Nevin Manimala

J Hosp Med. 2025 Apr 13. doi: 10.1002/jhm.70054. Online ahead of print.

ABSTRACT

BACKGROUND: Pediatric Hospital Medicine (PHM) has a rapidly changing landscape following subspecialty certification in 2016. As the field continues to evolve, so does the role of fellowship training.

OBJECTIVES: The goal of this study was to characterize postgraduate expectations of current PHM fellows to contribute to the understanding of PHM workforce dynamics.

METHODS: Using a constructivist approach, we employed a cross-sectional survey method with both multiple-choice and free-text questions to study PHM fellows’ perspectives regarding posttraining employment and motivations for pursuing fellowship. We used multiple listservs to recruit current PHM fellows for participation. We analyzed survey data using descriptive statistics and free-text responses using conventional inductive content analysis.

RESULTS: A total of 119 PHM fellows (response rate 61%) completed the survey. Most participants anticipated higher starting salaries, more protected time and leadership opportunities, and more efficient career advancement because of PHM fellowship training. Additionally, participants noted several modifiable factors influencing their postgraduate employment considerations which included workplace culture and lifestyle considerations. Participants reported various motivations for pursuing PHM fellowship training, including future job security and career flexibility.

CONCLUSIONS: Despite different reasons for pursuing additional training, the majority of PHM fellows in our study believe that fellowship training should result in increased compensation, resources, and career opportunities than if they had not completed fellowship training. These findings have implications for counseling trainees interested in PHM and for the PHM workforce.

PMID:40221932 | DOI:10.1002/jhm.70054

Knee Surg Sports Traumatol Arthrosc. 2025 Apr 13. doi: 10.1002/ksa.12675. Online ahead of print.

ABSTRACT

PURPOSE: Wearable technologies, like the Apple Watch, offer new possibilities for collecting objective data on physical activity post-operatively following total knee arthroplasty (TKA). This study aims to describe changes in daily physical activity levels using objective metrics over different time points following TKA.

METHODS: This study analyzed data from a prospective cohort of 152 patients undergoing a unilateral TKA. Patients wore an Apple Watch and used a digital care management application for data collection. Step count, steadiness, standing duration, gait speed and performance on a 6-min walk test were collected from Apple HealthKit at multiple time points: pre-operative, 6 weeks post-operatively, 6 months post-operatively and 12 months post-operatively. Statistical analyses were performed using R software, including descriptive statistics and paired t tests to compare outcomes at different time points post-operatively.

RESULTS: Participants demonstrated significant improvements in daily physical activity levels over the course of 12 months post-operative. At 6 months post-operative, participants showed the highest average daily step count (mean ± SD: 5293 ± 236 steps; p < 0.001), with improvements persisting at 12 months post-operative (5180 ± 260 steps; p < 0.001) compared to preoperative values. Gait speed increased from 0.88 ± 0.01 m/s preoperatively to 1.01 ± 0.01 m/s (p = 0.006) at 12 months post-operative. Standing hours increased from 9.99 ± 0.30 to 11.47 ± 0.31 h at 6 months post-operative and persisted. Steadiness and the estimated 6-minute walk test showed recovery trends, though variability remained at 12 months post-operative, suggesting the need for additional longitudinal assessment CONCLUSION: This study provides one of the first longitudinal analyses of post-operative functional recovery using Apple HealthKit, offering continuous real-world gait and activity tracking beyond traditional patient-reported measures. These findings highlight the value of wearable technology in monitoring post-operative activity and offering insights into TKA recovery patterns. The study suggests a critical recovery window at 6 months post-operative and emphasizes the need for ongoing support to maintain improvements. The integration of wearable technology in post-operative monitoring offers a promising approach to tracking patient progress and optimizing functional outcomes following TKA.

LEVEL OF EVIDENCE: Level II.

PMID:40221914 | DOI:10.1002/ksa.12675

West Afr J Med. 2024 Nov 29;41(11):1091-1096.

ABSTRACT

BACKGROUND: Chlamydia Trachomatis infection often runs an asymptomatic course with long-term sequelae. It commonly affects the fallopian tubes and could result in tubal blockage. A study of antichlamydial antibodies, a marker of the disease’s presence, could help understand the disease burden in a given population.

OBJECTIVE: To determine the prevalence of anti-chlamydial antibodies, and its association with tubal infertility among female partners of infertile couples in Enugu, South-eastern Nigeria.

