Tag: nevin manimala

Neurol Sci. 2025 Oct 9. doi: 10.1007/s10072-025-08546-4. Online ahead of print.

ABSTRACT

BACKGROUND: Urinary anticholinergic (AC) medications are commonly prescribed for Overactive Bladder (OAB) syndrome. Although recent studies suggest a potential link between their use and an increased risk of dementia, this association remains debated.

METHODS: We conducted a systematic review and meta-analysis to evaluate the risk of dementia in patients receiving AC treatment for OAB syndrome. A comprehensive search of PubMed, Embase, and Cochrane databases was performed. Outcomes of interest included dementia risk and its association with age, sex distribution, treatment duration, and follow-up length. Two subgroup analyses were assessed: (1) AC vs. no drug therapy and (2) AC vs. mirabegron, a beta-3 agonist and current standard of care for OAB syndrome. Relative risk (RR) with p-value < 0.05 was considered statistically significant.

RESULTS: Eight studies were included, comprising a total of 3,656,686 patients diagnosed with OAB syndrome, of whom 44.7% were exposed to urinary AC. The comparison between AC and no drug therapy showed a statistically significant higher risk of dementia in the exposed group (RR 1.2, 95% CI [1.09-1.32], I²=96%, p < 0.01). When the AC group was compared to patients who received Mirabegron, the AC use also presented a statistically significant increase in dementia risk (RR 1.28; 95% CI [1.03-1.58], I²=98%, p = 0.02).

CONCLUSIONS: Patients who received urinary AC therapy for OAB syndrome were associated with an increased risk of dementia compared to both no drug therapy and medical therapy with mirabegron. These findings suggest that, for the long-term treatment of adult patients with OAB syndrome, alternative therapeutic options to AC should be considered, with Mirabegron emerging as a valid choice in clinical decision-making.

PMID:41066055 | DOI:10.1007/s10072-025-08546-4

Lifetime Data Anal. 2025 Oct 9. doi: 10.1007/s10985-025-09673-y. Online ahead of print.

ABSTRACT

Many methods exist to jointly model either recurrent and related terminal survival events or longitudinal outcome measures and related terminal survival event. However, few methods exist which can account for the dependency between all three outcomes of interest, and none allow for the modeling of all three outcomes without strong correlation assumptions. We propose a joint model which uses subject-specific random effects to connect the survival model (terminal and recurrent events) with a longitudinal outcome model. In the proposed method, proportional hazards models with shared frailties are used to model dependence between the recurrent and terminal events, while a separate (but correlated) set of random effects are utilized in a generalized linear mixed model to model dependence with longitudinal outcome measures. All random effects are related based on an assumed multivariate normal distribution. The proposed joint modeling approach allows for flexible models, particularly for unique longitudinal trajectories, that can be utilized in a wide range of health applications. We evaluate the model through simulation studies as well as through an application to data from the Atherosclerosis Risk in Communities (ARIC) study.

PMID:41066052 | DOI:10.1007/s10985-025-09673-y

J Endocrinol Invest. 2025 Oct 9. doi: 10.1007/s40618-025-02718-x. Online ahead of print.

ABSTRACT

PURPOSE: The role of iodine treatment in congenital and acquired non-autoimmune subclinical hypothyroidism (SH) remains unclear, although it has been demonstrated that iodine can improve thyroid function in some dyshormonogenetic defects. We aimed to evaluate the effect of iodine administration in children with congenital hypothyroidism (CH) with gland in situ (GIS) and non-autoimmune SH diagnosed during childhood.

PATIENTS AND METHODS: 13 children with CH and GIS and 19 with non-autoimmune SH (7 females, 25 males; median age 10 years) were given iodine for 9 months at increasing doses from 50 µg/day to 150 µg/day, after stopping levothyroxine (LT4), when taken. 4 children had DUOX2 mutations, whereas the etiology was unknown in the remaining cases. Thyroid hormones, anti-thyroid antibodies and ultrasound were evaluated every 3 months for 12 months and then after 1 year.

RESULTS: At increasing of the daily iodine dose, there was in both groups a slight progressive increase in TSH, that became statistically significant only after 150 µg/day, both in the SH group (p 0.044) and in the whole group (p 0.015). The other parameters did not change with treatment. No children developed thyroid autoimmunity, even one year after iodine withdrawal, and iodine treatment did not modify the course of disease as shown by follow-up data.

