Nevin Manimala

Sleep Med Rev. 2025 Jan 15;80:102048. doi: 10.1016/j.smrv.2025.102048. Online ahead of print.

ABSTRACT

Major depressive disorder (MDD) and Insomnia disorder (ID) are characterized by sleep alterations. To define their polysomnographic profiles, we conducted a Network Meta-Analysis comparing MDD and ID patients versus healthy controls (HCs). The literature search, conducted from 2008 up to January 2023 and following PRISMA guidelines, covered PubMed, Web of Science, Scopus, and Embase databases. We addressed publication bias using funnel plot asymmetry inspection and Egger’s test, evaluated statistical heterogeneity with I², and local and global inconsistencies with the separate indirect from direct evidence method and Q between designs, respectively. Pairwise meta-analyses employed a fixed-effects model, while network analysis utilized a random-effect approach. We evaluated 86 ID and 17 MDD studies, comparing sleep parameters for 636 MDDs versus 491 HCs, and 3661 IDs versus 2792 HCs. The network meta-analysis reported that patients with MDD have greater rapid eye movement (REM) sleep duration and REMs density, and lower REM sleep latency compared to IDs. ID patients instead exhibited lower total sleep time and time in bed, and greater wake after sleep onset and non-REM sleep stage 3 than MDD patients. This work emphasized sleep depth and continuity alterations in both MDD and ID, with major involvement of REM sleep in MDD.

PMID:40054014 | DOI:10.1016/j.smrv.2025.102048

J Phys Chem Lett. 2025 Mar 7:2778-2784. doi: 10.1021/acs.jpclett.5c00073. Online ahead of print.

ABSTRACT

This study uses molecular dynamics simulations to investigate the structural features of carbon dioxide (CO₂) in the liquid and supercritical phases at different isobars. Density fluctuations, which mark the liquid-to-gas-like crossover, were quantified using advanced statistical tools such as nearest-neighbor distance distributions, interaction energies, and local density profiles derived from Voronoi analysis and density-based spatial clustering of applications with noise. Our findings reveal that these fluctuations arise from the temperature-dependent difference in the spatial extent of attractive contributions from electrostatic (ES) and Lennard-Jones (LJ) potentials, leading to a maximum in the contrast between the packed and loose density domains. Specifically, we demonstrate that the first and second solvation shells are characterized by neighbors experiencing maximal LJ and minimal ES attractive contributions, respectively. Within these shells, the orientation of the CO₂ molecules is governed by the maximal attractive contribution of ES interactions.

PMID:40054008 | DOI:10.1021/acs.jpclett.5c00073

JMIR Hum Factors. 2025 Mar 7;12:e63607. doi: 10.2196/63607.

ABSTRACT

BACKGROUND: Mobile health care (mHealth) apps are emerging worldwide as a vital component of internet health care, but there are issues, especially among older adults.

OBJECTIVE: We aim to investigate the factors influencing the intention to use (ITU) mHealth apps, focusing on those with and without prior mHealth experience.

METHODS: A cross-sectional study conducted from August 2022 to July 2023 included Thai citizens aged 45 years or older. Self-reported questionnaires collected data on sociodemographic information, health conditions, smartphone or tablet ownership, and mHealth usage experience. The Thai mHealth Senior Technology Acceptance Model questionnaires with a 10-point Likert scale evaluated mHealth acceptance. A multivariable logistic regression analysis, adjusted for age, gender, education, income, and living area, was performed for 2 subgroups: those who used ITU mHealth apps and those who did not.

RESULTS: Of 1100 participants, 537 (48.8%) intended to use mHealth apps, while 563 (51.2%) did not. The ITU group had a younger average age, higher education levels, higher income, and fewer underlying diseases compared to those who did not intend to use mHealth apps. For those who had never used mHealth apps, having a smartphone was strongly associated with higher odds of ITU (adjusted odds ratio 2.81, 95% CI 1.6 to 4.93; P<.001), while having any underlying disease was associated with lower odds of ITU (adjusted odds ratio 0.63, 95% CI 0.42 to 0.97; P=.034). Higher acceptance levels, characterized by a positive attitude toward mHealth and lower fear of making mistakes, were also associated with higher ITU. For those with prior mHealth experience, acceptance in areas such as perceived ease of use, gerontechnology anxiety, and facilitating conditions was significantly associated with ITU.

CONCLUSIONS: Among inexperienced users, a positive attitude toward mHealth significantly enhanced ITU. Conversely, having an underlying disease decreased ITU, indicating a need for tailored mHealth apps. For experienced users, acceptance levels in areas such as ease of use and gerontechnology anxiety were crucial. Future research should explore specific mHealth apps for more targeted insights.

