Nevin Manimala

Equine Vet J. 2025 Feb 26. doi: 10.1111/evj.14491. Online ahead of print.

ABSTRACT

BACKGROUND: Exercising arrhythmias are common in horses participating in eventing competitions. Heart rate variability (HRV) and a specific measure of the degree of heart rate fluctuation (Detrended Fluctuation Analysis alpha1; DFA-α1) are proposed as exercise intensity and fatigue markers.

OBJECTIVES: (1) To describe exercising arrhythmias and DFA-α1 values during 2-4* level eventing cross-country competitions in horses from two European countries; (2) to identify associations between exercising arrhythmias, DFA-α1 and competition results and (3) to evaluate whether markers of the intensity of exercise are associated with exercising arrhythmias, DFA-α1 or competition results.

METHODS: A convenience sample of exercising ECGs and competition results from horses during cross-country eventing competitions was examined. Statistical analysis was conducted using multivariable mixed-effects logistic, Poisson and linear regression models.

RESULTS: Arrhythmias were frequent during 69 cross-country competition ECGs from 43 horses. Detrended fluctuation analysis α1 was not associated with performance during cross-country, but a higher DFA-α1 during cross-country was associated with fewer showjumping phase penalties. More premature complexes, the presence of complex arrhythmias and arrhythmias during recovery were associated with fewer time penalties during cross-country. The presence of complex arrhythmias and arrhythmias during recovery of the cross-country phase was associated with more penalties during the showjumping phase. Higher blood lactate concentration, higher HR_peak and higher HR_mean were associated with fewer time penalties during cross-country.

MAIN LIMITATIONS: The arrhythmias observed do not allow conclusions to be drawn about the consequences of more severe arrhythmias. The associations described here were often of small magnitude or with large confidence intervals and must be interpreted cautiously.

CONCLUSIONS: Arrhythmias during the cross-country test of eventing competitions were frequently associated with positive competition results during the cross-country phase and negative results during the showjumping phase. The specific arrhythmia types and circumstances that should raise concern about performance and safety remain relevant but unanswered questions for equine practitioners.

PMID:40008417 | DOI:10.1111/evj.14491

J Pain Res. 2025 Feb 21;18:827-836. doi: 10.2147/JPR.S500984. eCollection 2025.

ABSTRACT

PURPOSE: To examine whether reported pain intensity over time is related to the single nucleotide polymorphisms of the catechol-O-methyltransferase (COMT rs4680) and mu-opioid receptor (OPRM1 rs1799971) in patients with opioid use disorder (OUD) choosing treatment with extended-release naltrexone (XR-NTX) or opioid agonist treatment (OAT).

PATIENTS AND METHODS: This exploratory study was part of a 24-week, open-label clinical prospective trial of patients with OUD who chose intramuscular XR-NTX, and patients receiving OAT. Men and women aged 18 to 65 years with OUD per the Diagnostic and Statistical Manual of Mental Disorders, fifth edition were included. Pain intensity was measured at baseline and at 24-week follow-up using the Numerical Pain Rating Scale-11 and genotyping was performed by TaqMan technology. Data were analyzed with ordinal logistic regression.

RESULTS: Of 317 participants included at baseline, 210 samples were obtained and analyzed. In the OAT group, there was a negative significant association between pain intensity and having the Val/Val allele of COMT rs4680 (wild-type = most common type) and the rare allele G of OPRM1 rs1799971 at 24-week follow-up. No such effects were seen in the XR-NTX group.

CONCLUSION: The wild-type allele Val/Val of COMT rs4680 and the rare allele G of OPRM1 rs1799971 may have a possible protective effect regarding pain intensity in patients with OUD receiving OAT. Given relatively low sample size, particularly low number of female participants in the XR-NTX group and other possible confounders, our findings should be interpreted with caution.

PMID:40008400 | PMC:PMC11853772 | DOI:10.2147/JPR.S500984

Front Reprod Health. 2025 Feb 11;7:1520938. doi: 10.3389/frph.2025.1520938. eCollection 2025.

ABSTRACT

BACKGROUND: Male infertility is a significant global public health issue, with modifiable lifestyle factors such as smoking, obesity, and psychological stress contributing to impaired semen quality and hormonal dysregulation. This study investigates the relationships between modifiable lifestyle factors, reproductive hormones, and semen quality in Ghanaian males attending an IVF clinic.

METHODS: A cross-sectional study was conducted with 212 male participants recruited from a fertility clinic in Ghana. Lifestyle factors were assessed using standardized questionnaires, and semen samples were analyzed following WHO guidelines. Hormonal profiles (LH, FSH, testosterone, estradiol) were measured using the enzyme-linked fluorescent assay (ELFA). Statistical analyses included Pearson’s product-moment correlation and Bonferroni correction.

