Tag: nevin manimala

J Assist Reprod Genet. 2025 May 6. doi: 10.1007/s10815-025-03496-4. Online ahead of print.

ABSTRACT

PURPOSE: The impact of oral GnRH antagonists on IVF treatment outcomes remains unclear. The aim of the study is to investigate the impact of GnRH antagonist over the outcomes of IVF.

METHODS: We performed an electronic search using MEDLINE® with the OvidSP interface PUBMED, Embase, Web of Science, and Cochrane Library up to December 16, 2024. We included experimental and non-experimental studies, assessing the role of oral GnRH during controlled ovarian stimulation protocols. Our main outcomes were cycle cancelation rate and mean number of mature oocytes retrieved at oocyte pickup (OPU) day.

RESULTS: We included four studies comprising 813 patients, of whom 452 women received oral GnRH antagonists and 294 received injectable subcutaneous GnRH antagonists. No statistical differences were noted in the meta-analysis between each outcome measured (cycle cancelation, mean overall and mature oocytes, fertilization rate, and blastulation rate). Using the GRADE criteria, the overall quality of the existing evidence was determined as moderate.

CONCLUSIONS: This is the first systemic review and meta-analysis to examine the usage of oral GnRH antagonists for ovulation suppression during IVF treatments. Our findings suggest the use of oral GnRH antagonists may be beneficial in infertility treatments; however, caution should be taken, as robust establishment of their effectivity and safety in clinical practice is still pending.

TRIAL REGISTRATION: Registration Number: PROSPERO study ID: CRD42024599730.

PMID:40327246 | DOI:10.1007/s10815-025-03496-4

J Patient Rep Outcomes. 2025 May 6;9(1):48. doi: 10.1186/s41687-025-00879-0.

ABSTRACT

BACKGROUND: Elexacaftor/Tezacaftor/Ivacaftor (ETI) is a therapy approved for cystic fibrosis (CF) that has given improved clinical outcomes in patients carrying the F508del mutation. There are few published data regarding ETI’s effects on patients’ quality of life (QoL). This study aims to (fill the data gap in current literature by assessing) evaluate the long-term effects of ETI on QoL.

METHODOLOGY: A prospective observational study was conducted with thirty-seven severe patients that received ETI for compassionate use (group A), 184 received it for on-label use (group B). All carried one F508del mutation. Patients were assessed using the CFQ-R (Cystic Fibrosis Questionnaire-Revised). The evaluation time-points were pre-treatment (T0), and after 12 (T1) and 24 months (T2); group A was also assessed after 36 months (T3). Twenty-five patients completed 3 years of treatment and 65 patients completed 2 years of treatment, in groups A and B respectively.

RESULTS: At T1, median values for almost all areas of CFQ-R statistically significant increased in group A, particularly Physical Functioning (+ 25.0), Respiratory (+ 22.2) and Health Perception (+ 22.2).The Social Functioning area statistically significant increased at T2 (+ 5.6). At T3, these improvements remained stable. At T1, all areas of CFQ-R statistically significant increased in group B, particularly the Health Perception (+ 22,2) heading. At T2, these improvements remained stable. For both groups, the changes identified at the last follow-up showed no major differences by gender, age or genetic status.

CONCLUSIONS: Treatment with ETI significantly improved patients’ QoL in both groups at 12-24 months, these improvements remaining stable in patients tested at 36 months.

PMID:40327240 | DOI:10.1186/s41687-025-00879-0

J Immigr Minor Health. 2025 May 6. doi: 10.1007/s10903-025-01672-3. Online ahead of print.

ABSTRACT

To identify distinct and shared health barriers, priorities, and desired information within minority communities by immigrant status. Health needs assessment surveys were conducted at three different health fairs in San Antonio from October 22, 2022 to January 14, 2023. Data was compared using descriptive statistics by immigration status. Among 59 US-born and 55 non-US-born respondents, nutrition and mental health were the highest health priorities. Time was a greater barrier among US-born respondents (p =.007) while lack of insurance was a greater barrier among non-US-born respondents (p =.008). Although the US-born group had higher rates of insurance (74%) compared to the non-US-born group (64%) (p =.019), both had similar rates of having a primary care provider. The US-born group had a higher number of emergency department (ED) visits (p =.030). There are multiple commonalities and differences among health needs in ethnically diverse communities in South Texas. Future health interventions targeted toward minority communities should consider nutrition and mental health while also addressing unique barriers. Multiple factors such as access to free clinics, personal safety, language, and health insurance status are integral to minority group health.

