Nevin Manimala

J Med Internet Res. 2025 May 6;27:e65272. doi: 10.2196/65272.

ABSTRACT

BACKGROUND: Worldwide, 30%-45% of adults have sleep disorders, which are linked to major health issues such as diabetes and cardiovascular disease. Long-term monitoring with traditional in-lab testing is impractical due to high costs. Wearable artificial intelligence (AI)-powered solutions offer accessible, scalable, and continuous monitoring, improving the identification and treatment of sleep problems.

OBJECTIVE: This scoping review aims to provide an overview of AI-powered wearable devices used for sleep disorders, focusing on study characteristics, wearable technology features, and AI methodologies for detection and analysis.

METHODS: Seven electronic databases (MEDLINE, PsycINFO, Embase, IEEE Xplore, ACM Digital Library, Google Scholar, and Scopus) were searched for peer-reviewed literature published before March 2024. Keywords were selected based on 3 domains: sleep disorders, AI, and wearable devices. The primary selection criterion was the inclusion of studies that utilized AI algorithms to detect or predict various sleep disorders using data from wearable devices. Study selection was conducted in 2 steps: first, by reviewing titles and abstracts, followed by full-text screening. Two reviewers independently conducted study selection and data extraction, resolving discrepancies by consensus. The extracted data were synthesized using a narrative approach.

RESULTS: The initial search yielded 615 articles, of which 46 met the eligibility criteria and were included in the final analysis. The majority of studies focused on sleep apnea. Wearable AI was widely deployed for diagnosing and screening disorders; however, none of the studies used it for treatment. Commercial devices were the most commonly used type of wearable technology, appearing in 30 out of 46 (65%) studies. Among these, various brands were utilized rather than a single large, well-known brand; 19 (41%) studies used wrist-worn devices. Respiratory data were used by 25 of 46 (54%) studies as the primary data for model development, followed by heart rate (22/46, 48%) and body movement (17/46, 37%). The most popular algorithm was the convolutional neural network, adopted by 17 of 46 (37%) studies, followed by random forest (14/46, 30%) and support vector machines (12/46, 26%).

CONCLUSIONS: Wearable AI technology offers promising solutions for sleep disorders. These devices can be used for screening and diagnosis; however, research on wearable technology for sleep disorders other than sleep apnea remains limited. To statistically synthesize performance and efficacy results, more reviews are needed. Technology companies should prioritize advancements such as deep learning algorithms and invest in wearable AI for treating sleep disorders, given its potential. Further research is necessary to validate machine learning techniques using clinical data from wearable devices and to develop useful analytics for data collection, monitoring, prediction, classification, and recommendation in the context of sleep disorders.

PMID:40327852 | DOI:10.2196/65272

Plast Reconstr Surg. 2025 May 5. doi: 10.1097/PRS.0000000000012179. Online ahead of print.

ABSTRACT

PURPOSE: Enophthalmos is an undesired outcome of orbital fracture repair (OFR). Risk factors for postoperative enophthalmos remain unclear. We sought to develop and validate a risk calculator for more accurate prediction of this outcome.

METHODS: We retrospectively reviewed adult trauma patients who underwent OFR at two trauma centers over 8 years. Patients with postoperative follow-up <2 weeks were excluded. Our primary outcome was incidence of postoperative enophthalmos at ≥2 weeks following OFR. The C-statistic (area under the ROC curve) and Hosmer-Lemeshow tests were used to assess the accuracy of the risk model.

RESULTS: Of 501 patients with OFR, 349 were included. Twenty-seven (7.7%) patients had postoperative enophthalmos. The risk model was developed and partially validated using patient data from 2015 to 2019 (n=253), and fully validated from 2020 to 2022 (n=96). Risk factors for postoperative enophthalmos were: older age, preoperative enophthalmos, medial wall involvement, near-total orbital floor defects, and delayed surgical repair beyond 1 month from injury. There was an incremental increase in the odds of postoperative enophthalmos with longer duration from injury to surgery. Our risk model showed very good discrimination (C-statistic=84.5%) and calibration (P=0.83). It was highly accurate in predicting enophthalmos using the validation dataset (C-statistic=0.89). For a risk cut-off of 9.5%, the sensitivity and negative predictive value were 85% and 99%, respectively.

CONCLUSION: We designed the first validated risk calculator that can be used to rule out enophthalmos following OFR. Our risk calculator enables surgeons to preoperatively predict the absence of postoperative enophthalmos in 99% of cases.

PMID:40327821 | DOI:10.1097/PRS.0000000000012179

Plast Reconstr Surg. 2025 May 5. doi: 10.1097/PRS.0000000000012178. Online ahead of print.

