Nevin Manimala

Front Endocrinol (Lausanne). 2025 Jul 24;16:1595097. doi: 10.3389/fendo.2025.1595097. eCollection 2025.

ABSTRACT

BACKGROUND: The prevalence of hypertension in children is rising globally, with early-onset high blood pressure linked to future cardiovascular risk. Identifying early risk markers beyond obesity and high salt intake is necessary. Although cost-effective indicators of insulin resistance (IR), such as TyG and METS-IR, have been associated with new-onset hypertension in adults, their links with pediatric hypertension, particularly specific phenotypes of hypertension remain unclear.

METHODS: 12,087 individuals aged 7-17 years from the 2017 China National Nutrition and Health Surveillance of Children and Lactating Women were included. Hypertension was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥95th percentile for sex, age, and height. Isolated systolic hypertension (ISH), defined as SBP ≥95th and DBP <95th percentile. Isolated diastolic hypertension (IDH), defined as DBP ≥95th and SBP <95th percentile. Systolic-diastolic hypertension (SDH), defined as both SBP and DBP ≥95th percentile. The associations of TyG and METS-IR with hypertension phenotypes were investigated using multivariable logistic regression and restricted cubic spline regression.

RESULTS: TyG and METS-IR were positively associated with hypertension and all its phenotypes after multivariable adjustment. Treated as continuous variables, each 1-unit rise in TyG corresponds to 44%, 47%, and 61% higher chance of ISH, IDH, and SDH, respectively (odds ratio [OR]: 1.44, 95% confidence interval [CI]: 1.31-1.59; OR: 1.47, 95%CI: 1.21-1.79; OR: 1.61, 95%CI: 1.35-1.91); each 1-unit rise in METS-IR corresponds to 10%, 6%, and 12% higher chance of ISH, IDH, and SDH, respectively (OR: 1.10, 95%CI: 1.09-1.12; OR: 1.06, 95%CI: 1.03-1.08; OR: 1.12, 95%CI: 1.10-1.14). Consistent positive associations were observed across different subgroups for ISH and SDH, whereas this association for IDH was not statistically significant in several subgroups (e.g., age ≥12 years, sufficient sleep, daily exercise). TyG and METS-IR exhibited linear dose-response relationships with all hypertension phenotypes (p-nonlinear >0.10).

CONCLUSION: TyG and METS-IR show strong relationships with three kinds of hypertension phenotypes. They are promising markers that may contribute to the primary prevention of hypertension in pediatric populations.

PMID:40778272 | PMC:PMC12328147 | DOI:10.3389/fendo.2025.1595097

Eplasty. 2025 Jun 27;25:e22. eCollection 2025.

ABSTRACT

BACKGROUND: Many amputees are left with chronic localized pain, centralized pain, and phantom limb pain or sensation, often resulting from neuromas in the residual limb. Historically, there is no reliably effective intervention for pain associated with neuroma-related residual or phantom limb pain. Targeted muscle reinnervation (TMR) is a surgical procedure first described in 2002 that involves the transfer of residual nerves from amputated limbs to new muscle targets. TMR has been shown to significantly reduce neuroma pain and facilitate the use of prostheses.

METHODS: A prospective study was conducted of 61 patients who underwent TMR for neuroma treatment or prevention between 2017 and 2022. Primary outcomes included overall, phantom, and residual limb pain recorded using the Visual Analog Scale (VAS), as well as Patient-Reported Outcomes Measurement Information System (PROMIS) forms for Pain Intensity, Quality, Interference, and Behavior. Retrospective data was collected for a propensity-matched cohort of non-TMR amputees to compare pain outcomes.

RESULTS: TMR was performed for 25 upper extremity and 35 lower extremity amputations, and 5 patients underwent TMR on multiple limbs. Significant reductions were observed in overall limb pain (-3.2 points), phantom limb pain (-2.6 points), and residual limb pain (-3.0 points) for the TMR cohort. Mean PROMIS scores for TMR patients were 49.7 for Pain Intensity, 54.0 for Pain Quality, 55.3 for Pain Interference, and 56.1 for Pain Behavior. At the 8.4-month follow-up, 43.8% of TMR patients (vs 84% of controls) remained on neuromodulators, opioids, or both, for pain control.

CONCLUSIONS: TMR improved phantom and residual limb pain in amputees, as evidenced by clinically and statistically significant reductions in pain with reduced need for long-term opioids and/or neuromodulators. These findings support the current understanding of TMR but underscore the need for continued investigation to comprehensively assess the potential of this promising technique in improving the functional outcomes and quality of life in the amputee population.