PMID:40327238 | DOI:10.1007/s10903-025-01672-3

Phys Eng Sci Med. 2025 May 6. doi: 10.1007/s13246-025-01540-2. Online ahead of print.

ABSTRACT

Breast tissue is mainly a mixture of adipose and fibro-glandular tissue. Cancer risk and risk of undetected breast cancer increases with the amount of glandular tissue in the breast. Therefore, radiologists must report the total volume glandular fraction or a BI-RADS classification in screening and diagnostic mammography. In this work, a Maximum Likelihood algorithm accounting for count statistics and scatter is shown to estimate the pixel-wise glandular fraction from mammographic images. The pixel-wise glandular fraction provides information that helps localize dense tissue. The total volume glandular fraction can be calculated from pixel-wise glandular fraction. The algorithm was implemented for images acquired with an anti-scatter grid, and those without using the anti-scatter grid but followed by software scatter removal. The work also studied if presenting the pixel-wise glandular fraction image alongside the usual mammographic image has the potential to improve the contrast-to-noise ratio on micro-calcifications in the breast. The algorithms are implemented and evaluated with TOPAS Geant4 generated images with known glandular fractions. These images are also taken with and without microcalcifications present to study the effects of glandular fraction estimation on microcalcification detection. The algorithm was then applied to clinical images with and without microcalcifications. For the TOPAS simulated images, the glandular fraction was estimated with a root mean squared error of 6.6% for the with anti-scatter-grid cases and 7.6% for the software scatter removal (no anti-scatter grid) cases for a range of 2-9 cm compressed breast thickness. Average absolute errors were 4.5% and 4.7% for a range of 2-9 cm compressed breast thickness respectively for the anti-scatter grid and software scatter-removal methods. For higher thickness and glandular fraction, the errors were higher. For the extreme case of 9 cm thickness, the glandular fraction estimation yielded 5%, 13% and 16% mean absolute errors for 20%, 30% and 50% glandular fraction. These errors lowered to 1.5%, 9% and 13.2% for a narrower spectrum for the 9 cm. Results from clinical images (where the true glandular fraction is unknown) show that the algorithm gives a glandular fraction within the average range expected from the literature. For microcalcification detection, the contrast-to-noise ratio improved by 17.5-548% in clinical images and 5.1-88% in TOPAS images. A method for accurately estimating the pixel-wise glandular fraction in images, which provides localization information about breast density, was demonstrated. The glandular fraction images also showed an improvement in contrast to noise ratio for detecting microcalcifications, a risk factor in breast cancer.

PMID:40327237 | DOI:10.1007/s13246-025-01540-2

Community Ment Health J. 2025 May 6. doi: 10.1007/s10597-025-01471-y. Online ahead of print.

ABSTRACT

Young adults experiencing psychosis are at high risk for disengagement from their daily lives. Occupational therapy (OT) services play an important role in fostering participation, yet their intervention efficacy in Early Intervention in Psychosis (EIP) remains poorly understood. To determine the commonly utilized OT interventions and measurement tools that require further research to determine their efficacy and effectiveness. Cross-sectional, mixed-methods survey study. Quantitative descriptive statistics were completed on Microsoft Excel and qualitative thematic analysis was completed by two researchers using Dedoose. Online survey. Occupational therapy practitioners (OTPs) working on EIP programs in the United States were recruited through purposive and snowball sampling. The survey consisted of 24 closed and open-ended questions assessing use of interventions, outcomes tracked, and measurement tools. Study had 21 respondents. The most frequent interventions were self-regulation and activities of daily living (ADL). Self-regulation interventions were overwhelmingly sensory-based. Most commonly reported outcome measure was observation of participation in occupations. This study confirms the use of sensory and ADL-based interventions by OTPs in EIP programs. Findings suggest a strong sense of the role of OT within EIP as intervention use is relatively consistent across programs and focuses on client-centered, occupation-based interventions. Outcome tracking and quality improvement were gaps as most OTPs are not using standardized methods or not performing this. Additional study is required to determine the efficacy of commonly used interventions and to improve outcome measurement methods in EIP programs. Occupational therapy is an undervalued profession on teams that provide services to young adults dealing with the onset of a psychotic illness. This study is the first of many needed to demonstrate the impact OT services can have on the outcomes of the young adults who receive care for their psychotic illness. This study identifies what OT interventions are common, and what outcomes OT professionals track to determine their services’ impact on these mental health care teams. These results will help to build the needed research on how helpful these common interventions are for young adults facing psychotic illnesses.

