Tag: nevin manimala

J Pediatr Orthop B. 2025 May 19. doi: 10.1097/BPB.0000000000001264. Online ahead of print.

ABSTRACT

This study was to identify some indicators that could be used to distinguish methicillin-resistant Staphylococcus aureus (MRSA) from methicillin-sensitive Staphylococcus aureus (MSSA) to more accurately guide empirical antibiotics. Data of 91 cases of acute osteomyelitis in children with Staphylococcus aureus infection (including 29 cases of MRSA and 62 cases of MSSA) from July 2017 to March 2024 were retrospectively analyzed. Age, sex, duration of onset, maximum body temperature at onset, and inflammatory indicators detected after admission were compared between the MRSA group and the MSSA group. According to the receiver operating characteristic (ROC) curve, the diagnostic efficiency of MRSA infection was evaluated. Logistic regression analysis was used to determine independent risk factors for MRSA infection. There were no significant differences in age, sex, duration of onset, maximum body temperature, white blood cell count, neutrophil count, and erythrocyte sedimentation rate between the MRSA group and the MSSA group (P > 0.05). The median C-reactive protein in the MRSA group and the MSSA group was 97.93 and 58.10 mg/L, respectively, with statistical significance (P < 0.05). The sensitivity, specificity, and area under the curve of C-reactive protein for detecting MRSA infection were 41.4, 90.3, and 0.646%, respectively. Logistic regression analysis showed that C-reactive protein greater than 116.46 mg/L (odds ratio = 6.588, 95% confidence interval: 2.149-20.197) was an independent risk factor for predicting MRSA infection (P < 0.05). C-reactive protein greater than 116.46 mg/L can independently predict the likelihood of MRSA infection, and it is recommended to empirically select anti-MRSA treatment for such children.

PMID:40397423 | DOI:10.1097/BPB.0000000000001264

J Ethn Subst Abuse. 2025 May 21:1-19. doi: 10.1080/15332640.2025.2505059. Online ahead of print.

ABSTRACT

The global incidence of ischemic stroke among young adults has risen, with emerging evidence suggesting a potential link to increased cannabis use. Despite widespread perceptions of cannabis as a relatively safe substance, its association with ischemic stroke remains unclear, especially as legalization and use rates grow. This systematic review and meta-analysis aimed to synthesize the current literature to assess the relationship between cannabis use and the risk of ischemic stroke. Following PRISMA guidelines, a comprehensive search was conducted across PubMed, Web of Science, Scopus, Embase, and Google Scholar (up to March 2025) to identify studies evaluating the association between cannabis use and ischemic stroke risk. Inclusion criteria required studies to compare cannabis users with non-users and report quantitative risk estimates (odds ratios, hazard ratios, or relative risks with 95% confidence intervals). Quality assessment utilized the Joanna Briggs Institute checklist. Data were pooled using a random-effects model, and heterogeneity was assessed with the I² statistic. From 821 initial records, seven studies (published 2007-2023; case-control, cohort, and cross-sectional designs) met inclusion criteria. The meta-analysis revealed a statistically significant association between cannabis use and increased risk of ischemic stroke (pooled OR = 2.05, 95% CI: 1.46-2.87; p < .001, I²=68.9%, p = .007). Cannabis use is associated with a significantly elevated risk of ischemic stroke, particularly among young adults. These findings highlight the need for further research to clarify causality and inform public health policy as cannabis use continues to rise globally.

PMID:40397400 | DOI:10.1080/15332640.2025.2505059

J Alzheimers Dis. 2025 May 21:13872877251344223. doi: 10.1177/13872877251344223. Online ahead of print.

ABSTRACT

BackgroundMotor impairment precede cognitive impairment and may be early biomarkers for dementia. We have previously reported an association between finger tapping and cognitive function; however, the link between finger motor movements and associated brain regions is unclear.ObjectiveIn this study, finger tapping movements were used to identify brain regions strongly associated with finger motor dexterity in individuals with Alzheimer’s disease (AD) and mild cognitive impairment (MCI).MethodsThis exploratory, cross-sectional study included individuals with AD or MCI who underwent finger motor movement measurements and 3D magnetic resonance imaging (MRI). Voxel-based morphometry analysis was conducted using Statistical Parametric Mapping 12 and Computational Anatomy Toolbox 12 to assess gray matter volume. Correlations between MRI and finger motor parameters were analyzed using intracranial volume, Mini-Mental State Examination score, age, and sex as covariates.ResultsWe included 136 individuals (AD, 71; MCI, 65). The number of taps and the number of freezing calculated from acceleration significantly correlated with gray matter volume in motor and sensory regions, including the primary motor (BA4) and primary somatosensory (BA3, 1, 2) cortices. Many correlations with the left hemisphere were found in both left- and right-handed bimanual alternating tapping tasks.ConclusionsFinger motor dexterity in individuals with cognitive impairment is associated with gray matter volume in specific brain regions, with a pronounced correlation in the left hemisphere. These findings suggest that finger motor skills may be linked to structural brain changes.

