Nevin Manimala

J Orthop Surg Res. 2025 Dec 2;20(1):1056. doi: 10.1186/s13018-025-06457-w.

ABSTRACT

BACKGROUND: Hip resurfacing arthroplasty (HRA) is now only rarely performed, but usually using the posterior approach (POS), while total hip arthroplasty is now commonly performed using the direct anterior approach (DAA). This study aims to compare outcomes between these two approaches for HRA using gait analysis, the oxford hip score (OHS), metabolic equivalent of task (MET).

METHODS: Seventeen unilateral DAA and 17 POS HRA males were matched for age and BMI. Patients underwent instrumented treadmill gait analysis and completed patient reported outcome scores (PROMs) at a mean of 1.5 (0.9-1.8) years post-operatively. Kinematics and kinetics were recorded using motion capture and force plate data. Group differences were assessed using statistical parametric mapping. These data were compared to a group of 19 healthy male controls matched for age and BMI.

RESULTS: Gait analysis postoperatively revealed no significant differences in hip kinematics in either the coronal or sagittal planes between the posterior and direct anterior approaches. Statistical parametric mapping showed no differences in vertical ground reaction forces across the stance phase. Spatiotemporal gait parameters, including top walking speed, cadence, step length, and step width, were comparable between groups and closely aligned with healthy controls. Both cohorts achieved similar postoperative OHS (mean:48, p = 0.651) and MET scores (POS:13.1 vs DAA:12.6, p = 0.856).

CONCLUSIONS: This is the first study to compare gait following HRA via both the POS and DAA. At one-year postoperatively, both approaches restored gait patterns comparable to healthy controls, with no significant differences in kinematics, kinetics, or spatiotemporal parameters. PROMs were similarly excellent across groups indicating high functional recovery and engagement in moderate-to-vigorous physical activity.

PMID:41331665 | DOI:10.1186/s13018-025-06457-w

J Imaging Inform Med. 2025 Dec 2. doi: 10.1007/s10278-025-01755-5. Online ahead of print.

ABSTRACT

The objective of this study was to evaluate the reliability and predictive ability of specific anthropometric mandibular measurements on three-dimensional (3D) reconstructed surfaces of cone-beam computed tomography (CBCT) records for sex determination. The study sample analyzed volumetric data from cone-beam computed tomography (CBCT) records of 204 Greek individuals aged 18-70 years, who sought general dental treatment at the School of Dentistry, National and Kapodistrian University of Athens, Greece. Patient records were screened for eligibility based on predefined inclusion criteria. The sample was distributed by sex and further categorized into four distinct age groups. Volumetric data of 204 patients (equally distributed between sexes) were reprocessed with the ViewBox 4 software, according to inclusion-exclusion criteria. Ten anatomical landmarks visible on three-dimensional CBCT reconstructions were digitally traced using the ViewBox 4 software, including superior points of the right and left condyles, the most proximal points of the inner poles of the right and left condyles, the inferior points of the right and left sigmoid notches, the superior points of the right and left coronoid processes and the right and left Gonion. This cross-sectional study employed a binary logistic regression (BLR) model for statistical analysis. All linear parameters exhibited statistically significant differences between sexes whereas angular measurements did not demonstrate a statistically significant difference. The developed model yielded an accuracy of 83.4% in predicting sex. Specific linear measurements are reliable predictors of sex and may be applied in forensic science as a supplementary method.

PMID:41331657 | DOI:10.1007/s10278-025-01755-5

J Imaging Inform Med. 2025 Dec 2. doi: 10.1007/s10278-025-01756-4. Online ahead of print.

