Tag: nevin manimala

Medicine (Baltimore). 2025 Apr 11;104(15):e41961. doi: 10.1097/MD.0000000000041961.

ABSTRACT

This research seeks to thoroughly examine the present state and research hotspots in Mendelian randomization (MR) in osteoporosis (OP)-related fields, providing a reference for future research directions in this area. Following an exhaustive search of the Web of Science Core Collection database, our analysis utilized citation statistics for osteoporosis studies conducted from January 1, 2007, through March 15, 2024. Bibliometric and visual analyses were conducted using two online analysis systems, CiteSpace and VOSviewer. The analysis included a variety of dimensions, including the distribution of citations, authorship, published journals, year of publication, countries, co-occurrence keywords and keyword clustering. From 2007 to 2024, the number of publications in MR in OP-related fields showed an overall increased. High-impact publications and leading contributors were primarily from China, followed by the USA and England. The journal with the largest number of publications in MR in OP-related fields is the Journal of Bone and Mineral Research. Risk factor research, genome-wide associations, meta-analysis, fractures, and gene loci were the main research hotspots. Interdisciplinary integration, MR research combined with data from clinical trials and observational studies, represents the future development trend. Research on MR in OP-related fields has mainly been conducted in China, the USA, and England. The research hotspots were aimed at exploring the causative between risk factors and OP. Future studies are likely to center on multidisciplinary integration.

PMID:40228251 | DOI:10.1097/MD.0000000000041961

Medicine (Baltimore). 2025 Apr 11;104(15):e42119. doi: 10.1097/MD.0000000000042119.

ABSTRACT

Autism Spectrum Disorder (ASD), characterized mainly by stereotyped behaviors and social impairments, affects about one in 100 children worldwide. Schizophrenia (SCZ), a chronic mental illness, affects 1% of the global population. The pathogenesis and specific treatment strategies for ASD and SCZ remain unclear. Previous research has suggested similarities in SCZ and ASD etiology and symptoms. However, no definitive correlation has been confirmed. Therefore, we conducted a Mendelian randomization study to assess the relationship between SCZ and ASD, providing new insights into their etiology and treatment. We used the two-sample Mendelian randomization (TSMR) approach to investigate the bidirectional causal association between SCZ and ASD, employing summary-level genome-wide association studies (GWAS) data. ASD summary data from the IEU GWAS database and SCZ summary data from the Psychiatric Genomics Consortium (PGC) were used as exposure and outcome variables, respectively. Statistical analysis was performed using the TwoSampleMR package in R version 4.3.2, with sensitivity analysis conducted to verify the result’s reliability. Based on the results of the MR analysis, we retrieved and analyzed the relevant genetic information from the GWAS Catalog. TSMR analysis revealed higher ASD risk in SCZ (IVW: OR: 1.19, 95% CI: 1.12-1.26, P < .001). Bidirectional MR analysis confirmed a causal relationship between ASD and SCZ (IVW: scz2018clozuk (Clozapine UK), OR: 1.12, 95% CI: 1.04-1.21, P = .003; scz2019asi, OR: 1.14, 95% CI: 1.05-1.23, P = .002). Our study demonstrated a bidirectional relationship between SCZ and ASD in the European population, suggesting that each may induce the onset of the other.

PMID:40228250 | DOI:10.1097/MD.0000000000042119

J Med Internet Res. 2025 Apr 14;27:e67772. doi: 10.2196/67772.

ABSTRACT

BACKGROUND: Crisis hotlines serve as a crucial avenue for the early identification of suicide risk, which is of paramount importance for suicide prevention and intervention. However, assessing the risk of callers in the crisis hotline context is constrained by factors such as lack of nonverbal communication cues, anonymity, time limits, and single-occasion intervention. Therefore, it is necessary to develop approaches, including acoustic features, for identifying the suicide risk among hotline callers early and quickly. Given the complicated features of sound, adopting artificial intelligence models to analyze callers’ acoustic features is promising.

OBJECTIVE: In this study, we investigated the feasibility of using acoustic features to predict suicide risk in crisis hotline callers. We also adopted a machine learning approach to analyze the complex acoustic features of hotline callers, with the aim of developing suicide risk prediction models.

