Nevin Manimala

Ann Plast Surg. 2025 Jan 27. doi: 10.1097/SAP.0000000000004233. Online ahead of print.

ABSTRACT

BACKGROUND: One-stage direct-to-implant (DTI) breast reconstruction is increasingly popular with the use of prepectoral reconstruction leading to increased demand for structural scaffolds. It is vital to determine if differences in safety profiles exist among scaffolds.

METHODS: We performed a retrospective cohort study of consecutive patients in our breast cancer center undergoing DTI reconstruction. Outcomes relating to postoperative infections, wound complications, and implant related complications were extracted. Outcomes were grouped into major, minor, and long-term complications. Univariate and multivariate analysis determined outcome differences and accounted for confounding variables.

RESULTS: Two hundred forty-two patients (404 breasts) underwent DTI reconstruction. One hundred ninety-two breasts were reconstructed with FlexHD Pliable Preformed (PP; MTF Biologics, Edison, NJ), 122 with AlloDerm Ready To Use (RTU; Allergan Aesthetics, Irvine, CA), 22 with DermACELL (LifeNet Health, Virginia Beach, VA), 21 with Galaflex (Galatea Surgical, Lexington, MA), 22 with Meso BioMatrix (MTF Biologics), and 25 with autologous dermal flaps alone. Univariate analysis demonstrated statistically significant differences among scaffolds in the incidence of cellulitis treated with oral antibiotics, capsular contracture, explantation for capsular contracture, seroma requiring operative drainage, minor complications, and long-term complications. On multivariate regression, FlexHD PP had reduced rates of capsular contracture, explantation for capsular contracture, minor complications, and long-term complications compared to AlloDerm RTU. Reconstruction with Galaflex had increased rates of capsular contracture when compared to FlexHD PP.

CONCLUSIONS: Certain structural scaffolds have differing safety profiles that should be considered when selecting, which product to use in DTI reconstruction.

PMID:39874556 | DOI:10.1097/SAP.0000000000004233

J Palliat Med. 2025 Jan 28. doi: 10.1089/jpm.2024.0379. Online ahead of print.

ABSTRACT

Background: Medical aid in dying is legal in 10 states plus Washington DC, covering 22% of the U.S. population. Much has been written about the ethics of aid in dying, but little about evidence-based care, especially the medications used. We investigated the efficacy of four commonly used aid-in-dying medication protocols-using the time to sleep and time to death as proxies for efficacy. Methods: We performed an independent, secondary analysis on deidentified data from four organizations, comparing four different medication protocols. Descriptive statistics for time to sleep and time to death for the different medication protocols were calculated. Medication protocols included one sedative and three sedative/cardiotoxin combinations. Results: We analyzed data from 3332 death reports covering 2009 to 2023, comparing a single sedative medication protocol with three different sedative/cardiotoxin combinations. The sedative alone yielded the most rapid median time to death of 0.4 hours, but with days-long outliers. Two of the sedative/cardiotoxin combinations yielded median times to death of 0.8 hours. But from 2018 to 2023, as the medication combinations shifted, the mean time to death declined while the median remained relatively steady-confirming that these combinations reduced the incidence of longer deaths (especially extreme outliers). Conclusion: This first-time analysis of aid-in-dying medication protocols showed that while a sedative alone had the best median time to death, the most recent sedative/cardiotoxin protocol had an acceptable median time to death of 0.8 hours, but with fewer prolonged-death outliers.

PMID:39874553 | DOI:10.1089/jpm.2024.0379

Ann Plast Surg. 2025 Jan 27. doi: 10.1097/SAP.0000000000004229. Online ahead of print.

ABSTRACT

INTRODUCTION: Adult-acquired buried penis (AABP) is an increasingly prevalent condition characterized by the penis “buried” in prepubic/suprapubic tissue. AABP affects urinary and sexual function, hygiene, and psychosocial well-being. Because many affected individuals are unfamiliar with the condition or hesitant to seek medical help, accessible, high-quality patient education materials (PEMs) are necessary. The American Medical Association recommends that PEMs be written at or below a 6th-grade reading level. This study aimed to assess the readability of the most easily accessible AABP PEMs.

METHODS: After disabling user account information, the top 10 results for “buried penis treatment” from 3 search engines were collected. Academic journal articles, advertisements, and pediatric PEMs were excluded. Plain texts without graphics and extraneous information were copied to the Readability Test Tool (WebFX, Harrisburg, PA) to generate readability scores. Descriptive statistics were used to analyze the data.

