Tag: nevin manimala

J Neurol. 2025 May 18;272(6):407. doi: 10.1007/s00415-025-13146-5.

ABSTRACT

BACKGROUND AND PURPOSE: Post-stroke cognitive impairment (PSCI) is one of the serious complications of stroke, which profoundly influences the quality of life of stroke survivors. The Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) are the two cognitive screening tools most widely used in stroke settings. Previous studies investigated the diagnostic accuracy of MoCA and MMSE but yielded controversial results. We conducted this study to compare the diagnostic accuracy of MoCA with MMSE for PSCI.

METHODS: Embase, PubMed, CINAHL, Web of Science, and The Cochrane Library were searched until August 17, 2024 for diagnostic accuracy studies comparing MoCA and MMSE. Data extraction was performed by two independent researchers. Risk of bias and applicability assessment was evaluated by the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Coupled forest plots and hierarchical summary receiver operating characteristic (hsROC) curves were created in R statistical software.

RESULTS: 9 studies with 1,135 patients were included in this review. Most studies were at high risk of bias. MoCA displayed a pooled sensitivity of 0.80 (95% CI 0.72 to 0.86) and specificity of 0.79 (95% CI 0.71 to 0.85). MMSE displayed a sensitivity and specificity of 0.76 (95% CI 0.71 to 0.81) and 0.78 (95% CI 0.73 to 0.83), respectively. No difference was shown between these modalities (SEN p = 0.36, SPE p = 0.80).

CONCLUSION: No difference was observed between MoCA and MMSE in the detection of PSCI. We recommend both screeners be considered for the detection of PSCI based on the purpose of the test and by other metrics, such as acceptability and feasibility. Although it should be noted MoCA and MMSE were cognitive screening tools in stroke settings and not a substitute for detailed clinical assessment.

PMID:40383729 | DOI:10.1007/s00415-025-13146-5

Sci Rep. 2025 May 18;15(1):17258. doi: 10.1038/s41598-025-02096-7.

ABSTRACT

Colorectal cancer (CRC) progression involves complex molecular alterations, including the dysregulation of long non-coding RNAs (lncRNAs). In this study, we identified key progression-related lncRNAs in CRC by integrating transcriptomic data from TCGA and single-cell RNA sequencing (scRNA-seq). Differential expression analysis revealed numerous lncRNAs associated with CRC progression. To systematically prioritize these lncRNAs, we developed a scoring system incorporating multiple progression-related signatures, differential expression, and survival analysis. This approach identified 198 key lncRNAs, including both known (e.g., LINC01615) and novel candidates (e.g., AC007998.3). Experimental validation confirmed that LINC01615 was significantly upregulated in CRC tissues, whereas AC007998.3 was downregulated. Further analyses indicated that these lncRNAs influence CRC progression through cis-, trans-, and post-transcriptional regulation. Patients were classified into distinct molecular subgroups based on lncRNA expression, exhibiting significant differences in prognosis and immune microenvironment composition. The enrichment of progression-related lncRNAs among differentially expressed lncRNAs was statistically significant, reinforcing their functional relevance. Validation across independent datasets demonstrated the robustness of our findings. Our research provides novel insights into the molecular mechanisms underlying CRC progression and highlights the potential of progression-related lncRNAs as prognostic biomarkers and therapeutic targets.

PMID:40383716 | DOI:10.1038/s41598-025-02096-7

J Matern Fetal Neonatal Med. 2025 Dec;38(1):2505083. doi: 10.1080/14767058.2025.2505083. Epub 2025 May 18.

ABSTRACT

BACKGROUND: This scoping review explores the need for labor induction in adolescent pregnancies (≤19 years). It aims to identify and synthesize evidence on adolescent motherhood’s unique challenges and implications on maternal and neonatal outcomes.

METHODS: This review followed the PRISMA-ScR guidelines. To identify relevant studies on labor induction in adolescent pregnancies, a comprehensive search strategy was implemented. Data were extracted from 8 eligible studies with a total population of 119,153 participants. The studies included maternal characteristics, mode of delivery, and neonatal outcomes. Both qualitative and quantitative synthesis methods were employed. The quality of the included evidence was assessed using the ROBINS-I tool.

