Tag: nevin manimala

Endocr Regul. 2025 Apr 21;59(1):42-47. doi: 10.2478/enr-2025-0006. Print 2025 Jan 1.

ABSTRACT

Objective. In this retrospective observational study, we aimed to evaluate the impact of insulin degludec/insulin aspart (IDegAsp) treatment on glycemic status, metabolic parameters, and weight/body mass index (BMI) change at a single tertiary diabetes center in Turkey. Methods. We conducted a retrospective cohort study of patients with type 2 diabetes who received IDegAsp treatment between October 2018 and November 2019 at the diabetes outpatient clinic. The patients who had inadequate responses (HbA1c ≥8%) to at least 3 months of experienced insulin (± oral antidiabetic drug [OAD]) treatment were included into the study. Results. One hundred patients (61% females) with a mean age of 61.7±10.0 years (range; 39-88 years) were analyzed. Mean fasting plasma glucose and HbA1c levels decreased by 3rd, 6th, 9th, and 12th months (p=0.010, p=0.007, p=0.027, and p=0.090, respectively and p<0.001, p<0.001, p<0.001, and p=0.001, respectively). Mean body weight and BMI values increased in the 3rd (83.1±15.6 kg and 31.6±5.7 kg/m2, repecitvely) and 6th (87.0±15.4 kg and 32.3±5.3 kg/m2, resepctively) months, although the changes were not statistically significant (p=0.10 and p=0.08, respectively). However, mean body weight returned to baseline levels by the 9th (80.8±17.0 kg and 30.5±6.4 kg/m2, respectively) and 12th (79.5±13.5 kg and 30.5±5.7 kg/m2, respectively) months (p=0.074 and p=0.400, respectively). Conclusions. IDegAsp can provide a significant decrease in HbA1c in a real-life setting. Although weight gain was observed in the first months of the treatment, this effect disappeared over time and decreased to the baseline levels.

PMID:40258224 | DOI:10.2478/enr-2025-0006

Endocr Regul. 2025 Apr 21;59(1):33-41. doi: 10.2478/enr-2025-0005. Print 2025 Jan 1.

ABSTRACT

Objective. Polycystic ovary syndrome (PCOS) is one of the commonest endocrinopathies in women characterized by hyperandrogenism, ovulatory dysfunction, and insulin resistance affecting 5-20% of reproductive-aged women worldwide. Recent studies have emphasized the role of the fat mass and obesity-associated (FTO) gene in the development of PCOS, specifically the rs9939609 A/T polymorphism, which is linked to an increased risk of PCOS. The study aimed to investigate the levels of FTO protein and its association with luteinizing hormone (LH), follicle-stimulating hormone (FSH) and anthropometric parameters in patients with PCOS compared to healthy controls. Materials. A total of 298 women, comprising 149 patients and 149 healthy controls, enrolled in the study. Anthropometric parameters (body mass index, BMI; waist circumference, WC; hip circumference, HC; waist-to-hip ratio, WHR), and hormonal assays (LH, FSH, LH/FSH ratio) were performed. FTO protein levels were measured by ELISA kit and their association with these parameters was analyzed. A receiver operator characteristic (ROC) curve analysis was performed to evaluate the discriminatory power of FTO protein levels in distinguishing PCOS cases and controls. A value p<0.05 was considered statistically significant. Results. FTO protein levels were significantly elevated in PCOS women with increased BMI, WC, HC, and WHR (p=<0.05). The mean of BMI showed a positive correlation with both WC (r=0.367, p<0.001) and HC (r=0.395, p<0.001). WC strongly correlated with HC (r=0.780, p<0.001) and WHR (r=0.465, p<0.001). LH significantly correlated with FSH (r=0.543, p<.001), and LH/FSH (r=0.553, p<.001). FTO protein showed a positive correlation with LH (r=0.364, p<0.001), and FSH (r=0.166, p<0.001). Additionally, a negative correlation of FTO protein with BMI (r=-0.190, p<0.05), WC (r=-0.277, p<0.05), and WHR (r=-0.408 p<0.001) was observed. The levels of FTO protein were significantly higher in PCOS patients compared to controls. Significant correlations were also found between FTO protein levels and the anthropometric or hormonal parameters. The AUC for FTO protein levels was 0.624 (p=0.550), indicating moderate discriminatory power, but lacking statistical significance. Conclusion. The study found that FTO protein levels are significantly higher in PCOS women correlating with anthropometric and hormonal parameters (increased LH, decreased FSH). This highlights potential involvement of FTO protein in the hormonal and metabolic disturbances characteristics of the syndrome indicating its biomarker character for the condition.