PMID:40397392 | DOI:10.1177/13872877251344223

J Back Musculoskelet Rehabil. 2025 May 21:10538127251344497. doi: 10.1177/10538127251344497. Online ahead of print.

ABSTRACT

BackgroundAcupuncture, a traditional oriental therapy, is increasingly being adopted globally as a method of complementary intervention for pain relief in patients with fibromyalgia (FM). The aim of this study was to evaluate the effectiveness of acupuncture compared to placebo, pharmacotherapy, or physiotherapy in reducing pain and improving function in patients with FM.MethodsAn electronic search was performed in the MEDLINE, Web of Science, CENTRAL, EMBASE, LILACS, CINAHL, PEDro, and SPORTDiscus databases. The eligibility criteria were systematic reviews of clinical trials that compared acupuncture versus control interventions for pain intensity and other clinical outcomes in women with FM.ResultsA total of 10 systematic reviews met the eligibility criteria for the quantitative synthesis. For pain intensity, the mean difference (MD) was -1.30 cm (95% CI = -1.85 to 0.76, p < 0.001). For functional status, the MD was -10.18 points (95% CI = -13.56 to -6.79, p < 0.001). For sleep quality, the MD was 0.46 points 95% CI = -1.85 to 0.76, p < 0.001). For fatigue, the standard mean difference (SMD) was -0.18 (95% CI = -0.86 to 0.51, p = 0.55). For depression, the MD was -6.28 points (95% CI = -9.80 to -2.76, p = 0.0005). Most of the differences were in favor of acupuncture, except for sleep quality.ConclusionCompared to pharmacotherapy and physiotherapy interventions, acupuncture showed statistically significant differences in pain intensity, functional status, and depression symptoms; however, all differences did not reach the minimum threshold to be considered clinically important in patients with FM. The quality of evidence was low to very low according to GRADE ratings.

PMID:40397389 | DOI:10.1177/10538127251344497

Anat Sci Int. 2025 May 21. doi: 10.1007/s12565-025-00853-2. Online ahead of print.

ABSTRACT

This study examines the effects of virtual reality (VR) and tablet-based mobile applications (TBMA) in teaching heart anatomy to middle school students. A randomized-controlled trial was conducted in which 84 middle school students were divided into three groups: VR (n = 28), TBMA (n = 28), and control (n = 28). The students’ knowledge levels regarding heart anatomy were assessed before and after the applications. In addition, the student’s metacognitive awareness and satisfaction levels were measured after the TBMA and VR applications. The participants’ opinions regarding the applications were evaluated using qualitative analysis techniques. Descriptive statistics, variance analysis, and t tests were used to analyze quantitative data, and Colaizzi’s education method was prepared sevenfold to examine qualitative data. A significant increase in heart anatomy knowledge levels was observed in the distribution of VR and TBMA. However, no significant difference was found between the groups (p > 0.05). In addition, while the metacognitive awareness of heart anatomy was higher in the students in the VR group, the students in the TBMA group were more satisfied with the learning process. Students stated that learning heart anatomy with VR and TBMA methods was fun, informative, and enjoyable and that such applications should be used more in classes. This study reveals that technology-supported teaching methods can positively affect students’ learning processes while teaching heart anatomy. More comprehensive research should be conducted with randomized-controlled and mixed-method studies in different age groups and various course subjects to evaluate the sustainability and effectiveness of technology-based applications.

PMID:40397374 | DOI:10.1007/s12565-025-00853-2

AIDS Behav. 2025 May 21. doi: 10.1007/s10461-025-04725-8. Online ahead of print.

