Tag: nevin manimala

Front Neurol. 2025 Apr 1;16:1566819. doi: 10.3389/fneur.2025.1566819. eCollection 2025.

ABSTRACT

OBJECTIVE: Many NHL teams roster players whose primary responsibility is fighting with opposing players. Over time, these “enforcers” may experience repetitive head impacts (RHI), a risk factor for serious long-term health consequences including neurodegenerative disease. This study examined whether retired NHL enforcers and non-enforcers differ on two long-term health outcomes.

METHODS: In this matched cohort study conducted with retrospective, publicly available data, cohorts of former NHL enforcers and non-enforcers were compared on mortality, and CTE diagnosis. NHL players were deemed enforcers (ENFs, n = 239) if listed in a Wikipedia piece entitled “List of NHL enforcers.” A randomly selected sample of non-enforcers (non-ENFs, n = 239) were matched to ENFs on year of birth and the first NHL season played. Goalies and players with less than 30 games of NHL experience were excluded.

RESULTS: The matching procedure resulted in equivalent cohorts with respect to birth year (1969.9) and first NHL season played (1991.3). Significantly more ENFs had died (n = 23, 9.6% vs. n = 9, 3.8%; p = 0.01) and significantly more ENFs had been given a diagnosis of CTE (n = 7, 2.9% vs. n = 1, 0.4%; p < 0.05). While not statistically significant, age at death averaged 9+ years younger among ENFs (mean = 53.6) compared to non-ENFs (mean = 63). Players born in Canada were over-represented in the ENF cohort.

CONCLUSION: This study found higher mortality and more diagnoses of CTE in a cohort of enforcers relative to matched non-enforcers. Given expanding evidence linking RHI to life-threatening long-term health impacts, the NHL must protect players and mandate rule changes that minimize or eliminate fighting.

PMID:40236900 | PMC:PMC11996648 | DOI:10.3389/fneur.2025.1566819

Front Neurol. 2025 Apr 1;16:1544135. doi: 10.3389/fneur.2025.1544135. eCollection 2025.

ABSTRACT

BACKGROUND: As a major cause of disability worldwide, stroke affects about 80% of survivors with upper limb (UL) motor dysfunction, significantly impairing their quality of life. Virtual reality (VR) has been recognized as an innovative rehabilitation tool; however, the effectiveness of VR systems with different immersion modalities is still uncertain. This systematic review and network meta-analysis (NMA) aims to evaluate the comparative effectiveness of intervention measures, including non-immersive gaming consoles, immersive VR (IVR), non-immersive VR (NIVR), and conventional therapy (CT) on upper limb motor function in stroke rehabilitation.

MATERIALS AND METHODS: A systematic search of PubMed, Embase, Cochrane Library, and Scopus identified randomized controlled trials (RCTs) published up to 12 June 2024. UL motor recovery was assessed using the Fugl-Meyer Upper Extremity (FMUE) scale. The NMA was performed using the Bayesian approach with the BUGSnet package in R software to calculate the relative effectiveness of each intervention.

RESULTS: 34 RCTs involving 1,704 participants were included. Among non-immersive gaming systems, Microsoft Kinect demonstrated the greatest effective in enhancing UL motor function, followed by Nintendo Wii, then NIVR and IVR head-mounted devices. CT showed the least effective. Specifically, Microsoft Kinect significantly improved FMUE scores (mean difference [MD] = 7.27, 95% confidence interval [CI]: 0.59 to 13.77, p < 0.05), followed by Nintendo Wii (MD = 4.53, 95% CI: 0.87 to 8.14, p < 0.05), and NIVR (MD = 3.57, 95% CI: 1.18 to 6.01, p < 0.05). In contrast, IVR head-mounted devices showed no statistically significant differences in outcomes, with MD of 4.16 (95% CI: -0.02 to 8.38).

CONCLUSION: Non-immersive gaming console of Microsoft Kinect is the most effective intervention for improving UL motor function in stroke survivors. In contrast, IVR head-mounted devices did not offer significant advantages over CT. These findings suggest that non-immersive gaming consoles of Microsoft Kinect could be a more cost-effective and accessible alternative for stroke rehabilitation.

