPRC of 0.848, indicating excellent generalization capability.

CONCLUSIONS: The proposed model demonstrates high sensitivity and a low false-alarm rate, enabling clinical health care providers to predict CA events in a more timely and accurate manner. The adopted meta-learning approach effectively enhances the model’s generalization capability, showcasing its promising clinical application.

PMID:41512300 | DOI:10.2196/78484

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PanForest: predicting genes in genomes using random forests

Bioinformatics. 2026 Jan 9:btag005. doi: 10.1093/bioinformatics/btag005. Online ahead of print.

ABSTRACT

MOTIVATION: The presence or absence of some genes in a genome can influence whether other genes are likely to be present or absent. Understanding these gene co-occurrence and avoidance patterns reveals fundamental principles of genome organisation, with applications ranging from evolutionary reconstruction to rational design of synthetic genomes.

IMPLEMENTATIONS: PanForest, presented here, uses random forest classifiers to predict the presence and absence of genes in genomes from the set of other genes present. Performance statistics output by PanForest reveal how predictable each gene’s presence or absence is, based on the presence or absence of other genes in the genome. Further, PanForest produces statistics indicating the importance of each gene in predicting the presence or absence of each other gene. The PanForest software can run serially or in parallel, thereby facilitating the analysis of pangenomes at Network of Life scale.

RESULTS: A pangenome of 12,741 accessory genes in 1,000 Escherichia coli genomes was analysed in around 5 hours using 8 processors. To demonstrate PanForest’s utility, we present a case study and show that certain genes associated with resistance to antimicrobial drugs reliably predict the presence or absence of other genes associated with resistance to the same drug. Further, we highlight several associations between those genes and others not known to be associated with antimicrobial resistance (AMR), or associated with resistance to other drugs. We envisage PanForest’s use in studies from multiple disciplines concerning the dynamics of gene distributions in pangenomes ranging from biomedical science and synthetic biology to molecular ecology.

AVAILABILITY: The software if freely available with a full manual and can be found with at www.github.com/alanbeavan/PanForest DOI: https://doi.org/10.5281/zenodo.17865482.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:41512299 | DOI:10.1093/bioinformatics/btag005

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sedimix: A workflow for the analysis of hominin nuclear DNA sequences from sediments

Bioinformatics. 2026 Jan 9:btag004. doi: 10.1093/bioinformatics/btag004. Online ahead of print.

ABSTRACT

SUMMARY: Sediment DNA–the ability to extract DNA from archaeological sediments– is an exciting new frontier in ancient DNA research, offering the potential to study individuals at a given archaeological site without destructive sampling. In recent years, several studies have demonstrated the promise of this approach by recovering hominin DNA from prehistoric sediments, including those dating back to the Middle or Late Pleistocene. However, a lack of open-source workflows for analysis of hominin sediment DNA samples poses a challenge for data processing and reproducibility of findings across studies. Here we introduce a snakemake workflow, sedimix, for processing genomic sequences from archaeological sediment DNA samples to identify hominin sequences and generate relevant summary statistics to assess the reliability of the pipeline. By performing simulations and comparing our results to two published studies with human DNA from ∼25,000 years ago (including shotgun data from a sediment sample and capture data from touch DNA recovered from a deer tooth pendant) we demonstrate that sedimix yields accurate and reliable inferences. sedimix offers a reliable and adaptable framework to aid in the analysis of sediment DNA datasets and improve reproducibility across studies.

AVAILABILITY AND IMPLEMENTATION: sedimix is available as an open-source software with the associated code, example data, and user manual with installation instructions available at https://github.com/jierui-cell/sedimix.A permanent archived version of this release is available via Zenodo: https://doi.org/10.5281/zenodo.17244854.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:41512286 | DOI:10.1093/bioinformatics/btag004

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Robotic versus video-assisted thoracoscopic lobectomy/segmentectomy: multilevel analysis in Japan

Interdiscip Cardiovasc Thorac Surg. 2026 Jan 8:ivag005. doi: 10.1093/icvts/ivag005. Online ahead of print.

ABSTRACT

OBJECTIVES: Large-scale comparative data on the perioperative safety of robotic-assisted thoracoscopic surgery and video-assisted thoracoscopic surgery in Asia are limited. We compared the perioperative outcomes of these two approaches for lung cancer.

METHODS: This retrospective study used data from the Diagnostic Procedure Combination database in Japan. We included 47,541 patients who underwent lobectomy or segmentectomy for lung cancer from 2018 to 2021 and performed multivariable analyses.

RESULTS: Among 47,541 patients, 2,835 underwent robotic-assisted thoracoscopic surgery. Perioperative mortality did not differ significantly between groups (incidence rate ratio, 1.71; 95% confidence interval, [0.88-3.33]). Robotic-assisted surgery was associated with longer anaesthesia time and a higher incidence of mechanical ventilation postoperatively (incidence rate ratio, 1.96; 95% confidence interval, [1.36-2.81]), although the absolute difference was small (Marginal risk difference, +0.52 percentage points; 95% confidence interval, +0.14 to + 0.91). No significant differences were observed in other major complications, reoperation, or hospital stay.

CONCLUSIONS: In this large, real-world Japanese cohort including the early experience with robotic surgery, overall perioperative safety was comparable between robotic-assisted and video-assisted thoracoscopic surgery, although a statistically significant but small absolute increase in postoperative ventilation was observed with the robotic approach. This association remained robust across a series of sensitivity analyses. However, it is likely influenced by unmeasured confounding. Future prospective studies should investigate specific procedural factors, including anaesthetic management, and patient selection to optimize outcomes.

PMID:41512284 | DOI:10.1093/icvts/ivag005