Category: Nevin Manimala

Int J Clin Pharm. 2025 Aug 23. doi: 10.1007/s11096-025-01990-4. Online ahead of print.

ABSTRACT

INTRODUCTION: Polypharmacy is a growing public health concern, yet its association with area-level socioeconomic deprivation in England has been under-explored.

AIM: To investigate whether socioeconomic deprivation, measured by the Index of Multiple Deprivation (IMD), is associated with polypharmacy among adults.

METHOD: We analysed cross-sectional data from the 2021 Health Survey for England, including 1705 adults aged 16+ who completed nurse visits and reported prescribed medication use in the past week. Polypharmacy was defined as the use of five or more prescribed medications. IMD scores were categorised into quintiles (least to most deprived). Multivariable logistic regression estimated adjusted odds ratios (ORs) with 95% confidence intervals (CIs), controlling for age, sex, ethnicity, multimorbidity, obesity, smoking, alcohol use, and GP visit frequency. A polynomial contrast test assessed linear trends, and adjusted predicted probabilities were calculated to illustrate the deprivation-polypharmacy gradient.

RESULTS: In the fully adjusted model, adults residing in the most deprived IMD quintile had significantly higher odds of polypharmacy (OR 1.82; 95% CI 1.09-3.04; p = 0.022) compared to those living in the least deprived areas. No statistically significant associations were observed for intermediate quintiles. A polynomial contrast test confirmed a significant linear trend across IMD levels (p = 0.010), indicating that the odds of polypharmacy increased progressively with greater area-level deprivation. This gradient was further illustrated by adjusted predicted probabilities, which rose from 18.3% (95% CI 15.3-21.3%) in the least deprived quintile to 24.6% (95% CI 20.1-29.2%) in the most deprived (p < 0.001).

CONCLUSION: Socioeconomic deprivation is independently associated with polypharmacy, even after adjusting for multimorbidity and other confounders, highlighting persistent health inequalities within England’s healthcare system. Targeted strategies, including regular medication reviews and enhanced access to care in deprived communities, may help mitigate risks and promote equity in prescribing practices.

PMID:40848116 | DOI:10.1007/s11096-025-01990-4

Surg Today. 2025 Aug 23. doi: 10.1007/s00595-025-03122-x. Online ahead of print.

ABSTRACT

PURPOSE: We investigated the surgical outcomes of completion lobectomy after primary segmentectomy for lung malignancies.

METHODS: A review of 1139 patients who underwent pulmonary segmentectomy for lung malignancies, identified 17 (1.5%) who underwent completion lobectomy. We analyzed the clinicopathological outcomes of completion lobectomy in these 17 patients, statistically, and evaluated the degree of surgical difficulty, using logistic regression models.

RESULTS: The primary segmentectomy was performed on the right-side in six patients, centrally in seven, in the upper lobe in nine, and as a complex segmentectomy in ten. Lung cancer was diagnosed in 13 patients. Completion lobectomy required an intrapericardial procedure in five patients, main pulmonary artery (PA) clamping in seven, bronchial plasty in five, and PA-plasty in five. The mean operative time was 219 min, and the mean blood loss was 193 ml. Cut-end recurrence was confirmed in nine (56%) patients, and Grade III or higher morbidity occurred in six patients (38%) with no short-term mortality. Logistic regression analysis revealed that upper lobe completion lobectomy was a significant predictor of surgical difficulty (OR 23.8, 95%CI 1.742-333.3, p = 0.018).

CONCLUSION: Completion lobectomy is technically challenging, especially in the upper lobe, but the oncological and surgical results are acceptable. This procedure is a promising and important strategy for treating secondary lesions in the residual lobe after segmentectomy.

PMID:40848109 | DOI:10.1007/s00595-025-03122-x

Prev Sci. 2025 Aug 23. doi: 10.1007/s11121-025-01836-5. Online ahead of print.

