Nevin Manimala

BMJ Ment Health. 2025 Mar 17;28(1):e301317. doi: 10.1136/bmjment-2024-301317.

ABSTRACT

QUESTION: The Green Brain Capital Model emphasises the bidirectional relationship between brain health and the environment, making it an environmentally focused type of brain capital. This work represents the initial stage of conceptualising the Green Brain Capital Model, which is essential to avoid ambiguity and misinterpretation while developing a quantitative model. Ecological intelligence (EI) is identified as a key component of the model in the literature. Therefore, the objective of this review was to systematically review the literature to define EI, its features and quantitative assessment tools, to develop comprehensive metrics for Green Brain Capital.

STUDY SELECTION AND ANALYSIS: We conducted a search in Scopus, ScienceDirect and Scopus secondary literature and identified 11 articles that provide definitions of EI and quantitative tools to assess it.

FINDINGS: The study revealed that EI is a multifaceted concept with cognitive, affective and behavioural domains. Seven quantitative tools for measuring EI were identified, with the Ecological Intelligence Measurement Tool by Okur-Berberoglu and the Ecological Intelligence Scale by Akkuzu, demonstrating strong theoretical grounding, reliability and validity. Additionally, our review included searching open-access databases provided by reputable organisations, but no indicators for the assessment of EI were found in these databases.

CONCLUSIONS: All the available tools were designed to assess EI at the individual level and for research purposes within certain cultural contexts. There is a lack of global indicators reflecting countries’ EI development status and global positioning. Establishing country-level indicators across EI domains is essential for policymaking and public awareness.

PMID:40097196 | DOI:10.1136/bmjment-2024-301317

Am J Perinatol. 2025 Mar 17. doi: 10.1055/a-2559-7261. Online ahead of print.

ABSTRACT

This study examined associations between prenatal care utilization and adverse obstetric outcomes including severe maternal morbidity (SMM), preterm birth, and stillbirth in a large, commercially insured U.S. patient population. This is a retrospective cohort study using an insurance claims database evaluating associations between prenatal care utilization and obstetric outcomes over four years (2017 – 2020). Prenatal care utilization was characterized based on the Adequacy of Prenatal Care Utilization (APNCU) index. The primary outcome was SMM (as per Centers for Disease Control). Secondary outcomes included preterm birth < 37 weeks and stillbirth. Associations between exposure and outcome were investigated using logistic regression models in designated “low” and “medium” maternal risk groups, defined based on obstetric co-morbidity index (OB-CMI) scores modeled at the time of the first trimester and at delivery. 297,453 patients were included: 78,100 in the sub-group who remained low-risk throughout pregnancy and 49,920 in the sub-group who remained medium-risk. The largest number of patients overall (29.9%) received “adequate plus” care, as defined by the APNCU index, while a plurality of low- and medium-risk patients received “intermediate” care (35.6% and 29.9%, respectively). 1.77% of patients experienced SMM, 8.63% delivered preterm, and 0.88% had stillbirth. Adjusted analysis comparing volume of prenatal care with these outcomes demonstrated no statistically significant associations, with the exception of preterm birth, which was positively associated with “adequate” and “adequate plus” care in low- and medium-risk patients. “Inadequate care” was not associated with any of the studied outcomes. Overall volume of prenatal care was not associated with a reduction in adverse obstetric outcomes. Clinical quality improvement and health policy efforts to improve prenatal care delivery models may need to bypass adherence to established guidelines in terms of gross visit number as a key metric and instead work to revise practices based on more meaningful clinical outcomes.

PMID:40097170 | DOI:10.1055/a-2559-7261

Br J Sports Med. 2025 Mar 17:bjsports-2024-108808. doi: 10.1136/bjsports-2024-108808. Online ahead of print.

ABSTRACT

OBJECTIVE: To prospectively examine the prevalence of diagnosed eating disorders (ED-diagnosis), ED-symptoms and factors predicting ED-symptoms in three male and female high school student groups: elite athletes, trained athletes and a non-athlete reference group at baseline (T1) and 1-year follow-up (T2).

METHODS: A survey was administered at baseline (T1) (n=1186) and 1-year follow-up (T2) (n=1144) (step-one). Participants classified with ED-symptoms by the Eating Disorder Examination Questionnaire (EDEQ 6.0) at T2 were invited to a diagnostic interview (step-two).

