Nevin Manimala

Physiother Res Int. 2026 Jan;31(1):e70164. doi: 10.1002/pri.70164.

ABSTRACT

BACKGROUND AND PURPOSE: Pain and a progressive loss of glenohumeral (GH) joint mobility are the hallmarks of frozen shoulder (FS), which can seriously hinder daily activities. Limited GH mobility may be linked to increased neural mechanosensitivity, which could contribute to pain and functional limitations, though the precise mechanisms are still unclear. This study was established to compare the effectiveness of slider median nerve neural mobilization techniques (NMTs) versus the tensioner technique on pain intensity, functional disability and passive ROM of the GH joint in patients with FS.

METHODS: Sixty-two patients with FS from both genders were randomly assigned to two equal groups. Group (A) received the slider technique of median nerve mobilization, whereas group (B) received the tensioner technique. All patients in both groups received GH joint mobilization and traditional physical therapy (three sessions per week for 6 weeks). Patients were evaluated for pain intensity by Visual Analog Scale (VAS), functional disability by Shoulder Pain and Disability Index (SPADI) and passive ROM of the GH joint by conventional goniometer at baseline and after the sixth week.

RESULTS: Intergroup comparison revealed that there were statistically significant differences in the post-treatment measured outcomes: VAS (p = 0.003), SPADI (p < 0.001), passive abduction ROM (p < 0.001), passive external rotation ROM (p < 0.001), passive internal rotation ROM (p < 0.001).

DISCUSSION: Both slider and tensioner median NMTs produce better improvements in pain alleviation, functional ability, and GH mobility in patients with FS, with slider approaches providing slightly greater, although incremental, benefits.

TRIAL REGISTRATION: NCT06664437.

PMID:41549328 | DOI:10.1002/pri.70164

Cardiovasc Diabetol. 2026 Jan 19. doi: 10.1186/s12933-025-03057-0. Online ahead of print.

ABSTRACT

OBJECTIVES: The emerging triglyceride-glucose (TyG) related index has attracted attention as a promising predictor of various cardiometabolic conditions. However, their prospective association with different stages of cardiovascular-renal metabolic (CKM) syndrome is still not fully established, and it remains unclear whether TyG related parameters have prognostic effects on mortality outcomes of CKM syndrome.

METHODS: The data were derived from the China Health and Retirement Longitudinal Study (CHARLS), and which were determined by the use of a standardised questionnaire during follow-up. TyG and its related parameters (TyG-body mass index, TyG-waist circumference, TyG-waist to height ratio, and TyG-a body shape index (TyG-ABSI) were calculated. Multivariate Cox regression analysis was used to analyze hazard ratios (HRs) and 95% confidence intervals (CI), and Kaplan-Meier survival curve was used to analyze the associations of TyG-ABSI with all-cause mortality and cardiovascular mortality in patients with CKM syndrome. Additionally, the multivariate adjusted restricted cubic spine was employed to examine the dose-response relationship. Mediation analysis was conducted to assess whether white blood cell (WBC) and C-reactive protein (CRP) mediated the associations. Subgroup analyses and interaction tests were conducted to evaluate the risk within various demographics. The National Health and Nutrition Examination Survey (NHANES) was used as validation to improve the reliability of the study results.

RESULTS: The study enrolled 11,235 participants with CKM syndrome from the CHARLS database, during the median follow-up of 5 years, a total of 747 (6.65%) all-cause mortality and 84 (0.75) cardiovascular mortality occurred. TyG-ABSI was associated with CKM syndrome (OR 1.55; 95% CI 1.35-1.79). Furthermore, among patients with CKM syndrome, TyG-ABSI was association with all-cause mortality (HR 1.14; 95% CI 1.04-1.35). In which continuous TyG-ABSI were converted to classified variable (tertile), compared to those with T1 group, the risk of advanced CKM syndrome was found to be 2.41-fold higher in those with T3 group (OR 2.41; 95% CI 1.18-3.20). Additionally, individuals in the T3 group had a 55% increased risk of all-cause mortality (HR 1.55; 95% CI 1.10-2.18). The mediation analysis results suggested that the relationship between TyG-ABSI and all-cause mortality risk is partially mediated by WBC, and CRP, the proportion of mediation were 15.16% and 11.83%. Additionally, analyses of 15,054 participants from the NHANES database indicated a significant positive association between TyG-ABSI and all-cause mortality and cardiovascular mortality among individuals diagnosed with CKM syndrome during the 10 years follow-up.