METHODS: We collected 525 suicide-related calls from the records of a psychological assistance hotline in a province in northwest China. Callers were categorized as low or high risk based on suicidal ideation, suicidal plans, and history of suicide attempts, with risk assessments verified by a team of 18 clinical psychology raters. A total of 164 clearly categorized risk recordings were analyzed, including 102 low-risk and 62 high-risk calls. We extracted 273 audio segments, each exceeding 2 seconds in duration, which were labeled by raters as containing suicide-related expressions for subsequent model training and evaluation. Basic acoustic features (eg, Mel Frequency Cepstral Coefficients, formant frequencies, jitter, shimmer) and high-level statistical function (HSF) features (using OpenSMILE [Open-Source Speech and Music Interpretation by Large-Space Extraction] with the ComParE 2016 configuration) were extracted. Four supervised machine learning algorithms (logistic regression, support vector machine, random forest, and extreme gradient boosting) were trained and evaluated using grouped 5-fold cross-validation and a test set, with performance metrics, including accuracy, F₁-score, recall, and false negative rate.

RESULTS: The development of machine learning models utilizing HSF acoustic features has been demonstrated to enhance recognition performance compared to models based solely on basic acoustic features. The random forest classifier, developed with HSFs, achieved the best performance in detecting the suicide risk among the models evaluated (accuracy=0.75, F₁-score=0.70, recall=0.76, false negative rate=0.24).

CONCLUSIONS: The results of our study demonstrate the potential of developing artificial intelligence-based early warning systems using acoustic features for identifying the suicide risk among crisis hotline callers. Our work also has implications for employing acoustic features to identify suicide risk in salient voice contexts.

PMID:40228243 | DOI:10.2196/67772

JMIR Mhealth Uhealth. 2025 Apr 14;13:e55433. doi: 10.2196/55433.

ABSTRACT

BACKGROUND: Despite the effects of poor relationship quality on individuals’, couples’, and families’ well-being, help seeking often does not occur until problems arise. Digital interventions may lower barriers to engagement with preventive relationship care. The Paired app, launched in October 2020, aims to strengthen and enhance couple relationships. It provides daily questions, quizzes, tips, and detailed content and facilitates in-app sharing of question and quiz responses and tagged content between partners.

OBJECTIVE: To explore the potential of mobile health to benefit couple relationships and how it may do this, we examined (1) Paired’s impact on relationship quality and (2) its mechanisms of action.

METHODS: This mixed methods evaluation invited Paired subscribers to complete (1) brief longitudinal surveys over 3 months (n=440), (2) a 30-item web-based survey (n=745), and (3) in-depth interviews (n=20). For objective 1, survey results were triangulated to determine associations between relationship quality measures and the duration and frequency of Paired use, and qualitative data were integrated to provide explanatory depth. For objective 2, mechanisms of action were explored using a dominant qualitative approach.

RESULTS: Relationship quality improved with increasing duration and frequency of Paired use. Web-based survey data indicate that the Multidimensional Quality of Relationship Scale score (representing relationship quality on a 0-10 scale) was 35.5% higher (95% CI 31.1%-43.7%; P=.002), at 7.03, among people who had used Paired for >3 months compared to 5.19 among new users (≤1 wk use of Paired), a trend supported by the longitudinal data. Of those who had used Paired for >1 month, 64.3% (330/513) agreed that their relationship felt stronger since using the app (95% CI 60.2%-68.4%), with no or minimal demographic differences. Regarding the app’s mechanisms of action, interview accounts demonstrated how it prompted and habituated meaningful communication between partners, both within and outside the app. Couples made regular times in their day to discuss the topics Paired raised. Daily questions were sometimes lighthearted and sometimes concerned topics that couples might find challenging to discuss (eg, money management). Interviewees valued the combination of fun and seriousness. It was easier to discuss challenging topics when they were raised by the “neutral” app, rather than during stressful circumstances or when broached by 1 partner. Engagement seemed to be enhanced by users’ experience of relationship benefits and by the app’s design.

CONCLUSIONS: This study demonstrates proof of concept, showing that Paired may have the potential to improve relationship quality over a relatively short time frame. Positive relationship practices became embedded within couples’ daily routines, suggesting that relationship quality improvements might be sustained. Digital interventions can play an important role in the relationship care ecosystem. The mixed methods design enabled triangulation and integration, strengthening our findings. However, app users were self-selecting, and methodological choices impact our findings’ generalizability.

PMID:40228241 | DOI:10.2196/55433

J Med Internet Res. 2025 Apr 14;27:e55621. doi: 10.2196/55621.

