Tag: nevin manimala

J Eval Clin Pract. 2025 Sep;31(6):e70276. doi: 10.1111/jep.70276.

ABSTRACT

BACKGROUND: Although testimonies of devastating impacts of care delivered in nondesignated hospital areas (corridor care) are mounting, there is a paucity of quantitative data. This study aimed to assess the associations between: (1) care in nondesignated areas and key performance indicators (KPIs), including ward moves and length of stay (LOS); and (2) between KPIs and mortality.

METHODS: Data from this cross-sectional study were derived from the National Hip Fracture Database audit programme (a quality-improvement initiative commissioned by the Healthcare Quality Improvement Partnership, NHS England). In total, 508 patients (65% women) consecutively admitted with hip fractures (January 2024-January 2025) were included. The duration (h:min) of care in nondesignated areas was categorised by tertiles (< 1:20; 1:20-4:20; > 4:20). Associations between variables were determined by logistic regression, presented as odds ratios (OR) and 95% confidence intervals.

RESULTS: Patients cared for in nondesignated areas (11%) and bed care patients (89%) had similar clinical characteristics (median age = 85.5 years). Care in nondesignated areas varied inversely with seasonal average local temperatures: 10.7% in summer (22.5°C), 19.6% autumn (15.9°C), 44.6% winter (8.6°C), and 25.0% spring (14.9°C), which was more discernible than the corresponding distribution of bed care: 21.2%, 23.7%, 25.9% and 29.2%. Compared with bed care patients, those cared for in nondesignated areas for ≥ 1 h:20 min were associated with ≥ 3 ward moves: OR = 4.02 (1.61-10.06). LOS on orthogeriatric wards for bed care patients was 13.4 days, and care in nondesignated areas > 4 h:20 min was 17.2 days, which increased to 19.7 days for all patients cared for in nondesignated areas with ≥ 3 ward moves. In turn, higher in-hospital mortality was associated with multiple ward moves: OR = 2.63 (1.23-5.66) and prolonged LOS: OR = 3.23 (1.53-6.81).

CONCLUSIONS: The impact of care delivered in nondesignated areas exposed by KPIs is consistent with testimonies from patients and NHS staff. This evidence serves as a stimulus to take urgent action to abolish care in nondesignated areas.

PMID:40975842 | DOI:10.1111/jep.70276

Community Dent Health. 2025 Sep 21:265539X251381496. doi: 10.1177/0265539X251381496. Online ahead of print.

ABSTRACT

Genome-Wide Association Studies (GWAS) are the primary method used to investigate the effects of common genetic variants on health and disease and are increasingly used as an arena for applied epidemiological methods. There are now a growing number of applications of GWAS in oral health research, yielding exciting findings and holding great potential for future discoveries. While exciting, the GWAS approach has inherent limitations, and the success of these experiments depends on achieving adequate statistical power. In the context of dental diseases, where multiple genetic variants have small effects, very large samples are needed to unlock the full potential of GWAS. This article discusses the motivation for undertaking these studies, introduces the GWAS method, and highlights the potential of GWAS to help unravel the complex factors influencing oral health and diseases. Alongside the promises of GWAS, this article also summarizes the key challenges that need to be addressed for this method to be deployed usefully and suggests criteria to consider during the appraisal of a GWAS paper.

PMID:40975827 | DOI:10.1177/0265539X251381496

Hand (N Y). 2025 Sep 21:15589447251369034. doi: 10.1177/15589447251369034. Online ahead of print.

ABSTRACT

BACKGROUND: Brief electrical stimulation (ES) of injured peripheral nerves for 1 hour has been shown to accelerate nerve regeneration with proximal action potential conduction to the neuron cell body, a requirement to elicit therapeutic benefit. Local anesthetic is often used to manage pain in patients. However, using lidocaine after ES therapy has been controversial. We assessed the effects of extraneural usage of lidocaine after ES therapy on nerve regeneration in a rodent nerve injury model.

