Tag: nevin manimala

Euro Surveill. 2025 Mar;30(11). doi: 10.2807/1560-7917.ES.2025.30.11.2500173.

ABSTRACT

We observed shifting trends in tuberculosis (TB) epidemiology in the EU/EEA between 2019 and 2023. In 2023, TB notifications among people of foreign origin increased by 24.6% after decreasing between 2019 and 2020. The majority originated from African and East Mediterranean regions, with a 316.4% upsurge in TB among Ukrainians in 2022-23. Rifampicin-resistant/multidrug-resistant TB increased by ≥ 60% in 2019-23, mainly among Ukrainians. Rapid response to shifting epidemiological patterns is crucial for efficient TB prevention and control within the EU/EEA.

PMID:40116035 | DOI:10.2807/1560-7917.ES.2025.30.11.2500173

Euro Surveill. 2025 Mar;30(11). doi: 10.2807/1560-7917.ES.2025.30.11.2400393.

ABSTRACT

BackgroundMalaria is primarily transmitted through mosquito bites; occasionally, direct transmission through blood has been reported. Healthcare-associated infections refer to infections acquired in a hospital or another healthcare setting.AimThis systematic review aims to explore determinants of healthcare-associated malaria (HAM) cases.MethodThis review follows the PRISMA guidelines and was registered in PROSPERO (CRD42022309701). We searched five databases for publications on HAM cases published between 1 January 2000 and 7 December 2023. We initiated a data call for HAM cases to public health authorities from 37 European countries. We performed a backward and forward search, reviewed health authorities’ websites, performed searches on Google and the European Scientific Conference on Applied Infectious Disease Epidemiology (ESCAIDE) conference abstracts book.ResultsWe identified 37 studies on HAM comprising 55 HAM cases, of which 35 (64%) were infected in Europe, primarily in Spain (nine cases), France and Italy (seven cases each). All cases were infected with Plasmodium falciparum except one individual. Fifty HAM cases were hospital inpatients and five were healthcare workers. Five patients died. Flushing of vascular catheters with contaminated heparin/saline solution and manipulation of intravenous catheters were the most frequently reported procedures leading to infection among patients.ConclusionsWhile rare, HAM transmission can be fatal. Healthcare-associated malaria is preventable through strict adherence to infection prevention and control procedures. Despite extensive investigations, the procedure leading to infection often remained unknown, highlighting the complexity of investigations. Guidance and protocols for conducting investigations may improve the success rate of such inquiries.

PMID:40116034 | DOI:10.2807/1560-7917.ES.2025.30.11.2400393

Euro Surveill. 2025 Mar;30(11). doi: 10.2807/1560-7917.ES.2025.30.11.2500172.

ABSTRACT

As tuberculosis (TB) in children is an indicator of ongoing transmission, we analysed surveillance data to understand the increase in notified TB cases among individuals aged < 15 years in the European Union/European Economic Area countries between 2015 and 2023. Several factors may have contributed to this increase, such as improved diagnosis and reporting, migration and the COVID-19 pandemic. The observed increasing trend, albeit low in absolute numbers, emphasises the importance of early case finding and timely prevention.

PMID:40116033 | DOI:10.2807/1560-7917.ES.2025.30.11.2500172

Euro Surveill. 2025 Mar;30(11). doi: 10.2807/1560-7917.ES.2025.30.11.2400489.

