Category: Nevin Manimala

Indian J Psychol Med. 2025 Aug 15:02537176251359425. doi: 10.1177/02537176251359425. Online ahead of print.

ABSTRACT

BACKGROUND: Alcohol Dependence Syndrome (ADS) is a prevalent condition marked by difficulty controlling alcohol use, with significant global health impacts. Despite the effectiveness of anti-craving medications like Naltrexone, Acamprosate, Baclofen, Ondansetron, and Topiramate, these medications remain underutilized by healthcare providers. This study aims to assess the relationship between craving and relapse rates among individuals prescribed anti-craving medications and to explore the correlation between medication dosage and craving severity.

METHODS: This was a prospective observational cohort study in which individuals prescribed anti-craving medications were monitored over three months. The study utilized the Penn Alcohol Craving Scale (PACS) to measure craving intensity and the Medication Adherence Rating Scale (MARS) to assess medication adherence. Alcohol use patterns were categorized into relapse, lapse, abstinence, and active use based on predefined operational definitions.

RESULTS: Participants were between 30 and 50 years old and predominantly male. Severe dependence was observed in the majority of cases, and baclofen was prescribed to most participants. Pearson’s correlation between Severity of Alcohol Dependence Questionnaire (SADQ-C) and PACS scores was r = 0.304 (p = .017), and MARS scores significantly predicted PACS scores (R = 0.757, R ² = 0.573, p < .001). Most participants were in the action phase, with a significant proportion maintaining abstinence. However, relapse rates increased as the study progressed. Overall, adherence to anti-craving medications reduced cravings and facilitated abstinence.

CONCLUSIONS: The research noted a significant reduction in craving in individuals receiving anti-craving medications. Nevertheless, no statistically significant correlation was identified between the dosage of Baclofen and PACS scores.

PMID:40832651 | PMC:PMC12357832 | DOI:10.1177/02537176251359425

BMJ Public Health. 2025 Aug 17;3(2):e002176. doi: 10.1136/bmjph-2024-002176. eCollection 2025.

ABSTRACT

BACKGROUND: The first 1000 days of life are a crucial foundational period during which many different factors can impact development. It is unknown to what extent different factors cluster and how this affects later-life outcomes.

METHODS: In this population-based cohort study, we used registry data of all children born in the Netherlands in 2006. We used latent class analysis to investigate clustering of circumstances in the first 1000 days of life, including socioeconomic indicators (household income, parental education), prenatal and perinatal biomedical factors (maternal age, late-start antenatal care, preterm birth/born small for gestational age/poor start in life), and adverse childhood experiences in the first 1000 days (parental death, separation, mental health problems and detention) and associated clusters with school performance (ie, highest secondary school level advice at age 12).

RESULTS: In the study population of 181 575 children, we identified five clusters. We labelled cluster 1 (39%) and cluster 2 (27%) as ‘resource-richest’, clusters 3 (15%) and 4 (15%) as ‘intermediate’, and cluster 5 (5%) as ‘resource-poorest’, with the latter having the highest probabilities of low socioeconomic resources, adverse prenatal and perinatal biomedical factors and adverse childhood experiences in the first 1000 days. Compared with those in the resource-richest cluster (cluster 2), children in the resource-poorest cluster (cluster 5) had poorer school performance (OR 0.13, 95% CI 0.11 to 0.14), also after adjustment for parental education and household income (OR 0.20, 95% CI 0.18 to 0.24).

CONCLUSIONS: Clustering of risk factors across different domains during the first 1000 days of life was associated with poorer school performance at age 12, suggesting that children growing up in resource-limited environments during this critical developmental window may face challenges in reaching their full developmental and educational potential. If we find similar associations with health-related outcomes, this would further underscore the importance of policies that strengthen resources across multiple domains early in life to support long-term human potential.

PMID:40832646 | PMC:PMC12359527 | DOI:10.1136/bmjph-2024-002176

BMJ Public Health. 2025 Aug 17;3(2):e001607. doi: 10.1136/bmjph-2024-001607. eCollection 2025.

ABSTRACT

BACKGROUND: Poor knowledge of sexual and reproductive health and rights (SRHR) among university students has been constantly reported in low-income and middle-income countries. This study aimed to assess University of Rwanda (UR) students’ knowledge on SRHR.

METHODS: This cross-sectional study involved an online survey of 441 students across UR. Data were collected using a validated 50-item SRHR knowledge questionnaire via Moodle. Data were cleaned and analysed using STATA. Descriptive and inferential statistics, such as a bivariate logistic regression model and multivariate logistic regression with backward elimination, were used for the final model. A P-value of 0.05 with 95% CI limits was considered. The association between explanatory variables and the outcome (SRHR knowledge) was evaluated. A mean cut-off was employed, categorising experiences into a binary outcome (poor and good SRHR knowledge scores). Stepwise backward elimination logistic regression analysis was conducted to identify predictors of good SRHR knowledge.