ABSTRACT

BACKGROUND: In Kienböck disease with carpal collapse, salvage procedures such as scaphocapitate fusion (SCF) and proximal row carpectomy (PRC) are mainstays of surgical treatment. This study analyzes objective (relative grip and range of motion) and patient-reported outcomes after SCF or PRC in laborers versus non-laborers.

METHODS: A retrospective cohort study of patients who underwent surgery for Kienböck disease within a single health system from 1976 to 2023 was conducted. Postoperative DASH and PRWE scores were surveyed from the available population. Labor status, grip, range of motion, and return to the operating room were collected in the medical record and radiographs were analyzed. Categorical comparisons were performed using Fisher’s exact test or Chi-square testing as deemed appropriate by count. Analysis of variance (ANOVA) was used for comparisons of continuous variables. An alpha of 0.05 was used for all statistical tests. Pairwise student t-testing was performed within groups for comparisons of continuous variables. Statistical analysis was performed in R (version 4.4.1) with an alpha of 0.05.

RESULTS: Sixty-four patients underwent PRC and 78 underwent SCF. Patients with PRC were significantly older than patients with SCF. Mean follow up was 29 (SD=53) months. There was no significant difference in post-operative range of motion or relative grip strength between the cohort groups. Laborers who underwent SCF demonstrated the least disability on DASH scores. There was no significant difference in postoperative DASH scores in PRC when comparing laborers versus non-laborers. In contrast, the DASH and PRWE scores of patients who underwent SCF postoperatively varied between laborers and non-laborers [mean (SD) 11.1 (13.9) vs. 30.5 (24.8) p=0.005 and 17.5 (19.4) vs. 42.3 (31.4) p=0.024]. Patients who underwent SCF had a greater rate of revision surgery compared to PRC (22/78 vs. 6/64, p=0.026). Wrist fusion rates were 19% for SCF compared to 1.6% for PRC (0.0007).

CONCLUSIONS: SCF and PRC demonstrated no difference in postoperative range of motion and grip based on labor status. Laborers with SCF had the least post-operative disability on DASH; however, SCF was associated with the need for additional surgical intervention and conversion to total wrist arthrodesis, likely due to the development of radiocarpal arthritis. Shared decision making remains paramount in discussion of the surgical treatment of Kienböck disease associated with carpal collapse.

PMID:40327820 | DOI:10.1097/PRS.0000000000012178

Plast Reconstr Surg. 2025 May 5. doi: 10.1097/PRS.0000000000012175. Online ahead of print.

ABSTRACT

BACKGROUND: Preoperative anemia is a significant concern in plastic surgery, particularly in procedures such as lipoabdominoplasty, where intraoperative blood loss can impact postoperative recovery. While oral iron supplementation is a common approach, its limited bioavailability and gastrointestinal intolerance often hinder effective anemia management.This study compares the efficacy of ferric carboxymaltose (Ferinject®) versus liposomal iron (Sideral Forte®) in optimizing preoperative iron levels and preventing postoperative anemia in patients undergoing 360° lipoabdominoplasty.

METHODS: A retrospective analysis was conducted on 44 female patients undergoing lipoabdominoplasty. Patients were divided into two groups:-Group A received oral liposomal iron (14 mg, twice daily) for one month preoperatively.-Group B received a single intravenous dose of ferric carboxymaltose (1000 mg) 72 hours before surgery.Hemoglobin, hematocrit, and ferritin levels were assessed preoperatively, on postoperative day 1, and on day 7. Statistical comparisons were performed using independent T-tests and Pearson correlation analysis.

RESULTS: Preoperative hemoglobin and hematocrit levels were comparable between groups. However, postoperative hemoglobin decline was significantly more pronounced in Group A (p < 0.05), while Group B showed a better preservation of iron stores and faster hematologic recovery. Ferritin levels remained significantly higher in Group B throughout the postoperative period (p < 0.05). No patients required blood transfusions or exhibited symptoms of acute anemia.

CONCLUSION: Intravenous ferric carboxymaltose is a superior strategy for preoperative iron optimization in lipoabdominoplasty, ensuring better perioperative stability, faster recovery, and reduced anemia-related complications compared to oral liposomal iron. Integrating this approach into perioperative protocols could enhance surgical outcomes.

PMID:40327819 | DOI:10.1097/PRS.0000000000012175

SICOT J. 2025;11:27. doi: 10.1051/sicotj/2025015. Epub 2025 May 4.

ABSTRACT

BACKGROUND: Pedicle screw fixation in the thoracolumbar spine has become more widely accepted with advancements in instrumentation and clinical efficacy have been made. The optimal way to interpret pedicle screw cortical breaches had the subject of a great deal of research. None of the previous classifications and grading systems include full neurological deficits that may result from screw misplacement and do not provide clear guidance for the management of screw violations, which is crucially needed in the literature.

