Tag: nevin manimala

Global Spine J. 2025 Nov 1:21925682251392178. doi: 10.1177/21925682251392178. Online ahead of print.

ABSTRACT

Study DesignRetrospective Cohort Study.ObjectivesTo evaluate the predictive performance of the Risk Analysis Index (RAI) and Modified 5-Item Frailty Index (mFI-5) in identifying risk for adverse postoperative outcomes in patients undergoing occipitocervical fusion (OCF).MethodsThe American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried for patients who underwent OCF from 2015 to 2020. Frailty was measured using both the RAI and mFI-5. The primary outcome was 30-day mortality. Secondary outcomes included major complications, minor complications, unplanned readmission, extended length of stay (eLOS), and non-home discharge (NHD). Multivariable logistic regression was used to assess associations, while receiver operating characteristic (ROC) curve analysis evaluated model discrimination.ResultsA total of 1637 patients were included (median age 68 years; 51.4% male). Higher frailty scores on both RAI and mFI-5 were associated with increased odds of mortality, major complications, and NHD. However, the RAI demonstrated superior discrimination for predicting mortality (C-statistic: 0.79 [95% CI: 0.75-0.83]) compared to mFI-5 (0.57 [95% CI: 0.53-0.61], P < .001), as well as for major complications (RAI: 0.64 vs mFI-5: 0.57, P = .01) and NHD (RAI: 0.73 vs mFI-5: 0.65, P < .001).ConclusionsThe RAI outperformed the mFI-5 in predicting key adverse outcomes following OCF. Incorporating RAI into preoperative evaluation may improve frailty-based risk stratification and guide surgical decision-making in vulnerable patients.

PMID:41175085 | DOI:10.1177/21925682251392178

Subst Use Misuse. 2025 Nov 1:1-8. doi: 10.1080/10826084.2025.2580510. Online ahead of print.

ABSTRACT

Background: Sensitivity to reward (SR), or the likelihood of engagement in positively reinforcing experiences, and sensitivity to punishment (SP), or the tendency to avoid behaviors associated with negative outcomes, are risk and maintenance factors for problematic alcohol use, particularly when proximal motivations for drinking are present. Trauma-exposed adults are at increased risk of engaging in problematic alcohol use, particularly if they are using alcohol to cope with negative emotions. Present Study: Thus, the present study examined, among trauma-exposed community adults, the indirect effects of SP and SR on alcohol use severity through drinking motives. Using two parallel mediation models, we hypothesized that coping motives and enhancement motives, would statistically mediate the associations between: a) SR and alcohol use severity and b) SP and alcohol use severity. We predicted that higher SP and SR would be associated with higher coping motives and enhancement motives, and in turn higher alcohol use severity. Method: Participants with histories of experiencing at least one DSM-5 PTSD Criterion A traumatic event (N = 284, M_age = 38.15, SD_age = 12.67, 63.0% men, 72.5% White) were recruited through Prolific and completed an online questionnaire battery. Results: Results revealed significant indirect effects of: a) SR on alcohol use severity through coping motives (b = 0.11, 95% CI [0.04, 0.18]) and b) SP on alcohol use severity through coping motives (b = 0.11, 95% CI [0.05, 0.17]). Conclusions: Findings suggest that drinking to cope may better explain the associations between SP and SR on alcohol use severity, compared to drinking for enhancement, in trauma-exposed samples.

PMID:41175079 | DOI:10.1080/10826084.2025.2580510

Appl Spectrosc. 2025 Nov 1:37028251396585. doi: 10.1177/00037028251396585. Online ahead of print.

ABSTRACT

Laser-induced breakdown spectroscopy (LIBS) offers a promising alternative due to its minimal sample preparation, real-time analysis capabilities, and versatility in analyzing a broad range of materials. However, the challenge lies in determining its ability to effectively distinguish high-iron ore content from mineralogically similar ores with lower iron content. This study focuses on differentiating iron ore from a variety of ores with lower iron content, including calcite, biotite, dolomite, chalcopyrite, rutile, chromite, olivine, limonite, and astrophyllite, using LIBS. By comparing the obtained spectra and applying receiver operating characteristic (ROC) curve analysis, the study assesses the specificity of the technique. The results demonstrate a high specificity (>70%) in distinguishing iron ore from biotite, dolomite, chalcopyrite, rutile, olivine, and astrophyllite, revealing the potential of LIBS for effectively identifying iron ore from some ore types. However, when comparing iron ore to other ore types, such as limonite, chromite, and calcite, the results are not statistically significant. This means that the spectral or compositional similarities between these ores may limit the method’s capacity to give clear separation in certain situations. To further validate the results, two common classification models, principal component analysis followed by linear discriminant analysis (PCA + LDA) and k-nearest neighbors (KNN) were applied to the spectral data. The comparison results demonstrate the resilience of LIBS classification and the impact of mineral matrix influences on diagnostic performance.

