Tag: nevin manimala

JAMA Netw Open. 2025 Jan 2;8(1):e2457506. doi: 10.1001/jamanetworkopen.2024.57506.

ABSTRACT

IMPORTANCE: While national guidelines recommend avoidance of hypoxia, hypotension, and hypocarbia in the prehospital care of traumatic brain injury (TBI), limited data validate the association of these adverse physiologic events with TBI outcomes.

OBJECTIVE: To validate the associations of prehospital hypoxia, hypotension, and hypocarbia with TBI outcomes in a US national trauma network.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study examined data from 8 level I trauma centers and their affiliated ground and air emergency medical services (EMS) agencies in the Linking Investigations in Trauma and Emergency Services (LITES) Network from January 1, 2017, to June 30, 2021. Adult patients (aged ≥18 years) with confirmed TBI (head Abbreviated Injury Score [AIS] of 1-6) and Injury Severity Score (ISS) of at least 9 were included. Interfacility transfers and patients who underwent prehospital cardiopulmonary resuscitation were excluded. Data were analyzed between April 20, 2022, and November 27, 2023.

EXPOSURES: Adverse prehospital TBI events, including hypoxia, hypotension, or hypocarbia.

MAIN OUTCOMES AND MEASURES: The primary outcomes were death in the emergency department (ED), hospital death, and unfavorable discharge disposition. Log-binomial regression models were used to estimate the association between adverse TBI events and outcomes, adjusting for sex, race and ethnicity, age, study site, transport mode, initial Glasgow Coma Scale, ISS, head AIS score, injury mechanism, and multiple trauma.

RESULTS: The analytic cohort included 14 994 patients (median [IQR] age, 47 [31-64] years; 71% male; median [IQR] head AIS, 3 [2-4]). Patients with adverse TBI events included 12% (1577 of 13 604) with hypoxia, 10% (1426 of 14 842) with hypotension, and 61% (650 of 1068) with hypocarbia among those with advanced airway management. Patient outcomes included 2% (259 of 14 939) who died in the ED, 12% (1764 of 14 623) who died in the hospital, and 25% (3705 of 14 623) with an unfavorable discharge disposition. Hypoxia (adjusted relative risk [ARR], 2.24; 95% CI, 1.69-2.97), hypotension (ARR, 2.05; 95% CI, 1.54-2.72), and hypocarbia (ARR, 7.99; 95% CI, 2.47-25.85) were associated with increased risks of ED death. Each adverse TBI event exposure was also associated with higher risks of hospital death and unfavorable discharge disposition.

CONCLUSIONS AND RELEVANCE: In this multicenter cohort study, prehospital hypoxia, hypotension, and hypocarbia were associated with poorer TBI outcomes. These results underscore the importance of optimal oxygenation, ventilation, and perfusion in prehospital TBI care.

PMID:39888614 | DOI:10.1001/jamanetworkopen.2024.57506

Geroscience. 2025 Jan 31. doi: 10.1007/s11357-025-01525-9. Online ahead of print.

ABSTRACT

The current study examined cross-sectional and longitudinal associations between nocturia and frailty in a cohort of men and women aged 60 years and older, as evidence on this topic was lacking. We analyzed baseline and follow-up data (n = 1671) from the Berlin Aging Study II (BASE-II), a prospective longitudinal cohort study focusing on the factors associated with “healthy” vs. “unhealthy” aging. Self-reported nocturia was dichotomized into < / ≥ 2 micturitions per night, and frailty was assessed using the Fried frailty phenotype. Covariables were identified a priori based on a review of the existing literature. At baseline, 70.2% of the participants were robust, 28.9% were pre-frail, and 0.9% were frail; 254 participants (23.6%) had self-reported nocturia. In longitudinal analyses, the prevalence and incidence of frailty at follow-up significantly increased when nocturia was present at baseline. Over a median follow-up of 7.1 years, there were 41 incident frailty cases (IR 5.6, 95%-CI 3.9-7.2 per 1000 person-years). After adjusting for age, sex, morbidity burden, and baseline frailty status, baseline nocturia was associated with a 2.23-fold increased risk (95%-CI 1.17-4.18) of frailty at follow-up. Nocturia is associated with an increased risk of developing or progressing in frailty in older adults, and may serve as an early clinical marker for the progression of frailty.

PMID:39888584 | DOI:10.1007/s11357-025-01525-9

Geroscience. 2025 Jan 31. doi: 10.1007/s11357-025-01537-5. Online ahead of print.

