Nevin Manimala

Acta Bioeng Biomech. 2025 Jan 28;26(2):73-79. doi: 10.37190/abb-02411-2024-03. Print 2024 Jun 1.

ABSTRACT

Purpose: The purpose of this study was to quantify the impact of smartphone use while sitting on the toilet on the spinal flexion angles and the time effect. Methods: Measurements of the spinal flexion angles in the sagittal plane were made by thirty participants while they sat on the toilet for 10 min, using a smartphone in either one, both, or neither hand. The individual’s forehead, cervical, thoracic and lumbar spinal areas were each fitted with five different inertial motion sensors. SPSS 26.0 software was used to statistically evaluate all of the data. Results: People who used smartphones with both hands had considerably larger (P < 0.05) cervical and spinal flexion angles than those who did not. A statistically significant (P < 0.001) association was observed by regression analysis between time and spinal flexion angle (r = 0.747 for no smartphone, r = 0.793 for a smartphone used in one hand and r = 0.855 for a smartphone used in both hands). Consequently, when using the smartphone with both hands, the flexion angle of the spine entered a more stable state of angles. Conclusions: The results showed that the cervical region’s flexion angles change when using a smartphone while sitting on the toilet. Even when not using a smartphone, the flexion angle of the spine when sitting on the toilet will progressively increase.

PMID:39874515 | DOI:10.37190/abb-02411-2024-03

Acta Bioeng Biomech. 2025 Jan 28;26(2):135-142. doi: 10.37190/abb-02458-2024-03. Print 2024 Jun 1.

ABSTRACT

Purpose: Brain tissue immersed in cerebrospinal fluid often exhibits complex mechanical behaviour, especially the nonlinear stress- strain and rate-dependent responses. Despite extensive research into its material properties, the impact of solution environments on the mechanical behaviour of brain tissue remains limited. This knowledge gap affects the biofidelity of head modelling. This study aimed to investigate the effect of solution environments on brain tissue under quasi-static and dynamic loading conditions. Methods: Porcine brain tissue was characterized in compression through quasi-static nonlinear testing and Dynamic Mechanical Analysis under various environments: air, physiological saline and artificial cerebrospinal fluid. Frequencies from 0.1 to 40 Hz were applied to determine dynamic behaviour, while brain samples were compressed up to a 0.3 strain level to obtain nonlinear response. The effects of strain, frequency and solution environment on the mechanical response of brain tissue were statistically evaluated. Results: As environmental conditions transitioned from air to artificial cerebrospinal fluid, the average stress of brain tissue increased by approximately 1.3, 1.3 and 1.4 times at strain levels of 0.1, 0.2 and 0.3, respectively. A statistically significant increase in dynamic storage and loss moduli was observed between air and artificial cerebrospinal fluid environments. At frequencies above 18 Hz, the tan delta in air was significantly lower. Conclusions: The mechanical characterization of brain tissue exhibited a dependency on solution environment under both quasi-static and dynamic loading conditions. Brain tissue showed higher stress levels and dynamic modulus in solution environments compared to an air environment. The results of this study are valuable for improving head simulations and brain material models.

PMID:39874509 | DOI:10.37190/abb-02458-2024-03

Acta Bioeng Biomech. 2025 Jan 28;26(2):81-91. doi: 10.37190/abb-02442-2024-02. Print 2024 Jun 1.

ABSTRACT

Purpose: This study evaluated changes in selected spatiotemporal and kinematic gait parameters and balance in girls with Adolescent idiopathic scoliosis (AIS) with and without the Chêneau brace. Methods: 15 subjects with scoliosis wearing the Chêneau brace and an equal comparative control group underwent objective gait analysis with the 3D BTS motion caption system. Balance assessment was done with the Kistler platform. The analysis was performed at comparison of gait and balance parameters in patients with scoliosis in two conditions: with and without the Chêneau brace during the study. Results: Statistically significant differences occurred in many spatiotemporal and kinematic parameters both for the AIS group with and without the Chêneau brace and in the AIS group with and without the Chêneau brace as compared to the control group. When comparing adolescents with AIS with and without the Chêneau brace, statistically significant differences were noted in the COP-X amplitude and in the path length in trials with closed eyes. Compared to the control group the following differences were statistically significant: the value of the COP-Y amplitude during the trial with closed eyes, both with and without the Chêneau brace, and the Equivalent area of the COP during the trial with closed eyes with the Chêneau brace. Conclusions: The Chêneau brace in patients with juvenile idiopathic scoliosis affects the level of selected balance and gait parameters.

PMID:39874506 | DOI:10.37190/abb-02442-2024-02

Epidemiology. 2025 Jan 28. doi: 10.1097/EDE.0000000000001840. Online ahead of print.

