Nevin Manimala

Acta Orthop. 2025 Mar 13;96:256-264. doi: 10.2340/17453674.2025.43188.

ABSTRACT

BACKGROUND AND PURPOSE: The use of spinal implants has increased substantially. Their widespread use raises public health concerns. We aimed to study spinal surgery trends in Italy from 2001 to 2019 and present a mapping for ICD9-CM codes potentially related to spinal diagnoses and procedures.

METHODS: ICD9-CM codes of interest were selected and mapped to clinically meaningful spinal diagnostic categories and procedure classes. The Italian National Hospital Discharge Records database was then browsed according to these codes. Surgical volumes and trends were described. Population incidence rates (IR) were estimated and provided with 95% confidence intervals (CI). Variations in IRs were reported in terms of incidence rate ratio. The statistical significance of counts and IR time series trends was assessed by using the Cox-Stuart test.

RESULTS: 1,560,969 spinal procedures were extracted from 209,818,966 admissions registered nationally. The annual number of spinal procedures increased significantly by 67%, from 58,369 in 2001 to 97,636 in 2019 (P < 0.002). 1,040,326 (67%) procedures did not include implants, while 590,643 (33%) used implants, 395,450 (25%) associated with fusions and 125,193 (8%) with non-fusions. Population IRs increased from 100.9 (CI 100.1-101.7) to 163.2 (CI 162.2-164.3) episodes per 100,000 inhabitants. Surgical volumes for non-implant-related procedures remained stable, while implant-related procedures increased significantly, by 420% over the 19 observed years (P = 0.002).

CONCLUSION: Spinal surgical procedures and their population incidence rates increased significantly. Fusions and other implant-related procedures increased substantially for most diagnostic categories. An ICD9-CM mapping for spinal diagnoses and procedures as a reproducible tool for further explorations was presented.

PMID:40099462 | DOI:10.2340/17453674.2025.43188

Acta Otorhinolaryngol Ital. 2025 Feb;45(1):21-27. doi: 10.14639/0392-100X-N2734.

ABSTRACT

OBJECTIVE: To assess the suitability of Bama pigs as a model for laryngopharyngeal reflux disease (LPRD) research.

METHODS: Sixteen 8-month-old male Bama pigs underwent esophageal manometry to determine the precise anatomical positioning of the upper (UES) and lower esophageal sphincters (LES) relative to the incisor teeth, as well as their respective contraction intensities. The pigs were randomly allocated into three experimental groups (n = 6, 5, 5), with each group subjected to Dx PH-probe monitoring. In Group 1, animals were fasted for 24 hours and water-deprived for 6 hours before undergoing pH monitoring under anaesthesia. Group 2 was anaesthetised two hours post-normal feeding and subsequently monitored. Group 3 also received anaesthesia two hours after eating but were monitored in an awake state.

RESULTS: The mean distance from the UES to the incisor teeth was found to be 19.8 ± 1 cm, while the LES was located at 40 ± 2.5 cm. The resting pressure measurements revealed a mean value of 64 ± 12 mmHg for the UES and 20 ± 4 mmHg for the LES in Bama pigs. Laryngopharyngeal pH values across the three groups were 7 ± 0.6, 7 ± 0.5, and 7.4 ± 1.2, respectively, showing no significant differences or reflux events. Similarly, there was no statistically significant difference in the lower oesophageal pH between Group 1 and Group 2.

CONCLUSIONS: The Bama pig emerges as a suitable animal model for studying LPRD, given its comparable physiological parameters. The feasibility of establishing a reflux model in Bama pigs and using it to investigate the underlying mechanisms of LPRD is convincingly supported by these findings.

PMID:40099443 | DOI:10.14639/0392-100X-N2734

J Eval Clin Pract. 2025 Mar;31(2):e70039. doi: 10.1111/jep.70039.

ABSTRACT

AIMS: A variety of complications can arise following a stroke, with post-stroke cognitive impairment (PSCI) being a prevalent consequence. The objective of the research was to explore the relationship between 25(OH)D levels, PSCI, and the duration of hospitalization.

METHODS: Serum concentrations of 25(OH)D were measured within the first 24 h of hospital admission. Cognitive impairment in stroke patients was assessed using the Mini-Mental State Examination (MMSE). Functional independence was evaluated on the day of discharge using the Barthel Index (BI). Additionally, the duration of hospitalization for each patient was recorded. Data analysis was performed using SPSS statistical software.