ABSTRACT

Accurate segmentation of upper airway structures such as the velum and OTE (oropharynx, tongue base, epiglottis) in drug-induced sleep endoscopy (DISE) images is crucial for predicting the degree and location of obstruction to determine treatment options for obstructive sleep apnea (OSA). This study systematically compares centralized learning (CL) and federated learning (FL) approaches for the semantic segmentation of these regions using multi-institutional DISE video data. A convolutional neural network (CNN)-based segmentation model was trained and evaluated for both learning paradigms. The results consistently showed that the CL approach achieved statistically significantly higher segmentation performance across all metrics-precision, recall, accuracy, and Dice similarity coefficient (DSC)-for both the velum and OTE regions compared with FL. For the velum region, CL achieved a DSC of 85.91 ± 1.01%, compared with FL’s 81.78 ± 0.58%. Similarly, for the OTE region, CL achieved an average DSC of 87.04 ± 0.41%, whereas FL achieved 85.20 ± 0.25%. Further analysis revealed that while both models struggled with ambiguous boundaries and anatomical variability-particularly for the tongue base-the epiglottis and oropharynx lateral wall were segmented with higher accuracy. These findings underscore the need for advanced techniques in FL, such as improved optimization algorithms and methods to address data heterogeneity, to narrow the performance gap with CL. This study provides foundational insights for developing more robust and clinically applicable deep learning models for upper airway analysis, emphasizing the importance of future research into advanced FL strategies and real-world validation.

PMID:41331654 | DOI:10.1007/s10278-025-01756-4

Addict Sci Clin Pract. 2025 Dec 2;20(1):93. doi: 10.1186/s13722-025-00615-5.

ABSTRACT

BACKGROUND: The utilisation of online evidence-based written educational resources is crucial in addressing problematic alcohol and other drugs (AOD) use through prevention, treatment, and intervention strategies. However, low health literacy among one in five Australian adults raises concerns regarding the effective understanding of health information. This study aims to evaluate the content, suitability, and readability of AOD resources in New South Wales (Australia), recognising the importance of accessible and informative resources in supporting AOD demand reduction strategies.

METHODS: In this research, a comprehensive desktop search was conducted to analyse one to two-page AOD resources readily accessible through the internet in New South Wales, published by government and not-for-profit organisations. The content was thoroughly analysed for its coverage of key AOD topics. The Suitability Assessment of Materials (SAM) instrument evaluated visual and written elements, examining aspects like layout, typography, and illustrations. Readability was assessed using Flesch -Kincaid Grade Level (FKGL), Gunning Fog Index (FOG), Simplified Measure of Gobbledygook (SMOG), and Flesch Reading Ease tools. Descriptive statistics, including frequency, percentage, and standard deviation were calculated.

RESULTS: The study analysed 88 AOD resources. Most resources had a target audience, but only three resources involved consumers in the development process. The content analysis showed 66% focused on drug-related topics, 20% on alcohol-related topics, and 14% covered both. Topics such as alcohol use during pregnancy and breastfeeding were well addressed in alcohol resources. Additionally, 90% of the resources had headings and subheadings. However, only 28% scored ‘superior’ for layout, and none achieved ‘superior’ ratings for typography. Furthermore, 74% did not use illustrations to highlight key messages. Most resources used an active voice and conversational style, but complex sentences were common. The average reading grade level of the resources was 9 ± 2.6 with FOG and Flesch’s reading ease indicating 10th-grade difficulty, while FKGL and SMOG suggested a 7th-grade level.

CONCLUSIONS: The evidence strongly suggests the need for the development of AOD resources that are accessible to individuals with low literacy levels without sacrificing content coverage. A key recommendation is to involve consumers in both developing and reviewing these resources.

PMID:41331651 | DOI:10.1186/s13722-025-00615-5

BMC Health Serv Res. 2025 Dec 2;25(1):1566. doi: 10.1186/s12913-025-13712-7.

ABSTRACT

BACKGROUND: Delivering person-centred care is a core responsibility of community pharmacies. However, no validated Japanese scale currently exists to evaluate community pharmacy services from the perspective of patient experience. This study aimed to translate, culturally adapt, and validate the Perceived Service Quality Scale (pSQS) and its short-form (pSQS-SF6), originally developed to assess patient experiences in community pharmacies, into Japanese (pSQS-J and pSQS-J-SF6).

METHODS: Following the established process, the pSQS-J was translated and culturally adapted from the original English version. The pSQS-J-SF6 was created by selecting one item from each domain. A survey was conducted among pharmacy users in Wakayama City, and descriptive statistics were reported. Confirmatory factor analyses (CFA) were performed to explore psychometric properties.

