Tag: nevin manimala

J Back Musculoskelet Rehabil. 2025 Mar 28:10538127251324728. doi: 10.1177/10538127251324728. Online ahead of print.

ABSTRACT

BackgroundPes planus is characterized by the flattening of the medial longitudinal arch of the foot, which can alter the biomechanics of the lower extremities and affect overall athletic performance. This randomized double-blinded controlled study was designed to investigate the effects of pes planus on jumping and balance performance.MethodsOne hundred thirty-one participants were assigned to the pes planus group (n = 66) and the control group (n = 65). Foot posture index (FPI) was used to determine pes planus. The vertical jump was measured by the VertiMetric device; horizontal jump performance by using the single leg hop test. Y Balance Test (YBT) was used to evaluate dynamic balance. The Mann-Whitney U test has been used for comparison of the groups and the alpha level is set at 0.05.ResultsVertical jump results of the pes planus group have been found statistically lower compared to the control group (p < 0.05). However, there were no statistically significant differences in the horizontal jump and YBT measurements between groups (p > 0.05). A weak negative correlation was found between the vertical jump distance and FPI scores (p < 0.05). There was a significant weak positive relationship between the FPI scores and anterior parameter of YBT in both sides (p < 0.05) and there were no statistically significant correlations between the posteromedial and posterolateral parameters in both sides (p > 0.05).ConclusionPes planus is associated with the only anterior reach of YBT, and vertical jumping performance; therefore, it is recommended to include strengthening and correction exercises for pes planus to improve vertical jumping performance and reduce risk of injuries.

PMID:40152012 | DOI:10.1177/10538127251324728

Asian Cardiovasc Thorac Ann. 2025 Mar 28:2184923251328119. doi: 10.1177/02184923251328119. Online ahead of print.

ABSTRACT

IntroductionInfective endocarditis (IE) is a severe infection of the endocardium, primarily affecting the heart valves, exhibiting high morbidity and mortality rates. Cardiac surgery for IE with cardiopulmonary bypass (CPB) can further exacerbate the inflammatory response and cytokine production from IE. The current meta-analysis evaluates the use of CytoSorb^® hemoadsorption in IE patients undergoing cardiac surgery to determine its efficacy in reducing inflammatory mediators and improving clinical outcomes.MethodsPubMed, Cochrane, Google Scholar, Clinical Trials, and Google Scholar were searched for articles until July 2024. After performing a risk of bias and quality assessment, data on operative times, mortality, and morbidity were extracted for meta-analysis. Statistical Software R (version 4.4.0) was used to calculate odds ratio (OR) and standardized mean differences using a random-effect model with a 95% confidence interval (CI) and p-value less than 0.05.ResultsEight studies, encompassing 1076 patients, were included in the analysis. These comprised three randomized controlled trials and five nonrandomized studies. The majority of these studies exhibited some concerns regarding bias. Hemoadsorption group showed lower discharge mortality (OR: 0.58, 95% CI: 0.33-1.00, p = 0.05) compared to controls, but no significant disparity is observed in other outcomes. In-hospital outcomes also showed higher heterogeneity, with an I² value greater than 50%.ConclusionCytoSorb use in patients undergoing cardiac surgery with CPB used for IE has no impact on operative mortality and morbidity but has a beneficial effect on discharge mortality.

PMID:40152004 | DOI:10.1177/02184923251328119

J Med Internet Res. 2025 Mar 7. doi: 10.2196/69351. Online ahead of print.

ABSTRACT

BACKGROUND: Escalating mental health demand exceeds existing clinical capacity, requiring scalable digital solutions. However, engagement remains challenging. Conversational agents enhance engagement by making digital programs more interactive and personalized but have not been widely used. This study evaluated a digital program for anxiety against external comparators. The program used an AI-driven conversational agent to deliver clinician-written content via machine learning, with clinician oversight and user support.

