Nevin Manimala

Med Sci Sports Exerc. 2025 Mar 14. doi: 10.1249/MSS.0000000000003703. Online ahead of print.

ABSTRACT

PURPOSE: We sought to evaluate the effect of intensive physical training on left ventricular (LV) hemodynamic forces (HDF) in athletes.

METHODS: Forty professional endurance athletes were evaluated at the beginning of their training cycle (off-season) and after a period of aerobic isotonic dynamic exercise (peak training period) using cardiac magnetic resonance (CMR). Images were analyzed off-line using dedicated software. LV HDF for the whole cardiac cycle and the different cardiac phases were measured. Standard statistics were used to compare off-season and peak training period values.

RESULTS: The average sport experience was 11 ± 7 years. There were no differences in LV volumes, stroke volume, LVEF and LV mass between off-season and peak training CMR. Similarly, there were no changes induced by physical training in the strain parameters. Physical training induced a significant increase of the longitudinal HDF (18.7 vs 21.2, p = 0.023) and an increase of the transverse HDF (3.4 vs 4.0, p = 0.048) throughout the entire heartbeat. After physical training, the peak values and the hemodynamic work (expressed as AUC) of the first part of the systole were significantly higher compared to off-season values (63.9 vs 53.9, p = 0.034; 4.67 vs 3.79, p = 0.015, respectively). The difference in the elastic rebound between off-season and peak training (-0.22 vs -0.37) did not reach statistical significance (p = 0.056).

CONCLUSIONS: Intense physical training induces an increase in LV HDF of the first part of the systole and of the elastic rebound phase, independent from geometric cardiac remodeling.

PMID:40085803 | DOI:10.1249/MSS.0000000000003703

NCHS Data Brief. 2024 Oct;(511).

ABSTRACT

INTRODUCTION: This report presents the latest findings from the National Health and Nutrition Examination Survey on the prevalence, awareness, treatment, and control of hypertension among adults in the United States during August 2021-August 2023.

METHODS: Nationally weighted prevalence estimates of hypertension (systolic blood pressure of 130 mm Hg or above or diastolic blood pressure of 80 mm Hg or above, or self-report of current blood pressure medication use), self-reported awareness, self-reported treatment, and control (blood pressure less than 130/80 mm Hg) were obtained using National Health and Nutrition Examination Survey August 2021-August 2023 data. Variance estimates accounted for the complex survey design by using Taylor series linearization. Differences between estimates overall, among subgroups, and compared with 2017-March 2020 were tested using a t statistic at the p < 0.05 significance level.

KEY FINDINGS: During August 2021-August 2023, the prevalence of hypertension in adults was 47.7%, was higher in men (50.8%) than women (44.6%), and increased with age: 23.4% for ages 18-39, 52.5% for 40-59, and 71.6% for 60 and older. Among adults with hypertension, 59.2% were aware of their hypertension status, more than one-half were currently taking medication to lower blood pressure, and about one-fifth had their blood pressure controlled to less than 130/80 mm Hg. No significant change in awareness, treatment, or control of hypertension was seen among adults with hypertension between 2017-March 2020 and August 2021-August 2023.

PMID:40085792

Int J Surg. 2025 Mar 14. doi: 10.1097/JS9.0000000000002330. Online ahead of print.

ABSTRACT

BACKGROUND: Fluid resuscitation represents a pivotal early therapeutic intervention in the management of acute pancreatitis (AP), yet a consensus on the optimal fluid type remains elusive. The present study endeavors to elucidate the differential effects of lactated Ringer’s solution (LR) and normal saline (NS) in the initial treatment of AP.

METHODS: A comprehensive literature search was conducted through the PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases, spanning from inception until July 2024. The primary outcome of interest was the likelihood of developing moderate-to-severe AP.

RESULTS: This meta-analysis synthesized evidence from six randomized controlled trials (RCTs) and four observational studies, involving a total of 1500 AP patients. Patients were stratified into two groups based on the administered fluid: LR (n = 689) and NS (n = 811). Our findings revealed that, compared to the NS group, patients in the LR group demonstrated a significantly lower risk of moderate-to-severe acute pancreatitis (OR 0.48; 95%Cl 0.34 to 0.67; P < 0.001; I2 = 0%), a shorter hospital stay (MD = – 0.74, 95% CI -1.20 to -0.28, P = 0.001; I2 = 0%), and a reduced ICU admission rate (RR = 0.42, 95% CI 0.20-0.89, P = 0.02; I2 = 0%). Moreover, the LR group also showed a lower incidence of local complications (RR = 0.58, 95% CI 0.34-0.98, P = 0.04). Conversely, no statistically significant differences were observed between the two groups in terms of mortality, organ failure rates, Fluid administered 24 h, systemic inflammatory response syndrome (SIRS).