RESULTS: The majority of the participants (56%) had poor SRHR knowledge. In the bivariate analysis, statistically significant variables included prior exposure to the SRHR course by using YouTube (OR 2.36 (1.12 to 4.97) and radio (OR 3.08 (1.20 to 7.88)), prior learning SRHR courses online (OR 1.92 (1.10 to 3.38)) and participant age group 21-24 years (OR 0.50 (0.27 to 0.93). In the multivariate analysis, prior exposure to the SRHR course through YouTube (adjusted OR (aOR) 5.48 (1.29 to 23.22)) and SRHR prior exposure through radio (aOR 5.56 (1.37 to 23.04)) were associated with SRHR knowledge.

CONCLUSION AND RECOMMENDATIONS: UR students do not have sufficient knowledge of SRHR. Every UR student can benefit from SRHR training from reliable sources so that they can make effective choices regarding their reproductive health.

PMID:40832645 | PMC:PMC12359537 | DOI:10.1136/bmjph-2024-001607

J Orthop. 2025 Aug 9;69:305-310. doi: 10.1016/j.jor.2025.08.008. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: Deep vein thrombosis (DVT) is a prevalent complication of KA following knee arthroplasty (KA), leading to the development of post-thrombotic syndrome (PTS). PTS is associated with declining quality of life (QoL) and increased treatment costs. This study aims to investigate the correlation between fibrinogen to albumin ratio (FAR) and lower extremity DVT and evaluate the predictive value of FAR in diagnosing DVT post-KA.

METHODS: A total of 331 patients undergoing KA at the Department of Joint Surgery between August 2020 and August 2022 were included in this study. Among them,38 patients with DVT identified through post-operative routine color Doppler flow imaging (CDFI) comprised the study group, while 278 patients without DVT formed the control group. Pre-operative FAR ratios were analyzed to investigate the association between pre-operative FAR and lower extremity DVT following KA.

RESULTS: No significant differences were observed in the basic characteristics between the two groups. Additionally, there were no statistically significant differences in the laboratory values, including white blood cells, neutrophils, hemoglobin, fibrinogen, albumin, and platelets before and after surgery. However, the pre-operative FAR in patients with DVT was significantly higher than that in the control group (0.077 ± 0.007 vs. 0.067 ± 0.012, P < 0.001). ROC curve analysis of FAR for predicting lower extremity DVT revealed a cut-off value of 0.070 (AUC = 0.732, P < 0.001), with a sensitivity of 94.7 % and specificity of 51.1 %. Multivariate logistic regression analysis showed pre-operative FAR was the only independent predictor of DVT post-KA (OR = 1.12, 95 %CI: 1.06-1.17, P < 0.001).

CONCLUSIONS: Pre-operative FAR has a good predictive capability for lower extremity DVT post-KA.Its detection may be a simple and useful method for the prediction of DVT in patients undergoing KA.

PMID:40832625 | PMC:PMC12359187 | DOI:10.1016/j.jor.2025.08.008

J Orthop. 2025 Aug 5;69:278-282. doi: 10.1016/j.jor.2025.07.031. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: Array pin placement into the pelvis is a necessary step for robotic-assisted total hip arthroplasty (RATHA). Despite the increase in RATHA being performed, there is limited literature investigating safe zones and pin trajectory to avoid neurovascular injury.

METHODS: This study utilized lower extremity magnetic resonance images of nine patients. The trajectory of three array pins placed at caudal angles of 35, 45, and 55 were recreated, and each pin was divided into four equidistant zones. For each pin, the distance was determined from each zone to nearby neurovascular structures: lateral femoral cutaneous nerve (LFCN), internal iliac artery (IIA), superior gluteal artery (SGA), superior gluteal nerve (SGN).

RESULTS: Pin 3 placed at a caudal angle of 35° was the furthest distance away from the IIA compared to pins 1 and 2 (p = 0.005). Pin 1 placed at a caudal angle of 55° was the furthest distance away from the SGA (p = 0.009) and SGN (p = 0.012) and was associated with the most distal portion of the pin being in bone compared to other caudal angles (p = 0.002). There were no statistically significant differences in distances from pins to neurovascular structures based on gender.

CONCLUSION: Pin placement is a required step for RATHA, and the results of this study show that caudal angle trajectory is important for placement of specific array pins to ensure the distal aspect is in bone as well as far away from important neurovascular structures to avoid injury.