PMID:41175056 | DOI:10.1177/00037028251396585

Int J Stroke. 2025 Nov 1:17474930251396062. doi: 10.1177/17474930251396062. Online ahead of print.

ABSTRACT

OBJECTIVE: To validate whether incorporating existing polygenic risk scores (PRSs) derived from East Asian or trans-ancestry populations into clinical risk equations improves stroke risk stratification in Chinese adults.

METHODS: Participants from the Chinese Multi-provincial Cohort study with genotyped data (n=2931) were included. Four well-established PRSs (i.e., PRS-GBMI, PRS-GIGA, PRS-ChinaPAR, PRS-MEGA) from either the predominantly Chinese or trans-ancestry populations were constructed and evaluated by assessing their associations with stroke and its subtypes. We tested the incremental predictive capability of the four PRSs on 10- and 20-year risk of stroke and its subtypes after adding PRSs to recalibrated China-PAR stroke risk equations, based on discrimination, calibration, and reclassification.

RESULTS: Over a median of 28.2 follow-up years, 340 stroke events were recorded. Higher PRSs were generally associated with a higher stroke risk, though only the highest quantile group of PRS-GIGA showed statistical significance (HR 1.79, 95% CI: 1.05-3.07). Adding PRS-GIGA to the recalibrated China-PAR stroke risk equations (i.e., the base model) yielded a moderate improvement in 20-year stroke risk, with 17.2% (95%CI: 3.8%-30.6%) more of participants correctly categorized into their corresponding risk groups. However, for ischemic stroke, adding PRS-GIGA, PRS-ChinaPAR, PRS-MEGA to the base model could correctly categorize 18.7%~23.8% more of participants into their corresponding 10-year risk groups and 27.8%~32.5% more of participants into their corresponding 20-year risk groups. Adding PRSs did not improve prediction for hemorrhagic stroke.

CONCLUSION: Adding existing PRSs, particularly PRS-GIGA, to clinical risk equations can improve all stroke and ischemic stroke risk stratification in Chinese adults.

PMID:41175054 | DOI:10.1177/17474930251396062

Cancer Control. 2025 Jan-Dec;32:10732748251390022. doi: 10.1177/10732748251390022. Epub 2025 Nov 1.

ABSTRACT

IntroductionThe burden of prostate cancer (PCa) is disproportionately concentrated in low- and middle-income countries (LMICs). Abiraterone and enzalutamide have improved survival rates and quality of life for men with PCa. However, cost constraints limit access to these medications due to limited insurance coverage and out-of-pocket payments. The survey assessed the current practices and opinions of Nigerian clinical oncologists and urologists regarding the use of low dose abiraterone and enzalutamide for the management of metastatic PCa.MethodsThis survey consisted of twenty multiple-choice questions, distributed via Google Forms to urologists and oncologists in Nigeria from August to November 2024. It examined current practices, awareness of effective dose reduction strategies, and opinions on their cost-effectiveness. The collected data were entered into Microsoft Excel, and responses were presented using tables and charts.ResultsA total of 104 respondents completed the survey. Among them, 37 (36%) reported that 61%-80% of their patients initially presented with advanced PCa. Additionally, 55 respondents (53%) were unaware of studies and guidelines regarding low-dose abiraterone. Furthermore, 66% of clinicians indicated that fewer than 20% of their patients could afford abiraterone, and 91 (87.5%) noted that few could afford enzalutamide. Moreover, 92 (89%) respondents believed that low-dose abiraterone would improve compliance, while 76% felt that reducing the enzalutamide dose would also enhance compliance and decrease patient costs. Sixty percent (58%) of respondents were willing to switch to low-dose abiraterone.ConclusionThe survey revealed limited awareness of landmark studies on dose-reduction strategies for abiraterone and enzalutamide. These strategies have the potential to enhance affordability and compliance in the management of advanced PCa in Nigeria.

PMID:41175049 | DOI:10.1177/10732748251390022

Int J Inj Contr Saf Promot. 2025 Nov 1:1-24. doi: 10.1080/17457300.2025.2572095. Online ahead of print.