OBJECTIVES: Our study aimed to evaluate the reliability and validity of the use of a new scoring system (the Meshtawy Pedicular Screw Malposition – MPSM) for evaluating pedicle screw misplacement by a detailed clinical-radiographic comprehensive scoring system (MPSM) with sharp guidance for treating injurious violations by assessing the correlation between the neurological data of patients and computed tomography (CT) findings.

PATIENTS AND METHODS: This prospective case series included 100 patients (508 pedicular screws) who underwent transpedicular fixation at Orthopedic department Al-Azhar University Hospital, Assiut branch, Egypt 255 (50.2%) screws were inserted on the right side, while 253 (49.8%) were inserted on the left side. Intra-observer reliability was examined by calculating Cronbach’s alpha intraclass correlation coefficient, which compares three measurements obtained by each observer at different time points. Inter-observer reliability was also examined by calculating Cronbach’s alpha intraclass correlation coefficient and comparing the average measurements obtained by each observer.

RESULTS: The MPSM demonstrated excellent (100%) intra-observer reliability for each observer regarding the violation score and total MPSM score. A strong positive and statistically significant correlation (Pearson test, P < 0.05) was found between severe neurological deficits and a greater degree of screw-pedicle violation.

CONCLUSION: MPSM scoring is a valid and reliable system for evaluating pedicular screw violations and their possible neurological consequences in the thoracic and lumbosacral spine from D7 to S1. Moreover, grades obtained from the MPSM score are helpful for making clear decisions for management.

PMID:40327785 | DOI:10.1051/sicotj/2025015

Am J Hypertens. 2025 May 6:hpaf078. doi: 10.1093/ajh/hpaf078. Online ahead of print.

ABSTRACT

BACKGROUND: High dietary sodium intake is associated with cardiovascular disease. We investigated the influence of sodium intake on the plasma proteome.

METHODS: Prospectively recruited normotensive participants underwent 2 controlled dietary sodium interventions to evaluate hormonal and proteomic (1,512 proteins) changes: sodium-restriction resembling ancestral hunter-gatherer intake (~10 mEq/day, ~230mg/day) and sodium-loading resembling modern industrialized intake (~200 mEq/day, ~4600mg/day). 24h urine collections were obtained after each diet. Plasma proteomic changes were assessed with correction for false-discovery.

RESULTS: Participants achieved a 24h urinary sodium excretion of 16 mEq/L when sodium-restricted and 249 mEq/L when sodium-loaded. 38 proteins displayed statistically significant changes with 15 additional proteins exhibiting notable trends that did not reach statistical significance. The most apparent changes were increases in proteins related to fibrosis and the extracellular matrix (ECM) when sodium loaded, whereas sodium restriction increased proteins related to immune/inflammatory pathways and the renin-angiotensin system (RAS)-kallikrein-kinin system (KKS)-complement pathway. NT-proBNP, FUMH (fumarate hydratase), LKHA4 (leukotriene A(4) hydrolase), COFA1 (collagen alpha-1(V) chain), COF2 (cofilin-2), BMP-4, and TGF-β RIII had the greatest increases when sodium-loaded, whereas renin, thrombin, apo A-1 (apolipoprotein A-1), FABPA (fatty-acid binding protein), and LEAP-1 (hepcidin) had the greatest increases when sodium-restricted.

CONCLUSION: When compared to a sodium-restricted diet resembling ancestral intake, the modern industrialized dietary sodium intake increased proteins related to fibrosis and the ECM, and decreased proteins related to the RAS, KKS, immunity and inflammation. These findings in normotensive people provide an atlas of proteomic changes, and biological pathways, that may contribute to hypertension and other sodium-related disorders.

PMID:40327765 | DOI:10.1093/ajh/hpaf078

J Nurs Res. 2025 May 6. doi: 10.1097/jnr.0000000000000675. Online ahead of print.

ABSTRACT

BACKGROUND: Vincristine-induced peripheral neuropathy (VIPN), a common side effect of chemotherapy in survivors of non-Hodgkin’s lymphoma (NHL), experience symptoms that may significantly impact quality of life (QoL). The age-related effects on NHL survivors with/without VIPN remain unclear.

PURPOSE: This study was designed to determine the variation in and severity of symptom manifestations in patients in two age groups as well as the effect of age on functional status and QoL.

METHODS: This cross-sectional study was conducted on 98 NHL survivors in two age groups: the younger group (< 65 years, n = 55) and the older group (≥ 65 years, n = 43). The two assessment tools used were the clinical total neuropathy score and the European Organization for Research and Treatment of Cancer Quality of Life-Core 30. Data analyses were conducted on SPSS (Version 22.0), with the chi-square test used on descriptive statistics and the Fisher’s exact test used on categorical variables. The Kruskal-Wallis test was used to compare differences attributable to age, VIPN status, functional status, and QoL.

