Nevin Manimala

Addiction. 2025 Feb 11. doi: 10.1111/add.70001. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: There is growing evidence that tobacco smoking causes depression, but it is unclear which constituents of tobacco smoke (e.g. nicotine, carbon monoxide) may be responsible. We used Mendelian randomisation (MR) to measure the independent effect of nicotine on depression, by adjusting the effect of circulating nicotine exposure [via nicotine metabolite ratio (NMR)] for the overall effect of smoking heaviness [via cigarettes per day (CPD)] to account for the non-nicotine constituents of tobacco smoke.

DESIGN: Univariable MR and multivariable MR (MVMR) were used to measure the total and independent effects of genetic liability to NMR and CPD on major depressive disorder (MDD). Our primary method was inverse variance weighted (IVW) regression, with other methods as sensitivity analyses.

SETTING AND PARTICIPANTS: For the exposures, we used genome-wide association study (GWAS) summary statistics among European ancestry individuals for CPD (n = 143 210) and NMR (n = 5185). For the outcome, a GWAS of MDD stratified by smoking status was conducted using individual-level data from UK Biobank (n = 35 871-194 881).

MEASUREMENTS: Genetic variants associated with NMR (n = 6) and CPD (n = 53).

FINDINGS: Univariable MR-IVW indicated a causal effect of CPD on MDD [odds ratio (OR) = 1.13, 95% confidence interval (CI) = 1.04-1.23, P = 0.003] but no clear evidence for an effect of NMR on MDD (OR = 0.98, 95% CI = 0.97-1.00, P = 0.134). MVMR indicated a causal effect of CPD on MDD when accounting for NMR (IVW: OR = 1.19, 95% CI = 1.03-1.37, P = 0.017; Egger: OR = 1.13, 95% CI = 0.89-1.43, P = 0.300) and weak evidence of a small effect of NMR on MDD when accounting for CPD (IVW: OR = 0.98, 95% CI = 0.96-1.00, P = 0.057; Egger: OR = 0.98, 95% CI = 0.96-1.00, P = 0.038).

CONCLUSIONS: The role of nicotine exposure in risk of depression cannot be entirely dismissed. However, the causal effect of tobacco smoking increasing depression risk appears to be largely independent of circulating nicotine exposure, which implies the role of alternative causal pathways.

PMID:39931798 | DOI:10.1111/add.70001

Spine (Phila Pa 1976). 2025 Feb 11. doi: 10.1097/BRS.0000000000005248. Online ahead of print.

ABSTRACT

STUDY DESIGN: Monocentric, retrospective, cross-sectional study.

OBJECTIVE: To investigate the age-related normative values of sagittal parameters and establish their relationships in asymptomatic community-dwelling adults aged over 50.

BACKGROUND CONTEXT: Degenerative changes in the spine with aging alter the sagittal balance, causing spine pathologies. However, there was a lack of comprehensive study on age-related normative values of sagittal alignment and their relationship during degenerative evolution.

METHODS: Among a total of 1,370 volunteers, 701 asymptomatic volunteers were recruited. Participants underwent a lateral X-ray, and sagittal parameters were assessed using a customized computer application.

RESULTS: Age showed a stronger correlation with upper arc of thoracic kyphosis (Upper_TK) (r=0.39) compared to sagittal vertical axis (SVA) (r=0.28) and T1_slope (r=0.29). Lumbar lordosis (LL) did not exhibit a significant decrease with age. The geometrical relationship revealed a significant correlation between TK and LL (r=0.52), and LL and pelvic incidence (PI) (r=0.63), as per the equations: TK=Upper_TK+Lower arc of TK (Lower_TK), LL=Upper arc of LL (Upper_arc)+sacral slope (SS), Lower_TK≈Upper_arc, and PI=SS+pelvic tilt (PT). However, after removing intermediate control variables of Lower_TK (Upper_arc) and SS, the correlation between TK, LL, and PI was statistically weak, due to the little to no correlation between Lower_TK (Upper_arc), SS, and PT. Upper_arc (Lower_TK) was a relatively stable parameter with an age-independent value of 15.93±5.61° in elderly adults. For adults aged 60, Upper_TK significantly increased with age, while individuals over 75 exhibited a significant increase in PT and a decrease in SS and LL.

