Nevin Manimala

Medicine (Baltimore). 2025 May 2;104(18):e41939. doi: 10.1097/MD.0000000000041939.

ABSTRACT

BACKGROUND: Osteoporosis (OP) is the second most detrimental chronic disease, and thus novel diagnostic and therapeutic approaches are needed. In recent years, there has been an increased emphasis on the utilization of gut microbiota (GM) in the context of OP. However, a comprehensive bibliometric analysis on this subject is currently lacking. Furthermore, a deeper exploration of the role of GM in bone health is imperative, and there is a pressing need to foster international and inter-agency exchange and experience in this field. Accordingly, this study aimed to provide an overview of the research trends in this field and propose suggestions for related scientific and technological research and development.

METHODS: The Web of Science database was searched for articles related to both GM and OP. Statistical analyses and data visualization were performed using the EXCEL and CiteSpace software.

RESULTS: China exhibited the highest number of publications, followed by the United States. NUTRIENTS and Sichuan University were identified as the journal and institution, respectively, with the highest number of articles. Notably, the keywords “gut microbiota” and “bone loss” have been increasingly used in publications.

CONCLUSION: In conclusion, this study fills the existing gap in the literature and contributes valuable insights to the understanding of the relationship between GM and OP.

PMID:40324264 | DOI:10.1097/MD.0000000000041939

Medicine (Baltimore). 2025 May 2;104(18):e42264. doi: 10.1097/MD.0000000000042264.

ABSTRACT

This study investigated the efficacy of the nurse-assisted modified Valsalva maneuver compared to the traditional Valsalva maneuver in the treatment of paroxysmal supraventricular tachycardia (PSVT) in patients with limited lower limb mobility following orthopedic surgery. Sixty patients with PSVT were randomly divided into 2 groups: the traditional Valsalva maneuver group and the modified Valsalva maneuver group. The patients’ sinus rhythm conversion effect and adverse reactions were observed. Compared to the traditional Valsalva maneuver, the modified Valsalva maneuver significantly increased the sinus conversion rate for PSVT treatment, with a statistically significant difference. There were no serious complications associated with the modified Valsalva maneuver compared to the traditional method, and the difference was not statistically significant. Additionally, the modified Valsalva maneuver reduced hospital stay duration and costs significantly. The modified Valsalva maneuver effectively increased the sinus conversion rate for PSVT in patients with restricted lower limb activities post-orthopedic surgery. It is a simple, safe, and cost-effective method, suitable for patients with limited lower limb mobility.

PMID:40324261 | DOI:10.1097/MD.0000000000042264

Medicine (Baltimore). 2025 May 2;104(18):e42331. doi: 10.1097/MD.0000000000042331.

ABSTRACT

A plethora of research has identified a comorbid association between smoke and an elevated risk of knee pain. Despite these findings, the causal link between genetically influenced smoke and the risk of knee pain remains to be elucidated. Considering this knowledge gap, we undertook a Mendelian randomization (MR) study to delineate the potential causal relationship. The instrumental variables were derived from genome-wide association studies (GWAS). We procured summary statistics for ever smoked from a GWAS dataset (280,508 cases and 180,558 controls, dataset: ukb-b-20261) to represent the exposure. The outcome was determined by GWAS data for knee pain for 3+ months, encompassing 76,910 cases and 20,979 controls (dataset: ukb-b-8906). The primary MR method employed was the inverse-variance weighted approach. Assessments for pleiotropy and heterogeneity were conducted utilizing the MR pleiotropy residual sum and outlier test, the MR-Egger intercept test, the leave-one-out analysis, and the Cochran Q test. There was a statistically significant genetic causal effect of smoke on the increased risk of knee pain (odds ratio = 1.08, 95% confidence interval = 1.01-1.16, P = .014]. Cochran Q statistic showed no heterogeneity (Q P = .66). The leave-one-out analysis chart, the global test P value in MR-pleiotropy residual sum, and outlier revealed no significant pleiotropy (global test P = 0.53). The intercept P value in MR-Egger revealed no significant pleiotropy (intercept P = 0.66). Our MR study showed no pleiotropy or heterogeneity. The findings from our study point toward an association between genetic predisposition to smoke and the incidence of knee pain. This genetic association underscores the clinical relevance of our findings, indicating that interventions aimed at smoking cessation could be particularly beneficial for those individuals who are predisposed to smoking or are at risk of developing knee pain.

PMID:40324260 | DOI:10.1097/MD.0000000000042331

Medicine (Baltimore). 2025 May 2;104(18):e42334. doi: 10.1097/MD.0000000000042334.