METHODOLOGY: It was a cross-sectional analytical study involving two groups of infertile women attending gynaecology clinics of two tertiary institutions in Enugu, south-eastern Nigeria. Group A (Study group) had tubal factor infertility (n = 143) while Group B (Control) had non-tubal factor infertility (n = 143). Data were obtained using a structured, interviewer-administered questionnaire. Peripheral blood samples were collected and analyzed for anti-chlamydial antibodies using Human chlamydial trachomatis ELISA kits. Statistical package for social science (SPSS) version 25.0 was used for analysis. P-value of <0.05 was statistically significant.

RESULT: The overall prevalence of chlamydial seropositivity was 28.0%. Women with tubal factor infertility were almost twice more likely to have chlamydial seropositivity than those with non-tubal factor infertility (33.6% vs 22.4%; OR = 1.75; 95% C.I = 1.03 – 2.96; p = 0.036). Bilateral tubal occlusion (66.4%) was the commonest tubal pathology identified in the hysterosalpingogram.

CONCLUSION: Anti-chlamydial antibodies were significantly associated with tubal factor infertility in Enugu, South-eastern Nigeria. It is recommended that serum anti-chlamydial antibody testing could be adopted as a screening test for tubal infertility in the study population.

PMID:40221906

Percept Mot Skills. 2025 Apr 13:315125251334155. doi: 10.1177/00315125251334155. Online ahead of print.

ABSTRACT

This study aimed to explore athletes’ perceptions of referees’ judgements in taekwondo competitions using text mining analysis. Participants comprised 100 taekwondo athletes taking part in the World Taekwondo Championships. A total of 898 pieces of identified keywords data were collected on the perceptions of refereeing judgments. The stability and reliability of the referees’ judgments were also examined quantitatively. SPSS, KrKwic, and Netminer 4.0 were used to process the data, and descriptive statistics, covariance matrix, and centrality analysis were performed. The study revealed that the overall perception of the referees’ judgments, including the head referee’s gam-jeom declarations and the assistant referee’s punch points, centered on “unfairness” and “inconsistency,” confirming that taekwondo competitors perceived referees’ judgments as unfair. In particular, ‘gam-jeom_declared’ was perceived as unfair, and other situations such as ‘punch_points,’ ‘clinch_position,’ and ‘video_replay’. The overall fairness confidence level was 37.23%, indicating that the players perceived the referees as unfair. The results of this study can be used as a basis for further research on refereeing fairness.

PMID:40221890 | DOI:10.1177/00315125251334155

Microsc Res Tech. 2025 Apr 13. doi: 10.1002/jemt.24868. Online ahead of print.

ABSTRACT

This study evaluated the effectiveness of conventional rotary instruments (CRI), atraumatic restorative treatment (ART), and the BRIX-3000 chemomechanical caries removal gel by measuring bone mineral density (BMD) and mineral composition in vitro. The carious dentin of 50 extracted human primary molar teeth was removed by using three different methods and restored with high-viscosity glass ionomer cement FUJİ-IX. The BMD values measured from all sections of the cavity floor in the BRIX-3000, ART, and CRI groups are 1.72, 1.79, and 1.66 g/cm³, respectively. SEM-EDX measurements were performed on five randomly selected teeth from the groups. In the BRIX-3000 group, the mean wt Ca% was 65.6, wt P% was 25.34, and the Ca/P ratio was 2.57. In the ART group, 65.75, 23.79, and 2.58 were found, respectively. In the CRI group, 65.73, 26.03, and 2.53 were found, respectively. While there was no difference between the wt Ca% values in all groups in the comparison of the cavity floor and adjacent sound dentin of the samples, the wt P% values were statistically significantly higher on the sound dentin surface.

PMID:40221886 | DOI:10.1002/jemt.24868

Am J Ind Med. 2025 Apr 13. doi: 10.1002/ajim.23722. Online ahead of print.

ABSTRACT

BACKGROUND: Prior work has linked work stressors to asthma. However, research related to gender-specific associations remains sparse and yielded mixed results. We aimed to address this gap.

METHODS: We drew on cross-sectional data from the 2015 National Health Interview Survey (individual-level response rate = 79.7%). Included were participants in employment who were aged 18-70 (n = 18,701). Work-to-family conflict, workplace bullying, and job insecurity were assessed as work stressors. Asthma was defined based on self-reports of a lifetime diagnosis by a doctor or other health professional. To account for the complex sampling design, variance estimation was used to compute weighted descriptive statistics and odds ratios (ORs) as well as corresponding 95% confidence intervals (CIs) using multivariable logistic regression. To test for interaction, interaction terms for work stressors and gender were included in additional models.