METHODS: Lewis rats underwent tibial nerve transection and immediate repair and randomized to 4 groups: control (REP), extraneural lidocaine alone (REP + LIDO), 60-minute ES (60 ES), and 60-minute ES with extraneural lidocaine (60 ES + LIDO). The tibial nerve was retrograde labeled distally from the neurorrhaphy 28 days post repair. Spinal cords and dorsal root ganglia were harvested to assess motor and sensory neuron counts. Data were analyzed using 1-way analysis of variance (ANOVA) with a post-hoc Tukey correction.

RESULTS: Using lidocaine after nerve repair did not affect nerve regeneration in the control group (REP vs REP + LIDO) or ES group (60 ES vs 60 ES + LIDO), with motor and sensory neuron counts not statistically different between groups. Electrical stimulation therapy showed at least a 60% increase in motor and sensory neuron counts than controls, a statistically significant effect (P < .001).

CONCLUSIONS: Extraneural usage of lidocaine after ES does not abolish the improved effect of ES on nerve regeneration. Future clinical studies should evaluate the usage of subcutaneous injection of lidocaine post ES for analgesia control.

PMID:40975801 | DOI:10.1177/15589447251369034

Ann Pharmacother. 2025 Sep 21:10600280251368386. doi: 10.1177/10600280251368386. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of the study was to review acoramidis, a new transthyretin stabilizer, for treatment of transthyretin amyloid cardiomyopathy by means of pharmacology, efficacy, and safety.

DATA SOURCES: An Embase, PubMed, and ClinicalTrials.gov search was conducted using the keywords acoramidis, Attruby, and AG10.

STUDY SELECTION AND DATA EXTRACTION: We included full-text, English-language studies that evaluated the pharmacology, efficacy, and safety of acoramidis in transthyretin amyloid cardiomyopathy.

DATA SYNTHESIS: Acoramidis slows or halts the accumulation of amyloid deposits in the heart by binding to the thyroxine-binding sites on the tetrameric transthyretin (TTR) protein preventing the TTR tetramer from dissociating into monomers. Acoramidis did not achieve statistical significance in terms of mortality reduction, but it outperformed placebo with respect to death from any cause, cardiovascular-related hospitalization, change in N-terminal pro-B-type natriuretic peptide, and change in 6-minute walk distance. In addition, by the end of the phase II clinical trial all acoramidis-treated patients achieved normal serum TTR concentrations. The overall incidence of subjects who experienced any treatment-emergent adverse events was similar between the acoramidis and placebo groups.Relevance to patient care and clinical practice in comparison to existing drugs:Acoramidis is the second TTR stabilizer approved for the treatment of transthyretin amyloid cardiomyopathy (ATTR-CM). Each medication to manage ATTR-CM similarly decreases the combined endpoints of all-cause mortality and progression of heart failure symptoms, when adjusted for risk factors. However, its place in therapy remains unclear among the treatment options for the management of ATTR-CM due to the lack of head-to-head trials.

CONCLUSIONS: Acoramidis is an effective and safe medication for the treatment of transthyretin amyloidosis cardiomyopathy.

PMID:40975800 | DOI:10.1177/10600280251368386

Ann Pharmacother. 2025 Sep 21:10600280251367432. doi: 10.1177/10600280251367432. Online ahead of print.

ABSTRACT

INTRODUCTION: While consensus guidelines exist for phenotype-guided proton pump inhibitor (PPI) dosing in Helicobacter pylori infection, the impact in gastroesophageal reflux disease (GERD) treatment in a real-world setting is unknown. The study aims were to determine whether CYP2C19 rapid metabolizers (RMs) and ultrarapid metabolizers (UMs) have higher PPI doses and more treatment failures than normal metabolizers (NMs) in the treatment of GERD.

