Category: Nevin Manimala

Scand J Occup Ther. 2025 Aug 29;32(1):2555182. doi: 10.1080/11038128.2025.2555182. Epub 2025 Sep 2.

ABSTRACT

BACKGROUND: Assessment of work ability is complex yet crucial in occupational health and vocational rehabilitation. Evaluating psychometric properties is essential to ensure the accuracy of assessment tools in this field.

AIM: The aim of this study was to investigate the psychometric properties of the Finnish version of the Assessment of Work Performance (AWP-FI) with a focus on construct validity.

MATERIAL AND METHODS: The AWP assesses a client’s observable working skills during work performance in three domains: motor skills, process skills, and communication and interaction skills. Ninety-four AWP-FI assessments were performed by 17 occupational therapists in Finland. A Rasch analysis was conducted to evaluate the psychometric properties.

RESULTS: The AWP-FI presented an overall fit to the Rasch model with acceptable item-fit statistics and items performing stably between gender, work tasks, and observation types. A suboptimal targeting was evident and issues concerning local dependency among items and indications of multidimensionality were indicated.

CONCLUSION: This study provides an initial validation of the AWP-FI, demonstrating generally acceptable psychometric properties, suggesting that the AWP-FI is valid and reliable for assessing work performance. Further testing is recommended to address the identified issues with local dependence and suboptimal targeting.

PMID:40891248 | DOI:10.1080/11038128.2025.2555182

Glob Health Action. 2025 Dec;18(1):2547495. doi: 10.1080/16549716.2025.2547495. Epub 2025 Sep 2.

ABSTRACT

Over the coming decades Africa is projected to undergo a significant demographic shift towards an older population. Healthcare provision for older adults is made more complex by age-related multimorbidity and frailty, which contribute to older adults more frequently requiring intensive, hospital-based treatment than those in younger age groups. We investigate age and sex-stratified, diagnosis-specific hospital referral patterns in Harare, Zimbabwe to understand referral practices for older adults. This retrospective analysis of attendance records from primary health clinics (n = 8) over six years (2016 to 2021) investigated associations between age, sex and diagnosis and recommended hospital referral. Analysis compared the percentage referred between those aged ≥65 years and those younger than 65 years. The records contained 195,999 attendances. Median attendee age was 9 years (IQR 1.75-32); 52.5% were female; 5.4% were aged ≥65 years. Overall, 14.9% attendances resulted in hospital referral. The highest referral percentage by diagnosis was for trauma (47.8% referred overall, 40.5% of those aged ≥65 years referred). The overall percentage referred in those aged ≥65 years (18.5%) was the same as those aged 35-44 years (18.0%); this pattern was observed across diverse diagnoses including acute respiratory infections, hypertension and musculo-skeletal pain. Despite age-associated morbidity and theoretically free public healthcare to those aged ≥65 years in Zimbabwe, older adults are no more likely to be referred than young adults to higher level care, across multiple disease classes, including infective, musculoskeletal and cardiovascular diseases. This may reflect a healthcare system not yet orientated towards an ageing population’s needs.

PMID:40891239 | DOI:10.1080/16549716.2025.2547495

Nord J Psychiatry. 2025 Sep 2:1-8. doi: 10.1080/08039488.2025.2553573. Online ahead of print.

ABSTRACT

INTRODUCTION: The hepatic cytochrome P450 system includes the polymorphic CYP2D6 gene. CYP2D6 ultra rapid metabolizers (UMs) were 10-fold more common in suicide victims than in the general population in a previous study. The aim of this study was to investigate if the occurrence of the CYP2D6 UM genotype differs between subjects with and without previous suicide attempt in patients treated for depression in secondary psychiatric care.

MATERIAL AND METHODS: The study “Genes, Depression and Suicidality” (GEN-DS) included 407 subjects treated for depression in secondary psychiatric care between 2012 and 2021. Subjects were genotyped for CYP2D6, interviewed according to a semi-structured protocol and diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders 4th ed (DSM-IV-TR).

