Category: Nevin Manimala

Front Physiol. 2025 Nov 26;16:1661258. doi: 10.3389/fphys.2025.1661258. eCollection 2025.

ABSTRACT

INTRODUCTION: Snoring is a common symptom of Obstructive Sleep Apnea (OSA) and has also been associated with an elevated risk of cerebrovascular disease. However, existing snoring detection studies predominantly focus on individuals with Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS), with limited attention given to the specific acoustic characteristics of patients with concomitant cerebrovascular diseases. To address this gap, this paper proposes a snoring classification method integrating dynamic convolution and attention mechanisms, and explores the acoustic feature differences between patients with cerebrovascular stenosis and those without stenosis.

METHODS: First, we collected nocturnal snoring sounds from 31 patients diagnosed with OSAHS, including 16 patients with cerebrovascular stenosis, and extracted four types of acoustic features: Mel spectrogram, Mel-frequency cepstral coefficients (MFCCs), Constant Q Transform (CQT) spectrogram, and Chroma Energy Normalized Statistics (CENS). Then, based on the ConvNeXt backbone, we enhanced the network by incorporating the Alterable Kernel Convolution (AKConv) module, the Convolutional Block Attention Module (CBAM), and the Conv2Former module. We conducted experiments on snoring versus non-snoring classification and stenotic versus non-stenotic snoring classification, and validated the role of each module through ablation studies. Finally, the Mann-Whitney U test was applied to compare intergroup differences in low-frequency energy ratio, snoring frequency, and snoring event duration.

RESULTS: This method achieves the best performance on the Mel spectrogram, with a snoring classification accuracy of 90.24%, compared to 88.16% for the ConvNeXt baseline model. It also maintains superiority in classifying stenotic versus non-stenotic snoring. Ablation analysis indicates that all three modules contribute to performance improvements. Moreover, the Mann-Whitney U test revealed significant differences $\left(p<0.05\right)$ between the stenotic and non-stenotic groups in terms of low-frequency energy ratio and nocturnal snoring frequency, whereas snoring event duration showed no significant difference.

DISCUSSION: The proposed method demonstrates excellent performance in snoring classification and provides preliminary evidence for exploring acoustic features associated with cerebrovascular stenosis.

PMID:41384251 | PMC:PMC12689313 | DOI:10.3389/fphys.2025.1661258

Front Physiol. 2025 Nov 26;16:1708619. doi: 10.3389/fphys.2025.1708619. eCollection 2025.

ABSTRACT

BACKGROUND: Badminton is a high-intensity sport that demands explosive strength, dynamic balance, and agility. Plyometric training (PT) is crucial for enhancing these abilities, yet there is limited research comparing sand-based PT to hard-surface PT in badminton players.

OBJECTIVE: This study compared the effects of sand-based PT and hard-surface PT on lower-extremity explosive strength, dynamic balance, and agility in male badminton players.

METHODS: Twenty-eight male collegiate badminton players were randomly assigned to a sand-based PT group (n = 14) or a hard-surface PT group (n = 14). Both groups performed plyometric programs twice weekly for 8 weeks. Outcomes measurement before and after training included countermovement jump (CMJ) height, squat jump (SJ) height, drop jump (DJ) height, standing long jump (SLJ) distance, Y-balance test (YBT), hexagon jump test, and badminton-specific agility test (lateral agility test and four-corner agility test). We used two-way repeated measures analysis of variance (ANOVA) (time × group) with Bonferroni post hoc tests, and effect sizes were reported as partial eta squared ( ${\eta }_p^2$ ) or Cohen’s d (p < 0.05).

RESULTS: Statistical analysis revealed significant time main effects across multiple metrics: CMJ height (F = 81.26, p < 0.01, ${\eta }_p^2$ = 0.75), SJ height (F = 82.86, p < 0.01, ${\eta }_p^2$ = 0.76), DJ height (F = 54.58, p < 0.01, ${\eta }_p^2$ = 0.68, large effect), SLJ distance (F = 49.86, p < 0.01, ${\eta }_p^2$ = 0.66), dynamic balance ability (p < 0.01), and agility (p < 0.01), no significant between-group differences were found for any of the variables (p > 0.05). Additionally, a significant interaction effect between time and group was observed in the left leg to right (F = 4.76, p = 0.04).

