Tag: nevin manimala

Int J Qual Health Care. 2025 Dec 16:mzaf123. doi: 10.1093/intqhc/mzaf123. Online ahead of print.

ABSTRACT

BACKGROUND: The specific impact of anticholinergic load on quality of life is understudied. We aimed to investigate relationships between anticholinergic load and quality of life in residential aged care facilities and differences between residents with and without dementia.

METHODS: A retrospective cohort study of 21 residential aged care facilities in New South Wales, Australia. Residents aged ≥65 years for permanent care. Residents had their quality of life measured using the Quality of Life Aged Care Consumers tool in 2023 at baseline (July-September) and follow-up (October-December, the study outcome). Higher scores indicate better quality of life. Anticholinergic load of administered medications between two quality of life measures was evaluated using five existing scales: Anticholinergic Cognitive Burden, Anticholinergic Drug Scale, Anticholinergic Loading Scale, Anticholinergic Risk Scale, and Clinician-rated Anticholinergic Score. Associations between anticholinergic load from each scale and follow-up quality of life scores were examined using linear regression, controlling for age, sex, baseline quality of life scores, and other potential confounders. Interactions between anticholinergic load and dementia were tested. Analyses were conducted for overall cohort and a subgroup analysis was performed for residents with and without dementia.

RESULTS: A total of 927 residents (69.7% female) were included. One-point higher anticholinergic load measured on each of the Anticholinergic Loading Scale, Anticholinergic Risk Scale, and Clinician-rated Anticholinergic Score, was associated with lower quality of life scores at follow-up: -0.24 (95% confidence interval -0.47, -0.01), -0.26 (95% confidence interval -0.46, -0.05), and -0.25 (95% confidence interval -0.49, -0.01), respectively. Associations did not differ by dementia status. In a subgroup analysis, the associations remained statistically significant in residents without dementia (n = 501), but not in those with dementia (n = 426).

CONCLUSION: Our results indicate that, controlling for baseline quality of life, anticholinergic load was associated with lower quality of life at follow-up over a short period (up to six months).

PMID:41400935 | DOI:10.1093/intqhc/mzaf123

Pharmacoecon Open. 2025 Dec 16. doi: 10.1007/s41669-025-00621-y. Online ahead of print.

ABSTRACT

BACKGROUND: Health state utility values (HSUVs) are vital in cost-utility analyses (CUAs) that inform policymaking. However, suboptimal selection and application of HSUVs have been reported in areas such as cardiovascular disease and cancer. This study reviewed the methodological quality and appropriateness of HSUV in CUA use for interventions targeting infectious diseases in aging populations.

METHODS: A systematic search of the MEDLINE database was conducted to identify CUAs that evaluated interventions against six major infectious diseases from January 2000 to July 2025. Two reviewers independently screened the identified studies based on eligibility criteria. The two reviewers then assessed the included studies using a modified checklist that covered how HSUVs were selected, elicited, and applied. Findings are summarized by descriptive statistics across the entire period (January 2000 to July 2025) and three sub-periods (2000-2009, 2010-2019, and 2020 to July 2025).

RESULTS: Among the 146 included CUA studies, only 10 (7%) relied exclusively on original sources for HSUVs, while 78% used economic data, either alone or in combination with other secondary sources or assumptions. Most studies (78-91%) did not provide sufficient rationale or descriptions for the population or how HSUVs were elicited, and 42% failed to report all utility components. Complete comparability between the CUAs and reference data for the diagnosis, severity, and country was observed in only 51-60% of studies. Notably, fewer than half of CUAs reported HSUVs that were consistent with their cited sources, and 80% did not discuss the limitations associated with HSUV use. Most criteria showed limited improvements, and in some cases declines, between January 2000 and July 2025.

CONCLUSION: CUAs of infectious diseases in aging populations are frequently associated with suboptimal practices in how HSUVs are selected, elicited, and applied. These shortcomings highlight the need for cautious interpretation of CUA data and for greater methodological transparency. Improving the quality of economic evaluations will require systematic approaches to how HSUVs are selected and elicited, with increased investment in primary data collection and the creation of accessible utility databases.

PMID:41400916 | DOI:10.1007/s41669-025-00621-y

J Neurooncol. 2025 Dec 16;176(2):125. doi: 10.1007/s11060-025-05312-6.

