Nevin Manimala

Psychol Rep. 2025 Dec 20:332941251409066. doi: 10.1177/00332941251409066. Online ahead of print.

ABSTRACT

Psychological research increasingly relies on high-dimensional data, yet it remains challenging to determine whether patterns of representation are independent across experimental contexts. Traditional multivariate approaches, such as decoding, are sensitive to pattern differences but do not directly test factorial hypotheses. In contrast, analysis of variance (ANOVA) provides inferential clarity but is limited to univariate measures. To address this gap, we introduce Multivariate Interaction Classification (MIC), a framework that combines the logic of factorial interaction tests with the sensitivity of multivariate pattern analysis. MIC evaluates representational independence by comparing within-context and cross-context decoding performance. Through simulation studies, we show that MIC reliably distinguishes modality-specific, modality-general, and hybrid representational structures. We then validate the method with affective ratings of gustatory and auditory stimuli, demonstrating how MIC can reveal the coexistence of specific and general codes. By providing a statistically grounded and easily implemented tool, MIC enables researchers to move beyond descriptive decoding toward confirmatory tests of representational hypotheses. All code and materials are openly available to ensure transparency and reproducibility.

PMID:41420430 | DOI:10.1177/00332941251409066

Vasc Endovascular Surg. 2025 Dec 20:15385744251410019. doi: 10.1177/15385744251410019. Online ahead of print.

ABSTRACT

BackgroundCarotid endarterectomy (CEA) remains the standard surgical intervention for carotid stenosis. While the conventional CEA (cCEA) and eversion techniques have been widely investigated, data on the clinical implications of modified eversion CEA (meCEA), which employs a limited arteriotomy of the carotid bulb, remain scarce. This study aimed to compare the early and mid-term outcomes of meCEA with those of cCEA using adjusted analyses.MethodsIn this retrospective study, 206 patients who underwent CEA between 2015 and 2025 at Daegu Catholic University Hospital were included. Patients were divided into the cCEA (n = 170) and meCEA (n = 36) groups. Baseline characteristics, operative profiles, and postoperative complications were compared using propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) to adjust for potential confounding. Overall survival (OS) and event-free survival (EFS) were evaluated using IPTW-adjusted Kaplan-Meier and Cox proportional hazards models.ResultsThe meCEA group showed marked intraoperative advantages, including a significantly lower rate of patch angioplasty (25.0% vs 87.1%), shorter operative time (94.3 ± 24.5 vs 139.8 ± 43.7 min), and reduced internal carotid artery clamp time (35.0 ± 12.7 vs 48.5 ± 12.5 min; all P < 0.001). No significant differences were observed in postoperative stroke, transient ischemic attack, or in-hospital mortality after PSM adjustment. IPTW-adjusted survival analysis revealed no statistically significant differences in OS (HR: 1.09, 95% CI: 0.38-3.14, P = 0.87) or EFS (HR: 1.29, 95% CI: 0.52-3.23, P = 0.581) between the groups. However, interpretation of long-term outcomes was limited by a shorter follow-up duration in the meCEA group (22.7 vs 63.9 months).ConclusionsThe meCEA technique offers significant operative benefits while demonstrating comparable early and mid-term safety profiles to conventional CEA. Although no significant survival difference was observed after adjustment, the results suggest that meCEA may serve as an effective alternative to cCEA. Further prospective studies with longer follow-up are needed to validate these findings.

PMID:41420426 | DOI:10.1177/15385744251410019

J Geriatr Psychiatry Neurol. 2025 Dec 20:8919887251409415. doi: 10.1177/08919887251409415. Online ahead of print.

