Nevin Manimala

Burns. 2025 Oct 28;51(9):107761. doi: 10.1016/j.burns.2025.107761. Online ahead of print.

ABSTRACT

Post-burn pruritus (PBP) is a common and refractory condition that can significantly impair quality of life (QoL). Curcumin, a bioactive compound with anti-inflammatory and neuroprotective properties, has been proposed as a therapeutic option for chronic pruritus. This study evaluated the efficacy of a nano-micelle formulation of curcumin in patients with refractory PBP. In this randomized controlled trial, 100 adults with PBP were assigned to receive standard treatment alone or with curcumin nano-micelle capsules (40 mg, twice daily) for 12 weeks. Outcomes included pruritus severity, frequency, distribution, sleep condition, sleep disturbance, total pruritus intensity, and QoL (ItchyQoL), assessed at baseline, week 6, and week 12. Analyses were performed using mixed-effects models with group, time, and group×time as factors. Both groups demonstrated significant within-group improvements in some pruritus domains. However, in the mixed-effects model, curcumin produced a significant between-group reduction in total pruritus intensity (adjusted mean difference -2.83; 95 % CI -5.54 to -0.11; p = 0.041). No significant between-group effects were observed for individual domains. Sleep condition improved with curcumin (adjusted mean difference -0.50; 95 % CI -1.04-0.03) but did not reach statistical significance. QoL improved significantly over time (time effect p = 0.045) in both groups, with a non-significant trend favoring curcumin (adjusted mean difference 2.85; 95 % CI -2.13-7.83). Adjunctive curcumin nano-micelle therapy significantly reduced overall pruritus intensity in patients with refractory PBP. Sleep and QoL outcomes improved in both groups, with trends favoring curcumin. Larger, longer trials with optimized dosing are warranted to confirm these findings.

PMID:41197197 | DOI:10.1016/j.burns.2025.107761

Gait Posture. 2025 Nov 1;124:110030. doi: 10.1016/j.gaitpost.2025.110030. Online ahead of print.

ABSTRACT

BACKGROUND: The gait analysis is a relatively commonly used tool for evaluating the functional deficits of various groups of patients, regardless of the origin of these deficits, but is especially common in patients with neurological deficits. One of the problems they encounter is disrupted coordination. One of the methods to asses it is cyclogram, or angle-angle plot.

RESEARCH QUESTION: Could cyclogram index, based on cyclograms for lower limbs contribute to understanding of the disrupted coordination in neurological patients?

METHODS: This paper presents the coordination index, which is based on the perimeters of four cyclograms: hip/pelvis, knee/hip and ankle/knee in the sagittal plane and hip/pelvis in the frontal plane. Data extracted from retrospective gait analyses of patients with spastic diplegia cerebral palsy, dystrophy and Guillain-Barre syndrome were used to calculate cyclograms, coordination index and gait indices: Gillette Gait Index (GGI), Gait Deviation Index (GDI) and Gait Profile Score (GPS).

RESULTS: The main finding of this paper is the independence of the new coordination index from commonly used indices: GGI, GDI and GPS. A discriminant analysis, in which the grouping variable was the name of the disease, revealed that cyclogram perimeters and coordination index were statistically significant predictors.

SIGNIFICANCE: Coordination index could be used as additional measure assessing the disrupted coordination in patients.

CONCLUSION: This paper shows the potential usefulness of the proposed method in clinical application, especially in the long-term changes induced by the various treatment methods.

PMID:41197188 | DOI:10.1016/j.gaitpost.2025.110030

Work. 2025 Nov 6:10519815251392187. doi: 10.1177/10519815251392187. Online ahead of print.