PMID:40258223 | DOI:10.2478/enr-2025-0005

PLoS Comput Biol. 2025 Apr 21;21(4):e1012990. doi: 10.1371/journal.pcbi.1012990. Online ahead of print.

ABSTRACT

The central nervous system can generate various behaviors, including motor responses, which we can observe through video recordings. Recent advances in gene manipulation, automated behavioral acquisition at scale, and machine learning enable us to causally link behaviors to their underlying neural mechanisms. Moreover, in some animals, such as the Drosophila melanogaster larva, this mapping is possible at the unprecedented scale of single neurons, allowing us to identify the neural microcircuits generating particular behaviors. These high-throughput screening efforts, linking the activation or suppression of specific neurons to behavioral patterns in millions of animals, provide a rich dataset to explore the diversity of nervous system responses to the same stimuli. However, important challenges remain in identifying subtle behaviors, including immediate and delayed responses to neural activation or suppression, and understanding these behaviors on a large scale. We here introduce several statistically robust methods for analyzing behavioral data in response to these challenges: 1) A generative physical model that regularizes the inference of larval shapes across the entire dataset. 2) An unsupervised kernel-based method for statistical testing in learned behavioral spaces aimed at detecting subtle deviations in behavior. 3) A generative model for larval behavioral sequences, providing a benchmark for identifying higher-order behavioral changes. 4) A comprehensive analysis technique using suffix trees to categorize genetic lines into clusters based on common action sequences. We showcase these methodologies through a behavioral screen focused on responses to an air puff, analyzing data from 280 716 larvae across 569 genetic lines.

PMID:40258220 | DOI:10.1371/journal.pcbi.1012990

Res Gerontol Nurs. 2025 Apr 23:1-12. doi: 10.3928/19404921-20250416-01. Online ahead of print.

ABSTRACT

PURPOSE: To describe characteristics and outcomes of family caregivers for persons with Parkinson’s disease and Lewy body dementia (PD/LBD) and compare them to those of other family caregivers.

METHOD: Using a California statewide database, we examined caregiver characteristics and outcomes (strain, loneliness, worse health, and depressive symptoms) and compared them by care recipient diagnosis (PD/LBD, Alzheimer’s disease and related dementias, or other chronic conditions) using descriptive statistics and multivariable logistic regression.

RESULTS: PD/LBD caregivers were more likely to identify as female, married, and college-educated; engage in high-intensity caregiving; and report their care recipient wakes them or others up at night. In multivariable models, PD/LBD caregiving was associated with worse health. Among PD/LBD caregivers, performing medical/nursing tasks was associated with higher odds of strain, loneliness, worse health, and depressive symptoms.

CONCLUSION: PD/LBD caregivers are a distinct group who often experience high-demand caregiving. Tailored support can help address the unique needs of this population. [Research in Gerontological Nursing, xx(x), xx-xx.].

PMID:40258218 | DOI:10.3928/19404921-20250416-01

J Psychosoc Nurs Ment Health Serv. 2025 Apr 23:1-9. doi: 10.3928/02793695-20250415-05. Online ahead of print.

ABSTRACT

PURPOSE: To examine the effectiveness of equine-assisted therapy on symptoms, quality of life, anxiety, and loneliness in individuals with schizophrenia.