ABSTRACT

Mediating variables serve a primary role in devising intervention theories and applying them to practice. Prevention scientists have repeatedly called for understanding how and why an independent variable (X; e.g., intervention) is related to a dependent variable (Y; e.g., drug use). Quantitative mediation is used to describe mediating variables that intervene in the causal path from X to Y. Most methodological development for mediation analysis has focused on statistical methods and the assumptions necessary for valid application of these statistical methods. The current paper describes how qualitative methods extend into mediation research and the unique strength of qualitative mediation in identifying potential mediators and mechanisms of change not previously hypothesized. Taking examples from prevention research, we outline how qualitative mediation generates unique and complementary information about mediating mechanisms that may only be available through interviews, focus groups, observation, archival analysis, and other qualitative methodology. We briefly describe cautions when using qualitative mediation including reliance of retrospective reports, potential to influence interviewees, and selective sampling. We underline how qualitative mediation analysis is particularly well suited for exploratory studies and extracting mechanisms of action for new or adapted interventions in prevention science.

PMID:40848098 | DOI:10.1007/s11121-025-01836-5

Clin Rheumatol. 2025 Aug 23. doi: 10.1007/s10067-025-07659-7. Online ahead of print.

ABSTRACT

BACKGROUND: IgA vasculitis (IGAV) is the most frequently encountered form of vasculitis in the pediatric population and typically follows a self-limiting course. In addition to well known inflammatory markers, several other inflammatory mediators, including Endocan, endothelial nitric oxide synthase (eNOS), and soluble CD89 (sCD89), have not been extensively investigated in the context of IGAV. The aim of this study was to evaluate the association between Endocan, endothelial nitric oxide synthase (eNOS), and soluble CD89 (sCD89) and established inflammatory markers (CRP, erythrocyte sedimentation rate), as well as their relationship with clinical manifestations and laboratory findings in pediatric patients diagnosed with IGAV.

METHODS: Patients diagnosed with IGAV during the study period (December 2019 to May 2021) were included in the study. These patients were invited for a follow-up visit 3 months after diagnosis. Additionally, 35 healthy children, matched for age and gender and with no known diseases, were included as a control group. At both the time of diagnosis and the 3-month follow-up, blood samples were collected in EDTA tubes in addition to routine hematological and biochemical tests. The samples were centrifuged at 4000 rpm for 10 min and stored at -80 °C. Endocan, sCD89, and eNOS levels were measured using ELISA kits.

RESULTS: The mean sCD89 level in the patient group, both during the acute and remission phases, was significantly lower than in the control group (1.42 ± 0.53 ng/mL and 1.46 ± 0.80 ng/mL vs. 1.83 ± 0.73 ng/mL; p = 0.010 and p = 0.004, respectively). However, there was no statistically significant difference in sCD89 levels between the acute and remission phases within the patient group (p = 0.376). The Endocan level during the remission phase was significantly lower in patients compared to the control group (378.4 ± 238.1 ng/mL vs. 478.9 ± 240.9 ng/mL; p = 0.014). However, no significant difference was found between the control group and the acute phase (p = 0.911). A statistically significant difference in Endocan levels was observed between the acute and remission phases in patients (p = 0.004) (Table 1). The mean eNOS level in the patient group, both during the acute and remission phases, was significantly lower than in the control group (25.29 ± 14.07 U/mL and 30.12 ± 18.10 U/mL vs. 37.71 ± 19.48 U/mL; p = 0.004 and p = 0.031, respectively). However, there was no statistically significant difference in eNOS levels between the acute and remission phases (p = 0.334).

CONCLUSION: The unexpectedly low levels of these vascular mediators may be due to the fact that endothelial damage in IGAV is triggered by immune complex-mediated mechanisms rather than a proinflammatory cytokine-driven process, which may result in reduced or suppressed endocan release. Secondly IGAV is primarily caused by the deposition of IgA1 immune complexes in the vessel walls. This mechanism differs from other systemic vasculitides. Key Points • This study systematically evaluated the levels of Endocan, Endothelial nitric oxide synthase (eNOS), and soluble CD89 (sCD89) in patients with IGAV. • The level of these mediators was lower than the controls unexpectedly. • It may be due to the fact that endothelial damage in IGAV is triggered by immune complex-mediated mechanisms rather than a proinflammatory cytokine-driven process, which may result in reduced or suppressed release of these mediators.