RESULTS: Of the 407 subjects, 128 subjects (31.4%) had a history of one or more suicide attempt. Two (1.6%) in the suicide attempt group were categorized as UMs, as compared to 9 (3.2%) in the non-suicide attempt group. There was no statistical significance between the groups (p = 0.27, Fisher’s exact test). Bipolar disorder, personality disorders, substance use disorders and lifetime presence of psychotic symptoms were more common in suicide attempters.

CONCLUSION: Based on our results, CYP2D6 UMs are not over-represented among suicide attempters in depressed patients treated in secondary psychiatric care. Analysis of CYP2D6 genotype can be useful for optimizing pharmacological treatment in depression but genotyping does not seem relevant for the clinical assessment of suicidality in difficult-to-treat depression.

PMID:40891234 | DOI:10.1080/08039488.2025.2553573

Phys Chem Chem Phys. 2025 Sep 2. doi: 10.1039/d5cp01448d. Online ahead of print.

ABSTRACT

The development and testing of methods in computational chemistry for the prediction of physicochemical properties is by now a mature form of scientific research, with a number of different methods ranging from molecular mechanics simulations, over quantum calculations, to empirical and machine learning models. Blind prediction challenges for these properties are regularly organized to allow researchers from academia and industry to test their methods in a fair and unbiased manner. At the same time, research data management (RDM) is still not utilized as extensively as it could be in the development and application of such models, especially in academia. In particular, the FAIR standards (Findable, Accessible, Interoperable, Reusable) can serve as guidelines for good RDM, but many models, the data used to train them, and the data they generate fall short of one, or multiple, of these standards. The goal of the first euroSAMPL pK_a blind prediction challenge was to promote and help develop good RDM standards for computational chemistry. To achieve this, the challenge was designed to rank not just the predictive performance of the models but also evaluate the adherence to the FAIR principles by cross-evaluation of the participants themselves. We here present the analysis of the blind prediction quality by their statistical metrics as well as of the cross-evaluation by a newly defined “FAIRscore”. The results suggest that multiple methods can predict the pK_a to within chemical accuracy, but also that “consensus” predictions constructed from multiple, independent methods may outperform each individual prediction. Furthermore, the state of research data management in the field of computational chemistry is discussed, and suggestions for future improvements developed.

PMID:40891233 | DOI:10.1039/d5cp01448d

Ethn Health. 2025 Sep 2:1-19. doi: 10.1080/13557858.2025.2550679. Online ahead of print.

ABSTRACT

OBJECTIVES: The Hispanic Health Paradox suggests that Hispanics and their culture may possess certain protective factors that mitigate the negative impact of lower socioeconomic status on health. Much of the existing literature has focused on the United States. Such paradoxical advantage on diabetes was explored among Hispanics in Canada.

DESIGN: Secondary data from four cycles of the Canadian Community Health Survey from 2015 to 2018 were examined. Multivariate logistic regression analyses were conducted with the following samples: Hispanics (1,799), Non-Hispanic White (168,225), and other racialized groups (33,730). The statistical and practical significance or strength and precision of the predictor-outcome relationships were estimated with odds ratios (OR) and their 95% confidence intervals (CIs) that were derived from regression statistics.

RESULTS: Despite overall lower socioeconomic status, Hispanics were about 79% less likely than Non-Hispanic Whites to have diabetes. Hispanic ethnicity significantly interacted with age, sex, income, and immigration status in predicting diabetes risk. Hispanic ethnicity was most protective for middle-aged adults (OR = 0.72) but not seniors. Hispanic males experienced greater protection (OR = 0.77) than females (OR = 0.90). Low-income Hispanics showed the strongest protective effects (ORs = 0.62-0.85). Recent immigrants to Canada (<10 years) exhibited moderate protection (ORs = 0.90-0.93), though unexpectedly, Canadian-born Hispanics had the lowest risk (OR = 0.59).

CONCLUSIONS: These findings highlight the nuanced and paradoxical protective effects of Hispanic ethnicity on diabetes risk.

PMID:40891229 | DOI:10.1080/13557858.2025.2550679

Scand J Urol. 2025 Sep 2;60:158-163. doi: 10.2340/sju.v60.44585.