CONCLUSION: This study indicates that both sand-based PT and hard-surface PT over 8 weeks significantly enhance explosive power, dynamic balance, and agility performance, with no significant differences between groups.

PMID:41384248 | PMC:PMC12689396 | DOI:10.3389/fphys.2025.1708619

Ther Adv Neurol Disord. 2025 Dec 9;18:17562864251396529. doi: 10.1177/17562864251396529. eCollection 2025.

ABSTRACT

BACKGROUND: Although migraine is the second most prevalent form of headache, its preventive treatment has some contraindications and complications. It has been postulated that lacosamide reacts with collapsin response mediator protein 2 and prevents its phosphorylation, inhibiting calcitonin gene-related peptide release in the trigeminal system, which might have a role in migraine management.

OBJECTIVE: Our study aimed mainly to evaluate the efficacy and safety of lacosamide as an alternative medication to topiramate for the prevention of migraine, especially in patients who had contraindications to topiramate and other approved antiseizure medications used for migraine prevention.

DESIGN: Our study included two parallel groups: the lacosamide and the topiramate groups.

METHODS: We recruited episodic migraine patients between the ages of 18 and 65; the lacosamide group received lacosamide 50 mg once daily for 1 week, then twice daily from the 8th day till the 90th day); while the topiramate group received topiramate 50 mg once daily for 1 week, then 50 mg twice daily from the 8th day till the 90th day.

RESULTS: There was not a statistically significant difference between the lacosamide and topiramate in the absolute change in monthly migraine days (MMD) at 90 days with p-value 0.34, there was no significant difference between lacosamide and topiramate groups regarding the percentage of patients with ⩾50% reduction in the baseline migraine days frequency in the last 4 weeks of the treatment period with a p-value 0.11. In total, 14.0 (4.7%) patients in the lacosamide group and 24.0 (8.0%) in the topiramate group stopped treatment prematurely due to intolerance to drug-related adverse effects, hazard ratio 2.83, 95% confidence interval (1.34-4.72), p-value 0.03.

CONCLUSION: In episodic migraine patients, the regular use of lacosamide 50 mg Bid for 3 months yielded reductions in the MMD, migraine days that required acute medications, and Headache Impact Test-6 score comparable to those achieved using topiramate 50 mg Bid. Lacosamide was more tolerable than topiramate in episodic migraine patients.

TRIAL REGISTRATION: Prospectively registered on clinicaltrials.gov, NCT06243692-January 29, 2024; https://clinicaltrials.gov/study/NCT06243692.

PMID:41384236 | PMC:PMC12690048 | DOI:10.1177/17562864251396529

J Abdom Wall Surg. 2025 Nov 26;4:15523. doi: 10.3389/jaws.2025.15523. eCollection 2025.

ABSTRACT

INTRODUCTION: Botulinum Toxin A is increasingly used as a preoperative adjunct in the management of complex abdominal wall hernias, particularly in those with wider defects and/or loss of domain. While its anatomical and surgical benefits have been documented, patient-reported outcomes remain underexplored.

METHODS: An international, retrospective, observational study was conducted using a structured, anonymised survey available in five languages (German, English, Polish, French, Spanish). The survey included nine closed-ended and one open-ended question assessing pain perception, mobility, respiratory, gastrointestinal, and urinary function, and changes in abdominal contour. It was distributed by medical teams and through patient support forums between 2024 and 2025. Patients included had received BTA injections 4-6 weeks prior to elective hernia surgery.

RESULTS: Seventy patients from multiple European centres completed the survey. Pain during injection was minimal in 71.5% of cases, with 85.7% reporting complete resolution of pain within 1-3 days. Most respondents (74.3%) experienced no breathing difficulties and only mild symptoms in 18.6%. Mobility remained unchanged in 80%, while 15.7% noted slight deterioration. Changes in urinary and bowel function were uncommon and mostly transient. Over half of patients reported visible changes in abdominal shape. No severe complications were identified.

CONCLUSION: This international patient survey suggests that BTA injections as preoperative preparation for complex hernias is well tolerated, with limited perceived side effects and functional disruption. These findings support its continued use and prompts further prospective data collection.