PMID:40236896 | PMC:PMC11996652 | DOI:10.3389/fneur.2025.1544135

Front Neurol. 2025 Mar 31;16:1551164. doi: 10.3389/fneur.2025.1551164. eCollection 2025.

ABSTRACT

BACKGROUND: Zoster-associated pain (ZAP) is a common complication after herpes zoster infection. In recent years, conventional temporary dorsal column stimulation (tDCS) has been widely used nationally and internationally as a safe and effective minimally invasive treatment for ZAP. It has also been shown that temporary dorsal nerve root stimulation (tDNRS) may also be an effective treatment for ZAP. However, there is no direct clinical comparison between the newer tDNRS and the conventional tDCS.

OBJECTIVE: To compare the procedure time, radiation dose, efficacy and cost of the tDNRS and tDCS for the treatment of ZAP. And the complications of the two surgical modalities were recorded.

METHODS: Eighty patients with ZAP who attended the pain department of the Second Affiliated Hospital of Guangxi Medical University from January 2022 to July 2023 were selected. They were divided into tDNRS group (n = 40) and tDCS group (n = 40) by using random number table method. The operation time, radiation dose, number of electrodes used, cost of medical consumables, and number of postoperative electrical stimulation adjustments were recorded for each case, and the patients’ pain level, sleep quality, quality of life, and overall efficacy were analysed and compared at preoperative (T0), 1 week (T1), 1 month (T2), 2 months (T3) and 3 months (T4) after the operation.

RESULTS: A total of 76 patients were finally enrolled, 38 in the tDNRS group and 38 in the tDCS group. During the 3-month follow-up period, all patients showed a significant decrease in Numerical Rating Scale (NRS) and Pittsburgh Sleep Quality Index (PQSI) scores and a significant increase in quality of life (QL-Index scale) scores after treatment with both methods. And there was no statistically significant difference between the two methods. However, patients who received tDNRS had a significantly shorter operative time and less intraoperative radiation exposure than those who received tDCS (p < 0.0001), and the mean number of postoperative stimulation parameter adjustments and the cost of medical consumables were significantly lower than those in the tDCS group (p < 0.0001).

CONCLUSION: Both tDNRS and tDCS were effective in the treatment of ZAP, but tDNRS had the advantages of more precise coverage, shorter procedure time, less radiation exposure, fewer electrical stimulation adjustments, and lower cost.

PMID:40236892 | PMC:PMC11997352 | DOI:10.3389/fneur.2025.1551164

Aesthet Surg J Open Forum. 2025 Feb 11;7:ojaf011. doi: 10.1093/asjof/ojaf011. eCollection 2025.

ABSTRACT

BACKGROUND: The superficial aspect of the submandibular gland can be removed to improve the aesthetic appearance of the face and neck. This study describes a novel surgical technique to resect part of the submandibular gland during a deep neck or facelift.

OBJECTIVES: Describe the technique to remove the superficial lobe of the submandibular gland using an ultrasonic dissector. Analyze the association between the uses of ultrasonic technology and reduced postoperative complications. Compare rates of postoperative complications between standard electrocautery and ultrasonic dissection.

METHODS: Experimental and control groups were established. A Sonicision ultrasonic dissector (Covidien, Dublin, Ireland) was used for resection in the experimental group, whereas electrocautery was used for resection in the control group. Postoperative outcomes of neuropraxia, hematoma, seroma, and sialocele formation were collected. Statistical analysis was performed using a Fisher’s exact test in RStudio.

RESULTS: Control patients (n = 32) experienced 1 hematoma, 3 seromas, 3 sialoceles, and 3 neuropraxias. Experimental patients (n = 48) experienced 2 seromas with no hematomas, sialoceles, or neuropraxia. No association of statistical significance between reduced risk of complications and use of ultrasonic dissection was found.

CONCLUSIONS: This novel technique has the potential to improve the safety and efficacy of partial submandibular gland resection. However, a follow-up study with a greater sample size and without confounding variables, such as intraoperative injection of Botulinum toxin, is necessary.

LEVEL OF EVIDENCE 3: (Therapeutic).

PMID:40236889 | PMC:PMC11997774 | DOI:10.1093/asjof/ojaf011

Arch Public Health. 2025 Apr 15;83(1):105. doi: 10.1186/s13690-025-01593-5.