RESULTS: An observation revealed that levels of 25(OH)D were comparatively reduced in stroke people who suffered from cognitive impairment as opposed to individuals without such impairment (p = 0.022). Patients with cognitive impairment following a stroke demonstrated reduced BI scores (p < 0.001) and longer durations of hospitalization (p = 0.002) in contrast to patients without cognitive impairment. Upon comparing groups with different concentrations of 25(OH)D, it was observed that individuals with low concentrations had longer hospitalization durations (p = 0.03) and higher NIHSS scores (p = 0.003) than those with high concentrations of 25(OH)D. Furthermore, binary logistic regression analysis indicated that a 25(OH)D level of < 25 nmol/L was a significant risk factor for cognitive impairment following a stroke.

CONCLUSIONS: The study indicated a potential linkage between reduced levels of 25(OH)D and an escalated susceptibility to cognitive impairment following a stroke. Furthermore, individuals with lower concentrations of 25(OH)D generally experienced longer hospital stays.

PMID:40099417 | DOI:10.1111/jep.70039

Mov Disord Clin Pract. 2025 Mar 18. doi: 10.1002/mdc3.70040. Online ahead of print.

ABSTRACT

BACKGROUND: Restless Legs Syndrome (RLS) is a neurological disorder reported to be associated with impulsivity and impairments in interoception and emotional regulation. However, limited research has explored the combined influence of RLS severity, psychological factors, and chronotype on impulsive decision-making and risk-taking behavior in RLS patients.

OBJECTIVES: To assess impulsive-decision making and its modulation by RLS severity, chronotype, and psychological factors (including interoception, anxiety, alexithymia, and sleep quality) in RLS patients compared to healthy controls (HC).

METHODS: A case-control study was conducted with 20 RLS patients and 20 age- and sex-matched HC. Participants completed a series of questionnaires measuring interoception, anxiety, alexithymia, sleep quality, and chronotype, followed by a temporal discounting task to assess impulsivity. Statistical analyses included Mann-Whitney U tests, Spearman’s rank correlations, and multiple regression analysis.

RESULTS: No significant differences in impulsive decision-making were observed between groups. RLS patients exhibited higher levels of depression and alexithymia, along with lower scores on interoceptive awareness compared to HC. However, within the RLS group, greater symptoms’ severity, poorer sleep quality, and higher anxiety were positively correlated with increased impulsivity. Regression analysis showed that the MAIA-2-Not Distracting sub-scale was a significant predictor of impulsivity in RLS patients.

CONCLUSIONS: Interoceptive deficits, particularly difficulties in ignoring bodily sensations, play a central role in impulsive decision-making in RLS patients. These findings highlight the importance of targeting interoception, emotional regulation, and sleep quality in therapeutic interventions for RLS. Further research with larger samples is needed to confirm these relationships.

PMID:40099406 | DOI:10.1002/mdc3.70040

Monaldi Arch Chest Dis. 2025 Mar 17. doi: 10.4081/monaldi.2025.3316. Online ahead of print.

ABSTRACT

The idea of heated tobacco products (HTPs) is to deliver nicotine to the consumer by heating the tobacco rather than burning it, possibly causing less release of many harmful and potentially harmful chemical constituents (HPHCs), including carbon monoxide (CO). This prospective observational study targets studying the acute effects of HTPs regarding exhaled CO, serum cotinine level, and pulmonary function. A total of 91 participants were included; 46 current traditional cigarette smokers were instructed not to smoke for a minimum of 12 hours before the study (not following the smoking cessation program) and then divided into two groups. Group 1 contained 23 participants who smoked their usual cigarette brands, and Group 2 consisted of 23 participants who smoked the I-Quit-Ordinary-Smoking tobacco sticks. Group 3 is the control group, including 45 normal healthy non-smoker participants. All participants were subjected to the subsequent thorough medical history and clinical examination, followed by assessment of the following parameters before smoking as well as 5 minutes after smoking (either heated tobacco or traditional cigarettes according to their groups): oxygen saturation (SpO₂), heart rate (HR), measurement of exhaled CO, spirometry, and blood sample for serum cotinine level (which was assessed 5 minutes as well as 30 minutes after smoking). The study’s findings showed that after smoking cigarettes, the amount of CO in the air was higher (mean 32.83±16.73 standard deviation) than after smoking heated tobacco, which was statistically significant. Serum cotinine levels also went up after smoking in both groups, but they were slightly higher after HTPs than after conventional cigarettes (CCs). Spirometry and SpO2 levels went down after smoking in groups 1 and 2, while HR levels went up after smoking in both groups, with a p-value of less than 0.001. We concluded that the HTPs have acute respiratory and cardiovascular effects similar to CCs but with less exhaled CO.

