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Nevin Manimala Statistics

Development and Validation of a Clinical Model (SHACEA) for Post-stroke Cognitive Impairment Prognosis Occurred at Acute Phase and Last to 6 Months

Mol Neurobiol. 2025 Feb 26. doi: 10.1007/s12035-025-04783-y. Online ahead of print.

ABSTRACT

Post-stroke cognitive impairment (PSCI) leads to poor long-term stroke outcomes, severely increasing social and economic burdens. It is helpful to identify and intervene in PSCI in the early stage. This study intends to develop a new clinical risk score for identifying stroke survivors at significant risk of PSCI from the acute phase to 6 months of onset and to validate the new score using both internal and external cohorts. Analysis aiming to evaluate prognostic factors of acute-phase cognitive impairment lasting 6 months was carried out using two independent datasets, with one for model development and the other for validation. All enrolled patients completed baseline demographic, clinical, and imaging data collection and cognitive function scale assessment. The follow-up period was 6 months after the stroke, and interviews and cognitive function assessments were completed. A multivariate logistic regression analysis was performed, and the most important predictors were finally screened for modeling a prediction model. Six months post-stroke, 39.19% maintained PSCI in the development dataset. The final nine-point SHACEA (Stenosis, Hyperintensity, Age, Chronic cortical infarcts, Education, Atrophy) had an AUROC of 0.87 (95% CI 0.69-0.92) and was overall predictive of PSCI (LR χ2 statistic of 89.34; p < 0.001). In the validation cohort, the SHACEA risk score was still relatively reliable in the validation cohort with an AUC of 0.74 (95% CI 0.71-0.80). The SHACEA risk score adequately identified acute stroke patients with cognitive impairment who are at an increased risk of developing PSCI after 6 months.

PMID:40009260 | DOI:10.1007/s12035-025-04783-y

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Nevin Manimala Statistics

Comparing maximum and average numerical rating scale pain scores in hidradenitis suppurativa

Arch Dermatol Res. 2025 Feb 26;317(1):496. doi: 10.1007/s00403-025-03943-3.

ABSTRACT

Pain is the most impactful and burdensome symptom of hidradenitis suppurativa (HS) and profoundly affects patients’ quality of life. There is variation in how trials measure HS pain, with some reporting maximum and others reporting average 7-day pain. It remains unknown whether there is a difference between these measures and which is more strongly associated with quality of life in HS. This is a retrospective cross-sectional study of 257 adults with HS who received care in an HS Specialty Clinic from January 2019 to August 2021. Patients self-reported their average pain and maximum pain severity in the past 7 days measured on a numerical rating scale (0-10). The absolute difference between patient-reported average and maximum pain was calculated and assessed for statistical differences using a paired t-test. Multivariable linear regression was used to assess the correlation between the average versus maximum pain score with Skindex-16 quality of life (QoL) score. The maximum pain scores were significantly higher than the average, with a mean absolute difference of 0.83 points (95% CI: 0.74, 0.92) (p < 0.0001). The association between Skindex-16 QoL and average pain was not significantly different from Skindex-16 QoL correlation with maximum pain severity (p = 0.52). This study highlights a small but statistically significant difference in HS patients’ maximum and average 7-day pain severities. Both maximum and average 7-day score correlated with skin-related QoL, suggesting equipoise as outcome measures for clinical HS studies.

PMID:40009252 | DOI:10.1007/s00403-025-03943-3

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Nevin Manimala Statistics

Comparison of cervical versus thoracic spinal cord injury outcomes in pediatric trauma patients

Pediatr Surg Int. 2025 Feb 26;41(1):86. doi: 10.1007/s00383-024-05933-4.

ABSTRACT

PURPOSE: To explore differences based on level of pediatric spinal cord injury (SCI), we compared cervical and thoracic SCI in pediatric trauma patients (PTPs), hypothesizing higher mortality and length of stay (LOS) for cervical SCI.

METHODS: The 2017-2021 Trauma Quality Improvement Program was queried for all PTPs ≤ 17 years-old with cervical or thoracic SCI. Bivariate analyses compared the two groups. The primary outcome was mortality and secondary outcomes included hospital LOS and injury severity scores (ISS). Logistic regression models were used to determine independent risk factors for death and prolonged ventilation.

