Nevin Manimala

PLoS One. 2025 May 21;20(5):e0324129. doi: 10.1371/journal.pone.0324129. eCollection 2025.

ABSTRACT

This study was conducted to determine and compare the effects of reformer pilates (RP) and mat pilates (MP) exercises on soccer players’ physical parameters and technical skills. Thirty voluntary participants were randomly assigned to either RP group (n = 10; age = 20.60 ± 1.65), MP group (n = 10; age = 19.40 ± 1.35) and control group (CG) (n = 10; age = 20.10 ± 1.15). Technical and physical performance tests were performed. In the RP group counter movement jump (CMJ), standing broad jump (SBJ), single leg triple hop right-left, balance right-left leg, flexibility, 10-20m sprint, german agility (GA), speed dribbling (SPD), loughborough soccer passing (LSPT), lobbed passing right food, lobbed passing total measurement results showed a statistically significant difference between pre-test and post-test mean values (p < 0.05). In the MP group, balance right-left leg, single leg triple hop right-left, 5 – 10m sprint, GA, SPD, LBP, lobbed passing right measurement results showed a statistically significant difference between pre-test and post-test mean values (p < 0.05). The control group had no significant difference in the pre-test and post-test mean values of technical and physical performance measurements (p > 0.05). Between-group comparisons revealed superior improvements in GA, LSPT, and single-leg triple hop right-left in the RP group compared to the MP group. Based on these findings, coaches and sports performance specialists may enhance athletes’ physical performance and technical skills by incorporating Pilates exercises (particularly RP) into training programs.

PMID:40397911 | DOI:10.1371/journal.pone.0324129

JMIR Res Protoc. 2025 May 21;14:e67678. doi: 10.2196/67678.

ABSTRACT

BACKGROUND: Given the high prevalence of coronary heart disease among older adults and aging populations, there is a need for secondary prevention interventions to help older adults become more physically active. Web-based interventions could be considered for this purpose, knowing that internet use is growing rapidly among older adults. In addition, since older adults would appreciate developing a trusting relationship with a nurse, web-based interventions should include this support, which is not widely observed in the literature.

OBJECTIVE: This study aims to evaluate a web-based nursing intervention aimed at promoting physical activity in people 65 years and older with coronary heart disease.

METHODS: A web-based nursing intervention was developed according to the Intervention Mapping framework in collaboration with a team of health care professionals (n=5) and based on the needs of older adults (n=10). The 7-week intervention (1 session per week) aims to support older adults living with coronary artery disease in resuming, maintaining, or increasing their level of physical activity after coronary bypass surgery or percutaneous coronary intervention. The intervention offers educational content on coronary heart disease and physical activity, suggestions for physical activity, reflective activities, case histories of older adults who have experienced different journeys, an electronic physical activity diary to track progress, and support from a nurse through feedback to increase knowledge, motivation, and sense of self-efficacy. The preliminary effects and impacts of the intervention will be assessed through a mixed method pilot study with a sequential explanatory design. First, a single-group pre-post test will be used to assess the intervention’s preliminary effects on physical activity (electronic journal), quality of life (36-Item Short Form Health Survey version 2), knowledge (quiz), motivation, and self-efficacy (visual analog scale) of 30 older adults living with coronary heart disease, as well as the feasibility of the intervention. Second, a descriptive qualitative design will use semistructured interviews to assess the intervention’s impacts as perceived by 8-12 older adults and its acceptability. Quantitative data on the effects of the intervention will be integrated with the collection and analysis of qualitative data to assess the impact perceived by older adults, using matrices. Nonparametric statistics and a thematic analysis will be produced. A joint display will be used to integrate mixed data.

RESULTS: The results of this study will provide insight into the preliminary evaluation of a web-based nursing intervention to support older adults living with coronary heart disease as they increase their physical activity levels. The recruitment commenced in June 2024, and data collection should be completed by June 2025.

CONCLUSIONS: With the potential to promote older adults’ health, this study could guide the development of new interventions to meet the needs of an aging population.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06197347; https://clinicaltrials.gov/study/NCT06197347.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/67678.

PMID:40397502 | DOI:10.2196/67678

JAMA Cardiol. 2025 May 21. doi: 10.1001/jamacardio.2025.1101. Online ahead of print.