ABSTRACT

BackgroundClimate change has been identified as the biggest threat to global public health.¹ Despite the clear connection between negative health outcomes and anthropogenic climate change, there are few guidelines for curricular inclusion within healthcare education, including occupational therapy (OT). However, the World Federation of Occupational Therapists has emphasized the importance of sustainability,² and the American Occupational Therapy Association published a policy asserting the profession’s commitment to addressing these topics.³ObjectiveThis study explored the perspectives of OT educators in the United States on the relevance, importance, and feasibility of integrating climate change and environmental sustainability into OT education programs.MethodsAn online Qualtrics survey was distributed, with 64 respondents across the United States. Descriptive and inferential statistics were conducted to determine relationships between respondent responses to question pairs. Qualitative responses underwent thematic analysis.ResultsMost educators acknowledged the relevance and importance of addressing climate change and environmental sustainability. Several barriers hindered implementation, including an already overloaded curriculum with a lack of explicitly related Accreditation Council for Occupational Therapy standards, limited time, a lack of awareness of how climate change and environmental sustainability fit into OT programs, and skepticism about climate change as relevant to OT practice.ConclusionsThe findings indicate varied perspectives among US-based OT faculty. They suggest a need for educational resources that link climate change and environmental sustainability to health, occupation and other core tenets of OT and offer strategies for integrating this content into OT education.

PMID:41197165 | DOI:10.1177/10519815251392187

Work. 2025 Nov 6:10519815251392188. doi: 10.1177/10519815251392188. Online ahead of print.

ABSTRACT

BackgroundThe study is based on the transportation sector (employees) in Turkiye due to its direct impact on each sector in today’s modern world.ObjectiveThis paper aims to search the relationship(s) between job satisfaction, job stress, and mental well-being notions from the perspective of gender and education level.MethodsThe sample (326 participants) was taken using a simple random sampling method, and participation in the study was voluntary. The research combined correlation, t-tests, and Confirmatory Factor analysis (CFA) as a statistical methodology. This article leverages the robust capabilities of CFA to demonstrate the distinctiveness of variables.ResultsFindings show a strong relationship between job satisfaction, mental well-being, and work stress for employees of both genders and education level was found to be a significant predictor of these three concepts.ConclusionsIt is noteworthy that the strongest correlation observed for female employees was between job satisfaction and job stress, while the strongest correlation for male employees was between mental well-being and job satisfaction.

PMID:41197160 | DOI:10.1177/10519815251392188

J Child Neurol. 2025 Nov 6:8830738251389081. doi: 10.1177/08830738251389081. Online ahead of print.

ABSTRACT

ObjectiveThe objective of this study was to investigate the effect of antiseizure medications (ASMs) on cognitive abilities in children and adolescent patients newly diagnosed with Juvenile Myoclonic Epilepsy (JME). Additionally, the study compared cognitive abilities between newly diagnosed JME patients and healthy controls.Methods38 patients newly diagnosed with JME based on clinical history and electroencephalographic findings (mean age 14.85 ± 1.80) and 30 healthy control participants (mean age 14.07 ± 1.86) were included in our study. In the JME group, there were 71.1% females and 28.9% males, whereas in the control group there were 60% females and 40% males. Bourdon Attention Test and Wechsler Intelligence Scales for Children-Revised (WISC-R) were performed to measure the cognitive abilities of the patient and control groups. In the JME group, the tests were performed before and 12 months after antiseizure medications were started. The patients’ clinical, laboratory, radiologic, and electroencephalographic (EEG) data, as well as their antiseizure medication use and treatment compliance were recorded and collected through our hospital database system during the outpatient clinic visits.ResultsThe results showed a very high and positive correlation between WISC-R-Pre and WISC-R-Post test scores in the patient group, and this was statistically significant (P =0.001). Although the WISC-R-Pre test average was 89.89 ± 20.28, the WISC-R-Post average was 92.66 ± 21.79. This increase was found to be statistically significant (P =0.023). Although the average score of the Bourdon-Pre test was 310.84 ± 104.84, the Bourdon-Post score was found to be 272.79 ± 75.616. This decrease was not found to be statistically significant (P = 0.063). Although the average number of seizures per year was 6.78 before treatment, it decreased to 2.52 after treatment. This difference was found to be statistically significant (P =0.001). The strongest significance with the lowest P value (0.003) was observed in the levetiracetam group. In the patient group, a positive correlation was found between the number of seizures and WISC-R-Post test scores and this was statistically significant (P =0.05).ConclusionsNo significant difference was found between the newly diagnosed JME patients and the healthy control group in terms of intelligence level and attention performance. However, it was concluded that the antiseizure medications initiated in the patient group had a positive effect on cognitive function. In addition, a statistically significant positive correlation was detected between the decrease in the number of seizures after medication and the WISC-R-Post test, demonstrating the positive effect of drug treatment on cognitive functions.