RESULTS: Of 5280 PTPs, 2538 (65.9%) had cervical SCI and 1316 (34.1%) had thoracic SCI. Motor vehicle collisions were the most common cause of both cervical and thoracic SCI (37.8 and 41.9%). PTPs with thoracic SCI had higher rates of positive drug screen as compared to cervical SCI (39.2 vs 29.8%, p = 0.001). PTPs with thoracic SCI had higher median ISS (25 vs 16, p < 0.001), while cervical SCI had higher mortality (13 vs 6.1%, p < 0.001) but decreased hospital LOS (median 9 vs 5 days, p < 0.001. Cervical SCI were associated with a nearly fourfold increase in the risk of death (95% CI 2.750-5.799, p < 0.001) and a 1.6-fold increase in the risk of prolonged ventilator requirement (95% CI 1.228-2.068, p < 0.001).

CONCLUSIONS: PTPs with cervical SCI have higher mortality while those with thoracic SCI have higher ISS and hospital LOS. Cervical SCI were associated with a fourfold higher risk of death. MVC was the most common cause of injury, and both groups had high rates of positive drug screens. Understanding differing outcomes may assist providers with prognostication and injury prevention.

PMID:40009251 | DOI:10.1007/s00383-024-05933-4

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Nevin Manimala Statistics

Behavioral evidence suggests the presence of a female-emitted sex pheromone in the water mite species, Arrenurus globator (O. F. Muller, 1776) (Acari: Hydrachnida; Arrenuridae)

Exp Appl Acarol. 2025 Feb 26;94(3):40. doi: 10.1007/s10493-025-01009-7.

ABSTRACT

Species from various animal taxa have been found to use pheromonal communication underwater. Although the use of pheromones in water mites has been previously suggested, experimental evidence for it remains sparse. We examined the behavioral responses of male and female Arrenurus globator to water in which conspecifics of the same and the opposite sex had been kept, in order to test the hypothesis that chemical communication occurs between sexes. Results suggest a putative female-produced sex pheromone that stimulates at least the initial steps of mating behavior in males. Males exhibited arrestant behavior, leg fanning and readiness posture more in female-conditioned water than in male-conditioned or control water. In contrast, females showed no response to either male-conditioned water or female-conditioned water.

PMID:40009247 | DOI:10.1007/s10493-025-01009-7

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Nevin Manimala Statistics

Reexamine the link between retinal layer thickness and cognitive function after correction of axial length: the Beijing Eye Study 2011

Graefes Arch Clin Exp Ophthalmol. 2025 Feb 26. doi: 10.1007/s00417-025-06777-x. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the relationship between retinal layer thickness and cognitive function in elderly Chinese, accounting for the influence of axial length.

METHODS: The participants of the Beijing Eye Study 2011 which is a population-based cross-sectional study without any retinal or optic nerve disease underwent a series of ocular examinations including spectral-domain optical coherence tomography (OCT) of the retina. Using a multiple-surface OCT segmentation algorithm, the retina was automatically segmented into 9 layers. Cognitive function was evaluated applying the Mini Mental Statement Examination (MMSE). Cognitive impairment was defined as an MMSE score < 26.

RESULTS: The study included 2067 participants (56.7% women) (2067 eyes) with a mean age of 61.4 ± 8.4 years. After adjusting for age, gender and axial length, a lower cognitive function was related with a thinning of the ganglion cell layer (GCL) (P = 0.029, B = 0.04) and photoreceptor outer segment layer (POS) (P = 0.042, B = 0.04), while the retinal nerve fiber layer (RNFL) thickness (P = 0.144) was not significantly associated with the cognitive function score. For every unit decrease in MMSE score, the GCL and POS thickness separately decreased by 0.06 µm (95%CI: 0.01 µm, 0.12 µm), and 0.05 µm (95%CI: 0.002 µm, 0.10 µm). As compared with cognitively normal participants, those with cognitive impairment had a significantly thinner GCL (P = 0.019, OR = 1.04), and POS (P = 0.022, OR = 1.04) in multivariate logistic regression.

CONCLUSION: After adding axial length as dependence in multivariate analysis, cognitive impairment was not significantly associated with the thickness of RNFL, while the association between a lower cognitive function score and thinner GCL and POS was statistically associated in current study.

