Nevin Manimala

Medicine (Baltimore). 2025 Mar 14;104(11):e41821. doi: 10.1097/MD.0000000000041821.

ABSTRACT

The COVID-19 pandemic has significantly impacted the mental health of healthcare workers globally. Given the critical role these professionals play, understanding the prevalence and predictors of post-traumatic stress disorder (PTSD) among healthcare workers is crucial for developing targeted interventions. Comprehensive data on the predictors of PTSD symptoms within this population remain limited. This cross-sectional study surveyed 852 healthcare workers across 4 Polish regions between 2021 and 2022. Data were collected using the Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C), which was culturally adapted and validated for Polish respondents. To identify key predictors of PTSD symptoms, researchers employed various statistical methods: Descriptive Statistics summarized key variables (e.g. age, job tenure) to provide an overview of data distribution and sample characteristics. Pearson Correlations examined linear relationships among variables like age, work experience, and PTSD severity, ensuring no multicollinearity through variance inflation factor checks. t-Tests and Mann-Whitney U tests compared PTSD symptom severity across demographic and professional subgroups, accounting for normality using the Kolmogorov-Smirnov test. And Hierarchical Regression Analysis identified significant predictors, incorporating demographic factors first and work-related variables (e.g. fear for personal health) in a second step. A total of 88.1% of participants were female, and 82.6% were nurses. The overall prevalence of PTSD symptoms was high, with a mean total PTSD score of 37.87. Gender differences were significant, with women reporting higher scores across the PTSD subscales, including avoidance and hyperarousal. Nurses had significantly higher intrusion symptoms compared to other professionals. Fear for personal health was the strongest predictor of PTSD symptoms (β = 0.15, P < .001), explaining 11% of the variance in the final regression model (R2 = 0.11, P < .001). The findings underscore the urgent need for targeted mental health interventions, particularly for women and nurses, who are disproportionately affected by PTSD during the pandemic. Predictive models should guide the development of support programs to mitigate the long-term psychological impact of COVID-19 and ensure better preparedness for future pandemics. The significant influence of fear for personal health on PTSD outcomes highlights the importance of protective measures and psychological support for frontline healthcare workers.

PMID:40101094 | DOI:10.1097/MD.0000000000041821

Medicine (Baltimore). 2025 Mar 14;104(11):e41880. doi: 10.1097/MD.0000000000041880.

ABSTRACT

Endolymphatic hydrops (EH) has been visualized on magnetic resonance imaging (MRI) in patients with various inner ear diseases. The purpose of this study was to evaluate the prevalence and risk factors of significant EH on inner ear MRI in patients with 1 or more audiovestibular symptoms and to predict the incidence of significant EH using multivariate analysis and multilayer perceptron artificial neural network modeling. This retrospective study included a total of 135 patients with 1 or more audiovestibular symptoms who do not meet the diagnostic criteria for MD and underwent inner ear MRI at our institution from July 2021 to January 2024. The EH grade of each patient was evaluated, and “significant EH” was considered grade II or III. Of 135 patients with 1 or more audiovestibular symptoms, 48 patients (35.6%) presented with significant EH and 87 patients (64.4%) without significant EH on inner ear MRI. The prevalence of significant EH was higher in males, which was statistically significant (P = .007). The prevalence of significant EH was higher in the right ear, and the mean age of patients with significant EH was 1.94 years higher, but no statistical significance was observed (P = .660 and .456, retrospectively). The odds ratio for significant EH development was 2.696 (95% confidence interval: 1.296-5.607) times higher in men, which was statistically significant. Predicting the incidence of significant EH development using multivariate analysis, sex was the only variable that was statistically significant (P = .008). Based on a predictive model using multilayer perceptron (MLP), the classification accuracy of the model was 79.5%. In our study, the male gender could be related to the risk of developing significant EH in patients with audiovestibular symptoms. The accuracy of our suggested MLP model for predicting the incidence of significant EH was 79.5%, with sex being the highest predictor importance. In the future, inner ear MRI and MLP neural network modeling can be combined as a noninvasive and precise support system in the diagnosis of EH.

PMID:40101092 | DOI:10.1097/MD.0000000000041880

Medicine (Baltimore). 2025 Mar 14;104(11):e41646. doi: 10.1097/MD.0000000000041646.