RESULTS: Prevalence of ED-diagnosis for males and females were 6.9% and 9.3% in elite athletes, 5.9% and 11.2% in trained athletes and 3.0% and 11.9% in references, respectively. No group differences were statistically significant. Male references had more ED-symptoms compared with elite and trained male athletes (EDEQ-global score 0.81 vs <0.55), while elite female athletes had fewer ED-symptoms compared with trained female athletes and female references (EDEQ-global score 1.14 vs >1.59). Trained female athletes increased ED-symptoms over time, whereas elite female athletes consistently had fewer ED-symptoms in comparison. High ED-symptom presentation was predicted by high body mass index and more psychological distress in males, whereas for females, ED-symptoms were predicted by lower resilience, more psychological distress and being a non-athlete reference.

CONCLUSION: No statistically significant group differences in the prevalence of ED-diagnosis were observed between elite athletes, trained athletes and a non-athlete reference group. Female elite athletes had fewer ED-symptoms compared with other female groups, and male references had more ED-symptoms compared with male athlete groups. Preventive measures that address psychological resilience and distress should be considered.

TRIAL REGISTRATION NUMBER: NCT04003675.

PMID:40097165 | DOI:10.1136/bjsports-2024-108808

Cold Spring Harb Perspect Biol. 2025 Mar 17:a041684. doi: 10.1101/cshperspect.a041684. Online ahead of print.

ABSTRACT

Telomeres, the long nucleotide repeats, and protein complex at chromosome ends, are central to genomic integrity. Telomere length (TL) varies widely between populations due to germline genetics, environmental exposures, and other factors. Very short telomeres caused by pathogenic germline variants in telomere maintenance genes cause the telomere biology disorders, a spectrum of life-threatening conditions including bone marrow failure, liver and lung disease, cancer, and other complications. Cancer predisposition with long telomeres is caused by rare pathogenic germline variants in components of the shelterin telomere protection protein complex and associated primarily with elevated risk of melanoma, thyroid cancer, sarcoma, and lymphoproliferative malignancies. In the middle, studies of the general population at risk of common illnesses, such as cardiovascular disease and cancer, have found statistically significant differences in TL but uncertain clinical applicability. This work reviews connections between telomere biology and human disease focusing on similarities and differences across the phenotypic spectrum.

PMID:40097157 | DOI:10.1101/cshperspect.a041684

Int J Radiat Oncol Biol Phys. 2025 Mar 15:S0360-3016(25)00239-1. doi: 10.1016/j.ijrobp.2025.03.014. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the intra-fractional anatomical variations during liver magnetic resonance-guided adaptive radiotherapy (MRgART) under abdominal compression (AC) using optical flow calculations.

METHODS: This study included 27 consecutive patients who underwent liver MRgART under AC. Overall, 387,566 slices from 145 single-slice cine MR series obtained from 29 different treatment plans were analyzed in the coronal and sagittal planes through tumor centers. After defining the square regions as 12 pixels centered on the isocenter for the tumor and 8 pixels between the inspiratory and expiratory phases, excluding the lung/liver boundary for the diaphragm, the vectors were calculated using Farnebäck optical flow. The intra-fractional superior-inferior (SI) motion range and the root-mean-square error (RMSE) between the position of the tumor and the diaphragm in the coronal (SI_coronal and RMSE_coronal) and sagittal planes (SI_sagittal and RMSE_sagittal) were classified according to the Couinaud-based tumor regions (segment I+IV, II+III, V+VIII, and VI+VII). Statistical significance was determined using the Wilcoxon signed-rank test with Holm-Bonferroni corrections (p < 0.05).

RESULTS: The median SI_coronal and SI_sagittal motion ranges of the tumor were 6.1 mm (range, 1.5-18.0 mm) and 8.1 mm (range, 1.0-21.0 mm), respectively (p < 0.05). When classified according to tumor location, segment VI+VII showed the largest difference, with the median SI_coronal and SI_sagittal motion ranges of 6.5 mm (range, 2.3-17.7 mm) and 10.6 mm (range, 4.8-21.0 mm), respectively (p < 0.05). The median RMSE_coronal and RMSE_sagittal values were the largest in segment VI+VII, showing significant differences of 2.6 mm and 2.2 mm, respectively (p < 0.05). These differences were due to the sliding motion of dorsally located tumors.

CONCLUSIONS: Optical flow analysis underestimated the SI motion range in the coronal plane compared with that in the sagittal plane during liver MRgART under AC. Tumor motion should be monitored in the sagittal plane, considering sliding motion of the liver, with individualized margins according to tumor location.

PMID:40097116 | DOI:10.1016/j.ijrobp.2025.03.014

J Stomatol Oral Maxillofac Surg. 2025 Mar 15:102316. doi: 10.1016/j.jormas.2025.102316. Online ahead of print.