CONCLUSIONS: Our study provided a normative age-related value of spinal sagittal parameters. To assess the spinal sagittal alignment, it was suggested that LL and TK be divided into two tangential arches based on the location of the lordotic or kyphotic apex. This study offered insights for spine surgeons in preparing for surgical corrections.

PMID:39931787 | DOI:10.1097/BRS.0000000000005248

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Sept 28;49(9):1477-1494. doi: 10.11817/j.issn.1672-7347.2024.230539.

ABSTRACT

OBJECTIVES: Persistent pulmonary hypertension of the newborn (PPHN) is a complex disease with poorly understood mechanisms and risk factors. Developing animal models that reflect the pathophysiological characteristics of PPHN is critical for studying its pathogenesis and treatment strategies. This study aims to analyze the applications, methodologies, and evaluation criteria of PPHN animal models through systematic literature analysis, and to provide guidelines for establishing scientific, cost-effective, and reproducible models.

METHODS: Relevant studies published until March 2023 were retrieved from Chinese databases (CNKI, Wanfang, VIP, and SinoMed) and English databases (PubMed, Web of Science, and Embase). Data were extracted on the applications, species, modeling methods and their principles, specific procedures, species and ages of animals used, and time to model establishment, and criteria for evaluating successful model establishment. A database was created and statistical analyses were performed using Excel 2021, with results presented as charts.

RESULTS: A total of 1 157 studies were identified, and 174 met the inclusion criteria. PPHN animal models were primarily used for pathophysiological and mechanistic research (47.70%). The species used including sheep, pigs, rats, cows, and mice, ranked by frequency of use. Modeling methods were categorized into 4 types: Hypoxia exposure (44.69%), prenatal ductus arteriosus (DA) constriction (41.34%), pharmacological induction (8.94%), and combined induction (hypoxia and indomethacin, 5.03%). Each method was associated with specific species and ages. Prenatal DA constriction was exclusively performed in fetal sheep. The time to model establishment varied: Hypoxia exposure typically required >3 days, prenatal DA constriction had a median of 8.5 days, and combined induction took 3 days. Criteria for evaluating successful model establishment were categorized into 5 dimensions: Anatomical structure, histological features, hemodynamic parameters, blood gas analysis, and other physiological indicators. The most common criteria were “right ventricular hypertrophy” and “significant pulmonary arterial pressure elevation”.

CONCLUSIONS: Current methods for modeling PPHN in animals are diverse, each with its strengths and limitations. Researchers should select the method most suitable for their study objectives and budget. Further exploration is needed to develop scientifically robust, cost-effective, and reproducible animal models for PPHN.

PMID:39931778 | DOI:10.11817/j.issn.1672-7347.2024.230539

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Sept 28;49(9):1431-1439. doi: 10.11817/j.issn.1672-7347.2024.230488.

ABSTRACT

OBJECTIVES: Polypoidal choroidal vasculopathy (PCV) is a major cause of vision loss among older adults worldwide and is particularly common in Asians. When the aneurysmal dilatation of blood vessels or the rupture of widened small veins/arteries occurs, it leads to submacular hemorrhage (SMH), which can result in irreversible damage to vision over time. This study aims to evaluate the surgical outcomes and complications of pars plana vitrectomy (PPV) combined with intraoperative subretinal injection of tissue-type plasminogen activator (t-PA) and postoperative intravitreal injection of anti-vascular endothelial growth factor (VEGF) for the treatment of SMH secondary to PCV.