ABSTRACT

BACKGROUND: Concerned significant others (CSOs) play a significant role in supporting individuals with substance use disorders. There is a lack of tailored support services for these CSOs, despite their substantial contributions to the well-being of their loved ones (LOs). The emergence of helplines as a potential avenue for CSO support is outlined, culminating in the focus on the Partnership to End Addiction’s helpline service, an innovative public health intervention aimed at aiding CSOs concerned about an LO’s substance use.

OBJECTIVE: The article analyzes the demographics and use patterns of the Partnership to End Addiction’s helpline service, highlighting the critical role of such services, and advocating for expanded, tailored support models.

METHODS: This observational study draws data from 8 data platforms spanning April 2011 to December 2021, encompassing 24,096 client records. Surveys were completed by helpline specialists during synchronous telephone calls or self-reported by CSOs before helpline engagement. Collected information encompasses demographics, interaction language, substance of concern, CSO-LO relationship, and the LO’s “use state,” that is, their location on the continuum of substance use.

RESULTS: CSOs primarily comprised women (13,980/18,373, 76.1%) seeking support for their children (1062/1542, 68.9%). LOs were mostly male (1090/1738, 62.7%), aged 18-25 years (2380/7208, 33%), with primary substance concerns being cannabis (5266/12,817, 40.9%), opioids (2445/12,817, 19%), and stimulants (1563/12,817, 12.1%). CSOs primarily sought aid for LOs struggling with substances who were not in treatment (1102/1753, 62.9%). The majority of CSOs were looking for support in English (14,738/17,920, 82.2%), while the rest (3182/17,920, 17.8%) preferred to communicate in Spanish. Spanish-speaking CSOs were significantly more likely to call about cannabis (n=963, 53.7% vs n=4026, 38.6%) and stimulants (n=304, 16.9% vs n=1185, 11.3%) than English-speaking CSOs (P<.001). On the other hand, English-speaking CSOs were more likely to be concerned about opioids than Spanish-speaking CSOs (n=2215, 21.3% vs n=94, 5.2%; P<.001).

CONCLUSIONS: The study illuminates the helpline’s pioneering role in aiding CSOs grappling with an LO’s substance use. It highlights helplines as crucial resources for CSOs, revealing key demographic, substance-related, and use-state trends. The dominant presence of women among users aligns with other helpline patterns and reflects traditional caregiving roles. While parents form a significant percentage of those reaching out, support is also sought by siblings, friends, and other family members, emphasizing the need for assistance for other members of an LO’s social network. Spanish-speaking individuals’ significant outreach underscores the necessity for bilingual support services. Substance concerns revolve around cannabis, opioids, and stimulants, influenced by age and language preferences. The helpline serves as an essential intermediary for CSOs, filling a gap between acute crisis intervention services and formalized health care and treatment services. Overall, the study highlights this helpline’s crucial role in aiding CSOs with tailored, accessible support services.

PMID:40228240 | DOI:10.2196/55621

Cancers (Basel). 2025 Apr 2;17(7):1209. doi: 10.3390/cancers17071209.

ABSTRACT

OBJECTIVES: Inflammatory fibroid polyps, also known as Vanek’s tumors, are rare benign lesions of the gastrointestinal tract. Although the exact cause remains unclear, several theories suggest an association with inflammatory processes and genetic factors. This study aims to present the largest cohort of inflammatory fibroid polyp cases to date, analyzing their clinical presentation, diagnostic methods, and treatment approaches.

MATERIALS AND METHODS: A retrospective multicentric analysis was conducted on 67 patients diagnosed with inflammatory fibroid polyps between 2013 and 2023 across four hospitals. Clinical data regarding tumor location, size, symptoms, and treatment were collected. Non-parametric statistical tests, including the chi-square test, Cramér’s V coefficient, and the Mann-Whitney U test, were used to identify association between tumor characteristics, location, and treatment outcomes.

RESULTS: The cohort included 67 patients (58.2% female, median age 60 years). The stomach was the most common tumor site (47.8%), followed by the colon (32.8%), and small intestine (10.4%). The majority of patients (73.1%) were asymptomatic, while 9% experienced intestinal obstruction, all of which were located in the small intestine. Endoscopic resection was successful in 77.6% of cases, but surgical intervention was more frequently required for tumors in the small intestine. A significant association was found between larger tumor size, emergency presentation, intestinal location, and the need for surgery.

