Tag: nevin manimala

Diagn Interv Radiol. 2025 Jun 3. doi: 10.4274/dir.2025.253324. Online ahead of print.

ABSTRACT

PURPOSE: This study investigates the accuracy of multiparametric magnetic resonance imaging (mpMRI), diffusion-weighted imaging (DWI), and magnetic resonance elastography (MRE) in differentiating benign and malignant liver lesions.

METHODS: This retrospective study included patients with focal liver lesions who underwent MRI and MRE between 2018 and 2022. Based on histopathologic analyses or follow-up imaging findings, 70 solid liver lesions were retrospectively evaluated as benign (n = 20) or malignant (n = 50).

RESULTS: There was no statistically significant difference between the benign and malignant liver lesions in pre-contrast T1 relaxation times (P > 0.05). Malignant liver lesions had a significantly lower T2 value, contrast-enhancement ratio (CER), T1 relaxation time reduction (T1D), T1D percentage [T1D (%)], and apparent diffusion coefficient (ADC), along with a significantly higher stiffness value (P < 0.05). In receiver operating characteristic analysis, the following cut-off values were determined for differentiating malignant from benign lesions: a CER of 1.99 [area under the curve (AUC): 0.828, sensitivity 78.6%, specificity 73.2%], a T1D of 749.5 ms (AUC: 0.817, sensitivity 71.4%, specificity 78%), a T1D (%) reduction of 49.71% (AUC: 0.831, sensitivity 78.6%, specificity 73.2%), a T2 relaxation time of 74 ms (AUC: 0.705, sensitivity 65%, specificity 76.6%), an ADC of 1.275 × 10^-3 mm²/s (AUC: 0.861, sensitivity 89.5%, specificity 81.2%), and a stiffness of 3.77 kPa (AUC: 0.848, sensitivity 85%, specificity 75%).

CONCLUSION: Combined mpMRI, DWI, and MRE provide high diagnostic accuracy, with ADC and MRE offering superior performance in differentiating malignant from benign liver lesions.

CLINICAL SIGNIFICANCE: This article highlights the accuracy of mpMRI, MRE, and DWI in distinguishing between malignant and benign liver lesions. These findings support the integration of mpMRI, DWI, and MRE into clinical practice for non-invasive liver lesion characterization.

PMID:40458855 | DOI:10.4274/dir.2025.253324

Can Rev Sociol. 2025 Jun 3. doi: 10.1111/cars.70006. Online ahead of print.

ABSTRACT

The mass expansion of higher education (HE) systems during the 20th century pushed social scientists to theorize how high participation systems continued to reproduce inequalities across socio-economic lines. One popular theory in sociology, dubbed effectively maintained inequality (EMI), suggests that families from the upper economic strata would maintain their competitive advantage by not only acquiring increasing amounts of education, but also gravitating toward the most prestigious tracks within HE. Despite the “flatter” status structure of Canada’s HE system vis-à-vis international counterparts, this is a theory that has received empirical support from several domestic studies. Through this study, we re-examine the EMI hypothesis using the 2005 Ontario University Applicant Survey (OUAS), a little-known and thus far unexamined dataset that offers notable advantages relative to those historically analyzed in the Canadian EMI literature, including representative coverage of applicants to Ontario universities, holistic coverage of academic and demographic controls, and the ability to analyze both within- and between-sector forms of status-seeking. Our statistical analyses suggest that applicants from privileged socio-economic backgrounds behave in ways consistent with EMI, gravitating towards more prestigious HE options. We conclude by sketching a path forward for social stratification research in Canadian HE.

PMID:40458852 | DOI:10.1111/cars.70006

Disaster Med Public Health Prep. 2025 Jun 3;19:e137. doi: 10.1017/dmp.2025.10063.

ABSTRACT

OBJECTIVES: Climate change is contributing to increased frequency and intensity of wildfires in California. This study evaluated the self-reported impacts of the California Oak Fire on the health of a medically at-risk population and identified their wildfire preparedness and information needs.