METHODS: Thirteen patients (13 eyes) with SMH secondary to PCV treated at the Eye Center, Xiangya Hospital, Central South University, from September 2020 to December 2021, were included in this study. All patients underwent PPV combined with subretinal injection of t-PA during surgery and received postoperative intravitreal injections of anti-VEGF. Best corrected visual acuity (BCVA), intraocular pressure, absorption of subretinal hemorrhage, progression of the primary lesion, surgical complications, and factors associated with postoperative efficacy were analyzed preoperatively, 1 week postoperatively, 1 month postoperatively, and 6 months postoperatively.

RESULTS: All patients completed the 6-month follow-up, and at the final visit, 100% of the subretinal hemorrhage of 13 patients was completely cleared. BCVA significantly improved at both 1 month and 6 months postoperatively compared to preoperative and 1-week postoperative levels (all P<0.05). Patients over 60 years old and those with lesions located beneath the fovea had statistically significant differences in visual recovery compared to younger patients and those with extrafoveal lesions (P=0.045 and P=0.006, respectively). No significant correlation was found between disease duration, extent of hemorrhage, presence or absence of preoperative vitreous hemorrhage (VH), and visual recovery at 6 months postoperatively (all P>0.05). Ten patients had an intact ellipsoid zone, and 5 patients had an intact retinal pigment epithelium layer, however, the difference in preoperative and postoperative visual acuity between those with and without intact microstructures was not statistically significant (all P>0.05). At the final follow-up, 2 patients had retinal neuroepithelial edema, and 1 patient had retinal pigment epithelium layer detachment. Postoperative complications included 1 patient of macular hole and 1 patient of retinal pigment epithelium layer tear.

CONCLUSIONS: PPV combined with subretinal t-PA injection and postoperative intravitreal anti-VEGF injection effectively clears SMH secondary to PVC with few surgical complications and significantly improves visual function of the patients over 6-month long-term follow-up.

PMID:39931773 | DOI:10.11817/j.issn.1672-7347.2024.230488

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Sept 28;49(9):1421-1430. doi: 10.11817/j.issn.1672-7347.2024.230603.

ABSTRACT

OBJECTIVES: The early imaging features of spinal tumors and spinal infections are similar, and the lack of specific early diagnostic indicators can lead to misdiagnosis or missed diagnosis. Although serum tumor markers have been widely used in early cancer screening, spinal tumors are mostly metastatic, lacking specific markers, and some patients with spinal tumors may even test negative for tumor markers. Therefore, the role of tumor markers in the early differential diagnosis of spinal tumors remains unclear. This study aims to investigate the value of tumor markers in the early differential diagnosis of spinal tumors and spinal infection.

METHODS: We retrospectively analyzed the clinical data of 221 patients with spinal bone destruction admitted to Xiangya Hospital of Central South University between April 2017 and October 2022. Peripheral blood levels of 10 tumor markers were measured upon admission, including carcinoembryonic antigen (CEA), alpha fetoprotein (AFP), neuron-specific enolase (NSE), cytokeratin 19 fragment antigen 21-1 (cyfra21-1), carbohydrate antigen 199 (CA199), carbohydrate antigen 125 (CA125), carbohydrate antigen 72-4 (CA72-4), pepsinogen I (PGI), pepsinogen II (PGII), and the PGI/PGII ratio (PGR). Univariate Logistic analysis was used to screen relevant variables, and the correlation between tumor markers was analyzed. Multivariate Logistic regression was then employed to identify risk and protective factors. The optimal cut-off values were calculated using the receiver operating characteristic (ROC) curve and Youden index, and a differential diagnosis model for early spinal tumors and spinal infections was constructed based on the selected indicators. Diagnostic performance was then evaluated.

