Category: Nevin Manimala

Ann Biomed Eng. 2025 Jul 3. doi: 10.1007/s10439-025-03775-2. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study was to characterize joint level morphology and alignment differences across stages of progressive collapsing foot deformity (PCFD) within the talocrural, subtalar, talonavicular, and calcaneocuboid joints using multi-bone statistical shape modeling (SSM) and joint distance measurements from weightbearing computed tomography (WBCT) scans. This was achieved by employing multi-bone SSM in conjunction with precise joint measurement analysis, utilizing WBCT scans to investigate the intricate changes within the talocrural, subtalar, talonavicular, and calcaneocuboid joints.

METHODS: A retrospective analysis was conducted on patients with PCFD who failed conservative treatment. Two groups of 20 feet each were formed for flexible PCFD and rigid PCFD, with 27 additional feet identified as asymptomatic controls. All 67 participants underwent a WBCT scan, and 3D models were created as inputs for multi-bone SSM and joint distance measures.

RESULTS: The first principal component analysis mode contained 45.8% of the variation in the population while the second mode contained 13.3% of the variation and the third mode contained 6.4% of variation accounting for 65.6% of the overall variation in the multi-bone model. Joint space distance measurement differences were observed between all three groups for all articulations. The primary difference between flexible PCFD and rigid PCFD multi-bone SSM was a statistically significant medial shift of alignment of the talar neck, resulting in worsened peritalar subluxation.

CONCLUSION: PCFD is quantifiably variable across a clinical population when evaluating joint level measurements as well as morphologic and alignment variations. Talonavicular joint malalignment severity may be a clinical key in distinguishing between stages of PCFD.

PMID:40608241 | DOI:10.1007/s10439-025-03775-2

Drug Saf. 2025 Jul 3. doi: 10.1007/s40264-025-01574-1. Online ahead of print.

ABSTRACT

INTRODUCTION: Opioid agonist treatment (OAT) reduces drug-related poisonings and injection-related infections among people with opioid use disorder (OUD). Despite buprenorphine-naloxone (BNX) and methadone (MET) both being first-line OAT options in Canada, their comparative effectiveness in preventing recurrent injection-related infections and poisonings remains unclear.

OBJECTIVES: This study compared the effectiveness of buprenorphine-naloxone and methadone in reducing recurrent risks of injection-related bacterial infections and opioid-related poisoning among people on OAT.

METHODS: We used administrative health data from Québec, Canada to create our cohort of adult patients (aged 18-65 years) on OAT maintenance between 2014 and 2019. We applied a time-dependent Cox proportional hazards model for our time-varying exposure definition to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the recurrent risks of injection-related bacterial infections and opioid-related poisoning, adjusting for age, sex, socio-demographic, and clinical factors. We also compared the effectiveness of buprenorphine-naloxone and methadone during the OAT induction phase (i.e., first 30 days of treatment).

RESULTS: The study population included 2010 patients (mean age: 41.21 years, 67.41% male). Compared to methadone, buprenorphine-naloxone was associated with 45% lower recurrent risk of opioid-related poisoning (HR: 0.55; 95% CI 0.35-0.86). Overall, the association between buprenorphine-naloxone and recurrent risk of injection-related bacterial infections suggested a weak protective effect (HR: 0.80; 95% CI 0.59-1.09). During the induction phase, there was limited evidence of differences between buprenorphine-naloxone and methadone for the recurrent risks of injection-related bacterial infections (HR: 0.91; 95% CI 0.51-1.60) and opioid-related poisoning (HR: 1.07; 95% CI 0.51-2.24).

CONCLUSION: Among patients in OAT maintenance, buprenorphine-naloxone was associated with lower risk of recurrent opioid-related poisoning compared to methadone, but not for injection-related infections. This advantage was not observed during induction, suggesting the need for improved treatment retention early in OAT.

PMID:40608239 | DOI:10.1007/s40264-025-01574-1

Qual Life Res. 2025 Jul 3. doi: 10.1007/s11136-025-04016-8. Online ahead of print.

ABSTRACT

OBJECTIVES: Two recently developed respiratory bolt-ons were shown to improve the construct validity of EQ-5D-5L among community-treated patients with obstructive airway disease (OAD). We evaluated their psychometric properties, including responsiveness and reliability in a specialist-managed OAD cohort.

METHODS: We performed in-depth interviews with ten OAD patients and ten clinicians to assess their content validity. We administered the Saint George’s Respiratory Questionnaire (SGRQ), EQ-5D-5L and two respiratory bolt-on items, (physical impediment, R1 & symptoms, R2) in adult OAD patients at baseline and follow-up visits. We used the baseline data to compare among four EQ-5D versions, EQ-5D-5L, + R1, + R2 & + R1R2: (1) ceiling using individual item responses; and (2) Spearman’s rho correlations (R_s) with SGRQ, (3) association with clinical characteristics using C-statistics from receiver operating characteristic (ROC) analyses, and (4) coefficient of determination from regression modelling using index/level sum scores. We used the follow-up data to compare intra-class correlation coefficients (ICCs)/Cohen’s Kappas (κ) of “stable” patients; and standardized effect sizes/C-statistics of “better” patients using SGRQ and clinical criteria, across the four versions.