METHOD: A randomized controlled trial was conducted with individuals with schizophrenia registered at a community mental health center. The study involved 61 participants (30 in the intervention group, 31 in the control group). An 8-week equine-assisted therapeutic intervention was implemented for the intervention group. Data were collected using a Personal Information Form, the Positive and Negative Syndrome Scale (PANSS), Trait Anxiety Inventory (TAI), Quality of Life Scale for Schizophrenia Patients (QLS), and UCLA Loneliness Scale (UCLA-LS). Data were analyzed using means, frequencies, percentage distributions, chi-square test, and dependent and independent samples t tests.

RESULTS: Statistically significant differences were found between pre- and post-test mean scores of the PANSS, TAI, UCLA-LS, and QLS in the intervention group (p < 0.05), and none were found in the control group (p > 0.05).

CONCLUSION: Equine-assisted therapy effectively reduced symptoms, anxiety, and loneliness in individuals with schizophrenia, while improving their quality of life. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

PMID:40258216 | DOI:10.3928/02793695-20250415-05

J Psychosoc Nurs Ment Health Serv. 2025 Apr 23:1-11. doi: 10.3928/02793695-20250415-04. Online ahead of print.

ABSTRACT

PURPOSE: To examine the correlation between internalized stigma and sleep in individuals diagnosed with bipolar disorder (BD).

METHOD: This study used a cross-sectional, descriptive, and correlational design with 35 individuals diagnosed with BD in the euthymic phase. Data were collected using the Participant Information Form, Internalized Stigma of Mental Illness (ISMI) Scale, and Pittsburgh Sleep Quality Index (PSQI).

RESULTS: A moderately positive significant relationship was found between duration of maintenance therapy and average total PSQI score. Total ISMI and PSQI scores were statistically different based on response to maintenance therapy. PSQI score and response to maintenance therapy were statistically significant predictors of ISMI score (R² = 0.52).

CONCLUSION: Psychiatric-mental health nurses should develop psychosocial interventions aimed at reducing stigma and improving sleep quality in individuals with BD and integrate these interventions into nursing care plans. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

PMID:40258214 | DOI:10.3928/02793695-20250415-04

Neurology. 2025 May 27;104(10):e213545. doi: 10.1212/WNL.0000000000213545. Epub 2025 Apr 21.

ABSTRACT

BACKGROUND AND OBJECTIVES: Intracerebral hemorrhage (ICH) is a common and fatal type of stroke, especially in central China. However, recent epidemiologic data are scarce. The study aimed to investigate the latest prevalence of ICH in central China and assess the risk of ICH in the next 10 years based on the Resident Health Records (RHR) data.

METHODS: First, this cross-sectional study was based on a large-scale face-to-face investigation of ICH, which was launched on residents aged 20 years or older from January 1, 2021, to December 31, 2021, and estimated the prevalence of ICH in Hunan, a representative province in central China. Then, based on the RHR database, we assessed the ICH risk, population attributable fraction (PAF), and effects of ICH prevention under different risk factor control scenarios over the next decade by the China Kadoorie Biobank (CKB)-cardiovascular disease (CVD) model.

RESULTS: In 2021, 1.78 million participants enrolled in the investigation (mean age = 50.1 years; 51% male). The age-standardized prevalence rate of ICH was 159.2 (95% CI 153.7-164.9) per 100,000. The prevalence rate of ICH in men was 193.6 (95% CI 185.2-202.5) per 100,000, while in women was 124.0 (95% CI 117.1-131.3) per 100,000, and it increased with age. Spatial aggregation was observed, with the peak prevalence rate of ICH at 327.3 (95% CI 293.1-365.5) per 100,000 in Zhuzhou, followed by Changsha was 215.8 (95% CI 190.6-243.9) per 100,000, while Shaoyang had the lowest rate was 62.8 (95% CI 51.2-77.1) per 100,000. For the assessment of 10-year ICH risk, we included a total of 8.36 million participants aged 30-79 with the RHR database into the CKB-CVD model. We found that there will be 354,146 cases (ICH risk: 4.2%) of ICH among the participants in the next decade. Controlling hypertension showed the highest potential for ICH prevention, with a PAF of 8.6%. By controlling hypertension, smoking, waist circumference, and diabetes, 56,673 ICH cases (PAF 19.1%) can be avoided in the next decade.