ABSTRACT

To analyze the effects of drug treatments and types of drugs on pregnancy outcomes in pregnant women at different gestational ages. The records of 526 pregnant women from our hospital from September 2018 to January 2024 were analyzed retrospectively. Women were categorized into 3 groups: normal delivery, artificial abortion, and spontaneous abortion. Data on maternal age, gestational age, smoking, drinking, radiation, medication timing, and types were collected and compared. Pearson correlation analysis assessed relationships between pregnancy outcomes, gestational age at medication, and medication types. After comparing multiple potential influencing factors, it was found that smoking history, timing of medication, and the use of antitussive and phlegm-reducing medications differed significantly among the different pregnancy outcome groups (P < .05). Multiple regression analysis showed that the gestational age at which pregnant women took medication was a significant positive influencing factor for adverse pregnancy outcomes, specifically artificial abortion (Coefficient = 0.210, P = .002). In addition, the use of antitussive and phlegm-reducing medications had a positive directional influence on adverse pregnancy outcomes, specifically spontaneous abortion (Coefficient = 0.294, P = .016). Further analysis showed that as the gestational age at the time of medication increased, the normal delivery rate initially increased and then decreased. The rate of artificial abortion first increased and then stabilized, while the spontaneous abortion rate showed minimal fluctuation. The use of medications by pregnant women and the duration of pregnancy significantly impact induced abortion rates. Cough and mucus-reducing medications can lead to miscarriage, while other drugs in early pregnancy generally do not affect outcomes. Antitussive and mucus-reducing drugs specifically increase the risk of spontaneous abortion. Raising awareness about proper medication use and conducting research on this topic is crucial for enhancing prenatal and postnatal care, reducing induced abortions, and promoting population growth.

PMID:40101089 | DOI:10.1097/MD.0000000000041646

Medicine (Baltimore). 2025 Mar 14;104(11):e41742. doi: 10.1097/MD.0000000000041742.

ABSTRACT

To evaluate the relationship between serum endothelial cell specific molecule-1 (Endocan), asymmetric dimethylarginine (ADMA) values, and penile Doppler ultrasonography (USG) findings in patients with severe erectile dysfunction (ED). This prospective study included 73 patients who were classified as severe ED and had an indication for penile Doppler USG in our urology outpatient clinic between April 2017 and January 2020. Fasting blood sugar, lipid profile, thyroid function tests, total testosterone, and serum Endocan and ADMA values were sampled, and penile Doppler USG examination data were recorded. Vasculogenic ED was detected in 51 (69.86%) of 73 patients, while the flow rates were normal in 22 (30.14%). Among those with vasculogenic ED, 15 (29.41%) had arterial insufficiency, 22 (43.13%) had venous leakage, and 14 (27.46%) had mixed. There was no statistically significant difference between the mean ADMA and Endocan values of ED with normal flow (14.44 ± 6.20 ng/mL and 0.18 ± 0.14 ng/mL) and the vasculogenic ED (12.31 ± 5.86 ng/mL and 0.21 ± 0.16 ng/mL) groups (P = .097 for ADMA and P = .315 for Endocan, respectively). Endocan and ADMA levels were not predictors of severe ED. There is a need for multicenter studies with larger patient populations to be conducted with different biomarkers that may have a higher predictive value in the future.

PMID:40101085 | DOI:10.1097/MD.0000000000041742

Medicine (Baltimore). 2025 Mar 14;104(11):e41676. doi: 10.1097/MD.0000000000041676.

ABSTRACT

This study aimed to explore the rule of acupoint selection in the treatment of somnolence by ancient acupuncture and moxibustion. Using “Duomei” and other words as search terms in the Encyclopaedia of Traditional Chinese Medicine, a table containing elements such as literature sources, acupoint names, and frequency of acupoint selection was created. The table data was imported into the Traditional Chinese Medicine Inheritance Calculation Platform Software V3.5 (TCMICS) for statistical analysis to summarize the rules of acupoint selection. In the ancient medical books, the high-frequency acupoints of acupuncture and moxibustion in the treatment of somnolence were KI(Kidney)4(Dazhong)(24times,9.76%),KI3(Taixi)(23times,9.35%),LI(Large Intestine)3Sanjian(23times,9.35%) from high to low, and the high-frequency acupoints used for specific acupoints were Shu, Luo, and Bahui points from high to low. Association rule analysis showed that the core combination of high-frequency related acupoints was 3 groups, namely,”KI3(Taixi)KI6(Zhaohai)”(5times,2.03%),”KI4(Dazhong)HT(Heart)5(Tongli)”(5times,2.03%), and “LI3(Sanjian) ST(Stomach)45(Lidui) SJ(SanJiao)10(Tianjing)”(5times,2.03%). Cluster analysis showed that the effective cluster combination of acupoints was “LI3(Sanjian), LI2(Erjian),KI3(Taixi),ST45(Lidui),SJ10(Tianjing),KI6(Zhaohai),””HT5(Tongli),KI4(Dazhong),””RN(Ren) 12(Zhongwan),BL(Bladder)43(Gaohuang),ST36(Zusanli),RN6(Qihai).” In the ancient medical books, acupuncture and moxibustion was used to treat somnolence with distal point selection, and acupuncture and moxibustion prescriptions often used “KI3(Taixi)KI6(Zhaohai)” and other core acupoint combinations from the perspective of tonifying deficiency, relieving excess and giving consideration to both deficiency and excess, combined with acupoint selection and coordination based on syndrome differentiation and meridian differentiation, and focused on overall adjustment.