RESULTS: Smoking and psychological stress were significantly associated with reduced sperm motility, viability, and concentration (p < 0.05). Elevated BMI correlated negatively with sperm concentration and testosterone levels (p < 0.05). Alcoholic bitters was linked to decreased semen quality, while caffeine consumption showed a positive association with progressive sperm motility.

CONCLUSION: Modifiable lifestyle factors, such as smoking, psychological stress, and increased body mass index (BMI), play a crucial role in male reproductive health by adversely affecting semen parameters and hormonal balance. These findings emphasize the need for public health interventions targeting modifiable behaviors to improve fertility outcomes.

PMID:40008399 | PMC:PMC11850308 | DOI:10.3389/frph.2025.1520938

MedEdPORTAL. 2025 Feb 25;21:11500. doi: 10.15766/mep_2374-8265.11500. eCollection 2025.

ABSTRACT

INTRODUCTION: Emergency medicine (EM) providers often care for patients who present with concerns related to sexual assault (SA) or intimate partner violence (IPV). However, many providers feel uncomfortable discussing SA and IPV with patients. We aimed to design a curriculum using trauma-informed care principles to improve self-assessed competency in caring for this patient population.

METHODS: EM learners, including residents, EM physician assistant fellows, and medical students, attended a 25-minute didactic session introducing the concept of trauma-informed care and important questions to ask in IPV and SA cases. Learners then participated in a 15-minute simulated single-patient encounter during which they practiced collecting a trauma-informed history identifying features of IPV or SA and appropriately responding to such disclosures. The encounters were observed by a trained SA medical forensic examiner or a victim advocate. The learners next participated in a 10-minute individual and 15-minute group debrief.

RESULTS: Sixteen pre- and 17 postcurriculum self-assessments were completed. There was a statistically significant increase in self-perceived confidence in the learners’ ability to collect information (p < .01), use strategies to help patients feel physically and psychologically safe (p < .001), recognize how bias influences patient encounters (p < .05), and provide counseling (p < .05). Learners overall found the learning exercise valuable.

DISCUSSION: The exercise introduced learners to trauma-informed care, improved learner confidence, and was well received. Many EM residency programs incorporate simulation into their curriculum; this simulation exercise can be adapted to other programs’ educational needs.

PMID:40008394 | PMC:PMC11850505 | DOI:10.15766/mep_2374-8265.11500

IEEE Trans Radiat Plasma Med Sci. 2024 Nov 15:1. doi: 10.1109/TRPMS.2024.3496779. Online ahead of print.

ABSTRACT

Reduced dose Positron Emission Tomography (PET) lowers the radiation dose to patients and reduces costs. Lower count data, however, degrades reconstructed image quality. Advanced reconstruction methods help mitigate image quality losses, but it is important to assess the resulting images from a clinical perspective. Two experienced clinicians assessed four PET reconstruction algorithms for [¹⁸F]FDG brain data, compared to a clinical standard reference (Maximum-Likelihood Expectation-Maximization (MLEM)), based on seven clinical image quality metrics: global quality rating, pattern recognition, diagnostic confidence (all on a scale of 0-4), sharpness, caudate-putamen separation, noise, and contrast (on a scale between 0-2). The reconstruction methods assessed were a guided and unguided version of self-supervised maximum a posteriori EM (MAPEM) (where the guidance case used the patient’s MR image to control the smoothness penalty). For 3 of the 11 patient datasets reconstructed, post-smoothed versions of the MAPEM reconstruction were also considered, where the smoothing was with the point-spread-function used in the resolution modelling. Statistically significant improvements were observed in sharpness, caudate-putamen separation, and contrast for self-supervised MR-guided MAPEM compared to MLEM. For example, MLEM scored between 1-1.1 out of 2 for sharpness, caudate-putamen separation and contrast, whereas self-supervised MR-guided MAPEM scored between 1.5-1.75. In addition to the clinical evaluation, pre-trained Convolutional Neural Networks (CNNs) were used to assess the image quality of a further 62 images. The CNNs demonstrated similar trends to the clinician, showing their potential as automated standalone observers. Both the clinical and CNN assessments suggest when using only 5% of the standard injected dose, self-supervised MR-guided MAPEM reconstruction matches the 100% MLEM case for overall performance. This makes the images far more clinically useful than standard MLEM.

PMID:40008384 | PMC:PMC7617360 | DOI:10.1109/TRPMS.2024.3496779

Breast J. 2025 Feb 18;2025:8410670. doi: 10.1155/tbj/8410670. eCollection 2025.