RESULTS: The pSQS-J was systematically translated and culturally adapted through a rigorous process. An online survey including the 19 pSQS-J items, along with demographic and related characteristics, was completed by 231 participants across nine pharmacies. After minor modifications (i.e., deleting one item and re-specifying another to a different factor), a six-factor correlated CFA model demonstrated acceptable fit and provided evidence of convergent and discriminant validity. A six-factor bifactor model demonstrated improved fit, and inspection of reliability indices reinforced the multidimensionality of the pSQS-J. However, the CFA results for pSQS-J-SF6 indicated insufficient evidence of convergent validity.

CONCLUSION: The pSQS-J is a valid and reliable instrument for evaluating patient experience in Japanese community pharmacies and may facilitate the advancement of person-centred care.

PMID:41331650 | DOI:10.1186/s12913-025-13712-7

BMC Sports Sci Med Rehabil. 2025 Dec 2. doi: 10.1186/s13102-025-01452-4. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Recent investigations into carpal biomechanical and ligamentous properties associated with dynamic scapholunate (SL) instability have contributed to the development of conservative treatment approaches. The aim of this study was to investigate the impact of isolated neuromuscular electrical stimulation (NMES) training of the forearm muscles combined with structured exercise training on weight bearing, muscle strength, proprioceptive sensation and upper limb functionality in individuals diagnosed with SL instability.

METHODS: This randomized, single-blind, controlled study included 30 patients (26 females / 4 males) aged between 18 and 50 years, who had been diagnosed with SL instability. The patients were randomly assigned to one of two groups: the Exercise Group (EG), who received an exercise program alone, and the Neuromuscular Electrical Stimulation Group (NMESG), who received NMES in addition to the same exercise program. The NMES protocol was applied three days a week for eight weeks, with 15 min each for the abductor pollicis longus, flexor carpi radialis, extensor carpi radialis longus, and extensor carpi radialis brevis muscles, for a total of 60 min. Each patient also exercised daily at home throughout the eight-week period. Exercise training was prescribed seven days per week. On clinic days, one supervised session was completed in the clinic, followed by two additional unsupervised home-based sessions later the same day. On non-clinic days, patients performed three unsupervised home sessions each day. The primary outcome measure was upper extremity disability, assessed using the QuickDASH questionnaire. The secondary outcome measures included activity-related pain (assessed using the Visual Analog Scale during activity (VAS-a)), wrist range of motion (ROM), the weight-bearing tolerance test (WBT), isokinetic muscle performance, grip strength, and proprioceptive sense. Pain was evaluated five times in total: at baseline and every two weeks thereafter. All the other assessments were performed twice: at baseline and at the end of the 8th week.

RESULTS: Significant improvements from before to after the intervention were observed in all parameters in both groups (p < 0.001). Statistically significant improvements were observed in the NMESG compared to the EG in terms of QuickDASH scores, VAS-a, WBT, and endurance in flexion (p < 0.005). Decreases in pain levels during activity were more pronounced in the NMESG from baseline to the 2nd, 4th, and 8th weeks of follow-up (p < 0.05).

CONCLUSION: The study results demonstrated that the application of NMES to target muscle groups together with stability-enhancing exercise strategies supports functional recovery. These findings are instructive in determining the ideal rehabilitation strategies for NMES applications as a conservative treatment for SL instability.

TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov under ClinicalTrials registration number NCT06627296 on 01/10/2024.

PMID:41331647 | DOI:10.1186/s13102-025-01452-4

BMC Public Health. 2025 Dec 2. doi: 10.1186/s12889-025-25789-0. Online ahead of print.

ABSTRACT

BACKGROUND: Sexual function is an integral component of overall well-being and is influenced by both biological and psychosocial factors. While psychological distress is known to affect health outcomes broadly, its specific impact on sexual function among adults attending primary health care services has not been well established. This study aims to examine the relationships between sexual functioning and depression, perceived stress, and sociodemographic variables among adults aged 18-45 who attend primary healthcare services, and to determine whether these psychological variables significantly predict sexual functioning.