PMID:40848083 | DOI:10.1007/s10067-025-07659-7

Osteoporos Int. 2025 Aug 23. doi: 10.1007/s00198-025-07607-w. Online ahead of print.

ABSTRACT

In the largest meta-analysis of international cohorts to date, a family history of fracture is confirmed as a significant BMD-independent predictor of future fracture risk. Parental and sibling histories of fracture carry the same significance for future fracture, including the impact of family hip fracture on future hip fracture risk.

PURPOSE: We have undertaken a meta-analysis of international prospective cohorts to quantify the relationship between a family history of fracture and future fracture incidence.

METHODS: The analysis dataset comprised 350,542 men and women from 42 cohorts in 29 countries followed for 2.8 million person-years. We investigated the relationship between family history of hip fracture or any fracture and the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture (MOF), and hip fracture alone using an extended Poisson model in each cohort. Models were adjusted for current age, sex, BMD, and follow-up time.

RESULTS: As no difference in influence of family history of fracture was seen between genders, results are presented for men and women combined. A parental history of hip fracture was associated with a higher risk of incident fracture across all fracture outcome categories, with a stronger relationship with future hip fracture (hazard ratios (HR, 95% CI) for hip and MOF 1.37, 1.23-1.52 and 1.19, 1.12-1.27, respectively). Associations were slightly reduced but remained significant when additionally adjusted for BMD and did not vary by baseline offspring age, follow-up time, or parent affected. In a more limited analysis, parental history of any fracture or a sibling history of hip or any fracture showed similar associations to those observed with parental history of hip fracture.

CONCLUSIONS: A family history of fracture is confirmed as a significant BMD-independent predictor of future fracture risk. While parental hip fracture appears the strongest factor for future hip fracture, a family history of other fractures might be appropriate for inclusion in future iterations of the FRAX tool.

PMID:40848065 | DOI:10.1007/s00198-025-07607-w

Br Dent J. 2025 Aug;239(4):266-273. doi: 10.1038/s41415-025-8665-8. Epub 2025 Aug 22.

ABSTRACT

Aim This study aimed to examine the association between all-cause and cardiovascular mortality in patients with rheumatoid arthritis (RA) who have missing teeth.Methods Data were obtained from RA patients aged 18 and older from the National Health and Nutrition Examination Surveys conducted between 1999-2004 and 2011-2014. Participants underwent detailed oral examinations. The relationship between the number of missing teeth and mortality risk was analysed using Cox regression models and restricted cubic splines.Results A cohort of 1,720 patients was followed for up to 187 months, during which 627 deaths occurred, including 191 attributable to cardiovascular causes. In RA patients, each additional missing tooth was associated with a 2% increase in all-cause mortality risk. Patients with 15-28 missing teeth demonstrated hazard ratios (HRs) of 4.05 (95% confidence interval [CI]: 2.94-5.57) for all-cause mortality and 2.47 (95% CI: 1.19-5.14) for cardiovascular mortality, compared to those with no missing teeth. Notably, when the number of missing teeth reached ten or more, the risk of cardiovascular mortality decreased by 14% per additional missing tooth (HR: 0.86 [95% CI: 0.81-0.91]).Conclusions In patients with RA, when the number of missing teeth is <10, cardiovascular mortality risk increased with additional tooth loss, whereas when the number is ≥10, cardiovascular mortality risk decreased with further tooth loss.

PMID:40847160 | DOI:10.1038/s41415-025-8665-8

Sci Rep. 2025 Aug 22;15(1):30957. doi: 10.1038/s41598-025-16653-7.

ABSTRACT

In recent days, due to potential growth of vehicle usage, the researchers have to concentrate on abnormal vehicle identification areas to provide solutions to avoid accidents. Though many vehicle identification works have been done by applying machine and deep learning approaches, still there is some problem with handling repetition frames and identifying the abnormal vehicles among vehicles in a camera. To overcome these challenges, this paper introduces KFEAVI (Key Frame Extraction based Abnormal Vehicle Identification) technique that uses statistical feature extraction technique and constrained angular second moment technique. The statistical feature extraction technique is used to extract the key frames in a statistical way by using beta distribution estimation. This technique handles well for both gradual and abrupt content changes in frames. The constrained angular second moment method is applied to find the vehicles to identify the abnormal vehicles movement. The experimental results are carried out using Car Accident Detection Dataset (CADP). For evaluating performance of KFEAVI, several algorithms are compared with the KFEAVI. The experimental results reveal that the KFEAVI achieved better results in terms of F-score.