ABSTRACT

BackgroundAs tuberculosis (TB) incidence rates decrease faster in native than migrant populations in European countries, addressing migrant health becomes increasingly important in TB programmes.AimTo inform European TB prevention and control policies, we analysed data on TB in migrants in low TB-incidence European countries (TB incidence < 10/100,000 population) during 2014-2020 by migrant origin, destination, and recent vs non-recent immigration.MethodsData on migrant TB patients were derived from the European Surveillance System (TESSy) and data on migrant populations from Eurostat or national statistical offices. We calculated annual migrant TB crude incidence rates (CIRs) per country of origin, destination country and year, for all migrants with TB and recently arrived migrants with TB, the latter defined by TB diagnosis within 1 year after arrival in the destination country.ResultsIn 2014-2020, 104,371 migrants with TB were reported to TESSy by 20 destination countries. Average annual migrant CIRs were highest in the United Kingdom (43/100,000). Origin countries of most migrant TB patients were India (n = 9,561), Romania (n = 8,345), and Pakistan (n = 7,300). The highest CIRs were found among migrants from Eritrea (480/100,000), Somalia (414/100,000) and The Gambia (343/100,000), and were higher than estimated World Health Organization incidences for those countries. The CIRs among recently arrived migrants appeared higher than in the overall migrant population.ConclusionsWe found substantially higher CIRs in certain migrant subpopulations than others. TB rates in recent migrants appeared to be up to 11 times higher than in corresponding origin countries. Tailored and regularly adapted TB prevention and control strategies are needed.

PMID:40116030 | DOI:10.2807/1560-7917.ES.2025.30.11.2400489

J Forensic Sci. 2025 Mar 21. doi: 10.1111/1556-4029.70021. Online ahead of print.

ABSTRACT

Strangulation-related homicides represent a complex and under-researched form of violent crime, characterized by distinct behavioral and situational elements. The aim of the research was to identify perpetrator typologies in strangulation homicides and to analyze their relationships with victim characteristics and crime scene factors. A retrospective analysis of 200 systematically sampled cases from the Radford/Florida Gulf Coast University Serial Killer Database employed Smallest Space Analysis (SSA) to examine 42 behavioral variables. The analysis revealed four primary typologies: Excessive (characterized by severe violence beyond lethality, including mutilation and torture), intended (marked by premeditation and organizational elements), personal (distinguished by intimate engagement and direct manual methods), and sexual (defined by sexual assault and sadistic behaviors). Statistical analysis demonstrated significant correlations between offender-victim relationships, crime scene characteristics, and degrees of violence within each typological category, with 97% of cases fitting distinctly into one category and 3% showing hybrid characteristics. The findings provide empirically based frameworks for forensic profiling and inform specific investigative strategies aligned with each typological pattern. These results equip law enforcement with targeted investigation and risk assessment approaches, potentially leading to more accurate offender identification and prevention efforts. The research advances the understanding of psychological and situational factors in strangulation-related homicides, contributing to both forensic literature and practical applications in criminal investigations.

PMID:40116021 | DOI:10.1111/1556-4029.70021

Cardiol Young. 2025 Mar 21:1-6. doi: 10.1017/S1047951125001386. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the outcomes of patients with single ventricle physiology supported with extracorporeal membrane oxygenation as a bridge to first-stage palliation.

METHODS: This was a retrospective registry-based study. Data from the Extracorporeal Life Support Organization registry were used to identify single ventricle physiology patients supported with extracorporeal membrane oxygenation prior to palliation from 2016 to 2021. Descriptive statistics and multivariate analyses for associations with mortality were conducted.

RESULTS: Primary outcome was death before hospital discharge. Patient characteristics including demographics and associated complications were evaluated as secondary outcomes. Sixty-five patients met inclusion criteria. Survival to discharge was 42%. Twenty-four (37%) patients died while on extracorporeal membrane oxygenation. There was no significant difference in demographics between survivors and non-survivors. Non-survivors had a significantly longer median duration on extracorporeal membrane oxygenation compared to survivors, 99-hrs [IQR (Interquartile Range), 160, 300] vs. 59-hrs [43, 124] (p<0.001). Multivariate analysis demonstrated extracorporeal membrane oxygenation duration (adjusted-OR [Odds Ratio] 1.01, 95% CI [Confidence Interval] 0.98, 0.99; p = 0.03) and requiring renal replacement therapy (42% vs. 19%; p = 0.04) were associated with mortality prior to discharge.