ABSTRACT

IMPORTANCE: Patients with chronic heart failure (HF) and left ventricular ejection fraction (LVEF) less than 40% who experience LVEF improvement to 40% or higher (HFimpEF) may still face residual risks.

OBJECTIVE: To assess the clinical profiles, risk, and treatment response to finerenone in participants with HFimpEF.

DESIGN, SETTING, AND PARTICIPANTS: A total of 6001 patients with HE, LVEF of 40% or higher, New York Heart Association class II to IV symptoms, and elevated natriuretic peptide levels, were enrolled between September 14, 2020, and January 10, 2023. Patients with a prior history of LVEF less than 40% were included. Data analysis was conducted between September 1 to December 10, 2024.

INTERVENTION: Participants received finerenone (titrated to 20 mg or 40 mg) or placebo.

MAIN OUTCOMES AND MEASURES: The primary end point was the composite of cardiovascular (CV) death and total (first and recurrent) worsening HF events.

RESULTS: Of the 6001 participants (mean [SD] age, 72 [9.7], years; 3269 male [55%]), 273 (5%) had a prior LVEF less than 40%. Among those with a prior LVEF of less than 40%, the median recorded prior LVEF was 35% [IQR, 30%-37%], with a median improvement of 12% [IQR, 8%-17%]. Over a median follow-up of 2.6 years, those with a history of LVEF of less than 40% experienced higher rates of the primary outcome of a composite of CV death and worsening of HF events (21.4 per 100 patient-years vs 16.0 per 100 patient-years) than did those whose LVEF was consistently 40% or higher. After adjustment for clinically relevant covariates; however, this rate ratio (RR) was not statistically different (absolute RR, 1.13; 95% CI, 0.85-1.49, P = .39). The treatment effect of finerenone on the primary outcome was consistent among those with a history of LVEF less than 40% and those with LVEF that was consistently 40% or higher (P for interaction = .36). Owing to higher baseline risk, the absolute risk reduction was greater among those with HFimpEF (9.2 vs 2.5 per 100 patient-years). Patients with HFimpEF tended to develop more hypotension with finerenone treatment, but otherwise, the safety profile of finerenone was similar in patients with and without previous LVEF less than 40%.

CONCLUSIONS AND RELEVANCE: In this prespecified analysis of a randomized clinical trial, patients with HFimpEF remained at high risk of CV events, underscoring the need for continued management despite LVEF improvement. The treatment benefits of finerenone observed among the overall population of patients with HF with preserved EF were consistent among patients with HFimpEF.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04435626.

PMID:40397470 | DOI:10.1001/jamacardio.2025.1101

JAMA Cardiol. 2025 May 21. doi: 10.1001/jamacardio.2025.1182. Online ahead of print.

ABSTRACT

IMPORTANCE: Peripheral artery disease (PAD) is a heritable atherosclerotic condition associated with functional decline and high risk for limb loss. With growing knowledge of the genetic basis for PAD and related risk factors, there is potential opportunity to identify individuals at high risk using polygenic risk scores (PRSs).

OBJECTIVE: To develop a novel integrated, multiancestry polygenic score for PAD (PRS-PAD) and evaluate its risk estimation for PAD and major adverse limb events in 3 populations.

DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cohort study was conducted among individuals with genotyping and electronic health record data in the UK Biobank (2006-2021), All of Us (AoU, 2018-2022), and the Mass General Brigham Biobank (MGBB, 2010-2023). Data were analyzed from July 2023 to February 2025.

EXPOSURES: PRS-PAD, previously published PAD polygenic scores, and clinical risk factors.

MAIN OUTCOMES AND MEASURES: The primary outcomes were PAD and major adverse limb events, defined as a surrogate of major amputation and acute limb ischemia.