PMID:40054006 | DOI:10.2196/63607

Phys Rev Lett. 2025 Feb 21;134(7):071903. doi: 10.1103/PhysRevLett.134.071903.

ABSTRACT

The subtraction function plays a pivotal role in calculations involving the forward Compton amplitude, which is crucial for predicting the Lamb shift in muonic atoms, as well as the proton-neutron mass difference. In this Letter, we present a lattice QCD calculation of the subtraction function using two domain wall fermion gauge ensembles near the physical pion mass. We utilize a recently proposed subtraction point, demonstrating its advantage in mitigating statistical and systematic uncertainties by eliminating the need for ground-state subtraction. Our results reveal significant contributions from Nπ intermediate states to the subtraction function. Incorporating these contributions, we compute the proton, neutron, and nucleon isovector subtraction functions at photon momentum transfer Q^{2}∈[0,2] GeV^{2}. For the proton subtraction function, we compare our lattice results with chiral perturbation theory prediction at low Q^{2} and with the results from the perturbative operator-product expansion at high Q^{2}. Finally, using these subtraction functions as input, we determine their contribution to two-photon exchange effects in the Lamb shift and isovector nucleon electromagnetic self-energy.

PMID:40053980 | DOI:10.1103/PhysRevLett.134.071903

J Neurosurg Spine. 2025 Mar 7:1-10. doi: 10.3171/2024.11.SPINE241048. Online ahead of print.

ABSTRACT

OBJECTIVE: The Social Deprivation Index (SDI) measures area-level social disadvantage. SDI values range from 0 (no distress/prosperous) to 100 (highest distress). This study investigated the association between SDI and lumbar spine surgery outcomes.

METHODS: A retrospective cross-sectional study was performed using electronic health record data from a multihospital academic health system from 2017 to 2024. Eligible patients included adults who underwent lumbar fusion or decompression alone. The primary exposure of interest was the binary SDI (low distress [SDI < 50] vs high distress [SDI ≥ 50 and ≤ 100]). SDI was associated with the patient’s zip code of residence. The associations between SDI category and pain reduction, physical function improvement, length of stay, and 30-day readmission were examined. Both unadjusted and adjusted regression models were created. Adjusted models included the following covariates: age, comorbidities, race, insurance, and surgery type. Multiple imputation by chained equations was used to impute missing values.

RESULTS: The total sample included 7598 patients with 5139 in the low-SDI group and 2459 in the high-SDI group. SDI category was not significantly associated with the likelihood of pain reduction or physical function improvement after surgery. In the adjusted model, residence in a high-SDI area was significantly associated with extended length of stay (OR 1.21, 95% CI 1.07-1.36, p = 0.002). In the unadjusted model, patients from high-SDI areas were significantly more likely to experience 30-day readmission (OR 1.35, 95% CI 1.07-1.71, p = 0.01). In the adjusted model, this association was no longer statistically significant (OR 1.00, 95% CI 0.74-1.36, p ≥ 0.99).

CONCLUSIONS: Patients from high-SDI areas had similar pain and physical function outcomes compared to patients from low-SDI areas after lumbar spine surgery. High SDI was significantly associated with length of stay. This study highlights the need for interventions that address the unique needs of patients from low-resource settings to improve lumbar spine surgery outcomes.

PMID:40053938 | DOI:10.3171/2024.11.SPINE241048

J Neurosurg. 2025 Mar 7:1-15. doi: 10.3171/2024.11.JNS241990. Online ahead of print.

ABSTRACT

OBJECTIVE: Essential tremor (ET) is a prevalent movement disorder that also includes nonmotor symptoms such as anxiety, depression, and cognitive impairment. Deep brain stimulation (DBS) is an established treatment for ET, yet its impact on nonmotor symptoms remains unclear. This study aims to describe neuropsychological outcomes following ventral intermediate nucleus (VIM) DBS in a large cohort of patients with ET and identify factors associated with changes in depression and cognitive function.

METHODS: A retrospective cohort study of patients who had undergone VIM DBS was performed. Inclusion criteria were ET diagnosis, surgery between October 2007 and March 2020, and available pre- and post-DBS neuropsychological testing results. Neuropsychological measures included the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and cognitive measures assessing attention, executive function, language, memory, and visuospatial function. Post-DBS tremor improvement was graded, and active electrode coordinates and stimulation parameters were identified. Statistical analyses included descriptive statistics, t-tests to compare pre- and postoperative scores at the group level, and one-way analysis of variance to compare variables among patients who improved, were stable, or worsened in psychiatric and cognitive characteristics after DBS.