CONCLUSIONS: Clinicians managing decompensated patients with single ventricle physiology may consider extracorporeal membrane oxygenation as a bridge to palliation. Survival to discharge was 42%. Evidence of renal injury and longer extracorporeal membrane oxygenation durations were associated with mortality. These data may be used to guide providers and to counsel families. However, more data are needed to refine indications and assess associations related to outcomes and decision-making.

PMID:40116014 | DOI:10.1017/S1047951125001386

J Endovasc Ther. 2025 Mar 21:15266028251326767. doi: 10.1177/15266028251326767. Online ahead of print.

ABSTRACT

PURPOSE: To describe a novel endovascular technique to treat ilio-femoral reflux in post-thrombotic syndrome (PTS). It consists of regulated exclusion of a femoral vein (FV) segment with indication based on Doppler ultrasound (DUS) scan and ascending and descending venogram.

TECHNIQUE: Through lower limb venous DUS, we identify a post-thrombotic refluxing FV, characterized by a duplicated FV and/or ascending collateral veins draining into a common trunk with a re-entry point into the refluxing FV itself. The above findings indicate a second-level venogram. If the descending phase confirms the FV reflux pattern, we perform an ascending venogram to confidently locate where the draining blood is shunted into the FV. We proceed with the scleroembolization of the segment below the shunt. The postoperative venogram documents the treated segment occlusion and the elimination of the reflux. We described 4 cases: 3 successful reflux eliminations and 1 case where we decided not to treat. Mean follow-up lasts 6.5 months with DUS showing the abolition of the reflux; the overall Villalta score, performed at the baseline and last follow-up visit, resulted statistically significant (p = 0.0087).

CONCLUSION: Performing an endovascular regulated exclusion of FV refluxing segment opens a great scenario for PTS treatment; multicenter randomized trials are warranted.Clinical ImpactRecanalized post-thrombotic syndrome, with reflux involving the ilio-popliteal segments, affects the patient’s life without any clear surgical indication. The proposed protocol and technique are based on performing a descending and ascending venogram to identify the point of femoral vein duplication. The regulated exclusion of the refluxing FV segment, below the duplication, by means of scleroembolization, allowed to permanent abolish the reflux. This novel technique is minimally invasive and presents great potential for treating a significant proportion of patients currently managed exclusively with conservative approaches.

PMID:40116011 | DOI:10.1177/15266028251326767

Eur J Neurol. 2025 Mar;32(3):e16510. doi: 10.1111/ene.16510.

ABSTRACT

BACKGROUND AND PURPOSE: Neurological involvement in long COVID (coronavirus disease 2019) is well known. In a previous study we identified two subtypes of neurological long COVID, one characterized by memory disturbances, psychological impairment, headache, anosmia and ageusia, and the other characterized by peripheral nervous system involvement, each of which present a different risk factor profile. In this study, we aimed to clarify the persistence of neurological long COVID symptoms with a significantly longer term follow-up.

METHODS: We prospectively collected data from patients with prior COVID-19 infection who showed symptoms of neurological long COVID. We conducted a descriptive analysis to investigate the progression of neurological symptoms over time at 3-, 6-, 12-, and 18-month follow-ups. We performed a k-means clustering analysis on the temporal evolution of the symptoms at 6, 12, and 18 months. Finally, we assessed the difference between the recovery course of vaccinated and non-vaccinated patients by computing the cumulative recovery rate of symptoms in the two groups.

RESULTS: The study confirmed the presence of two subtypes of neurological long COVID. Further, 50% of patients presented a complete resolution of symptoms at 18 months of follow-up, regardless of which subtype of neurological long COVID they had. Vaccination against SARS-Cov-2 appeared to imply a higher overall recovery rate for all neurological symptoms, although the statistical reliability of this finding is hampered by the limited sample size of the unvaccinated patients included in this study.

CONCLUSIONS: Neurological long COVID can undergo complete resolution after 18 months of follow-up in 50% of patients and vaccination can accelerate the recovery.