ABSTRACT

BACKGROUND & OBJECTIVES: Smokeless tobacco (SLT) use is a global burden, and its long-term use can result in health issues like oral cancers, oral potentially malignant disorders, etc. This review assessed the effectiveness of behavioural and pharmacological interventions for SLT cessation, adding new dimensions to the evidence found earlier in the literature, including recent trials.

SEARCH METHODS: Four electronic databases were used in the search: PubMed, Scopus, Cochrane, and Web-of-Science. Study Selection included randomized control trials (RCTs) comparing pharmacological and behavioural interventions with or without placebo to help users quit SLT with 3 & 6 months follow-up. Two review writers who separately evaluated abstracts for possible inclusion extracted data from included trials. Mantel-Haenszel’s random-effect method was used to assess pooled effects for trial subgroups. Furthermore, the effectiveness of the intervention was evaluated from the reported odds ratios, confidence intervals and quit rates.

RESULTS: Nineteen, consisting of 4575 participants, fulfilled the requirements to be listed in the review. A significant difference was observed at 6 months for pharmacological versus behavioural intervention with a low heterogeneity at a 95% confidence interval. Pooling the fifteen pharmacotherapy-versus-behavioural modification studies in adults, we discovered that pharmacotherapy had a statistically significant impact on raising quit rates by the conclusion of the follow-up period (OR 1.21, 95% CI 1.03 to 1.43; 3271 participants) with low heterogeneity (I² = 19%).

CONCLUSION: Worldwide, there has been minimal data on interventions for SLT cessation, yet the pharmacological interventional methods have been found to be comparatively effective than behavioural intervention. Adequate awareness, health care professionals training, and law implementation are necessary to achieve habit cessation.

CLINICAL TRIAL NUMBER: Not Applicable. The present systematic review is registered in PROSPERO’s International Prospective Register of Systematic Reviews (registration number CRD42023399178 dated 13th Feb 2023).

PMID:40235012 | DOI:10.1186/s13690-025-01593-5

Arch Public Health. 2025 Apr 15;83(1):107. doi: 10.1186/s13690-025-01579-3.

ABSTRACT

BACKGROUND: Self-medication with antibiotics (SMA) is increasingly occurring worldwide, yet it is a process that can lead to inappropriate use of antibiotics, with potentially multiple adverse consequences such as an increased risk of antibiotic resistance.

OBJECTIVE: The objective of this study is to assess the prevalence of self-medication with antibiotics among the Chinese population and investigate the factors associated with this behavior.

METHODS: A multi-stage sampling method was employed to carry out a national cross-sectional questionnaire survey among Chinese individuals aged 18 years and above from July 10, 2021, to September 15, 2021. Following the statistical analysis of the collected data, binary logistic regression was applied to identify the factors associated with respondents’ self-medication with antibiotics. Model robustness testing was also performed using best subset regression.

RESULTS: From a total of 11,031 questionnaires, 9,344 qualified samples were selected. The prevalence of self-medication with antibiotics among Chinese residents was found to be 34.63% (3,237/9,344). The most important factor considered in SMA was the advice of medical professionals, accounting for 89.00%, including recommendations from doctors (2,524/3,237, 77.97%) and pharmacists (1,905/3,237, 58.85%). The results of the binary stepwise logistic regression analysis showed that female, people older than 36 years, with higher education, had consumed alcohol in the past month, with mild depression, having residential or employee health insurance as the primary form of health coverage, having commercial insurance, having better family health status, and perceiving higher levels of social support were more likely to practice SMA (P < 0.05). Conversely, individuals diagnosed with major depressive disorder were found to be less likely to engage in self-medication with antibiotics (P < 0.05). The best subset regression method and stepwise regression method gave the same results.

CONCLUSION: The SMA issue of Chinese residents is still relatively serious. Residents’ SMA was associated with their demographic and sociological characteristics, depression, family health, and perceived level of social support. The primary consideration for resident SMA is the advice of medical staff. The problem of SMA in China should be improved through antibiotic management, education on antibiotic knowledge, and medical staff’s correct guidance.

PMID:40234996 | DOI:10.1186/s13690-025-01579-3

Mol Autism. 2025 Apr 15;16(1):24. doi: 10.1186/s13229-025-00657-1.