ABSTRACT

ObjectivesThis study aimed to compare the effects of different exercise interventions on brain-derived neurotrophic factor (BDNF) levels in patients with neurodegenerative diseases and to explore regulatory factors.MethodsSearched PubMed, Scopus, Web of Science Core Collection, CNKI and Cochrane Library databases up to March 15, 2025. Bayesian network meta-analysis was conducted using R software, and meta-regression analyzed the moderating effects of training period and frequency.Results42 randomized controlled trials covering 1482 patients were included. The Surface Under the Cumulative Ranking (SUCRA) indicated that stretching training (SUCRA = 78.92) and high-intensity interval training (SUCRA = 69.73) were ranked higher than other exercise modalities and exhibited more favorable effect on BDNF enhancement, although neither demonstrated statistically significant superiority over the blank control. In contrast, combined training (SUCRA = 35.58), aerobic training (SUCRA = 35.17), and resistance training (SUCRA = 12.98) showed relatively lower potential for BDNF enhancement (blank control SUCRA = 67.62). Meta-regression analysis showed that the effect of combined training was significantly and positively correlated with intervention period (P < 0.01).ConclusionsStretching training and high-intensity interval training appear promising for enhancing BDNF level in neurodegenerative diseases, while isolated aerobic or resistance training show relatively lower potential on improving BDNF. Combined training requires sustained implementation for significant benefits. These findings highlight the importance of tailored exercise prescription for improving BDNF levels.

PMID:41420424 | DOI:10.1177/08919887251409415

Psychol Rep. 2025 Dec 20:332941251409157. doi: 10.1177/00332941251409157. Online ahead of print.

ABSTRACT

The current progressive adoption of online platforms and web-based interventions, within the context of Cognitive Behavioral Therapy (CBT) services, offers a novel opportunity to scale evidence-based psychotherapy. In the present work, we depict the development of a web and native application within the Italian landscape, GRETA (Graphic Robotic Engine for Therapy Automation). GRETA provides the following functions: (a) Management of therapy appointments and payments; (b) Clinical data, therapy progress, and sessions summary between professionals; (c) Production of the medical report and notes for external institutions; (d) Homework, materials, psychometric measures, progress reports, and therapy notes; (e) Systematic monitoring of the therapeutic process and outcomes; (f) Ensuring confidentiality, security, and integrity of patient information; (g) Collection, aggregation, and analysis of anonymized patient data through statistical reports and graphical dashboards. Beyond the technological implementation, this study also assesses the effectiveness of therapy delivered through GRETA. Pre-post treatment comparisons were conducted on a sample of 442 patients discharged for any reason by the CBT service, categorized into three diagnostic groups: anxiety disorder, depressive disorder, and comorbid anxiety and depressive disorder. Results revealed significant improvements in symptom severity and functional adjustment across all groups. Future developments of GRETA will involve integrating Artificial Intelligence-based features, such as predictions of clinical outcomes.

PMID:41420419 | DOI:10.1177/00332941251409157

Orthod Craniofac Res. 2025 Dec 20. doi: 10.1111/ocr.70076. Online ahead of print.

ABSTRACT

OBJECTIVE: This cross-sectional study examined differences in orofacial features and oral health-related quality of life in previously treated young adults with either idiopathic condylar resorption (ICR) or TMJ involvement from juvenile idiopathic arthritis (JIA).

MATERIAL AND METHODS: The study included 17 patients with ICR and 15 patients with JIA-related TMJ involvement, all treated at the Section for Orthodontics, Aarhus University Craniofacial Clinic, Denmark and the Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Denmark. Data compared came from a standardised radiological examination with cone-beam computed tomography, a standardised clinical orofacial examination and a completed oral health-related quality of life questionnaire (OHIP-14). Validated methodologies were used to evaluate TMJ and dentofacial morphology.

RESULTS: The ICR patients reported a markedly higher number of TMJ pain symptoms, affected jaw function and difficulties in chewing food. The ICR group showed significantly more pronounced aberrant dentofacial morphology in relation to mandibular inclination, anterior/posterior face height ratio and mandibular sagittal position. No statistically significant differences were detected in the severity of condylar deformity between ICR and JIA patients. The oral health-related quality of life was significantly more negatively affected in the ICR group compared to the JIA group in the following domains: physical pain, psychological discomfort and psychological disability.

CONCLUSION: The present study illustrates more severe TMJ signs and symptoms, a greater degree of dentofacial deformity and negatively affected oral health-related quality of life in the ICR group when compared with the JIA group. The same degree of TMJ deformity was found in both groups. Our findings contribute valuable insights towards establishing diagnostic criteria for ICR patients and improving the differential diagnosis of JIA-related TMJ involvement.

PMID:41420415 | DOI:10.1111/ocr.70076

Global Spine J. 2025 Dec 20:21925682251409696. doi: 10.1177/21925682251409696. Online ahead of print.