PMID:40832624 | PMC:PMC12359154 | DOI:10.1016/j.jor.2025.07.031

J Orthop. 2025 Aug 8;69:265-270. doi: 10.1016/j.jor.2025.08.006. eCollection 2025 Nov.

ABSTRACT

INTRODUCTION: In total knee arthroplasty (TKA), positioning implants closer to the patient’s constitutional alignment improves joint line obliquity (JLO), replicating normal biomechanics and gait patterns. As a result, the joint line convergence angle (JLCA) has gained recognition as a key parameter for assessing intra-articular deformity and lateral soft tissue laxity. This study aimed to evaluate JLCA changes following robotic-assisted TKA (RA-TKA) using two alignment strategies. We hypothesized that a patient-specific alignment (PSA) strategy would result in greater JLCA correction and improved outcomes.

METHODS: A retrospective review of 98 patients (100 knees) undergoing RA-TKA was performed. Group I (50 knees) underwent mechanical alignment (MA), while Group II (50 knees) underwent PSA. JLCA was measured preoperatively and postoperatively by two independent observers. Demographic and functional data, including KOOS JR scores were collected, and statistical analyses were performed using STATA v.18.5.

RESULTS: Both groups showed significant postoperative improvement in JLCA: from 2.34° to 0.35° in the MA group, and from 2.43° to 0.29° in the PSA group. However, the degree of JLCA correction did not differ significantly between groups (p = 0.285). KOOS JR scores improved similarly in both groups, with no significant differences at 1-year follow-up.

CONCLUSIONS: Robotic-assisted TKA significantly improved JLCA regardless of alignment strategy. Patient-specific and mechanical alignment approaches yielded comparable radiographic and functional outcomes.

LEVEL OF EVIDENCE: Level IV.

PMID:40832623 | PMC:PMC12358653 | DOI:10.1016/j.jor.2025.08.006

J Orthop. 2025 Aug 9;69:283-287. doi: 10.1016/j.jor.2025.08.003. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: Osteochondral defects of the knee are a frequent cause of pain that often require surgical intervention. Restorative procedures such as osteochondral autograft transplantation (OAT) and osteochondral allograft transplantation (OCA) aim to replace cartilage lesions with healthy autologous tissue or cadaveric tissue from the distal femur, respectively. Osteochondral graft donor sites are selected to optimize donor-recipient site congruity by assessing factors such as surface topography, cartilage thickness, and contact pressures. However, few studies have evaluated subchondral bone mineral density (BMD) when selecting an osteochondral graft donor site.

PURPOSE: To examine bone morphology and characterize variation in subchondral BMD of the human distal femur.

STUDY DESIGN: Descriptive Laboratory Study.

METHODS: 18 human cadaveric distal femurs were utilized in the current study. All soft tissue and ligaments of the distal femur were removed. Dual-energy X-ray absorptiometry (DEXA) scans were performed on each femur to determine BMD of five regions of interest (ROI). ROIs included the entire distal femur, medial condyle, lateral condyle, posterior condyles, and trochlea. Subsequently, 90 osteochondral bone plugs (10 mm diameter, 10 mm depth) were harvested collectively from the medial and lateral trochlea of included specimens. DEXA scans of each osteochondral graft were then performed. Statistical analysis was performed via Welch Two-Sample t-test. Significance was defined as p < 0.05.

RESULTS: All specimens were included for analysis. There were no significant differences in the dimensional characteristics or BMDs of corresponding ROIs across distal femurs. There was no significant difference in the BMD of the medial condyle compared to the lateral condyle, and the posterior condyle compared to the trochlea. Also, there was no significant difference in BMD of grafts extracted from the medial and lateral trochlea (all p > 0.05).

CONCLUSION: No significant difference was found in BMD between the medial and lateral condyles, trochlea and posterior condyles, or osteochondral grafts harvested from the medial and lateral trochlear ridges of the distal femur.

CLINICAL RELEVANCE: Similar BMD between common osteochondral donor and recipient sites may provide surgeons with added confidence that fewer adjustments must be made to optimize congruity with respect to bone density.

PMID:40832622 | PMC:PMC12359186 | DOI:10.1016/j.jor.2025.08.003

Demogr Res. 2023 Jul-Dec;49(33):865-904. doi: 10.4054/demres.2023.49.33. Epub 2023 Nov 16.

ABSTRACT

BACKGROUND: The distribution of job tenure plays an important role in demography, economics, and sociology. Job tenure in a labor market is analogous to age in a population. Demographers have used indirect methods based on variable-r methods to estimate parameters for life table models. The variable-r method can also be employed to estimate the parameters of a job tenure table model that yields the expected length of job tenure and related measures.