ABSTRACT

Wearable systems for knee pathology detection and prosthetic control remain constrained by diagnostic limitations or rigid actuation. This study introduces an integrated two-phase framework combining non-invasive screening with adaptive prosthetic control. Phase 1 employs novel time-frequency features (Enhanced Mean Absolute Value/Enhanced Wavelength), achieving 94.7% abnormality detection accuracy via Extra Trees classifier, a + 3.16% improvement over conventional features, which is validated through 10-fold cross-validation and rigorous statistical testing (Friedman/Nemenyi, 95% confidence intervals). SHAP analysis yields clinician-interpretable thresholds (e.g. Semitendinosus EMAV > 0.3 mV). Phase 2 utilises multimodal fusion (EMG, FSR, IMU) to achieve 99.2% gait phase accuracy with XGBoost, enabling real-time health-adaptive prosthetic control that dynamically modulates: phase-transition timing (400 ms abnormal vs. 300 ms normal), EMG thresholds (0.15 mV vs. 0.10 mV), and motor gains (2.5× vs. 1.0×) based on pathology status. Validated in a LabVIEW-based control environment across variable terrains and speeds, this end-to-end diagnostics-to-control implementation delivers superior screening accuracy (>4.7% gain vs. deep learning) while enabling context-aware prosthetic adaptation, establishing a new paradigm for accessible musculoskeletal rehabilitation.

PMID:41175030 | DOI:10.1080/17457300.2025.2572095

Int J Methods Psychiatr Res. 2025 Dec;34(4):e70040. doi: 10.1002/mpr.70040.

ABSTRACT

OBJECTIVE: Estimate the psychometric properties of the interRAI Quality of Life for Mental Health and Addictions (interRAI QOL) instrument with users of Psychosocial Care Centers and participants of therapeutic groups in Primary Health Care, exploring age, gender, and service settings differences in quality of life.

METHOD: This quantitative study was conducted with 617 users from Psychosocial Care Centers and Primary Care services in two Brazilian states, Rio Grande do Sul and Rondônia. Data collection was carried out using the interRAI QOL. Confirmatory factor analysis and reliability assessment were performed using McDonald’s Omega index. Non-parametric tests, including Mann-Whitney and Kruskal-Wallis, were conducted to compare the Quality-of-Life dimensions among participants based on age, gender, and care unit.

RESULTS: The confirmatory factor analysis indicated a good fit for the hypothesized model (CFI = 0.97, RMSEA = 0.08). Reliability was adequate for all subscales according to McDonald’s Omega, ranging from 0.71 to 0.88. Gender differences were observed in the well-being and health dimensions, while all dimensions except support showed significant differences based on age group. The care unit location also revealed significant differences across all dimensions. Participants from Psychosocial Care Center Alcohol and Drugs and from Primary Health Care show better QOL profiles than in other settings and regions.

CONCLUSION: The interRAI QOL demonstrated adequate psychometric properties and proved to be a valuable new instrument for assessing quality of life among individuals receiving care in the psychosocial care network.

PMID:41175024 | DOI:10.1002/mpr.70040

Foot Ankle Spec. 2025 Nov 1:19386400251383440. doi: 10.1177/19386400251383440. Online ahead of print.

ABSTRACT

BackgroundThis study aims to analyze the effect of preoperative 5-factor modified frailty index (mFI-5) on 30-day complication, readmission, reoperation, and mortality rates following ankle fracture open reduction and internal fixation (ORIF).MethodsThe American College of Surgeons (ACS NSQIP) database was queried to identify 44 838 patients undergoing ankle fracture ORIF. Patients were stratified into groups based on preoperative mFI-5 scores.ResultsThe cohort was predominantly male (59.0%), and the mean age was 49.52 (range = 16-89) years. The mFI-5 score was statistically significantly predictive of any complication (P < .001), serious medical complication (P < .001), surgical site infection (P <.001), readmission (P <.001), reoperation (P <.001), mortality (P <.001), adverse discharge (P <.001), and increased hospital length of stay (LOS) (P <.001).ConclusionOur results indicate that mFI-5 score is a useful predictive measure for postoperative complications, adverse discharge, readmission, reoperation, mortality, and increased LOS in patients undergoing ankle fracture ORIF.Levels of Evidence:Level III, Retrospective cohort study.

