Category: Nevin Manimala

Anesth Pain Med. 2025 May 12;15(3):e160776. doi: 10.5812/aapm-160776. eCollection 2025 Jun 30.

ABSTRACT

BACKGROUND: The erector spinae plane block (ESPB) has traditionally been performed under ultrasound guidance, while fluoroscopic guidance has emerged as an alternative approach.

OBJECTIVES: This study aims to compare the efficacy of ESPB using ultrasound and fluoroscopic guidance in patients with cervical pain.

METHODS: This case series study includes fourteen patients with axial neck pain scheduled for cervical ESPB. According to the approach of ESPB (ultrasound or fluoroscopic guidance), patients were divided into two groups: Eight underwent ultrasound-guided ESPB, and six received fluoroscopy-guided ESPB. Pain and disability were assessed using the Numerical Rating Scale (NRS) and the Neck Disability Index (NDI) at baseline (pre-procedure), two weeks post-procedure, and three months post-procedure.

RESULTS: Both groups demonstrated significant improvements in NRS and NDI scores over time (P = 0.005). However, no statistically significant differences were observed in pain scores or disability indices at any of the evaluation points.

CONCLUSIONS: This study suggests that fluoroscopy-guided ESPB is as effective as ultrasound-guided ESPB for managing cervical radicular pain, providing a viable alternative for clinicians.

PMID:40727631 | PMC:PMC12297020 | DOI:10.5812/aapm-160776

J Public Health Res. 2025 Jul 24;14(3):22799036251351156. doi: 10.1177/22799036251351156. eCollection 2025 Jul.

ABSTRACT

BACKGROUND: Health is vital for survival and societal well-being, with global goals focusing on improved access and achieving progress in public health. In Bangladesh, investigating health determinants and disparities is crucial for effective interventions.

OBJECTIVE: This study investigates spatial and temporal variations in the influence of socioeconomic and health-related factors on the health index at a detailed district level in Bangladesh, aiming to discern disparities in health indicators among districts. Based on 21 years of secondary data across 64 districts in Bangladesh, this research deploys four Bayesian spatial-temporal models to analyze the health index and relevant variables.

DESIGN AND METHODS: The study identifies the optimal model by evaluating linear, analysis of variance, and autoregressive models of orders one and two. Comparative analysis utilizing the WAIC and DIC aids model selection. The MCMC method enhances precision in determining health index determinants, providing valuable insights for policymakers and researchers.

RESULTS: Our findings reveal that the AR (2) model demonstrated superior performance among all the spatiotemporal models. The health index demonstrated a consistent upward trend overall, but regional variations in residents’ health indices were noted. Positive spatial autocorrelation was identified in the health index, emphasizing interconnected health outcomes. Spatiotemporal models underscored the significance of the income index, child mortality, life expectancy, and the proportion of the active population as crucial factors shaping the health index in Bangladesh.

CONCLUSIONS: This study provides actionable insights for targeted health interventions in districts with specific needs, emphasizing focused policies on poverty, education, and healthcare to enhance overall well-being in Bangladesh.

PMID:40727627 | PMC:PMC12301593 | DOI:10.1177/22799036251351156

J Stat Phys. 2025;192(8):109. doi: 10.1007/s10955-025-03493-y. Epub 2025 Jul 26.