OBJECTIVE: This study aimed to evaluate the engagement, effectiveness, and safety of this structured, evidence-based digital program with human support for mild, moderate and severe generalized anxiety. Statistical analyses aimed to determine whether the program reduced anxiety more than a propensity-matched waiting control and was statistically non-inferior to real-world propensity-matched face-to-face and typed cognitive behavioral therapy (CBT).

METHODS: Prospective participants (N=299) were recruited from the NHS or social media in the UK and given the digital program to use for up to 9 weeks (study conducted from October 2023 to May 2024). Endpoints were collected before, during and after the digital program, and at one-month follow-up. External comparator groups were generated through propensity-matching of the digital program sample with NHS Talking Therapies (NHS TT) data from ieso Digital Health (typed-CBT) and Dorset Healthcare University NHS Foundation Trust (DHC) (face-to-face CBT). Superiority and non-inferiority analyses were conducted to compare anxiety symptom reduction (change on GAD-7 scale) in the digital program group and the external comparator groups. The program included human support and clinician time spent per participant was calculated.

RESULTS: Participants used the program for a median of 6 hours over 53 days, with 78% (n=232) engaged (i.e. completed a median of 2 hours over 14 days). There was a large clinically meaningful reduction in anxiety symptoms for the digital program group (per-protocol (PP; n=169): change on GAD-7 = -7.4, d = 1.6; intention-to-treat (ITT; n=299): change on GAD-7 = -5.4, d=1.1). The PP effect was statistically superior to the waiting control (d = 1.3), and non-inferior to the face-to-face CBT group (p <.001) and the typed-CBT group (p <.001). Similarly, for the ITT sample, the digital program showed superiority to waiting control (d=0.8) and non-inferiority to face-to-face CBT (p=.002) with non-inferiority to typed-CBT approaching significance (p=.06). Effects were sustained at one-month follow-up. Clinicians overseeing the digital program spent a mean of 1.6 hours (31 – 200 minutes) of clinician time in sessions per participant.

CONCLUSIONS: By combining AI and human support, the digital program achieved clinical outcomes comparable to human-delivered care while significantly reducing the required clinician time by up to 8 times relative to global care estimates. These findings highlight the potential of technology to scale evidence-based mental healthcare, address unmet need, and ultimately impact quality of life and economic burden globally.

CLINICALTRIAL: ISRCTN id: 52546704.

PMID:40152000 | DOI:10.2196/69351

Phys Chem Chem Phys. 2025 Mar 28. doi: 10.1039/d5cp00646e. Online ahead of print.

ABSTRACT

The more than 100-year-old Debye-Hückel theory displays the most widely used approach for modeling ionic activities in electrolytes. The Debye-Hückel theory finds widespread application, such as in equations of state and Onsager’s theory for conductivities. Here, a theoretical inconsistency of the Debye-Hückel theory is discussed, which originates from the employed Poisson-Boltzmann framework that violates the statistical independence of states presumed for the Boltzmann statistics. Furthermore, the static permittivity of electrolytic solutions is discussed as not directly measurable, while common methods for its extraction from experimental data are assessed as erroneous. A sensitivity analysis of modeled activity coefficients with respect to the permittivity and ionic radii as input parameters is conducted, showing that their influences overshadow physicochemical differences of common variations of Debye-Hückel models. Eventually, this study points out that the justification of the traditional and still often used Debye-Hückel models by experimental validation is affected by fitting ambiguities that eventually impede its predictive capabilities.

PMID:40151984 | DOI:10.1039/d5cp00646e

Popul Health Manag. 2025 Mar 28. doi: 10.1089/pop.2024.0232. Online ahead of print.

ABSTRACT

Virtual urgent care (VUC) and emergency department at home (ED at home) are two emerging interventions that may help address avoidable health care costs driven by inadequate access to primary care. This study evaluates the integration of VUC and ED at home as a combined mobile integrated care program, into a value-based primary care model that serves Medicaid and dual-eligible populations. Use of embedded VUC and ED at home among individuals with claim-identified physical health needs was associated with a statistically significant 27% reduction in inpatient admissions (P = 0.05), a 61% reduction in readmission (P = 0.04), and a 240% increase in engagement with primary care and care coordination (P < 0.001). Use of these services was also associated with a total cost of care decrease of $550 per member per month (P = 0.07). Findings suggest that virtual and home-based acute care services may be a promising lever for value-based payment models to enhance engagement and realize goals of improved cost and outcomes among populations with complex medical and social needs.