RESULTS: According to the pathological diagnosis, 91 patients had spinal tumors, and 130 patients had spinal infections. The levels of CEA, AFP, NSE, cyfra21-1, CA199, and CA72-4 were higher in the spinal tumor group than those in the spinal infection group, while PGR was lower, with statistically significant differences (all P<0.05). Univariate Logistic analysis showed significant differences in CEA, AFP, NSE, cyfra21-1, CA199, CA125, CA72-4, and PGR (all P<0.05). Correlation analysis indicated a strong positive correlation between CEA and cyfra21-1, CA199, and CA125, as well as a strong negative correlation of PGII with PGI and PGR. Multivariate Logistic analysis identified AFP and cyfra21-1 as risk factors (P<0.01) and PGR as a protective factor (P<0.05). When the standard cut-off values (AFP<20 ng/mL, cyfra21-1< 3.3 ng/mL, and PGR>3) were applied, AFP had a sensitivity of 3.3% and accuracy of 60.2%, cyfra21-1 had a sensitivity of 20.9% and accuracy of 66.1%, and PGR had a sensitivity of 2.2% and accuracy of 59.3%. The AUC of the early spinal tumor diagnosis model was 0.623. Using the optimal cut-off values (AFP<1.625 ng/mL, cyfra21-1<1.175 ng/mL, and PGR>11.05) from the ROC curve, AFP had a sensitivity of 69.2% and accuracy of 64.7%, cyfra21-1 had a sensitivity of 68.1% and accuracy of 70.1%, and PGR had a sensitivity of 62.6% and accuracy of 57.5%, with the model’s AUC at 0.772.

CONCLUSIONS: A comparative analysis of 10 serum tumor markers reveals that AFP, cyfra21-1, and PGR are significantly associated with spinal tumors. The diagnostic model constructed based on these 3 markers shows promising predictive performance and may be helpful to the differentiation for the early clinical diagnosis of spinal tumors and spinal infection.

PMID:39931772 | DOI:10.11817/j.issn.1672-7347.2024.230603

Health Promot J Austr. 2025 Apr;36(2):e70020. doi: 10.1002/hpja.70020.

ABSTRACT

ISSUE ADDRESSED: Type 2 diabetes (T2D) prevalence in Thailand is rapidly increasing, with significant challenges in achieving optimal glycemic control. There is a need for accessible interventions to help improve glycaemic control in people with type 2 diabetes in Thailand. This study evaluates a web application designed to enhance self-management in individuals with uncontrolled T2D. Pre- and post-intervention results indicate a statistically significant reduction in fasting blood glucose. Despite the inability to effectively utilise the web application for controlling blood sugar levels, the study suggests its suitability and potential for benefiting diabetes patient care.

BACKGROUND: Diabetes is a rapidly growing global health concern, with an estimated 537 million people affected worldwide in 2021, a number projected to rise to 783 million by 2045. In Thailand, diabetes cases have increased significantly, with over 3.3 million individuals affected in 2022. Effective diabetes management requires strict adherence to self-care behaviors, including diet, exercise, medication adherence, and glucose monitoring. However, many patients struggle with self-management, leading to severe complications. The integration of a web application in diabetes care has shown potential for enhancing patient engagement and glycemic control. This study explores the role of a web application in improving diabetes self-management and health outcomes.

METHOD: The quasi-experimental single-group research, assessing pre- and post-intervention outcomes, aims to investigate the feasibility of using a web application for diabetes patient care in controlling blood sugar levels. The study employs a web application focusing on dietary behaviour adjustment, physical activity and exercise among 80 diabetes patients selected through simple randomisation. Additionally, 10 nurses responsible for healthcare promotion at five hospitals oversee and empower patients’ behaviours over two months. The research concentrates on exploring the feasibility of the web application and includes (I) the application’s suitability and (II) the patient’s blood sugar levels. The research collected quantitative and qualitative data from November 2022 to May 2023. Tools used for data collection include the feasibility assessment and application suitability.