CONCLUSIONS: Our analysis underscores the superior efficacy of Lactated Ringer’s (LR) solution in comparison to Normal Saline (NS). It provides compelling evidence of LR’s ability to significantly mitigate the onset of moderate to severe pancreatitis. Additionally, our findings reveal that LR is associated with a reduced need for Intensive Care Unit (ICU) admissions, a lower incidence of local complications, and a shorter overall hospital stay, thereby offering a more favorable clinical outcome. However, no notable differences were discerned in other complications. Subgroup analyses further suggest LR’s potential to curb pancreatic necrosis and other indices, albeit these findings necessitate corroboration through extensive experimentation.

PMID:40085761 | DOI:10.1097/JS9.0000000000002330

JMIR Res Protoc. 2025 Mar 14;14:e63636. doi: 10.2196/63636.

ABSTRACT

BACKGROUND: Global concern for the mental well-being of university students is on the rise. Recent studies estimate that around 30% of students experience mental health disorders, and nearly 80% of these individuals do not receive adequate treatment. Brazil, home to around eight million university students, lacks sufficient research addressing their mental health. To address this gap, we aim to conduct a longitudinal mental health survey at 2 Brazilian universities.

OBJECTIVE: This paper outlines the research protocol for a web-based mental health survey designed to assess the well-being of Brazilian university students.

METHODS: The survey targets undergraduate students (N=8028) from 2 institutions: UniFAJ (Centro Universitário de Jaguariúna) and UniMAX (Centro Universitário Max Planck). Students will be invited to respond to self-reported questionnaires, including theSMILE-U (lifestyle and quality of life), the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]) self-rated level 1 cross-cutting symptom measure, and a brief version of the Adult Self-Report Scale for attention-deficit/hyperactivity disorder. Students who exceed thresholds for conditions such as depression, anxiety, and attention-deficit/hyperactivity disorder will receive additional diagnostic instruments. The survey will be conducted annually, tracking individual and group trajectories and enrolling new cohorts each year. Data will be analyzed using cross-sectional and longitudinal methods, focusing on descriptive, associative, and trajectory analyses.

RESULTS: The first wave of data collection began in February 2024 and is expected to conclude in December 2024. As of October 2024, a total of 2034 of 7455 (27.2 in 100) eligible students had completed the questionnaire. Cross-sectional statistical analysis is planned to commence immediately after data collection and is expected to be completed by June 2025.

CONCLUSIONS: This survey uses a scalable, cost-effective design to evaluate mental health conditions among Brazilian university students. The longitudinal framework facilitates the monitoring of mental health trends, supports the development of targeted interventions, and informs policy initiatives in higher education.

TRIAL REGISTRATION: OSF Registries OSF.IO/AM5WS; https://doi.org/10.17605/OSF.IO/AM5WS.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/63636.

PMID:40085140 | DOI:10.2196/63636

J Nurs Res. 2025 Mar 17. doi: 10.1097/jnr.0000000000000665. Online ahead of print.

ABSTRACT

BACKGROUND: Prolonged depressive symptoms in individuals with schizophrenia not only diminish their quality of life but also significantly increase their risk of suicide. This, in turn, may lead to a lower average life expectancy among people with schizophrenia compared to the general population.

PURPOSE: This study was designed to examine the effectiveness of rumination-focused cognitive behavior therapy (RFCBT) on depressive symptoms in individuals with schizophrenia.

METHODS: This study was conducted between July 2019 and March 2020. Seventy-seven participants, all of whom had been diagnosed with schizophrenia, were randomly divided into the experimental group (n = 38) and control group (n = 39). The experimental group underwent a 12-week, six-session RFCBT regimen, whereas the control group received six sessions of psychosocial education. Outcomes were measured using the Beck Depression Inventory-II and the revised short form of the Chinese Response Style Questionnaire at three time points: baseline, postintervention, and at the 3-month follow-up. Statistical analyses were conducted using chi-square tests, independent t tests, and generalized estimating equations, with the generalized estimating equations model assessing between-group differences over time after adjusting for 13 covariates.

RESULTS: No effect on depressive symptoms was observed immediately following RFCBT. However, at the 3-month follow-up, the mean Beck Depression Inventory-II score had reduced significantly in the experimental group (from 17.24 to 15.56) and increased in the control group (from 17.59 to 23.03; p = .016). Chinese Response Style Questionnaire-10 scores, which are used to represent ruminative responses, did not differ significantly between the groups at any of the three time points.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE: These findings offer compelling preliminary evidence in support of RFCBT as a potentially effective treatment strategy for alleviating depressive symptoms in patients with schizophrenia. The efficacy of RFCBT was demonstrated in terms of preventing the exacerbation of depressive symptoms. The findings have notable implications for clinicians, researchers, and policymakers with regard to developing more effective treatment strategies and enhancing outcomes for individuals with schizophrenia.