PMID:40327230 | DOI:10.1007/s10597-025-01471-y

J Patient Rep Outcomes. 2025 May 6;9(1):47. doi: 10.1186/s41687-025-00885-2.

ABSTRACT

BACKGROUND: Assessment of patient readiness for hospital discharge has been advocated as an important component of discharge preparation. However, no measures focused on hospital-to-home transitions for patients receiving a palliative approach to care, or the associated difficulties in coping at home after hospital discharge, have been developed to date. Using a co-design approach, the purpose of this study was to (1) adapt two scales to a palliative care population, one of which was developed to assess readiness for the hospital-to-home transition and another developed to assess difficulty in coping post-transition and to (2) test the content validity of both scales from the perspectives of patients, family caregivers, and healthcare providers. The scales chosen for adaptation were the Readiness for Hospital Discharge Scale and Post-Discharge Coping Difficulty Scale.

METHODOLOGY: The research team made initial adaptations to scale language prior to developing three parallel versions of each scale to be patient-, family caregiver-, and healthcare provider-facing. We conducted content validity testing of the items on both scales by asking each participant group to rate scale items on their usefulness, and to provide suggestions on ways items could be improved. We calculated the Item Content Validity Index and a modified Kappa statistic for each scale item, and calculated the Scale Content Validity Index for each of the three versions of the scales. Refinements were informed by qualitative feedback provided by participants during the content validity process. Final refinements were informed by members of a Patient and Family Advisory Council, and healthcare provider research team members.

RESULTS: Moderate modifications were required to the three versions of both scales. Modifications included adding items, modifying item language, and adding examples in parentheses to enhance item context. Patients, family caregivers, and healthcare providers deemed the research team’s initial modifications to the scales useful, as evidenced by each scale yielding a Scale Content Validity Index of higher than 0.5.

CONCLUSION: The methodology provided can be used as an example of ways to engage and leverage the experiences of healthcare system users and healthcare providers throughout the outcome measures development process. The next steps will be to utilize the adapted scales as intervention outcome measures in a subsequent implementation study.

PMID:40327215 | DOI:10.1186/s41687-025-00885-2

Cancer Causes Control. 2025 May 6. doi: 10.1007/s10552-025-02006-2. Online ahead of print.

ABSTRACT

PURPOSE: To estimate the number of screenings received, life-years (LYs) saved, and number of screenings per LY saved per woman who participated in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) (Program) compared with those who did not participate (no Program).

METHODS: We developed a time-to-event simulation model to compare the outcomes of women participating in the Program vs. no Program, categorized by race/ethnicity. Model input parameters included data from the Program’s minimum data elements, United States Cancer Statistics, National Health Interview Survey, and published literature. The Program’s impact was calculated as the difference in LYs between the Program and no Program using data from 2010 to 2019.

RESULTS: Among 1 million women of all races/ethnicities who participated in the NBCCEDP in the last 10 years, 457,152 (standard deviation [SD]: 848) received more screenings than those who did not participate. These participants saved an average of 0.027 LYs per woman screened. In addition, we estimated that about 17 screenings would be required to save an additional 1 LY per woman screened in the Program compared with no Program. Per woman screened by race/ethnicity, non-Hispanic Black women had the highest estimated 0.075 LYs saved, followed by Hispanic women with 0.025 LYs, non-Hispanic White with 0.014 LYs, and non-Hispanic American Indian/Alaska Native and Asian/Pacific Islander had the least health outcome with 0.011 LYs.

CONCLUSION: The reported findings underscore the importance of providing preventive health services to populations that might not otherwise have access to these services.

PMID:40327212 | DOI:10.1007/s10552-025-02006-2

Med Biol Eng Comput. 2025 May 6. doi: 10.1007/s11517-025-03367-1. Online ahead of print.