ABSTRACT

Previous studies have suggested a potential connection between schizophrenia (SCZ) and sleep and eating disorders. However, these studies have not sufficiently accounted for potential confounding factors, leaving the true causal relationship unclear. Understanding this causal link is essential for developing effective prevention and treatment strategies. To address this gap, we aim to investigate the causal effect of SCZ on sleep and eating disorders using Mendelian randomization (MR) analysis. This method offers a more robust approach by leveraging genetic variants as instrumental variables to rigorously examine the relationship between SCZ and its comorbidities. We conducted bidirectional MR analyses using genome-wide association study summary statistics of SCZ, sleep disorders, and eating disorders. These analyses were conducted after confirming adherence to the 3 core MR assumptions, removing instrumental variables with confounding effects, and directionally harmonizing all data. Then we used Cochran Q test, MR-Egger intercept analysis, and leave-one-out method to conduct the sensitivity analysis of this study to test its heterogeneity and pleiotropy. The results of the inverse-variance weighted (IVW) approach suggest that SCZ increases the risk of sleep disorders (IVW: odds ratio [OR] = 1.041, 95% confidence interval [CI]: 1.012-1.070, P < .01), whereas studies in the opposite direction have not found an effect of sleep disorders on SCZ. The results of IVW suggest that SCZ increases the risk of eating disorders (IVW: OR = 1.228, 95% CI: 1.090-1.384, P < .001), and the weighted median (WM) method similarly provided evidence that SCZ increases the risk of eating disorders (WM: OR = 1.200, 95% CI: 1.019-1.407, P < .05). This study concluded that SCZ is causally associated with sleep and eating disorders. In clinical practice, psychiatrists should pay attention to the daily sleep and eating status of patients with SCZ, and take appropriate measures and countermeasures as early as possible if there is any abnormality.

PMID:40324258 | DOI:10.1097/MD.0000000000042334

Medicine (Baltimore). 2025 May 2;104(18):e42271. doi: 10.1097/MD.0000000000042271.

ABSTRACT

Transcription factor EB (TFEB) is an endogenous protective factor. Here, we sought to discern the possibility of serum TFEB as a prognostic biomarker of moderate-severe traumatic brain injury (msTBI). Serum TFEB levels of 141 patients with msTBI and 70 controls were quantified in this prospective cohort study. Rotterdam computed tomography (CT) classification and Glasgow coma scale (GCS) were considered as the severity metrics. Glasgow outcome scale (GOS) scores of 1 to 3 at 6 months after trauma meant a poor prognosis. The results were analyzed using multivariate analysis. Patients versus controls had a notable reduction of serum TFEB levels. Serum TFEB levels of independent correlation with Rotterdam CT scores and GCS scores were independently relevant to continuous GOS scores and ordinal GOS scores. Serum TFEB levels of linear relation to risk of poor prognosis under restricted cubic spline were independently predictive of poor prognosis. Using receiver operating characteristic curve analysis, serum TFEB levels displayed analogous prognostic predictive ability to Rotterdam CT scores and GCS scores. The constructed model by merging the 3 prognostic independent predictors, that is serum TFEB, Rotterdam CT scores and GCS scores, was pictorially exhibited via the nomogram, and was demonstrated to perform well by adopting several statistical approaches. An obvious decline of serum TFEB levels subsequent to msTBI are firmly related to trauma severity and poor neurological outcomes of patients, reinforcing the clinical meaningfulness of serum TFEB as a prognostic biochemical indicator of msTBI.

PMID:40324256 | DOI:10.1097/MD.0000000000042271

Medicine (Baltimore). 2025 May 2;104(18):e42295. doi: 10.1097/MD.0000000000042295.

ABSTRACT

To examine the correlation between negative cognitive processing bias and the mental health, sleep status of peacekeepers across various time periods to establish a benchmark for peacekeeper mental health interventions. Symptom checklist 90 (SCL-90), Pittsburgh sleep quality index (PSQI), and negative cognitive processing bias questionnaire (NCPBQ) were adopted to investigate 172 Chinese peacekeepers in the Democratic Republic of the Congo at the early and middle stages of the mission. There was no statistically significant difference in the overall score of PSQI between the early and middle stages of the mission (P = .699). However, there was a statistically significant difference in the overall score of SCL-90 and NCPBQ (P < .05). Furthermore, there was a positive correlation between the negative cognitive processing bias and the scores of SCL-90 and PSQI (R = 0.114-0.528, P < .05). A negative cognitive processing bias was also found to be a strong predictor of the overall score on the SCL-90 and PSQI assessments, with explanation rates of 27.3% and 17.5%, respectively. Peacekeepers are prone to experiencing psychological issues during the initial phase of their mission, necessitating careful attention. The presence of negative cognitive processing bias significantly impacts both mental health and sleep quality. Alleviating negative cognitive processing bias can potentially enhance the mental well-being and sleep quality of peacekeepers.

PMID:40324253 | DOI:10.1097/MD.0000000000042295

Medicine (Baltimore). 2025 May 2;104(18):e42277. doi: 10.1097/MD.0000000000042277.