ABSTRACT

PURPOSE: Meningiomas are common, mostly benign, and often asymptomatic. Minimizing surgical adverse events (AE) is essential to maintain a favorable risk-benefit balance. Traditional AE grading systems often failed to account for disabling complications like neurologic deficits, which led to the development of the multidimensional therapy-disability-neurology grade (TDN). This study evaluates risk factors and consequences of AE in meningioma patients using TDN.

METHODS: Pre- and perioperative factors associated with the occurrence and severity of AE at discharge and follow-up were retrospectively identified in a monocentric cohort of consecutive patients undergoing surgery between 2013 and 2022. Significant variables of the univariable analysis were consequently tested in a multivariable analysis. Statistical analysis to detect the relationship between TDN and clinical outcomes was performed.

RESULTS: 367 patients were included with a mean age at surgery of 60.8 years. A total of 95 AE at discharge and 144 AE at follow-up were recorded. Generalized linear models showed a relationship between the modified Rankin Scale on admission, tumor complexity as measured by the Milan Complexity Scale, and preoperative embolization with the frequency of AE at discharge and follow-up. A correlation between TDN, Karnofsky Performance Scale at discharge, and length of hospital stay was observed.

CONCLUSION: The severity of AE as classified according to TDN correlated with the length of hospital stay and functional outcome following meningioma resection in our cohort and may be predicted by specific pre- and perioperative factors.

PMID:41400878 | DOI:10.1007/s11060-025-05312-6

J Robot Surg. 2025 Dec 16;20(1):90. doi: 10.1007/s11701-025-03071-0.

ABSTRACT

Robotic surgery has become an integral part of minimally invasive surgical practice across a variety of disciplines. However, training structures, access, and perceptions of its clinical value vary significantly among surgeons worldwide. To assess global trends in robotic and laparoscopic/thoracoscopic surgery training, practice patterns, and surgeon-perceived clinical outcomes across a range of procedures. A cross-sectional, web-based survey will be conducted among surgical professionals worldwide. The survey includes structured quantitative items using Likert scales and multiple-choice formats comparing the conventional laparoscopic/thoracoscopic approaches. Data will be analyzed using descriptive statistics, subgroup comparisons, and regression models where appropriate. The study aims to identify variability in training pathways, perceived clinical benefits, and barriers to robotic surgery adoption, possibly informing curriculum development and policy changes to enhance equitable access and training.

PMID:41400869 | DOI:10.1007/s11701-025-03071-0

Environ Monit Assess. 2025 Dec 16;198(1):46. doi: 10.1007/s10661-025-14783-z.

ABSTRACT

Chlorination of drinking water is the most widely utilized disinfection technique; however, its reaction with naturally occurring organic matter causes the production of disinfection byproducts (DBPs), such as haloacetic acids (HAAs), which are the second most common DBP after trihalomethanes. This study investigates the occurrence and spatial variation of five HAA species (monochloroacetic acid (MCAA), dichloroacetic acid (DCAA), trichloroacetic acid (TCAA), monobromoacetic acid (MBAA), and dibromoacetic acid (DBAA)) in drinking water samples collected from eight locations in Jamia Nagar, New Delhi, during March-April 2023. Among these, only two species, i.e., DCAA and TCAA, were quantified, with mean concentrations of 13.97 ± 2.87 µg/L and 13.22 ± 3.47 µg/L, respectively, and total HAAs ranging from 20.81 to 34.95 µg/L. These concentrations were well below the maximum contamination limit of 60 µg/L given by USEPA, whereas no corresponding standards exist in India. Statistical analysis revealed strong positive correlations of HAA formation with residual chlorine, total organic carbon, and pH, while temperature exhibited a weak negative influence. Principal component analysis confirmed that residual chlorine, total organic carbon, and pH were the dominant contributors to HAA variability. Spatial mapping using kriging interpolation demonstrated higher HAA concentrations at sampling locations farther from the water treatment plant, indicating the effect of longer contact time between chlorine and organic precursors. The results highlight the need to consider HAAs in Indian drinking water standards and suggest that spatial monitoring can guide treatment upgrades and evidence-based policy making to ensure safe drinking water.

PMID:41400868 | DOI:10.1007/s10661-025-14783-z

Sci Prog. 2025 Oct-Dec;108(4):368504251406564. doi: 10.1177/00368504251406564. Epub 2025 Dec 16.

