Tag: nevin manimala

Stud Health Technol Inform. 2025 Nov 12;333:28-33. doi: 10.3233/SHTI251571.

ABSTRACT

Prediabetes presents a critical window to prevent type 2 diabetes, a rising global health crisis, yet young adults often lack engaging preventive tools. This ongoing study aims to design and evaluate a web application to enhance health knowledge, engagement, and self-management for this at-risk group. This theoretical lens combines Design Science Research Methodology (DSRM), the theory of Task-Technology Fit (TTF), and the Unified Theory of Acceptance and Use of Technology (UTAUT). The proposed solution incorporates a unique combination of features learned through a previously conducted systematic literature review (SLR). Features include Machine Learning (ML)-based recommendations, educational modules, goal setting, gamification elements, and an artificial intelligence (AI)-incorporated chatbot. The proposed design to date is presented, in addition to the planned scenario-driven use cases to highlight the relevance of the proposed solution. A pilot study will assess usability, usefulness, satisfaction, and health knowledge via initial, midway, and final surveys mapped along with the design process. The data will be analysed via descriptive statistics and thematic analysis. This work-in-progress paper offers a streamlined, user-centred approach to designing and developing digital health interventions for prediabetes prevention while contributing insights for personalised digital health interventions.

PMID:41235488 | DOI:10.3233/SHTI251571

Stud Health Technol Inform. 2025 Nov 12;333:14-19. doi: 10.3233/SHTI251568.

ABSTRACT

This study explores Australian consumers’ digital literacy (DL), use of digital health technologies (DHTs), and curiosity toward emerging tools. A cross-sectional online survey (n = 416) examined DL levels, current usage of technologies such as telehealth, wearables, mHealth apps, e-pharmacy, and chatbots, and preferences for future innovations like smart glasses, virtual reality/augmented reality, medical drones, and robot companions. DL was highest in data and communication domains and varied by age, gender, education, and location. Despite women and younger adults reporting higher DL, technology adoption often hinged on perceived usefulness, usability, and trust. Telehealth was widely used (90%+) while emerging technologies attracted greater curiosity from men and the 30-39 age group. These findings suggest that curiosity – both diversive and specific – drives early exploration and continued engagement with DHTs. To support equitable adoption, digital health strategies should integrate DL-building interventions and curiosity-driven design, aligned with the Australian Digital Health Strategy’s goals for inclusive, consumer-centred innovation.

PMID:41235485 | DOI:10.3233/SHTI251568

Knee Surg Sports Traumatol Arthrosc. 2025 Nov 14. doi: 10.1002/ksa.70191. Online ahead of print.

ABSTRACT

PURPOSE: To develop a Kellgren-Lawrence (K-L) grading recognition framework for knee osteoarthritis (KOA) with enhanced capability for early-stage detection and to validate its transferability across three independent cohorts.

METHODS: Weight-bearing anteroposterior knee radiographs were obtained from three datasets: the osteoarthritis initiative (OAI), Wuchuan and Shunyi. The OAI dataset included baseline, 72-month, and 96-month follow-up images, while the Wuchuan and Shunyi datasets were collected from Wuchuan (China) and Shunyi District (Beijing), respectively. Contrastive learning was incorporated into model training to construct the Augmented Dataset-Wide-ResMRnet-Contrastive Loss-Cross Entropy (AW2C) framework.

RESULTS: The AW2C framework achieved overall classification accuracies of 83.0%, 82.0% and 80.5% on the OAI, Wuchuan and Shunyi datasets, respectively, with corresponding area under the curve (AUC) of 97.0%, 96.7% and 95.6%. Compared with the baseline model, accuracy for K-L grade 2 improved from 64% to 80%, and discrimination between K-L grades 1 and 2 was notably enhanced.

CONCLUSIONS: The proposed AW2C framework demonstrated robust and transferable performance for automated radiographic K-L grading of KOA, particularly improving recognition of early-stage and suspected disease. With further optimisation, it holds promise as a reliable tool for large-scale studies and clinical decision support.