RESULTS: Psychometric properties of the respiratory bolt-ons proved to be acceptable. We included 184 patients with a mean age of 54 (standard deviation, 18) years at baseline, and 120 at follow-up at 2.8 (standard deviation, 1.7) months. The ceilings were nullified in + R1, + R2 and + R1R2. Construct validity and responsiveness were consistently higher in + R2 and + R1R2 compared to EQ-5D-5L, while reliability remained comparable among the four versions.

CONCLUSIONS: Respiratory bolt-ons demonstrated good content validity and enhanced the psychometric properties of EQ-5D-5L in OAD.

PMID:40608236 | DOI:10.1007/s11136-025-04016-8

Mayo Clin Proc Digit Health. 2025 May 23;3(3):100229. doi: 10.1016/j.mcpdig.2025.100229. eCollection 2025 Sep.

ABSTRACT

OBJECTIVE: To combat influenza (flu)-vaccine misinformation and improve vaccine uptake using social media.

PATIENTS AND METHODS: Unbiased Science used an online survey to identify flu vaccine-hesitant demographic groups and their specific objections to vaccination. Targeted educational content was then created and deployed through a variety of media formats, including podcasts, newsletters, reels, and infographics. A postcampaign survey determined the proportion of individuals who changed their minds about vaccination as a result of the educational content. The study was conducted between October 28, 2022 and February 7, 2023.

RESULTS: In 3626 precampaign surveys, 187 individuals (5.1%) reported being unvaccinated and not planning to get the flu vaccine (the unvaccinated group). Multivariable analysis showed that geographic region (Northeast and Southeast), gender identity (male and other), race-ethnicity (non-Hispanic Black, and non-Hispanic other), and education level (high-school or less and some college) were independently associated with being unvaccinated. The main reasons were needlephobia, dismissal of flu severity, and concerns about vaccine components, multiple vaccines, and side effects. In 838 postcampaign surveys, 39 individuals (4.7%) indicated changing their mind about vaccination: of these, 27 (69.2%) said they were more likely to get vaccinated and 22 (56.4%) had gotten vaccinated. Twenty individuals (51.3%) said they changed their mind at least in part because of the targeted educational content.

CONCLUSION: Social media has the potential to change attitudes and behaviors around vaccination. When science messaging is deployed across several platforms and targeted to key demographic characteristics, it has the ability to combat misinformation and influence vaccine uptake.

PMID:40607109 | PMC:PMC12213263 | DOI:10.1016/j.mcpdig.2025.100229

Internet Interv. 2025 Jun 16;41:100843. doi: 10.1016/j.invent.2025.100843. eCollection 2025 Sep.

ABSTRACT

BACKGROUND: Up to 30 % of pregnant individuals experience high levels of stress. At the same time, 15-20 % of new mothers develop postpartum depression, and 25-35 % experience postpartum anxiety. Mobile applications have the potential to provide an accessible, scalable solution to these mental health challenges. However, previous evidence indicates that none of the commercially available apps for perinatal depression and anxiety have been rigorously evaluated through randomized clinical trials (RCTs), and the quality of these apps remains moderate. In response to this gap, we aim to develop and empirically evaluate Powerly, a mobile app intervention designed to prevent postpartum depression and anxiety.

METHODS: We will conduct a two-arm RCT with 140 healthy pregnant participants to assess the impact of Powerly use compared to care as usual (CAU). Powerly is based on cognitive behavioral therapy techniques and developed in consultation with stakeholders, including healthcare professionals and pregnant individuals. It will offer personalized psychological support tailored to users’ needs for four weeks. Self-reported mental health assessments will be collected at baseline, after four weeks of app use, and six weeks postpartum.

DISCUSSION: We anticipate that participants using Powerly will demonstrate significant improvements in mental health outcomes, including reduced rates of postpartum depression, compared to the CAU group. Additionally, we expect positive changes in emotion regulation, resilience, and mother and child outcomes, such as enhanced maternal bonding and a more positive birth experience. If proved effective, Powerly can offer a scalable, publicly accessible solution for pregnant individuals in need.

TRIAL REGISTRATION: NCT06610552.

PMID:40607107 | PMC:PMC12213272 | DOI:10.1016/j.invent.2025.100843

PNAS Nexus. 2025 Jun 14;4(7):pgaf200. doi: 10.1093/pnasnexus/pgaf200. eCollection 2025 Jul.