RESULTS: The research findings indicate that the primary assessment regarding the feasibility of using the web application for diabetes patient care in controlling blood sugar levels shows overall high feasibility. The overall assessment also falls within a high range. Comparing the average levels of fasting blood sugar (FBS) before and after using the web application showed a statistically significant decrease (p-value = 0.023). When comparing the average FBS levels before and after using the web application among diabetes patients, the average FBS decreased significantly from 157.07 ± 47.248 mg/dL to 150.00 ± 43.325 mg/dL (p = 0.023). However, the HbA1c levels showed no statistically significant change (9.17% ± 1.76 to 9.12% ± 1.82, p = 0.38). SO WHAT?: These outcomes may positively contribute to early effective interventions and as well as appropriate responses to diabetes mellitus. Further supported for the health care professionals the use of a web application for diabetes patient care in patients with poorly controlled blood sugar. Specifically, for patients with smartphones, this intervention could help address their issues and provide tools for better self-regulation of their eating habits, physical activities and overall well-being. This can lead to better blood sugar control efficacy.

PMID:39931764 | DOI:10.1002/hpja.70020

J Ultrasound Med. 2025 Feb 11. doi: 10.1002/jum.16660. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to compare changes in ultrasonic Doppler parameters, particularly the peak ratio (PR) of the ophthalmic artery (OA) and optic nerve sheath diameter (ONSD), in pregnancies complicated by fetal growth restriction (FGR). Furthermore, it sought to evaluate differences in these parameters across various subgroups and analyze the cut-off value of PR for predicting delivery within 1 week in pregnancies complicated by FGR.

METHODS: A total of 62 pregnant women in the mid-to-late stages of gestation were enrolled, comprising 31 participants in the FGR group and 31 in the control group. The general conditions, pregnancy outcomes, Doppler parameters of the OA, and ONSD were compared between the two groups. Comparative analysis was performed to investigate differences in OA Doppler parameters and ONSD across FGR subgroups. The predictive value of PR for delivery within 1 week was assessed using the area under the receiver operating characteristic curve.

RESULTS: The PR of the OA was significantly elevated in the FGR group compared to the control group, demonstrating a statistically significant difference. The threshold PR value for predicting delivery within 1 week was 0.565, with a sensitivity of 0.88 and a specificity of 0.58.

CONCLUSIONS: The PR value of the OA in pregnant women with FGR is significantly increased and may serve as a reliable predictor for pregnancies complicated by FGR.

PMID:39931757 | DOI:10.1002/jum.16660

Front Sports Act Living. 2025 Jan 27;7:1500723. doi: 10.3389/fspor.2025.1500723. eCollection 2025.

ABSTRACT

The study examined the effect of a 5-week Comprehensive School Physical Activity Program (CSPAP) on overhand throw skills and perceived motor competence in students from low socio-economic backgrounds. Participants were children recruited from a Title 1 school in the Southwest U.S. Students were assigned to either CSPAP condition (n = 60, 26 boys, 34 girls; Mgrade = 4.27, SD = .43) or a control condition (n = 20, 7 boys, 13 girls; Mgrade = 4.00, SD = .35). Overhand throwing and perceived motor competence were assessed at baseline and post-intervention using the Test of Gross Motor Development-2nd Edition and Perceived Motor Competence for Children (PMC-C). The Analysis of Covariance test showed that students who participated in the CSPAP performed statistically significant improvements in the overhand throw compared to control students in the post-test p < .001, with a moderate effect size. However, there was no significant difference in the PMC-C score after the 5-week intervention between the CSPAP students and control students. CSPAP can improve overhand throwing in students from low-income families, but new strategies are needed to enhance perceived motor competence in after-school contexts.

PMID:39931734 | PMC:PMC11808130 | DOI:10.3389/fspor.2025.1500723

Med Trop Sante Int. 2024 Aug 5;4(3):mtsi.v4i3.2024.557. doi: 10.48327/mtsi.v4i3.2024.557. eCollection 2024 Sep 30.

ABSTRACT

INTRODUCTION: Scabies is an often-neglected skin parasitosis which can affect patients’ quality of life, and its treatment may be delayed in some poor African countries due to a lack of trained healthcare personnel or a lack of financial resources. The aim of this study was to describe the treatment-seeking paths of patients seen in dermatological consultations in Lomé for scabies, the direct costs of treatment and the impact of this condition on the quality of life of patients suffering from it.