ABSTRACT

Introduction: Triple-negative breast cancers (TNBCs) constitute a significant proportion of breast cancers in Pakistan. Owing to the lack of expression of hormone (estrogen/progesterone) receptor and human epidermal growth factor receptor 2 (HER2neu), treatment options for TNBCs are limited. Therefore, it is important to identify markers that predict response to chemotherapy in these patients. Previous studies have demonstrated that the excision repair cross complementation group 1 (ERCC1) protein can successfully augur the response to chemotherapy in cancer; however, data related to TNBCs, particularly in Pakistan, are limited. Therefore, in this study, we evaluated the role of ERCC1 in predicting the response to neoadjuvant chemotherapy in patients with TNBCs. Methods: This cross-sectional study was conducted at the Liaquat National Hospital, Histopathology Department, between January 2019 and June 2023. A total of 132 biopsy-proven cases of breast cancer that were negative for estrogen receptor (ER), progesterone receptor (PR), and HER/2neu and were administered neoadjuvant chemotherapy before surgery were included in the study. ERCC1 immunohistochemical (IHC) staining was performed on prechemotherapy needle biopsies. The results were scored semiquantitatively by assessing the average intensity on a scale of 0-3 (0, no staining; 1, weak nuclear staining; 2, intermediate nuclear staining; and 3, strong nuclear staining) and the proportion of tumor cells showing positive nuclear staining. The intensity and proportion scores were then multiplied to give a score that was divided by 100 to give an overall score, and scores equal to or higher than 1.0 were considered positive. Neoadjuvant chemotherapy response was categorized as pathological complete response (pCR) when no residual invasive breast carcinoma was found on the postneoadjuvant chemotherapy excision specimen and as pathological partial response (pPR) when residual cancer cells were present in admixed chemotherapy-related changes. The residual cancer burden (RCB) was calculated using the MD Anderson RCB calculator. The association between ERCC1 expression and the chemotherapy response/RCB class was determined. Results: We found that 90.9% (n = 120) of TNBC cases expressed ERCC1, whereas pCR was noted in 24 (18.2%) cases. A significant association was observed between ERCC1 expression and pCR. Cases with negative ERCC1 expression had a significantly higher frequency of pCR (66.7%) than those with positive ERCC1 expression (13.3%). Additionally, the ERCC1-positive group showed a higher frequency of RCB classes II (36.7%) and III (43.3%) than the ERCC1-negative group (RCB II: 25%; RCB III: 0%). Moreover, positive ERCC1 expression was associated with higher nodal (N) stage. Conclusion: In this study, we established the role of negative ERCC1 expression in predicting the response to chemotherapy in neoadjuvant TNBC. Therefore, ERCC1 can be used as a predictive marker to stratify patients who will benefit from neoadjuvant therapy. Moreover, we also noted an association between ERCC1 expression and nodal metastasis; however, more large-scale studies are needed to establish its role as a prognostic biomarker in TNBC.

PMID:40008380 | PMC:PMC11858828 | DOI:10.1155/tbj/8410670

Front Psychol. 2025 Feb 11;16:1495733. doi: 10.3389/fpsyg.2025.1495733. eCollection 2025.

ABSTRACT

OBJECTIVE: Psychological frailty, an emerging concept, lacks a standardized definition, measuring instrument, and empirical evidence in Asian (especially Chinese) populations. An effective instrument to measure psychological frailty should be urgently developed. Therefore, this study aimed to develop and initially validate a Psychological Frailty Index (PFI) based on the China Health and Retirement Longitudinal Study (CHARLS). The study assessed the applicability of the PFI to adverse health outcomes as a secondary aim.

RESULTS: Factor analysis of the 15-item PFI extracted four factors of psychological frailty (psychological distress, cognitive decline, physical vulnerability, and memory decline). The PFI demonstrated satisfactory internal consistency (Cronbach’s alpha = 0.764) and criterion validity (rho = 0.806). Psychological frailty was significantly associated with lower life expectancy (odds ratio [OR] 1.98, 95% confidence interval [CI] 1.71-2.29), higher outpatient treatments (1.25, 1.03-1.51), and increased hospitalization (1.45, 1.22-1.74).

CONCLUSION: The PFI could be a reliable instrument for identifying psychological frailty. The PFI is a novel tool that measures health indicators of older adults at risk of increased psychological vulnerability, but it requires further validation.

PMID:40008339 | PMC:PMC11850362 | DOI:10.3389/fpsyg.2025.1495733

Front Psychol. 2025 Feb 11;16:1507198. doi: 10.3389/fpsyg.2025.1507198. eCollection 2025.

ABSTRACT

OBJECTIVE: Moderate Intensity Continuous Training (MICT) is recognized as an effective intervention for improving negative affect. However, research on its effects across varying levels of negative mood states in sedentary female college students remains limited. This study aimed to investigate the impact of a 12-week MICT intervention on different levels of negative mood in sedentary female college students.

