Nevin Manimala

Soc Psychiatry Psychiatr Epidemiol. 2025 Sep 15. doi: 10.1007/s00127-025-02991-4. Online ahead of print.

ABSTRACT

PURPOSE: Psychological distress (PD) affects health and healthcare utilization. This study uses a novel, comprehensive social determinants of health (SDOH) risk score to examine the association between cumulative social disadvantage and PD in a large, nationally representative sample from the National Health Interview Survey (NHIS).

METHODS: Data from the 2013 to 2017 NHIS was employed, including 124,361 adults aged ≥ 18 years. The Kessler 6 scale was used to assess PD. We measured SDOH across five domains: economic stability, education, healthcare system, neighborhood, and food security. An SDOH aggregate score was calculated, representing the cumulative number of individual unfavorable SDOH. Multivariable models were utilized to examine the association between SDOH score quartiles and PD.

RESULTS: A total of 124,361 adults (mean [SD] age 50.2 [18.1] years; 67,035 women [53.9%]) were included in the analysis. In models fully adjusted for age, sex, ethnicity, region, cardiovascular risk factors, atherosclerotic cardiovascular diseases, and comorbidities, participants in the highest quartile of adverse SDOH burden (Q4) were associated with higher odds of moderate PD (OR, 3.67; 95% CI, 3.42-3.93) and severe PD (OR, 15.23; 95% CI, 11.97-19.36), respectively, than those in Q1. At nearly each quartile, a higher prevalence rate of PD was observed among females, middle-aged, and non-Hispanic White adults compared to their counterparts.

CONCLUSIONS: In a large, nationally representative sample of US adults, adverse SDOH was associated with increased PD. Assessing and mitigating the multifaceted adverse SDOH could serve as a strategy to help identify individuals with PD and improve existing PD prevention frameworks.

PMID:40954344 | DOI:10.1007/s00127-025-02991-4

J Mol Neurosci. 2025 Sep 15;75(3):117. doi: 10.1007/s12031-025-02407-7.

ABSTRACT

Oligoclonal band (OCB) analysis in cerebrospinal fluid (CSF) remains a cornerstone for the early diagnosis of multiple sclerosis (MS), with recent criteria highlighting the κ-free light chain (κ-FLC) index as a sensitive marker of intrathecal immunoglobulin synthesis. However, both approaches rely on lumbar puncture. To address the need for less invasive tools, this study employed proton nuclear magnetic resonance (¹H-NMR)-based serum metabolomics to explore whether peripheral metabolic signatures can distinguish immunophenotypic subgroups, namely OCB Type 1 and Type 2, in patients with suspected early-stage MS. To investigate whether targeted proton nuclear magnetic resonance (¹H-NMR) serum metabolomics can differentiate between individuals with OCB Type 1 (no intrathecal synthesis) and OCB Type 2 (definite intrathecal synthesis), as a step toward non-invasive metabolic stratification in possible early-stage MS. Serum samples (n = 49) were classified by OCB profile and analysed using targeted ¹H-NMR spectroscopy. All spectra were acquired at 298 K on a Bruker Avance Neo 600 MHz spectrometer. Metabolites were identified using Bruker BioRefCode libraries, and absolute quantification was performed using the ERETIC (Electronic Reference To access In vivo Concentrations) signal. Statistical analysis included age-adjusted univariate tests (t-test or Wilcoxon rank-sum, depending on normality) with false discovery rate (FDR) correction, followed by multivariate analyses including principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA), variable importance in projection (VIP) scores, and ROC-AUC permutations using the pROC package in R. Of the quantified metabolites, Leucine emerged as a robust differentiator, showing significant elevation in OCB Type 2 after both age adjustment and multiple testing correction (p = 0.025, FDR-adjusted; VIP = 2.38; AUC = 0.74), and correlating moderately with the IgG index (r = 0.32, p = 0.026). Histidine, Glycine, Sarcosine, and Succinic acid met VIP > 1.5 thresholds but did not survive FDR correction and are therefore reported as exploratory candidates. This pilot study identifies Leucine as a promising serum biomarker candidate for early intrathecal immune activity. Although additional metabolites showed potential, their findings remain exploratory due to statistical limitations. These results highlight the potential of targeted serum metabolomics as a non-invasive adjunct in early MS risk stratification and support further validation studies incorporating κ-FLC data and longitudinal follow-up.