ABSTRACT

BACKGROUND: Hospital regionalization involves balancing hospital volume and travel time. We investigated how hospital volume and travel time affect perinatal mortality and the risk of delivery in transit using three different study designs.

METHODS: This nationwide cohort study used data from the Medical Birth Registry of Norway (1999-2016) and Statistics Norway. We compared estimates across three designs: (1) Observed confounder adjustment: Comparing women giving birth at hospitals of different sizes and travel times (1,066,332 births), (2) Sibling comparison: Comparing women who moved between hospital catchment areas between births (203,464 births), (3) Neighbor comparison: comparing women living in neighboring municipalities, but in different hospital catchment areas (460,776 births).

RESULTS: The study population included 5080 (0.48%) perinatal deaths and 7063 deliveries in transit (0.66%). For hospitals with 2000 compared with 500 births/year, observed confounder adjustment showed 1.81 times higher perinatal mortality (95% confidence interval [CI] 1.21-2.73). However, sibling and neighbor comparisons showed a factor 0.64 (95% CI 0.43-0.97) and 0.61% (95% CI 0.43-0.88) lower perinatal mortality, respectively. Increased travel time was strongly associated with higher perinatal mortality using observed confounder adjustment, but this was not supported by the other designs. Longer travel time was consistently linked to an increased risk of delivery in transit.

CONCLUSIONS: Perinatal mortality was higher in high-volume hospitals when adjusting for observed confounders. However, triangulating inferences from the other designs suggested the opposite, estimating that observed confounder control was insufficient. This supports the idea that access to higher-volume hospitals could improve perinatal outcomes at the population level.

PMID:39874482 | DOI:10.1097/EDE.0000000000001840

Res Nurs Health. 2025 Jan 28. doi: 10.1002/nur.22447. Online ahead of print.

ABSTRACT

The patient activation measure (PAM), a recognized measure of how active patients are in their care, is one of the most extensively used, widely translated, and tested instruments worldwide in measuring patient activation. This study aimed to assess the psychometric properties and construct validity of the Italian version of the 13-item Patient Activation Measure (PAM13-I) among patients undergoing elective laparoscopic cholecystectomy. A multicenter study was conducted across 111 surgical units in Italy. This study involved the preoperative administration of the PAM questionnaire to 4532 patients. The psychometric properties of the PAM were evaluated using Rasch analysis. The PAM13-I demonstrated good internal consistency (Cronbach’s α = 0.95) and reliability indices. While fit statistics were acceptable, ceiling effects were observed. No significant differential item functioning was found. However, issues with targeting and local response dependency were identified. The Italian PAM-13 showed promising psychometric properties among surgical patients, indicating its potential utility in assessing patient activation. However, concerns regarding ceiling effects and targeting suggest the need for further refinement and validation in surgical populations.

PMID:39874068 | DOI:10.1002/nur.22447

J Magn Reson Imaging. 2025 Jan 28. doi: 10.1002/jmri.29719. Online ahead of print.

ABSTRACT

BACKGROUND: Multifrequency MR elastography (mMRE) enables noninvasive quantification of renal stiffness in patients with chronic kidney disease (CKD). Manual segmentation of the kidneys on mMRE is time-consuming and prone to increased interobserver variability.

PURPOSE: To evaluate the performance of mMRE combined with automatic segmentation in assessing CKD severity.

STUDY TYPE: Prospective.

PARTICIPANTS: A total of 179 participants consisting of 95 healthy volunteers and 84 participants with CKD.

FIELD STRENGTH/SEQUENCE: 3 T, single shot spin echo planar imaging sequence.

ASSESSMENT: Participants were randomly assigned into training (n = 58), validation (n = 15), and test (n = 106) sets. Test set included 47 healthy volunteers and 58 CKD participants with different stages (21 stage 1-2, 22 stage 3, and 16 stage 4-5) based on estimated glomerular filtration rate (eGFR). Shear wave speed (SWS) values from mMRE was measured using automatic segmentation constructed through the nnU-Net deep-learning network. Standard manual segmentation was created by a radiologist. In the test set, the automatically segmented renal SWS were compared between healthy volunteers and CKD subgroups, with age as a covariate. The association between SWS and eGFR was investigated in participants with CKD.

STATISTICAL TESTS: Dice similarity coefficient (DSC), analysis of covariance, Pearson and Spearman correlation analyses. P < 0.05 was considered statistically significant.

