Tag: nevin manimala

Support Care Cancer. 2025 Apr 26;33(5):424. doi: 10.1007/s00520-025-09481-y.

ABSTRACT

PURPOSE: Nonroutine discharge is associated with increased healthcare costs and higher readmission rates among surgical patients with spinal metastases. However, the factors influencing nonroutine discharge remain inadequately summarized, and related research is still in its early stages. This review aims to identify and analyze the risk factors associated with nonroutine discharge in these patients, with the goal of informing discharge planning.

METHODS: A scoping review was conducted following the framework established by Arksey and O’Malley. We systematically searched PubMed, Web of Science, and CINAHL for studies examining risk factors influencing nonroutine discharge in surgical patients with spinal metastases. Data extraction was performed independently by two researchers, with discrepancies resolved by a third reviewer.

RESULTS: Nine studies were included, which identified a range of factors influencing nonroutine discharge. These factors were categorized into three main domains: (1) sociodemographic factors (age, race, insurance status, marital status, and family member involvement), (2) disease-related factors (spinal cord injury grade, serum albumin level, body mass index, spinal surgery segment, type of surgery, preoperative functional dependency, ASA grade, emergency versus elective surgery, and activities of daily living at discharge), and (3) other factors (frailty index, comorbidity index, and the efficiency of the referral or discharge process).

CONCLUSION: The risk of nonroutine discharge in surgical patients with spinal metastases is influenced by sociodemographic, disease-related, and other factors. Early identification of patients at risk for nonroutine discharge is crucial for implementing a comprehensive, nurse-led discharge plan aimed at reducing hospital stay duration and minimizing related complications.

PMID:40285919 | DOI:10.1007/s00520-025-09481-y

Environ Monit Assess. 2025 Apr 26;197(5):600. doi: 10.1007/s10661-025-14049-8.

ABSTRACT

As an important crop in China, wheat serves as a crucial source of micronutrients and a potential vector for toxic elements in human diets. This study systematically collected wheat grains from 54 counties in Henan Province and conducted in vitro physiological extraction experiments to assess the bioavailability of Mn, Cu, Fe, and Cd in wheat samples. Results turned out that the bioavailability of Cd significantly decreased from the gastric to the intestinal stage. The bioavailability of Mn exhibited similar trends to Cd in the two phases, whereas Cu and Fe showed a higher bioaccessibility in the intestinal phase compared to the gastric phase. Correlation analysis revealed that higher total metal concentrations always resulted in a higher bioaccessible fraction, and the bioaccessibility of Cd was positively correlated with Mn and its bioaccessibility. Eventually, health risk to Cd from wheat consumption evaluated by Monte Carlo simulation indicated that children exhibited a heightened vulnerability to health risks in comparison to adults and risks could be decreased significantly by introducing bioaccessibility. Consequently, it is evident that refining the relationship between bioaccessibility and biotoxicity of elements could provide the methodology to accurately and efficiently assess human health risks.

PMID:40285907 | DOI:10.1007/s10661-025-14049-8

Ecotoxicology. 2025 Apr 26. doi: 10.1007/s10646-025-02889-6. Online ahead of print.

ABSTRACT

In Europe, the risk assessment of pesticides to soils organisms is based on standardized laboratory toxicity tests using artificial soil containing kaolin clay. However, kaolin is not the most representative clay type for European agricultural soils, and its use may affect the bioavailability and toxicity of pesticides, potentially leading to an underestimation of the actual risk to soil organisms. In this study, reproduction toxicity tests with the earthworm Eisenia andrei following OECD guideline 222 were performed in artificial soils prepared with kaolin or bentonite clay, using the pesticides carbendazim and imidacloprid. The results showed that the OECD guideline 222 quality criteria could be met in soils prepared with bentonite clay. EC₅₀ reproduction values (and 95% CIs) in soils prepared with kaolin and bentonite clay were 1.80 (1.02-2.57) and 4.19 (-10.4-18.8) mg kg^-1 for carbendazim, and 0.71 (0.06-1.36) and 2.27 (-0.26-4.80) mg kg^-1 for imidacloprid. For both pesticides, toxicity (LCx, ECx biomass, ECx reproduction) was higher in soils prepared with kaolin clay, although the differences were not always statistically significant. Differences in toxicity between the soils were likely due to a combination of the bentonite’s larger interlayer distance, providing space for the pesticides to enter in between the clay sheets, and the higher cation exchange capacity (7.30 and 22.8 cmol_c kg^-1 for kaolin and bentonite soil, respectively) leading to increased pesticide sorption. Overall, these findings suggest that kaolin is a suitable clay type for standardized artificial soil, as it exhibited the highest toxicity, and thus provided a “worst-case” scenario.