PMID:41197155 | DOI:10.1177/08830738251389081

J Perinat Med. 2025 Nov 6. doi: 10.1515/jpm-2025-0250. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the comparative effectiveness of four pharmacologic regimens – oxytocin, carbetocin, oxytocin plus tranexamic acid (TXA), and carbetocin plus TXA – for postpartum hemorrhage (PPH) prophylaxis in cesarean deliveries.

METHODS: This prospective cohort study was conducted at a tertiary center in Istanbul, Turkey, between March 2024 and January 2025. A total of 400 women undergoing cesarean delivery at 34+0-39+6 weeks of gestation were sequentially assigned to one of four prophylactic intervention groups (n=100 each): oxytocin, oxytocin+TXA, carbetocin, or carbetocin+TXA. Medications were administered post-placental delivery. Third-stage labor management was standardized. Primary outcomes included estimated blood loss (EBL), 24-h hemoglobin change (ΔHb), and need for transfusion or intravenous iron. Baseline neonatal characteristics, including birthweight and Apgar scores, were recorded to ensure comparability across groups.

RESULTS: Baseline characteristics were similar across groups. Hemoglobin decline differed significantly (p=0.015), being lowest in the carbetocin+TXA group (7.73 ± 6.68 %) and highest in the oxytocin group (10.70 ± 7.23 %). Although mean EBL was lowest in the carbetocin+TXA group, the difference was not statistically significant (p=0.172). Transfusion and iron supplementation rates were low and comparable. No adverse neonatal outcomes were observed.

CONCLUSIONS: Carbetocin combined with TXA was associated with the most favorable hematologic profile. These findings support the use of multimodal pharmacologic strategies for PPH prevention in cesarean births and may inform future protocol development.

PMID:41197149 | DOI:10.1515/jpm-2025-0250

Am J Trop Med Hyg. 2025 Nov 6:tpmd250065. doi: 10.4269/ajtmh.25-0065. Online ahead of print.

ABSTRACT

Although maternal influenza vaccination can prevent influenza morbidity and mortality, data are limited on vaccine efficacy/effectiveness against severe disease in low- and middle-income countries (LMICs) at the community level. We evaluated the impact of maternal influenza vaccination on maternal influenza disease severity across seasons in a rural subtropical area in South Asia by analyzing data from a vaccine clinical trial conducted between 2011 and 2014 in Sarlahi District, Nepal. Participants were randomized 1:1 to trivalent seasonal influenza vaccine or saline placebo and followed through 180 days postpartum. Weekly household-based active respiratory surveillance was conducted; if participants reported fever and respiratory symptoms, a midnasal swab was collected and tested for influenza using reverse transcription polymerase chain reaction. Among 3,693 participants (n = 1,847 vaccine; n = 1,846 placebo), we detected 75 influenza illness episodes, including 40 with care seeking and 22 with fever for more than 3 days. Using proportional hazards regression, maternal influenza vaccination reduced the estimated hazard of influenza-associated care-seeking visits and fever for more than 3 days by 36% and 21%, respectively, compared with placebo; however, these differences were not statistically significant. The estimated numbers needed to vaccinate to prevent one influenza illness with care seeking and fever for more than 3 days were 224 and 785, respectively, at 270 days postvaccination. These findings suggest that maternal immunization may reduce the risk of moderate influenza illness among pregnant/postpartum individuals in LMICs, particularly in rural areas where access to care is limited.

PMID:41197135 | DOI:10.4269/ajtmh.25-0065

Acta Radiol. 2025 Nov 6:2841851251389937. doi: 10.1177/02841851251389937. Online ahead of print.