PMID:41175018 | DOI:10.1177/19386400251383440

Ther Adv Respir Dis. 2025 Jan-Dec;19:17534666251390672. doi: 10.1177/17534666251390672. Epub 2025 Nov 1.

ABSTRACT

BACKGROUND: Interstitial lung disease (ILD) leads to progressive lung function decline and significant respiratory symptoms. Although antifibrotic agents preserve lung function and reduce mortality in ILD, their impact on health-related quality of life (HRQoL) remains unclear.

OBJECTIVES: We aimed to evaluate whether antifibrotic agents improve HRQoL and their effectiveness in treating HRQoL-related symptoms in patients with ILD.

DESIGN: Systematic review and meta-analysis.

DATA SOURCES AND METHODS: A literature search was conducted using MEDLINE, EMBASE, and the Cochrane Library from inception to August 25, 2025. The search included terms related to ILD, antifibrotic agents, and measures of HRQoL. HRQoL outcomes were assessed using the St. George’s Respiratory Questionnaire (SGRQ), including total and domain scores. Data were pooled using a random-effects model, with outcomes reported as mean differences (MD) or relative risks (RR) and heterogeneity evaluated using the I² statistic.

RESULTS: A total of 13 randomized controlled trials were included. Antifibrotic agents showed significant improvement in SGRQ scores, particularly in the symptom (MD: -2.59, 95% confidence interval [CI]: -4.56 to -0.61; I² = 32%) and activity (MD: -2.88, 95% CI: -4.82 to -0.94; I² = 34%) domains. Antifibrotics reduced the rate of cough (RR: 0.77, 95% CI: 0.64-0.94; I² = 0%) and dyspnea (RR: 0.71, 95% CI: 0.56 to 0.89; I² = 0%). However, fatigue was frequently observed in patients treated with antifibrotics (RR: 1.48, 95% CI: 1.20-1.83; I² = 0%) compared with the non-antifibrotic group. Most trials were judged to have low-to-moderate risk of bias, and the certainty of evidence was rated very low for total SGRQ scores but low to moderate for domain-specific outcomes and symptoms.

CONCLUSION: Antifibrotic agents may improve HRQoL and reduce dyspnea and cough in patients with ILD, but the certainty of evidence is low, and they may increase fatigue, requiring careful monitoring.Trial registration:The study protocol was registered in PROSPERO (CRD42023450917).

PMID:41174997 | DOI:10.1177/17534666251390672

Inquiry. 2025 Jan-Dec;62:469580251385397. doi: 10.1177/00469580251385397. Epub 2025 Nov 1.

ABSTRACT

Stroke is a leading cause of morbidity and disability, with limited data on in-hospital mortality from low-resource settings. This study aimed to identify predictors of in-hospital mortality among stroke patients at a tertiary care hospital in Nepal. A prospective cohort study was conducted among 120 stroke patients aged ≥ 18 years, enrolled between November 2023 and April 2024. The primary outcome was in-hospital mortality following admission. Data was analysed using SAS version 9.4. Kaplan-Meier survival analysis and Cox proportional hazards regression were employed to identify predictors of in-hospital mortality. A p-value < .05 was considered statistically significant. The cohort comprised 68.3% ischemic and 31.7% haemorrhagic strokes, with an overall in-hospital mortality rate of 9.0%. Multivariate analysis revealed that a Glasgow Coma (GCS) score < 8 (AHR: 12.36; 95% CI: 2.73-56.00), National Institutes of Health Stroke Scale (NIHSS) ≥12 (AHR: 14.75; 95% CI: 3.01-72.28), moderate to severe disability (mRS ≥ 3; AHR: 9.92; 95% CI: 1.10-89.24), hemiplegia (AHR: 6.70; 95% CI: 1.835-53.748), territorial infarcts (AHR: 26.33; 95% CI: 2.093-331.203), capsuloganglionic infarcts (AHR: 14.6; 95% CI: 1.819-160.877), presence of chronic obstructive pulmonary disease (COPD) (AHR: 2.48; 95% CI: 1.317-45.091), and alcohol use (AHR: 3.87; 95% CI: 1.014-18.478) were significant predictors of in-hospital mortality. Neurological impairment at admission, specific infarct locations, hemiplegia, COPD, and alcohol use are significant predictors of in-hospital mortality among stroke patients. These findings underscore the importance of early neurological assessment, systematic risk stratification, and targeted interventions to improve stroke outcomes in resource-constrained settings.

PMID:41174984 | DOI:10.1177/00469580251385397