METHODS: A cross-sectional mixed-methods survey was conducted from April-July of 2023 of those with self-identified special needs in emergencies. The survey assessed self-reported wildfire preparedness, information needs, evacuation response, and health impacts.

RESULTS: A total of 53 surveys were completed for a response rate of 23.1%. Most respondents had medical conditions (94%). One-fifth (21%) of respondents reported missed or delayed medical appointments and harm to their health from the Oak Fire; these groups reported significantly more medical conditions (4.1 v. 2.5, P = 0.0055) and use of more medical devices (3.5 v 2, P = 0.007) than those without harm to their health. The most common way respondents learned about the Oak Fire was by seeing fire plumes/smelling smoke (59%); the most trusted information source was county officials (77%). Less than half of respondents (40%) evacuated during the Oak Fire.

CONCLUSIONS: Wildfires are associated with interruptions in medical care that harm health, particularly for medically at-risk populations.

Climate change is contributing to increased frequency and intensity of wildfires in California. This study evaluated the self-reported impacts of the California Oak Fire on the health of a medically at-risk population and identified their wildfire preparedness and information needs. A cross-sectional mixed-methods survey was conducted of those with self-identified special needs in emergencies. A total of 53 surveys were completed for a response rate of 23.1%. Most respondents had baseline medical conditions (94%). One-fifth (21%) of respondents reported missed or delayed medical appointments and harm to health from the Oak Fire; these groups reported significantly more medical conditions and use of more medical devices. The most common way respondents learned about the Oak Fire was by seeing fire plumes/smelling smoke (59%); the most trusted information source was county officials (77%). Wildfires are associated with interruptions in medical care that harm health, particularly for medically at-risk populations.

PMID:40458849 | DOI:10.1017/dmp.2025.10063

Disaster Med Public Health Prep. 2025 Jun 3;19:e136. doi: 10.1017/dmp.2025.10073.

ABSTRACT

OBJECTIVES: The February 6, 2023 Türkiye earthquake caused widespread destruction and significantly affected public health priorities. This study aimed to analyze the impact of the disaster on public interest in dermatological issues, using Google Trends.

METHODS: Two dermatologists selected 10 dermatological topics based on textbooks and Google Trends data availability. Search trends in Hatay, Kahramanmaraş, and Adıyaman were analyzed for 52 weeks before and after the earthquake. Topics with a significant interest change due to the earthquake in at least 2 of 3 provinces (“dermatology” and “scabies”) were analyzed across all 11 affected provinces.

RESULTS: Search interest in “dermatology” significantly decreased in Hatay (-27.5%, P = 4.16×10^-4), Kahramanmaraş (-25%, P = 0.009), and Malatya (-56.9%, P = 0.0005). Other conditions, including “acne,” “eczema,” “psoriasis,” “urticaria,” and “wart” exhibited varying trends, but none of these changes reached statistical significance. Searches for “scabies” showed a substantial and statistically significant increase in Hatay (+69%, P = 4.11×10^-10), Kahramanmaraş (+112%, P = 6.96×10^-8), Adıyaman (+144%, P = 0.0179), Gaziantep (+54.3%, P = 2.56×10^-9), Malatya (+91.8%, P = 0.00074), Diyarbakır (+50.5%, P = 2.43×10^-8), Adana (+20.7%, P = 4.99×10^-5), Şanlıurfa (+50.5%, P = 8.96×10^-8), Elazığ (+421%, P = 5.25×10^-4), and Osmaniye (+78.4%, P = 1.25×10^-4). Hatay, previously ranked 9th, became the top province post-earthquake, with most others, except Adana and Elazığ, also rising in rank.

CONCLUSIONS: The earthquake significantly impacted public interest in dermatology, especially scabies. Google Trends can help identify health concerns, guiding resource allocation and targeted interventions post-disaster.

PMID:40458839 | DOI:10.1017/dmp.2025.10073

BJS Open. 2025 May 7;9(3):zraf046. doi: 10.1093/bjsopen/zraf046.