ABSTRACT

BACKGROUND: Divergent age-related functional brain connectivity in autism spectrum disorder (ASD) has been observed using resting-state fMRI, although the specific findings are inconsistent across studies. Common statistical regression approaches that fit identical models across functional brain networks may contribute to these inconsistencies. Relationships among functional networks have been reported to follow unique nonlinear developmental trajectories, suggesting the need for flexible modeling. Here we apply generalized additive models (GAMs) to flexibly adapt to distinct network trajectories and simultaneously describe divergent age-related changes from childhood into mid-adulthood in ASD.

METHODS: 1107 males, aged 5-40, from the ABIDE I & II cross-sectional datasets were analyzed. Functional connectivity was extracted using a network-based template. Connectivity values were harmonized using COMBAT-GAM. Connectivity-age relationships were assessed with thin-plate spline GAMs. Post-hoc analyses defined the age-ranges of divergent aging in ASD.

RESULTS: Typically developing (TD) and ASD groups shared 15 brain connections that significantly changed with age (FDR-corrected p < 0.05). Network connectivity exhibited diverse nonlinear age-related trajectories across the functional connectome. Comparing ASD and TD groups, default mode to central executive between-network connectivity followed similar nonlinear paths with no group differences. Contrarily, the ASD group had chronic hypoconnectivity throughout default mode-ventral attentional (salience) and default mode-somatomotor aging trajectories. Within-network somatomotor connectivity was similar between groups in childhood but diverged in adolescence with the ASD group showing decreased within-network connectivity. Network connectivity between the somatomotor network and various other functional networks had fully disrupted age-related pathways in ASD compared to TD, displaying significantly different model curvatures and fits.

LIMITATIONS: The present analysis includes only male participants and has a restricted age range, limiting analysis of early development and later life aging, years 40 and beyond. Additionally, our analysis is limited to large-scale network cortical functional parcellation. To parse more specificity of brain region connectivity, a fine-grained functional parcellation including subcortical areas may be warranted.

CONCLUSION: Flexible non-linear modeling minimizes statistical assumptions and allows diagnosis-related brain connections to follow independent data-driven age-related pathways. Using GAMs, we describe complex age-related pathways throughout the human connectome and observe distinct periods of divergence in autism.

PMID:40234995 | DOI:10.1186/s13229-025-00657-1

Breast Cancer Res. 2025 Apr 15;27(1):55. doi: 10.1186/s13058-025-01995-x.

ABSTRACT

BACKGROUND: Among premenopausal women, higher body mass index (BMI) is associated with lower breast cancer risk, although the underlying mechanisms are unclear. Investigating adiposity distribution may help clarify impacts on breast cancer risk. This study was initiated to investigate associations of central and peripheral adiposity with premenopausal breast cancer risk overall and by other risk factors and breast cancer characteristics.

METHODS: We used individual-level data from 14 prospective cohort studies to estimate hazard ratios (HRs) for premenopausal breast cancer using Cox proportional hazards regression. Analyses included 440,179 women followed for a median of 7.5 years (interquartile range: 4.0-11.3) between 1976 and 2017, with 6,779 incident premenopausal breast cancers.

RESULTS: All central adiposity measures were inversely associated with breast cancer risk overall when not controlling for BMI (e.g. for waist circumference, HR per 10 cm increase: 0.92, 95% confidence interval (CI): 0.90-0.94) whereas in models adjusting for BMI, these measures were no longer associated with risk (e.g. for waist circumference: HR 0.99, 95% CI: 0.95-1.03). This finding was consistent across age categories, with some evidence that BMI-adjusted associations differed by breast cancer subtype. Inverse associations for in situ breast cancer were observed with waist-to-height and waist-to-hip ratios and a positive association was observed for oestrogen-receptor-positive breast cancer with hip circumference (HR per 10 cm increase: 1.08, 95% CI: 1.10-1.14). For luminal B, HER2-positive breast cancer, we observed an inverse association with hip circumference (HR per 10 cm: 0.84, 95% CI: 0.71-0.98), but positive associations with waist circumference (HR per 10 cm: 1.18, 95% CI: 1.03-1.36), waist-to-hip ratio (HR per 0.1 units: 1.29, 95% CI: 1.15-1.45) and waist-to height ratio (HR per 0.1 units: 1.46, 95% CI: 1.17-1.84).