LEVEL OF EVIDENCE: Level III.

PMID:41235478 | DOI:10.1002/ksa.70191

Knee Surg Sports Traumatol Arthrosc. 2025 Nov 14. doi: 10.1002/ksa.70194. Online ahead of print.

NO ABSTRACT

PMID:41235476 | DOI:10.1002/ksa.70194

Epilepsia Open. 2025 Nov 14. doi: 10.1002/epi4.70185. Online ahead of print.

ABSTRACT

OBJECTIVE: This study evaluated the long-term risk of major cardiovascular diseases (CVDs) in patients with epilepsy using a nationwide cohort, aiming to address critical gaps in population-based evidence on brain-heart interactions.

METHODS: Data from the Korean National Health Insurance Service (2002-2013) were analyzed. For each cardiovascular outcome, an independent matched cohort was constructed, comprising 1740 to 3164 patients with newly diagnosed epilepsy and corresponding 10-fold matched controls. The primary outcomes included six CVDs: hypertension (HTN), ischemic heart disease (IHD), cardiac arrhythmia (CA), heart failure (HF), atherosclerosis (AS), and peripheral artery disease (PAD). Incidence rate ratios (IRRs) and adjusted hazard ratios (aHRs) were calculated using multivariable Cox regression models.

RESULTS: Epilepsy was significantly associated with increased risk of all six CVDs. The highest aHRs were observed for CA (2.02 [95% CI, 1.70-2.39]), IHD (1.71 [95% CI, 1.50-1.95]), and HF (1.64 [95% CI, 1.28-2.10]). Risk was higher in patients aged <60 years and in men. Notably, younger patients showed substantially elevated risks for CA (2.61 [95% CI, 1.99-3.42]) and AS (2.06 [95% CI, 1.47-2.89]). The sex-specific difference was most prominent for HF, with higher aHRs in men (1.86 [95% CI, 1.29-2.67]) than in women (1.49 [95% CI, 1.07-2.09]).

SIGNIFICANCE: Patients with epilepsy have a significantly increased long-term risk of CVD, especially CA, IHD, and HF. Risk is disproportionately elevated in younger individuals and men, suggesting the need for targeted cardiovascular surveillance and prevention in these subgroups.

PLAIN LANGUAGE SUMMARY: People with epilepsy may face a higher risk of heart and blood vessel diseases such as heart attack, irregular heartbeat, and heart failure. This study analyzed national health data from Korea and found that epilepsy patients had more cardiovascular problems than those without epilepsy, especially younger men. These results suggest that doctors should monitor heart health more closely in people living with epilepsy.

PMID:41235461 | DOI:10.1002/epi4.70185

Knee Surg Sports Traumatol Arthrosc. 2025 Nov 14. doi: 10.1002/ksa.70150. Online ahead of print.

ABSTRACT

PURPOSE: To compare tensile strain changes on the lateral tibial cortex during the opening procedure of medial opening wedge high tibial osteotomy (MOWHTO) with and without hinge wire, and to evaluate strain changes after hinge wire removal.

METHODS: MOWHTO was performed on five pairs of fresh-frozen human cadaveric knees (10 knees in total), which were allocated into two groups: with a hinge wire (n = 5) and without a hinge wire (n = 5). A uniaxial strain gauge was attached to the lateral tibial cortex to measure tensile strain, with negative values indicating compression and positive values indicating tension. All procedures were guided by a 3D-printed patient-specific cutting guide with a target opening gap of 9 mm, and fixation was completed using a locking plate. Tensile strain during the opening procedure was compared between groups, and strain before and after wire removal was assessed in the hinge wire group.

RESULTS: In four out of five matched pairs, the hinge wire group exhibited smaller tensile strain changes during opening than the contralateral group without a hinge wire. During the opening procedure, the median tensile strain change was -267 με (range: -2390 to -213 με) in the hinge wire group and -753 με (range: -1889 to -383 με) in the without hinge wire group (p = 0.345). Following hinge wire removal, the median strain change was minimal (44 με; range: 21-72 με).