ABSTRACT

ObjectiveTo evaluate the role of rivaroxaban in preventing arteriovenous graft (AVG) thrombosis following endovascular intervention, assess the risk of recurrent thrombosis, and develop a clinically applicable predictive model.MethodsA retrospective analysis was performed on 108 patients with AVG thrombosis who underwent endovascular treatment at our center between October 2020 and October 2024. Patients were stratified into a rivaroxaban group (n = 71) and a control group (n = 37). Fifteen variables from the two groups were analyzed and summarized. Four machine learning algorithms (random forest, Support Vector Machine – Recursive Feature Elimination, Least Absolute Shrinkage and Selection Operator, and XGboost) were applied to identify risk factors for recurrent thrombosis. A predictive model was constructed using logistic regression and validated with an internal dataset.ResultsAmong the 108 patients, 69 were male and 39 were female, with ages ranging from 21 to 89 years. Fibrinogen levels were significantly lower in the rivaroxaban group (4.02 ± 0.87 vs. 4.59 ± 1.03, p < 0.01), More notably, the 12-month postprocedural patency rate was significantly higher in the rivaroxaban group (75%) than in the nonrivaroxaban group (17%), with a statistically significant difference (p < 0.01). No statistically significant differences were observed between the two groups in other aspects (p > 0.05). The model exhibited a C-index of 0.87 (95% CI: 0.78-0.95). The receiver operating characteristic and decision curve analysis curves demonstrated that the multifactor model had superior discriminative ability and net clinical benefit for identifying recurrent AVG thrombosis compared to single factors (AUC_{linear predictor} = 0.87, AUC_{rivaroxaban use} = 0.78, AUC_D-dimer = 0.60). Validation in the internal validation set and the entire cohort confirmed good calibration and efficacy (validation set: AUC = 0.86, entire cohort: AUC = 0.85).ConclusionRivaroxaban may exert a positive effect on maintaining the patency of AVG fistulas after endovascular treatment for thrombosis. The constructed nomogram prediction model can be used to predict the risk of recurrent thrombosis following endovascular treatment of AVG fistula thrombosis.

PMID:41400855 | DOI:10.1177/00368504251406564

Infection. 2025 Dec 16. doi: 10.1007/s15010-025-02712-8. Online ahead of print.

ABSTRACT

PURPOSE: We compared nationwide data on the clinical characteristics of deceased and non-deceased patients with Respiratory Syncytial Virus (RSV)-coded hospitalization to evaluate potential risk factors for in-hospital fatality by age group.

METHODS: Data from International Statistical Classification of Diseases (10th Revision)-based German Hospital Statistics for patients from 2010-2019 with a primary discharge diagnosis code for RSV-related pneumonia (J12.1), bronchitis (J20.5) or bronchiolitis (J21.0) were assessed by remote data retrieval. Selected underlying conditions and complications were reported stratified by age group and outcome.

RESULTS: Overall, 612 (0.3% of 205,352) RSV-coded patients died in hospital (103 children < 18 years, 51 adults 18-59 years, 458 seniors > 59 years). Children and adults with underlying chronic cardiovascular, neurological, immunological, or lower respiratory diseases had a higher risk of dying than those without (Odds Ratio 109, 58, 28, 6 in children, and 3, 3, 3, 2 in adults). In seniors, the risk was increased for patients with chronic neurological conditions (OR 1.3) but not for other underlying conditions. Acute respiratory distress syndrome, sepsis and pneumonia increased the risk of a fatal outcome in all age groups.

CONCLUSION: In-hospital fatality of RSV-coded patients varied considerably with age, chronic conditions and complications. Seniors were the most affected age group and may therefore benefit from the RSV vaccination recommended in Germany since 2024 for all over 75 years and seniors with pre-existing conditions.

PMID:41400853 | DOI:10.1007/s15010-025-02712-8

J Mol Model. 2025 Dec 16;32(1):18. doi: 10.1007/s00894-025-06591-6.

ABSTRACT

CONTEXT: In order to increase the efficiency of dye-sensitized solar cells (DSSC), we propose to study the influence of maximizing the push-pull effect by quantifying the donor force (Ds) and the acceptor capacity (Ap) calculated as functions of the Electrophilicity, Orbital Hardness, and Polarizability. The sum of the donor force and the acceptor capacity is the inductive force, which allows the push-pull effect to be maximized. With this approach, we applied the Barrera-Crivelli-Loeb (BCL) model to a series of eleven Zinc Porphyrins to correlate the Global Efficiency Index (GEI) with the experimental measurement of Photo Conversion Efficiency (PCE). The use of this strategy together with the use of siloles and siloxanes allows the design of two new dyes, BCL 516 and BCL 520, with theoretically calculated efficiencies of 10.64% and 10.61%.