PMID:40009225 | DOI:10.1007/s00417-025-06777-x

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Nevin Manimala Statistics

Exploring the multifaceted side effects of isotretinoin: a deep dive into case reports and observational studies

Arch Dermatol Res. 2025 Feb 26;317(1):499. doi: 10.1007/s00403-025-04019-y.

ABSTRACT

This review addresses gaps in understanding isotretinoin’s side effects for acne vulgaris. While effective, the risks are often underestimated. It emphasizes careful patient selection and monitoring to optimize outcomes and minimize harm. By providing a comprehensive evaluation, the review aims to enhance patient safety and inform clinical decision-making. This review examined isotretinoin’s side effects through case reports and observational studies. A literature search on Google Scholar, PubMed, Scopus, and Web of Science covered publications from 2000 to 2024 using terms like “isotretinoin” and “side effects,” focusing on English-language studies. Inclusion criteria targeted studies detailing adverse effects across dermatological, musculoskeletal, psychiatric, ocular, gastrointestinal, endocrine, and renal areas. Data included population size, dosage, treatment duration, and side effects. No statistical analysis was performed. This review underscores a wide array of side effects associated with isotretinoin, ranging from common issues such as dry skin and cheilitis to more serious conditions including psychiatric disorders, musculoskeletal complications, and autoimmune diseases. Notably, rare side effects like psychosis and rhabdomyolysis have also been observed. The review emphasizes the necessity for meticulous patient selection, thorough risk assessment, and vigilant monitoring, especially for at-risk populations such as women of reproductive age. This review emphasizes the need for personalized evaluations and monitoring during isotretinoin treatment, particularly for high-risk groups like women of reproductive age. Healthcare providers must consider the risk-benefit ratio due to potential side effects. Regular check-ups and proactive management are crucial to optimize outcomes and minimize risks.

PMID:40009222 | DOI:10.1007/s00403-025-04019-y

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Nevin Manimala Statistics

Dynamics of an epidemic model arising in a spatial segregation control strategy

J Math Biol. 2025 Feb 26;90(4):34. doi: 10.1007/s00285-025-02195-z.

ABSTRACT

In this paper, we propose a free boundary problem to model the spread of an epidemic by introducing a spatial segregation control strategy. The model consists of two coupled reaction-diffusion equations along with an ordinary differential equation, while the free boundary is described by an integro-differential equation. The results reveal a trichotomy in which the epidemic can shrink, reach equilibrium, or expand spatially. Moreover, we establish the final size of the cumulative number of infected populations and characterize the threshold phenomenon of epidemic outbreak using the principal eigenvalue of an elliptic operator. Additionally, we apply this model to simulate the spatial spread of the COVID-19 epidemic in Xi’an, China, during 2021-2022. This study provides valuable model references for dynamically designing spatial isolation control strategies for newly emerging major infectious diseases.

PMID:40009217 | DOI:10.1007/s00285-025-02195-z

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Nevin Manimala Statistics

From Expert to Facilitator: Unveiling the Teaching Styles of Singapore’s Medical Practitioners

Clin Teach. 2025 Apr;22(2):e70056. doi: 10.1111/tct.70056.

ABSTRACT

BACKGROUND: A teaching style is the approach a teacher uses in choosing instructional methods. Grasha’s model categorises them as ‘expert’, ‘formal authority’, ‘personal model’, ‘facilitator’ and ‘delegator’. The teaching styles of doctors in Singapore have yet to be studied. In the author’s department, teaching is often didactic. This study aimed to explore senior doctors’ preferred teaching styles and whether these styles explained the consistent use of didactic approaches.

METHODS: A web-based survey using Grasha’s Teaching Styles Inventory (TSI) was conducted among senior doctors in the Department of General Medicine at Sengkang General Hospital, Singapore from September 2020 to February 2021. Participants were recruited through convenience sampling. Due to non-normal distribution, TSI scores were analysed using non-parametric tests, while additional demographic data offered insights into factors influencing these preferences.

FINDINGS: Out of 68 senior doctors, 40 responded, showing the strongest preference for ‘facilitator’ teaching style. Female doctors were less likely to adopt ‘expert’, ‘formal authority’ and ‘personal model’ styles than males. Those with formal education training endorsed all teaching styles more than those without, although not all differences were statistically significant. Only 35% of the senior doctors preferred a combination of teaching styles associated with didactic lectures.