RESULTS: Mean DSCs between standard manual and automatic segmentation were 0.943, 0.901, and 0.970 for the renal cortex, medulla, and parenchyma, respectively. The automatically quantified cortical, medullary, and parenchymal SWS were significantly correlated with eGFR (r = 0.620, 0.605, and 0.640, respectively). Participants with CKD stage 1-2 exhibited significantly lower cortical SWS values compared to healthy volunteers (2.44 ± 0.16 m/second vs. 2.56 ± 0.17 m/second), after adjusting age.

CONCLUSION: mMRE combined with automatic segmentation revealed abnormal renal stiffness in patients with CKD, even with mild renal impairment.

PLAIN LANGUAGE SUMMARY: The renal stiffness of patients with chronic kidney disease varies according to the function and structure of the kidney. This study integrates multifrequency magnetic resonance elastography with automated segmentation technique to assess renal stiffness in patients with chronic kidney disease. The findings indicate that this method is capable of distinguishing between patients with chronic kidney disease, including those with mild renal impairment, while simultaneously reducing the subjectivity and time required for radiologists to analyze images. This research enhances the efficiency of image processing for radiologists and assists nephrologists in detecting early-stage damage in patients with chronic kidney disease.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.

PMID:39874058 | DOI:10.1002/jmri.29719

Lymphology. 2024;57(3):157-168.

ABSTRACT

This study examined the effect of lymphedema self-care patient school education on patient functionality, quality of life, body value, and lymphedema volume in patients with lower extremity lymphedema. The study utilized a single-group quasi-experimental design. The study sample included 21 patients with primary and secondary lower extremity lymphedema. A multidisciplinary team created a face-to-face lymphedema self-care patient education program that lasted three weeks with four hours each week to enhance lymphedema self-care management. Data collected from participants prior to the program and then at third and sixth months via Lower Extremity Functional Scale (LEFS), Lymphedema Functionality, Disability and Quality of Life Scale in Lower Extremity Lymphedema (LYMPH-ICF-LL), Body Value Scale, and extremity volumes. The average age of the patients was 54.85±11.99 years and two-thirds had secondary lymphedema. A statistically significant difference was found in the mean scores of LEFS (p<0.001), LYMPH-ICF-LL total (p= 0.006) in the 3rd and 6th months after the completion of the program, and in the lymphedema volume change (p= 0.031) in the 6th month. It was found that the lymphedema self-care patient school improved functionality and quality of life in patients with lower extremity lymphedema and decreased lymphedema volume. This lymphedema self-care patient education pro-gram is a safe and effective educational method for self-care management in individuals with lower extremity lymphedema.

PMID:39874052

JAMA Netw Open. 2025 Jan 2;8(1):e2456898. doi: 10.1001/jamanetworkopen.2024.56898.

ABSTRACT

IMPORTANCE: Climate change can adversely affect mental health, but the association of ambient temperature with psychiatric symptoms remains poorly understood.

OBJECTIVE: To assess the association of ambient temperature exposure with internalizing, externalizing, and attention problems in adolescents from 2 population-based birth cohorts in Europe.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed data from the Dutch Generation R Study and the Spanish INMA (Infancia y Medio Ambiente) Project. Generation R recruited 9898 women during pregnancy or shortly after birth, with children born between 2002 and 2006. INMA recruited 2270 pregnant women from Gipuzkoa, Sabadell, and Valencia, Spain, with children born between 2003 and 2008. Individuals born from live singleton births with available outcome and exposure data were included in the study. Data were analyzed between October 2023 and November 2024.

EXPOSURE: Daily ambient temperature 2 weeks, 1 month, and 2 months preceding outcome assessment was calculated between December 2015 and November 2022 at the residence at 100 × 100 m resolution utilizing the UrbClim model.

MAIN OUTCOMES AND MEASURES: The primary outcomes were internalizing, externalizing, and attention problems, measured with the maternal-reported Child Behavioral Checklist for ages 6 to 18 years; raw scores were square-root transformed, with higher scores indicating more problems. Distributed lag nonlinear models evaluated the associations of temperature exposure with problem scores in each country and region. For Spain, results from the 3 INMA regions were combined using random-effects meta-analysis. Results show the accumulated temperature association over each exposure period.