RESULTS: In the full sample, work-to-family conflict, workplace bullying and job insecurity showed positive associations with asthma (OR = 1.20, 95%CI = 1.03-1.40; OR = 1.45, 95%CI = 1.17-1.80; and OR = 1.20, 95%CI = 0.99-1.45, respectively). We did not observe meaningful gender differences in the magnitudes of the ORs. All interaction terms were not statistically significant.

CONCLUSIONS: Work stressors were positively associated with asthma, but there was no evidence of gender differences. Prospective studies are needed to determine the potential temporal relation of these associations.

PMID:40221872 | DOI:10.1002/ajim.23722

J Orthop Res. 2025 Apr 12. doi: 10.1002/jor.26083. Online ahead of print.

ABSTRACT

Non-governmental educational programs such as the annual Orthopaedic Research and Education Foundation (OREF) Resident Research Symposia aim to elevate and fund trainee research endeavors. This study investigates the translation of research recognized at the Resident Research Symposia into peer-reviewed publication and the rate of awardees who pursue academic careers after training. Awards from the OREF Resident Research Symposia between 2008 and 2023 were aggregated. Characteristics of awardees and projects were noted. Conversion to publication and journal characteristics were identified by indexing major research databases. The current practice type and specialty of each trainee was queried using the American Academy of Orthopedic Surgeons roster and institutional sites. Descriptive statistics, univariate and multivariate regression models were performed. Primary outcomes included rates of OREF symposia presentation conversion to publication and trainees pursuing a career in academia. Three hundred and eighty-nine awards were included with 72 (18.5%) females and 317 (81.5%) males. One hundred and forty-two (36.5%) were first place awards, 101 (25.9%) second place, 131 (33.7%) third place, and 15 (3.9%) presenter’s choice, across five regions. Basic science projects were more likely to win first-place awards (p = 0.001). Awarded projects translated to 300 (77%) peer-reviewed publications, with an average impact factor of 1.78 ± 1.65. Male and first-place awardees were more likely to publish (p = 0.014, p = 0.001). The current practice types of 376 distinct awardees were identified with 149 awardees currently practicing in academia (42.3%). Awardees that successfully published their projects (p < 0.001), and those from the Mid-Atlantic region (p = 0.01) were more likely to pursue academic careers. Research awarded at the OREF symposium translates to peer-reviewed publication at a high rate, and awardees enter academia at a disproportionately high rate. OREF provides an effective platform to identify and support budding surgeon-scientists, which is vital given that musculoskeletal research is historically underfunded at a national level.

PMID:40221869 | DOI:10.1002/jor.26083

Bioinformatics. 2025 Apr 12:btaf171. doi: 10.1093/bioinformatics/btaf171. Online ahead of print.

ABSTRACT

SUMMARY: Statistical methods that measure the extent of haplotype homozygosity on chromosomes have been highly informative for identifying episodes of recent selection. For example, the integrated haplotype score (iHS) and the extended haplotype homozygosity (EHH) statistics detect long-range haplotype structure around derived and ancestral alleles indicative of classic and soft selective sweeps, respectively. However, to our knowledge, there are currently no publicly available methods that classify ancestral and derived alleles in genomic datasets for the purpose of quantifying the extent of haplotype homozygosity. Here, we introduce the Polaris package, which polarizes chromosomal variants into ancestral and derived alleles and creates corresponding genetic maps for analysis by selscan and HaploSweep, two versatile haplotype-based programs that perform scans for selection. With the input files generated by Polaris, selscan and/or HaploSweep can produce the appropriate sign (either positive or negative) for outlier iHS statistics, enabling users to distinguish between selection on derived or ancestral alleles. In addition, Polaris can convert the numerical output of these analyses into graphical representations of selective sweeps, increasing the functionality of our software.

RESULTS: To demonstrate the utility of our approach, we applied the Polaris package to Chromosome 2 in the European Finnish, Middle Eastern Bedouin, and East African Maasai populations. More specifically, we examined the regulatory sequence in intron 13 of the MCM6 gene associated with lactase persistence (ie, the ability to digest the lactose sugar present in fresh milk), a region of intense interest to human evolutionary geneticists. Our analyses showed that derived alleles (at known enhancers for lactase expression) sit on an extended haplotype background in the Finnish, Bedouin, and Maasai consistent with a classic selective sweep model as determined by iHS and EHH statistics. Importantly, we were able to immediately identify this target allele under selection based on the information generated by our software. We also explored outlier statistics across Chromosome 2 in two distinct datasets from these populations: i) one containing polarized alleles generated with Polaris and ii) the other containing unpolarized alleles in the original phased vcf file. Here, we found an excess of outlier statistics on Chromosome 2 in the unpolarized datasets, raising the possibility that a subset of these ‘hits’ of selection may be unreliable. Overall, Polaris is a versatile package that enables users to efficiently explore, interpret, and report signals of recent selection in genomic datasets.