DISCUSSION: The ICH prevalence in central China remained high. Strict blood pressure control could significantly reduce the risk of ICH in the next 10 years. It is important to continually improve ICH prevention strategies in the general population.

PMID:40258204 | DOI:10.1212/WNL.0000000000213545

Clin Orthop Relat Res. 2025 Apr 15. doi: 10.1097/CORR.0000000000003498. Online ahead of print.

ABSTRACT

BACKGROUND: Lower extremity injuries are common in conflict-related trauma, with gunshot wounds (GSWs) causing localized damage and explosive trauma leading to extensive tissue injuries. Existing research lacks direct comparisons of injury severity and treatment outcomes between GSWs and explosive trauma in modern conflicts. This study clarifies these differences to improve triage strategies, surgical planning, and rehabilitation protocols.

QUESTIONS/PURPOSES: (1) How did GSWs and explosive trauma differ in terms of injury severity, including the proportion of patients in each group who experienced open fractures, neurovascular injuries, and amputations, during the Israel-Gaza conflict? (2) What was the comparative frequency and type of surgical intervention performed for GSWs versus explosive trauma in lower extremities?

METHODS: Between October 7, 2023, and December 31, 2023, a total of 1815 patients were entered into the Israel National Trauma Registry (INTR) as having been injured during the Israel-Gaza conflict. The INTR is a comprehensive national database that collects standardized injury and treatment information from all Level 1 and Level 2 trauma centers in Israel, ensuring high-quality, consistent reporting of war-related injuries. Of these, we considered patients with lower extremity injuries and ICD-9 E-codes E979 and E990-E999 (terror and war-related injuries) as potentially eligible. Based on this criterion, 1318 patients sustained extremity injuries, and 51% (674) met our inclusion criteria for this study. Among them, 53% (357 of 674) sustained GSWs and 47% (317) suffered explosive injuries. The groups did not differ in terms of mean ± SD ages (gunshot 28.5 ± 11.7 years, explosive 28.0 ± 11.4 years; p = 0.61). Most patients in both groups were men (gunshot 91%, explosive 95%; p = 0.09), with no between-group difference in terms of the proportion of patients who were men. Missing data were minimal in both groups, with complete data sets available for all primary outcomes. Comparisons were made between the two groups regarding the severity of injuries (such as open fractures and amputations), frequency and type of surgical interventions, and associated injuries (including those to the chest, abdomen, and face). Statistical analysis included chi-square tests for categorical variables and independent t-tests for continuous variables, with a significance threshold of p < 0.01 because of the large number of comparisons made.

RESULTS: GSWs resulted in a higher proportion of patients with open fractures (32% [115 of 357] versus 20% [64 of 317]; p = 0.001), particularly in the tibia and fibula (17% [62 of 357] versus 10% [33 of 317]; p = 0.01), whereas explosive injuries led to more amputations (10% [31 of 317] versus 3% [11 of 357]; p < 0.001); neurovascular injuries did not differ (p = 0.14 for nerve and p = 0.54 for vascular). A higher proportion of gunshot injuries were treated surgically (73% versus 59%; p < 0.001).

CONCLUSION: Understanding the distinct injury patterns and outcomes of GSWs and explosive trauma is essential for improving patient care and resource allocation during conflicts. Given the high amputation rates in blast injuries, early rehabilitation and prosthetic support should be prioritized, while gunshot-related open fractures often call for expanded orthopaedic fixation and infection control. Trauma training should emphasize early surgery for GSWs and hemorrhage control for blast injuries. Future research should focus on long-term functional outcomes, protective gear efficacy, and improved battlefield evacuation strategies to enhance survivability and recovery.