PMID:40778246 | PMC:PMC12331023

Jpn J Appl Phys (2008). 2022 Jul;61(SG):SG1049. doi: 10.35848/1347-4065/ac48d3. Epub 2022 May 30.

ABSTRACT

In a previous study, an annular-array transducer was employed to characterize homogeneous scattering phantoms and excised rat livers using backscatter envelope statistics and frequency domain analysis. A sound field correction method was also applied to take into account the average attenuation of the entire scattering medium. Here, we further generalized the evaluation of backscatter coefficient (BSC) using the annular array in order to study skin tissues with a complicated structure. In layered phantoms composed of two types of media with different scattering characteristics, the BSC was evaluated by the usual attenuation correction method, which revealed an expected large difference from the predicted BSC. In order to improve the BSC estimate, a correction method that applied the attenuation of each layer as a reference combined with a method that corrects based on the attenuation of the analysis position were applied. It was found that the method using the average attenuation of each layer is the most effective. This correction method is well adapted to the extended depth of field provided by an annular array.

PMID:40778239 | PMC:PMC12330873 | DOI:10.35848/1347-4065/ac48d3

Npj Ment Health Res. 2025 Aug 7;4(1):35. doi: 10.1038/s44184-025-00153-7.

ABSTRACT

Investigating long-term posttraumatic stress disorder (PTSD) course and its predictors may guide prevention and early intervention strategies following trauma exposure, potentially reducing the long-lasting impact of trauma. N = 155 emergency-admitted adults with (suspected) serious injury were repeatedly assessed until one-year post-trauma and completed a 12-15 year follow-up including a clinical PTSD interview. Adverse one-year PTSD trajectories; more exposure to additional potentially traumatic events and recent life stressors; and early post-trauma predictors (younger age, greater perceived impact of prior potentially traumatic events, higher heart rate) were significantly associated with higher PTSD symptom severity 12-15 years post-trauma. This study showed high consistency between one-year PTSD and its early post-trauma predictors with long-term PTSD outcomes. Early post-trauma predictors had predictive value up to 12-15 years. This suggests that early risk identification of one-year PTSD and subsequent effective early interventions also hold long-term beneficial effects for PTSD outcome.

PMID:40775520 | DOI:10.1038/s44184-025-00153-7

Sci Rep. 2025 Aug 7;15(1):28935. doi: 10.1038/s41598-025-14817-z.

ABSTRACT

Carbapenem-resistant Enterobacterales (CRE), particularly carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Escherichia coli (CREC), are significant pathogens causing healthcare-associated infections. This retrospective study assesses the effectiveness of ceftazidime-avibactam (CAZ/AVI) in achieving perianal swab (PAS) negativity compared to other treatments, including colistin, polymyxin B, meropenem, and combinations with fosfomycin. We retrospectively analyzed 147 CRE-colonized patients (76 females) screened with PAS samples from January 14, 2021, to April 27, 2024. Patients were divided into two groups: those treated with CAZ/AVI (n = 40) and those receiving alternative treatments (n = 44) for bloodstream infections or ventilator associated pneumonia caused by CRE. PAS negativity was defined as conversion from positive to negative, while relapse was a positive PAS result after initial negativity. A p-value below 0.05 was considered to be statistically significant. The CAZ/AVI group achieved a higher rate of PAS negativity (32 patients) with a median time to PAS negativity of 1 week. Relapse rates were similar between CAZ/AVI (23/24) and non-CAZ/AVI groups (8/10). Significant differences in PAS negativity were observed at two weeks (p < 0.001) but not at four weeks (p = 0.492). The median time to PAS negativity was shorter in the CAZ/AVI group (1 week) compared to the non-CAZ/AVI group (2 weeks; p = 0.027). CAZ/AVI is more effective than alternative treatments for short-term PAS negativity, but relapse rates are comparable, highlighting challenges in long-term CRE management. Continuous surveillance and personalized decolonization strategies are essential. Further research is needed to investigate relapse mechanisms and evaluate combination therapies or novel strategies for sustained decolonization.

PMID:40775514 | DOI:10.1038/s41598-025-14817-z

Sci Rep. 2025 Aug 7;15(1):28982. doi: 10.1038/s41598-025-14555-2.