CONCLUSIONS: The hinge wire group showed smaller tensile strain changes during the opening procedure in most specimens, though the difference was not statistically significant. These findings provide preliminary biomechanical evidence suggesting that the hinge wire may serve as a protective method against fracture of the lateral hinge during MOWHTO, and that its removal after the plate fixation does not compromise lateral cortex stability.

LEVEL OF EVIDENCE: N/A. (cadaveric biomechanical study).

PMID:41235460 | DOI:10.1002/ksa.70150

Rhinology. 2025 Nov 14. doi: 10.4193/Rhin24.049. Online ahead of print.

ABSTRACT

BACKGROUND: A healthy olfactory cleft is critical to normal olfactory function. The aim of this study was to explore the differential orthonasal and retronasal olfactory functions in patients with olfactory cleft (OC) obstructions including a combination of OC syndrome, chronic rhinosinusitis with or without nasal polyps (CRSwNP or CRSsNP), and respiratory adenomatoid epithelial hamartoma (REAH).

METHODS: Patients (n = 93) presenting to an ENT clinic with OC obstruction underwent nasal endoscopy, chemosensory event-related potential (ERP) recordings, and radiologic assessment, and were subsequently diagnosed with OC syndrome, CRSsNP with OC syndrome, CRSwNP in the OC, REAH, and CRSwNP with REAH. Orthonasal and retronasal function were assessed using the complete Sniffin’ Sticks test and a set of 30 powders, respectively.

RESULTS: Orthonasal function was lower in patients with REAH and CRSwNP+REAH compared to CRSwNP in OC patients. Retronasal function was similarly diminished in REAH compared to CRSwNP in OC. Patients with OC syndrome alone had higher orthonasal scores than those with CRSsNP plus OC syndrome and CRSwNP in OC but not statistically different retronasal function. There was no significant difference in orthonasal or retronasal scores in REAH patients based on concurrent CRSwNP.

CONCLUSIONS: REAH corresponded with greater orthonasal and retronasal olfactory loss compared to other olfactory cleft obstructions, indicating a greater effect on the olfactory mucosa beyond disrupting airflow. The difference between CRS and OC syndrome is more pronounced orthonasally than retronasally.

PMID:41235453 | DOI:10.4193/Rhin24.049

Knee Surg Sports Traumatol Arthrosc. 2025 Nov 14. doi: 10.1002/ksa.70188. Online ahead of print.

ABSTRACT

PURPOSE: The primary objective was to assess the clinical efficacy and patient satisfaction following arthrolysis for Cyclops syndrome postanterior cruciate ligament reconstruction (ACLr). The secondary objective was to compare clinical and functional outcomes in patients who underwent early and late arthroscopic debridement. We hypothesised that arthroscopic anterior arthrolysis for Cyclops syndrome post-ACLr leads to significant improvement in functional outcomes and patient satisfaction.

METHODS: One hundred ninety-seven patients underwent arthroscopic anterior arthrolysis for Cyclops syndrome after primary ACLr between 1 January 2018 and 1 July 2024. The simple knee value (SKV), International Knee Documentation Committee (IKDC), return to sports after injury (RSI) score, Tegner score and time to return to sports (RTS) were assessed. Subgroup analyses were performed to compare early (≤6 months) versus late debridement (>6 months) and evaluate the impact of age and symptoms, using a linear and logistic regression analyses.

RESULTS: 4.3% (n = 197) of our primary ACLr underwent an arthroscopic arthrolysis for Cyclops syndrome. One hundred eighty-two patients (92%) would repeat the anterior debridement. The mean SKV was 79.6 ± 16.4%, the mean IKDC score was 80.1 ± 13.3 and the mean RSI score was 62.7 ± 26.6. Younger age than 24.5 at ACLr was significantly associated with RTS to preinjury level following arthroscopic debridement of the Cyclops lesion (p = 0.039), and age younger than 29.5 years was significantly linked to resumption of running (p = 0.001). No statistically significant difference was found between early and late debridement when it came to RTS (6.9 ± 5.5 vs. 5.3 ± 4.4; p = 0.10) and functional scores (SKV 82.1 ± 10.6 vs. 79.0 ± 17.5; p = 0.19, IKDC 83.3 ± 11.1 vs. 79.3 ± 13.7; p = 0.12, RSI 67.4 ± 22.9 vs. 61.4 ± 27.4, p = 0.23).