CONCLUSION: This study shows a failure of physiological doses of iodine to improve mild CH with GIS and idiopathic SH. The increase of serum TSH during treatment may reflect the spontaneous course of the disease in children rather than a detrimental effect of iodine.

PMID:41066039 | DOI:10.1007/s40618-025-02718-x

Chempluschem. 2025 Oct 9:e202500494. doi: 10.1002/cplu.202500494. Online ahead of print.

ABSTRACT

The electrochemical characterization of DNA films with different base mismatches or with Cu^II– or Ag^I-mediated pairs was carried out to assess possible immobilization and interaction effects. Toward this end, 3-hydroxy-2-methylpyridin-4(1H)-one (H), imidazole-4-carboxylate (K), purine-6-carboxylate (P), and 7-deaza-6-pyrazolylpurine (D) were used as artificial metal-binding nucleobases. Cyclic voltammetry and square-wave voltammetry confirmed the immobilization of suitably modified oligonucleotides on Au electrodes. The incorporation of the metal ions into the base mismatches to form metal-mediated base pairs showed a negligible effect on the peak potentials. Ambiguous electrochemical impedance spectroscopy results were obtained for DNA with metal-mediated base pairs, as some duplexes showed no effect of metal ion addition, while others showed variable charge transfer resistance (R_CT) with no discernible pattern. Notably, the formation of Ag^I-mediated base pairs induced larger relative changes in R_CT compared to Cu^II-mediated base pairs. Amongst the latter, only strands containing the artificial nucleobase H showed statistically relevant sequence- and distance-dependent charge transfer changes upon metalation. The data indicate that neither nucleobase charge nor nucleobase size directly correlates with the charge transfer resistance, but suggest that changes in DNA film stiffness and hence permeability outweigh other effects.

PMID:41066038 | DOI:10.1002/cplu.202500494

J Pediatr Gastroenterol Nutr. 2025 Oct 9. doi: 10.1002/jpn3.70218. Online ahead of print.

ABSTRACT

OBJECTIVES: Adequate bowel preparation facilitates Ileocolonoscopy completion. Paediatric Endoscopy Quality Improvement Network (PEnQuIN) quality standards recommend unadjusted rates of adequate bowel preparation of ≥80% and terminal ileal intubation ≥85% for paediatric ileocolonscopy. A Boston Bowel Preparation Scale (BBPS) score of ≥6 is considered adequate. This study aims to identify whether UK hospitals are attaining these PEnQuIN standards and review medications used.

METHODS: UK paediatric endoscopy centres were invited to complete standardised questionnaires and to provide anonymous BBPS data. Patients meeting the inclusion criteria were grouped according to the bowel preparation drug type for analysis, and a Kruskal-Wallis test was performed.

RESULTS: Complete data for 209 patients from 11 hospitals were collated. Seven hospitals achieved the PEnQuIN standard for adequate bowel preparation, and nine for terminal ileal intubation. Bowel preparation drugs varied greatly among hospitals. Considering drug subgroups, only Group D (Citric Acid and Magnesium Carbonate) achieved the desired adequate bowel preparation rate of ≥80%. A Kruskal-Wallis test revealed no statistically significant difference in median BBPS score between medication subgroups (H = 1.017, p = 0.907). There was significant variability within subgroups regarding timing, dosage and frequency of drug, resulting in heterogeneity.

CONCLUSIONS: This initial study highlights marked variability in the use of bowel preparation medications in the United Kingdom. While only subgroup D met the standard for bowel preparation, more met the standard for ileal intubation, raising the question of whether important pathology is being missed. A large prospective multicentre trial is required to establish the ideal medication type and protocol for bowel preparation in children.

PMID:41064981 | DOI:10.1002/jpn3.70218

Am J Hum Biol. 2025 Oct;37(10):e70154. doi: 10.1002/ajhb.70154.

ABSTRACT

OBJECTIVES: This study evaluates differences in the nutritional status of children under 5 years old among the Bodi (Mela) of southwest Ethiopia, in the context of a sedentarization program which involved resettlement of pastoralist families in government-designed villages (villagization sites).