PMID:40285899 | DOI:10.1007/s10646-025-02889-6

Eur J Orthop Surg Traumatol. 2025 Apr 26;35(1):169. doi: 10.1007/s00590-025-04262-z.

ABSTRACT

BACKGROUND: The burden of orthopedic admissions has notably increased in recent years. Managing orthopedic conditions is challenging in clinical settings. Orthopedic complaints often necessitate urgent medical intervention to prevent complications and mortality. Despite advancements in medical care, some patients still experience severe complications, extended hospital stays, and death following orthopedic admission. In this study, we aimed to explore the distribution of potential risk factors and common patterns in orthopedic patients who died during their hospitalization.

MATERIALS AND METHODS: All the patients who were admitted to three tertiary trauma centers with orthopedic complaints from 2010 to 2023 and died during hospitalization were enrolled in this study. Demographic, injury-related, laboratory-related, intervention-related, complication-related, and healthcare-related data were extracted using the patient’s medical records. Descriptive analysis of the collected data was performed using the SPSS version 27 software.

RESULTS: 333 patients who died in the hospital with orthopedic complaints were included in the study and examined. The mean age of patients in this study was 67.89 years, comprising 68% males and 32% females. Trauma was patients’ most common clinical cause of admission (63.7%). The prevalence of death before surgery, death during the first 24 h after surgery, and death after 24 h postoperatively were 26.4%, 18.6%, and 55%, respectively.

CONCLUSIONS: Our findings suggest a high prevalence of trauma as a clinical complaint leading to death among patients, emphasizing the importance of developing an integrated protocol for trauma preventive strategies.

PMID:40285897 | DOI:10.1007/s00590-025-04262-z

Rheumatol Int. 2025 Apr 26;45(5):126. doi: 10.1007/s00296-025-05885-5.

ABSTRACT

Despite growing female participation in the workforce, gender disparities persist across sectors. Little is known about how these manifest in academic rheumatology in Argentina. To analyze recently published rheumatology research by Argentine authors from a gender perspective. A bibliometric analysis was conducted on rheumatology publications from 2018 to 2022 in the Argentine Journal of Rheumatology (AJR) and PubMed-indexed journals that included at least one Argentine author. Argentine authors were classified by gender, and authorship roles (overall, first, and corresponding authors) were assessed, along with pharmaceutical industry conflicts of interest (COIs). Of 130 AJR articles (1183 Argentine authors), 61.8% were women. In 440 PubMed-indexed articles (1957 Argentine authors), 55.2% were women. Women were more frequently first authors in both AJR and PubMed (67.7% vs. 58.4%; p = 0.13), but less often corresponding authors in PubMed (44%) than in AJR (60%; p = 0.02). In AJR, female authors had a higher median number per article (3, Interquartile range or IQR 2-6) than male authors (2, IQR 1-4; p = 0.002). In PubMed, male authors showed slightly greater median participation (1, IQR 1-2 vs. 1, IQR 0-2; p = 0.02). In industry-sponsored studies, only 28.1% of authors were women. In COI-declaring publications, 71.0% listed only male disclosures; of 153 total reports, just 26.8% were by women. Although women are the majority in Argentine rheumatology research, they remain underrepresented in leadership roles and industry-funded studies. Continued monitoring of gender and COI data is needed.

PMID:40285893 | DOI:10.1007/s00296-025-05885-5

Neurosurg Rev. 2025 Apr 26;48(1):389. doi: 10.1007/s10143-025-03509-x.

