Tag: nevin manimala

BMC Womens Health. 2025 Mar 8;25(1):107. doi: 10.1186/s12905-025-03636-z.

ABSTRACT

BACKGROUND: Nigeria faces a dual challenge of high fertility rates and limited female education. Studies suggest that education can contribute to fertility reduction. This study aimed to show the differences and quantify the disparity in fertility rates between educated and uneducated women in Nigeria.

METHODS: A repeated cross-sectional analysis was conducted using secondary data from the Nigeria Demographic and Health Surveys (2003, 2008, 2013, 2018; Total = 121,774). Fertility differentials for women aged 15-49 were measured using Oaxaca-Blinder decomposition (α = 0.05).

RESULTS: The proportion of women without education remained high throughout the study period (41.6% in 2003, 35.8% in 2008, 37.8% in 2013 and 34.9% in 2018). Uneducated women consistently exhibited higher fertility rates than educated women across all survey years and regions. The risk difference of high fertility was greatest in the SouthEast region (34.0) and lowest in the North East (22.19). Factors contributing to the disparity included maternal age, age at first marriage, wealth index, and age at first birth.

CONCLUSION: Marked fertility inequalities exist between educated and uneducated women across Nigerian regions. These findings highlight the crucial role of female education in fertility reduction efforts.

PMID:40057721 | DOI:10.1186/s12905-025-03636-z

Eur J Radiol. 2025 Feb 27;185:112017. doi: 10.1016/j.ejrad.2025.112017. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: CT-Guided Microwave Ablation Combined with Percutaneous Vertebroplasty for Spinal Metastases is an emerging minimally invasive therapeutic option. This study aimed to compare the clinical efficacy and risk factors for bone cement leakage in CT-guided percutaneous vertebroplasty (PVP) with or without microwave ablation (MWA) in the treatment of spinal metastases.

MATERIALS AND METHODS: A retrospective analysis was conducted on 69 patients with 104 vertebral metastases treated between January 2019 and December 2022, divided into two groups: PVP group(n = 23, 37 vertebrae) underwent PVP alone, and MWA + PVP group(n = 46, 67 vertebrae) underwent MWA combined with PVP. Postoperative pain, daily living capabilities, and other parameters were compared, and CT and MRI were used to assess bone cement leakage and tumor control. Logistic regression analysis was used to evaluate the risk factors for leakage.

RESULTS: The technical success rate was 100 % for both groups.The Visual Analog Scale（VAS), Daily Morphine Consumption(DMC), Oswestry Disability Index(ODI), and Activity of Daily Living Scale(ADL) scores at various postoperative time points in both the PVP and MWA + PVP groups showed significant improvements compared to preoperative levels (P < 0.05). However, there were no significant differences between the two groups within 12 weeks (P > 0.05), but at the 24-week follow-up, the MWA + PVP group exhibited superior scores (P < 0.05).At the 24-week postoperative follow-up, the local tumor control rates for patients and lesions in the PVP group were 78.26 % (18/23) and 78.38 % (29/37), respectively, while those in the MWA + PVP group were 91.30 % (42/46) and 91.04 % (61/67), respectively. PVP group had mild bone cement leakage in 64.80 % of vertebrae, compared to 22.30 % in MWA + PVP group. Multifactorial logistic analysis revealed that microwave ablation is an independent protective factor against bone cement leakage, cortical bone cement leakage, and vascular bone cement leakage, with an approximately consistent odds ratio (OR) of 0.2 for its protective effect, and these associations were statistically significant (P-values of 0.008, 0.005, and 0.007, respectively).Conversely, Pathological fractures (OR = 29.6,P < 0.001)and posterior vertebral wall ruptures（OR = 17.3,P = 0.01） were two independent risk factors for bone cement leakage, and the volume of bone cement injected was an independent risk factor for spinal canal bone cement leakage （OR = 1.7, P = 0.01）.

CONCLUSION: Compared with PVP alone, MWA combined with PVP in the treatment of spinal metastases not only demonstrates more pronounced tumor control efficacy but also effectively reduces the risk of bone cement leakage. This finding offers a novel perspective for the minimally invasive treatment of spinal metastases and provides robust clinical evidence for optimizing treatment regimens and enhancing patients’ quality of life. It holds promise as one of the significant options in the therapeutic arsenal against spinal metastases.

PMID:40054036 | DOI:10.1016/j.ejrad.2025.112017

Neural Netw. 2025 Feb 26;187:107297. doi: 10.1016/j.neunet.2025.107297. Online ahead of print.