PMID:40101083 | DOI:10.1097/MD.0000000000041676

Medicine (Baltimore). 2025 Mar 14;104(11):e41830. doi: 10.1097/MD.0000000000041830.

ABSTRACT

BACKGROUND: With the COVID-19 pandemic and the serious sequelae, foreign factor-induced Guillain-Barré syndrome (GBS) has become a research focus in autoimmune peripheral neuropathies. The study employs a bibliometric system to illustrate the research hotspots and trends in GBS based on pertinent literature from January 2013 to October 2023.

METHODS: The Web of Science Core Collection retrieved articles on GBS from January 1, 2013, to October 28, 2023. These articles were then visualized and statistically evaluated using VOSviewer, CiteSpace software, R version 4.2.1, and Microsoft Office Excel 2019.

RESULTS: A total of 4269 articles on GBS were gathered. The United States of America produced the most publications (28.55%, 1219/4269), followed by China (14.22%, 607/4269). The world’s leading country was the United States of America, with the most publications, the most substantial international cooperation, and the highest centrality (0.17). Union of French Research Universities (UDICE)-French Research Universities in France was the most productive organization (189 articles). Lancet was the highest cocited journal (2428), and Professor Jacobs, Bart C., was the most prolific author (93). The most significant increases were shown for the keywords coronavirus, respiratory failure, and coronavirus disease 2019. The novel coronavirus is an emerging virus that may cause GBS, indicating a promising area of research.

CONCLUSIONS: The study on GBS was illustrated using bibliometrics, and it covers trends in international collaboration, publications, and research hotspots. These findings allow the scientific community to pinpoint the novel ideas and directions that will drive future GBS research.

PMID:40101082 | DOI:10.1097/MD.0000000000041830

Medicine (Baltimore). 2025 Mar 14;104(11):e41768. doi: 10.1097/MD.0000000000041768.

ABSTRACT

Colorectal cancer (CRC) is one of the most common cancers worldwide, necessitating the identification of risk factors and preventive measures. Fatty acids, vital nutrients involved in various bodily functions, have been linked to CRC; however, findings are inconsistent. This Mendelian randomization study utilized data from the UK Biobank and included 18 fatty acid-related phenotypes. We used single-nucleotide polymorphisms as instrumental variables to examine the Causal connections between fatty acids and CRC. Statistical analysis involved the inverse-variance-weighted, Mendelian randomization-Egger, and weighted median methods to ensure robust findings. Our analysis revealed that docosahexaenoic acid and omega-3 fatty acids were positively associated with CRC risk. No significant associations were found between CRC and total fatty acids, saturated fatty acids, polyunsaturated fatty acids, or monounsaturated fatty acids. The degree of unsaturation was positively associated with CRC, while the ratio of omega-6 to omega-3 fatty acids was negatively associated. The study highlights a positive association between docosahexaenoic acid, omega-3 fatty acids, and CRC, suggesting that specific fatty acids may influence CRC risk. Further research in diverse populations is needed to confirm these findings and explore the underlying mechanisms.

PMID:40101081 | DOI:10.1097/MD.0000000000041768

Medicine (Baltimore). 2025 Mar 14;104(11):e41854. doi: 10.1097/MD.0000000000041854.