AVAILABILITY AND IMPLEMENTATION: The Polaris package is free and open source on GitHub (https://github.com/alisi1989/Polaris) and on DropBox (https://www.dropbox.com/scl/fo/mlxizft5267vem9u62qkn/AAnM0qX923zPzQBlPX8iteM?rlkey=uezrp4t2waffpj0nmo1evr320&e=1&st=jaodccws&dl=0).

CONTACT: [email protected]; [email protected].

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:40221866 | DOI:10.1093/bioinformatics/btaf171

Br J Radiol. 2025 Apr 12:tqaf081. doi: 10.1093/bjr/tqaf081. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to compare 3-minute delayed phase images with 5-minute delayed phase images for quantifying hepatic extracellular volume fraction (ECV) using dual-energy computed tomography (CT).

METHODS: Between January 2020 and July 2022, eighty consecutive patients with chronic liver disease (45 men and 35 women, mean age: 69.3 ± 10.4 years) were included in this study cohort. All patients underwent both 3- and 5-minute delayed phase CT scans for assessing focal liver lesions. ECV value was calculated by the iodine densities of the hepatic parenchyma and aorta, and compared between in each phase. Correlations between ECV values in each phase with the albumin-bilirubin (ALBI) score and grade, fibrosis-4 index (Fib-4), and clinical fibrosis stage were statistically analyzed.

RESULTS: No significant difference was found in ECV values between the 3- and 5-minute delayed phase images (p = 0.056). The ratio of ECV values for 3-minute to 5-minute delayed phase images was 0.984 ± 0.078, ranging from 0.85 to 1.16. The ECV calculated on 3- and 5-minute delayed phase images showed strong and moderate correlations with ALBI grade (Spearman’s ρ; 0.763 and 0.724, respectively) and ALBI score (Spearman’s ρ; 0.707 and 0.668, respectively), and also showed moderate correlations with Fib-4 (Spearman’s ρ; 0.548 and 0.543, respectively) and clinical fibrosis stage (Spearman’s ρ; 0.468 and 0.435, respectively).

CONCLUSION: Three-minute delayed phase images were found to be equivalent to 5-minute delayed phase images for the calculation of ECV.

PMID:40221863 | DOI:10.1093/bjr/tqaf081

Rheumatology (Oxford). 2025 Apr 12:keaf207. doi: 10.1093/rheumatology/keaf207. Online ahead of print.

ABSTRACT

OBJECTIVES: Psoriatic arthritis (PsA) is a heterogeneous inflammatory disease in which a significant proportion of patients remain refractory to existing therapies. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) initiated a project aimed at unraveling the reasons for treatment failures in PsA, culminating in the establishment of definitions for Difficult-to-Treat PsA (D2T-PsA) and Complex-to-Manage PsA (C2M-PsA). This study explores patient perspectives on treatment-resistant PsA, incorporating a broader patient perspective into the overarching GRAPPA project.

METHODS: Multilingual (10 languages), online survey to explore PsA patients’ perspectives on treatment inefficacies. Developed collaboratively by GRAPPA members and patient research partners. It included sections on demographic data, structured questions about treatment failures, and open-ended questions. Data analysis used descriptive statistics and inductive coding of qualitative responses via Dedoose.

RESULTS: Among 570 respondents, most were female (68.8%) and White (72.6%), with an average PsA diagnosis delay of 4.3 years. Key contributors to D2T- and C2M-PsA were persistent joint pain and psoriasis (65.7%), fatigue (52.8%), and medication side effects (41.7%). Ranked by impact, arthritis was the most debilitating symptom. Quality of life concerns were notable, with sleep impairment and reduced life enjoyment being reported by 66.4%. Language differences emerged; for instance, with Dutch and Italian respondents prioritizing fatigue and daily life impact, respectively.

CONCLUSION: This is the first international study to highlight patient-driven insights in the management of resistant PsA, emphasizing a multidimensional approach that considers biological and psychosocial factors. These insights will inform the ongoing GRAPPA initiative to standardize definitions for treatment-resistant PsA, ultimately improving patient care.

PMID:40221862 | DOI:10.1093/rheumatology/keaf207