ABSTRACT

Dietary restriction (DR) is widely considered to be one of the most potent approaches to extend healthy lifespan across various species, yet it has become increasingly apparent that DR-mediated longevity is influenced by biological and non-biological factors. We propose that current priorities in the field should include understanding the relative contributions of these factors to elucidate the mechanisms underlying the beneficial effects of DR. Our work conducted in two laboratories represents an attempt to unify DR protocols in Drosophila and to investigate the stochastic effects of DR. Across 64 pairs of survival data (DR/ad libitum, or AL), we find that DR does not universally extend lifespan. Specifically, we observed that DR conferred a significant lifespan extension in only 26.7% (17/64) of pairs. Our pooled data show that the overall lifespan difference between DR and AL groups is statistically significant, but the median lifespan increase under DR (7.1%) is small. The effects of DR were overshadowed by stochastic factors and genotype. Future research efforts directed toward gaining a comprehensive understanding of DR-dependent mechanisms should focus on unraveling the interactions between genetic and environmental factors. This is essential for developing personalized healthspan-extending interventions and optimizing dietary recommendations for individual genetic profiles.

PMID:39888582 | DOI:10.1007/s11357-025-01537-5

Ir J Med Sci. 2025 Jan 31. doi: 10.1007/s11845-025-03872-0. Online ahead of print.

ABSTRACT

BACKGROUND: Lab users should display an understanding of microbiology tests and avoid inappropriate requests which may yield negative clinical consequences. Our research addressed diagnostic stewardship education and the perspectives of paediatric hospital doctors on their (1) self-perceived knowledge, (2) motivators for test ordering, (3) proposed educational interventions and (4) preferred teaching modalities.

METHODS: An anonymous, mixed-methods, 34-item online questionnaire was distributed to paediatric doctors across three Irish hospital sites from March to May 2023. Descriptive statistics summarised Likert-scale responses and inductive thematic analysis was used to analyse open-ended items. Subgroup analyses examined differences between consultants and non-consultant hospital doctors (NCHDs).

RESULTS: The analysis included 100 respondents (n = 45 consultants, n = 55 NCHDs, 24% response rate). Consultants scored higher than NCHDs in self-perceived knowledge (p < 0.001). Patient comorbidity, clinical status, local guidelines and accuracy of microbiological tests were the strongest motivators for test-ordering. Consultants were more likely to be influenced by accuracy (p = 0.03), costs (p = 0.01) and laboratory workload (p = 0.01). Only 27% reported formal teaching on diagnostic stewardship. NCHDs demonstrated increased willingness to engage in educational interventions (p = 0.024), and a comparatively higher interest in in-person teaching (p = 0.002) and gamification (p = 0.02). Respondents indicated a preference for formal guidelines on microbiology testing, in-person teaching, cost familiarisation and e-learning modules. Novel methods (peer-to-peer programmes, simulation and gamification) were less favoured. Dominant themes included; collaborative learning, increased microbiology presence, accessibility to education, barriers and administrative issues.

CONCLUSION: Formal diagnostic stewardship educational programmes should be integrated into post-graduate curriculums for both NCHDs and consultants. Focuses for educational interventions include; development of local diagnostic stewardship guidelines, teaching on the cost and accuracy of microbiology tests, senior supervision and role-modelling.

PMID:39888580 | DOI:10.1007/s11845-025-03872-0

World J Microbiol Biotechnol. 2025 Jan 31;41(2):58. doi: 10.1007/s11274-025-04273-2.

ABSTRACT

Exopolysaccharides (EPS) produced by lactic acid bacteria with immunomodulatory potential are promising natural food additives. This study employs small-scale, 250 mL bioreactors combined with a central composite design to optimise two important bioprocess parameters, namely temperature and airflow, to achieve high yields of biomass and EPS from Lacticaseibacillus rhamnosus LRH30 (L. rhamnosus LRH30). A quadratic model was determined to be the best fit for the production of both products. The optimum critical process parameters for maximised biomass were identified to be 37.01 °C with an airflow of 0.12 vvm, while optimum criteria was 20.1 °C with an airflow of 0.18 vvm for maximum EPS production. Under these optimized conditions, small-scale batch experiments yielded a biomass concentration of 10.1 g/L and an EPS yield of 520.2 mg/L. In comparison, scale-up experiments in 2L reactors resulted in a biomass concentration of 8.54 g/L (a reduction of 18%) and an EPS yield of 654.6 mg/L (an increase of 26%). The produced EPS was purified and characterised through Fourier transform infrared spectroscopy and showed characteristic peaks associated with polysaccharides. The immunomodulatory potential of the L. rhamnosus LRH30 cells and EPS was evaluated through cytokine and chemokine secretion in a J774A.1 murine macrophage, resulting in a predominantly anti-inflammatory effect of L. rhamnosus LRH30 and EPS.