PMID:40847125 | DOI:10.1038/s41598-025-16653-7

Surg Radiol Anat. 2025 Aug 22;47(1):190. doi: 10.1007/s00276-025-03701-0.

ABSTRACT

PURPOSE: Despite the increasing use of craniofacial morphometry worldwide, there is a lack of population-specific normative data based on high-resolution 3D skull models for the Turkish population. This study aimed to fill this gap by investigating cephalic, nasal, and orbital indices using precise measurements derived from 3D models, and to evaluate their variations according to sex, age, and laterality.

METHODS: In this retrospective study, multidetector computed tomography (MDCT) data of 240 adults (120 males, 120 females) without any deformity or trauma were used. Cephalic, nasal and orbital indices were calculated using precise anatomical landmarks on high-precision 3D skull models obtained from these data, and comprehensive statistical analyses were performed with SPSS 20.0.

RESULTS: Cranial length, piriform aperture width and orbital width were higher in males than females (p < 0.001). Orbital height was higher in females than in males (p = 0.003). Cephalic and orbital indices were higher in females, whereas nasal index was higher in males (p < 0.001). In terms of anatomical asymmetry, left orbital measurements were higher than the right side in both sexes (p < 0.001). In addition, as age increased, the skull shape shifted towards dolichocephalic type, orbital proportions decreased and nasal aperture widened (p < 0.001).

CONCLUSION: The findings clearly revealed sex-related differences, age-related morphological changes, and significant orbital asymmetry. The obtained data may increase the accuracy of sex estimation in forensic anthropology, support preoperative planning in craniofacial and reconstructive surgeries with region-specific reference measurements, and form the basis for anthropological research by contributing to ethnic and regional morphometric databases.

PMID:40847124 | DOI:10.1007/s00276-025-03701-0

Clinics (Sao Paulo). 2025 Aug 21;80:100731. doi: 10.1016/j.clinsp.2025.100731. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the effects of Bifid Triple Viable (BTV) capsule on inflammatory factors and intestinal barrier function in children with abdominal infection.

METHODS: 100 children with abdominal infections were selected. The control group (50 cases) was given conventional treatment, and the observation group (50 cases) was given BTV capsule treatment on the basis of the control group. The remission of clinical symptoms was compared, and the changes in inflammatory factors, intestinal mucosal barrier function indices, intestinal flora number, and immune function indices were observed, and the occurrence of adverse reactions during treatment was statistically analyzed.

RESULTS: The time of vomiting remission, fever remission, stool recovery, and abdominal pain remission in the observation group was shorter than those in the control group. IL-6, CRP, and TNF-α in the observation group were lower and IFN-γ was higher compared with the control group. DAO, D-lactic acid, LPS, Occludin, and ZO-1 in the observation group were lower than those in the control group. The quantity of bifidobacterium, acidobacteria, and clostridium leptum in the observation group was higher than that in the control group, and the quantity of enteric bacillus and enterococcus was lower. IgA and IgG levels in the observation group were lower than those in the control group after treatment.

CONCLUSION: BTV capsule can reduce the local inflammatory response of abdominal infection and improve the intestinal mucosal barrier function and immune function.

PMID:40845476 | DOI:10.1016/j.clinsp.2025.100731

JMIR Form Res. 2025 Aug 22;9:e70613. doi: 10.2196/70613.

ABSTRACT

This study analyzed all public X (formerly Twitter) posts in Japan in 2023 and identified a substantial number mentioning ikizurasa (pain of living), with notable fluctuations over time. The findings suggest a link between ikizurasa and stress in minority groups, particularly minority ethnic and gender groups.

PMID:40845391 | DOI:10.2196/70613