RESULTS: The study populations included 400 533 individuals from the UK Biobank (median [IQR] age, 58.2 [45.0-71.4] years; 216 215 female participants [53.9%]), 218 500 from AoU (median [IQR] age, 53.6 [37.7-65.0] years; 132 647 female participants [60.7%]), and 32 982 from MGBB (median [IQR] age, 56.0 [32.0-80.0] years; 18 277 female participants [55.4%]). In the UK Biobank validation cohort, PRS-PAD was associated with an odds ratio [OR] per SD increase of 1.63 (95% CI, 1.60-1.68; P < .001). After adjusting for clinical risk factors, the OR for the top 20% of PRS-PAD was 1.68 (95% CI, 1.62-1.74; P < .001) compared to the remainder of the population. Among PAD cases without a history of diabetes, smoking, or chronic kidney disease (n = 3645), 1097 individuals (30.1%) had a high PRS-PAD (top 20%). In incident disease analysis, PRS-PAD improved discrimination (C statistic, 0.761), which was nearly equivalent to the performances of diabetes (C statistic, 0.760) and smoking (C statistic, 0.765). Among individuals with prevalent PAD, high PRS-PAD was associated with an increased risk of incident major adverse limb events in the UK Biobank (hazard ratio [HR], 1.75; 95% CI, 1.18-2.57; P = .005), MGBB (HR, 1.56; 95% CI, 1.06-2.30; P = .02), and AoU (HR, 1.57; 95% CI, 1.06-2.33; P = .03).

CONCLUSIONS AND RELEVANCE: This cohort study develops a new PRS that stratifies risk of PAD and adverse limb outcomes. Incorporating polygenic risk into PAD care warrants further investigation to guide screening and tailor management to prevent major adverse limb events.

PMID:40397457 | DOI:10.1001/jamacardio.2025.1182

Chembiochem. 2025 May 21:e202500209. doi: 10.1002/cbic.202500209. Online ahead of print.

ABSTRACT

Clozapine is an excellent antipsychotic that has been widely used to treat conventional antipsychotic-refractory schizophrenia. Since a body of evidence indicates the involvement of the dysfunction of the N-methyl-D-aspartate type glutamate receptor (NMDAR) in the pathophysiology of antipsychotic-resistant and responsive symptoms of schizophrenia, we have explored the exact mechanisms underlying the superior clinical efficacy of clozapine by studying the effects of clozapine on brain extracellular signaling of NMDAR-related amino acids in the rat medial prefrontal cortex using an in vivo dialysis technique by a quantitative HPLC detection method. Intra-peritoneal injection of clozapine (5, 10 and 20 mg/kg) failed to affect the prefrontal extracellular levels of D-serine, a coagonist for the NMDAR acting at the glycine site, and its precursor, L-serine, from 20 to 160-min post-injection The cortical extracellular concentrations of glycine, another NMDAR coagonist, and L-arginine, a nitric oxide/NMDAR pathway-associated factor, were significantly reduced by 10mg/kg of clozapine. Clozapine administration (20 mg/kg) nominally elevated the prefrontal extracellular levels of L-glutamate, which was not statistically significant after multiple comparisons. The present findings are consistent with the view that clozapine could influence the NMDAR function, at least in part, through modulation of the prefrontal cortical extracellular levels of glycine, L-arginine and glutamate.

PMID:40397451 | DOI:10.1002/cbic.202500209

JAMA Netw Open. 2025 May 1;8(5):e2511641. doi: 10.1001/jamanetworkopen.2025.11641.

ABSTRACT

IMPORTANCE: Serious bacterial infections such as bacteremia, endocarditis, osteomyelitis, and septic arthritis typically require prolonged intravenous antibiotics. Long-acting lipoglycopeptides (laLGPs), such as dalbavancin and oritavancin, offer extended treatment intervals for gram-positive infections that may benefit populations with barriers to traditional treatment, including persons who use drugs (PWUD individuals).

OBJECTIVE: To assess the effectiveness of laLGPs in managing serious bacterial infections in both PWUD and non-PWUD populations compared with standard-of-care (SOC) antibiotics.

DESIGN, SETTING, AND PARTICIPANTS: This comparative effectiveness study using a target trial emulation framework included data extracted from the US Cerner Real World Data platform. Individuals hospitalized and discharged for serious bacterial infections between October 1, 2015, and October 1, 2022, were included in the analysis. Data were analyzed from July 7, 2023, to February 28, 2025.

INTERVENTION: Receipt of an laLGP (dalbavancin or oritavancin) vs SOC antibiotics.

