Tag: nevin manimala

J Magn Reson Imaging. 2025 Oct 8. doi: 10.1002/jmri.70145. Online ahead of print.

ABSTRACT

BACKGROUND: Magnetic resonance elastography (MRE) has demonstrated potential in characterizing intracranial tumors, including glioblastoma. The influence of pathology on measurement consistency and interobserver agreement needs evaluation to promote MRE implementation as a quantitative biomarker.

PURPOSE: To assess repeatability and interobserver agreement of absolute and normalized magnitude of the complex shear modulus (|G*|), storage modulus (G’), and loss modulus (G″) in glioblastoma.

STUDY TYPE: Prospective.

POPULATION: Thirteen adults (5 male, 8 female, mean age 66.23 years) with histopathologically confirmed glioblastoma.

FIELD STRENGTH/SEQUENCE: 3 T MRI, modified single-shot spin-echo echo-planar imaging.

ASSESSMENT: Two same-session MRE acquisitions were performed with patient repositioning. The solid tumor component was independently segmented by 2 observers on contrast-enhanced T1-weighted images co-registered to MRE maps.

STATISTICAL TESTS: Repeatability was assessed using the repeatability coefficient, coefficient of variation, and Bland-Altman plots, and interobserver agreement by the intraclass correlation coefficient. The Wilcoxon signed-rank test compared parameters and coefficients of variation between tumor-normal-appearing white matter and absolute and normalized measurements. Significance was set at 0.05.

RESULTS: Tumor |G*| and G’ showed repeatability coefficients of 0.07-0.08 kPa and 0.05 kPa, compared with 0.13 kPa (|G*|) and 0.15-0.16 kPa (G’) for normalized measurements. Coefficients of variation in tumor regions were 1.42% ± 1.12%-1.60% ± 1.41% for |G*| and 1.19% ± 0.96%-2.08% ± 2.22% for G’, significantly lower than normalized values (4.82% ± 4.49%-4.21% ± 4.27% for |G*|; 5.12% ± 5.04%-5.45% ± 4.53% for G’). Tumor |G*| and G’ showed excellent interobserver agreement (intraclass correlation coefficients 0.97 and 0.95). Tumor G″ demonstrated higher variability than |G*| and G’ (coefficients of variation 8.58% ± 7.69%-7.51% ± 6.73%), with no significant difference between absolute and normalized measurements (p = 0.14).

DATA CONCLUSION: Tumor |G*| and G’ are the most repeatable metrics in glioblastoma. Normalization reduces measurement repeatability due to normal-appearing white matter variability. The small sample size (n = 13) limits generalizability.

EVIDENCE LEVEL: 2.

TECHNICAL EFFICACY: Stage 2.

PMID:41061165 | DOI:10.1002/jmri.70145

JMIR Hum Factors. 2025 Oct 8;12:e66514. doi: 10.2196/66514.

ABSTRACT

BACKGROUND: Patients with inflammatory rheumatic diseases often experience drug-related problems (DRPs). As these can result in negative health consequences, DRPs should be identified and addressed in a timely manner. Text messaging between patients and pharmacists at the initiative of the patient has the potential to deliver support with DRPs more continuously, increase accessibility and efficiency, and enhance patient involvement in the process of identifying and solving DRPs.

OBJECTIVE: This study aimed to assess the feasibility of text messaging from both the patients’ and health care practitioners’ perspectives before a large-scale implementation.

METHODS: Adult patients using a disease-modifying antirheumatic drug were given access to text messaging with pharmacists to discuss DRPs for a period of 8 weeks. Patients received a response from a pharmacist within 4 working hours. Feasibility was evaluated based on five domains of Bowen’s framework for designing feasibility studies: (1) demand: actual use, expressed interest (user version of the Mobile Application Rating Scale – section E), and factors impacting future use; (2) limited efficacy: number of DRPs solved, DRPs resulting in follow-up, and DRPs warranting involvement of health care provider; (3) implementation: degree of execution (number of conversations answered within service level) and resources needed (pharmacists’ time investment per conversation); (4) acceptability: satisfaction and appropriateness (theoretical framework of acceptability); and (5) practicality: ability to carry out intervention activities (System Usability Scale). Data were collected by means of usage data and a questionnaire.