METHODS AND DATA: Only two retrospective surveys of current employee tenure lengths and a count of between-survey hires are required to estimate the parameters of a period tenure table using the variable-r method. Tenure-specific sources of decrement allow an analyst to estimate the parameters of multiple-decrement tenure tables and associated single-decrement tenure tables that isolate the proximate contribution of a specific decrement to the job separation process. I illustrate and evaluate the method using publicly available US data.

RESULTS: Variable-r methods generated reasonable parameter estimates: The expected job tenure was 2.48 years at 2002-2004 decrement rates. Multiple-decrement methods can estimate the fraction of employment relationships that end via job displacement. Cause-deleted tenure tables can capture the static effect of eliminating a particular risk to the population of employment relationships.

CONTRIBUTION: Arthur and Vaupel (1984) provide a framework for studying nonstable populations that subsume the variable-r relations that I utilize in this work. Vaupel had an interest in formal demography throughout his life but started his academic career in business statistics. This paper combines those interests.

PMID:40832619 | PMC:PMC12360750 | DOI:10.4054/demres.2023.49.33

Prev Med Rep. 2025 Aug 7;57:103196. doi: 10.1016/j.pmedr.2025.103196. eCollection 2025 Sep.

ABSTRACT

OBJECTIVES: Veterinarians are observed to be vulnerable to various occupational hazards due to the nature of their work. Veterinary students face an even greater risk, as their academic and professional training in animal handling is still incomplete. Therefore, this study aimed to investigate the prevalence of and factors associated with occupational hazard exposure among undergraduate veterinary students in Bangladesh.

METHODS: A cross-sectional study was conducted from August 25, 2024 to September 10, 2024 among 330 veterinary students from two conveniently selected institutions in Bangladesh. Third- to fifth-year students were invited to participate through a self-administered questionnaire. Statistical analyses were performed with the chi-square test and logistic regression to investigate the associated factors.

RESULTS: Overall, 62.4 % students reported exposure to occupational hazards. Physical hazards were the most frequently reported (44.2 %), followed by chemical (19.4 %), psychosocial (17.6 %), biological (13.6 %), and ergonomic hazards (9.1 %). Senior-level students reported a higher exposure to hazards than 3rd year students (4th year: adjusted odds ratio [AOR] = 2.45, 95 % confidence interval [CI] = 1.04, 5.74; 5th year: AOR = 2.43, 95 % CI = 1.30, 4.55). Those who received formal training outside the curriculum were more likely to report exposure (AOR = 2.49, 95 % CI = 1.16, 5.36). Moreover, a higher knowledge level was a protective factor for occupational hazards (AOR = 0.56, 95 % CI = 0.31, 0.99).

CONCLUSION: Our findings emphasize the need for training programs both within and beyond the curriculum to improve students’ practical skills, particularly among senior-level students involved in clinical duties.

PMID:40832616 | PMC:PMC12359168 | DOI:10.1016/j.pmedr.2025.103196

Ther Innov Regul Sci. 2025 Aug 19. doi: 10.1007/s43441-025-00845-4. Online ahead of print.

ABSTRACT

BACKGROUND: Tazemetostat, an EZH2 inhibitor approved for select sarcomas and lymphomas, has limited post-marketing safety data despite growing clinical use. This study aimed to evaluate the real-world safety profile of tazemetostat using data from the FDA Adverse Event Reporting System (FAERS) between Q1 2020 and Q4 2024.

METHODS: Reports listing tazemetostat as the primary suspect drug were extracted, deduplicated, and analyzed using four disproportionality methods. Preferred Terms (PTs) were standardized via MedDRA 26.1 and mapped to System Organ Classes (SOCs). Subgroup analyses and time-to-onset assessments were performed across age, sex, and reporter types.

RESULTS: A total of 1,179 adverse event reports associated with tazemetostat were retrieved from FAERS. Disproportionality analysis revealed significant signals across gastrointestinal, hematologic, and general systemic domains. Fatigue, nausea, decreased appetite, and anemia were the most commonly reported events. Significantly, taste disorder and somnolence were identified as new signals that were not present in FDA labeling. Most events occurred within the first 60 days of treatment, with similar onset patterns across demographic subgroups.

CONCLUSION: This FAERS-based analysis confirmed known toxicities and identified novel signals associated with tazemetostat in routine clinical use. These findings underscore the importance of continued pharmacovigilance to detect emerging adverse events and inform real-world monitoring strategies.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40830697 | DOI:10.1007/s43441-025-00845-4