ABSTRACT

The number of spinal surgeries, including decompression and fusion procedures, has increased significantly. Despite the potential benefits, these surgeries can result in substantial blood loss, requiring perioperative blood transfusions. However, transfusions can pose risks, such as infections and thromboembolic events. This study aimed to compare the outcomes between transfusion and non-transfusion groups in spinal surgery patients, focusing on infection rates, DVT, mortality, and other complications. A systematic search was conducted across PubMed, Medline, Embase, and Scopus from inception to April 1, 2024, yielding 15 studies involving a total of 60,920 patients. These studies focused on adult patients undergoing spinal surgery for conditions such as tumors, trauma, infection, or congenital diseases, comparing those who received blood transfusions (PRBC, FFP, platelets, and allogeneic blood transfusions) to those who did not. Eligible studies reported outcomes such as mortality, ischemic events, surgery duration, pulmonary embolism, surgical site infections (SSI), and urinary tract infections (UTI). Statistical analysis was conducted using Comprehensive Meta-Analysis Version 3.3, applying a random-effects model. Outcomes were expressed as odds ratios (OR) for dichotomous variables and standard differences in means for continuous outcomes. The quality of studies was assessed using the Newcastle-Ottawa quality assessment scale. Heterogeneity was evaluated using I² statistics, and publication bias was assessed using funnel plots. Results indicated no significant difference in surgery duration between transfusion and non-transfusion groups. However, patients receiving transfusions experienced longer hospital stays (SMD: 1.462, p = 0.021) and higher odds of complications (OR: 3.11, p < 0.001). Moreover, the transfusion group exhibited elevated odds of mortality (OR: 3.96, p < 0.001), ischemic events (OR: 3.527, p < 0.001), respiratory complications (OR: 4.18, p < 0.001), renal complications (OR: 2.43, p < 0.001), pulmonary embolism (OR: 2.67, p = 0.012), deep vein thrombosis (OR: 2.737, p < 0.001), and thrombotic complications (OR: 5.232, p < 0.001). Additionally, the transfusion group had higher odds of surgical site infection (OR: 1.951, p < 0.001), while the non-transfusion group had decreased odds of urinary tract infection (OR: 2.960, p < 0.001). No significant difference was observed in respiratory tract infection (OR: 1.936, p = 0.09). Patients receiving blood transfusions had significantly higher odds of complications, including mortality, ischemic events, and thrombotic issues, as well as longer hospital stays. However, no significant difference was found in surgery duration between the transfusion and non-transfusion groups.

PMID:40285887 | DOI:10.1007/s10143-025-03509-x

Invest Radiol. 2025 Apr 25. doi: 10.1097/RLI.0000000000001198. Online ahead of print.

ABSTRACT

OBJECTIVES: In cardiac amyloidosis (CA) protein misfolding and consecutive storage into the extracellular myocardial compartment causes left ventricular hypertrophy and, in later stages of the disease, heart failure. The aim of this study was to compare extracellular volume (ECV) measurements obtained from photon-counting CT (PCCT) to the imaging reference cardiac magnetic resonance imaging (CMR) and to evaluate coronary artery disease (CAD) in a CA cohort.

MATERIALS AND METHODS: Thirty CA patients (mean age 77.5 +/- 7.9 years) underwent clinically indicated coronary CT angiography (CCTA) for the evaluation of CAD on a first-generation PCCT including a late-phase scan for assessment of ECV. ECV in PCCT was derived using 2 different techniques: (I) a single-energy (SE) technique, based on attenuation changes between the precontrast calcium scoring scan and delayed CCTA in the equilibrium phase (II) a dual-energy (DE) technique, based on iodine density maps from the delayed scan. Both methods were compared with CMR-derived ECV. Statistical analysis included repeated-measures analysis of variance (RM-ANOVA) with Bonferroni-adjusted pairwise comparisons. Correlations between methods were assessed using Pearson’s correlation coefficient, and agreement was evaluated using Bland-Altman analysis.

RESULTS: CMR exhibited the highest mean ECV value (42.93 ± 10.14), followed by the SE method (42.5 ± 9.1), while the DE method yielded the lowest ECV values (40.7 ± 9.2). When compared with CMR, ECV obtained via the DE method was significantly lower (MDiff = -2.24, P = 0.04). In contrast, no significant difference was observed between CMR and the SE method (MDiff = 0.43, P = 1.00). Differences between the DE and SE methods were significant (MDiff = -1.82, P < 0.001). Despite these differences, all 3 methods demonstrated excellent positive correlations. The strongest correlation was observed between the DE and SE methods (r = 0.98, P < 0.001), indicating high consistency in their measurements. Comparatively, the correlation between CMR and DE (r = 0.892, P < 0.001) was slightly stronger than that between CMR and SE methods (r = 0.882, P < 0.001). CAD was present in 29 (97.0%) CA patients with a mean Agatston score of 1086 ± 1398 (range 0-6848.5). Despite this high mean plaque burden and 14 (47.6%) patients presenting with atrial fibrillation, image quality was preserved in 29 (97.0%) patients with 17 (57.6%) of the patients having nonobstructive CAD.

CONCLUSIONS: Compared to the imaging reference standard CMR, ECV derived from the DE and SE methods via PCCT demonstrated excellent positive correlations with CMR. The DE method exhibited minor differences compared to CMR, which were clinically not relevant. CAD with an extensive burden of calcified plaque was highly prevalent in CA; however, 57.6% of patients presented with nonobstructive CAD. Therefore, PCCT is a valuable tool for imaging both the coronary arteries and myocardial structure in CA.

PMID:40279664 | DOI:10.1097/RLI.0000000000001198

Med Sci Sports Exerc. 2025 Apr 25. doi: 10.1249/MSS.0000000000003742. Online ahead of print.

ABSTRACT

PURPOSE: We aimed to develop and validate a risk-assessment tool for energy deficiency in young exercising women using disordered eating subscales and self-reported health-related information.