CONCLUSIONS: Inflammatory fibroid polyps are commonly managed with endoscopic resection, particularly in gastric and colonic locations. However, small intestinal tumors more often need surgical treatment, especially when presenting with complications like intestinal obstruction.

PMID:40227778 | DOI:10.3390/cancers17071209

Cancers (Basel). 2025 Apr 1;17(7):1200. doi: 10.3390/cancers17071200.

ABSTRACT

BACKGROUND: The relationship between body composition and bladder cancer outcomes is complex. While a higher body mass index (BMI) has been associated with an increased risk of bladder cancer development, its impact on survival outcomes is less clear. This study aimed to explore the association between BMI, survival, health-related quality of life, and the performance of ADLs in a cohort of older patients with bladder cancer.

METHODS: Data were obtained from the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey, including patients diagnosed with bladder cancer who had recorded BMI values. Analysis of variance was used to assess the association between BMI categories and patient demographics as well as cancer/treatment characteristics. Generalized linear models examined the impact of BMI on health-related quality of life, as measured by the physical and mental component summary scores when controlling for confounding variables. Kaplan-Meier survival curves across BMI categories were compared using log-rank tests.

RESULTS: The final cohort consisted of 8013 patients (age ≥ 65) with a mean age of 77.7 ± 7.1 years, the majority of whom were White (85.6%) and male (74.8%). We observed no significant association between BMI and cancer/treatment characteristics. The severely obese subgroup had the highest rate of disability in performing ADLs (18.3%) followed by the underweight subgroup (10.3%). Overweight patients exhibited the highest physical and mental component summary scores, indicating better health-related quality of life. BMI was a significant predictor of overall survival, with overweight, obese, and severely obese patients demonstrating improved survival compared to those with healthy or underweight BMI. These findings remained statistically significant in multivariable analysis.

CONCLUSIONS: Our findings suggest a dual role of BMI in older patients with bladder cancer: higher BMI provides a survival advantage and, to an extent, a QoL advantage. At the same time, severe obesity did lead to the lowest QoL despite improved survival outcomes. These results underscore the complex interplay between BMI, survival, and QoL in this bladder cancer population.

PMID:40227765 | DOI:10.3390/cancers17071200

Cancers (Basel). 2025 Apr 1;17(7):1199. doi: 10.3390/cancers17071199.

ABSTRACT

Background/Objectives: Proliferative verrucous leukoplakia (PVL) is an oral disorder with the greatest degree of malignant transformation. However, it is relatively rare. This study compared the clinical characteristics of patients with oral squamous cell carcinoma (OSCC) who had and had not been previously diagnosed with PVL. Methods: This case control study compared the clinical characteristics of patients classified as early (T1 and T2) or advanced (T3 and T4) OSCC according to the T size of the Tumor, Node, Metastasis (TNM) classification, including age, gender, location, and clinical type of oral squamous cell carcinoma. The analysis involved 140 patients. Group 1: 50 OSCC patients with PVL (OSCC-PVL) and Group 2: 90 OSCC patients without PVL (OSCC-noPVL). Results: The patients with OSCC-PVL were younger than those with OSCC-noPVL, but this did not reach statistical significance. Regarding patient gender, those with OSCC-PVL were much more frequently female (70%), while OSCC-noPVL was more prevalent in men (65.5%) (p < 0.01). There were also significant differences in the oral locations between the two groups: the gingiva was most prevalent in OSCC-PVL and the tongue in OSCC-noPVL. Erythroleukoplastic forms were significantly more common in OSCC-PVL (30% vs. 7.7%), while ulcerated forms were more frequent in OSCC-noPVL (63.3% vs. 42%). Finally, early T stages were much more prevalent in our patients with OSCC-PVL. Conclusions: We found that OSCC preceded by PVL was much more frequent in women, had less aggressive clinical forms, and had significantly more frequent early T stages than in OSCC-noPVL.

PMID:40227760 | DOI:10.3390/cancers17071199

Cancers (Basel). 2025 Mar 31;17(7):1182. doi: 10.3390/cancers17071182.

ABSTRACT

BACKGROUND: Peripherally Inserted Central Catheters (PICCs) and midline catheters are crucial for chemotherapy and supportive care in cancer patients. Their use requires ongoing monitoring to prevent late complications such as infections, dislodgements, and replacements. The COVID-19 pandemic challenged healthcare systems, potentially increasing these complications due to reduced outpatient services and limited specialized personnel.

OBJECTIVES: This study compared the incidence of late complications associated with PICCs and midline catheters in cancer patients during and after the COVID-19 pandemic.