CONCLUSION: The study showed a preference for student-centred teaching styles among senior doctors and highlighted a disparity between actual teaching practices and preferred teaching styles. These findings provide valuable information for instructional designers to enhance their faculty development programmes and call for further investigation into the persistence of didactic lectures in medical education.

PMID:40008485 | DOI:10.1111/tct.70056

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Nevin Manimala Statistics

Factors associated with nonparticipation and loss to follow-up in bereavement research using data from a cohort of parents with a loss in pregnancy or the neonatal period

Death Stud. 2025 Feb 26:1-11. doi: 10.1080/07481187.2025.2469138. Online ahead of print.

ABSTRACT

Factors shaping participation in longitudinal cohorts may introduce bias, but there is a lack of research concerning participation patterns in cohorts of bereaved. Our aim was to study this in a longitudinal cohort of parents with a loss in pregnancy or during the neonatal period. Using data from the Danish national registers we identified all parents who experienced a pregnancy or neonatal loss in 2016-2018 and linked that with data on participants from the Life After the Loss cohort. Analyzing 725 parents, baseline participation was 25.7%, with 72.6% and 59.7% continuing at the seven- and 13-month follow-up. Partners and parents with lower education were underrepresented at baseline and at follow-up. Although not statistically significant, substantial underrepresentation of parents with mental health conditions and of parents who lived alone was observed at baseline. Although initial participation was low, after enrollment, most parents engaged in follow-up, minimizing the risk of attrition bias.

PMID:40008484 | DOI:10.1080/07481187.2025.2469138

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Nevin Manimala Statistics

Utilising Digital Ocular Imaging for Paediatric Retinal Haemorrhages

Ir Med J. 2025 Jan 27;118(1):3.

ABSTRACT

AIM: To evaluate the role of paediatric ocular imaging in paediatric ophthalmology through a case series, defining the retinal features observed in various paediatric pathological and trauma-related (abusive or non-abusive) conditions in patients aged four weeks to 16 years in a tertiary paediatric hospital in Dublin, Ireland.

METHODS: A retrospective record-based study was conducted at Children’s Health Ireland (CHI) at Temple Street, analysing ocular images of patients aged four weeks to 16 years, spanning five years, from 2018 to 2022. Following pupillary dilation, retinal examinations were performed using the ‘RetCam 3’, a handheld device for supine examinations in younger children, or the ‘Topcon KR 800’ for older patients. Images were reviewed with haemorrhages categorised by number, size, and location. Demographic and clinical details were tabulated, with counts and percentages calculated for categorical variables. Odds ratios and 95% confidence intervals (CI) were derived using the Mantel-Haenszel method, with statistical significance set at p-value <0.05.

RESULTS: Of the 25 cases that met the age category of four weeks to 16 years, RHs were most common in infants (16 cases). Retinopathy of prematurity (ROP) was identified in nine cases (age range: 2 mo – 19 mo, mean age 7 mo), presumed trauma in five cases (age range: 2 mo – 10 mo, mean age 6 mo), metabolic/genetic conditions in four cases (age range: 8 mo – 8 years), infections in two cases, tumours in two cases, and three cases with no confirmed diagnosis. Most RHs were few, intraretinal, located in the posterior pole and periphery of the eye. RH incidence was significantly higher in ROP and trauma cases (p = 0.027), with an odds ratio of 1.4 (95% CI: 0.08 – 25.14). ROP cases showed small, localised haemorrhages, while cases of presumed trauma had multilayer and large (> 5 disc diameter (DD)) haemorrhages (p = 0.058) that extend to the ora serrata (p = 0.018).

DISCUSSION: The study highlights paediatric ocular imaging’s role in documenting RH patterns, aiding differential diagnosis across paediatric conditions. Paediatric ocular imaging’s detailed capabilities provide clinical insights, reducing the need for multiple exams while promoting standardised documentation. Integrating ocular imaging technology supports establishing national guidelines and training programs that improve accessibility across diverse healthcare settings. Future research should validate these findings through multi-modal approaches and standardised practices, exploring paediatric ocular imaging utility in routine paediatric care. Additionally, advancements in artificial intelligence (AI) can further improve retinal examination efficiency, ultimately enhancing paediatric ophthalmology and child welfare in Ireland.

PMID:40008479