ABSTRACT

OBJECTIVE: To evaluate oncological and functional outcomes after salvage robotic-assisted laparoscopic radical prostatectomy (sRALP).

MATERIAL AND METHODS: We included 60 patients, consecutively treated with sRALP for radiorecurrent prostate cancer (PCa) at Oslo University Hospital (OUS). Data were collected from our PCa registry and electronic patient journal (EPJ). PSA persistence was defined as PSA ≥ 0.1 ng/mL 6 weeks postoperatively, and these patients were not included in the survival analysis. Logistic regression was used to find -variables associated with PSA persistence. Biochemical recurrence (BCR) was defined as PSA ≥ 0.2 ng/mL. Cox regression was used to analyse BCR-free survival. Urinary leakage was graded as minor, moderate or severe. Complications were classified according to the Clavien-Dindo classification.

RESULTS: Twenty-three patients (38%) had persistent PSA. With a median follow-up of 82 months (interquartile range [IQR] 48-101 months), 16 patients (28%) had no BCR or start of androgen deprivation therapy (ADT). Twelve patients (20%) were deceased, 10 (17%) from PCa. Preoperative PSA was statistically significantly associated with persistent PSA (p = 0.01). International Society of Urological Pathology (ISUP) Grade Group 5 showed a statistically significant association with BCR (p = 0.01). Anastomosis leakage and strictures occurred in 27 (45%) and 15 patients (33%), respectively. Twenty-nine patients (48%) suffered severe urinary leakage, whilst 11 patients (24%) had moderate urinary leakage. Eleven patients (18%) received artificial urinary sphincters, and 10 patients (17%) underwent urinary diversion. Two patients suffered a grade 4 complication (sepsis), whilst 25 patients (41%) had grade 3 complications, most of which were related to intervention in the urinary system. Conclusion: Salvage RALP for radiorecurrent PCa has limited effect on oncological outcomes. Patients should be thoroughly informed about the high risk of urinary leakage and severe surgical complications.

PMID:40891205 | DOI:10.2340/sju.v60.44585

Clin Endocrinol (Oxf). 2025 Sep 2. doi: 10.1111/cen.70024. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the diagnostic performance of biochemical markers in normocalcemic primary hyperparathyroidism (nPHPT), analyse their temporal variations, and assess their correlation with adenoma localisation and size.

METHODS: In this multicenter retrospective study-the largest patient cohort reported in the literature to date (n = 474) we comprehensively profiled normocalcemic patients diagnosed with primary hyperparathyroidism nPHPT was diagnosed based on persistently elevated PTH levels with normal serum calcium after excluding secondary causes such as vitamin D deficiency, renal impairment, and other conditions. This retrospective multicenter study included a large cohort of patients whose biochemical markers-including serum calcium, phosphorus, magnesium, vitamin D, parathyroid hormone (PTH), and glomerular filtration rate (GFR)-were measured at three time points, using standardised laboratory protocols. Although in routine clinical practice these measurements are typically performed at regular intervals of 3-6 months, resulting in approximately three assessments during an 18-month follow-up period. Urinary calcium and creatinine levels were also determined, and imaging modalities (ultrasonography, sestamibi scintigraphy, and computed tomography) were employed for adenoma detection. Statistical analyses comprised repeated measures ANOVA, logistic regression, correlation analysis, and ROC analysis, performed using Jamovi software.

RESULTS: Serial evaluations revealed significant temporal changes in key biochemical parameters, including a significant decline in serum calcium and PTH levels alongside a significant increase in urinary calcium excretion. Logistic regression analysis identified higher PTH levels, higher corrected calcium, and larger adenoma size as independent predictors of adenoma localisation, while ROC analysis confirmed that PTH exhibited the highest diagnostic accuracy (AUC = 0.91, 95% CI: 0.84-0.95, p < 0.001).