RESULTS: The top 10 results for each search engine, excluding duplicates, resulted in 12 unique articles. Of 5 readability tests used by the Readability Test Tool, the mean grade level necessary to comprehend resource content was 12.3, or about a 12th-grade level. The mean age estimated for understanding was 17.7, or an age range of 17-18 years old. Complex words comprised on average, 16.6% of a resource’s material.

CONCLUSIONS: This study emphasizes the inadequate readability of current PEMs for AABP. The readability for most accessible materials exceeds the recommended reading level of at or below 6th grade. Providers should aim to publish easily comprehensible online PEMs to promote patient awareness and comprehension.

PMID:39874550 | DOI:10.1097/SAP.0000000000004229

Res Gerontol Nurs. 2025 Jan 30:1-11. doi: 10.3928/19404921-20250122-01. Online ahead of print.

ABSTRACT

PURPOSE: To gain a deeper understanding of Black older adults’ (aged ≥65 years) experiences with adverse childhood experiences (ACEs), including racism, and their use of active coping throughout their life course.

METHOD: Qualitative interviews were conducted with 21 Black older adults followed by administration of the First 18 Years Survey (measuring ACEs) and the John Henryism Active Coping Scale. Qualitative data were analyzed using thematic narrative analysis. Quantitative data were analyzed using descriptive statistics. Qualitative and quantitative data were integrated using a triangulation process.

RESULTS: Four major themes emerged from the qualitative data. Participants reported experiencing pervasive racism throughout their lives. Quantitative results indicated participants experienced fewer ACEs and made high use of active coping. Triangulation indicates qualitative findings and explains the quantitative results.

CONCLUSION: Although participants faced ACEs including racism, they found strategies to help them actively cope. [Research in Gerontological Nursing, xx(x), xx-xx.].

PMID:39874546 | DOI:10.3928/19404921-20250122-01

J Chem Inf Model. 2025 Jan 28. doi: 10.1021/acs.jcim.4c02088. Online ahead of print.

ABSTRACT

Identification of potential drug-target interactions (DTIs) is a crucial step in drug discovery and repurposing. Although deep learning effectively deciphers DTIs, most deep learning-based methods represent drug features from only a single perspective. Moreover, the fusion method of drug and protein features needs further refinement. To address the above two problems, in this study, we develop a novel end-to-end framework named DO-GMA for potential DTI identification by incorporating Depthwise Overparameterized convolutional neural network and the Gated Multihead Attention mechanism with shared-learned queries and bilinear model concatenation. DO-GMA first designs a depthwise overparameterized convolutional neural network to learn drug representations from their SMILES strings and protein representations from their amino acid sequences. Next, it extracts drug representations from their 2D molecular graphs through a graph convolutional network. Subsequently, it fuses drug and protein features by combining the gated attention mechanism and the multihead attention mechanism with shared-learned queries and bilinear model concatenation. Finally, it takes the fused drug-target features as inputs and builds a multilayer perceptron to classify unlabeled drug-target pairs (DTPs). DO-GMA was benchmarked against six newest DTI prediction methods (CPI-GNN, BACPI, CPGL, DrugBAN, BINDTI, and FOTF-CPI) under four different experimental settings on four DTI data sets (i.e., DrugBank, BioSNAP, C.elegans, and BindingDB). The results show that DO-GMA significantly outperformed the above six methods based on AUC, AUPR, accuracy, F1-score, and MCC. An ablation study, robust statistical analysis, sensitivity analysis of parameters, visualization of the fused features, computational cost analysis, and case analysis further validated the powerful DTI identification performance of DO-GMA. In addition, DO-GMA predicted that two drug-protein pairs (i.e., DB00568 and P06276, and DB09118 and Q9UQD0) could be interacting. DO-GMA is freely available at https://github.com/plhhnu/DO-GMA.

PMID:39874533 | DOI:10.1021/acs.jcim.4c02088

J Strength Cond Res. 2025 Feb 1;39(2):249-259. doi: 10.1519/JSC.0000000000004995.