METHODS: We retrospectively analyzed 7 studies in competitive and recreationally active women [n = 202, age 21.7 ± 0.3 years, body mass index (BMI) 21.21 ± 0.14 kg/m2, (mean ± SEM)]. Participants completed the Health, Exercise and Nutrition Survey (HENS), the Three-Factor Eating Questionnaire (TFEQ), and the Eating Disorder Inventory-3 (EDI-3). Energy deficiency was defined as fasting serum total triiodothyronine (TT3) <73.2 ng/dL. A cut-off of TT3 < 80 ng/dL was also tested. Potential predictors of energy deficiency were: age of menarche, gynecological age, disordered eating, menstrual status, and bone health items (HENS); dietary cognitive restraint (TFEQ); and Perfectionism, Body Dissatisfaction, and Drive for Thinness (EDI-3). A model set (n = 152; 21.8 ± 0.3 years, 21.23 ± 0.16 kg/m2) was used to select predictors, identify interaction terms, and fit 500 random iterations of stepwise logistic regression. Predictors included in ≥450 models were used in a final model and tested on a validation set (n = 50; 21.6 ± 0.4 years, 21.15 ± 0.3 kg/m2).

RESULTS: The final model included BMI; number of menstrual cycles in the last 6 months, dietary cognitive restraint, and body dissatisfaction index. The FED-Q coefficient detected TT3 < 73.2 ng/dL with 84.2% sensitivity, 80.6% specificity, and 82% accuracy, and TT3 < 80 ng/dL with 85% sensitivity, 83.3% specificity, and 84% accuracy.

CONCLUSIONS: At present, the Female Energy Deficiency Questionnaire is the only questionnaire that is specifically designed as an indicator of energy deficiency in female athletes across a variety of sports.

PMID:40279653 | DOI:10.1249/MSS.0000000000003742

J Med Internet Res. 2025 Apr 25;27:e59085. doi: 10.2196/59085.

ABSTRACT

BACKGROUND: Motivational interviewing (MI) is frequently used to facilitate behavior change. The use of change talk during motivational interviews can predict subsequent behavior change. However, no studies have compared the information obtained from traditional face-to-face motivational interviews and computer-mediated motivational interviews or resulted in the same amount of behavior change.

OBJECTIVE: This study aimed to investigate if face-to-face motivational-type interviews (MTIs) and computer-mediated MTIs elicit the same amount of “change talk” and behavior change when young adults discuss their ambivalence about using marijuana.

METHODS: A total of 150 users, including frequent marijuana users, occasional marijuana users, and non-marijuana users, participated in the study. All participants reported being at least moderately ambivalent about their current level of marijuana use. Participants were randomly assigned to complete a brief MTI using either the standard face-to-face format or a computer-mediated format. Amrhein’s manual for assessing the presence of “change talk” and “sustain talk” was used to code the language produced by respondents in each interview format. A reduction in marijuana use was assessed at a 2-month follow-up.

RESULTS: The word count was significantly higher in face-to-face MTIs compared with computer-mediated MTIs (P<.001). After controlling for verbosity, face-to-face MTIs, and computer-mediated MTIs did not differ statistically in the overall amount of change talk (P=.47) and sustain talk (P=.05). Face-to-face MTIs elicited significantly more reasons for reducing future marijuana use (ie, change talk; P=.02) and readiness toward not using marijuana (ie, change talk; P=.009), even after controlling for verbosity. However, these differences were not statistically significant after using a conservative Bonferroni correction (P<.004). After controlling for marijuana use at Time 1, the relationship between the strength of commitment language at Time 1 and marijuana use at Time 2 was not statistically significant (semipartial correlation r=0.03, P=.57). The association between Time 1 change talk and Time 2 marijuana use depended on the type of motivational interview that participants experienced: face-to-face MTI versus computer-mediated MTI (B=0.45, P=.01). A negative binomial regression with a log link function was used to probe this relationship after controlling for 2 covariates: gender and Time 1 (baseline assessment) marijuana use. Among participants in the face-to-face MTI condition, Time 2 (follow-up) marijuana use decreased as the strength of Time 1 change talk increased, although this finding was not significant (B=-0.21, P=.08). However, among participants in the computer-mediated MTI condition, Time 2 marijuana use was not significantly related to the strength of Time 1 change talk (B=0.13, P=.16).

CONCLUSIONS: Computer-mediated MTIs and face-to-face MTIs elicit both change talk and sustain talk, which suggests that motivational interviews could potentially be adapted for delivery via text-based computer platforms. However, further research is needed to enhance the predictive validity of the type of language obtained via computer-delivered MI.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06945471; https://clinicaltrials.gov/study/NCT06945471.

PMID:40279644 | DOI:10.2196/59085