ABSTRACT

Current livestock breeding is slow to respond to rapidly mounting environmental pressures that threaten sustainable animal protein production. New approaches can accelerate genetic improvement by multiplying valuable embryonic, rather than adult genotypes. Chimeras, derived from complementing a sterile host with a fertile donor embryo, provide a pathway to multiply and exclusively transmit elite male germlines. We established genetically sterile hosts and optimized embryo complementation conditions to achieve absolute germline transmission in sheep. The spermatogonia-specific gene NANOS2 was disrupted in male (NANOS2^+/- , NANOS2^-/- ) and female (NANOS2^-/- ) ovine fetal fibroblasts via gRNA-Cas9-mediated homology-directed repair. Targeted cell strains and wild-type controls were used to produce cloned offspring for breeding and phenotyping. Male homozygous knockout clones lacked detectable germ cells, while the somatic compartment of the testis remained intact. By contrast, male monoallelic and female biallelic targeting of NANOS2 did not affect germline development, resulting in fertile animals capable of producing fertile offspring with normal reproductive performance. The germ cell niche in NANOS2^-/- hosts was most efficiently complemented by aggregating compacted morulae, rather than earlier cleavage stages, resulting in 97% blastocyst chimerization. Embryo-complemented cloned lambs from two different donor cell lines showed variable chimerism across tissues from each germ layer, including various degrees of germline colonization. A subset of germline chimeras contained normal numbers of prospermatogonia, indicating that the germline was fully restored for absolute transmission of the donor cell genotype.

PMID:40607105 | PMC:PMC12218192 | DOI:10.1093/pnasnexus/pgaf200

Mater Sociomed. 2025;37(2):164-168. doi: 10.5455/msm.2025.37.164-168.

ABSTRACT

BACKGROUND: Stroke patients have significant disability and an increased risk of falling.

OBJECTIVE: To determine the incidence of falls and the degree of disability in stroke patients and to determine the correlation of falls with the degree of disability.

METHODS: This is a prospective study of 100 stroke patients confirmed by computed tomography and magnetic resonance imaging of the brain. We used a demographic questionnaire together with the Glasgow Coma Scale, Stroke Assessment Scale, Rankin Scale and Morse Scale to collect data and analyzed them using SPSS 17, including statistical measures, including Pearson correlation.

RESULTS: Hemorrhagic stroke patients had a higher incidence of falls (p = 0.06). There was no difference in the incidence of falls according to the gender of the patients (p = 0.07). Older people had a higher frequency of falls, and women and patients with hemorrhagic stroke had a higher risk of falling (p = 0.2). Patients with a stroke in the area of the anterior circulation were statistically significantly more disabled (p < 0.05). A weak positive correlation was calculated between the frequency of falls of patients after stroke and the degree of disability (r = 0.08, n = 94, p = 0.4). Stroke patients who also had atrial fibrillation as a comorbidity had a statistically significantly higher frequency of falls compared to patients with other comorbidities (p = 0.02).

CONCLUSION: Patients with hemorrhagic stroke have a higher frequency of falls. Women, elderly people, patients with a stroke in the area of the anterior circulation and with atrial fibrillation as a comorbidity are statistically significantly more disabled after a stroke. There is a positive correlation between the frequency of falls in patients after a stroke and the degree of disability.

PMID:40607099 | PMC:PMC12212237 | DOI:10.5455/msm.2025.37.164-168

Mater Sociomed. 2025;37(2):106-110. doi: 10.5455/msm.2025.37.106-110.

ABSTRACT

BACKGROUND: Benign acute childhood myositis (BACM) is a rare complication of viral URTIs, usually occurring in winter. It is characterized by acute onset of bilateral calf pain and difficulty/refusal to walk. A prodromal phase precedes these manifestations, consisting of catarrhal and constitutional symptoms. These are associated with increased muscle-specific enzymes, usually normal inflammatory parameters, and leukopenia.

OBJECTIVE: Our study aimed to define the demographic, clinical, and laboratory characteristics of BACM patients and determine the etiology leading to their development.

METHODS: Medical charts for patients diagnosed with BACM from October to April 2023/2024 at the Pediatric Clinic Clinical Center University of Sarajevo, Department of Allergology, Rheumatology, and Immunology were reviewed retrospectively. Relevant medical information was collected for 20 patients. Statistical analysis was done in Microsoft Excel 2013.

RESULTS: Demographic analysis demonstrated male predominance (75%), with primarily school-aged children affected (median age 8.36). Most cases occurred in winter (60%). The majority of patients presented with bilateral calf pain (100%), difficulty walking (90%), and fever (100%). All cases demonstrated increased CK levels, with median values of 3779 U/L; a notable number had leukopenia (70%). The most commonly isolated pathogen was Influenza B virus (75%).