ABSTRACT

BACKGROUND: Osteoradionecrosis (ORN) refers to necrotic bone that remains unhealed for a minimum of 3 months following radiotherapy in an irradiated region. The aim of this systematic meta-analysis was to evaluate the efficacy of hyperbaric oxygen therapy and surgery alone or in combination in the treatment of patients with ORN.

METHODS: A systematic review and analysis of literature were performed to ascertain the role of surgery and HBO in the treatment of ORN. In May 2024 we updated the searches of the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library, Issue 1), MEDLINE, EMBASE, DORCTIHM and reference lists of articles.

RESULTS: Among patients who underwent both HBO and surgery, the success rate of the treatment was 69% (95% Confidence Interval [CI]: 0.47-0.85, df = 9). Patients who solely received HBO had a success rate of 38% (CI: 0.20-0.61, df = 4), while those who only had surgery had a success rate of 36% (CI: 0.19-0.58, df = 3). The statistical analysis showed no significant difference in the results between patients who received only hyperbaric oxygen therapy or surgical treatment (z=0.139, p=0.889). The analysis indicated significant disparities in treatment success rates among patients receiving a combination of HBO and surgery compared to those treated solely with HBO or surgery alone (z = 2.428, p = 0.015 for HBO vs HBO+surgery, z = 2.655, p = 0.008 for surgery vs HBO+surgery).

CONCLUSION: The findings of this study indicate that the combination of HBO and surgery is a more effective approach for managing ORN, with better results observed when treatments are combined rather than used individually.

PMID:40097107 | DOI:10.1016/j.jormas.2025.102316

Actas Urol Esp (Engl Ed). 2025 Mar 15:501744. doi: 10.1016/j.acuroe.2025.501744. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the diagnostic value of serum metabolic markers such as HCY, sdLDL-C, Crea, inflammatory factor IL-6 and prostate-specific antigen in elderly patients with prostatic hyperplasia (BPH).

METHODS: 150 senile patients with hyperplasia of prostate were selected as observation group and 169 healthy senile patients were selected as control group. The tPSA, fPSA, fPSA/t PSA and prostate size data of the two groups were collected, and serum samples of the subjects were collected for the detection of HCY, sdLDL, Crea, IL-6 and other indicators. Univariate analysis, correlation analysis and Logistic regression analysis were conducted to analyze the relationship between each index and senility prostatic hyperplasia. The diagnostic efficiency of each serum metabolite was analyzed by receiver operating characteristic curve (ROC).

RESULTS: Serum levels of tPSA, fPSA, Crea, HCY, sdLDL-C and IL-6 were significantly increased, fPSA/tPSA ratio and HDL were significantly decreased, and TCHO, TG and LDL had no statistical significance. Serum tPSA and fPSA levels were positively correlated with prostate size, serum IL-6, Crea and HCY levels were positively correlated with tPSA and fPSA levels, and serum sdLDL-C levels were negatively correlated with fPSA levels. Logistic regression analysis showed that tPSA, fPSA, prostate size, HCY, Crea and IL-6 were risk factors for prostate hyperplasia. HDL and fPSA/tPSA are protective factors for benign prostatic hyperplasia. ROC curve analysis showed that the sensitivity and specificity of fPSA/tPSA and IL-6 were 82.7% and 72%, 83.4% and 80.5%, and the area under ROC curve were 0.840 and 0.825, respectively. tPSA and fPSA combined with HCY, IL-6 and Crea had the best diagnostic efficiency, with the area under ROC curve reaching 0.881, specificity and sensitivity reaching 84% and 77.3%, respectively.

CONCLUSION: The combined detection of prostate-specific antigen, HCY, Crea and IL-6 can significantly improve the diagnostic efficiency of senile prostatic hyperplasia, and optimize the diagnosis and treatment scheme can even be used as a major screening index to evaluate and predict the incidence of BPH in senile prostatic hyperplasia.

PMID:40097101 | DOI:10.1016/j.acuroe.2025.501744

Tunis Med. 2025 Feb 5;103(2):217-224. doi: 10.62438/tunismed.v103i2.5318.

ABSTRACT

INTRODUCTION: There are no clear data on the incidence and predictors of arterial and venous thromboembolic (TE) events in COVID-19 ambulatory patients.

AIM: We conducted this study to analyze thromboembolic complications in this setting and to compare the efficacy and safety of Rivaroxaban to LMWHs as a thromboprophylaxis treatment.

METHODS: This is an observational study including COVID-19 patients treated on an outpatient basis. We analysed the predictors of thromboembolic events.