METHODS: A retrospective observational study was conducted at a Cancer Center in Italy from March 2020 to April 2024. Catheter-related complications were divided into two cohorts: during the pandemic (March 2020-March 2022) and post-pandemic (April 2022-April 2024). The primary outcome was the incidence of late complications requiring device removal, categorized as infections, dislodgements, and replacements. Statistical analyses included the Chi-squared test for categorical variables and the Kruskal-Wallis test for continuous variables.

RESULTS: Of 4104 PICC and midline catheter placements, 2291 removals were recorded, with 550 (24%) due to late complications-404 during the pandemic and 146 post-pandemic (p < 0.001). Suspected infections were the most frequent complication, significantly higher during the pandemic (p < 0.001). Dislodgements and replacements also decreased markedly post-pandemic. Limited outpatient services and disrupted healthcare workflows likely contributed to higher complication rates during the pandemic.

CONCLUSIONS: The COVID-19 pandemic negatively impacted catheter management in cancer patients, increasing late complications. The post-pandemic decline highlights the importance of consistent care, infection prevention, remote monitoring, and stronger healthcare resilience to reduce risks in future crises.

PMID:40227726 | DOI:10.3390/cancers17071182

JAMA Neurol. 2025 Apr 14. doi: 10.1001/jamaneurol.2025.0465. Online ahead of print.

ABSTRACT

IMPORTANCE: Poststroke epilepsy (PSE) is a major complication among young adults and is associated with problems with functional recovery and daily life. Although scores have been developed to predict risk of PSE, they have not been validated among patients with stroke at a young age.

OBJECTIVES: To investigate both the risk of and risk factors for PSE at a young age and validate current PSE risk scores among a cohort of young adults.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from ODYSSEY (Observational Dutch Young Symptomatic Stroke Study), a prospective cohort study conducted among 17 hospitals in the Netherlands between May 27, 2013, and March 3, 2021, with follow-up until February 28, 2024. Participants included 1388 consecutive patients aged 18 to 49 years with neuroimaging-proven ischemic stroke or intracerebral hemorrhage (ICH) and without a history of epilepsy. Statistical analysis took place between June and August 2024.

EXPOSURE: First-ever neuroimaging-proven ischemic stroke or ICH.

MAIN OUTCOMES AND MEASURES: Poststroke epilepsy was defined as at least 1 remote symptomatic seizure (>7 days). Cumulative incidence functions were used to calculate the 5-year risk of PSE. Fine-Gray regression models were used to identify risk factors associated with PSE (age, sex, clinical stroke, and neuroimaging variables). The performances of the SeLECT (severity of stroke, large-artery atherosclerosis, early seizure, cortical involvement, and territory of middle cerebral artery) 2.0 risk score (for ischemic stroke) and the CAVE (cortical involvement, age, bleeding volume, and early seizure) risk score (for ICH) were assessed with C statistics and calibration bar plots.

RESULTS: This study included 1388 patients (ischemic stroke, 1231 [88.7%]; ICH, 157 [11.3%]; median age, 44.1 years [IQR, 38.0-47.4 years]; 736 men [53.0%]; median follow-up, 5.3 years [IQR, 3.4-7.4 years]), of whom 57 (4.1%) developed PSE. The 5-year cumulative risk of PSE was 3.7% (95% CI, 0.2%-4.8%) after ischemic stroke and 7.6% (95% CI, 3.5%-11.8%) after ICH. Factors associated with PSE after ischemic stroke were an acute symptomatic seizure (<7 days) (hazard ratio [HR], 10.83 [95% CI, 2.05-57.07]; P = .005) and cortical involvement (HR, 5.35 [95% CI, 1.85-15.49]; P = .002). The only factor associated with PSE after ICH was cortical involvement (HR, 8.20 [95% CI, 2.22-30.25]; P = .002). The C statistic was 0.78 (95% CI, 0.71-0.84) for the SeLECT 2.0 risk score and 0.83 (95% CI, 0.76-0.90) for the CAVE risk score, and calibration was good for both scores.

CONCLUSION: This study suggests that the risk of PSE among young adults is relatively low and that the factors that were associated with PSE were similar to variables included in the existing risk scores, which can therefore also be applied for young adults after stroke. Future clinical trials should investigate the optimal primary and secondary prophylaxis for patients at high risk.

PMID:40227717 | DOI:10.1001/jamaneurol.2025.0465