PATIENTS AND METHOD: This was a descriptive and analytical study of patients diagnosed with scabies in one of Lomé’s dermatology departments from January 1 to December 31, 2021. The variables studied were sociodemographic; the patient’s therapeutic course prior to the dermatology consultation; the direct cost of the present consultation and the patient’s quality of life. The Dermatology Life Quality Index (DLQI) was used. Statistical analysis was performed with EPI Info software version 7.2.5.0.

RESULTS: A total of 157 patients were selected, including 114 cases of clinical scabies. The median age of patients was 26 years, and 29.3% were under 15 years of age. The sex-ratio M/F = 1.03. Out of them, 139 patients had one or more courses of treatment prior to the dermatological consultation, including self-medication (80.9%), consultations with non-dermatological healthcare personnel (62.4%). The average cost to the patient and family of drugs prescribed during the dermatological consultation was 19,817 CFA francs (30.2 €). The mean DQLI score for adults was 7.4, and 34.9% had moderate impairment of quality of life. The mean CDQLI score for children was 7.2, and 71.4 % had moderate impairment of quality of life.

CONCLUSION: Scabies is a parasitosis that impair patients’ life quality. In the absence of subsidized treatment and financial resources for patients, treatment remains limited, which could contribute to the spread of the disease.

PMID:39931727 | PMC:PMC11809070 | DOI:10.48327/mtsi.v4i3.2024.557

Med Trop Sante Int. 2024 Jul 3;4(3):mtsi.v4i3.2024.431. doi: 10.48327/mtsi.v4i3.2024.431. eCollection 2024 Sep 30.

ABSTRACT

BACKGROUND: Vaccination adherence among populations is a complex process involving, on the one hand, the expected benefit of a vaccine, and on the other, the perceived risk. To develop an evidence-based communication strategy aimed at improving vaccination coverage in Niger, we conducted a mixed socio-anthropological study of the perceptions among the population on the benefit and the risk of the childhood (Expanded Program on Immunization, EPI) and the Covid-19 vaccines. While the vaccine coverage for some of the EPI vaccines is above 80%, only 33% of the children are fully vaccinated, according to the national vaccination schedule. The first objective of our study was to understand the perceptions that might explain this drop off.The second objective was to identify the drivers of the low adherence to the Covid-19 vaccination, 22% of the illegible population being vaccinated.

MATERIALS AND METHODS: In March 2023, we interviewed 509 people for the quantitative study and 40 people through focus groups and individual interviews for the qualitative one, in Niamey (80% of the interviewees) and two villages.

RESULTS: 96.9% of the interviewees think that childhood vaccines are “a good thing,” even though 30.6% know that they might have negative side effects. While 87.8% think that it is “easy” or “very easy” to get children vaccinated, 21.4% point out as “annoying” the lack of amiability by the health care workers and 16.9% the waiting time. The qualitative study showed that these two complaints drive some women not to complete the vaccination schedule. We might also hypothesize that, given the perceived lack of amiability, some women don’t get enough information on the side effects and their management. Surprisingly, 73.3% of the interviewees think that vaccines against the disease are a good thing, and 83% of those who have heard messages promoting the vaccination approve them. This apparent contradiction with the low vaccine uptake is explained by a very low perception of the Covid-19 risks. More than half of the population surveyed believe that the disease is not present in the country, a very large majority believe that only ill people can transmit the disease, while only 12.8% think they know anybody who has ever been sick with Covid-19. According to our results, the circulating rumors on the vaccines don’t play a significant role in the low adherence to Covid-19 uptake, nor in the insufficient completeness of the EPI vaccination schedule.

CONCLUSION: The communication efforts on EPI vaccination should focus on the explanation of the side effects and their management, as well as improving the organization of the vaccination sessions. The communication on Covid-19 vaccination should focus on the reality of the disease in the country and the groups at risk for severe forms.

PMID:39931726 | PMC:PMC11809066 | DOI:10.48327/mtsi.v4i3.2024.431