RESULTS: In total, 45 patients (median age 57, IQR 52-65 y; n=31, 69% female) and 5 pharmacists (median age 41, IQR 26-47 y; n=1, 20% female) actively participated in this study. In the demand domain, 158 unique DRPs were raised in 133 conversations, with a median of 3 (IQR 2-4) unique DRPs per patient. Expressed interest was rated high by patients (median 4, IQR 4-5), and 90% (37/41) of patients would recommend text messaging to others. In the limited-efficacy domain, all DRPs were solved, and 77% (122/158) of DRPs warranted involvement of a health care provider. In the implementation domain, 87% (116/133) of conversations were answered within the promised timeframe with a median time investment of 4:15 (IQR 2:21-7:27) minutes per conversation. Acceptability was rated high by patients (median 4, IQR 4-5) and pharmacists (median 5, IQR 4-5). Finally, in the practicality domain, System Usability Scale was scored above average for patients (mean 72, SD 18) and pharmacists (mean 81, SD 16).

CONCLUSIONS: Text messaging with pharmacists at the initiative of patients with rheumatic diseases seems feasible for discussing DRPs in terms of limited efficacy, implementation, acceptability, demand, and practicality for patients and pharmacists.

PMID:41061137 | DOI:10.2196/66514

BJS Open. 2025 Sep 8;9(5):zraf098. doi: 10.1093/bjsopen/zraf098.

ABSTRACT

BACKGROUND: Faecal immunochemical testing has rapidly been established as the first-line triage for patients with symptoms suspicious for colorectal cancer. However, the reported low compliance of test returns issued from primary care is concerning. This article reports the real-world impact of implementation of a double-faecal immunochemical testing pathway for symptomatic referrals into routine clinical practice.

METHODS: All eligible referrals between November 2021 and October 2022 were sent two faecal immunochemical tests via the faecal immunochemical testing interface office. Colorectal investigations were instigated if either test result was ≥10 µg haemoglobin per g. Referrals with double-negative results were reviewed by consultants who decided whether symptoms merited further investigation. Cancer registry follow-up data were cross-checked, and a further electronic registry allowed capture of re-referrals.

RESULTS: Some 5425 patients were triaged using double-faecal immunochemical testing, with 5116 (94.3%) completing at least 1 and 4607 (84.9%) both faecal immunochemical tests. The positivity of one test was 20.8%, rising to 27.8% where both tests were completed. The number of referred patients undergoing colorectal investigation fell from 90% before faecal immunochemical testing-directed pathways to 56.6% owing to a reduction in investigating patients with double-negative results. The double-faecal immunochemical testing pathway had a sensitivity of 94.3% for the detection of colorectal cancer, with 37.5% of cancers with a negative first test being detected by the second. Only 3.3% of patients triaged through the double-faecal immunochemical testing pathway were re-referred.

CONCLUSION: The double-faecal immunochemical testing pathway demonstrated high test return rates, a reduction in unnecessary investigations, and colorectal cancer detection rates similar to preimplementation rates.

PMID:41061132 | DOI:10.1093/bjsopen/zraf098

BJS Open. 2025 Sep 8;9(5):zraf096. doi: 10.1093/bjsopen/zraf096.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) screening programmes aim to detect early, asymptomatic cancers and improve survival. This study aimed to establish the proportion of interval cancers, and the consequences with regard to stage, clinical outcome, and overall survival. Risk factors associated with interval CRCs were investigated.

METHODS: The Scottish Bowel Screening Programme uses faecal immunochemical testing at a threshold of 80 µg haemoglobin per g as a positive trigger for investigation. Screening was offered to all eligible individuals in one region, from November 2017 to October 2021. Cancer registries were cross-checked to ensure complete capture of all cancers including interval CRCs. The primary outcome was rate of interval CRCs among participants with follow-up of 24 months, and its relationship to faecal immunochemical testing results, clinical variables, stage, time to diagnosis, and survival. The secondary outcome was identification of risk factors associated with interval CRCs.