RESULTS: One hundred thirty-nine patients met the study inclusion criteria. BDI-II scores significantly decreased postoperatively (9.82 ± 6.77 vs 8.29 ± 6.18, p < 0.001, Cohen’s d = 0.176), whereas BAI scores remained unchanged. Both language (p = 0.003, Cohen’s d = 0.259) and memory (p < 0.001, Cohen’s d = 0.336) domains showed statistically significant small-magnitude declines following surgery, whereas attention, executive function, and visuospatial function were unchanged. Patients with improved depression (14.3%) following VIM DBS had significantly higher BDI-II scores preoperatively (p < 0.001, ω2 = 0.226). Patients with worsened language (18.7%) had higher preoperative language scores (p < 0.001, ω2 = 0.058). Patients with worsened memory (15.1%) had higher BAI scores preoperatively (p = 0.002, ω2 = 0.079). Preoperative scores were similar between patients with improved and worsened overall cognition postsurgery. Patients with improved overall cognition had improvements in attention, language, and visuospatial function.

CONCLUSIONS: VIM DBS for ET did not result in large-magnitude neuropsychological changes. There were statistically significant, though likely not clinically meaningful, small-magnitude improvements in depression and worsening in language and memory scores. Associations were found between multiple preoperative mood and cognitive scores and post-DBS neuropsychological changes. These findings can help inform clinical decision-making and patient counseling for DBS.

PMID:40053934 | DOI:10.3171/2024.11.JNS241990

Knee Surg Sports Traumatol Arthrosc. 2025 Mar 7. doi: 10.1002/ksa.12645. Online ahead of print.

ABSTRACT

PURPOSE: Bereiter trochleoplasty (TP) is a well-described procedure to address trochlear dysplasia (TD). Post-operative joint stiffness with reduced range of motion (ROM) is a common complication usually requiring arthroscopically assisted manipulation (AAM) with the removal of adhesions and scar tissue. Inferior clinical outcomes after TP have been reported for patients with subsequent surgery. We hypothesised that a 2-year improvement in patient-reported outcomes would be lower in patients treated with AAM.

METHODS: This was a retrospective cohort study of prospectively collected data comparing subgroups of patients with and without post-operative joint stiffness from a consecutive cohort of 374 knees with high-grade TD who underwent TP according to the Copenhagen patello-femoral instability (PFI) algorithm. All patients received supervised training exercises led by a physiotherapist. At 3-month follow-up, patients with an extension deficit >10° and/or flexion <120° were diagnosed with post-operative joint stiffness and treated with AAM. Outcomes were mean differences from baseline in Kujala, Knee injury and Osteoarthritis Outcome Score (KOOS) and Lysholm scores 1 and 2 years after surgery.

RESULTS: Forty-nine (38 females, 11 males) of the 374 knees (12%) had post-operative joint stiffness and underwent AAM. Nine patients underwent subsequent AAMs. Full extension and flexion >135° were achieved in 37 out of 49 cases (75%). In 11 cases, flexion remained reduced, while data on ROM could not be retrieved in one case. While both patients with and without AAM showed clinically relevant improvements in the Kujala, KOOS and Lysholm scores, no statistically significant between-group differences were seen in these improvements.

CONCLUSIONS: Post-operative joint stiffness was a common complication after Bereiter TP following the Copenhagen PFI algorithm. Twenty-five per cent of the AAM patients, or 3% of the study population, did not regain full ROM. We did not find that post-operative joint stiffness was associated with inferior improvements in patient-reported outcomes 1 and 2 years after surgery.

LEVEL OF EVIDENCE: Level IV, a retrospective cohort study.

PMID:40053930 | DOI:10.1002/ksa.12645

Knee Surg Sports Traumatol Arthrosc. 2025 Mar 7. doi: 10.1002/ksa.12643. Online ahead of print.

ABSTRACT

PURPOSE: Fixed flexion deformity (FFD) is traditionally addressed in total knee arthroplasty (TKA) with extensive soft tissue release and distal femoral recut, which increases bone stock consumption and raises the knee joint line (JL). This study aimed to evaluate differences in the anatomical restoration of the JL and bone stock preservation between FFD knees and a control group during robotic-assisted (RA) TKA combined with functional alignment (FA).