METHODS: A descriptive cross-sectional study was conducted between January and March 2025 in five randomly selected family health centres located in Türkiye. The study was completed with a total of 573 participants. Data were collected using the Beck Depression Inventory (BDI) to assess levels of depression, the Perceived Stress Scale-10 (PSS-10) to measure perceived stress, and the Arizona Sexual Experiences Scale (ASEX) to evaluate sexual functioning. Statistical analyses included independent samples t-tests, one-way analysis of variance, correlation analyses, and multiple regression analyses to explore relationships between psychological factors and sexual health outcomes.

RESULTS: Analysis of ASEX scores by sociodemographic characteristics revealed significant differences among both male and female participants (p < 0.01). Correlation analyses showed no significant relationship between ASEX and BDI or PSS-10 scores in men, whereas significant positive correlations were found in women. Regression analyses indicated that BDI and PSS-10 explained only 0.3% of the variance in ASEX scores in men (adjusted R² = 0.003; p = 0.09), while their explanatory power was higher in women (adjusted R² = 0.114; p < 0.01).

CONCLUSIONS: The results indicate that the psychological variables assessed (depression and perceived stress) predict sexual functioning to a greater extent in women than in men. These findings highlight the importance of considering psychological factors such as depression and stress in the assessment of sexual functioning, particularly among female patients, and underscore the value of integrating such considerations into primary care services. Psychological assessments using tools like the BDI and PSS-10 may contribute to a better understanding of risk factors related to sexual functioning and support more holistic approaches within primary care settings.

PMID:41331634 | DOI:10.1186/s12889-025-25789-0

J Orthop Surg Res. 2025 Dec 2. doi: 10.1186/s13018-025-06533-1. Online ahead of print.

ABSTRACT

BACKGROUND: Calcaneal fractures are the most common tarsal fractures and often result in long-term disability. Although various treatment options exist, but the relationship between Essex-Lopresti subtypes, treatment methods, and dynamic functional recovery remains unclear.

METHODS: This retrospective study included 66 patients with intra-articular calcaneal fractures, treated between 2011 and 2021. Fractures were categorized according to the Essex-Lopresti classification (1 A-1 C, 2 A-2 C) and managed by conservative treatment, Steinmann pin fixation, or plate fixation. Functional outcomes were assessed, using the American Orthopaedic Foot and Ankle Society (AOFAS) score, radiographic parameters (Böhler and Gissane angles), and pedographic gait analysis with the Win-Track platform. Statistical analysis was performed using Kruskal-Wallis tests with Dunn-Bonferroni post-hoc analyses, Mann-Whitney U or independent-samples t-tests as appropriate, chi-square (or Fisher’s exact) tests for categorical variables, and Spearman’s rho for correlation.

RESULTS: Functional outcomes varied across subtypes and treatment methods. Across subtypes, the distribution of AOFAS categories did not differ significantly (χ², p = 0.587). Type 2 A fractures treated with Steinmann pin fixation demonstrated the highest AOFAS scores (80.4 ± 10.2; p = 0.587). Böhler’s angle was numerically higher in the conservative group (17.0 ± 11.4°) but did not correlate with AOFAS scores (ρ = 0.01, p = 0.94). Pedographic analysis showed that maximum plantar pressure was highest in the conservative group (1625 ± 142 kPa) and lowest in the plate fixation group (1437 ± 188 kPa; overall p = 0.033). Gait asymmetries-particularly prolonged swing and stride duration tended to be greater in the Type 2B and 2 C subgroups, although statistical significance was limited ((p = 0.195-0.795)).

CONCLUSION: Essex-Lopresti subtypes strongly influence clinical and gait outcomes following calcaneal fractures. Steinmann pin fixation is advantageous in Type 2 A fractures, while Type 2B fractures consistently show poor recovery. Radiographic angles alone are insufficient predictors of long-term outcomes, emphasizing the importance of integrating gait analysis with clinical scoring. Subtype-specific approaches may optimize treatment strategies and patient care.

IRB NUMBER: Ethics Committee of Fırat University (2022/04-04).

PMID:41331633 | DOI:10.1186/s13018-025-06533-1

Malar J. 2025 Dec 2. doi: 10.1186/s12936-025-05706-x. Online ahead of print.