RESULTS: Adolescents were less likely to undergo labor induction than adults (18.1% vs. 24.4%; p = 0.009). Adolescent induction showed higher success rates, with lower failure rates (1.69% vs. 2.52%; p < 0.05). Neonatal outcomes demonstrated a higher risk of low birth weight (<2500 g) (OR = 1.7, 95% CI: 1.2-2.4; p < 0.001) and stillbirth in adolescent pregnancies. Despite these risks, adolescents had higher rates of spontaneous vaginal delivery (85.0% vs. 59.5%; p < 0.001) and lower rates of cesarean sections (13.8% vs. 23.1%; p < 0.001). Maternal anemia was significantly more prevalent in adolescents (19.3% vs. 11.8%; p < 0.001).

CONCLUSIONS: Labor induction in adolescent pregnancies is less common but associated with favorable outcomes. However, adolescents face a higher risk of pregnancy and neonatal complications. These findings emphasize the significance of labor induction in this group and highlight the need for further research to establish evidence-based timing and indications for its use.

PMID:40383707 | DOI:10.1080/14767058.2025.2505083

Aust Health Rev. 2025 May 19. doi: 10.1071/AH24324. Online ahead of print.

ABSTRACT

ObjectiveAustralian Bureau of Statistics data on socio-economic status, service accessibility/remoteness and population denominators are useful in epidemiology, though complex to understand and apply. We provide information and resources to facilitate their use.MethodsWe compiled data from the Socio-Economic Indexes for Areas (SEIFA), the Accessibility/Remoteness Index of Australia (ARIA) and population estimates from across multiple years, taking into account changes in availability and formats of these data over time. Syntax was written to support use of these data in studies using administrative health data, alongside a user guide with notes and instructions.ResultsWhere research data contains an event date plus a postcode, Statistical Area Level 2 and/or Statistical Local Area, these resources can be used to attach a SEIFA score and decile, remoteness areas and age-sex-specific population denominators to each record for years 2000-2025 (population denominators to 2023). These variables can be used as cohort descriptors, as model covariates or to calculate ARIA/SEIFA stratified rates.ConclusionsThese resources are useful for individual research projects, while also contributing to building capacity in the use of geographical measures. We focused on the measures most commonly used in Australia, although the approach outlined can be applied to other geographical measures.

PMID:40383705 | DOI:10.1071/AH24324

Cancer Genet. 2025 May 12;294-295:171-180. doi: 10.1016/j.cancergen.2025.05.001. Online ahead of print.

ABSTRACT

PURPOSE: Glioma arises from glial cells and comprises ∼80 % of malignant adult brain tumors. The polymorphic mitochondrial genome plays a key role in maintaining redox homeostasis and generation of reactive oxygen species (ROS). ROS have a well-established role in glial tumors. We investigated associations between germline mtDNA variants and haplogroups with glioma grade and glioblastoma (GBM) survival.

METHODS: We conducted germline mtDNA sequencing for 388 patients (300 Caucasians, 88 African Americans [AA]) with incident glioma (105 non-GBM, 283 GBM). Across all patients we identified 1431 homoplasmic mtDNA variants, including 692 variants observed only in Caucasians, 474 only in AAs, and 265 in both groups. We estimated Odds Ratios (OR) and 95 % Confidence Intervals (CI) for mtDNA common variants, haplogroups, and gene variant burden in relation to glioma grade and tertiles of survival in GBM patients. Bonferroni and Benjamini-Hochberg correction were applied for multiple comparisons.

RESULTS: No mtDNA haplogroup was associated with glioma grade or patient survival in GBM. Common variants m.3010G>A, m.195T>C, and m.16189T>C were linked to lower-grade glioma risk. For GBM survival, m.1719G>A, m.14766T>C, m.16129G>A, and m.204T>C were associated with a poorer prognosis while variant m.73A>G was associated with an improved prognosis. A higher variant burden in MT-ND1 and MT-ND5 was associated with a better prognosis. No results remained statistically significant after correction.

CONCLUSION: This is the first comprehensive study of germline mtDNA sequence variation in relation to glioma grade at diagnosis and gliobastoma patient survival. Results warrant further study in larger populations and investigation of biologic mechanisms linking mtDNA polymorphism to these endpoints.

