Tag: nevin manimala

J Child Neurol. 2025 Apr 23:8830738251330110. doi: 10.1177/08830738251330110. Online ahead of print.

ABSTRACT

Evidence to guide the critical care management of children with ruptured brain arteriovenous malformations is lacking. We aimed to determine whether there are associations between physiologic parameters and outcome in children with ruptured brain arteriovenous malformations. We performed a single-center retrospective review of patients ≤18 years of age with a ruptured brain arteriovenous malformation from 2011 to 2023. Categorization of outcome was based on the Pediatric Stroke Outcome Measure. Descriptive statistics were used. Most patients with an arteriovenous malformation rupture had a poor outcome at discharge (31/49, 63%) and in follow-up at 3-12 months (21/37, 57%). Patients who were normothermic and normoglycemic for the first 7 days after arteriovenous malformation rupture were less likely to have a poor outcome at discharge than those who had a temperature ≥38 °C (odds ratio [OR] 0.14, 95% confidence interval [CI] 0.04-0.52; P = .01) or a blood glucose ≥200 mg/dL (OR 0.11, 95% CI 0.01-0.92; P = .04). A lower minimum hemoglobin concentration (10.00 g/dL [standard deviation (SD) 1.67] vs 12.46 g/dL [SD 6.29], t(47) 2.07, P = .04) and a higher average partial pressure of carbon dioxide (Paco₂) (40.98 mm Hg [SD 4.30] vs 35.58 mm Hg [SD 7.72], t(47) -2.09, P = .046) were also associated with a poor discharge outcome. A higher average maximum temperature was associated with a poor outcome in follow-up (37.46° C [SD 0.49] vs 37.09 °C [SD 0.59], t(47) -2.09; P = .04). Temperature, blood glucose, hemoglobin concentration, and Paco₂ are potentially modifiable parameters that could be targeted by quality improvement interventions to improve outcomes in this population.

PMID:40266567 | DOI:10.1177/08830738251330110

Mol Neurobiol. 2025 Apr 23. doi: 10.1007/s12035-025-04967-6. Online ahead of print.

ABSTRACT

Due to progressive cognitive loss and subsequent incapability of daily life, the development of novel therapeutics is urgently needed for dementia patients. We performed a two-sample bi-directional Mendelian randomization (MR) analysis using summary-level statistics to identify causality between peripheral and cerebrospinal fluid (CSF) proteins and the risk of dementia. Genetic variants were subtracted from the Genome-Wide Association Studies (GWAS) results. Wald ratio (WR) and inverse-variance weighted (IVW) ratio were utilized to estimate the causal effects of plasma and CSF proteins on dementia. Reverse MR, Steiger filtering, Bayesian co-localization phenotype scanning, and external validation were integrated to strengthen the robustness of primary MR results. After sensitivity analysis, six circulating proteins were identified in three dementia classifications, whereas no causality was found in frontotemporal dementia (FTD). Elevated levels of circulating C1R protein increased the odds of developing Alzheimer’s disease (AD), while PILRA and CELA2A were estimated to protect against the pathogenesis of AD; genetically predicted increase of α-synuclein and APOE elevated the occurrence of Dementia of Lewy Bodies (DLB); elevated level of circulating CRP was assessed to increase the onset of vascular dementia (VD). Our MR analyses identified a genetically predicted association between circulating C1R, PILRA, and CELA2A and the risk of AD, causal estimates between α-syn, APOE protein, and the onset of DLB, and a robust correlation between CRP and the etiology of VD. This study might guide the discovery of disease etiology and build up a novel disease-modifying paradigm of dementia.

PMID:40266545 | DOI:10.1007/s12035-025-04967-6

Int J Clin Pharm. 2025 Apr 23. doi: 10.1007/s11096-025-01915-1. Online ahead of print.

ABSTRACT

BACKGROUND: Antiseizure medications, particularly gabapentinoids like pregabalin, are increasingly prescribed for pain management. Despite their growing use, evidence of their effectiveness for pain is mixed. This highlights the need for a clearer understanding of the prevalence and prescribing patterns of antiseizure medications in pain management.

AIM: To investigate the initiation of antiseizure medications in people with and without pain or epilepsy diagnoses and to explore the concurrent use of opioids.

METHOD: This cross-sectional study used deidentified primary care data from 542 general practices in Victoria, Australia. Descriptive statistics were used to analyze antiseizure medication prevalence, concurrent opioid use, and prescribing patterns by age and gender.

RESULTS: We identified 171,619 primary care patients who initiated an antiseizure medication between January 1, 2018, and May 31, 2023, among whom 80.1% had pain without epilepsy. Pregabalin was the most commonly prescribed medicine (58.2%), followed by sodium valproate (7.0%), gabapentin (6.9%), and clonazepam (6.7%). Among younger patients (14-49 years old) with an epilepsy diagnosis, women were twice as likely as men to initiate topiramate (6.5% vs 4.4%) and lamotrigine (21.8% vs 11.4%), while men were more commonly initiated with sodium valproate (38.7% vs 18.9%).