PMID:40099401 | DOI:10.4081/monaldi.2025.3316

Basic Clin Pharmacol Toxicol. 2025 Apr;136(4):e70019. doi: 10.1111/bcpt.70019.

ABSTRACT

BACKGROUND: The relational equation for predicting arterial oxygen saturation (SaO₂) with a partial pressure of oxygen (PaO₂) has been described and used in clinical settings. However, the equation has limitations as it was derived empirically. This study aimed to assess the relationship between PaO₂ and SaO₂ using a turnover model.

MATERIAL AND METHODS: In a controlled desaturation study to assess the accuracy of a pulse oximeter, volunteers (n = 12) breathed hypoxic gas mixtures via a mouthpiece. Various target SaO₂ values were achieved within the range of 70%-100%. PaO₂ and SaO₂ were measured using a CO-oximeter. A turnover model was fitted to PaO₂-SaO₂ pair data. The performance of the two SaO₂ prediction methods (conventional formula and turnover model) was evaluated using additional volunteer data not used in the model-building process.

RESULTS: The pharmacodynamic parameters were as follows: k_out (1/min) = 4.45 for Asians, 0.93 for Africans, I_max = 0.837 and IC₅₀ (mmHg) = 79.2%, γ = 5.24. PaCO₂ and pH were not significant covariates. The median prediction and median absolute prediction error were 5.6% and 5.7%, respectively, for the conventional formula, and 0.1% and 1.2%, respectively, for the turnover model.

CONCLUSION: The relationship between PaO₂ and SaO₂ was better explained by the turnover model than by the conventional formula within the 70%-100% SaO₂ range.

PMID:40099357 | DOI:10.1111/bcpt.70019

Autism Res. 2025 Mar 18. doi: 10.1002/aur.70021. Online ahead of print.

ABSTRACT

Language screening tools are frequently used to identify children with potential undiagnosed language difficulties. These difficulties are more prevalent in autistic children and those with attention deficit hyperactivity disorder (ADHD) compared to neurotypical peers. Despite the widespread use of tools like the Clinical Evaluation of Language Fundamentals, Fifth Edition Screening Test (CELF-5 Screener) and the Vineland Adaptive Behavior Scales, Third Edition (Vineland-3), their sensitivity and specificity for this population have not been empirically validated. This study aimed to evaluate the screening accuracy of the CELF-5 Screener and Vineland-3 in children diagnosed with autism and/or ADHD and compare their performance to the gold standard measure. The sample consisted of 132 participants (n_autism = 25; n_ADHD = 29, and n_autism+ADHD = 78; M_{age in years} = 9.6; % male = 59) from the Monash Autism-ADHD Genetics and Neurodevelopment Project. The sensitivity, specificity, positive predictive value, and negative predictive value of the CELF-5 Screener and Vineland-3 receptive and expressive language subdomain scores were compared against those of the clinician-administered CELF-5 receptive and expressive language composite scores. The screening accuracy of each tool was further evaluated through Receiver Operating Characteristic analyses and calculations of Youden’s J statistic. The CELF-5 Screener demonstrated poor sensitivity for receptive language difficulties (35.6%) while demonstrating high specificity (95.3%). Similarly, for expressive language difficulties, the sensitivity was low (37.9%), and the specificity was high (91.1%). The Vineland-3 showed high sensitivity (93.3%) but low specificity (48%) for expressive language difficulties and inadequate sensitivity (80.9%) and specificity (22.4%) for receptive language difficulties. Both the CELF-5 Screener and Vineland-3 may miss a significant number of children with co-occurring language difficulties related to autism and/or ADHD. Examiners must understand these tools’ strengths and limitations, especially when assessing neurodivergent children whose language development might not follow a normative trajectory.