PMID:40382795 | DOI:10.1016/j.cancergen.2025.05.001

Age Ageing. 2025 May 6;54(5):afaf123. doi: 10.1093/ageing/afaf123.

ABSTRACT

BACKGROUND: Allied health professionals provide essential healthcare services to older adults with chronic health conditions. However, there are challenges to access and utilisation of these services for rural communities and limited scope of the existing literature.

OBJECTIVE: To conduct a scoping review of the literature related to access and utilisation of allied health services for older adults living in rural areas.

DESIGN: Scoping review.

METHODS: Four databases were searched. Articles were included based on pre-determined criteria and were limited to articles published between 2010 and 2023. Data were extracted with a focus on access and utilisation factors, enablers and barriers related to care recipients, care providers, other stakeholders and the healthcare system.

RESULTS: Thirty four studies met the inclusion criteria. The majority of studies focussed on accessibility from the perspective of the consumer (n = 31), whilst few studies focussed on the perspective of the care providers (n = 3). ‘Availability and accommodation’ was the most frequently explored dimension of accessibility in the included papers, from the consumers’ perspective (n = 18) and from the health system (n = 15).

CONCLUSION: This is the first scoping review to improve understanding of older adults’ access to and utilisation of allied health services in rural areas. Understanding the most impactful accessibility dimensions can enhance strategies for improving access and utilisation of allied health services, especially when tailored to the local context. More studies are needed to understand accessibility of allied health services in rural areas from the perspective of care providers.

PMID:40382790 | DOI:10.1093/ageing/afaf123

Dis Esophagus. 2025 May 3;38(3):doaf036. doi: 10.1093/dote/doaf036.

ABSTRACT

Paraesophageal hernia repair often includes both gastropexy and fundoplication. The fundoplication may cause persistent side effects, and the necessity of the procedure is uncertain. This study aimed to compare gastropexy with or without fundoplication. A retrospective multicenter study was conducted from three Scandinavian hospitals. Patients, with grade III-IV hiatal hernia, who had a laparoscopic repair with total hernia sack removal, closure of hiatus, gastropexy either with or without Nissen fundoplication were included. Outcomes were per- and postoperative complications, postoperative symptom control, and recurrence. A total of 320 patient cases were included in the study (72 patients with Nissen fundoplication and 248 patients without fundoplication). Baseline variables were comparable between the two groups. We found no difference in perioperative or postoperative events, reflux control or recurrence. Median operation time differed with 49 minutes (P < 0.001) in patients with fundoplication (Median: 108 minutes, interquartile range (IQR): 88-131 minutes) compared to patients without fundoplication (59 minutes, IQR = 46-78 minutes). We also found an increased risk for second repair in the fundoplication group (OR 4.3, 95% CI 1.4-13.3). This study shows no benefits of adding a Nissen fundoplication procedure to anterior gastropexy for paraesophageal hernia repair. It was not superior compared to gastropexy alone in terms of postoperative reflux control or preventing recurrence. In contrast, the fundoplication was associated with a four-fold increase of second repair, but the study design limits firm conclusions on this matter.

PMID:40382786 | DOI:10.1093/dote/doaf036

Drug Alcohol Rev. 2025 May 18. doi: 10.1111/dar.14052. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to provide a first-ever comprehensive epidemiology of vaping behaviours among Australian gender and sexuality diverse (LGBTQA+) youth.

METHODS: Using cross-sectional data from the Health4Life study, (N = 4,445 students, Mage = 15.7yrs), descriptive statistics and hierarchical mixed effects logistic regression models with nested random intercepts were used to calculate prevalence and differences in vaping behaviours by gender (trans [n = 142] vs. cisgender [n = 4,144]) and sexuality (gay or lesbian [n = 77], bisexual [n = 279], questioning [n = 167], queer [n = 90] vs. heterosexual [n = 3,638]), and associations of vaping with use of cigarettes and alcohol (including binge drinking), depression, and anxiety.

