Category: Nevin Manimala

Burns. 2025 Aug 5;51(8):107650. doi: 10.1016/j.burns.2025.107650. Online ahead of print.

ABSTRACT

BACKGROUND: Burn injuries significantly impact quality of life and physical functionality. Early, accurate evaluation of burn wounds is essential, yet assessing burns remains a challenge, especially for non-specialists. This pilot study examines the efficacy of an AI-powered diagnostic tool using multispectral imaging (MSI) to help medical teams determine whether conservative or surgical management is required for burn wounds.

METHODS: Thirty-one acute burn wounds in adult patients (within 7 days of injury) were assessed at a super-regional burn center. Clinical examinations were performed by an experienced burn doctor, with two adjunct devices used: the AI-driven MSI DeepView SnapShot Imaging (Version 1.0.1) and the Moor Laser Doppler Imaging (LDI) device, as per NICE recommendations. Wounds on the face, hands, feet, and genitals were excluded. Predictive outcomes from MSI and LDI were compared to final clinical management decisions.

RESULTS: MSI predicted clinical outcomes in 58 % of cases, while LDI achieved 90 % accuracy. Concordance between MSI and LDI was observed in 52 % of cases, with a statistically significant difference between their outcomes (McNemar’s test p = 0.012).

CONCLUSION: This study highlights the potential of AI in burn wound management. However, the binary classification of current AI models may not fully address the complexities of burn healing. The observed accuracy suggests limitations in AI’s ability to capture the multifactorial nature of burn wounds, indicating the need for further refinement and collaboration with clinical expertise.

PMID:40834474 | DOI:10.1016/j.burns.2025.107650

Burns. 2025 Jul 21;51(8):107626. doi: 10.1016/j.burns.2025.107626. Online ahead of print.

ABSTRACT

INTRODUCTION: Lower urinary tract symptoms (LUTS) are frequently observed following perineal burn injuries, but their long-term clinical implications and predictors of prognosis remain poorly understood. This study aimed to investigate the clinical characteristics of newly developed LUTS in patients with perineal burns and to identify factors associated with persistent symptoms.

METHODS: We retrospectively reviewed 172 patients who were admitted to a burn center with perineal burns and subsequently referred to the urology department for evaluation of new-onset LUTS between August 2010 and December 2023. LUTS were evaluated at the time of urologic referral using available clinical data. Patients were categorized into transient and persistent symptom groups based on whether pharmacologic treatment was required beyond 3 months. Multivariate logistic regression was used to identify independent predictors.

RESULTS: The most common LUTS were urinary frequency (44.2 %), nocturia (28.5 %), and incomplete bladder emptying (25.6 %). Storage symptoms were observed in 64.5 % of patients, while voiding symptoms were noted in 58.1 %. Most patients showed symptom resolution with short-term standard treatment. However, 30 % experienced persistent LUTS beyond 3 months, requiring continued pharmacologic therapy. Eleven patients (6.4 %) ultimately needed catheter-based management. Among burn-related factors, electrical burns were independently associated with persistent LUTS (OR 7.7, 95 % CI 2.3-26.0, p = 0.001), whereas other variables were not statistically significant.

CONCLUSION: LUTS following perineal burns generally resolve with short-term treatment, but a substantial proportion of patients experience persistent symptoms requiring long-term care. Early identification and management are particularly important in patients with electrical burns.

PMID:40834473 | DOI:10.1016/j.burns.2025.107626

Geriatr Nurs. 2025 Aug 19;66(Pt A):103581. doi: 10.1016/j.gerinurse.2025.103581. Online ahead of print.

ABSTRACT

Fatigue is one of the most common and distressing symptoms in patients with chronic obstructive pulmonary disease (COPD). This study applied MICT, EFT and their combination (MICT and EFT) to COPD patients with fatigue through factorial design analysis method, aiming to explore non-drug management strategies that are more conducive to relieving fatigue in COPD patients. This study had a total of 112 participants. Patients were randomly divided into Control group, MICT group, EFT group and Combination group (MICT-plus-EFT group) by random number table method. The intervention duration was 8 weeks. The results showed that there were statistically significant differences in fatigue scores, anxiety and depression scores, sleep quality scores, and 6MWT scores among the four groups at T₁, T₂, and T₃(P<0.05). The results of factorial analysis showed that there was no significant interaction between MICT and EFT on fatigue score, HADS score, PSQI score and 6WMT.The overall effect of the combined intervention was better than that of the single intervention, but the effect of the combined intervention may simply be the superposition of the effects of the two measures.