PMID:41384233 | PMC:PMC12689444 | DOI:10.3389/jaws.2025.15523

Cureus. 2025 Nov 9;17(11):e96428. doi: 10.7759/cureus.96428. eCollection 2025 Nov.

ABSTRACT

Background and aim Electroconvulsive therapy (ECT) has a well-established role in the management of patients who do not respond to psychopharmacological treatment. The therapeutic effect of ECT on major depressive disorder is widely investigated; the search for an ideal induction agent for ECT is an ongoing process. The present study was conducted to compare the effects of 3 mg/kg of intravenous thiopentone versus 0.2 mg/kg of intravenous etomidate on modified electroconvulsive therapy (MECT) in patients with major depressive disorder. Methods The present study was carried out as a double-blinded randomized study on 40 patients diagnosed with major depressive disorder. The study was approved by the institutional ethics committee, and written informed consent from each patient was obtained before the study. A total of 40 patients were divided into two groups of 20 each by block randomization. Group A patients (n = 20) received IV etomidate 0.2 mg/kg. Group B (n = 20) patients received IV thiopentone 3 mg/kg. After induction and muscle relaxation, electrical stimulus was applied, and the duration of seizure quality was measured using the cuff method. Results All statistical tests were done with IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York, United States). The average seizure duration was 54 seconds in group A (etomidate), and it was 42 seconds in group B (thiopentone). Etomidate showed longer seizure duration compared to thiopentone with a significant p-value of 0.001 using an independent-samples T-test. Conclusion Etomidate, as an induction agent for patients with major depressive disorder, showed good seizure quality compared to thiopentone.

PMID:41384213 | PMC:PMC12689468 | DOI:10.7759/cureus.96428

Cureus. 2025 Nov 10;17(11):e96492. doi: 10.7759/cureus.96492. eCollection 2025 Nov.

ABSTRACT

This systematic review and meta-analysis aim to synthesize the current evidence from randomized clinical trials (RCTs) comparing the anesthetic success of mental/incisive nerve block (MINB) versus inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis affecting mandibular premolars. A thorough literature search was performed using databases such as PubMed, Web of Science, Science Direct, Cochrane Database, and Google Scholar. The search covered publications up to June 2025. The focused PICOTT question for this review was: “What is the anesthetic efficacy of mental/incisive nerve block compared to inferior alveolar nerve block in mandibular premolars with symptomatic irreversible pulpitis?”. The included studies were evaluated for quality using the ROB 2 tool for non-randomized designs, while the certainty of the evidence was assessed through the GRADE approach. A meta-analysis was performed using a random-effects model to address potential variability among studies. Three RCTs were included. Overall, the risk of bias was considered low to moderate using the ROB 2 tool. The GRADE assessment indicated that the certainty of evidence was rated as very low. The overall pooled analysis showed no statistically significant difference in success rates between the MINB and IANB techniques (OR = 1.25; 95% CI: 0.74 to 2.12; P = 0.40), with low heterogeneity (I² = 0%). Subgroup analysis by premolar type showed no significant differences between techniques for either first (OR = 1.03; 95% CI: 0.64-1.65; P = 0.90; I² = 0%) or second premolars (OR = 1.23; 95% CI: 0.76-1.98; P = 0.40; I² = 0%). In conclusion, the findings of this systematic review and meta-analysis indicate no clear difference in anesthetic efficacy between MINB and IANB techniques. However, most studies suggest that achieving adequate pulpal anesthesia requires the use of supplemental anesthesia.

PMID:41384210 | PMC:PMC12694680 | DOI:10.7759/cureus.96492

Cureus. 2025 Nov 9;17(11):e96461. doi: 10.7759/cureus.96461. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: The cervical spine comprises vertebrae and intervertebral discs that facilitate neck mobility and protect neurovascular structures. Intervertebral foramina serve as conduits for spinal nerves and vessels and may undergo morphological changes with aging and degeneration, potentially leading to neurological symptoms. The objectives of this study included performing a CT analysis of the morphometry of intervertebral foramina and the height of the intervertebral disc across different levels of the cervical spine, with comparisons based on age, vertebral level, gender, and laterality.