PMID:39888560 | DOI:10.1007/s11274-025-04273-2

Sports Med. 2025 Jan 31. doi: 10.1007/s40279-024-02149-3. Online ahead of print.

ABSTRACT

BACKGROUND: Endurance athletes tend to accumulate large training volumes, the majority of which are performed at a low intensity and a smaller portion at moderate and high intensity. However, different training intensity distributions (TID) are employed to maximize physiological and performance adaptations.

OBJECTIVE: The objective of this study was to conduct a systematic review and network meta-analysis of individual participant data to compare the effect of different TID models on maximal oxygen uptake (VO_2max) and time-trial (TT) performance in endurance-trained athletes.

METHODS: Studies were included if: (1) they were published in peer reviewed academic journals, (2) they were in English, (3) they were experimental or quasi-experimental studies, (4) they included trained endurance athletes, (5) they compared a polarized (POL) TID intervention to a comparator group that utilized a different TID model, (6) the duration in each intensity domain could be quantified, and (7) they reported VO_2max or TT performance. Medline and SPORTDiscus were searched from inception until 11 February 2024.

RESULTS: We included 13 studies with 348 (n = 296 male, n = 52 female) recreational (n = 150) and competitive (n = 198) endurance athletes. Mean age ranged from 17.6 to 41.5 years and VO_2max ranged from 46.6 to 68.3 mL·kg^-1·min^-1, across studies respectively. Based on the time in heart rate zone approach, there was no difference in VO_2max (SMD = – 0.06, p = 0.68) or TT performance (SMD = – 0.05, p = 0.34) between POL and pyramidal (PYR) interventions. There were no statistically significant differences between POL and any of the other TID interventions. Subgroup analysis showed a statistically significant difference in the response of VO_2max between recreational and competitive athletes for POL and PYR (SMD = – 0.63, p < 0.05). Competitive athletes may have greater improvements to VO_2max with POL, while recreational athletes may improve more with a PYR TID.

CONCLUSIONS: Our results indicate that the adaptations to VO_2max following different TID interventions are dependent on performance level. Athletes at a more competitive level may benefit from a POL TID intervention and recreational athletes from a PYR TID intervention.

PMID:39888556 | DOI:10.1007/s40279-024-02149-3

J Autism Dev Disord. 2025 Jan 31. doi: 10.1007/s10803-025-06726-x. Online ahead of print.

ABSTRACT

This study aimed to examine early mathematical abilities in young children with autism aged four to seven without intellectual disabilities and their connection with autism severity, non-verbal intelligence, and linguistic abilities (receptive vocabulary and grammar). The study involved 42 children with autism. We assessed participants’ cognitive, mathematical, and linguistic abilities. Their mathematical performance was compared with that of typically developing children using standardized measures. Statistical analyses were conducted to identify potential cognitive or linguistic differences across groups based on mathematical performance, and to determine predictive factors for mathematical abilities in children with autism. The findings indicated a higher prevalence of mathematical difficulties among the participants compared to typically developing children. A classification based on mathematical performance revealed statistically significant differences in cognitive and linguistic variables across groups, particularly in the low-performance group. However, no significant differences were found according to autism severity between the groups. The analysis further identified that a combination of visuo-spatial and linguistic abilities was the most predictive factor for mathematical performance. The study suggests that young children with autism without intellectual disabilities may be more likely to experience mathematical difficulties compared to typically developing children. Assessing cognitive and linguistic abilities could serve as a predictive measure for mathematical difficulties of children with autism, even without a formal diagnosis. Future research, with larger samples or longitudinal approaches, could validate these findings or explore which specific mathematical abilities are more related to non-verbal intelligence and which ones to structural language.

PMID:39888554 | DOI:10.1007/s10803-025-06726-x

Indian J Pediatr. 2025 Jan 31. doi: 10.1007/s12098-024-05405-6. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare six doses of intrapleural streptokinase (SK) vs. the conventional three doses in children with empyema.

METHODS: In this randomized controlled trial, children with empyema received intrapleural streptokinase, either twice daily for 3 d (total 6 doses); or once daily for 3 d (total 3 doses). The outcomes assessed were treatment failure, volume of fluid drained, duration of fever, duration of respiratory distress, length of hospitalization, need for surgical decortication, adverse events and cost.