METHODS: Data were collected in 2013 from two settings: state-run villagization sites (Hana), where families were forcibly resettled 6-18 months earlier to farm and receive food aid, and comparison communities in cattle camps (Gura). Families with at least one child under 5 years old were recruited. Household characteristics, disease incidence, infant feeding practices, and anthropometric measurements (weight, height, mid-upper arm circumference, triceps skinfold, and head circumference) were recorded. Age-adjusted z-scores were calculated and compared between sites. Ethical approval for the study was obtained from Emory University, Wolaita Sodo University, and the Southern Nations, Nationalities and People’s Region Health Bureau.

RESULTS: A total of 106 children from 75 families participated (40 in Hana, 35 in Gura). Nearly one-third of the children were stunted (31.5%) or underweight (27.4%), while 7.6% were wasted. Anthropometric measurements did not differ significantly between the two sites; however, in a sex-stratified analysis, boys in the villagization site had higher weight-for-height but lower triceps skinfold-for-age than those in the comparison site. No significant difference in the proportion wasted was observed. Families in Hana were less likely to report their child having consumed animal milk in the past 24 h and more likely to report a case of diarrhea in the past month.

CONCLUSIONS: Approximately 1 year after sedentarization, there was no consistent pattern of change in nutritional status among children in resettled families compared to those in pastoralist families.

PMID:41064952 | DOI:10.1002/ajhb.70154

Am J Biol Anthropol. 2025 Oct;188(2):e70139. doi: 10.1002/ajpa.70139.

ABSTRACT

OBJECTIVES: Sexual dimorphism in primates reflects evolutionary, ecological, and social pressures and varies widely across species, complicating its analysis. This study builds on previous research to investigate sexual dimorphism in the long bones of great apes, aiming to improve sex estimation and evaluate the effectiveness of various methods in classifying unsexed specimens.

MATERIALS AND METHODS: External morphology of humeri and femora from modern great apes-including Homo, Pan, Gorilla, and Pongo-was analyzed using 3D anatomical landmarks and geometric morphometrics. Various statistical approaches and dimensionality reduction techniques were employed alongside classification methods, including supervised machine learning algorithms.

RESULTS: Size, rather than shape, emerged as the main factor distinguishing male and female long bones in great apes-except in Pan, where dimorphism is minimal and classification accuracy remains low. Incorporating size improved classification accuracy for Gorilla, Pongo, and Homo, with results indicating strong dimorphism in Gorilla and Pongo, moderate dimorphism in Homo sapiens, and minimal dimorphism in Pan.

DISCUSSION: This study shows that combining geometric morphometrics with machine learning can enhance sex classification of great ape long bones. Nonetheless, limitations such as small or imbalanced samples highlight the need for larger datasets and further research-including internal bone structure-to better understand skeletal dimorphism and its evolutionary drivers.

PMID:41064926 | DOI:10.1002/ajpa.70139

Neuropsychol Rehabil. 2025 Oct 9:1-43. doi: 10.1080/09602011.2025.2558883. Online ahead of print.

ABSTRACT

Interventions targeting social cognition following moderate-to-severe Traumatic Brain Injury (TBI) have shown some benefit, however, there remains a need to systematically review, statistically synthesize, and evaluate these interventions to inform the development of Clinical Practice Guidelines. Six databases were searched from inception to May 2024. Eligible studies targeted adults with a moderate-to-severe TBI (P); evaluated interventions targeting social cognition (I); compared to a control, baseline performance, or phase without treatment (C); based on objective social-cognitive ability/performance (O). Studies were screened by two independent reviewers. A random effects model estimated treatment effects for RCTs (Hedge’s g) and observational (pre-post) studies (SMD) separately. Risk of bias was assessed. Certainty of evidence was evaluated using GRADE. Twenty-five studies were eligible, including 478 participants. RCTs targeting emotion perception and ToM produced a small effect (g = 0.38 (95%CI, 0.17, 0.59), p < .001). Observational studies targeting emotion perception and ToM produced a small-medium effect (SMD = 0.42 (95% CI 0.22, 0.61), p < .001). Interventions targeting empathy or alexithymia were limited. Our review provides initial evidence for the effectiveness of social-cognitive interventions targeting emotion perception and/or ToM. More research is needed to develop and evaluate interventions for other social-cognitive domains, including empathy and alexithymia.