RESULTS: The Scottish Bowel Screening Programme generated 316 583 tests during the study period. Participation was 71.0% of the eligible population (212 664 patients); it was greater among women (71.9 versus 70.0%; P < 0.001) and in higher socioeconomic areas (76.9 versus 58.6%; P < 0.001). In the screened population, 546 CRCs were diagnosed within 2 years of screening. Some 289 of these patients (52.9%) had positive bowel screening. There were 257 patients with interval CRCs, who waited a median of 13 (interquartile range 7-20) months for diagnosis. Of CRCs diagnosed, 24.9% had screening faecal immunochemical test results of < 10 µg haemoglobin per g. The interval CRC rate was greater in women, older patients, and among the least socioeconomically deprived. Interval CRCs were associated with worse 2-year all-cause mortality than screen-detected CRCs (23.0 versus 10.8%; P < 0.001). Importantly, 121 of the 257 interval CRCs (47.1%) had detectable faecal immunochemical test results at 10-79 µg haemoglobin per g.

CONCLUSION: Patients with interval CRCs and a detectable faecal immunochemical test result below the predetermined threshold appear to be significantly disadvantaged with respect to stage at presentation and survival. Almost half of interval CRCs diagnosed within 2 years had detectable haemoglobin on screening faecal immunochemical test and would be a target for lower positivity thresholds.

PMID:41061131 | DOI:10.1093/bjsopen/zraf096

ANZ J Surg. 2025 Oct 8. doi: 10.1111/ans.70308. Online ahead of print.

ABSTRACT

BACKGROUND: The demand for conversion gastric bypass bariatric procedures has increased; however, the ideal procedure remains contentious, and access to government-funded procedures remains limited. This study aimed to determine if the medium-term weight loss, reflux, and safety outcomes are significantly different in patients who receive conversion Roux-en-Y gastric bypass (RYGB) and One Anastomosis Gastric Bypass (OAGB) in an Australian government-funded hospital (GFH).

DESIGN: This was a retrospective observational study of 251 adult participants who received conversion gastric bypass surgery at the Royal Brisbane and Women’s Hospital between January 1, 2015, and April 30, 2023. The primary outcome measure was the annual percentage total weight loss (%TWL) from 12 months to 5 years following conversion to RYGB versus OAGB. Secondary outcome measures were post-operative reflux, hospital length of stay (LOS), and complications within 90 days.

RESULTS: The annual median %TWL from 1 to 5 years post-surgery did not demonstrate a statistically significant difference between conversion RYGB and OAGB. Participants who had previously received a laparoscopic adjustable gastric banding (LAGB) and had a conversion to RYGB for gastro-oesophageal reflux demonstrated statistically significantly better annual %TBWL out to 4 years compared to those who had received a prior sleeve gastrectomy (SG) χ²(1) = 6.4, p = 0.011. Similarly, there was a statistically significant improved %TWL in patients with gastro-oesophageal reflux, who were converted to OAGB from primary LAGB compared to primary SG; however, this was only statistically significant out to 2 years χ²(1) = 4.2, p = 0.041. Pre- and post-operative gastro-oesophageal reflux and LOS were comparable in conversion RYGB and OAGB procedures. RYGB demonstrated a significantly higher incidence of the post-operative complications out to 90 days; p = 0.008.

CONCLUSION: RYGB and OAGB provide durable medium-term weight loss when performed as conversion procedures. Our results suggest that consistent, improved medium-term weight loss can be achieved in participants who undergo conversion gastric bypass in the context of reflux if they have previously received LAGB. There was no significant difference in the incidence of de-novo gastro-oesophageal reflux following either RYGB or OAGB.

PMID:41059548 | DOI:10.1111/ans.70308

J Cosmet Dermatol. 2025 Oct;24(10):e70490. doi: 10.1111/jocd.70490.

ABSTRACT

BACKGROUND: The use of electromagnetic energy as an alternative to surgical procedures for subcutaneous fat reduction has gained popularity in recent years. In this pilot study, the effects of using amplified radio-frequency energy in the medium wave delivery range, in conjunction with exercise intervention, were investigated for their potential reduction of abdominal subcutaneous and visceral fat.

OBJECTIVES: The study aimed to evaluate the effects of combined intervention on the volume of abdominal fat, analyzing changes in lipid profile, metabolic factors, and inflammatory markers.

METHODS: Thirty-four participants were selected and assigned to a 10-day intervention utilizing a Capenergy device every weekday except Saturday and Sunday. This involved the application of amplified energy through a belt covering the abdominal area of 800 cm² followed by a 45-min submaximal aerobic exercise. Measurements were conducted pretreatment and after the intervention. Lipid profile, leptin, insulin, and protein C were measured. Body fat was measured by MRI of the entire abdomen. Follow-up measurements were also taken at the 6-month mark.