CONCLUSION: Higher TyG-ABSI is associated with an increased risk of advanced CKM syndrome and mortality. It further emphasizes the role of TyG-ABSI in the management of CKM syndrome stages and the risk of all-cause mortality and cardiovascular mortality.

PMID:41549315 | DOI:10.1186/s12933-025-03057-0

BMC Res Notes. 2026 Jan 18. doi: 10.1186/s13104-026-07648-2. Online ahead of print.

ABSTRACT

OBJECTIVE: The study examined the association between adiponectin levels and markers of Insulin Resistance (IR) in obese and non-obese adults with type 2 diabetes. Insulin Resistance was estimated using HOMA-IR, while group differences were assessed using appropriate statistical tests. Multiple linear regression was applied to evaluate associations between adiponectin and obesity indices while adjusting for HOMA-IR.

RESULTS: Mean serum adiponectin did not differ significantly across obese diabetics, non-obese diabetics, and controls (5.9 ± 3.6 µg/mL, 6.4 ± 3.2 µg/mL, and 6.8 ± 3.5 µg/mL, respectively; p = 0.13). Mean HOMA-IR values were comparable among obese diabetics (1.4 ± 2.1), non-obese diabetics (1.3 ± 1.0), and controls (1.1 ± 0.6). In multivariable regression models, serum adiponectin was not independently associated with obesity indices or HOMA-IR (all p > 0.05). Serum adiponectin levels were not significantly different across the study groups, although numerically lower values were observed in obese individuals with diabetes. No significant relationship was found between adiponectin and clinical or biochemical markers of IR. These findings suggest that adiponectin may have limited utility as an isolated marker of IR in Nigerian adults with type 2 diabetes and underscore the need for larger, longitudinal studies to clarify its role.

PMID:41549305 | DOI:10.1186/s13104-026-07648-2

Cardiovasc Diabetol. 2026 Jan 18. doi: 10.1186/s12933-025-03074-z. Online ahead of print.

NO ABSTRACT

PMID:41549299 | DOI:10.1186/s12933-025-03074-z

Eur J Med Res. 2026 Jan 19. doi: 10.1186/s40001-026-03857-4. Online ahead of print.

ABSTRACT

BACKGROUND: Sepsis is a life-threatening condition that requires rapid and accurate identification of causative pathogens to guide timely antimicrobial therapy. Blood culture is the current diagnostic standard, but it suffers from low sensitivity and long turnaround times. Droplet digital polymerase chain reaction (ddPCR) has emerged as a promising molecular tool that may overcome these limitations. This study aimed to evaluate the diagnostic utility of ddPCR compared with conventional blood culture in patients with sepsis.

METHODS: We performed a retrospective study of 115 patients admitted with sepsis to Tianjin First Central Hospital between October 2024 and June 2025. All patients underwent both blood culture and ddPCR testing on admission. Clinical characteristics, laboratory parameters, and infection outcomes were collected. Diagnostic performance, including sensitivity, specificity, positive predictive value, and negative predictive value, was calculated using blood culture as the reference standard. Concordance between ddPCR, blood culture, and non-blood specimen cultures was analyzed. Statistical analysis was performed using descriptive statistics and agreement measures.

RESULTS: Blood culture identified pathogens in 27.8% of patients, whereas ddPCR detected organisms in 53%. ddPCR revealed a broader microbial spectrum, particularly Gram-negative bacteria such as Escherichia coli and Klebsiella pneumoniae, and identified mixed infections frequently missed by culture. Within its detection panel, ddPCR demonstrated a sensitivity of 81.3% and specificity of 56.6%, with a high negative predictive value of 88.7%. ddPCR findings showed strong agreement with non-blood culture results in cases where blood cultures were negative, underscoring its clinical relevance. Early in the study, false-positive Candida results were observed but eliminated after stricter aseptic protocols were implemented.

CONCLUSIONS: Droplet digital polymerase chain reaction significantly outperformed blood culture in pathogen detection for sepsis, especially for Gram-negative and polymicrobial infections. Its high negative predictive value supports its use as a complementary tool to exclude bloodstream infections and guide early antimicrobial de-escalation. While positive findings must be interpreted with clinical context to avoid overtreatment, ddPCR offers substantial potential to accelerate pathogen identification, improve antimicrobial stewardship, and enhance outcomes in septic patients.

PMID:41549293 | DOI:10.1186/s40001-026-03857-4

J Orthop Surg Res. 2026 Jan 18. doi: 10.1186/s13018-026-06662-1. Online ahead of print.