ABSTRACT

Lung ultrasound (LUS) is a noninvasive, easily repeatable, and radiation-free technique that can be applied at the bedside and is used increasingly often in patient management. This study aims to examine the relationship between the mortality of patients with COVID-19 pneumonia followed in the intensive care unit and their LUS scores obtained by evaluating different areas of the thorax and to reveal the prognostic value of this method. Fifty patients diagnosed with COVID-19 by PCR tests and followed in our intensive care unit were included in this study. The LUS scores were obtained within 24 hours of the patients’ hospitalization. The patients’ demographic data, APACHE II and SOFA scores, laboratory data, and survival status were retrospectively reviewed. Comparisons were made according to 28-day mortality. The mortality rate was found to be 31 (62%) among all patients included in the study. The LUS scores of the patients who died were statistically significantly higher than those of patients who survived (30.77 ± 4.31 vs 24.21 ± 5.4, P = .001). The APACHE II (P = .001) and SOFA scores (P < .001) and lactate (P = .020) and ferritin (P = .005) levels of the patients who died were also significantly higher. In correlation analysis, LUS scores were positively correlated with APACHE II (R = 0.379, P = .007) and SOFA (R = 0.457, P = .001) scores, while they were negatively correlated with PaO2 (r = -0.483, P = .001) and PaO2/FiO2 (r = -0.297, P = .036). ROC curve analysis revealed that LUS scores of ≥ 30 predicted mortality with 80.65% sensitivity and 84.21% specificity (AUC: 0.836, P = .001). The likelihood of observing a LUS score of ≥ 30 in the patients who died was 22.222 times higher compared to surviving patients (odds ratio for LUS score: 22.222, 95% confidence interval: 4.854-101.741). We determined in this study that LUS scores successfully predicted the prognosis of COVID-19 patients in the intensive care unit. Therefore, the LUS score can provide significant information to clinicians for patient management and the determination of the degree of lung involvement.

PMID:40324231 | DOI:10.1097/MD.0000000000042277

Medicine (Baltimore). 2025 May 2;104(18):e42214. doi: 10.1097/MD.0000000000042214.

ABSTRACT

The aim was to study the morphological and positional characteristics of temporomandibular joints (TMJ) in adult females with different vertical bony facial types of bony class II. A total of 60 adult females with bony class II were divided into high-angle group, low-angle group, and an average-angle group in the Frankfort horizontal plane-gonion-gnathion angle (MP-FH). In the control group, there were 20 patients with bony class I homogeneous angle, and the ages of each group were between 18 and 35 years old. Dolphin software was used to generate lateral cranial views and perform fixed-point tracing. Invivo 5.3 software was used to reconstruct the 3-dimensional image of the TMJ, and the following items were measured under the view of the TMJ: (1) bony structures such as condyle and fossa and (2) condyle position. The statistical software SPSS27.0 was used to collate and analyze the data. There was no significant difference in bilateral TMJ measurements between the groups (P > .05). Compared with the other groups, the long axis of the condyle, short axis, and supra-articular space (SS) were larger, the fossa depth was deeper, articular eminence inclination was steeper, the long-term axis and the short axis of the high angle were smaller, the fossa depth, and articular eminence inclination were smaller, the anterior articular space was larger (P < .05), and the supra-articular and posterior spaces were smaller. The position of the condyle was mainly in the median and anterior positions in the control group, the anterior and posterior positions in the average angle group, the median and posterior positions in the low-angle group, and the posterior position in the high-angle group. The morphology and position of bilateral TMJ were basically symmetrical between the skeletal class II adult females and the control group, and the position and morphology of the TMJ in the vertical skeletal type of adult females with bony class II were different.

PMID:40324230 | DOI:10.1097/MD.0000000000042214

Medicine (Baltimore). 2025 May 2;104(18):e42345. doi: 10.1097/MD.0000000000042345.

ABSTRACT

The COVID-19 pandemic has raised critical concerns about its long-term effects on cardiovascular health, particularly concerning autonomic nervous system (ANS) function. Little is known about the differences in ANS function between physically active and inactive individuals exposed and nonexposed to COVID-19. This study aimed to compare the impact of self-reported physical activity on ANS function using heart rate variability (HRV) metrics in individuals exposed and nonexposed to COVID-19. In total 142 participants from the Riyadh region, Saudi Arabia, were divided into exposed (n = 70) and nonexposed (n = 71) groups based on their COVID-19 exposure. HRV was assessed using photoplethysmography and analyzed using time and frequency domains. Physical activity was assessed using simple yes or no question, and duration was categorized into less than 30 minutes, 30 minutes, and more than 30 minutes. Physically active participants generally exhibited higher HRV metrics, suggesting better autonomic function, although this effect was more pronounced in the nonexposed group. Interestingly, the low-frequency to high-frequency ratio was the only HRV metric that showed a statistically significant difference between active and inactive participants in the nonexposed group (P = .04). There were no significant differences in HRV metrics based on the duration of reported physical activity in either the COVID-19-exposed or nonexposed groups. The study underscored the importance of monitoring cardiovascular health in post-COVID-19 populations and suggested that while physical activity is beneficial, the virus may blunted its benefits. Further research is needed to explore the long-term implications of COVID-19 on autonomic function and the potential for physical activity to mitigate these effects.

PMID:40324227 | DOI:10.1097/MD.0000000000042345