PMID:40954342 | DOI:10.1007/s12031-025-02407-7

Oral Maxillofac Surg. 2025 Sep 16;29(1):152. doi: 10.1007/s10006-025-01451-2.

ABSTRACT

PURPOSE: Cosmetic surgery rates have shown a marked increase globally over the past few decades. Patient satisfaction is closely link to individuals’ ability to communicate expectations about surgical outcomes. However, people with alexithymia (a condition marked by difficulty in recognizing and expressing emotions) often struggle to articulate their desires or specific concerns about their appearance. This study aimed to evaluate the impact of alexithymia on patient satisfaction following cosmetic surgery, addressing a gap in the existing literature.

METHODS: This is a cross-sectional observational study incorporated multivariate analysis. The sample was selected by using convenience sampling, based on predefined inclusion and exclusion criteria. Statistical analyses included p-values, independent t-tests, Pearson’s correlation coefficients, and multivariate linear regression.

RESULTS: Among 304 participants, 29.9% exhibited high levels of alexithymia, 17.4% moderate, and 52.6% low. Regression analysis indicated that higher alexithymia scores were significantly associated with lower patient satisfaction (β = -0.20, 95% CI: -0.33 to -0.07, p = 0.001). While statistically significant, the effect size was small. Other variables such as age, marital status, and history of mental disorders were not significant predictors of satisfaction. The number of cosmetic surgeries showed a borderline positive association with satisfaction (β = 3.42, 95% CI: -0.02 to 6.86, p = 0.05), suggesting a possible relationship that warrants further investigation.

CONCLUSION: Alexithymia may modestly influence satisfaction with cosmetic surgery, highlighting the importance of emotional awareness in patient-provider communication. Our findings provide compelling evidence that individuals with alexithymia are more likely to report lower levels of satisfaction with their cosmetic procedure outcome.

PMID:40954341 | DOI:10.1007/s10006-025-01451-2

Aesthetic Plast Surg. 2025 Sep 15. doi: 10.1007/s00266-025-05200-4. Online ahead of print.

ABSTRACT

BACKGROUND: Seroma formation is a common complication, particularly in surgical procedures involving extensive tissue dissection and creation of potential spaces. The pathophysiology of seroma has traditionally been attributed to three main factors: lymphatic leakage, increased inflammatory exudate, and the formation of dead space. This study aims to evaluate the effect of platelet-rich fibrin (PRF) on seroma formation using an experimental rat model.

METHODS: A total of 23 Wistar albino rats were used and randomly divided into three groups of seven. The remaining two rats were used as the donor group for PRF harvesting. 21 of them underwent unilateral removal of cutaneous maximus and latissimus dorsi muscles, axillary dissection, and dermal lymphatic injury. The intervention groups received 1 cc of either saline, fibrin glue, or PRF intraoperatively. Seroma formation was assessed via aspiration on postoperative day 7. On day 21, biomechanical adhesion testing and histopathological evaluations were performed.

RESULTS: Median seroma volumes were 6.6 ml in the control group, 1 ml in the fibrin glue group, and 0.4 ml in the PRF group (p = 0.01). Neovascularization was significantly greater in the fibrin glue group (p = 0.04), whereas collagen deposition was highest in the PRF group (p = 0.01). Biomechanical adhesion testing revealed no statistically significant differences between groups (p > 0.05).

CONCLUSION: PRF effectively reduces seroma formation and promotes tissue adhesion. As an easy-to-apply, cost-effective, and autologous option, PRF may be used as an alternative to fibrin glue for the same purpose.

NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

PMID:40954314 | DOI:10.1007/s00266-025-05200-4

Nat Med. 2025 Sep 15. doi: 10.1038/s41591-025-03953-8. Online ahead of print.