RESULTS: Over one-third of trans and bisexual adolescents had ever tried vaping. Trans adolescents were significantly more likely to report ever vaping, daily vaping, and intention to vape in the future, compared with their cisgender peers, irrespective of age, socio-economic status, and school. Relative to heterosexual peers, gay/lesbian adolescents were nearly three times as likely to report current regular use of vaping and bisexual adolescents were significantly more likely to report ever vaping and intentions to vape in the future. Among LGBTQA+ adolescents, ever using a vape was associated with increased odds of ever using cigarettes, ever binge drinking, ever drinking alcohol alone, probable depressive/anxiety disorders.

DISCUSSION: Vaping is significantly more common among LGBTQA+ adolescents, especially trans and bisexual adolescents, compared with their cisgender, heterosexual peers. Government health and education bodies should partner with LGBTQA+ community organisations to address the unique contexts of vaping among LGBTQA+ young people in an LGBTQA+ affirmative harm reduction manner.

PMID:40382785 | DOI:10.1111/dar.14052

J Burn Care Res. 2025 May 18:iraf089. doi: 10.1093/jbcr/iraf089. Online ahead of print.

ABSTRACT

The U.S. faces a surgeon shortage, threatening a decline in burn care specialists as surgeons shift to other fields. With only 0.3% of the workforce in burn surgery, attrition could severely impact burn care availability. Addressing recruitment and retention challenges requires identifying stressors and workload factors contributing to the strain of operative burn care. In May 2024, a de-identified survey was conducted with Institutional Review Board approval to assess burn surgeons’ self-reported well-being. A diverse surgeon panel reviewed the survey, and the American Burn Association distributed it via email and Survey Monkey™. Statistical analysis included Chi-square and t-tests. Seventy-seven burn surgeons (62% male) participated, representing a 20% response rate. Most took burn call (95%) and worked in an academic setting (80%). While 73% were satisfied with their careers and 91% valued the complexities of burn care, 54% lacked time for personal activities, and 62% felt maternity/paternity leave was insufficient. Forty percent experienced burnout, and 26% considered leaving the field. Over half (54%) felt they lacked time to recover after demanding cases, and 65% believed burn surgery negatively impacted their health. Using a Likert scale (10 = high performance), they rated their ability to meet job demands at 7 (±1), with a projected decline to 4.2 (±0.5) in two years. Despite overall career satisfaction, burn surgeons face challenges that threaten their health and the quality and sustainability of burn care. Our findings highlight the need for interventions to mitigate burnout and enhance well-being, ensuring the long-term viability of burn surgery and patient care.

PMID:40382783 | DOI:10.1093/jbcr/iraf089

J Frailty Aging. 2025 May 16;14(3):100052. doi: 10.1016/j.tjfa.2025.100052. Online ahead of print.

ABSTRACT

OBJECTIVES: Examine the effect of frailty on physical function recovery in people admitted to hospital who received a physiotherapy Early Rehabilitation program.

METHODS: Observational cohort (1 January 2021 to 31 December 2021). Patients admitted to the acute site at Austin Health, Australia who received an Early Rehabilitation program (targeted physical rehabilitation to address goals aligned to physiotherapy intervention in parallel with acute medical treatment) were eligible. Frailty was measured with the Clinical Frailty Scale (CFS). The primary outcome was, across the CFS, magnitude of change from admission to discharge in physical function assessed with the modified Iowa Level of Assistance Scale (mILOA). Secondary outcomes were length of stay and discharge destination. Generalised additive models were used.

RESULTS: There were 674 patients included in the study. Irrespective of frailty status, mean improvement in physical function from admission to discharge exceeded the minimal datable change of 5.8 points for the mILOA. Larger average improvements in mILOA were observed in patients with lower degrees of frailty (p < 0.001 overall effect), where a portion of patients with severe frailty did not make clinically meaningful gains in physical function following Early Rehabilitation. Mean improvement in physical function and predicted probabilities for discharge home were similar; where greater frailty severity was associated with a lesser chance of going home at acute hospital discharge (p = 0.002 overall effect).

CONCLUSIONS: Validating the link between predictions for change in physical function and discharge home in people receiving early rehabilitation during acute hospitalisation would be of great clinical utility.

PMID:40382776 | DOI:10.1016/j.tjfa.2025.100052