ABSTRACT

BACKGROUND: Reports from East and Horn of Africa showed artemisinin resistance is threatening control efforts. The Pfkelch13 (k13) gene mutation in Plasmodium falciparum is essential for tracking artemisinin resistance, which significantly jeopardizes malaria treatment effectiveness. The objective of this study was to assess the occurrence and prevalence of k13 gene polymorphisms at selected public health facilities of Arbaminch and Mirab Abaya, Ethiopia.

METHODS: A cross-sectional study was conducted in Arbaminch and Mirab Abaya from May to December 2023. A total of 52 P. falciparum mono-infection samples confirmed by PCR were analysed. Sanger sequencing was used to obtain the sequences of k13 gene propeller domain, and phylogenetic analysis was performed using Molecular Evolutionary Genetic Analysis software version 11. Gene flow and differentiation were analysed with DnaSP6, while sequences from six other African countries were included from global database for haplotype network analysis using PopART 1.7.

RESULTS: Among the 52 participants, 28 (52.8%) were male and 24 (47.2%) were female. The median age was 19 years old with an interquartile range of 15 to 32 years. There was no polymorphism identified in the studied samples indicating high genetic conservation (pairwise similarity index = 0.982). Isolates from Mirab Abaya exhibited strong genetic homogeneity, while Arbaminch samples showed slight divergence and yet remained largely conserved. Ethiopian haplotypes contributed significantly to a dominant African haplotype, with no k13 mutations detected. Although mild genetic diversity was observed in some African countries, haplotype and nucleotide diversity were not statistically significant. A negative Fu and Li’s D statistic was observed, suggesting that low-frequency mutations could be due to selective sweep in the parasite population.

CONCLUSION: This study found no evidence of P. falciparum k13 gene mutations in isolates from Arbaminch and Mirab Abaya, indicating a high level of genetic conservation. Although minor genetic divergence was observed, particularly among Arbaminch isolates, the overall population remained genetically homogeneous. These findings highlight the continued effectiveness of artemisinin-based combination therapy in the region and emphasize the need for ongoing molecular surveillance to monitor potential resistance emergence.

PMID:41331631 | DOI:10.1186/s12936-025-05706-x

Ann Clin Microbiol Antimicrob. 2025 Dec 2. doi: 10.1186/s12941-025-00837-0. Online ahead of print.

ABSTRACT

BACKGROUND: Bloodstream infections remain a major cause of morbidity and mortality worldwide, with the increasing threat of antimicrobial resistance (AMR) complicating treatment options. This study aimed to describe the frequency, distribution, and patterns of AMR among blood culture isolates over 5 years at the University Teaching Hospital of Kigali, in Rwanda.

METHODS: A retrospective cross-sectional surveillance analysis was performed on 1352 bacterial isolates from 8301 blood cultures conducted between January 1, 2020, and December 31, 2024. The distribution of pathogens, antimicrobial resistance profiles, and comparisons of resistance patterns between isolates from outpatient and hospitalized patients were analyzed using SPSS version 28. A p-value less than 0.05 was considered statistically significant.

RESULTS: The most common isolates were Staphylococcus aureus (37.2%), Klebsiella pneumoniae (22.4%), Escherichia coli (13%), and Acinetobacter baumannii (11.6%). Nearly all isolates originated from inpatients (98.6%), with the pediatric unit accounting for 40.7%. Alarmingly high resistance rates were observed for ampicillin (94.2%), amoxicillin-clavulanic acid (92.5%), third-generation cephalosporins (79-86%), and ciprofloxacin (58.7%). Notably, vancomycin (1%) for Gram-positive bacteria, and polymyxin B (27.1%), imipenem (25.5%), and amikacin (15.6%) for Gram-negative bacteria generally exhibited lower resistance rates. Additionally, AMR was significantly more prevalent in isolates from hospitalized patients compared to ambulatory patients (p < 0.0001).

CONCLUSION: This study reveals a substantial burden of AMR in blood culture isolates, particularly affecting hospitalized and pediatric patients. The high resistance rates to commonly used antibiotics highlight an urgent need for strengthened antimicrobial stewardship programs, improved infection prevention measures, and enhanced diagnostic laboratory capacity to guide therapy.

PMID:41331622 | DOI:10.1186/s12941-025-00837-0