ABSTRACT

We say of an isolated macroscopic quantum system in a pure state $\psi$ that it is in macroscopic thermal equilibrium (MATE) if $\psi$ lies in or close to a suitable subspace $H_{\text{eq}}$ of Hilbert space. It is known that every initial state ${\psi }_0$ will eventually reach and stay there most of the time (“thermalize”) if the Hamiltonian is non-degenerate and satisfies the appropriate version of the eigenstate thermalization hypothesis (ETH), i.e., that every eigenvector is in MATE. Tasaki recently proved the ETH for a certain perturbation $H_{\theta }^{\text{fF}}$ of the Hamiltonian $H_0^{\text{fF}}$ of $N\gg 1$ free fermions on a one-dimensional lattice. The perturbation is needed to remove the high degeneracies of $H_0^{\text{fF}}$ . Here, we first point out that also for degenerate Hamiltonians all ${\psi }_0$ thermalize if the ETH holds, i.e., if every eigenbasis lies in MATE, and we prove that this is the case for $H_0^{\text{fF}}$ . Inspired by the fact that there is one eigenbasis of $H_0^{\text{fF}}$ for which MATE can be proved more easily than for the others, with smaller error bounds, and also in higher spatial dimensions, we show for any given $H_0$ that the existence of one eigenbasis in MATE implies quite generally that most eigenbases of $H_0$ lie in MATE. We also show that, as a consequence, after adding a small generic perturbation, $H=H_0+\lambda V$ with $\lambda \ll 1$ , for most perturbations V the perturbed Hamiltonian H satisfies ETH and all states thermalize.

PMID:40727612 | PMC:PMC12296827 | DOI:10.1007/s10955-025-03493-y

Arch Acad Emerg Med. 2025 Jul 11;13(1):e56. doi: 10.22037/aaemj.v13i1.2678. eCollection 2025.

ABSTRACT

INTRODUCTION: Meta-analyses of diagnostic/prognostic studies for calculating the pooled sensitivity and specificity require true positive (TP), true negative (TN), false positive (FP), and false negative (FN) counts. However, few studies report these values directly. This study aimed to consolidate practical methods to reconstruct sensitivity and specificity from minimal data.

METHODS: Our framework addresses three main situations: (1) algebraic rearrangements to compute specificity given partial metrics; (2) digitization of receiver operating characteristic (ROC) curves to obtain threshold-specific sensitivity and specificity; and (3) application of the binormal model when only AUC and prevalence are available. We tested these methods on a dataset related to mortality prediction in myocardial infarction (MI) using machine learning models, assessing how well they reconstructed sensitivity and specificity.

RESULTS: Algebraic formulas and ROC digitization yielded reliable estimates when partial metrics or graphical curves were sufficiently detailed. However, the binormal model, which assumes equal variances, showed noticeable inaccuracies, especially for sensitivity. Linear regression analyses indicated that higher prevalence and higher AUC reduced estimation errors.

CONCLUSION: These methods offer practical alternatives for reconstructing diagnostic accuracy measures when data are incomplete. Relying solely on AUC-based estimations may introduce substantial bias, particularly in low-prevalence contexts. We recommend that primary studies report threshold-specific sensitivity and specificity to support more accurate meta-analytic estimations.

PMID:40727603 | PMC:PMC12303406 | DOI:10.22037/aaemj.v13i1.2678

Arch Acad Emerg Med. 2025 Jun 25;13(1):e57. doi: 10.22037/aaemj.v13i1.2693. eCollection 2025.

ABSTRACT

INTRODUCTION: By enabling direct consultation with neurologists, Real-Time Telemedical Oversight (ReTMO) can facilitate rapid stroke assessment and decision-making. This study aimed to assess the efficacy of prehospital stroke management before and after ReTMO implementation.

METHODS: A single-center retrospective before-and-after study was conducted at Ramathibodi Hospital, Bangkok, Thailand, from January 2020 to December 2024. In March 2022, a structured prehospital stroke protocol was integrated with the ReTMO system in this hospital. We evaluated its impact by comparing stroke patients transported by emergency medical services (EMS) before and after protocol implementation. Neurological outcomes at hospital discharge were analyzed using multivariable ordinal logistic regression. In contrast, door-to-treatment times in the emergency department (ED) and hospital length of stay were assessed using multivariable Gaussian regression.