ABSTRACT

Riboli, A, Nardi, F, Osti, M, Cefis, M, Tesoro, G, and Mazzoni, S. Training load, official match locomotor demand, and their association in top-class soccer players during a full competitive season. J Strength Cond Res 39(2): 249-259, 2025-To examine training load and official match locomotor demands of top-class soccer players during a full competitive season and to evaluate their association. Twenty-five top-class soccer players competing in UEFA international competitions were included. The season was divided into 2 different categories: 2 matches (M2) or 3 matches (M3) in 8 days. Starters and nonstarters were classified. Total distance (TD), high-speed running (HSR, 15-20 km·h-1), very high-speed running (VHSR, 20.1-24 km·h-1), sprint (SPR, >24.1 km·h-1), and accelerations/decelerations (Acc + Dec, >3 m·s2) were recorded. Trivial to moderate differences (p < 0.05) in training load between M2 and M3 were found: HSR, VHSR, and SPR were higher in M2 than M3, whereas TD and Acc + Dec were higher in M3 than M2. Week-by-week variability in training load ranged from ∼16 to ∼59% depending on metrics. Official match locomotor demands were similar (p > 0.05) in M2 and M3 with ∼5 to ∼29% match-to-match variability depending on metrics. Total load (i.e., training plus match loads) was higher (p < 0.05, ES: 0.75/1.61) in starters than nonstarters, because of a higher match load and no difference in the training load. Very high-speed running and SPR accumulated during training sessions were largely to very largely (r = 0.60 to 0.72) associated with TD, HSR, VHSR, and Acc + Dec covered during official match; VHSR and TD during training were largely to very largely (r = 0.57 and 0.71) associated with SPR and Acc + Dec during official match. In conclusion, (a) congested periods seemed to not affect official match locomotor performance; (b) practitioners may consider high week-by-week workload variability for individualizing training prescriptions, especially for nonstarters; and (c) the VHSR and SPR accumulated during training were associated with the official match locomotor demands, and it may be considered for maximizing performance.

PMID:39874527 | DOI:10.1519/JSC.0000000000004995

J Nurs Res. 2025 Feb 1;33(1):e374. doi: 10.1097/jnr.0000000000000657.

ABSTRACT

BACKGROUND: Menstruation is a physiological process that may be accompanied by pain, headache, edema, emotional changes, and other symptoms, all of which affect quality of life. Although the results of some studies indicate lifestyle habits can affect the menstrual cycle and associated symptoms, few have investigated this issue, and even fewer have explored the impact of these symptoms on quality of life, in Spanish women.

PURPOSE: The objectives of this study were to determine the prevalence of dysmenorrhea and premenstrual syndrome (PMS) among students at a Spanish university, assess the impact of these conditions on quality of life, and analyze the relationship among lifestyle habits, dysmenorrhea, and PMS.

METHODS: A cross-sectional study was carried out on 743 women enrolled at the University of Extremadura in the 2021-2022 academic year. Data related to the menstrual cycle, pain, and PMS-related physical and emotional symptoms were collected. Quality of life related to menstruation was evaluated using the CVM-22 scale. Lifestyle data collected included adherence to a Mediterranean diet (PREDIMED [Prevención con Dieta Mediterránea] questionnaire), level of physical activity (International Physical Activity Questionnaire), and alcohol and tobacco consumption (Alcohol, Smoking, and Substance Involvement Screening Test Version 3). Also, other clinical data were recorded.

RESULTS: In terms of the sample, the median age was 21 (19-23) years, the prevalence of dysmenorrhea was 57.9%, 92.7% reported premenstrual physical symptoms, and 55.6% reported experiencing premenstrual emotional changes. Having a low level of adherence to a Mediterranean diet was associated with the presence of dysmenorrhea, with an adjusted odds ratio (aOR) of 1.47 (95% CI [1.06, 2.03]). Having a low level of physical activity was strongly associated with the presence of premenstrual physical symptoms, with an aOR of 5.89 (95% CI [1.71, 20.26]). Also, an association was found between tobacco use and premenstrual emotional changes, with an aOR of 2.02 (95% CI [1.25, 3.25]). Furthermore, dysmenorrhea and PMS were both associated with a low quality of life, with pain and emotional changes being the most significantly associated factors, with ORs of 16.25 (95% CI [10.36, 25.47]) and 26.73 (95% CI [16.46, 43.40]), respectively.

CONCLUSIONS: Similar to previous studies, the findings of this study indicate a high prevalence of dysmenorrhea and PMS among young university students in western Spain, with both of these symptoms impacting quality of life significantly and negatively. In addition, lifestyle habits, diet, physical activity, and tobacco use seem to influence the occurrence of these symptoms. Promoting lifestyle changes may be an effective strategy to reduce the incidence of dysmenorrhea and PMS and improve the quality of life of young women.

PMID:39874525 | DOI:10.1097/jnr.0000000000000657

Acta Bioeng Biomech. 2025 Jan 28;26(2):73-79. doi: 10.37190/abb-02411-2024-03. Print 2024 Jun 1.