ABSTRACT

Study DesignRetrospective cohort study.ObjectivesPrior studies have shown that adult spinal deformity (ASD) patients undergoing revision surgery due to mechanical complications had less radiographic improvement and worsening patient-reported outcomes scores. The combination of customized 3D planning and personalized implants has been shown to contribute to improved achievement of alignment goals. This study aimed to determine whether such improved correction also results in a correspondingly lower revision surgery rate due to mechanical complications.MethodsPre- and postoperative radiographic alignment measures, including lumbar lordosis (LL), distal lumbar lordosis (DLL), pelvic incidence (PI) – LL mismatch, and L1 pelvic angle (L1PA), as well as data on mechanical complications leading to reoperation were collected on 115 ASD patients with personalized interbody implants and minimum 2-year follow-up. This cohort was statistically compared to a multicenter dataset (ISSG) of 997 ASD patients treated using stock devices and using the same reoperation classifications.ResultsPostoperatively achieved alignment measures correlated significantly with their respective preoperative alignment goals, with the following average offsets from plan: 2.4° LL, -0.2° DLL, -2.4° PI-LL, 0.3° L1PA. Compared to the ISSG cohort that utilized stock interbody implants, the cohort utilizing 3D preoperative planning and personalized interbody implants resulted in significantly fewer revisions for mechanical complications up to 2 years postoperatively: 5/115 (4.3%) vs 166/997 (16.6%), P < 0.001.ConclusionsThese findings suggest that achieving planned alignment targets with personalized interbody devices is associated with reduced revision surgery for mechanical complications, a result which may have positive implications for improved patient outcomes and reduced cost.

PMID:41420413 | DOI:10.1177/21925682251409696

Clin Otolaryngol. 2025 Dec 20. doi: 10.1111/coa.70076. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effects and morbidities associated with perioperatively administered analgesics in paediatric patients undergoing tonsillectomy.

DESIGN AND SETTING: Systematic review and network meta-analysis (NMA) of randomised controlled trials.

PARTICIPANTS: Paediatric patients undergoing tonsillectomy.

MAIN OUTCOME MEASURES: The treatment networks included five interventions (paracetamol, paracetamol with opioids, ibuprofen, ketorolac or opioids) and a control group (placebo or saline). The outcomes measured were the incidence of postoperative bleeding (any event and those requiring surgical intervention), postoperative nausea and vomiting (PONV) and the frequency of analgesic intake. Both pairwise analysis and NMA were utilised to assess the data.

RESULTS: No treatments induced significant postoperative bleeding compared with the control. Paracetamol, ibuprofen and ketorolac tended to decrease the incidence of PONV. Only ibuprofen significantly reduced the need for analgesics (odds ratio = 0.32, 95% confidence interval = 0.11-0.91, p < 0.05). All other comparisons showed trends but lacked statistical significance, as their confidence intervals included 1.0. The ranking hierarchy revealed that ketorolac ranked the lowest in postoperative bleeding but first in the incidence of PONV. Paracetamol ranked second in postoperative bleeding, PONV, and need for analgesics.

CONCLUSION: While ibuprofen appeared to be the most effective in managing postoperative pain, paracetamol showed favourable trends in reducing postoperative bleeding, PONV, and the need for additional analgesics. Ketorolac tended to be associated with a lower incidence of PONV but showed a tendency toward a higher incidence of postoperative bleeding. However, further well-designed, standardised studies would be needed to confirm these conclusions.

PMID:41420409 | DOI:10.1111/coa.70076

Int J Gynaecol Obstet. 2025 Dec 20. doi: 10.1002/ijgo.70750. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the rate of pharmacological treatment failure in early pregnancy loss, assess post-treatment residua thickness as a predictor of retained products of conception (RPOC), identify a clinically relevant cutoff, and evaluate additional clinical and sonographic predictors.

METHODS: This retrospective cohort study was conducted at a tertiary medical center and included patients treated with mifepristone-misoprostol for first-trimester pregnancy loss between January 2019 and January 2022. Treatment success was assessed via transvaginal ultrasound, with residua thickness measured 14 days post-treatment. The primary outcome was failure, defined as histologically confirmed RPOC following hysteroscopy. Secondary analyses evaluated clinical and sonographic predictors, focusing on post-treatment residual thickness. Statistical analysis included receiver operating characteristic (ROC) curve assessment and multivariable logistic regression.