METHODS: A total of 144 participants were randomly assigned to two groups, each consisting of 72 individuals. The participants were further categorized into three negative mood groups: depression, anxiety, and stress, with 24 participants in each group. Within each mood group, participants were divided into three subgroups based on the severity of their mood (mild, moderate, and severe), with 8 participants in each subgroup. The experiment spanned 12 weeks, with two 45-min training sessions per week. Intensity was monitored throughout the experiment using the Borg Rating of Perceived Exertion (RPE), and heart rate was measured immediately following each session. The training intensity was maintained at 60-69% of HRmax throughout the 12 weeks.

RESULTS: After 12 weeks of MICT, MICT had a positive effect on mild and severe depressive mood, moderate anxiety, and mild stressful mood in sedentary female college students (p < 0.05), but MICT did not have statistically significant effects on moderate depressive mood, mild and severe anxiety, and moderate and severe stressful mood in sedentary female college students (p > 0.05).

CONCLUSION: MICT may have a beneficial effect on sedentary female college students, particularly those with lower levels of emotional distress. However, due to the absence of a positive control group, it is difficult to draw definitive conclusions about its specific impact. Future studies should employ more rigorous control designs to better assess the role of MICT in improving both the physical and mental health of sedentary female college students.

PMID:40008338 | PMC:PMC11850354 | DOI:10.3389/fpsyg.2025.1507198

Front Psychol. 2025 Feb 11;16:1490022. doi: 10.3389/fpsyg.2025.1490022. eCollection 2025.

ABSTRACT

INTRODUCTION: Cyberbullying is a pervasive issue in the digital age, closely linked to social media usage. However, existing research has largely overlooked the role of tie strength on social media platforms in shaping cyberbullying dynamics. This study, grounded in tie strength theory and medium theory, investigates the association between social media usage and cyberbullying, focusing on how tie strength moderates this relationship.

METHODS: A sample of 813 healthy adults (M_age = 20.06 ± 2.30 years, 498 females) completed an online survey, including the Chinese version of the Social Network Site Intensity Scale and the Cyberbullying Inventory for College Students (CICS).

RESULTS: (1) Tie strength varies from platform to platform. The order of tie strength between users and the four platforms is as follows: WeChat > Bilibili > Weibo > Douyin. (2) Strong-tie social media platforms exhibited higher levels of users’social media engagement compared to those with weak ties. (3) Weak ties significantly moderated the relationship between social media usage and cyberbullying, whereas strong ties did not. Increased social media usage was associated with a higher likelihood of both engaging in and being a victim of cyberbullying on weak-tie platforms, while strong-tie platforms showed a lower likelihood of both engaging in or being a victim of cyberbullying with increased usage.

CONCLUSION: These findings highlight the interplay between tie strength theory and medium theory in explaining cyberbullying dynamics and underscore the need for platform-specific interventions to address this pervasive issue.

PMID:40008336 | PMC:PMC11850326 | DOI:10.3389/fpsyg.2025.1490022

Resusc Plus. 2025 Jan 28;22:100882. doi: 10.1016/j.resplu.2025.100882. eCollection 2025 Mar.

ABSTRACT

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a significant global public health issue, few studies describe characteristics and trends in China. This study examines OHCA features and trends in Shenzhen, one of the fastest-growing cities.

METHODS: This retrospective study analysed data from the Shenzhen Emergency Center database (2011-2018), including ambulance dispatch and pre-hospital medical records. Descriptive statistics and temporal trends were used to examine the incidence, patients characteristics, pre-hospital treatment, and outcome.

RESULTS: Among 18,772 medical cause OHCA cases, the crude incidence rate was 17.4 per 100,000 population, with an age-standardised rate of 38.4. Incidence increased over time. Resuscitation was attempted in 43.8% of cases, with a median patient age of 56 years and 73.5% being male. Most arrest (69.0%) occurred at home, and 82% were presumed to be cardiac cause.The median response time was 11.2 min. Bystander cardiopulmonary resuscitation (CPR) rates increased from 4.6% in 2011 to 14.5% in 2018, while bystander automated external defibrillator (AED) use remained low (0.2%). Pre-hospital electrocardiogram (ECG) recording improved from 40.6% to 91.9%, with shockable rhythms 2.2%. Intravenous access was established in 69.7% of patients, 51.9% received epinephrine, 19.29% received pre-hospital defibrillation, and 16.4% underwent advanced airway management. The pre-hospital Return of Spontaneous Circulation (ROSC) rate increased from 2.7% to 5.8%, with a total ROSC rate of 3.11%.

CONCLUSIONS: OHCA incidence in Shenzhen is lower than both domestic and international levels but increasing. Low bystander intervention rated and prolonged response times contribute to poor outcome, underscoring the need for system improvements.

PMID:40008323 | PMC:PMC11851179 | DOI:10.1016/j.resplu.2025.100882