PMID:40085129 | DOI:10.1097/jnr.0000000000000665

Ophthalmic Surg Lasers Imaging Retina. 2025 Mar 1:1-8. doi: 10.3928/23258160-20250127-02. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: While anti-vascular endothelial growth factor (anti-VEGF) therapy has revolutionized treatment for diabetic macular edema, many patients still manifest refractory disease. This study evaluated rates of diabetic macular edema (DME) refractory to intravitreal bevacizumab in a diverse real-world setting, with the aim of studying demographic and optical coherence tomography (OCT)-based morphological factors associated with refractory disease.

PATIENTS AND METHODS: This was a retrospective cohort study of patients receiving treatment. Refractory DME was defined as a gain in visual acuity of < 5 letters after three consecutive injections of bevacizumab or less than 20% reduction in central retinal thickness (CRT) after three consecutive injections of bevacizumab. OCT images from preand post-injection visits were reviewed by two independent image readers. Multivariate logistic regression analysis evaluated for statistical significance between responders and those refractory to bevacizumab, and between Hispanic and non-Hispanic groups.

RESULTS: Ninety-nine patients were included. Of the participants, 42% were Hispanic, 10% were reported as white, 11% were Asian, 11% were Black, and 26% were defined as “not reported.” Fifty-four (54.5%) patients were refractory to bevacizumab and 45 were responders. Between responders and refractory patients, race was statistically significant (P = 0.04) with more refractory subjects found to be Hispanic (28/54, 51.9%). OCT morphologic characteristics (CRT, number of hyperreflective foci, disorganization of inner retinal layers, ellipsoid zone discontinuity, and sub-retinal fluid) were not statistically significant between responders and refractory subjects. Multivariate logistic regression demonstrated an odds ratio of 5.7 for refractory disease for Hispanics (CI 1.687 to 19.445, P = 0.01). When comparing Hispanics to non-Hispanics, Hispanics had an average lower baseline visual acuity, lower CSTs, and higher HbA1C.

CONCLUSIONS: Our study showed that Hispanics have a nearly 6 times relatively higher likelihood of refractory disease. There is a notable under-representation of these patients in completed clinical trials for diabetic retinopathy and DME. [Ophthalmic Surg Lasers Imaging Retina 2025;56:XX-XX.].

PMID:40085095 | DOI:10.3928/23258160-20250127-02

Soc Cogn Affect Neurosci. 2025 Mar 14:nsaf028. doi: 10.1093/scan/nsaf028. Online ahead of print.

ABSTRACT

Social interaction plays a crucial role in human societies, encompassing complex dynamics among individuals. To understand social interaction at the neural level, researchers have utilized hyperscanning in several social settings. These studies have mainly focused on inter-brain synchrony and the efficiency of paired functional brain networks, examining group interactions in dyads. However, this approach may not fully capture the complexity of multiple interactions, potentially leading to gaps in understanding inter-network differences. To overcome this limitation, the present study aims to bridge this gap by introducing methodological enhancements using the multilayer network approach, which is tailored to extract features from multiple networks. We applied this strategy to analyze the triad condition during social behavior processes to identify group interaction indices. Additionally, to validate our methodology, we compared the multilayer networks of triad conditions with group synchrony to paired conditions without group synchrony, focusing on statistical differences between alpha and beta waves. Correlation analysis between inter-brain and group networks revealed that this methodology accurately reflects the characteristics of actual behavioral synchrony. The findings of our study suggest that measures of paired brain synchrony and group interaction may exhibit distinct trends, offering valuable insights into interpreting group synchrony.

PMID:40085071 | DOI:10.1093/scan/nsaf028

Fa Yi Xue Za Zhi. 2024 Dec 25;40(6):582-588. doi: 10.12116/j.issn.1004-5619.2023.431005.

ABSTRACT

OBJECTIVES: To analyze the independent influencing factors of intimate partner homicide (IPH) cases, construct an IPH prediction model, and provide a basis for criminal profiling.

METHODS: A total of 476 convicted homicide cases in Guangdong Province from January 1, 2014, to December 31, 2020, were collected as modeling dataset. They were divided into the IPH group (n=180) and the non-intimate partner homicide (N-IPH) group (n=296) based on whether the offender and victim were intimate partners. Logistic regression was used to build the model, the model was evaluated through the receiver operating characteristic (ROC) curve analysis and a nomogram was drawn. Internal validation was conducted using ten-fold cross-validation method. A total of 126 court judgments from outside Guangdong Province from January 1, 2011, to December 31, 2020, were randomly collected for external validation.