RESULTS: The study included 91 prehospital stroke patients, with 36 in the pre-protocol group and 55 in the post-protocol group. Implementation of the structured prehospital stroke protocol was associated with a significant reduction in door-to-computed tomography (CT) scan time by 10.47 (95% confidence interval (CI): -17.62 to -3.3) minutes and door-to-laboratory result time by 15.90 (95% CI: -30.48 to -1.33) minutes. Additionally, adjusted ordinal logistic regression analysis demonstrated a significant improvement in neurological outcomes at hospital discharge (odds ratio (OR) = 0.14, 95% CI: 0.02-0.99, P = 0.049). However, reductions in ED stroke treatment time and hospital length of stay were not statistically significant.

CONCLUSIONS: Implementing ReTMO alongside a structured prehospital stroke protocol significantly reduced in-hospital delays in door-to-CT and door-to-laboratory result times while also improving neurological outcomes at hospital discharge.

PMID:40727597 | PMC:PMC12303409 | DOI:10.22037/aaemj.v13i1.2693

Int J Nanomedicine. 2025 Jul 22;20:9291-9300. doi: 10.2147/IJN.S503954. eCollection 2025.

ABSTRACT

INTRODUCTION: MicroRNAs (miRNAs) are small, non-coding RNA molecules critical for cellular function, growth, and development. Recent advances in remote diagnostic technologies have highlighted the potential of urinary miRNAs as non-invasive biomarkers for disease monitoring. This study introduces a simple, rapid, and cost-effective reagent for exosomal miRNA extraction, designed for urine-based exosome screening. We further identified hsa-miR-16-5p (miR-16) as a promising diagnostic biomarker for prostate cancer (PCa), with the goal of integrating this method with biosensors to enable rapid result acquisition and support early cancer detection and treatment planning.

MATERIALS AND METHODS: The extraction reagent was formulated using polyethylene glycol (PEG), sodium dodecyl sulfate (SDS), and diethyl pyrocarbonate (DEPC), differing from commercial kits. miRNAs were extracted and validated through RT-qPCR, focusing on miR-16 and the reference control miR-21. Results were compared against commercial kits. A cohort of 39 clinical samples-28 PCa patients, 1 benign prostatic hyperplasia (BPH) case, and 10 healthy controls (Ctr)-was analyzed. Statistical evaluations included T-tests and receiver operating characteristic (ROC) analysis to assess the diagnostic value of miR-16.

RESULTS: miR-16 expression significantly differed across PCa stages and between cancerous and non-cancerous individuals (Ctr vs Stage IV: p < 0.05; Stage II vs III: p < 0.05; Stage II vs IV: p < 0.005; Stage III vs IV: p < 0.05). ROC analysis confirmed miR-16’s diagnostic potential, particularly in detecting mid-stage PCa.

CONCLUSION: The proposed extraction method matches commercial kits in performance but offers notable advantages: a simplified five-step process, reduced extraction time (1.08 hours), and low cost ($0.13/test). These findings support the use of urinary miR-16 as a biomarker for PCa staging and highlight the practical value of the newly developed extraction reagent.

PMID:40727581 | PMC:PMC12301110 | DOI:10.2147/IJN.S503954

Front Cardiovasc Med. 2025 Jul 14;12:1608655. doi: 10.3389/fcvm.2025.1608655. eCollection 2025.

ABSTRACT

INTRODUCTION: This study aims to systematically investigate the association between the triglyceride-glucose index multiplied by waist circumference (TyG-WC) and the risk of cardiovascular disease (CVD) and further explore how this relationship varies across different glycemic statuses, including normal glucose regulation (NGR), prediabetes (Pre-DM), and diabetes mellitus (DM).

METHODS: Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), including a total of 7,812 middle-aged and older adults. Kaplan-Meier survival analysis, multivariable Cox proportional hazards models, and restricted cubic spline (RCS) regression were employed to assess the association between baseline TyG-WC and incident CVD risk. Subgroup analyses were conducted based on glucose metabolism status to evaluate potential heterogeneity in the associations.