ABSTRACT

Neuronavigation is integral to modern neurosurgery. Clinical studies demonstrate its effectiveness. The primary tracking modalities in neurosurgical navigation are optical tracking systems (OTS) and electromagnetic tracking systems (EMTS). OTS remains the gold standard due to its accuracy and reliability. However, inherent inaccuracies due to brain deformation, image resolution, tool calibration, and registration errors can impact overall accuracy significantly, which differs from the system-declared accuracy. Augmented reality (AR) technologies solve traditional navigation challenges by integrating virtual information with the patient’s anatomy, enhancing the surgeon’s focus and cognitive load management. Head-mounted displays (HMDs) offer ergonomic benefits, although most AR-based neuronavigation studies have been limited to proof-of-concept trials. This study aims to evaluate VOSTARS, a novel hybrid video and optical see-through HMD designed for precision surgery, specifically in neurosurgical oncology for targeting supratentorial tumors. Previous in-vitro studies using patient-specific phantoms have shown promising results, with high accuracy in real-to-virtual target visualization and craniotomy trajectory tracing. With this work, we further assessed VOSTARS’ targeting accuracy within a realistic neurosurgery clinical workflow and compared its performance to the commercial StealthStation system on a patient-specific phantom. Our results demonstrate that users achieved the same median accuracy, 2 mm (IQR: 1 mm), over 60 measurements with both VOSTARS and the StealthStation with no statistically significant difference between the systems, confirming the non-inferiority of the VOSTARS platform compared to a commercial optical tracking-based surgical navigator.

PMID:40775508 | DOI:10.1038/s41598-025-14555-2

Sci Rep. 2025 Aug 7;15(1):28984. doi: 10.1038/s41598-025-14676-8.

ABSTRACT

Hyperuricemia is closely linked to metabolic diseases and cardiovascular conditions, while circadian syndrome (CircS) plays a pivotal role in metabolic syndrome (MetS) and its related disorders. This study examines the relationship between CircS, serum uric acid (SUA) levels, and the risk of hyperuricemia using data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Weighted multivariable linear and logistic regression analyses were employed to assess the relationships between CircS, its components, SUA levels, and the risk of hyperuricemia, supplemented by subgroup analyses and interaction tests to understand the influence of other risk factors. Restricted cubic spline (RCS) regression was utilized to investigate potential nonlinear relationships. The study included 16,785 adults aged 20 and older, of whom 5,833 exhibited CircS and 3,572 had hyperuricemia. The weighted linear regression revealed a significant positive association between CircS and SUA levels (β = 0.108, 95% CI 0.034, 0.182; P = 0.005), with triglyceride scores showing the strongest association (β = 0.168, 95% CI 0.105, 0.231; P < 0.001). Additionally, weighted multivariable logistic regression indicated a significant link between CircS and hyperuricemia occurrence (OR = 1.227; 95% CI: 1.073, 1.402; P = 0.003), with blood pressure scores having the most substantial contribution (OR = 1.538; 95% CI: 1.347, 1.756; P < 0.001). Subgroup analyses confirmed the robustness of these correlations across various populations. RCS results demonstrated significant nonlinear relationships between CircS, SUA levels, and hyperuricemia (P < 0.001). In conclusion, this study establishes a significant positive association between CircS and both SUA levels and the risk of hyperuricemia, highlighting a notable nonlinear relationship between the two.

PMID:40775505 | DOI:10.1038/s41598-025-14676-8

Sci Rep. 2025 Aug 7;15(1):28908. doi: 10.1038/s41598-025-13404-6.

ABSTRACT

Maintaining physical function and mobility is essential for older adults to preserve independence, reduce fall risk, and minimise dependence on care. “Power Centering for Seniors” (PCS) is a mindfulness-based, proprioceptive training programme combining Tai Chi and Qi Gong with functional strength and balance practices. This study assessed the efficacy of the PCS programme on physical functional performance in older community-dwelling adults. The study included 57 participants aged 70 years or older, randomised into an intervention group (IG) or a control group (CG). The PCS intervention consisted of 24 supervised sessions over 12 weeks, with additional home exercises. Physical functional performance was measured using the Continuous Scale Physical Functional Performance 10 (CS-PFP-10) test, focusing on the subdomain Lower Body Strength and Balance & Coordination. A linear mixed-effects model was used to analyse the data, adjusting for baseline CS-PFP-10 scores, sex, and age. Fifty-one participants completed the study. The PCS intervention led to non-significant improvements in the CS-PFP-10 total score compared to the CG, with an adjusted difference of 2.05 points (95% CI: -0.78 to 4.89; p = 0.163; Cohen’s d = 0.403). Similar trends were observed in the sub-scores for Lower Body Strength (adjusted difference: 2.84, 95% CI: -0.21 to 5.90; p = 0.074; Cohen’s d = 0.517) and Balance & Coordination (adjusted difference: 3.34, 95% CI: -0.09 to 6.79; p = 0.063; Cohen’s d = 0.541). The PCS intervention showed potential for improving physical function in older adults in areas critical for maintaining mobility and independence. While trends were favourable, the results did not reach statistical significance.Trial registration ClinicalTrials.gov NCT04861831; date of registration: April 27, 2021.