PMID:40151977 | DOI:10.1089/pop.2024.0232

Occup Ther Health Care. 2025 Mar 28:1-17. doi: 10.1080/07380577.2025.2482929. Online ahead of print.

ABSTRACT

This study measured the effectiveness and feasibility of therapeutic drumming for autistic children, targeting the meaningful occupational components of authentic social and personal participation of children. A 6-week therapeutic drumming intervention was implemented interprofessionally in two early-childhood classrooms with ten autistic children (N = 10), ages two through six. Two outcome measures were completed pre- and post-intervention: the Behavior Assessment System for Children, Third Edition (BASC-3), the Social and Personal Relationship Scale (SPRS). Descriptive statistics on pre- and post-intervention mean scores were generated and Wilcoxon signed rank tests were used to determine the areas where mean score changes were statistically significant. Significant differences were found between each component of the SPRS, and on two BASC-3 subsections (e.g. response to teacher, transition movement). Misalignment between language on the BASC-3 and neurodiversity affirming practice was identified as a notable limitation of the study. Feedback collected from lead facilitators regarding efficacy and implementation feasibility was collected via interview following the program. The implication of this pilot study provides preliminary evidence supporting the effectiveness and feasibility of therapeutic drumming, which must be further explored.

PMID:40151974 | DOI:10.1080/07380577.2025.2482929

Conserv Biol. 2025 Mar 28:e70016. doi: 10.1111/cobi.70016. Online ahead of print.

ABSTRACT

Wild game harvesting in Amazonia provides rural residents with protein and cash income but can threaten wildlife populations and forest ecosystem functions. As yet, the socioeconomic and environmental drivers that shape hunter livelihoods remain poorly understood. We studied hunting behavior in the Peruvian Amazon through a quantitative characterization of hunters accounting for community and household factors. Data on livelihood activities from a sample of nearly 3800 households in 232 stratified and randomly selected communities were drawn from a survey of the environmental and socioeconomic characteristics of 919 communities. Our double-hurdle model (i.e., 2-stage statistical model that describes whether a household participates in an activity and the amount they participate) separated household game harvesting decisions into 2 parts: first, based on a selection equation that estimated the decision to engage in hunting as a livelihood strategy and, second, based on a truncated lognormal regression equation that estimated total amount of game harvested by households engaged in hunting. We found that 28% of households surveyed reported hunting and that community factors, such as forest cover and distance to the city, drove hunting participation and harvests, although the factors predicting whether a household hunted differed from those that explained game harvests. Household traits, including initial land assets and household head age, were helpful in identifying hunters in communities. Government and nongovernmental organizations should consider socioeconomic and ecological interactions beyond the individual hunter when developing conservation initiatives. Informed targeting of communities in remote areas of Amazonia promises better allocation of scarce resources for wildlife conservation.

PMID:40151970 | DOI:10.1111/cobi.70016

J Holist Nurs. 2025 Mar 28:8980101251324696. doi: 10.1177/08980101251324696. Online ahead of print.

ABSTRACT

Objective: This study aimed to investigate the effect of Reiki on surgical fear and anxiety in laparoscopic cholecystectomy patients. Study design: This study is a three-arm, parallel, randomized, controlled trial. Methods: Forty-eight patients who underwent elective laparoscopic cholecystectomy in the General Surgery Clinic of a university hospital between November 2022 and December 2023 were included in the study. Patients were assigned to Reiki, Sham Reiki, and control groups according to the group they were assigned to. Surgical Fear Questionnaire and Surgical Anxiety Questionnaire were measured to the patients before and after the procedure according to the group they were assigned to. Descriptive statistics, t-tests, and ANOVA were used to analyze the data. Results: A statistically significant relationship was found between the surgical fear and anxiety scores of the patients in the Reiki group both within themselves and when compared with the other groups, and they were found to be lower (p < 0.05). Conclusions: Reiki application was effective in reducing preoperative surgical fear and anxiety scores of patients undergoing laparoscopic cholecystectomy. This study demonstrated the effectiveness of Reiki, an easy-to-apply complementary therapy application, in reducing surgical fear and anxiety.