RESULT: During an average follow-up period of 8.25 years, a total of 1,638 incident CVD events were recorded, corresponding to a cumulative incidence of 20.97%. Kaplan-Meier curves showed that individuals in higher TyG-WC strata had significantly greater cumulative CVD incidence compared to those in lower strata across all glucose metabolism categories (log-rank test, P < 0.05). After adjusting for potential confounders, the hazard ratios (HRs) [95% confidence intervals (CIs)] for CVD in the second, third, and fourth TyG-WC quartiles (Q2-Q4) were 1.20 (1.05-1.37), 1.30 (1.14-1.49), and 1.54 (1.34-1.77), respectively, compared to Q1. In the NGR and Pre-DM groups, TyG-WC was positively and linearly associated with CVD risk. In contrast, a significant non-linear association was observed in the DM group (P for non-linear = 0.046). Specifically, TyG-WC was positively associated with CVD risk when values were below 816.16, whereas above this threshold the increased risk plateaued and was no longer statistically significant.

CONCLUSION: TyG-WC is a practical and effective metabolic indicator for evaluating CVD risk among middle-aged and older Chinese adults. Its clinical application may facilitate early identification and precise stratification of high-risk individuals, thereby providing strong support for CVD prevention and targeted intervention strategies.

PMID:40727573 | PMC:PMC12301363 | DOI:10.3389/fcvm.2025.1608655

Ann Pancreat Cancer. 2025 Mar 30;8:1. doi: 10.21037/apc-24-22. Epub 2025 Mar 7.

ABSTRACT

BACKGROUND: Bibliometric review offers a comprehensive and quantitative evaluation of pancreatic cancer research, focusing on journal and author productivity. Despite significant efforts to improve pancreatic cancer outcomes and expand the literature on the topic, there is still insufficient data on influential journals and article impact measures to guide researchers through journal submissions. This article aims to evaluate research productivity and identify influential journals and authors within the field. Utilizing bibliometric indices like impact factor, h-index, and eigenfactor will facilitate the assessment process.

METHODS: A comprehensive search on July 1, 2023 in the Scopus database to identify articles related to pancreatic cancer. The search criteria included the keyword “Pancreatic Cancer” in the subject area of “Medicine”, limited to English language articles published between January 1989 and December 2022. We calculated publication and citation counts at the article, journal, and first author levels, employing various measures of centrality. Statistical analysis was conducted using the Student t-test.

RESULTS: The search yielded 52,154 articles from 3,155 journals with total citations of 1,903,916. The journal with the largest median citations dealing solely with pancreatic cancer was the Annals of Surgery. The journal with the highest number of publications is Pancreas. Six of the top twenty most cited articles were treatment-related articles. Of the top 30 journals by article count, JAMA had the highest median citation count, 340 of 33 articles. The most cited authors list was not associated with high productivity, similarly, the most productive authors were not associated with a high rate of citations.

CONCLUSIONS: This study offers valuable insights for researchers and institutions in guiding journal selections and themes identified as popular among the research community. It positively impacts the selection of appropriate journals to submit articles on the topic by easily identifying the most impactful and cited journals. The findings emphasize the growing interest in the field, the emergence of specialized journals, and a focus on treatment-related investigations. Overall, this analysis underscores the relevance of bibliometric approaches in advancing pancreatic cancer research.

PMID:40727572 | PMC:PMC12302548 | DOI:10.21037/apc-24-22

Ther Adv Drug Saf. 2025 Jul 24;16:20420986251360888. doi: 10.1177/20420986251360888. eCollection 2025.

ABSTRACT

BACKGROUND: Valproate (valproic acid, sodium valproate) is authorised in Montenegro for epilepsy and bipolar disorder treatment. Due to known teratogenicity, risk minimisation measures were introduced in 2014 and further reinforced in 2018 by the implementation of the Pregnancy Prevention Programme (PPP). Despite these measures, consumption of valproate in Montenegro increased in the period 2016-2022.