CONCLUSION: The large scale of our patient cohort reinforces the robustness of our statistical analyses and provides comprehensive insight into the dynamic nature of nPHPT. Our findings demonstrate that, even in normocalcemic patients, higher PTH levels and relatively higher calcium levels within the normal range are important indicators of parathyroid adenoma. Integrating serial biochemical measurements with targeted imaging can facilitate earlier diagnosis, potentially preventing future complications and informing more tailored management strategies.

PMID:40891177 | DOI:10.1111/cen.70024

J Korean Med Sci. 2025 Sep 1;40(34):e254. doi: 10.3346/jkms.2025.40.e254.

ABSTRACT

BACKGROUND: Very low birth weight infants (VLBWIs) are vulnerable to growth restrictions and neurodevelopmental impairments. Congenital anomalies further complicate these risks; however, their long-term effects remain unclear. This study examined the impact of congenital anomalies on the growth and neurodevelopment of VLBWIs.

METHODS: This prospective cohort study analyzed data from the Korean Neonatal Network (2013-2017). A total of 172 VLBWIs with congenital anomalies were matched by gestational age to 516 without anomalies at 18-24 months corrected age, and 136 were matched to 408 at 3 years of age. Growth was assessed using WHO standards, and neurodevelopment was evaluated using the Bayley Scales of Infant Development (II/III) and Korean Developmental Screening Test. Logistic regression analyses were used to identify factors associated with adverse outcomes, with statistical significance set at P < 0.05.

RESULTS: VLBWIs with congenital anomalies had significantly lower weight, height, and head circumference z-scores at both time points. Growth restriction persisted, and neurodevelopmental delays, particularly in motor function, were more prevalent. Infants with multiple congenital anomalies had the highest risk of severe growth restriction and developmental impairment.

CONCLUSION: Congenital anomalies pose significant challenges to the growth and neurodevelopment of VLBWIs. Early and individualized interventions, structured neurodevelopmental follow-up, and multidisciplinary care are essential for improving long-term outcomes.

PMID:40891162 | DOI:10.3346/jkms.2025.40.e254

Eur J Med Res. 2025 Sep 2;30(1):834. doi: 10.1186/s40001-025-03007-2.

ABSTRACT

BACKGROUND: The rising incidence of cancer has highlighted the need for effective treatment strategies, particularly for bone tumors like distal femoral tumors. These tumors are among the most prevalent types of bone malignancies, often necessitating extensive surgical intervention to achieve optimal outcomes. Limb-salvage surgery, which involves resecting the tumor and reconstructing the limb with prosthetic devices, has become the standard approach for managing both malignant and aggressive benign tumors of the distal femur. This technique has largely replaced amputation, allowing patients to retain limb function and improve their quality of life. Despite advancements in surgical methods and prosthetic designs, complications such as aseptic loosening, periprosthetic fractures, and infections remain common, frequently requiring revision surgeries. The choice between cemented and uncemented prostheses in these revision procedures is crucial, as it significantly impacts patient outcomes and long-term functional recovery. This study aims to compare clinical outcomes between cemented and uncemented prostheses in distal femoral tumor revision surgeries, addressing existing gaps in the literature and providing guidance for clinical decision-making.

METHODS: This retrospective study analyzed data from 46 patients who underwent revision surgery for distal femoral tumor prostheses at Shanghai Sixth People’s Hospital from 2019 to 2024. Patients were divided into two groups: 22 in the cemented prosthesis group (control) and 24 in the uncemented prosthesis group (experimental). Inclusion criteria required patients to be aged 20-50 years, with confirmed epiphyseal closure and clinical diagnosis of aseptic loosening after distal femoral tumor prosthesis replacement. Patients with severe systemic conditions or infections were excluded to ensure a homogeneous study population. Key parameters evaluated included operation time, intraoperative blood loss, length of hospital stay, and postoperative drainage duration. Functional outcomes were assessed using the Musculoskeletal Tumor Society (MSTS) scoring system and the Karnofsky Performance Status (KPS) scale. Statistical analyses were performed using SPSS software, with significance set at a P value of ≤ 0.05, ensuring robust comparisons of clinical, radiological, and functional outcomes between the two prosthesis types.