ABSTRACT

BACKGROUND: Amputation is a treatment of last resort for peripheral arterial disease. This study examined associations between socioeconomic deprivation, ethnicity, above-knee amputation (AKA) and below-knee amputation (BKA) rates, and post-amputation survival in England.

METHODS: Hospital Episode Statistics data identified patients aged ≥25 years who underwent an AKA or BKA related to peripheral arterial disease in 2006-2018. Data on ethnicity, comorbidity and socioeconomic deprivation was recorded. An ecological study design, based on population-level data, analysed amputation rates (Poisson regression), and a cohort study design investigated mortality subsequent to amputation (Cox regression).

RESULTS: Within a population of 35.7 million people aged ≥25 years, 47 249 patients underwent peripheral arterial disease-related major amputation over 12 years (94.1% White, 1.9% Black, and 1.6% Asian ethnicity). AKA : BKA ratios were 1.03, 0.73, and 0.80 for White, Black, and Asian ethnicities respectively. Amputation rates increased with increasing socioeconomic deprivation. The amputation rate ratio for the most relative to the least deprived category varied with age, ranging from 4.94 (95% confidence interval 4.24 to 5.75) for age 45-54 years to 1.35 (1.21 to 1.49) for age ≥85 years for AKA, and from 3.88 (3.44 to 4.37) to 1.12 (0.97 to 1.29) for BKA. Post-amputation mortality hazard ratios also increased with increasing socioeconomic deprivation, ranging from 1.26 (1.04 to 1.53) for age 25-54 years to 1.11 (1.03 to 1.19) for age ≥75 years for AKA, and from 1.25 (1.08 to 1.46) to 1.17 (1.08 to 1.27) for BKA. Over 12 years, amputation rates decreased in all socioeconomic categories in the population aged ≥65 years, but there was little change in the population aged 25-64 years. Black ethnicity was associated with lower adjusted AKA and BKA rate ratios relative to White ethnicity in those aged 25-64 years, and similar AKA but higher BKA rate ratios in those aged ≥65 years. Black ethnicity was also associated with lower post-amputation mortality, except in those aged 25-54 years within 90 days of BKA. Asian ethnicity was associated with lower AKA and BKA rate ratios relative to White ethnicity, but similar post-amputation mortality with some exceptions.

CONCLUSION: The main policy and practice implications relate to socioeconomic inequalities. Greater efforts are needed in disadvantaged areas to prevent and manage peripheral arterial disease and reduce amputation.

PMID:40458837 | DOI:10.1093/bjsopen/zraf046

Disaster Med Public Health Prep. 2025 Jun 3;19:e135. doi: 10.1017/dmp.2025.10078.

ABSTRACT

OBJECTIVES: On February 6, 2023, seismic activity struck Kahramanmaraş, with earthquakes of magnitudes 7.7 and 7.6. The study aimed to determine the effect of the presence of PTSD and its scores on hygiene behaviors.

METHODS: This cross-sectional study was conducted in Adıyaman, Türkiye, between September and October 2023. The study population comprised individuals aged 18 and above who had experienced the earthquake. The PTSD Checklist-Civilian (PCL-C) scale was used to evaluate PTSD, and the Hygiene Inventory was used to evaluate the participants’ hygiene behaviors.

RESULTS: Females, those with lower levels of education, the unemployed, singles, those living in tents, individuals who lost a loved one in the earthquake, and those with PTSD had worse hygiene behaviors compared to other groups. In the multivariate model of linear regression analysis of hygiene total score, only the PTSD score retained its predictive significance for hygiene behavior. More than 50% of the participants had scores meeting PTSD. The total PTSD score and the prevalence of PTSD among women was notably greater.

CONCLUSIONS: Mental health plays a pivotal role in shaping individuals’ hygiene practices and behavior patterns post-disaster. Swift implementation of mental health interventions is crucial for the prevention of behavioral pathologies.