ABSTRACT

Purpose: The purpose of this study was to quantify the impact of smartphone use while sitting on the toilet on the spinal flexion angles and the time effect. Methods: Measurements of the spinal flexion angles in the sagittal plane were made by thirty participants while they sat on the toilet for 10 min, using a smartphone in either one, both, or neither hand. The individual’s forehead, cervical, thoracic and lumbar spinal areas were each fitted with five different inertial motion sensors. SPSS 26.0 software was used to statistically evaluate all of the data. Results: People who used smartphones with both hands had considerably larger (P < 0.05) cervical and spinal flexion angles than those who did not. A statistically significant (P < 0.001) association was observed by regression analysis between time and spinal flexion angle (r = 0.747 for no smartphone, r = 0.793 for a smartphone used in one hand and r = 0.855 for a smartphone used in both hands). Consequently, when using the smartphone with both hands, the flexion angle of the spine entered a more stable state of angles. Conclusions: The results showed that the cervical region’s flexion angles change when using a smartphone while sitting on the toilet. Even when not using a smartphone, the flexion angle of the spine when sitting on the toilet will progressively increase.

PMID:39874515 | DOI:10.37190/abb-02411-2024-03

Acta Bioeng Biomech. 2025 Jan 28;26(2):135-142. doi: 10.37190/abb-02458-2024-03. Print 2024 Jun 1.

ABSTRACT

Purpose: Brain tissue immersed in cerebrospinal fluid often exhibits complex mechanical behaviour, especially the nonlinear stress- strain and rate-dependent responses. Despite extensive research into its material properties, the impact of solution environments on the mechanical behaviour of brain tissue remains limited. This knowledge gap affects the biofidelity of head modelling. This study aimed to investigate the effect of solution environments on brain tissue under quasi-static and dynamic loading conditions. Methods: Porcine brain tissue was characterized in compression through quasi-static nonlinear testing and Dynamic Mechanical Analysis under various environments: air, physiological saline and artificial cerebrospinal fluid. Frequencies from 0.1 to 40 Hz were applied to determine dynamic behaviour, while brain samples were compressed up to a 0.3 strain level to obtain nonlinear response. The effects of strain, frequency and solution environment on the mechanical response of brain tissue were statistically evaluated. Results: As environmental conditions transitioned from air to artificial cerebrospinal fluid, the average stress of brain tissue increased by approximately 1.3, 1.3 and 1.4 times at strain levels of 0.1, 0.2 and 0.3, respectively. A statistically significant increase in dynamic storage and loss moduli was observed between air and artificial cerebrospinal fluid environments. At frequencies above 18 Hz, the tan delta in air was significantly lower. Conclusions: The mechanical characterization of brain tissue exhibited a dependency on solution environment under both quasi-static and dynamic loading conditions. Brain tissue showed higher stress levels and dynamic modulus in solution environments compared to an air environment. The results of this study are valuable for improving head simulations and brain material models.

PMID:39874509 | DOI:10.37190/abb-02458-2024-03

Acta Bioeng Biomech. 2025 Jan 28;26(2):81-91. doi: 10.37190/abb-02442-2024-02. Print 2024 Jun 1.

ABSTRACT

Purpose: This study evaluated changes in selected spatiotemporal and kinematic gait parameters and balance in girls with Adolescent idiopathic scoliosis (AIS) with and without the Chêneau brace. Methods: 15 subjects with scoliosis wearing the Chêneau brace and an equal comparative control group underwent objective gait analysis with the 3D BTS motion caption system. Balance assessment was done with the Kistler platform. The analysis was performed at comparison of gait and balance parameters in patients with scoliosis in two conditions: with and without the Chêneau brace during the study. Results: Statistically significant differences occurred in many spatiotemporal and kinematic parameters both for the AIS group with and without the Chêneau brace and in the AIS group with and without the Chêneau brace as compared to the control group. When comparing adolescents with AIS with and without the Chêneau brace, statistically significant differences were noted in the COP-X amplitude and in the path length in trials with closed eyes. Compared to the control group the following differences were statistically significant: the value of the COP-Y amplitude during the trial with closed eyes, both with and without the Chêneau brace, and the Equivalent area of the COP during the trial with closed eyes with the Chêneau brace. Conclusions: The Chêneau brace in patients with juvenile idiopathic scoliosis affects the level of selected balance and gait parameters.

PMID:39874506 | DOI:10.37190/abb-02442-2024-02