ABSTRACT

In feed-forward neural networks, dataset-free weight-initialization methods such as LeCun, Xavier (or Glorot), and He initializations have been developed. These methods randomly determine the initial values of weight parameters based on specific distributions (e.g., Gaussian or uniform distributions) without using training datasets. To the best of the authors’ knowledge, such a dataset-free weight-initialization method is yet to be developed for restricted Boltzmann machines (RBMs), which are probabilistic neural networks consisting of two layers. In this study, we derive a dataset-free weight-initialization method for Bernoulli-Bernoulli RBMs based on statistical mechanical analysis. In the proposed weight-initialization method, the weight parameters are drawn from a Gaussian distribution with zero mean. The standard deviation of the Gaussian distribution is optimized based on our hypothesis that a standard deviation providing a larger layer correlation (LC) between the two layers improves the learning efficiency. The expression of the LC is derived based on a statistical mechanical analysis. The optimal value of the standard deviation corresponds to the maximum point of the LC. The proposed weight-initialization method is identical to Xavier initialization in a specific case (i.e., when the sizes of the two layers are the same, the random variables of the layers are {-1,1}-binary, and all bias parameters are zero). The validity of the proposed weight-initialization method is demonstrated in numerical experiments using a toy dataset and real-world datasets.

PMID:40054026 | DOI:10.1016/j.neunet.2025.107297

Sleep Med Rev. 2025 Jan 15;80:102048. doi: 10.1016/j.smrv.2025.102048. Online ahead of print.

ABSTRACT

Major depressive disorder (MDD) and Insomnia disorder (ID) are characterized by sleep alterations. To define their polysomnographic profiles, we conducted a Network Meta-Analysis comparing MDD and ID patients versus healthy controls (HCs). The literature search, conducted from 2008 up to January 2023 and following PRISMA guidelines, covered PubMed, Web of Science, Scopus, and Embase databases. We addressed publication bias using funnel plot asymmetry inspection and Egger’s test, evaluated statistical heterogeneity with I², and local and global inconsistencies with the separate indirect from direct evidence method and Q between designs, respectively. Pairwise meta-analyses employed a fixed-effects model, while network analysis utilized a random-effect approach. We evaluated 86 ID and 17 MDD studies, comparing sleep parameters for 636 MDDs versus 491 HCs, and 3661 IDs versus 2792 HCs. The network meta-analysis reported that patients with MDD have greater rapid eye movement (REM) sleep duration and REMs density, and lower REM sleep latency compared to IDs. ID patients instead exhibited lower total sleep time and time in bed, and greater wake after sleep onset and non-REM sleep stage 3 than MDD patients. This work emphasized sleep depth and continuity alterations in both MDD and ID, with major involvement of REM sleep in MDD.

PMID:40054014 | DOI:10.1016/j.smrv.2025.102048

J Phys Chem Lett. 2025 Mar 7:2778-2784. doi: 10.1021/acs.jpclett.5c00073. Online ahead of print.

ABSTRACT

This study uses molecular dynamics simulations to investigate the structural features of carbon dioxide (CO₂) in the liquid and supercritical phases at different isobars. Density fluctuations, which mark the liquid-to-gas-like crossover, were quantified using advanced statistical tools such as nearest-neighbor distance distributions, interaction energies, and local density profiles derived from Voronoi analysis and density-based spatial clustering of applications with noise. Our findings reveal that these fluctuations arise from the temperature-dependent difference in the spatial extent of attractive contributions from electrostatic (ES) and Lennard-Jones (LJ) potentials, leading to a maximum in the contrast between the packed and loose density domains. Specifically, we demonstrate that the first and second solvation shells are characterized by neighbors experiencing maximal LJ and minimal ES attractive contributions, respectively. Within these shells, the orientation of the CO₂ molecules is governed by the maximal attractive contribution of ES interactions.

PMID:40054008 | DOI:10.1021/acs.jpclett.5c00073

JMIR Hum Factors. 2025 Mar 7;12:e63607. doi: 10.2196/63607.

ABSTRACT

BACKGROUND: Mobile health care (mHealth) apps are emerging worldwide as a vital component of internet health care, but there are issues, especially among older adults.

OBJECTIVE: We aim to investigate the factors influencing the intention to use (ITU) mHealth apps, focusing on those with and without prior mHealth experience.

METHODS: A cross-sectional study conducted from August 2022 to July 2023 included Thai citizens aged 45 years or older. Self-reported questionnaires collected data on sociodemographic information, health conditions, smartphone or tablet ownership, and mHealth usage experience. The Thai mHealth Senior Technology Acceptance Model questionnaires with a 10-point Likert scale evaluated mHealth acceptance. A multivariable logistic regression analysis, adjusted for age, gender, education, income, and living area, was performed for 2 subgroups: those who used ITU mHealth apps and those who did not.