PMID:40458832 | DOI:10.1017/dmp.2025.10078

Front Nutr. 2025 May 19;12:1599830. doi: 10.3389/fnut.2025.1599830. eCollection 2025.

ABSTRACT

INTRODUCTION: The Prognostic Nutritional Index (PNI) reflects immune and nutritional status and has been widely used to assess various diseases. However, research on the PNI and mortality in patients with depression is limited.

OBJECTIVE: The study aimed to assess the association between the PNI and both all-cause and cardiovascular disease (CVD) mortality in adults with depression.

METHODS: This study analyzed the PNI levels in a cohort of 2,396 adults with depression. The analysis was conducted using data obtained from the National Health and Nutrition Examination Survey (NHANES), which was conducted between 2005 and 2018. Mortality outcomes were determined through a comprehensive review of the National Death Index records through December 31, 2019. Multivariable weighted Cox proportional hazards regression models were employed to investigate the hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and CVD mortality. Restricted cubic spline analyses were utilized to explore the potential nonlinear association between PNI levels and mortality.

RESULTS: The weighted mean PNI level was 41.89 (standard error 0.1), and the median follow-up duration was 84 months. There were 295 all-cause deaths and 73 CVD deaths during the follow-up period. Higher PNI levels were significantly associated with a reduced risk of all-cause mortality (HR, 0.47; 95% confidence interval [CI], 0.31-0.73; p for trend < 0.001) and CVD mortality (HR, 0.51; 95% CI, 0.27-0.96; p for trend = 0.038) compared with lower PNI levels. Each 1-unit increase in PNI was associated with a 12% reduction in the risk of all-cause mortality (HR, 0.88; 95% CI, 0.84-0.93; p < 0.001) and a 12% reduction in the risk of CVD mortality (HR, 0.88; 95% CI, 0.80-0.96; p = 0.006). After multivariable adjustment, a linear association was observed (p for nonlinearity = 0.114 and 0.071 for all-cause and CVD mortality, respectively). Subgroup analyses showed that no statistically significant interactions were observed in any of the subgroups, as the p-values were all above 0.05.

CONCLUSION: Higher PNI levels were associated with lower all-cause and CVD mortality in adults with depression. These findings suggest that PNI may serve as a clinically useful indicator to predict the prognosis of patients with depression.

PMID:40458829 | PMC:PMC12127161 | DOI:10.3389/fnut.2025.1599830

Front Nutr. 2025 May 19;12:1551048. doi: 10.3389/fnut.2025.1551048. eCollection 2025.

ABSTRACT

BACKGROUND: Malnutrition and inflammation are associated with poorer surgical outcomes in patients with gastrointestinal cancer. However, it is still debated which parameters should be used to assess nutritional and inflammatory status. The aim of the present study was to investigate the prognostic role of specific parameters in predicting postoperative outcomes in this specific subgroup of patients.

METHODS: This retrospective study included 391 adult patients. Malnutrition risk, was assessed by preoperative validated Malnutrition Universal Screening Tool (MUST) score ≥2, lymphocyte count <900 n/mm³, albumin value <3.5 g/dL or a combination of the previous two parameters, the Prognostic Nutritional Index (PNI) < 45; inflammation was evaluated using preoperative Neutrophil-to-Lymphocyte Ratio (NLR) > 5, Platelet-to-Lymphocyte Ratio (PLR) > 150 and Lymphocyte-to-Monocyte Ratio (LMR) < 5. Statistical analysis was carried out using Univariate and Multivariate Analysis and General Linear Models.