ABSTRACT

Amphetamine-type stimulants (ATS) have become prevalent among men who have sex with men (MSM), often associated with a higher risk of HIV acquisition. However, little is known about ATS use among MSM in Thailand. This study identifies ATS use patterns and associated factors among MSM in Bangkok, Thailand. Between January 2018 and May 2019, Thai MSM aged 18 years and older were recruited from an HIV testing center in Bangkok, for an 18-month longitudinal study. At each 6-month visit, participants underwent HIV testing and completed a self-administered questionnaire on demographics, substance use, sexual behavior and, mental health. Baseline characteristics and substance use patterns were summarized using descriptive statistics. Determinants of ATS use were identified by logistic regression analysis. Of 1375 MSM enrolled (median age 26), 146 (10.6%) reported using ATS in the past six months. They had more sexual partners, were more likely to engage in sex work, and were more likely to use multiple substances. HIV prevalence was higher among MSM who reported recent ATS use (19.9% vs. 10.0%, p-value < 0.001). Among those reporting ATS use, 92.5% used crystal methamphetamine, 44.4% used it via injection, and 94.5% used multiple substances. ATS use was associated with monthly income > 30,000 baht, group sex, current PrEP use or interest, and Post-Traumatic Stress Disorder and depressive symptoms. These findings highlight the patterns and determinants of ATS use among MSM, underscoring the necessity for integrated sexual and mental health services in harm reduction strategies to effectively address the complex needs of this population.

PMID:40397372 | DOI:10.1007/s10461-025-04725-8

Intern Emerg Med. 2025 May 21. doi: 10.1007/s11739-025-03968-6. Online ahead of print.

ABSTRACT

Coronary functional assessment plays a critical role in guiding decisions regarding coronary revascularization. Traditional methods for evaluating functional myocardial ischemia, such as invasive procedures or those involving radiation, have their limitations. Echocardiographic myocardial strain has emerged as a non-invasive and convenient indicator. However, the interpretation of strain values can be subject to inter-operator variability. Artificial intelligence (AI) and machine learning techniques may promise to reduce the variability. By training AI algorithms on a diverse range of echocardiographic data, including strain values, and correlating them with ischemia, it may be possible to develop a robust and automated diagnostic tool. This study aims to provide a non-invasive and effective solution for automated myocardial ischemia detection that can be used in clinical practice. To construct the machine learning model, we used an automatic left ventricular endocardium tracing tool to extract myocardial strain data and integrated it with six clinical features. A coronary angiography-derived fractional flow reserve (caFFR) ≤ 0.80 was defined as the indicator of myocardial ischemia. A total of 636 suspected coronary artery disease subjects were enrolled in this pilot study, where 282 cases (44.3%) had myocardial ischemia. These subjects were randomly divided into training (n = 508) and testing (n = 128) sets at a 4:1. Using ensemble-learning algorithms to train and optimize the model, its diagnostic performance versus caFFR was diagnostic accuracy 85.9%, sensitivity 88.9%, specificity 83.1%, positive predictive value 83.6%, negative predictive value 88.5%. The optimized model achieved an area under the receiver operating characteristic curve (AUC) of 0.915 (95% confidence interval [CI] 0.862-0.968). Our machine learning prototype model based on echocardiographic myocardial strain shows promising results in detecting myocardial ischemia. Further studies are needed to validate its robustness and generalizability on larger patient populations.

PMID:40397367 | DOI:10.1007/s11739-025-03968-6

Eur J Epidemiol. 2025 May 21. doi: 10.1007/s10654-025-01228-7. Online ahead of print.

ABSTRACT

There is an unsettled concern that treatment with aromatase inhibitors (AIT) may adversely affect lipid-levels. In light of the improved survival of women with breast cancer and increased risk of atherosclerotic cardiovascular disease in older people, unfavorable effects on lipid-levels may represent a significant health concern for this group of patients. We used linked data from nationwide registries, including a clinical breast cancer database with information about allocated and dispensed AIT. Based on these, we investigated changes in plasma lipid-levels (primary outcome: low-density lipoprotein (LDL)-cholesterol, secondary outcomes: high-density lipoprotein (HDL)-cholesterol, total cholesterol, and triglycerides) following AIT in a nationwide cohort of postmenopausal women with early breast cancer, Denmark, 2009-2020. Included women had at least one LDL-cholesterol measurement before and after breast cancer diagnosis. Exposure was allocated and dispensed AIT as compared with not allocated to and no dispensed AIT. Outcome was the adjusted difference in lipid-level-change (from before to after breast cancer diagnosis) according to AIT. Among 10,461 women, there were 22,693 pre-breast cancer LDL-cholesterol measurements and 42,750 post-breast cancer LDL-cholesterol measurements. Overall, 7919 of the women were exposed to AIT and 2542 women were unexposed. For AIT exposed, the LDL-cholesterol-change was – 0.16 mmol/L (mM), and for unexposed, – 0.15 mM, respectively. The corresponding adjusted difference in LDL-cholesterol change for AIT exposed versus unexposed was – 0.03 mM (95% CI – 0.07 to 0.003). We found similar results in analysis of secondary outcomes. This study does not support the concern that AIT adversely affects lipid-levels.