RESULTS: Of 1100 participants, 537 (48.8%) intended to use mHealth apps, while 563 (51.2%) did not. The ITU group had a younger average age, higher education levels, higher income, and fewer underlying diseases compared to those who did not intend to use mHealth apps. For those who had never used mHealth apps, having a smartphone was strongly associated with higher odds of ITU (adjusted odds ratio 2.81, 95% CI 1.6 to 4.93; P<.001), while having any underlying disease was associated with lower odds of ITU (adjusted odds ratio 0.63, 95% CI 0.42 to 0.97; P=.034). Higher acceptance levels, characterized by a positive attitude toward mHealth and lower fear of making mistakes, were also associated with higher ITU. For those with prior mHealth experience, acceptance in areas such as perceived ease of use, gerontechnology anxiety, and facilitating conditions was significantly associated with ITU.

CONCLUSIONS: Among inexperienced users, a positive attitude toward mHealth significantly enhanced ITU. Conversely, having an underlying disease decreased ITU, indicating a need for tailored mHealth apps. For experienced users, acceptance levels in areas such as ease of use and gerontechnology anxiety were crucial. Future research should explore specific mHealth apps for more targeted insights.

PMID:40054006 | DOI:10.2196/63607

Phys Rev Lett. 2025 Feb 21;134(7):071903. doi: 10.1103/PhysRevLett.134.071903.

ABSTRACT

The subtraction function plays a pivotal role in calculations involving the forward Compton amplitude, which is crucial for predicting the Lamb shift in muonic atoms, as well as the proton-neutron mass difference. In this Letter, we present a lattice QCD calculation of the subtraction function using two domain wall fermion gauge ensembles near the physical pion mass. We utilize a recently proposed subtraction point, demonstrating its advantage in mitigating statistical and systematic uncertainties by eliminating the need for ground-state subtraction. Our results reveal significant contributions from Nπ intermediate states to the subtraction function. Incorporating these contributions, we compute the proton, neutron, and nucleon isovector subtraction functions at photon momentum transfer Q^{2}∈[0,2] GeV^{2}. For the proton subtraction function, we compare our lattice results with chiral perturbation theory prediction at low Q^{2} and with the results from the perturbative operator-product expansion at high Q^{2}. Finally, using these subtraction functions as input, we determine their contribution to two-photon exchange effects in the Lamb shift and isovector nucleon electromagnetic self-energy.

PMID:40053980 | DOI:10.1103/PhysRevLett.134.071903

J Neurosurg Spine. 2025 Mar 7:1-10. doi: 10.3171/2024.11.SPINE241048. Online ahead of print.

ABSTRACT

OBJECTIVE: The Social Deprivation Index (SDI) measures area-level social disadvantage. SDI values range from 0 (no distress/prosperous) to 100 (highest distress). This study investigated the association between SDI and lumbar spine surgery outcomes.

METHODS: A retrospective cross-sectional study was performed using electronic health record data from a multihospital academic health system from 2017 to 2024. Eligible patients included adults who underwent lumbar fusion or decompression alone. The primary exposure of interest was the binary SDI (low distress [SDI < 50] vs high distress [SDI ≥ 50 and ≤ 100]). SDI was associated with the patient’s zip code of residence. The associations between SDI category and pain reduction, physical function improvement, length of stay, and 30-day readmission were examined. Both unadjusted and adjusted regression models were created. Adjusted models included the following covariates: age, comorbidities, race, insurance, and surgery type. Multiple imputation by chained equations was used to impute missing values.

RESULTS: The total sample included 7598 patients with 5139 in the low-SDI group and 2459 in the high-SDI group. SDI category was not significantly associated with the likelihood of pain reduction or physical function improvement after surgery. In the adjusted model, residence in a high-SDI area was significantly associated with extended length of stay (OR 1.21, 95% CI 1.07-1.36, p = 0.002). In the unadjusted model, patients from high-SDI areas were significantly more likely to experience 30-day readmission (OR 1.35, 95% CI 1.07-1.71, p = 0.01). In the adjusted model, this association was no longer statistically significant (OR 1.00, 95% CI 0.74-1.36, p ≥ 0.99).

CONCLUSIONS: Patients from high-SDI areas had similar pain and physical function outcomes compared to patients from low-SDI areas after lumbar spine surgery. High SDI was significantly associated with length of stay. This study highlights the need for interventions that address the unique needs of patients from low-resource settings to improve lumbar spine surgery outcomes.

PMID:40053938 | DOI:10.3171/2024.11.SPINE241048

J Neurosurg. 2025 Mar 7:1-15. doi: 10.3171/2024.11.JNS241990. Online ahead of print.