RESULTS: A statistically significant decrease was noted in both subcutaneous and visceral fat in the abdominal area, as well as a decrease in weight, waist-to-hip, and all biochemical values, without side effects, just a slight redness. These effects on abdominal fat were maintained at the 6-month follow-up with no reports of regaining fat.

CONCLUSION: The utilization of amplified radiofrequency with an abdominal belt with static electrodes and temperature sensors, together with exercise intervention, has significant potential for reducing abdominal subcutaneous and visceral fat, while also improving associated factors safely and effectively, even after a follow-up period.

TRIAL REGISTRATION: NCT06377358.

PMID:41059542 | DOI:10.1111/jocd.70490

J Am Heart Assoc. 2025 Oct 7;14(19):e039197. doi: 10.1161/JAHA.124.039197. Epub 2025 Oct 8.

ABSTRACT

BACKGROUND: Over the past decade, higher blood pressure (BP) variability and postural changes in BP have been associated with lower cognitive function. However, only one study has investigated the specific association between BP postural changes variability and brain health, showing a greater risk of dementia with higher systolic BP (SBP) postural changes variability. We aimed to investigate the association between BP postural changes variability and cognitive function in community-dwelling older adults.

METHODS: Participants from the S.AGES (Sujets ÂGES) cohort underwent clinical examinations every 6 months during 3 years. At each clinical visit, an orthostatic SBP ratio was calculated: (seated SBP/standing SBP)×100. A similar method was used to compute an orthostatic diastolic BP ratio. Then, we assessed the visit-to-visit BP postural changes variability according to several indicators including coefficient of variation. Cognition was evaluated annually using the Mini-Mental State Examination. Statistical analyses were performed with linear mixed models.

RESULTS: We included 2974 patients (mean age, 78 years). After adjustment for demographics, cardiovascular risk factors and disease, seated SBP/diastolic BP, and BP-lowering treatment, visit-to-visit SBP postural changes variability was significantly associated with lower cognition (per 1-SD increase in coefficient of variation: adjusted β=-0.15 [95% CI, -0.27 to -0.04], P=0.01). Similar results were found with visit-to-visit diastolic BP postural changes variability.

CONCLUSIONS: Visit-to-visit SBP and diastolic BP postural changes variability were associated with lower cognition. Further studies are needed to assess whether controlling orthostatic BP instability over time could help preserve cognitive function.

REGISTRATION: URL: https://clinicaltrials.gov; Unique identifier: NCT01065909.

PMID:41059541 | DOI:10.1161/JAHA.124.039197

Front Physiol. 2025 Sep 22;16:1646143. doi: 10.3389/fphys.2025.1646143. eCollection 2025.

ABSTRACT

INTRODUCTION: The supplementation of chicken embryos with bioactive compounds may elicit a beneficial effect on the development of their gut microbiome and enhance protection against infectious agents after hatching. Therefore, this study aimed to evaluate the effect of in ovo co-supplementation with a multi-strain probiotic and zinc-glycine chelate on the levels of pro- and anti-inflammatory cytokines, acute-phase proteins, and immunoglobulins in the peripheral blood and tissues of broiler chickens on the day of hatching and 7 days post hatching. The effect of supplementation on the growth parameters of chickens was assessed as well.

METHODS: The study was conducted on 1,500 hatching eggs from a broiler breeding flock (Ross × Ross 308) at 36 weeks. ELISA kits were used to determine levels of acute-phase proteins and immunoglobulins. Expression of immunoglobulins was determined by means of qRT-PCR.

RESULTS: The results indicate enhanced synthesis of acute-phase proteins in the liver and increased levels of serum amyloid A in the small intestine tissue, as well as IgA and IgM mRNA and suppressed synthesis of pro-inflammatory cytokines IFN-γ and TNF-α. During the cumulative experimental period (days 0-42), the mean body weight gain (BWG) and feed intake (FI) in the group supplemented with a multi-strain probiotic were statistically significantly lower than the control group.

DISCUSSION: It may be concluded that the combined in ovo use of a multi-strain probiotic and Zn-Gly chelate modulates the immune response, helps maintain the balance between the synthesis of Th1 and Th2 cytokines, inhibits inflammatory processes, and stimulates immune system development.

PMID:41059496 | PMC:PMC12497791 | DOI:10.3389/fphys.2025.1646143

Front Physiol. 2025 Sep 22;16:1678866. doi: 10.3389/fphys.2025.1678866. eCollection 2025.