PMID:40151965 | DOI:10.1177/08980101251324696

CRISPR J. 2025 Mar 27. doi: 10.1089/crispr.2024.0058. Online ahead of print.

ABSTRACT

Design of guide RNA (gRNA) with high efficiency and specificity is vital for successful application of the CRISPR gene editing technology. Although many machine learning (ML) and deep learning (DL)-based tools have been developed to predict gRNA activities, a systematic and unbiased evaluation of their predictive performance is still needed. Here, we provide a brief overview of in silico tools for CRISPR design and assess the CRISPR datasets and statistical metrics used for evaluating model performance. We benchmark seven ML and DL-based CRISPR-Cas9 editing efficiency prediction tools across nine CRISPR datasets covering six cell types and three species. The DL models CRISPRon and DeepHF outperform the other models exhibiting greater accuracy and higher Spearman correlation coefficient across multiple datasets. We compile all CRISPR datasets and in silico prediction tools into a GuideNet resource web portal, aiming to facilitate and streamline the sharing of CRISPR datasets. Furthermore, we summarize features affecting CRISPR gene editing activity, providing important insights into model performance and the further development of more accurate CRISPR prediction models.

PMID:40151952 | DOI:10.1089/crispr.2024.0058

Circ Genom Precis Med. 2025 Mar 28:e004968. doi: 10.1161/CIRCGEN.124.004968. Online ahead of print.

ABSTRACT

BACKGROUND: In the MI-GENES clinical trial (URL: https://www.clinicaltrials.gov; Unique identifier: NCT01936675), participants at intermediate risk of coronary heart disease (CHD) were randomized to receive a Framingham risk score (Framingham risk score group, n=103) or an integrated risk score (integrated risk score group [IRS_g], n=104) that additionally included a polygenic risk score. After 6 months, IRS_g participants had higher statin initiation and lower low-density lipoprotein cholesterol. We conducted a post hoc 10-year follow-up analysis to investigate whether disclosure of a polygenic risk score for CHD was associated with a reduction in major adverse cardiovascular events (MACE).

METHODS: Participants were followed from randomization in October 2013 to September 2023 to ascertain MACE, testing for CHD, and changes in risk factors. The primary outcome was time to first MACE, defined as cardiovascular death, nonfatal myocardial infarction, coronary revascularization, and nonfatal stroke. Statistical analyses included Cox proportional hazards regression and linear mixed-effects models.

RESULTS: We followed all participants who completed the trial, 100 in Framingham risk score group and 103 in IRS_g (mean age at the end of follow-up, 68.2±5.2; 48% male). During a median follow-up of 9.5 years, 9 MACEs occurred in Framingham risk score group and 2 in IRS_g (hazard ratio, 0.20 [95% CI, 0.04-0.94]; P=0.042). In Framingham risk score group, 47 (47%) underwent at least 1 diagnostic test for CHD, compared with 30 (29%) in IRS_g (hazard ratio, 0.51 [95% CI, 0.32-0.81]; P=0.004). A higher proportion of IRS_g participants were on statin therapy during the first 4 years postrandomization and had a greater reduction in low-density lipoprotein cholesterol for up to 3 years postrandomization. No significant differences were observed between 2 groups in other traditional cardiovascular risk factors during follow-up.

CONCLUSIONS: Disclosure of an integrated risk score that included a polygenic risk score to individuals at intermediate risk for CHD was associated with lower MACE incidence after 10 years, likely due to higher statin initiation, leading to lower low-density lipoprotein cholesterol levels.

PMID:40151934 | DOI:10.1161/CIRCGEN.124.004968