PMID:40834442 | DOI:10.1016/j.gerinurse.2025.103581

Geriatr Nurs. 2025 Aug 19;66(Pt A):103556. doi: 10.1016/j.gerinurse.2025.103556. Online ahead of print.

ABSTRACT

OBJECTIVE: Evidence-based development and empirical application of a discharge preparation service program for cataract day surgery patients.

METHODS: Evidence-based construction of a discharge preparation service programme for cataract day surgery patients. Using the convenience sampling method, 84 patients undergoing cataract day surgery in July-August 2024 were divided into a control group and an intervention group; Comparing the level of readiness for hospital discharge, quality of discharge teaching, caregiver preparedness, patients’ ability to self-care, complication rate and unplanned readmission rate 1 month post-discharge between the two groups.

RESULTS: The intervention group scored higher than the control group in terms of readiness for hospital discharge, quality of discharge teaching, caregiver readiness, and patient self-care ability (P < 0.05), but the differences in post-discharge complications and unplanned readmissions were not statistically significant.

CONCLUSION: Evidence-based construction of a discharge preparation service programme for cataract day surgery patients has good practical value.

PMID:40834438 | DOI:10.1016/j.gerinurse.2025.103556

Epilepsia Open. 2025 Aug 20. doi: 10.1002/epi4.70119. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to predict the side of epilepsy as well as the pre- and postoperative verbal and nonverbal memory performance in a cohort of left and right temporal lobe epilepsy (TLE) patients based on hippocampal activations during three different memory fMRI tasks (verbal, nonverbal and combined verbal and nonverbal) using support vector machines (SVM).

METHODS: Thirty-five patients with unilateral TLE (20 left) were investigated before mesial temporal resection using a verbal, a nonverbal, and a face-name (combined verbal and nonverbal) memory fMRI paradigm. SVM was used to test whether voxel-by-voxel activation patterns within the bilateral hippocampus during each of the three paradigms can be used to classify TLE patients according to their side of epilepsy, preoperative and postoperative verbal and nonverbal memory outcome.

RESULTS: Classification accuracy regarding the side of epilepsy was best for the face-name paradigm closely followed by the verbal paradigm. Classification accuracy of the preoperative verbal memory performance was formally statistically significant for all three paradigms, but specificities were low. Regarding the preoperative nonverbal memory performance, activations during the nonverbal and the verbal paradigm provided high prediction accuracies. The results regarding the postoperative memory outcome revealed that activations during the verbal paradigm can be used to predict postoperative verbal memory outcome, whereas activations during the nonverbal paradigm can be used for the prediction of the nonverbal memory outcome. Preoperative activations during the face-name paradigm were able to predict both the verbal and the nonverbal postoperative memory outcome.

SIGNIFICANCE: It is possible to classify TLE patients according to their side of epilepsy as well as their postoperative memory performance using SVM based on hippocampal activations during task-based memory fMRI. The highest classification accuracies were obtained for the face-name paradigm, suggesting this combined verbal and nonverbal paradigm to be most suitable to address these clinical questions. However, further validation in a larger cohort would be necessary.

PLAIN LANGUAGE SUMMARY: This study aims to investigate whether it is possible to predict the side of epilepsy as well as the preoperative and postoperative verbal and nonverbal memory performance in left and right temporal lobe epilepsy patients using support vector machines (a machine learning technique) based on hippocampal activations during three different memory fMRI tasks. Results showed that classification of patients according to their side of epilepsy and their postoperative memory performance is possible, with the highest classification accuracies being obtained using a face-name association task.

PMID:40834432 | DOI:10.1002/epi4.70119

JMIR Public Health Surveill. 2025 Aug 20;11:e76465. doi: 10.2196/76465.

ABSTRACT

BACKGROUND: Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations have diverse cultural, immigration, and sociodemographic characteristics. Aggregated data could mask substantial differences in substance use between cultural subgroups in this population. Yet, studies examining substance use among the AANHPI population are limited.

OBJECTIVE: This study aimed to describe cigarette, cannabis, and alcohol use among AANHPI adults by cultural subgroup and sex.

METHODS: We analyzed data from 3411 AANHPI respondents of a multilingual national survey “COMPASS” during December 2021-May 2022. Primary outcomes were self-report current (every day or some days) use of cigarettes, cannabis, and alcohol. Cultural subgroups included Asian Indian, Ethnic Chinese, Filipino, Japanese, Korean, Native Hawaiian and Pacific Islander, Vietnamese, other cultural groups, and multicultural groups. Other covariates include sex, other sociodemographics, experiences of discrimination (Everyday Discrimination Scale), and mental health (Patient Health Questionnaire 4). Multivariable logistic regressions were used to examine correlates of each substance use among AANHPI adults.