ABSTRACT

The threads of dental implants are critical components that transfer occlusal loads to the surrounding bone. The appropriate size of thread parameters can influence the stability of the implant after implantation. Despite several research studies on the effectiveness of implant thread parameters, there is limited structured information available. This study aims to conduct a systematic review to evaluate the biomechanical effects of thread parameters, namely, thread depth, thread width, thread pitch, and thread angle on implant stability. A comprehensive literature review was conducted in PubMed/MEDLINE, Scopus, ScienceDirect, and Web of Science for research published in English in the last two decades according to the PRISMA protocols. The extracted data were organized in the following order: area, bone layers, bone type, implant design, implant material, failure criteria/unit, loading type, statistical analysis/optimization, experimental validation, convergence analysis, boundary conditions, parts of the Finite Element Model, studied variables, and main findings. The search yielded 580 records, with 39 studies meeting the selection criteria and being chosen for the review. All four thread parameters were found to affect the stress and strain distribution in cancellous and cortical bones. Thread pitch and depth are more important for implant primary stability as they are directly correlated with the functional surface area between the implant and bone. Moreover, thread pitch, depth, and width can increase the insertion torque, which is favorable for implant primary stability, especially in low-quality bones. The thread angle can also direct occlusal forces to the bone more smoothly to prevent bone overloading and destructive shear stresses, which cause bone resorption. This structured review provides valuable insights into the biomechanical effects of thread parameters on implant stability.

PMID:40327205 | DOI:10.1007/s11517-025-03367-1

Blood Res. 2025 May 6;60(1):29. doi: 10.1007/s44313-025-00078-2.

ABSTRACT

BACKGROUND: Immune thrombocytopenia (ITP) is an autoimmune condition characterized by low platelet count and increased risk of bleeding. Several pathophysiological processes contribute to the disease, including complement activation by autoantibodies bound to platelet surfaces. This study aimed to assess complement levels in ITP patients and determine their correlation with clinical presentation and disease severity.

PATIENTS AND METHODS: This case-control study enrolled 40 patients (both sexes, aged 18-40 years) with primary ITP and 40 healthy controls. All participants underwent a comprehensive health assessment, thorough physical examination, laboratory investigations, and abdominal ultrasound. These included a complete blood count (CBC) with blood film, renal and hepatic function tests, hepatitis B surface antigen (HBsAg), hepatitis C virus antibodies (HCV-Abs), human immunodeficiency virus (HIV) antibodies, hepatitis B core antibody (HBcAb), C-reactive protein (CRP), antinuclear antibody (ANA), thyroid-stimulating hormone (TSH), erythrocyte sedimentation rate (ESR), serum complement levels (C3 and C4), and Helicobacter pylori antigen in stool.

RESULTS: Mean C3 and C4 levels were significantly lower in patients with ITP than in healthy controls. A statistical significant negative correlation was found between CRP and C4 levels in ITP patients. However, no statistically significant relationship was observed between C3 and C4 levels and platelet count in ITP patients, regardless of the presence of bleeding complications.

CONCLUSION: Complement levels were significantly lower in patients with ITP than in healthy controls. Complement levels were also significantly lower in treatment-naïve patients than in patients who received treatment. Therefore, complement levels could serve as a valuable laboratory test for disease activity.

PMID:40327196 | DOI:10.1007/s44313-025-00078-2

Emerg Radiol. 2025 May 6. doi: 10.1007/s10140-025-02346-1. Online ahead of print.

ABSTRACT

PURPOSE: Diagnosing adnexal torsion is challenging due to non-specific presentation and ultrasound findings. MRI may provide alternative assessment of adnexal torsion. We evaluated an MRI appendicitis protocol for torsion identification.

METHODS: Retrospective chart and image review was performed for girls with appendicitis MRI exams from 2013 to 2019. Ovarian volumes, stromal T2 signal, and apparent diffusion coefficient (ADC) ratios were tabulated. Ovarian and paratubal cysts’ size and location were recorded as well as presence or absence of torsion. Statistical analysis was performed.

RESULTS: Six hundred-fifty cases were included, eight with torsion. Higher ovarian volumes and volume ratios were found with torsion (p < 0.0001 and p < 0.0001, respectively). Ovarian volume ratio less than 4:1 had 99.7% negative predictive value (NPV). Ovarian volume less than 20 mL had 99.8% NPV. Five of six cases with 7 cm or larger adnexal cysts were torsed. T2 signal and ADC ratios overlapped between torsed and untorsed groups. No torsed adnexa appeared normal on MRI.

CONCLUSION: Torsed cases tended to have larger ovaries and higher volume ratios. Adnexal cysts greater than 7 cm diameter were likely to be torsed. No torsion cases had normal adnexae on MRI. Normal appearing adnexae on MRI are very unlikely to be torsed.

PMID:40327188 | DOI:10.1007/s10140-025-02346-1