RESULTS: Of the 717 patients included, 537 (74.9%) achieved successful medical management without further intervention, while 180 (25.1%) required intervention. Treatment failure was associated with greater post-treatment residua thickness (mean 19.1 ± 9.1 mm vs. 10.4 ± 6.7 mm, P < 0.001). Residua thickness was an independent predictor of failure (adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI]: 1.13-1.21, P < 0.001). ROC analysis identified an optimal cutoff of 14.9 mm, yielding 70% sensitivity and 81% specificity (area under the curve [AUC]: 0.835, 95% CI: 0.80-0.87) for predicting the need for surgical intervention.

CONCLUSION: Post-treatment residual thickness is a significant predictor of pharmacological treatment failure in early pregnancy loss, with a clinically relevant cutoff of approximately 15 mm. Histologic validation provides a promising framework for refining management protocols, emphasizing the need for further studies to establish robust predictive criteria.

PMID:41420407 | DOI:10.1002/ijgo.70750

Physiol Rep. 2025 Dec;13(24):e70704. doi: 10.14814/phy2.70704.

ABSTRACT

The microcirculation comprises small vessel networks that regulate blood perfusion within tissues. The relationship between tissue shape or size and its microvascular properties is not yet clear. This study develops an algorithm for computationally simulating branching arteriolar networks within ellipsoidal tissue volumes, including user-adjustable parameters (e.g., tissue width-length-height dimensions and microvessel density) for application within different rodent skeletal muscles. The algorithm is developed using principles from constrained constructive optimization, an iterative network generation framework based on proposed mechanisms of vascular growth. Networks generated within muscles of varying shapes and sizes were analyzed over a range of geometric (e.g., mean diameter, length, and number of bifurcations per Strahler’s and centrifugal order, fractal dimension) and hemodynamic (e.g., Murray’s law exponent, hematocrit) properties. Statistical similarity was observed across different skeletal muscle tissues, with differences due to tissue shape being observed only above a vessel diameter threshold of ~25 μm (varying at large or small tissue volumes at the scale m³ or mm³). The algorithm was comprehensively validated against in vivo data using different modeling approaches (whole tissue vs. subsection simulations). The algorithm’s accuracy and adaptability support a wide range of research objectives and contributes to advancing current understanding of perfusion distribution in healthy tissue.

PMID:41420392 | DOI:10.14814/phy2.70704

J Pharm Pract. 2025 Dec 19:8971900251408312. doi: 10.1177/08971900251408312. Online ahead of print.

ABSTRACT

Introduction: Heart failure is a leading cause of morbidity and mortality worldwide. Literature suggests that the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors can be beneficial to decrease hospitalizations and cardiac mortality in patients with heart failure with an ejection fraction >40%. Research Question: This study assessed the impact of a pharmacist monitoring program on the use of SGLT2 inhibitors for patients hospitalized with heart failure with an ejection fraction >40%, accounting for documented reasons for not prescribing. Study Design: This was a single-center, retrospective, pre/post interventional study. The pre-intervention cohort was assessed for usage prior to initiation of the pharmacist monitoring program, whereas the post-intervention group was assessed after initiation. Methods: Hospitalized patients were identified retrospectively through a report of intravenous diuretic use on the cardiology floor in conjunction with a documented diagnosis of heart failure and ejection fraction >40%. Data Analysis: Data was assessed via Chi-squared or student’s t-test for comparison between the pre-intervention and post-intervention groups. Results: There was a statistically significant increase in documented appropriate use of SGLT2 inhibitors after implementation of pharmacist monitoring program (40.9% pre-intervention vs 62.7% post-intervention, P = <0.001). The most common reasons they were held was due to risk of infection and renal dysfunction. Conclusion: Implementation of a pharmacist monitoring program was associated with an increase in utilization of SGLT2 inhibitors in eligible patients, driven by an increase in documentation. There was an increase in prescribing in patients that were eligible for the medication.

PMID:41420391 | DOI:10.1177/08971900251408312