RESULTS: The prevalence of current cigarette, cannabis, and alcohol use was 4.2% (142/3359), 5.5% (184/3235) and 37.6% (1265/3361), respectively. Cigarette use ranged from 1.0% (1/100) in Asian Indian females to 14.8% (10/71) in multicultural males. Cannabis use ranged from 1.9% among Asian Indian (1/53) and Vietnamese males (4/211) to 15.7% (11/70) in multicultural females. Alcohol use varied from 6.6% (4/61) in Native Hawaiian and Pacific Islander females to 56.3% (40/71) among multicultural males. Male participants with elevated depression and anxiety symptoms were more likely to report using all 3 substances than males with minimal symptoms. However, depression and anxiety symptoms were only associated with cannabis and alcohol use among female participants. US-born female participants were more likely to report using all 3 substances compared to foreign-born females, while being US-born was only associated with higher odds of alcohol use among males. Perceived discriminatory experience was associated with higher odds of smoking in both sexes and alcohol drinking in males.

CONCLUSIONS: Cigarette smoking, cannabis, and alcohol use varied widely across AANHPI cultural groups, between and within each sex. These findings underscore the necessity to disaggregate data for substance use behaviors to guide health policy and intervention programs for AANHPI adults.

PMID:40834431 | DOI:10.2196/76465

JMIR Biomed Eng. 2025 Aug 20;10:e70938. doi: 10.2196/70938.

ABSTRACT

BACKGROUND: Accurately assessing pain severity is essential for effective pain treatment and desirable patient outcomes. In clinical settings, pain intensity assessment relies on self-reporting methods, which are subjective to individuals and impractical for noncommunicative or critically ill patients. Previous studies have attempted to measure pain objectively using physiological responses to an external pain stimulus, assuming that the participant is free of internal body pain. However, this approach does not reflect the situation in a clinical setting, where a patient subjected to an external pain stimulus may already be experiencing internal body pain.

OBJECTIVE: This study investigates the hypothesis that an individual’s physiological response to external pain varies in the presence of preexisting pain.

METHODS: We recruited 39 healthy participants aged 22-37 years, including 23 female and 16 male participants. Physiological signals, electrodermal activity, and electromyography were recorded while participants were subject to a combination of preexisting heat pain and cold pain stimuli. Feature engineering methods were applied to extract time-series features, and statistical analysis using ANOVA was conducted to assess significance.

RESULTS: We found that the preexisting pain influences the body’s physiological responses to an external pain stimulus. Several features-particularly those related to temporal statistics, successive differences, and distributions-showed statistically significant variation across varying preexisting pain conditions, with P values <.05 depending on the feature and stimulus.

CONCLUSIONS: Our findings suggest that preexisting pain alters the body’s physiological response to new pain stimuli, highlighting the importance of considering pain history in objective pain assessment models.

PMID:40834427 | DOI:10.2196/70938

JMIR Public Health Surveill. 2025 Aug 20;11:e71494. doi: 10.2196/71494.

ABSTRACT

BACKGROUND: Pre-exposure prophylaxis (PrEP) programs have been implemented in multiple countries. Evidence from clinical trials and cohort studies has proven the safety and effectiveness of PrEP. However, minimizing drug-related adverse effects and cost should be primarily considered in PrEP. Most trials used tenofovir combined with emtricitabine as the intervention; yet, the use of tenofovir disoproxil fumarate (TDF) (ie, Tenofovir) alone has not been thoroughly evaluated. Furthermore, the medication regimen in most trials was used every day, with a few studies proposing an optimal medication regimen for PrEP.

OBJECTIVE: This study was designed to systematically evaluate the preventive efficacy and safety profile of TDF-based PrEP in the Chinese population. We also aimed to explore medication compliance, changes in sexual behavior, and hazard factors of HIV infection.

METHODS: We conducted a pragmatic randomized controlled trial (RCT) to evaluate the effectiveness and safety of TDF for HIV PrEP. Participants were randomly assigned (1:1:1) to a time-driven group (TDF 300 mg administered orally once daily), an event-driven group (TDF 300 mg administered orally 24 to 48 h before sexual activity and 2 hours after sexual activity, not exceeding 300 mg within 24 h), or an untreated control group. The primary outcomes were the effectiveness and safety of TDF during periods of PrEP use. Secondary outcomes focused on the effectiveness of TDF among participants with good compliance during PrEP use. Tertiary outcomes included the risk factors of HIV infection and behavioral changes from PrEP initiation to the last visit. For ethical reasons, all participants received condoms and health education. This study was registered with the Chinese Clinical Trial Registry (ChiCTR-TRC-13003849).