METHODS: In this work, all calculations were performed with the Amsterdam Density Functional 2023 package. For geometry optimization (ground state and first singlet), the optimized Perdew-Becke-Ernzerhof exchange correlation functional was employed with a DZP basis set for H, C, N, O, S, and a Zeroth Order Regular Approximation (ZORA) – TZP basis set for Ti and Zn. Time-Dependent Density Functional Theory (TDDFT) calculations were achieved with the Statistical Average Orbital model exchange correlation potential (SAOP), including solvent effects with the Conductor-like Screening Model (COSMO). Calculations of molecular properties like electrophilicity, orbital hardness, and polarizability were carried out in the gas phase with the SAOP potential model after optimization of the target molecule with the OPBE exchange correlation functional. To determine the orbital hardness of the HOMO and LUMO, the occupation number of the frontier orbital was modified by 0.3 units.

PMID:41400849 | DOI:10.1007/s00894-025-06591-6

Int Ophthalmol. 2025 Dec 16;46(1):28. doi: 10.1007/s10792-025-03883-x.

ABSTRACT

PURPOSE: To evaluate the clinical and aesthetic efficacy of postoperative topical treatments compared to conservative management following standard upper eyelid blepharoplasty.

METHODS: This prospective, randomized controlled trial included 69 patients undergoing isolated upper eyelid blepharoplasty. Participants were randomized into three groups: (1) antibiotic-steroid ointment (Maxitrol), (2) antibiotic-only ointment (chloramphenicol), and (3) no topical treatment (control). Primary outcomes included patient satisfaction, pain, perceived swelling, and aesthetic results using the Stony Brook Scar Evaluation Scale (SBSES), assessed at one week and four months postoperatively. Adverse events and complications were also recorded.

RESULTS: There were no statistically significant differences among the three groups in patient-reported outcomes at either time point, including pain (p = 0.05), satisfaction (p = 0.3), or eyelid swelling (p = 0.9). Aesthetic evaluation by a blinded independent senior plastic surgeon showed no significant difference in SBSES scores between groups (p = 0.7). No adverse effects or postoperative infections were reported.

CONCLUSION: Routine use of postoperative topical antibiotic or corticosteroid-containing ointments following standard upper eyelid blepharoplasty does not confer additional benefit in terms of patient satisfaction, symptom control, or aesthetic outcomes when compared with conservative care alone. Given the low infection risk, potential side effects, and concerns regarding antimicrobial resistance, a simplified postoperative regimen focusing on lubrication alone may be sufficient for uncomplicated cases. These findings support a more minimalist approach to postoperative management and emphasize the need for larger, multicenter trials to validate these results across broader surgical contexts.

PMID:41400848 | DOI:10.1007/s10792-025-03883-x

Br J Radiol. 2025 Dec 16:tqaf299. doi: 10.1093/bjr/tqaf299. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate solid volume ratio (SVR) in predicting long-term postoperative outcomes in lung adenocarcinoma patients.

METHODS: This study retrospectively analyzed the clinical, pathological, and CT data of patients with lung adenocarcinoma who underwent surgical resection and were pathologically confirmed in the Department of Thoracic Surgery of our hospital from June 2014 to June 2023. Multivariate COX analysis was also conducted to identify independent factors that affect treatment effect. P < 0.05 was considered statistically significant.

RESULTS: A total of 154 patients (82 males and 72 females) were included in this study. The average age was 62.11 ± 8.74 years. There were 60 patients (38.96%) who smoked, and 63 patients (40.90%) had positive pleural invasion. The 3-year DFS rate and OS rate after surgical resection were 87.5% and 92.0%, respectively; the 5-year DFS rate and OS rate after surgical resection were 81.6% and 89.1%, respectively. Multiple COX regression analysis showed that gender (P = 0.009, OR: 4.197, 95% CI: 1.426-12.353), and the solid volume ratio (P = 0.004, OR: 1.021, 95% CI: 1.007-1.036) were identified as an independent predictor of recurrence. Multivariate COX analysis showed that SVR (P = 0.003, OR: 1.028, 95% CI: 1.009-1.046) was identified as an independent predictor of postoperative survival in patients with lung cancer.

CONCLUSION: In this study, compared with consolidation tumor rate (CTR), the SVR has certain value in evaluating the therapeutic efficacy of lung adenocarcinoma.

ADVANCES IN KNOWLEDGE: SVR is an independent predictor of postoperative recurrence and survival in lung cancer, and provides new ideas for postoperative efficacy evaluation.

PMID:41400845 | DOI:10.1093/bjr/tqaf299