RESULTS: A total of 3934 participants from Generation R (mean [SD] age at assessment, 13.6 [0.4] years; 1971 female [50%]) and 885 from INMA (mean [SD] age at assessment, 14.9 [1.0] years; 458 female [52%]) were included. Most parents in both cohorts were native to the respective countries of each cohort and had relatively high socioeconomic status. Daily temperatures ranged from -5.2 °C to 32.6 °C in the Netherlands and 3.3 °C to 33.9 °C in Spain. In Generation R, the mean (SD) square-root transformed scores were 2.0 (1.2) for internalizing problems, 1.6 (1.3) for externalizing problems, and 1.5 (1.0) for attention problems, while in INMA these were 2.4 (1.2), 2.1 (1.3), and 1.5 (1.1), respectively. In the Netherlands, cumulative exposure to cold was associated with more internalizing problems (eg, 0.76 [95% CI, 0.20-1.32] higher square-root points at 5.5 °C exposure over a 2-month exposure). In Spain, cumulative exposure to heat was associated with more attention problems (eg, 1.52 [95% CI, 0.39-2.66] higher square-root points at 21.7 °C exposure over a 2-month exposure).

CONCLUSIONS AND RELEVANCE: In this cohort study, exposure to cold in the Netherlands and heat in Spain were associated with more psychiatric symptoms, highlighting distinct temperature exposure and mental health associations among adolescents. Future studies should explore this across diverse climates to further quantify the intricate and multifactorial association of climate change with mental health.

PMID:39874035 | DOI:10.1001/jamanetworkopen.2024.56898

JAMA Netw Open. 2025 Jan 2;8(1):e2457069. doi: 10.1001/jamanetworkopen.2024.57069.

ABSTRACT

IMPORTANCE: Cannabis use has increased globally, but its effects on brain function are not fully known, highlighting the need to better determine recent and long-term brain activation outcomes of cannabis use.

OBJECTIVE: To examine the association of lifetime history of heavy cannabis use and recent cannabis use with brain activation across a range of brain functions in a large sample of young adults in the US.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data (2017 release) from the Human Connectome Project (collected between August 2012 and 2015). Young adults (aged 22-36 years) with magnetic resonance imaging (MRI), urine toxicology, and cannabis use data were included in the analysis. Data were analyzed from January 31 to July 30, 2024.

EXPOSURES: History of heavy cannabis use was assessed using the Semi-Structured Assessment for the Genetics of Alcoholism, with variables for lifetime history and diagnosis of cannabis dependence. Individuals were grouped as heavy lifetime cannabis users if they had greater than 1000 uses, as moderate users if they had 10 to 999 uses, and as nonusers if they had fewer than 10 uses. Participants provided urine samples on the day of scanning to assess recent use. Diagnosis of cannabis dependence (per Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) was also included.

MAIN OUTCOMES AND MEASURES: Brain activation was assessed during each of the 7 tasks administered during the functional MRI session (working memory, reward, emotion, language, motor, relational assessment, and theory of mind). Mean activation from regions associated with the primary contrast for each task was used. The primary analysis was a linear mixed-effects regression model (one model per task) examining the association of lifetime cannabis and recent cannabis use on the mean brain activation value.

RESULTS: The sample comprised 1003 adults (mean [SD] age, 28.7 [3.7] years; 470 men [46.9%] and 533 women [53.1%]). A total of 63 participants were Asian (6.3%), 137 were Black (13.7%), and 762 were White (76.0%). For lifetime history criteria, 88 participants (8.8%) were classified as heavy cannabis users, 179 (17.8%) as moderate users, and 736 (73.4%) as nonusers. Heavy lifetime use (Cohen d = -0.28 [95% CI, -0.50 to -0.06]; false discovery rate corrected P = .02) was associated with lower activation on the working memory task. Regions associated with a history of heavy use included the anterior insula, medial prefrontal cortex, and dorsolateral prefrontal cortex. Recent cannabis use was associated with poorer performance and lower brain activation in the working memory and motor tasks, but the associations between recent use and brain activation did not survive false discovery rate correction. No other tasks were associated with lifetime history of heavy use, recent use, or dependence diagnosis.

CONCLUSIONS AND RELEVANCE: In this study of young adults, lifetime history of heavy cannabis use was associated with lower brain activation during a working memory task. These findings identify negative outcomes associated with heavy lifetime cannabis use and working memory in healthy young adults that may be long lasting.

PMID:39874032 | DOI:10.1001/jamanetworkopen.2024.57069

Arch Environ Occup Health. 2025 Jan 28:1-5. doi: 10.1080/19338244.2025.2451903. Online ahead of print.

ABSTRACT

Following a legionnaire’s disease outbreak in Barcelona in 2022, sport fields’ sprinklers were identified as potential sources of Legionella infection. The Agency of Public Health of Barcelona inspected all 40 urban municipal sports fields in the city. Legionella was found in 55% of them, including Legionella pneumophila serotype 1 in 11 samples. There were no statistically significant differences for Legionella detection according to the installation characteristics.These findings prompted the implementation of a set of preventive measures for risk mitigation and a specific control plan for sport fields.

PMID:39874031 | DOI:10.1080/19338244.2025.2451903