RESULTS: A total of 1914 participants underwent randomization. During the follow-up of 3513.5 person-years from June 2013 to May 2016, HIV seroconversion was observed in 30 persons (2.02 per 100 person-years) in the time-driven group (time-driven vs control group: hazard ratio [HR] 0.93, 95% CI 058-1.51; P=.78), 35 (1.73 per 100 person-years) in the event-driven group (event-driven group vs control group: HR 0.83, 95% CI 0.52-1.31; P=.42), and 37 (2.06 per 100 person-years) in the control group. Post hoc analysis showed that participants with good medication compliance reduced their HIV infection risk by 53% (P=.01) and event-driven medication with good compliance reduced the risk by 62% (P=.009). We recorded no severe adverse events during the trial. For tertiary outcomes, low medication compliance, sexual role, no condom use, and more number of sexual partners remained significantly associated with HIV risk.

CONCLUSIONS: The TDF-based PrEP is ineffective without good adherence. However, when medication compliance is achieved, event-driven dosing is recommended as an optimal PrEP regimen.

PMID:40834420 | DOI:10.2196/71494

JMIR Infodemiology. 2025 Aug 20;5:e67825. doi: 10.2196/67825.

ABSTRACT

BACKGROUND: Antimicrobial resistance (AMR) is a major global health issue heavily influenced by human behavior. Effective communication and awareness-raising are crucial in curbing AMR, with social network sites (SNSs) significantly shaping health behaviors. Despite their potential, current analyses of AMR on SNSs have focused mainly on top-down communication initiatives.

OBJECTIVE: This study aims to examine AMR on Instagram (Meta Platforms), identifying key actors, content themes, and the nature of the communication to understand how AMR is portrayed and perceived.

METHODS: Based on the sender-message-channel-receiver model, this study used content analysis to review publicly accessible posts on Instagram. The data refer to 24 months, focusing on the hashtag “#antibioticresistance.” After cleaning the data, 610 posts (10% of the total 6105) were analyzed.

RESULTS: Content creators were predominantly information drivers or professionals in science and health. Posts frequently featured text-dominated visuals or images of bacteria and laboratory tests. However, the AMR posts were found to be siloed, with limited engagement beyond specific interest groups. The study highlighted the neutrality and accuracy of the content but noted the challenge of reaching a broader audience.

CONCLUSIONS: While Instagram serves as a platform for accurate and informative AMR communication, the post of it remains confined to niche groups, limiting its broader impact. To enhance engagement, AMR discussions should be integrated into more general interest content, use visually compelling formats, and encourage institutional participation and interactive user engagement.

PMID:40834419 | DOI:10.2196/67825

J Proteome Res. 2025 Aug 20. doi: 10.1021/acs.jproteome.5c00075. Online ahead of print.

ABSTRACT

Hypertensive nephropathy (HN) complicates hypertension with subtle early symptoms, hindering diagnosis. To address this, an integrated urinary metabolomics and peptidomics analysis was conducted comparing HN patients to hypertensive (HTN) controls, aiming to identify molecular signatures indicative of disease progression and clarify the pathophysiological mechanisms driving HN development. Urine samples were analyzed from both discovery (51 HTN vs 51 HN patients, including 27 early stage and 24 advanced-stage) and validation (21 HTN vs 21 HN) cohorts. Multivariate statistical analysis identified 40 differential metabolites across various stages: hypertension, early stage HN, and advanced-stage HN. These metabolites were associated with metabolic pathways including amino acid, carbohydrate, short-chain fatty acid, and nucleotide metabolism, such as cysteine and methionine, tyrosine, and nicotinate metabolism. Moreover, 10 differential urinary peptides were linked to coagulation regulation, immune processes, and plasminogen activation. Combining 43 clinical-correlated molecules, a high-performance diagnostic model was developed, demonstrating remarkable discrimination: AUCs of 0.973 (HTN vs early-HN), 0.998 (HTN vs advanced-HN), and 0.941 (early vs advanced-HN) in the discovery cohort, which were maintained at 0.847-0.970 in validation. Advanced-HN detection achieved exceptional accuracy (90.5%), specificity (95.2%), precision (94.7%), and an F1-score of 0.900. These urinary biomarkers aid HN diagnosis and advance mechanistic understanding.

PMID:40834388 | DOI:10.1021/acs.jproteome.5c00075