METHODS: This observational study analyzed CT scans of the cervical spine from 104 patients. Vertical height, anteroposterior depth, and cross-sectional area of intervertebral foramina were measured bilaterally at levels C2C3 to C6C7. Intervertebral disc height was also assessed. Participants were categorized into four age groups and by sex. Statistical analyses included one-way ANOVA, paired samples t-test, Pearson correlation coefficient, and one-sample t-test.

RESULTS: Foraminal dimensions, especially vertical height and cross-sectional area, showed a statistically significant decline with increasing age, most prominently at lower cervical levels (C5C6 and C6C7). Intervertebral disc height also decreased significantly with age, particularly at C5C6. Males demonstrated consistently larger foraminal dimensions and disc heights compared to females. Except for C4C5, foraminal dimensions were largely symmetrical between right and left sides. Age-related degenerative changes in the cervical spine predominantly affect the lower cervical levels, leading to a reduction in foraminal size and disc height.

CONCLUSION: The observed morphometric variations, alongside gender differences, underscore the importance of individualized anatomical assessment in the diagnosis and management of cervical spine pathologies.

PMID:41384205 | PMC:PMC12690273 | DOI:10.7759/cureus.96461

J Health Popul Nutr. 2025 Dec 11. doi: 10.1186/s41043-025-01176-8. Online ahead of print.

ABSTRACT

BACKGROUND: Age-, sex-, and country-specific reference values for lipoprotein levels are essential for identifying lipoprotein disorders, such as familial hypercholesterolemia (FH). However, the Thai-specific data are limited. This study aimed to establish age-and sex-specific reference percentiles for lipid and lipoprotein levels in Thai adults.

METHODS: This study analyzed plasma lipid and lipoprotein levels from the 6th National Health Examination Survey (NHES-VI) conducted in Thailand. Data from Thai adults without cardiovascular disease or lipid-lowering medication were examined to determine age- and sex-specific percentiles. Participants were grouped into 5-year age intervals for both sexes to assess trends across the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of lipid measurements. The weighting was applied to account for the complex survey design and ensure representativeness of the national population. The Kruskal-Wallis test was used to examine statistically significant differences in lipid levels between age groups within sex. A P-value < 0.05 was considered significant.

RESULTS: 17,018 participants (7,244 men and 9,774 women) aged ≥ 20 years were included. Both total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels increased with age in both sexes. The highest median LDL-C levels were found in men aged 45-49 (129 mg/dL) and women aged 55-59 (137 mg/dL). The median and 95th percentile values of LDL-C across different age groups were 126 and 194 mg/dL in men, and 131 and 198 mg/dL in women, respectively. High-density lipoprotein cholesterol (HDL-C) levels were higher in women than in men across all age categories, whereas triglyceride levels were higher in men than in women in all age categories below 70 years old. These findings highlight important age-and sex-related differences that may inform clinical cut-offs for lipoprotein disorders in Thailand.

CONCLUSIONS: This study establishes the first comprehensive, population-based reference values for lipids in the Thai adult population. Our data reveal notably high LDL-C levels compared with other populations, suggesting that the current universal diagnostic thresholds for lipid disorders may need re-evaluation in the Thai context. These findings provide a crucial evidence base for updating national clinical guidelines and public health strategies.

PMID:41382310 | DOI:10.1186/s41043-025-01176-8

BMC Psychol. 2025 Dec 11. doi: 10.1186/s40359-025-03697-7. Online ahead of print.

ABSTRACT

AIM: Given the demanding nature of teacher education, understanding how resilience relates to academic success and social adaptation is crucial. The aim of this study was to examine the relationship between resilience and academic achievement and to determine whether this relationship varies based on the personality/mental health profile of future teachers.

METHOD: A total of 793 university students enrolled in teacher training programs participated in this study. Data were collected via validated questionnaires measuring resilience (CD-RISC-25) with 5-factor solution including (1) Positive acceptance of change and secure relationships, (2) Trust in one’s instincts, tolerance of negative affect, and strengthening effects of stress, (3) Personal competence, high standards, and tenacity, (4) Control, and (5) Spiritual influences (entered as explanatory or predictor variables in regression models); academic achievement (AAQ) with (1) Study performance, (2) Coping with study demands and (3) Social adaptation domains (treated as dependent variables); personality traits (TIPI) covering Big Five traits (as input for cluster analysis); and mental health indicators (PHQ-4) including depression and anxiety (as input for cluster analysis). Analyses were associative and exploratory; terms such as ‘predictor’ denote statistical prediction, not causation. First, correlation and regression analyses were conducted to determine the overall association between resilience and academic achievement. Next, these associations were tested in groups with different personality/mental health profiles (based on cluster analysis).