RESULTS: We included 2089 patients with COVID19 managed on an outpatient basis during the period from October 01, 2020 to December 31, 2021. The mean age of our patients was 43±16 years. The incidence of venous and arterial TE complications was 0.9%. Predictive factors for arteriovenous thromboembolic complications were hormonal contraception (OR=23), moderate clinical form (OR=3.5), recent surgery or miscarriage in the month preceding COVID-19 (OR=9.2) and CT signs of COVID-19 (OR=4.9). In contrast, physical activity proved to be a protective factor. Thromboprophylaxis was prescribed in 22.5% of cases: LMWH in 18.1%, Rivaroxaban in 3.7% and a combination of the two molecules successively in 0.6% of patients. There was no statistical difference in thromboembolic or major bleeding complications between the Rivaroxaban and LMWH groups.

CONCLUSION: Our study showed that the incidence of thromboembolic complications is very low in Covid-19 ambulatory patients.

PMID:40096722 | DOI:10.62438/tunismed.v103i2.5318

J Pediatr Psychol. 2025 Mar 17:jsaf010. doi: 10.1093/jpepsy/jsaf010. Online ahead of print.

ABSTRACT

OBJECTIVES: To inform and improve future program development, particularly with economically marginalized families, this study aimed to examine the acceptance and satisfaction of a mindfulness-based healthy eating and stress management program among participating parents and daycare teachers in a pilot trial.

METHODS: A mixed-methods study was conducted to evaluate a 14-week mindfulness-based program implemented with 107 English-speaking Head Start children (ages 3-5 years) and their parents. The program included a school-based mindful eating curriculum, a home-based parent component to promote mindful eating and reduce parental stress, and a bridging activity connecting home practice with school learning. Quantitative evaluation data were collected from 84 parents (Mage = 30.12 years) and 12 teachers (Mage = 43.92 years) via Qualtrics. Semistructured interviews were conducted with 20 parents (Mage = 31.55 years). Descriptive statistics and thematic analysis were used to analyze data.

RESULTS: Both quantitative (95.2%) and qualitative data demonstrated overall satisfaction with the entire program. About 83%-92% of teachers and 85% of parents considered the school-based curriculum to be satisfactory and acceptable. About 88%-100% of parents were satisfied with the Facebook private group and parent meetings. Approximately 91% of parents found the child letters helpful in connecting and translating school learning into mindful practices at home.

CONCLUSIONS: Results demonstrate high levels of acceptance and satisfaction with the mindfulness-based program among economically marginalized families and daycare teachers. Findings provide several key implications for future interventions to incorporate a mindful eating curriculum into daycare routines, proactively connect home practices with school learning to enhance the interactive influence between children and parents, and form a virtual peer support community through social media platforms and group meetings.

PMID:40096702 | DOI:10.1093/jpepsy/jsaf010

PLoS Comput Biol. 2025 Mar 17;21(3):e1012830. doi: 10.1371/journal.pcbi.1012830. eCollection 2025.

ABSTRACT

The ability to process visual stimuli rich with motion represents an essential skill for animal survival and is largely already present at the onset of vision. Although the exact mechanisms underlying its maturation remain elusive, spontaneous activity patterns in the retina, known as retinal waves, have been shown to contribute to this developmental process. Retinal waves exhibit complex spatio-temporal statistics and contribute to the establishment of circuit connectivity and function in the visual system, including the formation of retinotopic maps and the refinement of receptive fields in downstream areas such as the thalamus and visual cortex. Recent work in mice has shown that retinal waves have statistical features matching those of natural visual stimuli, such as optic flow, suggesting that they could prime the visual system for motion processing upon vision onset. Motivated by these findings, we examined whether artificial neural network (ANN) models trained on natural movies show improved performance if pre-trained with retinal waves. We employed the spatio-temporally complex task of next-frame prediction, in which the ANN was trained to predict the next frame based on preceding input frames of a movie. We found that pre-training ANNs with retinal waves enhances the processing of real-world visual stimuli and accelerates learning. Strikingly, when we merely replaced the initial training epochs on naturalistic stimuli with retinal waves, keeping the total training time the same, we still found that an ANN trained on retinal waves temporarily outperforms one trained solely on natural movies. Similar to observations made in biological systems, we also found that pre-training with spontaneous activity refines the receptive field of ANN neurons. Overall, our work sheds light on the functional role of spatio-temporally patterned spontaneous activity in the processing of motion in natural scenes, suggesting it acts as a training signal to prepare the developing visual system for adult visual processing.

PMID:40096645 | DOI:10.1371/journal.pcbi.1012830