RESULTS: Thirty-six children were enrolled. Cumulative pleural pus drainage was significantly higher with six doses [median (IQR) 367 (266, 850) vs. 195 (142, 422) ml, p 0.02]. The mean (SD) durations of fever and respiratory distress, after completing intrapleural therapy were also shorter; 2.3 (0.8) vs. 5.7 (1.6) d, p 0.04; and 2.2 (0.9) vs. 6.3 (1.9) d, p 0.03 respectively. However, there were no statistically significant differences in the length of hospitalization after completing therapy [median (IQR) 9 (6, 17) vs. 12 (4, 16) d], total duration of intercostal drainage [median (IQR) 13 (11, 21) vs. 12 (7, 19) d], treatment failure rate [4/16 (25%) vs. 7/16 (43.7%)], or need for surgical decortication [2/16 (16.2%) vs. 1/16 (6.2%)]. There were no significant adverse effects necessitating cessation or modification of therapy in either group. The cost of therapy was identical in both groups.

CONCLUSIONS: Six doses of intrapleural streptokinase appear superior to the conventional three doses in children with empyema, with comparable safety and cost.

PMID:39888550 | DOI:10.1007/s12098-024-05405-6

Environ Geochem Health. 2025 Jan 31;47(3):63. doi: 10.1007/s10653-025-02374-3.

ABSTRACT

People spend about 90% of their day indoors and are at increased risk of exposure to metal elements (MEs), water-soluble ions (WSIs) and polycyclic aromatic hydrocarbons (PAHs) contained in indoor PM_2.5. Therefore, firstly this study investigated indoor PM_2.5 pollution to explore the distribution characteristics of MEs, WSIs and PAHs. Secondly, the carcinogenic risk of MEs and PAH to the population was analyzed using health risk assessment models. Finally, the sources of MEs and PAHs were identified using statistical analyses. The results of the study show that PM_2.5 concentrations fluctuate between spring and winter, with the most significant fluctuations reaching around 100 µg/m³ in March and January. Concentrations of most MEs, WSIs and PAHs during the heating season are twice as high as during the non-heating season. The main sources of MEs and PAHs are industrial, coal-fired emission sources, vehicle exhaust and metallurgical chemical emission sources. The non-carcinogenic and carcinogenic risks of metallic elements to the population are mainly due to Co, which contribute up to 80% in both adults and children. The carcinogenicity risk indices of the six monomeric PAHs, BaP, DbA, Bbf, Bkf, Inp and BaA, were greater than 10^-6, indicating a potential carcinogenic risk.

PMID:39888536 | DOI:10.1007/s10653-025-02374-3

Lasers Med Sci. 2025 Jan 31;40(1):57. doi: 10.1007/s10103-025-04310-4.

ABSTRACT

The purpose of this study was to compare the penetration of methylene blue (MB) dye after laser irradiation using PIPS (photon-induced photoacoustic streaming) and SWEEPS (shockwave enhanced emission photoacoustic streaming) methods compared to Passive ultrasonic irrigation (PUI) and to study their effect on dentin microhardness. A total of 44 single-rooted human teeth which were extracted for orthodontic or periodontal reasons were used. The teeth were decapitated to standardize roots to 12 mm in length. Canals were prepared up to size #30.6% and divided randomly into four groups (n = 11/group) according to the method of NaOCl activation: Group I: Er: YAG laser activation with PIPS tip; Group II: Er: YAG laser activation with SWEEPS tip; Group III: passive ultrasonic irrigation (PUI) and Group IV: conventional needle irrigation (CI). MB dye was injected then teeth were sectioned horizontally into coronal, middle and apical sections. Penetration depth/area percentages were measured using stereomicroscopy. Coronal specimens were further subjected to Vickers microhardness testing. Data were statistically analyzed. SWEEPS and PIPS activation methods provided higher dye penetration depth and area percentages compared to PUI with no statistically significant differences between all test groups. However, all test groups showed statistically significant differences with the CI (control) group. SWEEPS activation provided higher microhardness values with statistically significant differences with the other groups. Laser irrigant activation using PIPS and SWEEPS is comparable to PUI concerning MB dye penetration. However, SWEEPS preserved dentin microhardness significantly which can be beneficial for the long-term prognosis of root canal treated teeth.

PMID:39888502 | DOI:10.1007/s10103-025-04310-4