PMID:41064916 | DOI:10.1080/09602011.2025.2558883

Ther Adv Respir Dis. 2025 Jan-Dec;19:17534666251383662. doi: 10.1177/17534666251383662. Epub 2025 Oct 9.

ABSTRACT

BACKGROUND: Unplanned extubation (UE) in intensive care units (ICUs) is a significant patient safety concern, associated with increased morbidity and healthcare utilization; the reported rates of UE vary from 1% to 15%. There is sparse data on the effects of multiple performance improvement (PI) strategies to decrease the rate of UE, particularly in inner-city ICU populations. This study evaluates the impact of PI strategies on UE rates and associated patient outcomes in an adult ICU.

OBJECTIVES: To determine the impact of performance improvement (PI) strategies on rates of unplanned extubation (UE), reintubation, tracheostomy, mortality, and length of hospital stay in ICU patients.

DESIGN: Retrospective cohort studyMethods:This retrospective observational study included 6,397 mechanically ventilated patients admitted to a single tertiary ICU between 2015 and 2023. Three distinct time periods were compared: Period 1 (2015-2017, pre-PI), Period 2 (2018-2020, early-PI), and Period 3 (2021-2023, sustained-PI). Demographics, sedation practices, UE characteristics, and outcomes were analyzed using logistic regression.

RESULTS: UE incidence declined significantly from 3.79% in Period 1 to 2.17% in Period 3 (p = 0.002). Reintubation rates dropped from 45.2% to 26.7% (p = 0.011), and tracheostomy rates from 19.0% to 2.2% (p < 0.001). Multivariate analysis showed reduced odds of reintubation in Periods 2 (OR = 0.219, p = 0.001) and 3 (OR = 0.345, p = 0.021) and reduced odds of tracheostomy in Period 3 (OR = 0.011, p = 0.016). Risk factors for reintubation included the absence of prior intubation history and not undergoing spontaneous breathing trials. Older age (⩾71 years) and positive urine toxicology for opiates were strongly associated with tracheostomy.

CONCLUSION: Implementation of PI strategies significantly reduced rates of unplanned extubation, reintubation, and tracheostomy. These findings support continued quality improvement initiatives in ICU airway management.

PMID:41064905 | DOI:10.1177/17534666251383662

Acta Medica (Hradec Kralove). 2025;68(2):50-57. doi: 10.14712/18059694.2025.19.

ABSTRACT

OBJECTIVE: The objective of this study is to assess the expression levels of different immaturity CD markers in diverse subtypes of Acute Lymphoblastic Leukemia (ALL) among children and adults, and determine any statistically significant variations in marker expression between these two groups.

METHODS: This dataset included CD marker expressions (CD34, HLA-DR, TdT, and CD38) for 130 ALL patients (51 pediatric B-ALL, 16 pediatric T-ALL, 44 adult B-ALL, and 19 adult T-ALL patients). The Shapiro-Wilk test analysis was conducted to check for normality distribution in all data points before proceeding with the statistical analysis test. As a result for each marker within these subtypes, descriptive statistics were calculated. Independent samples t-tests were initially conducted to compare mean expression levels of CD markers between groups. Moreover, since non-normal distributions are likely to occur, Mann-Whitney U tests were used for Pediatric T-ALL and Adult T-ALL.

RESULTS: Descriptive analysis indicated variability in CD marker expression levels among the different subtypes of ALL. Both t-tests and Mann-Whitney U tests revealed statistically significant differences (p < 0.05) in the expression levels of CD markers between pediatric and adult groups, or between B-ALL and T-ALL groups.

CONCLUSION: Significant differences have been identified using different analysis methods across the studied groups. The investigation analyzes the expression levels of CD34, HLA-DR CD38, and TdT within pediatric B-ALL patients and pediatric T-ALL patients along with adult B-ALL patients and adult T-ALL patients. The patterns need appreciation because they might reveal biological differences at their base which influence disease development and both treatment results and patient survival outcomes.

PMID:41064890 | DOI:10.14712/18059694.2025.19