CONCLUSIONS: Our analyses did not support an association between central adiposity and overall premenopausal breast cancer risk after adjustment for BMI. However, our findings suggest associations might differ by breast cancer hormone receptor and intrinsic subtypes.

PMID:40234955 | DOI:10.1186/s13058-025-01995-x

J Health Popul Nutr. 2025 Apr 15;44(1):119. doi: 10.1186/s41043-025-00858-7.

ABSTRACT

INTRODUCTION: Several epidemiological studies have reported inconsistent findings on the association between carotenoid intake and fracture risk. This study aimed to determine the association between individual carotenoid intake and fracture risk.

METHODS: A cross-sectional study based on data from the National Health and Nutrition Examination Survey (NHANES), 2013-2018. This study identified elderly individuals with valid and complete data on carotenoid intake and fracture risk. The average dietary intakes of α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein + zeaxanthin was taken based on the two 24-hour recall interviews. Matching was done based on age, sex, and body mass index (BMI). Logistic regression models were used to test the associations between carotenoids and fracture risk. All analyses were performed by using R (version 3.4.3; R Foundation for Statistical Computing, Vienna, Austria).

RESULTS: A total of 5491 (1140 cases and 4351 control) subjects were included in this study. The average age of the subjects was 55.62 ± 14.84 years old. In the adjusted model, the risk of osteoporotic fracture was decreased by 6.2% (odd ratio (OR): 0.938; 95% confidence interval (CI): 0.699 to 0.989) and 1.4% (OR 0.986; 95% CI: 0.975 to 0.997) for dietary intake of beta-carotene and lycopene, respectively.

CONCLUSIONS: Dietary intakes of beta-carotene and lycopene have significantly reduced the risk of osteoporotic fracture among the elderly population in the United States of America.

PMID:40234943 | DOI:10.1186/s41043-025-00858-7

Lipids Health Dis. 2025 Apr 15;24(1):139. doi: 10.1186/s12944-025-02560-3.

ABSTRACT

IMPORTANCE: Visceral adiposity index (VAI) vividly reflects body fat distribution through comprehensively integrating body mass index, sex, waist circumference, triglycerides, and high-density lipoprotein cholesterol. While VAI is an established predictor of various clinical outcomes, its relationship with premature mortality and life expectancy remains unclear.

OBJECTIVE: To explore the association between VAI and premature mortality or life expectancy in a nationally representative cohort of US adults.

METHODS: This study included adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, linked to the National Death Index through December 31, 2019. Data were analyzed from August to October, 2024. VAI was categorized into quartiles from the lowest Q1 to the highest Q4. Primary endpoints were premature mortality (death before 80 years of age) and life expectancy.

RESULTS: A total of 43,672 participants (women: 22,164; men: 21,508) aged > 20 years were included. Over a median follow-up of 9.2 years (IQR: 4.9-13.8), 3,187 premature deaths were documented. Higher VAI quartiles were significantly associated with increased multi-adjusted premature mortality risk compared to Q1 (Q3 vs. Q1: hazard ratio [HR], 95% confidence interval [CI]: 1.30, 1.05 to 1.61; Q4 vs. Q1: 1.68, 1.34 to 2.11). This association was particularly pronounced in women (Q3 vs. Q1: 1.53, 1.01 to 2.30; Q4 vs. Q1: 2.36, 1.52 to 3.68), with significant linear trends (P < 0.001). Estimated life expectancy at age 40 years was 41.45 (95% CI: 41.24 to 41.66), 41.32 (41.11 to 41.53), 40.55 (40.35 to 40.75), and 39.26 (39.08 to 39.45) years in Q1, Q2, Q3, and Q4 of VAI, respectively. By sex, estimated life expectancy at age 40 in Q4 was reduced by 3.33 years in women and 1.24 years in men, compared to Q1. By race and ethnicity, it was shortened by 3.90 years in Black participants and 1.68 years in White participants in Q4 group, compared to Q1.

CONCLUSIONS: In this nationwide cohort study, higher VAI was significantly associated with an increased risk of premature mortality and reduced life expectancy at age 40 among US adults. These associations we heterogeneous by sex, race and ethnicity, more pronounced in women and Black participants.

PMID:40234930 | DOI:10.1186/s12944-025-02560-3