ABSTRACT

BackgroundComputed tomography (CT) fluoroscopy provides high-resolution images and is widely used for safe and accurate procedures, but it exposes operators to high radiation doses.PurposeTo develop and evaluate a tunnel-shaped shielding system to reduce operator exposure to scattered radiation during CT fluoroscopy-guided procedures.Material and MethodsThe shield, designed based on scattered radiation distribution, consists of a semi-cylindrical leaded acrylic part and a bottom plate with a non-lead shielding board surrounding the patient. Radiation doses were measured with and without the shield using patient and operator phantoms. Dosimeters were placed at 10 locations on the operator phantom, including the eye lens, thyroid, chest, abdomen, pelvis, legs, patient-side armpit, and needle-holding hand. Percentage reductions in radiation exposure were calculated.ResultsThe tunnel-shaped shield significantly reduced radiation exposure, with dose reductions of 83%-100% at the eye lens, 88%-96% at the thyroid, 84%-95% at the upper chest, 84%-92% at the lower chest, 88%-94% at the abdomen, 91%-94% at the pelvis, 57%-68% at the upper leg, 44%-83% at the lower leg, 90%-94% at the patient-side armpit, and 73%-86% at the needle-holding hand. All reductions were statistically significant.ConclusionPhantom experiments demonstrated that the tunnel-shaped shielding system effectively reduces operator exposure to scattered radiation during CT fluoroscopy-guided procedures.

PMID:41197134 | DOI:10.1177/02841851251389937

JMIR Form Res. 2025 Nov 6;9:e73527. doi: 10.2196/73527.

ABSTRACT

BACKGROUND: Maintaining and motivating physical functioning among older adults has substantial health-related benefits, such as reducing the risk of falls and increasing the opportunities for independent living. Supporting preventive actions among older adults also has socioeconomic relevance. Previous studies have shown that digital tools involving video feedback can facilitate reflection and learning by encouraging active engagement.

OBJECTIVE: This study aimed to explore health care professionals’ experiences of using a video-based tool as part of the rehabilitation to facilitate physical functioning among older adults (aged ≥65 years) living at home.

METHODS: An experience-based co-design approach was used, involving 20 health care professionals. Nine iterative workshops were conducted, followed by 9 group interviews held between 2022 and 2023. The data were analyzed using reflexive thematic analysis.

RESULTS: The results from this study captured the experiences of health care professionals using a video-based tool to facilitate physical functioning in older adults living at home. The participants described focusing on supporting patient commitment, creating a shared language to enhance collaboration in the rehabilitation process, and navigating barriers to adopting the video-based tool in practice.

CONCLUSIONS: From the perspective of health care professionals, video feedback has the potential to improve movement performance in daily activities and may play a crucial role in providing motivation and promoting sustainable physical functioning among older adults. Clinical recommendations include training health care professionals to introduce video feedback in a patient-centered manner and using it to foster shared communication that promotes professional development and patient engagement. Further research is needed to assess the impact of video feedback on older adults’ health outcomes and to identify strategies for implementation in complex rehabilitation needs.

PMID:41197125 | DOI:10.2196/73527

Int J Biostat. 2025 Nov 6. doi: 10.1515/ijb-2024-0051. Online ahead of print.

ABSTRACT

Information borrowing from historical data is gaining increasing attention in clinical trials for rare and pediatric diseases, where small sample sizes may lead to insufficient statistical power for confirming efficacy. While Bayesian information borrowing methods are well established, recent frequentist approaches, such as the test-then-pool and equivalence-based test-then-pool methods, have been proposed to determine whether historical data should be incorporated into statistical hypothesis testing. Depending on the outcome of these hypothesis tests, historical data may or may not be utilized. This paper introduces a dynamic borrowing method for leveraging historical information based on the similarity between current and historical data. Similar to Bayesian dynamic borrowing, our proposed method adjusts the degree of information borrowing dynamically, ranging from 0 to 100 %. We present two approaches to measure similarity: one using the density function of the t-distribution and the other employing a logistic function. The performance of the proposed methods is evaluated through Monte Carlo simulations. Additionally, we demonstrate the utility of dynamic information borrowing by reanalyzing data from an actual clinical trial.

PMID:41197120 | DOI:10.1515/ijb-2024-0051