LEVEL OF EVIDENCE: Level III, therapeutic study.

PMID:40258172 | DOI:10.1097/CORR.0000000000003498

J Am Acad Orthop Surg Glob Res Rev. 2025 Apr 15;9(4). doi: 10.5435/JAAOSGlobal-D-24-00262. eCollection 2025 Apr 1.

ABSTRACT

INTRODUCTION: Increasingly ambulatory surgery centers (ASC) are being used for patients undergoing total joint arthroplasty (TJA). The purpose of this study was to evaluate the effect of transitioning TJAs to a newly opened ASC on hospital quality measures of patients undergoing TJA in the hospital.

METHODS: A retrospective review of 7,775 patients undergoing TJA at a single hospital from January 2018 to October 2023 was performed. Overall, 4,554 cases who underwent TJA in the hospital from 2018 to 2019, before the ASC opening, were compared with 3,221 cases who underwent TJA in the hospital from 2022 to 2023, post ASC opening. Univariate statistics were used to examine differences between the groups.

RESULTS: Post ASC opening, patients were older (69.8 vs. 66.8 years; P < 0.001) and a higher percentage of patients had an American Society of Anesthesiologists score of 3+ (50.6% vs. 41.7%; P < 0.001). Post ASC opening, more patients had 0-day length of stay (16.5% vs. 6.3%; P < 0.001), fewer were discharged to skilled nursing facility (6.9% vs. 9.3%; P = 0.002), and total charge was lower ($12,095.6 vs. $12,555.1 USD; P = 0.001).

CONCLUSION: Following the opening of an ASC, the acuity of TJAs performed in the hospital increased, but outcomes remained consistent or improved. The use of a coordinated clinical TJA pathway can potentially mitigate the adverse effects of increased hospital acuity after shifting appropriate patients to ASCs.

PMID:40257832 | DOI:10.5435/JAAOSGlobal-D-24-00262

J Am Acad Orthop Surg Glob Res Rev. 2025 Apr 21;9(4). doi: 10.5435/JAAOSGlobal-D-24-00288. eCollection 2025 Apr 1.

ABSTRACT

INTRODUCTION: Despite increasing numbers of female medical students, there is low female representation in orthopaedic residencies across the globe. It is unknown whether female representation in orthopaedics is lower than other specialties and whether regional presence relates to patient population or residency positions.

METHODS: The provider directory from the United States Centers for Medicare and Medicaid Services was reviewed from 2018 to 2023. Data for eight specialty subgroups (anesthesia, family medicine, gastroenterology, general surgery, internal medicine, obstetrics/gynecology, orthopaedics, and urology) were examined and grouped according to regions depicted by the Electronic Residency Application Service.

RESULTS: The mean percentage of female orthopaedic Centers for Medicare and Medicaid Services providers increased 1.49% over the 6-year period, at a markedly lower rate compared with general surgery (3.7%, P = 0.018) and obstetrics and gynecology (4.7%, P = 0.012). It was also lower compared with gastroenterology (3.73%), family medicine (3.52%), urology (3.10%), internal medicine (1.82%), and anesthesia (1.66%). Pacific-West and South-Atlantic regions demonstrated the greatest increase in representation. The number of female orthopaedic surgeons and growth in all orthopaedic surgeons in a state correlated with increased representation, whereas residency positions and patient population did not. Graduation year was 6 years later for female versus male students.

DISCUSSION: This study demonstrated a statistically significantly lower rate of change in female representation within orthopaedics compared with other specialties. Presence of practicing female orthopaedic surgeons was associated with growth in certain geographic regions. Future work should investigate factors associated with regional growth if specialties seek to move toward sex representation that reflects the United States population.

PMID:40257831 | DOI:10.5435/JAAOSGlobal-D-24-00288