METHODS: In this retrospective chart review, adults with pharmacogenetic (PGx) testing results at the study center and treated with PPI therapy for GERD were included for enrollment into 1 of 3 cohorts: CYP2C19 UM, RM, and NM. Pertinent baseline characteristics collected were age, body mass index, tobacco, and alcohol history. The primary outcome was the comparison of total daily omeprazole equivalents (OEs) of the highest prescribed PPI dose. Secondary outcomes included incidence of upper gastrointestinal bleed (UGIB) and historical trials of PPIs, histamine-2 blockers, antacids, sucralfate, and prokinetics. Continuous outcomes were compared with one-way analysis of variance, and nominal outcomes were compared with a χ² in RStudio.

RESULTS: There were 48 UM, 298 RM, and 432 NM that met study inclusion. Baseline characteristics were similar across cohorts. Mean total OE did not differ between groups: UM 41.6 mg, RM 40.1 mg, NM 38.5 mg (P = 0.52). There were no differences seen among individual gastric agents or mean total number of historical gastric medications trialed: UM 2.5, RM 2.4, NM 2.3 (P = 0.17) medications. The incidence of UGIB was not statistically different between cohorts: UM 12.5%, RM 12.8%, NM 9.3% (P = 0.13).

CONCLUSION AND RELEVANCE: There was no association between CYP2C19 phenotype and historical medication prescribing for GERD.

PMID:40975799 | DOI:10.1177/10600280251367432

Comput Methods Biomech Biomed Engin. 2025 Sep 20:1-11. doi: 10.1080/10255842.2025.2555398. Online ahead of print.

ABSTRACT

This work reports the extraction and evaluation of clinically relevant spatiotemporal and statistical gait parameters from developed wireless foot sensor module as recommended by the Biomathics and Canadian Gait Consortium Initiative. Further, normalization of extracted spatiotemporal gait parameters reduces inter-subject physiological variations. To validate their performance towards gait analysis, a machine learning framework is implemented for personnel identification. The study results suggest a promising potential for utilizing the extracted feature-set for the automatic multiclass gait disorders classification. Developed module is a low cost, easy-to-use device, and has potential application for setups with limited access to state of art gait analysis laboratory.

PMID:40975784 | DOI:10.1080/10255842.2025.2555398

Med Sci Monit. 2025 Sep 21;31:e950237. doi: 10.12659/MSM.950237.

ABSTRACT

BACKGROUND Aphasia is a common consequence of stroke and traumatic brain injury (TBI) that significantly impairs communication and quality of life. Transcranial direct current stimulation (tDCS) has emerged as a non-invasive technique potentially enhancing language rehabilitation. This study aimed to evaluate the efficacy of tDCS in combination with speech-language therapy (SLT) in improving language functions in patients with aphasia. MATERIAL AND METHODS A group of 90 patients diagnosed with TBI- or stroke-related aphasia were randomly assigned to 3 groups: tDCS alone (Group I), SLT alone (Group II), and tDCS combined with SLT (Group III). Treatment procedures spanned 5 months. tDCS sessions lasted 30-40 minutes each (1-1.5 mA), targeting the left dorsolateral (F3) and the right (F4) prefrontal cortex. Language function was assessed using the Frenchay Aphasia Screening Test (FAST), Aphasia Evaluation Scale (SODA), and Token Test (TT). Statistical analyses compared pre- and post-intervention outcomes within and between groups. RESULTS All groups demonstrated significant improvements in language function (p < 0.001). Group III showed the greatest gains in verbal expression, comprehension, and reading (32.6% improvement in FAST scores), significantly outperforming Group I (24.3%) and Group II (17.8%). tDCS alone was more effective than SLT alone (p = 0.04). Combining tDCS with SLT resulted in superior patient-reported improvements in daily communication and confidence in verbal expression compared to either treatment alone. CONCLUSIONS Patients who received combined tDCS and SLT had notable improvements across all measured parameters, including verbal expression, comprehension, reading, and writing, as assessed by the FAST, SODA, and TT tests.

PMID:40975782 | DOI:10.12659/MSM.950237

Prep Biochem Biotechnol. 2025 Sep 20:1-14. doi: 10.1080/10826068.2025.2560541. Online ahead of print.