CONCLUSION: Given the widespread off-label use of gabapentinoids and the potential for serious harm, further research is warranted to better understand their clinical and safety outcomes.

PMID:40266531 | DOI:10.1007/s11096-025-01915-1

Brain Imaging Behav. 2025 Apr 23. doi: 10.1007/s11682-025-01006-9. Online ahead of print.

ABSTRACT

Cognitive dysmetria suggests a disorganization of cognitive processes, particularly in relation to the cerebellum’s role in coordinating thoughts and actions. This phenomenon has been extensively studied in various psychiatric disorders, including schizophrenia (SCHZ), bipolar disorder II (BIPOL), and attention-deficit/hyperactivity disorder (ADHD). Understanding the relationship between cognitive dysmetria and functional connectivity in these disorders would reveal significant insights into their neurobiological underpinnings. This study explores how distinct and similar functional network connectivity (FNC) patterns between brain regions are associated with clinical symptoms and trait assessments across SCHZ, BIPOL, and ADHD patients by examining both working memory and task-free conditions compared to healthy volunteers (HC). Leveraging an open-source fMRI dataset from the UCLA Consortium for Neuropsychiatric Phenomics, we analyzed FNC patterns across 115 default mode and salience network regions, including cortical, subcortical, and cerebellar regions of interest in 135 participants (39 HC, 27 SCHZ patients, 38 BIPOL patients, and 31 ADHD patients). Abnormal FNC patterns compared to HC were localized to the cerebellar, thalamic, striatal, hippocampal, medial prefrontal and anterior insular cortices. Post-hoc multiple comparison analysis showed abnormal network connectivity predominantly in SCHZ and ADHD patients during rest, while the task condition demonstrated differential effects across all three disorders. Statistical analysis using a factor-by-covariance approach (GLM MANCOVA) suggested that regional functional connectivity was associated with select symptoms and traits pointing to neural signatures underlying psychiatric conditions. Our study suggests that examining and harnessing dysfunctional relationships in subcortical and cerebellar regions could provide a new perspective on the neurobiological basis of psychoses and help improve available treatment strategies.

PMID:40266512 | DOI:10.1007/s11682-025-01006-9

J Thromb Thrombolysis. 2025 Apr 23. doi: 10.1007/s11239-025-03087-1. Online ahead of print.

ABSTRACT

Although prior research has investigated the link between fibrinogen and mortality risk, there is a notable lack of long-term cohort studies. This study seeks to examine the relationship between plasma fibrinogen levels and all-cause mortality. Fibrinogen levels were divided into low and high groups based on the median and further categorized into quartiles. Kaplan-Meier analysis was employed for survival analysis, and hazard ratios (HRs) were calculated using the Cox proportional hazards model. Our study included 5,690 participants, divided into a lower fibrinogen group (fibrinogen ≤ 370 mg/dL, N = 2,851) and a higher fibrinogen group (fibrinogen > 370 mg/dL, N = 2,839). The survival probability of the lower fibrinogen group was higher than that of the higher group (70.98% vs. 47.98%, P < 0.0001). All-cause mortality was higher in the higher fibrinogen group compared to the low fibrinogen group (HR 1.26, 95% CI 1.09-1.45, P = 0.002). Compared to Q1, mortality risk increased in Q2 (HR 1.26, 95% CI 1.00-1.59, P = 0.05), Q3 (HR 1.39, 95% CI 1.15-1.69, P < 0.001), and Q4 (HR 1.51, 95% CI 1.23-1.87, P < 0.001). Higher fibrinogen levels correlate with an elevated risk of all-cause mortality, suggesting fibrinogen is a potential biomarker for mortality risk.

PMID:40266502 | DOI:10.1007/s11239-025-03087-1

Intern Emerg Med. 2025 Apr 23. doi: 10.1007/s11739-025-03947-x. Online ahead of print.

ABSTRACT

This study aims to investigate the effects of virtual reality (VR) interventions on the state anxiety levels of residents working 24-h shifts in an emergency department. This study utilizes a single-center, simulation-based, quasi-experimental design. In the study’s first phase, participants’ anxiety levels were measured using the STAI-I scale during their shifts, between 7:00 PM and 10:00 PM (Pre-Rest) and after a 10-min rest, a second measurement was performed (Post-Rest). In the second phase, anxiety levels were measured during the same time interval in their next shift (pre-VR), followed by another evaluation after 10 min of using a VR headset (Post-VR). The effects of rest and VR use on state anxiety levels compared. A total of 26 emergency medicine residents participated in the study. The mean age of the participants was 29 ± 2.6 years, with an equal gender distribution. The median pre-rest anxiety score was 46 (28-68), while the post-rest median was 43 (22-62), with a statistically significant difference (p = 0.02). The median anxiety score before VR use was 47 (25-73), and after VR use, it decreased to 30 (20-73), which was significant (p = 0.001). When comparing the changes in anxiety levels after rest and VR use, the median Δanxiety rest was 4.5 (- 17-25), whereas the median Δanxiety VR was 11.5 (- 21-47) (p = 0.017). Based on our study’s results, a 10-min VR session during a 24-h shift reduces emergency physicians’ state anxiety levels and is more effective than a rest break.