PMID:40775497 | DOI:10.1038/s41598-025-13404-6

Z Rheumatol. 2025 Aug 8. doi: 10.1007/s00393-025-01701-4. Online ahead of print.

ABSTRACT

OBJECTIVE: Enthesitis is a hallmark of axial spondyloarthritis (axSpA) with a notable impact on quality of life. However, information on the prevalence, burden of damage, and associated characteristics of trochanteric enthesitis is lacking. This novel study aimed to explore the prevalence of radiographic trochanteric enthesitis in axSpA patients and analyze its association with disease activity and functional impairments in detail.

METHODS: This retrospective cross-sectional observational study included 165 patients diagnosed with axSpA who underwent pelvic radiography. Clinical and demographic data were collected, including disease activity scores, functional status, and spinal mobility. Statistical analyses examined associations with trochanteric enthesitis; binary logistic regression identified independent predictors.

RESULTS: Radiographically, trochanteric enthesitis was observed in 19 patients (11.5%), more commonly bilaterally (89.5%) and more prevalently in radiographic axSpA (17.7% vs. 5.8%, p = 0.032). Patients with trochanteric enthesitis had higher inflammatory markers (erythrocyte sedimentation rate [ESR], C‑reactive protein [CRP]; p = 0.034, p = 0.006), disease activity scores (axial spondyloarthritis disease activity score with CRP [ASDAS-CRP], ASDAS-ESR, Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]; p = 0.004, p = 0.034, p = 0.032), and impaired spinal mobility (Bath Ankylosing Spondylitis Metrology Index [BASMI], p = 0.014). Functional impairments were observed in lumbar lateral flexion, intermalleolar distance, cervical rotation, and chest expansion (p = 0.048, p = 0.009, p = 0.029, p = 0.029). In binary logistic regression, age (p = 0.015) and CRP (p = 0.011) emerged as independent predictors of radiographic trochanteric enthesitis.

CONCLUSION: Trochanteric enthesitis affects a notable subset of axSpA patients, especially those who are older and have elevated CRP. It is associated with higher disease activity, increased systemic inflammation, and functional impairment.

PMID:40775493 | DOI:10.1007/s00393-025-01701-4

Radiol Phys Technol. 2025 Aug 7. doi: 10.1007/s12194-025-00948-5. Online ahead of print.

ABSTRACT

In acute ischemic stroke (AIS), where the shortest possible assessment is required to minimize time to mechanical thrombectomy (MT). With recent advancements in MRI reconstruction technology, MRI has also become valuable in the decision-making process for AIS treatment planning. In this study, we compared the examination times of our MRI protocol with those of a standard CT protocol for evaluating AIS through phantom simulations to obtain timing information directly relevant to treatment strategies, and evaluated the utility of MRI for MT. Ten radiological technologists performed scans using the same phantom for each modality. Evaluation items included time for hemorrhage detection, time for penumbra evaluation, and time for brain artery evaluation, and total examination time. The total examination time was slightly shorter with CT (696.2 ± 52.7 s) compared to MRI (701.8 ± 15.8 s), although this difference was not statistically significant (p = 0.4). For other parameters, MRI demonstrated significantly faster detection times: hemorrhage detection (CT, 80.9 ± 12.8 s; MRI, 66.3 ± 1.7 s; p = 0.0002), penumbra evaluation (CT, 696.2 ± 52.7 s; MRI, 262.1 ± 9.3 s; p = 0.0002), and brain artery evaluation (CT, 592.1 ± 32.3 s; MRI, 367.8 ± 8.3 s; p = 0.0002). The coefficient of variation (CV) was lower for MRI compared to CT, indicating less variability in examination times with MRI. This study demonstrates that MRI protocols, including perfusion imaging, can more rapidly visualize factors essential for MT decision-making and do not delay time to MT.

PMID:40775486 | DOI:10.1007/s12194-025-00948-5