ABSTRACT

The purpose of this study was to determine the prevalence and factors associated with influenza vaccine nonreceipt among adults in the United States. This nationally representative, cross-sectional study analyzed self-reported data on influenza vaccination status and sociodemographic, physical health, and health care access factors among 27,189 adults from the 2022 National Health Interview Survey. The primary outcome was influenza vaccination nonreceipt in the past 12 months. A multivariable logistic regression model evaluated associations between 19 sociodemographic, physical health, and health care access variables with influenza vaccine nonreceipt. Shapley Additive Explanations assessed the relative importance of covariates associated with nonreceipt in the regression model. The population-weighted analysis indicated 52.8% influenza vaccination nonreceipt among US adults. The logistic regression model identified 15 covariates as significantly associated with vaccine nonreceipt. When evaluating the relative importance of the variables, the key determinants of vaccine nonreceipt were younger age, lack of doctor visits in the past year, and lower educational attainment. Influenza vaccine nonreceipt was 92.4% among adults with all 3 characteristics compared to only 16.0% among those with none of the characteristics. In conclusion, influenza vaccine coverage in the overall US adult population remains well below public health goals. Significant disparities persist among subgroups like younger adults, those without recent health care visits, and individuals with lower educational attainment. There is an urgent need for expanded outreach efforts targeting vulnerable populations to address disparities in vaccine uptake.

PMID:40101075 | DOI:10.1097/MD.0000000000041854

Am J Hypertens. 2025 Mar 18:hpaf029. doi: 10.1093/ajh/hpaf029. Online ahead of print.

ABSTRACT

BACKGROUND: Percutaneous adrenal ablation (PAA) is an effective and safe therapy for treating patients with primary aldosteronism (PA). However, its effectiveness in comparison to that of adrenalectomy (ADX) and mineralocorticoid receptor antagonists (MRAs) remains unclear.

METHODS: Databases were searched including: Pubmed, Embase, and The Cochrane Library. Studies were included if patients with PA who received two of three different treatments (ADX, MRAs, or PAA) and reported our interested outcomes, including blood pressure, serum potassium and the aldosterone-to-renin ratio (ARR).

RESULTS: In total of 10,681 patients from forty-seven studies were identified. Both ADX and PAA showed superior clinical success (systolic BP: ADX: -4.69 [-6.4, -2.95], PAA: -3.96 [-9.05, 0.99]; diastolic BP: ADX: -3.14 [-4.55, -1.85], PAA: -2.99 [-6.96, 0.98]) compared with MRAs. According to the Bayesian ranking curves (SUCRA values), ADX ranked first for all outcomes of interest (systolic BP: 81.02%, diastolic BP: 76.95%, serum potassium: 96.55%, and ARR: 88.03%), while PAA ranked second for all outcomes (systolic BP: 65.94%, diastolic BP: 69.66%, serum potassium: 50%, and ARR: 45.14%).

CONCLUSIONS: The findings of this network meta-analysis suggest that PAA could be an alternative treatment for patients with PA who are unable to opt for surgery or MRA therapy, and its clinical and biochemical success fall between those of ADX and MRAs.

PMID:40099475 | DOI:10.1093/ajh/hpaf029

Pest Manag Sci. 2025 Mar 18. doi: 10.1002/ps.8772. Online ahead of print.

ABSTRACT

BACKGROUND: The occurrence of migratory takeoff behavior is the essential first step for long-distance migration of insects. However, its characteristics, frequency of occurrence, and the identity of environmental and physiological factors influencing this process remain largely unknown.

RESULTS: We investigate the global pest fall armyworm (FAW, Spodoptera frugiperda) as an exemplar species to investigate the behavioral traits associated with migratory takeoff of nocturnally migrating moths in year-round breeding areas. Our studies of FAW were carried out in Yunnan (2020-2022) and Hainan (2023) provinces of South China. Most migratory FAW moths were observed to takeoff at the age of Day (D)1-3, with the highest migratory proportion on D2, whereas mating behavior mostly happened during the first half night on D1. Typically, the migratory individuals took off within 40 min after sunset when the illumination fell below 2.7 lx, reaching its peak within 15 min. The optimal conditions for their takeoff are warm and dry weather with gentle winds. Yunnan and Hainan field populations showed a similar seasonal pattern in their migratory proportion, with the highest proportion in spring, and then decreasing as the seasons progress. Additionally, FAW moths emerging from caterpillars fed on maize plants at V14-R1 stages showed a higher migratory proportion than those from larvae fed on maize plants at other growth stages. Compared with nonmigratory individuals, migratory ones had slightly longer forewings (marginally significant) and flew faster, with higher wingbeat frequency, but other morphological characteristics and flight parameters were similar.

CONCLUSION: The study of FAW moths in Yunnan and Hainan from 2020 to 2023 found that migratory moths take off under specific conditions and show a seasonal pattern, with those from certain maize stages having higher migratory proportion, longer forewings and faster flight. These findings advance our understanding of the migratory takeoff behavior of FAW and, thus, provide a basis for the accurate prediction and management of the migratory dynamics. © 2025 Society of Chemical Industry.

PMID:40099473 | DOI:10.1002/ps.8772