OBJECTIVES: To investigate the effects of risk minimisation measures on valproate prescription in Montenegro.

DESIGN: A retrospective, observational, 7-year, nationwide study.

METHODS: The Primary Health Care Information System (PHCIS) was used as a data source. The health records of women of childbearing potential (12-55 years) for the period 2016-2022 were analysed. Additionally, unstructured data were reviewed to determine the number and characteristics of valproate-exposed pregnancies. The software PASW, version 25.0 (SPSS Inc., Chicago, IL, USA) was used for the statistical analysis.

RESULTS: A total of 2247 women of childbearing potential using valproate were identified during the observed period. The number of patients using valproate for epilepsy treatment decreased by 24% while the use of valproate in psychiatry increased by 45% over the observed period. The age of the patient was the only predictive factor for successful PPP implementation (chi-square = 35.811, df = 4 and p < 0.001). The odds ratio (OR) for the age category was 1.22 (95% CI: 1.10-1.35). Contraception prescription was recorded in only 1.5% of patients following the PPP implementation. A total of 11 cases of exposed pregnancies were identified, while epilepsy was the indication in 5 (45%) cases.

CONCLUSION: Regulatory risk minimisation measures had a limited impact on reducing the risk of valproate teratogenicity in Montenegro, with the most success in the group of youngest patients. Measures were more effective in the epilepsy indication. The rising use of valproate for psychiatric indications is concerning. Targeted education, better preconception care and improved coordination among healthcare professionals are necessary.

PMID:40727569 | PMC:PMC12301610 | DOI:10.1177/20420986251360888

Endocrines. 2025 Sep;6(3):32. doi: 10.3390/endocrines6030032. Epub 2025 Jul 2.

ABSTRACT

BACKGROUND/OBJECTIVES: Endocrine hormones play critical roles in regulating physiological processes, and previous studies have reported their associations with psychiatric disorders. Levels of endocrine hormones and the risk of developing psychiatric disorders are influenced by both genetic and non-genetic factors. However, the shared genetic basis underlying these associations remains largely unexplored. This study aims to dually evaluate the genetic correlations among endocrine hormones, including thyroid and sex hormones, as well as between endocrine hormone metrics and psychiatric disorders to identify potential shared genetic architectures.

METHODS: We obtained genome-wide association study summary statistics for six thyroid hormone metrics, three sex hormone metrics, and ten psychiatric disorders from predominantly European-ancestry populations. Genetic correlations were computed using linkage disequilibrium score regression after harmonizing variant data to ensure consistency across studies.

RESULTS: Significant genetic correlations were observed among thyroid and sex hormone metrics, indicating a strong shared genetic basis. Sex hormones exhibited multiple genetic correlations with psychiatric disorders, including negative correlations between sex hormone-binding globulin and attention-deficit hyperactivity disorder (ADHD) (p = 3.95 × 10^-12) and major depressive disorder (p = 4.67 × 10^-5), and positive genetic correlations with anorexia nervosa (p = 2.86 × 10^-12) and schizophrenia (p = 2.00 × 10^-4). Testosterone and estradiol had negative genetic correlations with ADHD and major depressive disorder, while testosterone had positive genetic correlations with anorexia nervosa and schizophrenia. Although thyroid hormone metrics did not exhibit Bonferroni-significant genetic correlations, nominal associations were observed, such as a negative genetic correlation between thyroid-stimulating hormone and major depressive disorder (p = 2.33 × 10^-2).

CONCLUSIONS: These findings suggest a shared genetic basis between endocrine hormones and psychiatric disorders, particularly for sex hormones. Future studies leveraging larger, more diverse populations are warranted to validate and extend the genetic correlations observed in this study.

PMID:40727568 | PMC:PMC12290917 | DOI:10.3390/endocrines6030032