PMID:40115993 | DOI:10.1111/ene.16510

Stroke. 2025 Mar 21. doi: 10.1161/STROKEAHA.124.048183. Online ahead of print.

ABSTRACT

BACKGROUND: Robotic rehabilitation, which provides a high-intensity, high-frequency therapy to improve neuroplasticity, is gaining traction. However, its effectiveness for upper extremity stroke rehabilitation remains uncertain. This study comprehensively reviewed meta-analyses on the effectiveness of upper extremity robot-assisted therapy in patients with stroke.

METHODS: We combined results from 396 randomized controlled trials (RCTs) in 16 meta-analyses and conducted a new meta-analysis using nonoverlapping RCTs and 6 additional RCTs published after 2024. Duplicate studies were removed, all data were from RCTs, and a random-effects model resolved heterogeneity. Effects were analyzed by comparing robot-assisted therapy with conventional therapy at the same dose and as an add-on to conventional therapy.

RESULTS: Compared with conventional therapy, the effect of robot-assisted therapy on the Fugl-Meyer assessment was summarized as a significant standardized mean difference (SMD) of 0.29 (95% CI, 0.14-0.44; number of individual RCTs reanalyzed, 100 RCTs), and the additional effect of robot-assisted therapy was an SMD of 0.42 (95% CI, 0.23-0.61; 16 RCTs). However, these Fugl-Meyer assessment improvements did not meet the minimum clinically important difference thresholds identified in previous studies: 12.4 for subacute and 3.5 for chronic stroke. For activities of daily living, only the additional effect was significant by SMD of 0.35 (95% CI, 0.17-0.54; 26 RCTs), muscle strength was significant by SMD of 0.46 (95% CI, 0.22-0.70; 31 RCTs), and spasticity was not significant by SMD of -0.25 (95% CI, -0.55 to 0.06; 25 RCTs).

CONCLUSIONS: Robot-assisted therapy shows statistically significant improvements in motor recovery as measured by the Fugl-Meyer assessment in patients with stroke, both at the same dose and as an add-on to conventional therapy; however, these improvements do not meet the minimum clinically important difference. These benefits are consistent across different stages of stroke recovery, different types of robotic devices, duration of intervention, and training sites. However, the heterogeneity of included studies in patient population, stroke severity, intervention protocol, and robot type limits generalizability. High-quality trials are needed to better define the value of robot-assisted therapy across various devices and strategies.

PMID:40115991 | DOI:10.1161/STROKEAHA.124.048183

Psychophysiology. 2025 Mar;62(3):e70045. doi: 10.1111/psyp.70045.

ABSTRACT

Facial expressions provide critical details about social partners’ inner states. We investigated whether event-related potentials (ERP) related to the visual processing of facial expressions are modulated by participants’ perceived arousal and valence at the stimulus level. ERPs were recorded while participants (N = 80) categorized the gender of faces expressing fear, anger, happiness, and no emotion. Participants then viewed each face again and rated them on arousal and valence using 1-9 Likert scales. For each participant, ratings of each unique face were linked back to corresponding ERP trials. ERPs were analyzed at all time points and electrodes using hierarchical mass univariate statistics. Three different ANOVA models were employed: the original emotion model, and models with valence or arousal ratings as trial-level regressors. Results from models with ratings highly overlapped with the original model, although they were more temporally restricted. The N170 component was the most impacted by arousal and valence ratings, with four out of six emotion contrasts revealing significant valence or arousal interactions. Emotion effects on the P2 component were mostly unrelated to ratings. On the EPN component, only two contrasts related to both arousal and valence ratings. Thus, ERP emotion effects are related to participants’ perceived arousal and valence of the stimuli, although this association depends on the contrast analyzed. These findings, their limitations, and generalizability are discussed in reference to existing theories and literature.

PMID:40115983 | DOI:10.1111/psyp.70045