CONCLUSION: Arthroscopic anterior arthrolysis for Cyclops syndrome post-ACLr is an effective and satisfactory procedure regardless of timing. Young population achieve superior functional recovery and RTS to preinjury level.

LEVEL OF EVIDENCE: Level IV.

PMID:41235440 | DOI:10.1002/ksa.70188

AIDS Patient Care STDS. 2025 Nov;39(11):462-472. doi: 10.1177/10872914251395736.

ABSTRACT

Young Black sexual minority men living with HIV (YBSMM+) consistently report reduced engagement in the HIV care continuum. YBSMM+ are also highly burdened by depressive symptoms, which are strongly associated with suboptimal HIV care outcomes. Yet, little is known about the processes that drive depression-related disparities among YBSMM+. Informed by Minority Stress Theory, we examined three indirect effects, assessing whether the associations between experiences of racism, heterosexism, and HIV-related discrimination and depressive symptoms were mediated by three corresponding forms of internalized stigma. Participants included 216 YBSMM+ from the Southern United States who were assessed at three consecutive time points (longitudinal analyses), as well as 172 YBSMM+ who completed a fourth assessment (cross-sectional analysis). Data were collected from November 2016 to October 2022. Multiple regression analyses revealed that more frequent HIV-related discrimination at baseline significantly predicted greater internalized HIV stigma at the subsequent assessment, and that greater internalized racism at the fourth visit was significantly associated with more frequent depressive symptoms. No indirect effects achieved statistical significance, although recall bias due to long follow-up intervals may have affected the findings. These results suggest that, compared with internalized heterosexism and HIV stigma, internalized racism may be uniquely related to depressive symptoms, emphasizing the importance of exploring the impact of distinct forms of stigma on mental health. Future research may benefit from employing shorter time intervals to capture more nuance, assessing how ingrained internalized stigma has become, and considering the salience of internalized negative attitudes to core self-conceptions in similar longitudinal models.

PMID:41235433 | DOI:10.1177/10872914251395736

Afr J Emerg Med. 2025 Dec;15(4):100913. doi: 10.1016/j.afjem.2025.100913. Epub 2025 Oct 29.

ABSTRACT

The overwhelming flow of non-emergent cases burdens Emergency Medical Services (EMS), reducing their capacity to respond to life-threatening emergencies and compromising care for patients with emergent clinical needs. This study evaluated the appropriateness of the EMS deployment in a district of the North West Province in South Africa.

METHODS: A retrospective quantitative descriptive analysis was conducted on cases completed by the district EMS service between 1 and 12 January 2022. Patient report forms and control room assessment forms, containing demographic and clinical data, were analysed to assess the EMS deployment accuracy. Descriptive statistics were used to analyse the continuous and categorical variables, while Pearson’s chi-square test and ANOVA tests examined associations between call prioritisation decisions, on-scene resource allocation, and the qualifications of call takers and dispatchers.

RESULTS: Of the 535 records meeting the inclusion criteria, 71.1% revealed mismatches between call prioritisation and on-scene triage. The over-prioritisation rate was 90.9%, while the under-prioritisation rate was 17.1%. Additionally, 35.0% of patients were transported to a medical facility without receiving any medical interventions.

CONCLUSION: Significant disparities exist between call prioritisation and actual patient clinical needs, exacerbating the strain on an already resource-constrained EMS system. Standardised call prioritisation protocols and improved training for call takers and dispatchers are necessary to enhance EMS efficiency.

PMID:41235402 | PMC:PMC12607023 | DOI:10.1016/j.afjem.2025.100913