RESULTS: In the older group, VIPN had a higher severity score compared to the younger group (p = .022), particularly in terms of muscle strength (30.2% vs. 9.1%, p = .009) and deep tendon reflex (60.5% vs. 25.5%, p = .005). In the younger group, NHL patients with VIPN showed poorer physical function, while those in the older group reported poorer QoL. Furthermore, those with VIPN showed poorer cognitive function compared to those without VIPN.

CONCLUSIONS/IMPLICATION FOR PRACTICE: In terms of older survivors with VIPN, essential measures include early fall prevention education and low-intensity exercise programs to maintain muscle strength and limb coordination and preserve overall QoL. Younger survivors with VIPN require comprehensive support for both physical and emotional challenges, with early understanding and intervention critical. Also, cognitive function impairment should not be neglected in NHL survivors with VIPN symptoms, highlighting the significance of assessing and addressing cognitive health in long-term follow-up plans.

PMID:40327764 | DOI:10.1097/jnr.0000000000000675

Sci Signal. 2025 May 6;18(885):eadt8686. doi: 10.1126/scisignal.adt8686. Epub 2025 May 6.

ABSTRACT

Bacterial serine-threonine kinases (STKs) regulate diverse cellular processes associated with cell growth, virulence, and pathogenicity and are evolutionarily related to the druggable eukaryotic STKs. A deeper understanding of how bacterial STKs differ from their eukaryotic counterparts and how they have evolved to regulate diverse bacterial signaling functions is crucial for advancing the discovery and development of new antibiotic therapies. Here, we classified more than 300,000 bacterial STK sequences from the NCBI RefSeq nonredundant and UniProt protein databases into 35 canonical and seven pseudokinase families on the basis of the patterns of evolutionary constraints in the conserved catalytic domain and flanking regulatory domains. Through statistical comparisons, we identified features distinguishing bacterial STKs from eukaryotic STKs, including an arginine residue in a regulatory helix (C helix) that dynamically couples the ATP- and substrate-binding lobes of the kinase domain. Biochemical and peptide library screens demonstrated that evolutionarily constrained residues contributed to substrate specificity and kinase activation in the Mycobacterium tuberculosis kinase PknB. Together, these findings open previously unidentified avenues for investigating bacterial STK functions in cellular signaling and for developing selective bacterial STK inhibitors.

PMID:40327749 | DOI:10.1126/scisignal.adt8686

J Surg Orthop Adv. 2025 Summer;34(1):46-49.

ABSTRACT

Patellar crepitus and patellar clunk syndrome are potential complications seen in patients undergoing total knee arthroplasty (TKA). The etiology of this phenomenon is incompletely understood. A retrospective chart review was performed to identify a consecutive series of patients who underwent primary TKA with either a traditional posterior-stabilized implant (group 1, 728 TKAs) or a cruciate substituting implant (group 2, 393 TKAs). All surgical procedures were performed by a single surgeon at the same institution using the same surgical technique, including selective patellar resurfacing and release of the posterior cruciate ligament. The incidence of patellar clunk requiring arthroscopic debridement was recorded. Statistical analysis was performed. The incidence of patellar clunk requiring arthroscopic debridement was significantly higher in group 1 versus group 2 (6.6% vs. 0% respectively, p < 0.001) with standardization of surgeon and technique factors, suggesting implant design is a critical variable in the development of this complication. (Journal of Surgical Orthopaedic Advances 34(1):046-049, 2025).

PMID:40327739

J Surg Orthop Adv. 2025 Summer;34(1):41-45.

ABSTRACT

The rates and risk factors of postoperative hyponatremia and acute kidney injury (AKI) were examined in spine surgery patients. A 2-year retrospective review of 348 patients was performed. Patients were instructed to take their routine nonsteroidal anti-inflammatory drugs and antihypertensive medications the morning of surgery. Postoperative hyponatremia and AKI were studied. Statistical analysis included bivariate and multivariable logistic regression analysis with odds ratio and quantile regression model. Thirty-eight percent of patients (133/348) had postoperative hyponatremia (serum sodium < 135 mEq/L). Seven percent (24/348) had AKI (0.3 mg/dL or > 50% increase in baseline serum creatinine). On the multivariable logistic regression model, two factors remained significant for hyponatremia: preoperative sodium level and operative time. Body mass index and use of preoperative angiotensin blocking medications were significant for AKI. Patients with hyponatremia and AKI demonstrated a longer length of hospital stay. In conclusion, postoperative hyponatremia (38%) and AKI (7%) are common following spine surgery. (Journal of Surgical Orthopaedic Advances 34(1):041-045, 2025).

PMID:40327738