MAIN OUTCOME AND MEASURES: The primary outcome measure was a composite of readmission, emergency department visit, and inpatient death or discharge to hospice within 90 days post discharge from the index admission. Analyses were stratified by PWUD and non-PWUD status. Clone censor weighting was used to emulate a per-protocol analysis. Hazard ratios (HR) of time to the composite event and 95% CIs were calculated using bootstrapping.

RESULTS: Among 42 067 included individuals, median age was 61 (IQR, 47-73) years, 24 704 were male (58.7%), and 5047 (12.0%) were classified as PWUD. laLGPs were prescribed in 825 individuals (2.0%). There was no statistically significant difference in the composite outcome between the laLGP and SOC groups in both the PWUD (HR, 1.01; 95% CI, 0.88-1.13) and non-PWUD (HR, 0.93; 95% CI, 0.86-1.00) participants.

CONCLUSIONS AND RELEVANCE: In this study of laLGPs vs SOC, findings suggested that laLGPs were effective as step-down treatment of serious gram-positive bacterial infections, offering comparable outcomes to those of SOC antibiotics in PWUD and non-PWUD individuals. Clinicians may consider laLGPs as alternative step-down options to SOC antibiotics for the treatment of serious gram-positive bacterial infections.

PMID:40397442 | DOI:10.1001/jamanetworkopen.2025.11641

Eur Heart J Cardiovasc Pharmacother. 2025 May 21:pvaf024. doi: 10.1093/ehjcvp/pvaf024. Online ahead of print.

ABSTRACT

AIMS: To evaluate risk of incident dementia associated with sacubitril/valsartan in patients with heart failure (HF) in South Korea.

METHODS AND RESULTS: We conducted a retrospective cohort study using National Health Insurance Database in South Korea. Patients diagnosed with HF and prescribed either sacubitril/valsartan or angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) within 90 days of their first HF diagnosis between October 2017 and December 2020 were included. The primary outcome was incident dementia, categorized into Alzheimer’s dementia and vascular dementia. Follow-up began after 1 year from the prescription date, to accommodate dementia onset latency, until the earliest occurrence of dementia, death, or end of study period (March 2023). After 1:4 propensity score matching, hazard ratio (HR) with 95% confidence interval (CI) for dementia was estimated using Cox proportional hazards model. Among 7 085 sacubitril/valsartan users and 359 153 ACEI/ARB users, 6 930 sacubitril/valsartan users (mean [SD] age, 61.7 [14.6] years; 70.9% male) were matched on propensity score to 27 720 ACEI/ARB users (mean [SD] age, 61.7 [15.8] years; 71.1% male). During a mean follow-up of 2.2 and 2.3 years, dementia occurred in 200 (2.9%) sacubitril/valsartan users and 980 (3.5%) ACEI/ARB users, respectively. Sacubitril/valsartan showed a 16% lower risk of dementia compared with ACEI/ARB (HR 0.84; 95% CI 0.72-0.98). However, of 1 180 cases of incident dementia, 1 079 (91.4%) were categorized as Alzheimer’s dementia and statistical significance was not reached in this main group.

CONCLUSION: Despite plausible biological mechanisms, no association between sacubitril/valsartan and an increased risk of dementia was observed in patients with HF.

PMID:40397431 | DOI:10.1093/ehjcvp/pvaf024

J Pediatr Orthop B. 2025 May 19. doi: 10.1097/BPB.0000000000001264. Online ahead of print.