ABSTRACT

BACKGROUND: The unique vulnerability of the neonatal joint to septic arthritis poses a substantial risk for lifelong musculoskeletal disability. Precise estimates of long-term functional outcomes are crucial for prognostication and clinical decision-making, yet robust pooled data remain scarce. This systematic review and meta-analysis was therefore conducted to determine the aggregate rate of favorable prognosis in neonates following septic arthritis.

METHODS: We queried four major databases (PubMed, Embase, Cochrane Library, and Web of Science) from inception until September 2025 to identify studies reporting Prognostic outcomes of neonatal septic arthritis. The primary outcome was the pooled rate of favorable prognosis, defined as normal/near-normal joint function, synthesized under a random-effects model. Heterogeneity was quantified (I² statistic), and we explored its sources via pre-specified subgroup analyses and sensitivity analyses.

RESULTS: Thirteen studies (258 patients) were included. The pooled rate of favorable prognosis was 69.7% (95% CI: 60.5-77.7). Significant heterogeneity (I² = 40.9%) was observed. Subgroup analyses identified longer follow-up (> 2 years), non-hip joint involvement, and prompt intervention (≤ 7 days) as significant positive predictors of outcome.

CONCLUSION: Approximately one-third of infants with neonatal septic arthritis experience adverse sequelae. Prognosis is significantly influenced by follow-up duration, anatomic site of involvement (particularly the hip), and the timeliness of intervention. These findings highlight the paramount importance of early diagnosis and urgent treatment, providing crucial evidence for family counseling and structuring long-term follow-up protocols.

PMID:41549270 | DOI:10.1186/s13018-026-06662-1

BMC Anesthesiol. 2026 Jan 19. doi: 10.1186/s12871-026-03621-5. Online ahead of print.

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) is an effective treatment for end-stage knee osteoarthritis, but postoperative pain and delayed recovery remain challenges. This study aimed to evaluate the effects of hypobaric unilateral fine-needle spinal anesthesia combined with multimodal analgesia (MMA) on postoperative recovery in TKA patients.

METHODS: A randomized controlled triple-blind trial enrolled 118 patients scheduled for TKA between January 2022 and June 2023. Patients were divided into three groups: hypobaric fine-needle spinal anesthesia (Group A, n=40), isobaric fine-needle spinal anesthesia (Group B, n=39), and hypobaric spinal-epidural combined anesthesia (Group C, n=39). Outcomes included puncture success rates, puncture time, maximum active knee flexion angle, breakthrough analgesia frequency, statistical test and complications.

RESULTS: No significant differences were observed in puncture success rates. However, Group C had a significantly longer puncture time than Groups A and B. Group B showed a lower maximum active knee flexion angle on postoperative day 1 compared to Groups A and C. Group C had a higher incidence of low back pain and headache within 7 days. Postoperative pain scores (NRS) were significantly lower in Group A at all time points.

CONCLUSIONS: Hypobaric fine-needle spinal anesthesia (Group A) demonstrated superior performance in puncture time, postoperative mobility, and complication rates, making it a preferred anesthetic strategy for TKA.

TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2500100428). Registered on 9 April 2025. Retrospectively registered.

PMID:41549267 | DOI:10.1186/s12871-026-03621-5

BMC Geriatr. 2026 Jan 19. doi: 10.1186/s12877-026-06982-1. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: This study examined whether different levels of cognitive impairment influence postural control (PC) in physically independent older women, using complementary time domain and time-frequency analyses. Understanding these associations may help identify early markers of cognitive vulnerability and guide preventive strategies aimed at reducing fall risk in aging.

METHODS: A cross-sectional sample of 129 women aged ≥ 60 years (mean age 69), physically independent and not engaged in structured exercise for at least three months, was categorized into three groups according to Montreal Cognitive Assessment (MoCA) scores: normal cognition (NC), mild cognitive impairment (MCI), and advanced cognitive impairment (ACI). PC was assessed through time domain variables, mean sway velocity (anteroposterior and mediolateral) and the area of the center of pressure (A-COP), and through time-frequency parameters categorized into low (0.05-0.5 Hz; visual-vestibular contribution), medium (0.5-1.5 Hz; cerebellar modulation), and high (1.5-10 Hz; proprioceptive contribution) frequency bands. Confirmatory analyses for the primary conditions (BSEO and BIUS) were performed using ANCOVA adjusted for age, body mass index (BMI), Charlson Comorbidity Index (CCI), and Falls Efficacy Scale (FES) scores. Exploratory outcomes were analyzed with one-way ANOVA, followed by Sidak-adjusted post hoc tests. Effect sizes were estimated using partial eta squared.