PMID:40397354 | DOI:10.1007/s10654-025-01228-7

Ann Biomed Eng. 2025 May 21. doi: 10.1007/s10439-025-03747-6. Online ahead of print.

ABSTRACT

PURPOSE: Accurate quantification of head acceleration event (HAE) exposure is critical for investigating brain injury risk in contact sports athletes. However, missing HAEs may be unavoidable in real-world data collection. This study introduces missing data imputation methods to estimate complete video- and sensor-based HAE exposure.

METHODS: We captured and verified university men’s ice hockey HAEs using video and instrumented mouthguards (iMGs) in one varsity season (n_athletes = 27, n_games = 31). A statistical mapping technique was first introduced to impute missing video-based HAEs during away games with limited camera angles. We then applied multiple imputation to impute missing iMG-based HAEs using captured data, including the complete video-based HAE exposure. This enabled estimation of complete exposure data at a per-athlete level over all games of the season.

RESULTS: Among 591 athlete-games, 45% did not have any recorded iMG data. We find that data imputation increased the median values of per-athlete-season video- and iMG-based HAE counts by 10% and 69%, respectively. Consequently, common head kinematics- and brain deformation-based cumulative exposure metrics also increased substantially (median per-athlete-season cumulative peak linear acceleration by 95%, peak angular acceleration by 109%, and corpus callosum strain by 69%).

CONCLUSION: This study highlights the potential underestimation of exposure metrics due to missing HAEs and fills a critical gap in sports HAE exposure research. Future studies should incorporate missing data imputation methods for more accurate estimation of HAE exposure in investigating acute and long-term brain trauma risks.

PMID:40397312 | DOI:10.1007/s10439-025-03747-6

Target Oncol. 2025 May 21. doi: 10.1007/s11523-025-01146-4. Online ahead of print.

ABSTRACT

Treatment strategies to improve outcomes in patients with metastatic castration-resistant prostate cancer (mCRPC) are evolving. Of particular interest are therapies that target DNA damage responses in tumor cells by inhibiting poly(ADP-ribose) polymerase (PARP) activity. Several PARP inhibitors have recently received regulatory approval for the treatment of patients with mCRPC, of which olaparib was the first for prostate cancer. Olaparib received approval as a monotherapy following the PROfound study (NCT02987543) and in combination with abiraterone following the PROpel study (NCT03732820) for mCRPC. Both PROfound (homologous recombination repair mutation biomarker-selected) and PROpel (biomarker unselected) patients demonstrated statistically significant longer radiographic progression-free survival (rPFS) with olaparib versus their respective control arms in the intention-to-treat population. In both studies, the greatest clinical benefit with olaparib was seen in patients with BRCA1 and/or BRCA2 mutations (BRCAm): PROfound rPFS hazard ratio (HR) 0.22 (95% confidence interval [CI] 0.15-0.32); PROpel rPFS HR 0.23 (95% CI 0.12-0.43). Clinical benefit was also observed in terms of overall survival: PROfound HR 0.63 (95% CI 0.42-0.95); PROpel HR 0.29 (95% CI 0.14-0.56). We provide a comprehensive overview of the utility of olaparib for patients with mCRPC harboring a BRCAm. Key clinical and safety data in BRCAm subgroup populations are discussed, predominantly based on findings from PROfound and PROpel, as well as investigator-initiated studies, to help inform treatment decision-making in this patient population. We also discuss the importance of genetic testing to identify patients who may optimally benefit from treatment with olaparib, either as a monotherapy or in combination with abiraterone.

PMID:40397306 | DOI:10.1007/s11523-025-01146-4