ABSTRACT

OBJECTIVE: Essential tremor (ET) is a prevalent movement disorder that also includes nonmotor symptoms such as anxiety, depression, and cognitive impairment. Deep brain stimulation (DBS) is an established treatment for ET, yet its impact on nonmotor symptoms remains unclear. This study aims to describe neuropsychological outcomes following ventral intermediate nucleus (VIM) DBS in a large cohort of patients with ET and identify factors associated with changes in depression and cognitive function.

METHODS: A retrospective cohort study of patients who had undergone VIM DBS was performed. Inclusion criteria were ET diagnosis, surgery between October 2007 and March 2020, and available pre- and post-DBS neuropsychological testing results. Neuropsychological measures included the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and cognitive measures assessing attention, executive function, language, memory, and visuospatial function. Post-DBS tremor improvement was graded, and active electrode coordinates and stimulation parameters were identified. Statistical analyses included descriptive statistics, t-tests to compare pre- and postoperative scores at the group level, and one-way analysis of variance to compare variables among patients who improved, were stable, or worsened in psychiatric and cognitive characteristics after DBS.

RESULTS: One hundred thirty-nine patients met the study inclusion criteria. BDI-II scores significantly decreased postoperatively (9.82 ± 6.77 vs 8.29 ± 6.18, p < 0.001, Cohen’s d = 0.176), whereas BAI scores remained unchanged. Both language (p = 0.003, Cohen’s d = 0.259) and memory (p < 0.001, Cohen’s d = 0.336) domains showed statistically significant small-magnitude declines following surgery, whereas attention, executive function, and visuospatial function were unchanged. Patients with improved depression (14.3%) following VIM DBS had significantly higher BDI-II scores preoperatively (p < 0.001, ω2 = 0.226). Patients with worsened language (18.7%) had higher preoperative language scores (p < 0.001, ω2 = 0.058). Patients with worsened memory (15.1%) had higher BAI scores preoperatively (p = 0.002, ω2 = 0.079). Preoperative scores were similar between patients with improved and worsened overall cognition postsurgery. Patients with improved overall cognition had improvements in attention, language, and visuospatial function.

CONCLUSIONS: VIM DBS for ET did not result in large-magnitude neuropsychological changes. There were statistically significant, though likely not clinically meaningful, small-magnitude improvements in depression and worsening in language and memory scores. Associations were found between multiple preoperative mood and cognitive scores and post-DBS neuropsychological changes. These findings can help inform clinical decision-making and patient counseling for DBS.

PMID:40053934 | DOI:10.3171/2024.11.JNS241990

Knee Surg Sports Traumatol Arthrosc. 2025 Mar 7. doi: 10.1002/ksa.12645. Online ahead of print.

ABSTRACT

PURPOSE: Bereiter trochleoplasty (TP) is a well-described procedure to address trochlear dysplasia (TD). Post-operative joint stiffness with reduced range of motion (ROM) is a common complication usually requiring arthroscopically assisted manipulation (AAM) with the removal of adhesions and scar tissue. Inferior clinical outcomes after TP have been reported for patients with subsequent surgery. We hypothesised that a 2-year improvement in patient-reported outcomes would be lower in patients treated with AAM.

METHODS: This was a retrospective cohort study of prospectively collected data comparing subgroups of patients with and without post-operative joint stiffness from a consecutive cohort of 374 knees with high-grade TD who underwent TP according to the Copenhagen patello-femoral instability (PFI) algorithm. All patients received supervised training exercises led by a physiotherapist. At 3-month follow-up, patients with an extension deficit >10° and/or flexion <120° were diagnosed with post-operative joint stiffness and treated with AAM. Outcomes were mean differences from baseline in Kujala, Knee injury and Osteoarthritis Outcome Score (KOOS) and Lysholm scores 1 and 2 years after surgery.

RESULTS: Forty-nine (38 females, 11 males) of the 374 knees (12%) had post-operative joint stiffness and underwent AAM. Nine patients underwent subsequent AAMs. Full extension and flexion >135° were achieved in 37 out of 49 cases (75%). In 11 cases, flexion remained reduced, while data on ROM could not be retrieved in one case. While both patients with and without AAM showed clinically relevant improvements in the Kujala, KOOS and Lysholm scores, no statistically significant between-group differences were seen in these improvements.

CONCLUSIONS: Post-operative joint stiffness was a common complication after Bereiter TP following the Copenhagen PFI algorithm. Twenty-five per cent of the AAM patients, or 3% of the study population, did not regain full ROM. We did not find that post-operative joint stiffness was associated with inferior improvements in patient-reported outcomes 1 and 2 years after surgery.

LEVEL OF EVIDENCE: Level IV, a retrospective cohort study.

PMID:40053930 | DOI:10.1002/ksa.12645