RESULTS: Time domain analyses showed that women with better cognitive performance demonstrated better postural control, reflected by lower sway velocity, particularly in the BSEO and BIUS conditions. Exploratory analyses also identified group differences in the BIVR condition. Although the time-frequency analyses did not reveal statistically significant differences between groups, the descriptive patterns suggested that lower-frequency components were more evident during less demanding tasks, whereas medium and high frequency components appeared more prominent in more challenging conditions. Effect-size estimates supported the clinical relevance of time domain differences between cognitive groups.

CONCLUSION: Cognitive status influences postural control in physically independent older women. Time domain measures, particularly sway velocity, were sensitive to poorer balance among those with cognitive impairment, while time-frequency parameters did not differentiate cognitive groups. These findings highlight the importance of incorporating cognitive screening into balance assessment and fall-prevention strategies in aging populations.

PMID:41549246 | DOI:10.1186/s12877-026-06982-1

Ir J Med Sci. 2026 Jan 19. doi: 10.1007/s11845-025-04276-w. Online ahead of print.

ABSTRACT

OBJECTIVE: The Figure-8 Walk Test (F8WT) is a standardized clinical assessment used to evaluate walking performance, including straight walking and maneuvering around obstacles, as required in daily life. The aim of this study was to establish reference values for the F8WT in healthy adults.

METHODS: A total of 1,145 healthy Turkish adults participated in this cross-sectional study. Individuals aged ≥ 18 years who were able to walk independently without assistive devices were included. Participants with a history of neurological, musculoskeletal, or cardiopulmonary disorders affecting gait, recent lower extremity injury or surgery, or cognitive impairment were excluded. The F8WT was administered, and anthropometric as well as sociodemographic parameters were recorded.

RESULTS: The 25th, 25th-75th, and > 75th percentiles were classified as low, average, and high fall risk for both men and women based on F8WT performance. For men, < 3.06 s indicated low fall risk, 3.06-9.34 s indicated average fall risk, and 9.34-22.31 s indicated high fall risk. For women, < 2.41 s indicated low fall risk, 2.41-8.43 s indicated average fall risk, and 8.43-16.06 s indicated high fall risk. Statistically significant differences were observed between men and women in terms of age, height, body weight, and body mass index (BMI) (p < 0.01). In the overall sample, F8WT performance was significantly correlated with age (r = 0.575, p < 0.001), height (r = -0.145, p < 0.001), weight (r = 0.242, p < 0.001), and BMI (r = 0.359, p < 0.001).

CONCLUSION: This study provides reference values for the F8WT according to age and sex in healthy adults. Women demonstrated shorter F8WT completion times than men, and test duration increased with advancing age.

CLINICAL TRIAL NUMBER: NCT06314347.

PMID:41549207 | DOI:10.1007/s11845-025-04276-w

Environ Geochem Health. 2026 Jan 19;48(2):102. doi: 10.1007/s10653-026-02995-2.

ABSTRACT

The study examined natural radionuclide levels in edible muscles of cephalopod species consumed in Kerala. Uranium (²³⁸U) concentrations ranged from 1.14 ± 0.06 to 1.72 ± 0.07 Bq kg^-1, while thorium (²³²Th) levels were between 0.08 ± 0.02 and 0.66 ± 0.04 Bq kg^-1. Polonium (²¹⁰Po) showed higher concentrations, ranging from 4.7 ± 0.9 to 27.2 ± 3.3 Bq kg^-1, and lead (²¹⁰Pb) levels varied from 3.8 ± 0.9 to 24.6 ± 6.8 Bq kg^-1. Squids, being pelagic, accumulated higher amounts of ²³⁸U and ²¹⁰Po, whereas cuttlefishes, being benthic, showed greater levels of ²³²Th and ²¹⁰Pb. Statistical analysis revealed significant differences in radionuclide concentrations among and within cephalopod species, influenced by habitat and taxonomy (p < 0.05). The annual committed effective dose (ACED) for coastal residents consuming these cephalopods was assessed. ²¹⁰Po was the main contributor to radiation dose, comprising over 80% of the total dose from all radioisotopes analyzed. Despite this significant contribution, the study concluded that health risks from consuming these cephalopods were within acceptable safety limits.

PMID:41549201 | DOI:10.1007/s10653-026-02995-2