CONCLUSION: BACM is relatively rare but presents acutely and leads to plenty of distress for both patients and their parents. A child with coryzal symptoms complicated by bilateral calf pain or difficulty/refusal to walk and an increase in CK levels should raise suspicion of BACM. The condition is self-limiting and usually resolves without complications.

PMID:40607097 | PMC:PMC12212264 | DOI:10.5455/msm.2025.37.106-110

Mater Sociomed. 2025;37(2):131-135. doi: 10.5455/msm.2025.37.131-135.

ABSTRACT

BACKGROUND: Laryngeal squamous cell carcinoma (LSC) is the leading malignant tumour of the head and neck. Establishing new biomarkers is extremely important because they can be important for early diagnosis and prognosis of LSC.

OBJECTIVE: The aim of this study was to establish the significance of cytokeratin fragment antigen 21-1 (CYFRA 21-1) in the early diagnosis and prognosis of LSC.

METHODS: This was prospective research involving 35 patients of both sexes with pathohistologically confirmed LSC, who were treated in the period from 2022 to 2024. The control group consisted of 30 patients who underwent surgery for other non-malignant diseases and who had a normal indirect laryngoscopy findings. The levels of CYFRA 21-1 were determined for three time periods: preoperative, four weeks after surgery, and three months after radiotherapy or concomitant chemoradiotherapy. For the statistical analysis of data we used descriptive statistics methods, the Student T-test and the χ2 test to calculate the significance of the tested differences, where differences on the level of p<0.05 were considered to be statistically significant.

RESULTS: Statistically significantly higher mean serum levels of CYFRA 21-1 were found preoperatively in the experimental group in comparison with the control group (p<0.001). Statistically significant lower levels of CYFRA 21-1 were found four weeks after surgery in the experimental group in comparison with preoperative levels (p=0.004). A statistically significant decrease in serum levels of CYFRA 21-1 was also found three months after radiotherapy or concomitant chemoradiotherapy in comparison with the preoperative levels (p=0.001). The serum levels of CYFRA 21-1 were statistically significantly higher preoperatively in patients with stage III/IV of the disease in comparison with stage I/II (p<0.001).

CONCLUSION: Increased levels of CYFRA 21-1 are a significant indication of the presence of LSC, especially in patients with advanced stages of the disease.

PMID:40607093 | PMC:PMC12212222 | DOI:10.5455/msm.2025.37.131-135

Mater Sociomed. 2025;37(2):159-163. doi: 10.5455/msm.2025.37.159-163.

ABSTRACT

BACKGROUND: Posterior pericardiotomy has been proposed as a preventive strategy against postoperative pericardial effusion and cardiac tamponade in patients undergoing coronary artery bypass grafting (CABG). However, data regarding its clinical outcomes and potential associations with postoperative complications remain limited.

OBJECTIVE: To evaluate intraoperative and postoperative outcomes in patients undergoing off-pump CABG with concomitant posterior pericardiotomy, and to assess potential associations between perioperative variables and the development of common postoperative complications.

METHODS: This retrospective study included 38 patients who underwent off-pump CABG with posterior pericardiotomy. Demographic and clinical characteristics, procedural details, postoperative complications, and outcomes were analyzed. Associations between operative time, comorbidities (sex, diabetes mellitus, smoking), and postoperative complications such as atrial fibrillation, pleural and pericardial effusions, and drainage volume were statistically evaluated using chi-square and correlation analysis.

RESULTS: The study cohort had a mean age of 66.64 ± 7.28 years, with 68.1% male patients. Arterial hypertension was present in all patients, diabetes mellitus in 44.7%, and prior myocardial infarction in 65.7%. The mean left ventricular ejection fraction was 42.86 ± 10.21%, and triple-vessel disease was observed in 63.2% of patients. All patients underwent off-pump CABG. The mean operative time was 254.31 ± 59.04 minutes. Postoperative complications included new-onset atrial fibrillation in 15.7% of patients, pleural effusion in 42.1%, and pericardial effusion in 10.5%. No cases of cardiac tamponade were reported. A significant association was found between smoking and new-onset atrial fibrillation (p = 0.050), while no significant associations were observed between sex or diabetes and postoperative complications. Operative time was not significantly associated with pericardial or pleural effusion, nor with drainage volume. Complete recovery was observed in all 100.0% of patients.

CONCLUSION: Posterior pericardiotomy performed during off-pump CABG was associated with a low incidence of pericardial effusion and no occurrence of cardiac tamponade. The procedure appears to be safe and may contribute to favorable postoperative outcomes. Smoking may be a risk factor for new-onset atrial fibrillation, warranting further investigation.

PMID:40607089 | PMC:PMC12212279 | DOI:10.5455/msm.2025.37.159-163