ABSTRACT

The Standards for Reporting Diagnostic Accuracy (STARD) 2015 statement facilitates transparent and complete reporting of diagnostic test accuracy studies. However, there are unique considerations associated with artificial intelligence (AI)-centered diagnostic test studies. The STARD-AI statement, which was developed through a multistage, multistakeholder process, provides a minimum set of criteria that allows for comprehensive reporting of AI-centered diagnostic test accuracy studies. The process involved a literature review, a scoping survey of international experts, and a patient and public involvement and engagement initiative, culminating in a modified Delphi consensus process involving over 240 international stakeholders and a consensus meeting. The checklist was subsequently finalized by the Steering Committee and includes 18 new or modified items in addition to the STARD 2015 checklist items. Authors are encouraged to provide descriptions of dataset practices, the AI index test and how it was evaluated, as well as considerations of algorithmic bias and fairness. The STARD-AI statement supports comprehensive and transparent reporting in all AI-centered diagnostic accuracy studies, and it can help key stakeholders to evaluate the biases, applicability and generalizability of study findings.

PMID:40954311 | DOI:10.1038/s41591-025-03953-8

JMIR Res Protoc. 2025 Sep 15;14:e73704. doi: 10.2196/73704.

ABSTRACT

BACKGROUND: Patients with cardiovascular disease (CVD) often encounter challenges in establishing and maintaining heart-healthy physical activity habits, even after successfully completing a cardiac rehabilitation program. Digital health technologies hold promise to support long-term habit formation in the secondary prevention of CVD. The aktivplan digital health intervention has been developed to support patients with CVD in establishing long-term heart-healthy physical activity habits.

OBJECTIVE: The primary study aim is to pilot and assess the feasibility of a future randomized controlled trial design to investigate the effectiveness of the aktivplan intervention and to assess the usability, user experience, and acceptance of the aktivplan app. The secondary objective is to collect clinical and safety outcomes.

METHODS: This multicenter, mixed method, randomized controlled pilot study aims to recruit 40 patients with an established diagnosis of CVD or with increased risk of CVD (physically inactive along with 1 further CVD risk factor) who are undergoing phase II rehabilitation at 2 rehabilitation centers in Austria. Participants will be allocated to the intervention or standard care control group by stratified randomization and will be monitored for 10 weeks after discharge from phase II rehabilitation. Participants, health care professionals, and outcome assessors are not masked (blinded) to group allocation. Data collection will include recruitment and drop-out rate; data completeness; adherence to the intervention; usability, user experience, and user acceptance questionnaires; technical reliability of the intervention; clinical assessments (exercise capacity, physical activity behavior, and CVD risk factors); adverse events; self-reported outcome measures (health-related quality of life, exercise self-efficacy, depression and anxiety, and kinesiophobia); patient interviews, and focus groups with health care professionals. Quantitative data will be analyzed descriptively, and 95% CIs will be calculated for recruitment and drop-out rates and for data completeness. No confirmatory inferential statistical analysis or hypothesis testing will be conducted. Qualitative data will be analyzed thematically by framework analysis.

RESULTS: A total of 34 participants were recruited between October 2023 and May 2024. Data collection was completed in August 2024. Currently, the data are being analyzed and prepared for publication. The first publication of feasibility results is expected by summer 2025.

CONCLUSIONS: This pilot study is expected to generate valuable and comprehensive insights to inform the study design of a future definitive effectiveness trial of the aktivplan intervention, guide the need for further iteration of the aktivplan app before entering a definitive trial, and inform future implementation strategies for the intervention.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06025526; https://clinicaltrials.gov/study/NCT06025526.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/73704.

PMID:40953438 | DOI:10.2196/73704

JMIR Res Protoc. 2025 Sep 15;14:e75854. doi: 10.2196/75854.

ABSTRACT

BACKGROUND: Ultrasound-guided regional anesthesia in hip surgery has been shown to reduce the need for opioids and conventional analgesics, facilitate ambulation and early recovery, improve respiratory dynamics, and decrease the incidence of venous thrombosis and pneumonia. Lumbar erector spinae plane block (L-ESPB) has been proposed as a novel ultrasound-guided locoregional technique to relieve pain in hip surgery; however, the supporting evidence remains scarce.