ABSTRACT

This study was to identify some indicators that could be used to distinguish methicillin-resistant Staphylococcus aureus (MRSA) from methicillin-sensitive Staphylococcus aureus (MSSA) to more accurately guide empirical antibiotics. Data of 91 cases of acute osteomyelitis in children with Staphylococcus aureus infection (including 29 cases of MRSA and 62 cases of MSSA) from July 2017 to March 2024 were retrospectively analyzed. Age, sex, duration of onset, maximum body temperature at onset, and inflammatory indicators detected after admission were compared between the MRSA group and the MSSA group. According to the receiver operating characteristic (ROC) curve, the diagnostic efficiency of MRSA infection was evaluated. Logistic regression analysis was used to determine independent risk factors for MRSA infection. There were no significant differences in age, sex, duration of onset, maximum body temperature, white blood cell count, neutrophil count, and erythrocyte sedimentation rate between the MRSA group and the MSSA group (P > 0.05). The median C-reactive protein in the MRSA group and the MSSA group was 97.93 and 58.10 mg/L, respectively, with statistical significance (P < 0.05). The sensitivity, specificity, and area under the curve of C-reactive protein for detecting MRSA infection were 41.4, 90.3, and 0.646%, respectively. Logistic regression analysis showed that C-reactive protein greater than 116.46 mg/L (odds ratio = 6.588, 95% confidence interval: 2.149-20.197) was an independent risk factor for predicting MRSA infection (P < 0.05). C-reactive protein greater than 116.46 mg/L can independently predict the likelihood of MRSA infection, and it is recommended to empirically select anti-MRSA treatment for such children.

PMID:40397423 | DOI:10.1097/BPB.0000000000001264

J Ethn Subst Abuse. 2025 May 21:1-19. doi: 10.1080/15332640.2025.2505059. Online ahead of print.

ABSTRACT

The global incidence of ischemic stroke among young adults has risen, with emerging evidence suggesting a potential link to increased cannabis use. Despite widespread perceptions of cannabis as a relatively safe substance, its association with ischemic stroke remains unclear, especially as legalization and use rates grow. This systematic review and meta-analysis aimed to synthesize the current literature to assess the relationship between cannabis use and the risk of ischemic stroke. Following PRISMA guidelines, a comprehensive search was conducted across PubMed, Web of Science, Scopus, Embase, and Google Scholar (up to March 2025) to identify studies evaluating the association between cannabis use and ischemic stroke risk. Inclusion criteria required studies to compare cannabis users with non-users and report quantitative risk estimates (odds ratios, hazard ratios, or relative risks with 95% confidence intervals). Quality assessment utilized the Joanna Briggs Institute checklist. Data were pooled using a random-effects model, and heterogeneity was assessed with the I² statistic. From 821 initial records, seven studies (published 2007-2023; case-control, cohort, and cross-sectional designs) met inclusion criteria. The meta-analysis revealed a statistically significant association between cannabis use and increased risk of ischemic stroke (pooled OR = 2.05, 95% CI: 1.46-2.87; p < .001, I²=68.9%, p = .007). Cannabis use is associated with a significantly elevated risk of ischemic stroke, particularly among young adults. These findings highlight the need for further research to clarify causality and inform public health policy as cannabis use continues to rise globally.

PMID:40397400 | DOI:10.1080/15332640.2025.2505059

J Alzheimers Dis. 2025 May 21:13872877251344223. doi: 10.1177/13872877251344223. Online ahead of print.

ABSTRACT

BackgroundMotor impairment precede cognitive impairment and may be early biomarkers for dementia. We have previously reported an association between finger tapping and cognitive function; however, the link between finger motor movements and associated brain regions is unclear.ObjectiveIn this study, finger tapping movements were used to identify brain regions strongly associated with finger motor dexterity in individuals with Alzheimer’s disease (AD) and mild cognitive impairment (MCI).MethodsThis exploratory, cross-sectional study included individuals with AD or MCI who underwent finger motor movement measurements and 3D magnetic resonance imaging (MRI). Voxel-based morphometry analysis was conducted using Statistical Parametric Mapping 12 and Computational Anatomy Toolbox 12 to assess gray matter volume. Correlations between MRI and finger motor parameters were analyzed using intracranial volume, Mini-Mental State Examination score, age, and sex as covariates.ResultsWe included 136 individuals (AD, 71; MCI, 65). The number of taps and the number of freezing calculated from acceleration significantly correlated with gray matter volume in motor and sensory regions, including the primary motor (BA4) and primary somatosensory (BA3, 1, 2) cortices. Many correlations with the left hemisphere were found in both left- and right-handed bimanual alternating tapping tasks.ConclusionsFinger motor dexterity in individuals with cognitive impairment is associated with gray matter volume in specific brain regions, with a pronounced correlation in the left hemisphere. These findings suggest that finger motor skills may be linked to structural brain changes.

PMID:40397392 | DOI:10.1177/13872877251344223