ABSTRACT

BACKGROUND: Badminton requires high-intensity lower limb explosive power and agility for executing rapid lunges, jumps, and directional changes. Complex training (CT) combines heavy resistance exercises with plyometric activities to enhance maximal strength and explosive performance through post-activation performance enhancement (PAPE). However, limited research exists on CT effects in adolescent female badminton players.

OBJECTIVE: To investigate the effects of an 8-week complex training program on lower limb explosive power and movement agility in adolescent female badminton players.

METHODS: Thirty-two adolescent female badminton players were randomly allocated into complex training group (CT group, n = 16, age: 15.69 ± 0.95 years) and resistance training group (RT group, n = 16, age: 15.63 ± 1.15 years). The CT group performed resistance exercises (75%-85% 1RM) paired with plyometric exercises twice weekly for 8 weeks, while the RT group completed traditional resistance training with the same frequency. Pre- and post-intervention assessments included squat jump (SJ), countermovement jump (CMJ), bilateral and unilateral jumps, sprint tests (5 m, 10 m, 15 m, 20 m), hexagon test, modified 505 change of direction (COD) test, on-court COD test, and isometric mid-thigh pull (IMTP). Two-way repeated measures ANOVA was used for statistical analysis (p < 0.05).

RESULTS: Significant group × time interactions were observed for SJ, CMJ, unilateral jumps, sprint performance (5 m, 10 m, 20 m), and agility tests (all p < 0.05). The CT group showed greater improvements compared to RT group: SJ (1.83 cm vs. 0.95 cm, Cohen’s d = 1.196 vs. 0.642), CMJ (3.64 cm vs. 1.27 cm, Cohen’s d = 1.949 vs. 0.681), 5 m sprint (0.18s vs. 0.06s improvement, Cohen’s d = 1.889 vs. 0.667), hexagon test (1.29s vs. 0.03s improvement), and COD performance. Both groups significantly improved IMTP with no between-group differences (p > 0.05).

CONCLUSION: An 8-week complex training program elicited significantly greater improvements in lower limb explosive power, sprint acceleration, and multidirectional agility compared to traditional resistance training in adolescent female badminton players. These findings suggest CT is an effective, sport-specific training intervention that capitalizes on the heightened neuromuscular plasticity of adolescent athletes.

PMID:41059493 | PMC:PMC12497702 | DOI:10.3389/fphys.2025.1678866

Emerg Med Int. 2025 Sep 28;2025:6711086. doi: 10.1155/emmi/6711086. eCollection 2025.

ABSTRACT

Background: An electrocardiogram is a diagrammatic representation of a heart’s electrical activity. This technique can detect life-threatening conditions within minutes. It is one of the major investigative modalities at which emergency physicians should be accurate. The accuracy of emergency residents varies from country to country, with improvement in interpretation as the year of residency increases. There have been no published papers on ECG interpretation among emergency residents until now, but studies on graduating medical students have shown low competency. Methods: A cross-sectional study was conducted on emergency and critical care medicine residents of Tikur Anbessa Specialized Hospital and Saint Paul Millennium Medical College. Data were collected from April 2021 to September 2021 via a structured questionnaire. The data were entered, cleaned, edited, and analyzed via SPSS Version 26.0 statistical analysis software. Descriptive statistics and bivariate and multivariate binary logistic regressions were used to analyze the data. Results: Fifty-seven emergency and critical care medicine residents were able to participate in this study, 33 (57.9%) of whom were from Addis Ababa University and 24 (42.1%) of whom were from Saint Paul Millennium Medical College. The average percentage of EMCC residents who interpreted the ECGs was 29.5%. Only 10 residents (17%) were able to correctly interpret > 50% of the ECGs. Most of the residents who participated in this study were Year 1 residents, followed by Year 2 residents. Among the 15 ECG abnormalities, the commonly identified were polymorphic ventricular tachycardia, normal sinus rhythm, and a double-chamber pacemaker. The year of residency (AOR 3.34) was found to be significantly associated with greater performance in ECG interpretation. Conclusion: According to this study, the interpretation accuracy of ECGs by emergency medicine and critical care residents is low, which is comparable to the findings of studies performed in South Africa and Australia.

PMID:41059469 | PMC:PMC12497519 | DOI:10.1155/emmi/6711086