METHODS: A retrospective comparative cohort study examined 120 knees undergoing RA TKA. The knees were categorised into two groups: the study group, with FFD > 5°, and the control group, without FFD. Further analysis stratified the study group based on the severity of the deformity: mild (5-9°), intermediate (10-14°) and advanced (>15°). The Mann-Whitney U test was utilised to investigate the differences between the control and study groups.

RESULTS: The study group comprised 64 knees, presenting an average flexion contracture and range of motion (ROM) of 11.3 ± 4.7° and 112.7 ± 11.6°, respectively. The control group comprised 56 knees, with an extension deficit and ROM of 1.6 ± 2.1° and 123.5 ± 8.3°, respectively. The JL was proximally displaced on average by 0.1 ± 1.2 mm in the study group and lowered by 0.7 ± 0.9 mm in the control group. Analysis of JL in the subgroups showed a lowering of 0.3 ± 1.2 mm in the mild deformity subgroup and a rise of 0.08 ± 1.3 mm and 0.8 ± 0.8 mm in the intermediate and advanced FFD subgroups, respectively, showing no statistical significance. The combined thickness of tibial proximal and femoral distal bone cuts measured 12.3 ± 1.6 mm in the study group and 11.4 ± 1.4 mm in the control group.

CONCLUSIONS: FA in RA-assisted TKA can correct FFD, minimising bone cuts while preserving anatomical JL level.

LEVEL OF EVIDENCE: Level III.

PMID:40053918 | DOI:10.1002/ksa.12643

Spine (Phila Pa 1976). 2025 Apr 1;50(7):493-499. doi: 10.1097/BRS.0000000000005218. Epub 2024 Nov 18.

ABSTRACT

STUDY DESIGN: Retrospective cohort.

OBJECTIVE: This study seeks to establish the normal distribution of the vasculature surrounding the SI joint while also demonstrating associations between distribution and laterality, sex, and ethnicity.

SUMMARY OF BACKGROUND DATA: Sacroiliac (SI) joint fusion surgery has emerged as a viable treatment option for patients suffering from low back pain due to chronic SI joint dysfunction. Due to potential complications from iatrogenic injury to vasculature, it becomes critical to understand normal anatomy and locations with a high vasculature concentration surrounding the SI joint.

METHODS: The authors retrieved medical and radiographic records of patients who underwent computed tomography angiography (CTA) of the pelvis. Anterior and posterior compartments of the SI joint were established on the transverse view by creating an even coronal division of the SI joint. The superior, middle, and inferior compartments were established on the coronal view as three equal transverse compartments. The compartments in which vasculature was visualized were recorded.

RESULTS: Distribution of vasculature around the right and left hemipelvis concentrated in the inferior compartments and decreased in concentration while moving superiorly. Anterior compartments contain a higher vascularity than posterior compartments. Vasculature was present in <3% of the posterior middle, and posterior superior compartments while present in >83% of the inferior compartments. There were no significant differences with respect to vascular distribution when comparing the laterality of the right versus left hemipelvis. There were statistically significant relationships between vascular distribution and sex (P<0.05), as well as across self-reported ethnicity (P<0.05).

CONCLUSIONS: SI screw placement in the posterior superior has the lowest risk of iatrogenic vascular injury. Careful consideration should be taken during SI joint fusion surgery in the inferior compartments due to its high vasculature density.

PMID:40053916 | DOI:10.1097/BRS.0000000000005218

Int J Med Robot. 2025 Apr;21(2):e70057. doi: 10.1002/rcs.70057.

ABSTRACT

BACKGROUND: The advantages of robotic-assisted pancreatoduodenectomy (RPD) in comparison with open pancreatoduodenectomy (OPD) have not been well-established. We aimed to compare their short-term outcomes by inverse probability of treatment weighting (IPTW) analysis.

METHODS: Patients who underwent RPD/OPD at our hospital were recruited. Stabilised IPTW were performed to adjust observed covariates. Short-term outcomes were compared.

RESULTS: After IPTW, the effective sample comprised 807 patients (199 RPD, 608 OPD) with balanced clinicopathological characteristics. RPD had a longer operation time, fewer intraoperative blood loss (IBL), and lower blood transfusion rate than OPD. RPD was associated with a lower incidence of clinically relevant postoperative pancreatic fistula and reoperation but did not reach statistical significance. In pancreatic adenocarcinoma, RPD had a significantly higher number of lymph nodes examined. There were no significant differences in postoperative morbidities and length-of-stay.

CONCLUSIONS: RPD was associated with fewer IBL and transfusion rates than OPD. RPD can be considered feasible and safe.

PMID:40053906 | DOI:10.1002/rcs.70057