OBJECTIVE: This study aims to provide evidence on the role of L-ESPB in perioperative pain management during hip surgery. We hypothesize that patients receiving L-ESPB compared to those without block will have lower opioid consumption and less pain after hip surgery. The primary outcome is the difference in pain intensity, measured using the visual analog scale, at 2 hours postoperatively between the L-ESPB group and the control group. We will compare postoperative analgesic needs and opioid consumption in both groups, assess the technical ease of performing L-ESPB, and record any side effects in both treatment arms. Finally, we will evaluate the level of patient satisfaction.

METHODS: This is a pragmatic, single-center, parallel-group randomized controlled trial. After patients provide informed consent, they will be randomly assigned in a 1:1 ratio to receive either ultrasound-guided L-ESPB or conventional intravenous analgesia. A total of 180 patients (n=90, 50% in each group) will be enrolled. Data analysis will be performed using SPSS software.

RESULTS: This clinical trial was approved by the European Medicines Agency on May 27, 2024, following approval by the local ethics committee earlier that month. Patient recruitment took place between June 2024 and May 2025. Statistical analysis is currently ongoing, and final results are expected to be submitted for publication in early 2026.

CONCLUSIONS: This clinical trial will enable us to assess the analgesic effectiveness of L-ESPB in hip surgery. We will also evaluate its safety and potential adverse effects compared with conventional analgesia and opioid consumption.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06567522; https://www.clinicaltrials.gov/study/NCT06567522.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/75854.

PMID:40953436 | DOI:10.2196/75854

IEEE Trans Pattern Anal Mach Intell. 2025 Sep 15;PP. doi: 10.1109/TPAMI.2025.3610169. Online ahead of print.

ABSTRACT

Variance reduction has been shown to improve the performance of Stochastic Gradient Descent (SGD) in centralized machine learning. However, when it is extended to federated learning systems, many issues may arise, including (i) mega-batch size settings; (ii) additional noise introduced by the gradient difference between the current iteration and the snapshot point; and (iii) gradient (statistical) heterogeneity. In this paper, we propose a lightweight algorithm termed federated adaptive batch size time evolving variance reduction (FedATEVR) to tackle these issues, consisting of an adaptive batch size setting scheme and a time-evolving variance reduction gradient estimator. In particular, we use the historical gradient information to set an appropriate mega-batch size for each client, which can steadily accelerate the local SGD process and reduce the computation cost. The historical information involves both global and local gradient, which mitigates unstable varying in mega-batch size introduced by gradient heterogeneity among the clients. For each client, the gradient difference between the current iteration and the snapshot point is used to tune the time-evolving weight of the variance reduction term in the gradient estimator. This can avoid meaningless variance reduction caused by the out-of-date snapshot point gradient. We theoretically prove that our algorithm can achieve a linear speedup of of $mathcal {O}(frac{1}{sqrt{SKT}})$ for non-convex objective functions under partial client participation. Extensive experiments demonstrate that our proposed method can achieve higher test accuracy than the baselines and decrease communication rounds greatly.

PMID:40953432 | DOI:10.1109/TPAMI.2025.3610169

WMJ. 2025;124(3):312-316.

NO ABSTRACT

PMID:40953402

WMJ. 2025;124(3):270-273.

ABSTRACT

BACKGROUND: Alcohol-related mortality is an increasing public health concern in the United States. To date, no study has considered trends in alcohol-related deaths during the full COVID-19 pandemic period.

METHODS: We analyzed deaths from Wisconsin vital statistics to explore the relationship between the pandemic period and any changes in alcohol-related mortality.

RESULTS: In Wisconsin, the pandemic period was associated with additional alcohol-related mortality above and beyond a previously reported upward trend.

DISCUSSION: We show that the COVID-19 pandemic was associated with exacerbated alcohol-related mortality in Wisconsin. Alcohol use may need to be considered as an additional public health risk in future pandemic scenarios.

PMID:40953391