RESULTS: Through multi-factor Logistic regression analysis, 7 variables were ultimately selected for inclusion in the model. The Hosmer-Lemeshow goodness of fit test result of the model was χ²=13.158, P=0.068. The ROC area under the curve (AUC) of the model was 0.939 (95% CI: 0.919-0.959), the cut-off value was 0.292, the sensitivity was 0.900, and the specificity was 0.865. The calibration curve was close to the ideal curve. The ten-fold cross-validation showed the accuracy of 0.863 and a Kappa value of 0.708. The external validation results showed an AUC of 0.922 (95% CI: 0.872-0.971), a cut-off value of 0.292, a sensitivity of 0.890, and a specificity of 0.886. The calibration curve tended to the ideal curve.

CONCLUSIONS: The IPH prediction model based on forensic field indicators has good predictive ability, reliable accuracy and stability, and can provide a scientific method for criminal profiling.

PMID:40085040 | DOI:10.12116/j.issn.1004-5619.2023.431005

Int Endod J. 2025 Mar 14. doi: 10.1111/iej.14221. Online ahead of print.

ABSTRACT

AIM: To characterize the deep dentinal caries microbiota in teeth diagnosed with normal pulp with deep caries (NP), reversible pulpitis (RP), symptomatic irreversible pulpitis (SIP), and asymptomatic irreversible pulpitis (AIP), and to identify potential key pathogens associated with pulpitis progression, exploring their roles in disease advancement.

METHODOLOGY: In this cross-sectional study, we collected 108 dentinal caries samples, categorized into NP (n = 27), RP (n = 27), SIP (n = 27), and AIP (n = 27), according to the American Association of Endodontists’ diagnostic criteria. 2 NP samples and 2 RP samples were excluded due to contamination. Samples were processed using Illumina MiSeq high-throughput sequencing. Alpha and beta diversity, taxa abundance differences, co-occurrence network analysis, and functional prediction were evaluated. Correlation analysis between the abundance of bacteria associated with clinical diagnosis, clinical signs, and pulp exposure status was performed with Spearman analysis and the Mantel test.

RESULTS: The bacteriome of deep dentinal caries exhibited statistically significant differences among NP, RP, SIP, and AIP groups. NP and RP showed similar microbial community structures, with comparable alpha diversity, beta diversity, bacterial phenotypes, functions, and network structures. In contrast, AIP and SIP displayed distinct microbial community profiles. AIP was characterized by higher alpha diversity and a greater abundance of gram-negative bacteria, with Propionibacterium and Prevotella_7 identified as bacteria associated with AIP pathogenesis. On the other hand, SIP showed lower alpha diversity and a higher abundance of facultative anaerobes, with Lactobacillus and Limosilactobacillus identified as bacteria associated with SIP pathogenesis. Fusobacterium, Prevotella, Treponema, and Selenomonas were identified as bacteria associated with both AIP and SIP. Compared to NP and RP, the microbial networks in AIP and SIP are more complex and contain more gram-negative endodontic pathogens. These pathogens form complex positive correlations with each other and numerous negative correlations with lactic acid bacteria.

CONCLUSIONS: The bacteriome of deep dentinal caries differs significantly across teeth diagnosed with NP, RP, AIP, and SIP. NP and RP exhibit similar microbial communities, whereas SIP and AIP display distinct microbial profiles.

PMID:40085030 | DOI:10.1111/iej.14221

Pain. 2025 Mar 13. doi: 10.1097/j.pain.0000000000003583. Online ahead of print.

ABSTRACT

Pain is the hallmark symptom of sickle cell disease (SCD). By adolescence, 20% of youth with SCD develop chronic SCD pain. Our randomized controlled trial found significant reductions in pain in youth receiving digital cognitive-behavioral therapy (CBT) vs education control. However, little is known about factors that moderate the effects of CBT in adolescents with SCD. This secondary data analysis aims to identify adolescent and family characteristics that moderate treatment effects on pain outcomes in 111 adolescents aged 12 to 18 with SCD (M = 14.9, SD = 1.9, girls = 59%) and their caregivers. Adolescents were randomly assigned to digital CBT (N = 57) or education control (N = 54). Digital CBT included separate content for parents/caregivers (ie, a website to learn problem-solving skills and behavioral and communication strategies) and youths (ie, a smartphone app and website to learn pain management skills). Outcomes were assessed at pretreatment, posttreatment (2 months), and follow-up (6 months). Potential moderators included pretreatment variables (ie, adolescent variables: age, executive functioning, anxiety, depression; parent variables: psychological distress, protective behaviors, family functioning). There was a significant overall effect modification on pain intensity outcomes from pretreatment parent psychological distress (P = 0.012), where CBT appeared more effective among those with elevated parental distress. Differential intervention effects were observed across multiple potential moderator groups, though most of these differences did not reach statistical significance. Our study underscores the importance of family factors in understanding the efficacy of digital CBT for adolescent SCD pain, pointing to the need for future research to optimize CBT through targeted family-focused strategies.

PMID:40085012 | DOI:10.1097/j.pain.0000000000003583