PMID:40099345 | DOI:10.1002/aur.70021

West J Nurs Res. 2025 Mar 18:1939459251324833. doi: 10.1177/01939459251324833. Online ahead of print.

ABSTRACT

BACKGROUND: Along with the global rise in the population of older adults, addressing depression among this population has become a critical public health concern. Reminiscence therapy is one of the interventions shown to be effective in reducing depression and depressive symptoms.

OBJECTIVES: To systematically summarize the effectiveness of reminiscence interventions in reducing depression and depressive symptoms in community-dwelling older adults without significant cognitive impairment.

METHODS: The literature search was conducted through four electronic databases: PubMed, CINAHL, PsycINFO, and Scopus for studies published in English. Risks of bias were evaluated using the Cochrane Risk of Bias 2 tool and the Joanna Briggs Institute Quality Appraisal Instrument.

RESULTS: The systematic review included 11 studies involving 650 community-dwelling older adults, with mean ages ranging from 65.3 to 78.7. Nine articles found reminiscence therapy effective in alleviating depression and depressive symptoms in community-dwelling older adults without significant cognitive impairment. Structured reminiscence interventions were effective in reducing depression and depressive symptoms in six out of seven studies. Group reminiscence interventions demonstrated significant improvements in depression in 87.5% of studies. Memories triggers, suggested by four included studies, were practical tools to help initiate reminiscence sessions. All included studies were rated as having a low risk of bias.

CONCLUSION: Reminiscence has the potential as a valuable and effective treatment for depression and depressive symptoms in community-dwelling older adults without significant cognitive impairment. Future research should focus on exploring diverse modalities, incorporating active control groups, and having longer follow-up periods to assess sustained benefits.

PMID:40099342 | DOI:10.1177/01939459251324833

Vestn Otorinolaringol. 2025;90(1):15-19. doi: 10.17116/otorino20259001115.

ABSTRACT

Underground working conditions of uranium mining production are characterized by the predominance of industrial noise, determining a high occupational risk of hearing loss.

OBJECTIVE: To perform the analysis of occupational risk of hearing loss in uranium mining workers.

MATERIAL AND METHODS: The indicators of working conditions of uranium mining production of the «Rosatom» state corporation and tonal threshold audiometry data of 113 staff members as a part of preventive medical examination were used; a priori and a posteriori occupational risks of hearing loss were determined.

RESULTS: The highest levels of industrial noise and the highest noise dose have been noted in stope miners (SMs), that determines a priori risk of their hearing function impairment. The mean length of service in persons of SMs group is over 25 years. Indicators of a posteriori risk of occupational sensorineural hearing loss are predominant in SMs with long service period (25 years and more) – 50%.

CONCLUSION: The highest occupational risk of hearing loss is identified in stope miners, that means the need to optimize preventive measures to preserve their hearing function.

PMID:40099330 | DOI:10.17116/otorino20259001115

Workplace Health Saf. 2025 Mar 18:21650799251322201. doi: 10.1177/21650799251322201. Online ahead of print.

ABSTRACT

BACKGROUND: Individuals living with multiple chronic conditions (MCC; e.g., obesity, hypertension, diabetes, dyslipidemia) are at an increased risk for occupational injuries, decreased work productivity, and early departure from the workforce.

METHODS: A cross-sectional online survey of 200 working adults with obesity and hypertension, diabetes, and/or dyslipidemia was conducted to examine the relationships across self-efficacy, physical function, and healthy behaviors in addition to their relationship with the work environment.

FINDINGS: Self-efficacy was found to have a statistically significant positive association with physical function (p < .001) as well as with eating behaviors (p < .001). Full-time workers reported greater physical function than part-time workers (p < .001), and those working in active/manual labor positions reported more physical activity compared to those working in sedentary positions (p = .001).

CONCLUSION: Individuals with greater self-efficacy for managing their chronic conditions also had higher physical function capabilities and healthier eating behaviors. In addition, individuals who work full-time reported higher physical function capabilities, and those in active work positions had higher physical activity scores. Future research is needed to implement and evaluate the effectiveness of interventions.

APPLICATION TO PRACTICE: Occupational health nurses need to work with employees with MCC to help accommodate healthcare provider visits and/or work restrictions to allow employees to maintain full-time work in addition to encouraging sedentary workers to increase physical activity.

PMID:40099317 | DOI:10.1177/21650799251322201