RESULTS: The uncemented prosthesis group demonstrated superior clinical outcomes compared to the cemented group. Operation time was significantly shorter (124.75 ± 12.54 min vs. 162.67 ± 19.17 min, P < 0.001), and intraoperative blood loss was markedly lower (412.45 ± 32.12 mL vs. 647.56 ± 37.45 mL, P < 0.001). Postoperative recovery indicators also favored the uncemented group, with shorter hospital stays (16.64 ± 2.67 days vs. 19.78 ± 2.86 days, P = 0.004) and reduced drainage duration (9.85 ± 3.52 days vs. 13.47 ± 3.17 days, P = 0.007). Functional outcomes, measured by MSTS scores, were significantly higher in the uncemented group (70.24 ± 7.35 vs. 56.70 ± 4.98, P < 0.001), and KPS scores showed similar trends (78.32 ± 3.87 vs. 62.45 ± 4.12, P < 0.001).

CONCLUSION: In conclusion, this study demonstrates that uncemented prostheses provide superior clinical outcomes in revision surgeries for distal femoral tumors compared to cemented prostheses. The significant advantages include shorter operation times, reduced intraoperative blood loss, faster recovery, and improved functional outcomes, as indicated by higher MSTS and KPS scores. The biological fixation mechanism of uncemented prostheses promotes osseointegration, enhancing long-term stability and minimizing complications, such as aseptic loosening and infections. Although oncological outcomes, including disease-free survival and overall survival, were comparable between both groups, uncemented prostheses were particularly beneficial for younger patients with adequate bone stock. Despite limitations such as a small sample size and insufficient long-term follow-up, these findings offer valuable insights into the clinical application of uncemented prostheses and underscore the importance of personalized treatment strategies tailored to individual patient needs. Future research should involve larger, multicenter studies to validate these results and further explore the mechanisms behind the observed differences in outcomes.

PMID:40890832 | DOI:10.1186/s40001-025-03007-2

Eur J Med Res. 2025 Sep 2;30(1):832. doi: 10.1186/s40001-025-03112-2.

ABSTRACT

PURPOSE: Aseptic loosening remains a leading cause of revision in medial unicompartmental knee arthroplasty (UKA). This imaging study aimed to identify recurrent patterns of coronal alignment deviation in patients undergoing revision to total knee arthroplasty (TKA) to explore whether subtle malalignment may contribute to biomechanical failure.

METHODS: Imaging of patients who underwent revision surgery of a medial UKA to TKA for aseptic loosening of the tibial or femoral component was retrieved. Lower limb axes were evaluated using anteroposterior plain radiographs of the leg using the software MediCAD Knie 2D (mediCAD Hectec GmbH, Altdorf, Germany). The radiographic axes of revised patients were compared with established reference values, as defined by the MediCAD Knie 2D software and published literature, to identify common alignment patterns potentially associated with aseptic loosening.

RESULTS: Data from 62 patients were analysed. Before the revision surgery, the joint line convergence angle (JLCA, P = 0.002) and the anatomical-mechanical angle (AMA, P < 0.0001) were statistically significantly greater than the corresponding reference values. In contrast, the mechanical lateral distal femoral angle (mLDFA, P < 0.0001), the mechanical and anatomical medial proximal tibial angle (mMPTA and aMPTA, P < 0.0001), and the mechanical and anatomical lateral distal tibial angle (mLDTA and aLDTA, P < 0.0001) were significantly lower than reference. No statistically significant difference was found in the mechanical lateral proximal femoral angle (mLPFA, P = 0.9) or in the mechanical axis deviation (MAD, P = 0.5) when compared to normative data.

CONCLUSION: Our cohort of patients revised from medial UKA to TKA for aseptic loosening frequently exhibited consistent deviations in lower limb alignment, particularly increased AMA and JLCA, and reduced mLDFA, mMPTA, and mLDTA. These subtle but recurrent patterns may alter load distribution across the medial compartment, contributing to implant micromotion and loosening. A detailed preoperative axis assessment may help identify patients at a higher biomechanical risk.

PMID:40890827 | DOI:10.1186/s40001-025-03112-2