PMID:40266498 | DOI:10.1007/s11739-025-03947-x

Integr Psychol Behav Sci. 2025 Apr 23;59(2):43. doi: 10.1007/s12124-025-09908-5.

ABSTRACT

In this article, a new approach to outlier analysis in categorical data is proposed. Standard outlier analysis defines outliers in terms of such data characteristics as mutual distances or correlations among data points. This applies to the analysis of continuous and categorical data, and to univariate and multivariate outlier analysis as well as to data mining. In this article, a new specification of outlying data points is proposed, specifically, it is proposed to define outliers as data points that are extreme with respect to substantive hypotheses. It is also proposed to perform two forms of outlier analysis of the same data. The first is standard outlier analysis that inspects data characteristics. The second is Configural Frequency Analysis (CFA). This method defines outliers as extreme cells that contradict a substantive null hypothesis, the CFA base model. A data example is given, in which, first, outliers are identified using cluster analysis (unsupervised classification). Subsequently, the data are analyzed with CFA (supervised classification). Results show that outliers that were identified under unsupervised classification have the potential of distorting results of supervised classification. The mutual relations of unsupervised and supervised classification, both performed on the same data, are discussed. Configural Frequency Analysis and outlier analysis.

PMID:40266496 | DOI:10.1007/s12124-025-09908-5

Am J Mens Health. 2025 Mar-Apr;19(2):15579883251332732. doi: 10.1177/15579883251332732. Epub 2025 Apr 23.

ABSTRACT

Physical activity is associated with cancer of the male genitalia. However, the genetic causality of this association remains unclear. In this study, Mendelian randomization (MR) was used to explore the potential causal relationship between different intensities of physical activity and cancer of the male genitalia. This study utilized single nucleotide polymorphisms (SNPs) associated with vigorous exercise obtained from published genome-wide association studies (GWAS) and summary genetic data associated with male genital cancer from published GWAS. The main analysis method used was the inverse variance weighted (IVW) method for two-sample MR analysis. The heterogeneity of the results was assessed using Cochran’s Q statistic, while horizontal pleiotropy was assessed using MR-Egger. Sensitivity analysis included a “leave-one-out” test. The results showed that light DIY activity was a risk factor for male genital cancer (OR = 1.045, 95% confidence interval [1.004, 1.089], p = .033). The result passed the sensitivity test. This study found the effect of light DIY activities on male genital cancer. Future studies should further explore the impact of different types of physical activity on specific types of male genital cancer to improve relevant prevention strategies.

PMID:40265237 | DOI:10.1177/15579883251332732

J Health Psychol. 2025 Apr 23:13591053251333950. doi: 10.1177/13591053251333950. Online ahead of print.

ABSTRACT

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that imposes significant life impairment. Smoking is an addictive and potentially exacerbating behavior that may be important to IBS, but the psychological factors linking IBS and smoking remain underexplored. This study aims to investigate gastrointestinal-specific anxiety (GI-specific anxiety) in relation to smoking processes among adults with IBS who smoke. The sample consisted of 263 adults who met the criteria for IBS and reported smoking at least 5 cigarettes per day for the past year (Mean age = 44.1 years, SD = 12.71, 52.1% female). Hierarchical regression results indicated that higher GI-specific anxiety was statistically significantly associated with greater perceived barriers for smoking cessation, increased negative affect reduction smoking expectancies, and stronger urges to smoke for relief of negative affect. The present investigation found that GI-specific anxiety is an important construct informing smoking among individuals with IBS. Future research considerations are explored.

PMID:40265221 | DOI:10.1177/13591053251333950

Int Wound J. 2025 Apr;22(4):e70670. doi: 10.1111/iwj.70670.

ABSTRACT

Q. Guo, W. Li, R. Xie, Y. Wang, Y. Xie, K. Cheng, and Z. Sun, “Visualization of the Relationship Between Macrophage and Wound Healing From the Perspective of Bibliometric Analysis,” International Wound Journal 21, no. 4 (2024): e14597, https://doi.org/10.1111/iwj.14597. The above article, published online on 20 December 2023, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons Ltd. Following an investigation by the publisher, all parties have concluded that this article was accepted on the basis of a compromised peer review process. In addition, further investigation by the publisher found that this article is missing the underlying dataset, which contradicts the Data Availability Statement. The investigation found that the Methods and Results included irrelevant citations or otherwise lacked proper citations, which leaves large sections of the statements made unsubstantiated by the academic literature. Lastly, the investigation found that the statistical analysis was incomplete. The editors have therefore decided to retract the article. The authors did not respond to our notice regarding the retraction.

PMID:40265216 | DOI:10.1111/iwj.70670