RESULTS: The findings of the whole sample analysis revealed that resilience was significantly associated with coping with study demands and social adaptation, accounting for ~ 21% and 30% of the variance in those outcomes, respectively. In particular, Personal Competence, High Standards, and Tenacity (PCHST) and Positive Acceptance of Change and Secure Relationships (PACSR) were found to show the strongest association. In contrast, resilience did not manifest direct association with academic performance. Subsequent subgroup analysis showed that relationship between resilience and academic achievement remained consistent across different personality or mental health profiles, suggesting relevance across personality/mental-health profiles.

CONCLUSION: The cross-sectional findings indicate that resilience is significantly related to the academic achievement of future teachers, and this relationship is independent of their personality structure and mental health issues. These findings underscore the potential importance of resilience in enhancing coping mechanisms and social integration among future teachers. Teacher training programs may consider incorporating resilience-building strategies to support students in managing academic stress and fostering professional preparedness.

PMID:41382303 | DOI:10.1186/s40359-025-03697-7

BMC Ophthalmol. 2025 Dec 11. doi: 10.1186/s12886-025-04458-1. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the changes in macular vascular density (VD), ganglion cell complex GCC thickness, and Fovea Avascular Zone (FAZ) Area at one and six months after Sub-Scleral Trabeculectomy SST with mitomycin C (MMC) in patients with Primary Open Angle Glaucoma POAG and correlate those changes with reduction of IOP using optical coherence tomography angiography (OCTA).

METHODS: Thirty eyes of 30 patients with POAG who underwent SST with MMC were prospectively evaluated. OCTA (AngioVue, Optovue) was used before surgery and at one and six months after surgery to quantify the vascular density of superficial capillary plexus (SCP-VD), deep capillary plexus (DCP-VD), whole image (WI-VD), fovea (F-VD), Parafovea (PAF-VD), Perifovea (PER-VD), in addition to the GCC thickness, FAZ area (FAZ-A), FAZ perimeter (FAZ-P), and foveal density (FD).

RESULTS: All patients showed a significant reduction in mean IOP at each follow-up from (31.31 ± 4.52) preoperatively to 14.19 ± 2.10 and 13.75 ± 1.27 mmHg at one month and six months postoperative, respectively (p < 0.001). There was a significant improvement in macular deep capillary plexus DCP-VD in all parameter’s values (p < 0.001). The mean whole-image DCP-VD increased from 48.19 ± 2.20% preoperatively to 49.50 ± 2.30% at one month and 53.38 ± 1.78% at six months postoperatively. Similar significant increases were observed in the foveal, parafoveal and perifoveal regions. The FAZ area decreased significantly from 0.398 ± 0.062 mm² preoperatively to 0.357 ± 0.060 mm² at one month and 0.372 ± 0.058 mm² at six months (p = 0.010). The FAZ perimeter also showed a significant reduction from 2.238 ± 0.385 mm preoperatively to 1.889 ± 0.350 mm at one month and 2.075 ± 0.293 mm at six months (p = 0.001). Foveal density increased significantly from 46.88 ± 1.81% preoperatively to 48.52 ± 2.00% at one month and 49.71 ± 2.56% at six months (p < 0.001). Postoperative increases in macular SCP-VD and GCC thickness were minimal and not statistically significant (p > 0.05). A significant negative correlation was found between IOP reduction and DCP-VD at six months (p < 0.05), whereas IOP reduction correlated positively with decreases in FAZ area and perimeter at one month (p = 0.011, p = 0.027) and six months (p = 0.010, p = 0.029).

CONCLUSION: OCTA revealed significant postoperative improvement in deep macular vessel density and FAZ metrics following SST with MMC. These findings highlight the vascular benefits of surgical IOP reduction in restoring macular microcirculation among patients with POAG.

PMID:41382301 | DOI:10.1186/s12886-025-04458-1