ABSTRACT

Low-grade Gracilaria verrucosa biomass, typically discarded during seaweed processing, remains underutilized despite its rich polysaccharide content. This study explores the valorization of this waste stream through optimized acid hydrolysis, comparing conventional water bath heating and pressurized steam pretreatment. A low-concentration sulfuric acid (H₂SO₄) hydrolysis process was statistically optimized using response surface methodology (RSM), employing a central composite design (CCD), yielding a maximum reducing sugar concentration of 56.54 g/L under pressurized steam conditions-substantially higher than 37.51 g/L under water bath treatment. Structural changes in the biomass were characterized via scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), and density measurements, revealing enhanced polysaccharide breakdown under pressurized conditions. Importantly, the sugar-rich hydrolysate, dominated by glucose and xylose, demonstrates potential as a substrate for microbial fermentation, supporting downstream bioproduct development such as biodegradable plastics. These findings offer a sustainable pathway for converting seaweed processing waste into high-value biochemical feedstocks using a mild, cost-effective hydrolysis process.

PMID:40975779 | DOI:10.1080/10826068.2025.2560541

Environ Monit Assess. 2025 Sep 20;197(10):1131. doi: 10.1007/s10661-025-14625-y.

ABSTRACT

Water hardness plays a critical role in regulating pollutant toxicity to freshwater aquatic organisms. It can significantly influence the bioavailability and toxicity intensity of pollutants. Water hardness varies regionally and optimal levels for freshwater aquatic organisms are often species specific. This study employed a meta-analysis approach to systematically evaluate the regulatory effects of water hardness on pollutant toxicity to freshwater aquatic organisms, supplemented by qualitative analysis to provide additional evidence. We systematically searched the Web of Science database to screen and integrate data from 32 eligible studies. Standardized mean differences (SMD) were calculated using random-effects models, with heterogeneity assessed through I² statistics. Qualitative analysis revealed that 20 out of the 23 studies demonstrated significant inverse correlations between water hardness and pollutant toxicity. High-hardness water reduces the bioavailability of pollutants through competitive mechanisms involving calcium and magnesium ions, which mitigates the toxic effects on freshwater aquatic organisms. Quantitative analysis demonstrated that high water hardness exerted a statistically significant protective effect against pollutant toxicity. However, significant heterogeneity was observed among studies, with developmental stages of species, chemical forms of pollutants, and differences in hardness gradient design identified as major confounding factors. This study integrated the effect relationship between water hardness and pollutant toxicity in multiple regions around the world by meta-analysis, confirming that hardness is a key moderating factor for pollutant toxicity.

PMID:40975754 | DOI:10.1007/s10661-025-14625-y

Biogerontology. 2025 Sep 20;26(5):182. doi: 10.1007/s10522-025-10325-9.

ABSTRACT

Aging is characterized as a process resulting in the structural and functional deterioration of several essential organs and tissues. This study aimed to determine the effects of normal aging on the cerebellum by using histological and histometric techniques. A total of 24 male Wistar albino rats were divided into three groups: young (4-6 weeks), adult (20-22 weeks), and old (22-24 months). Cerebellar tissue samples were treated using histological and immunohistochemical techniques. The slides were evaluated using a light microscope. Molecular layer thickness was high in the adult group compared to the younger and older groups, whereas the granular layer was significantly thicker in both the adult and elderly groups than in the young rat group (P < 0.05). The total cortical thickness exhibited statistically significant differences among all age groups. The thickest cortex was observed in the adult group (P < 0.05). PAS-positive aging pigment granules were observed in the cytoplasm of Purkinje cells in older rat groups. The density of glial fibrillary acidic protein-immunoreactive (GFAP-IR) astrocytes in old rats was significantly increased compared to young and adult rats with distinct hypertrophy and strong GFAP immunoreactivity in astrocyte cell bodies. It was established that, despite age-related variations that exist, cerebellar folia height and width gradually increased from young to adult rat. In contrast, old rats have decreased cerebellar folia height and width than adults.

PMID:40975742 | DOI:10.1007/s10522-025-10325-9