RESULTS: Patients with higher preoperative MUST score (p < 0.0001), lower albumin level (p = 0.0002) or lower PNI (p = 0.002) had a greater need for parenteral nutrition support and a longer hospital stay was reported in patients with higher MUST score (p < 0.0001), lower albumin (p < 0.0001), lower PNI (p = 0.0002), higher NLR (p = 0.005) or lower LMR (p = 0.027). Complications were more common in patients with a higher MUST score (p = 0.029), lower albumin (p = 0.008) or lower PNI (p = 0.006). A MUST score ≥ 1 or a PNI < 45 was associated with a two-fold risk of postoperative complications (p = 0.008; p = 0.001), whereas albumin levels <35 g/L were correlated with a Three-fold risk of postsurgical complications (p = 0.008). OS was also worse in patients with higher MUST score (p = 0.004), PNI (p = 0.031) or NLR (p = 0.0002), with a three-fold risk of not surviving at 1 year in patients with a MUST score ≥2 (p = 0.003) or NLR ≥ 5 (p = 0.0003). Using general linear models for repeated measures, a preoperative MUST score >1 or albumin levels < 35 mg/dL was associated with lower postoperative erythrocyte cells and hemoglobin levels. Multivariate analysis confirmed MUST score, PNI and NLR as independent prognostic factors for survival or postoperative complications.

CONCLUSION: The presence of preoperative malnutrition and/or inflammation is associated with worse postoperative outcomes in patients with gastrointestinal cancer. Early nutritional assessment, including all the above parameters, may allow more tailored intervention to reduce the risk of adverse postoperative outcomes.

PMID:40458822 | PMC:PMC12127174 | DOI:10.3389/fnut.2025.1551048

Drug Des Devel Ther. 2025 May 29;19:4517-4525. doi: 10.2147/DDDT.S503714. eCollection 2025.

ABSTRACT

BACKGROUND: Emergence agitation(EA) is common in the early phase of recovery from general anesthesia in adults, which can potentially cause unpredictable harm to both patients and medical staff. This study aimed to examine the effects of preoperative magnesium sulphate infusion on emergence agitation and postoperative quality of recovery in patients undergoing thoracoscopic lobectomy.

PATIENTS AND METHODS: 84 patients undergoing thoracoscopic lobectomy were randomly assigned to either the magnesium sulphate group (group M) or the control group (group C). Group M received a 50 mg/ kg intravenous bolus of magnesium sulphate 20 minutes before induction, whereas group C was administered an equivalent volume of saline. The Riker Sedation-Agitation Scale (SAS) and the 40-item Quality of Recovery questionnaire (QoR-40) were used to evaluate emergence agitation and postoperative quality of recovery, respectively.

RESULTS: In comparison to group C, group M demonstrated a significantly lower incidence of EA (9.5% vs 42.9%; OR, 0.14; 95% CI, 0.04-0.47; P < 0.001) and dangerous agitation (0% vs 14.3%; OR, 2.17; 95% CI, 1.71-2.75; P =0.011), along with a reduction in the maximal SAS score (P < 0.05). Group M exhibited higher global QoR-40 scores than group C on postoperative day 1 (POD 1)(168.3±13.8 vs 155.6±16.5, P<0.001). Additionally, group M displayed lower Numerical rating scale (NRS) pain scores both at rest and during coughing in PACU and on POD 1 (P < 0.001). There were no significant statistically differences between the two groups in terms of time to extubation, incidence of delayed recovery and residual sedation (P > 0.05).

CONCLUSION: Preoperative magnesium sulphate infusion effectively decreased the incidence and severity of EA in patients undergoing thoracoscopic lobectomy. Furthermore, it alleviated postoperative pain and improved postoperative quality of recovery, without an increase in adverse events.

PMID:40458810 | PMC:PMC12129083 | DOI:10.2147/DDDT.S503714

Front Pharmacol. 2025 May 19;16:1537679. doi: 10.3389/fphar.2025.1537679. eCollection 2025.

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of Shuxuening injection (SXNI) in the treatment of patients with intracerebral hemorrhage (ICH).

METHODS: This study included randomized controlled trials published before 1 June 2024 in eight databases. Patients with ICH were included, with the control group receiving conventional treatment (CT) and the treatment group receiving additional SXNI on this basis. The primary outcome was neurological impairment score. The secondary outcomes were overall efficacy, cerebral hematoma volume, cerebral edema volume, activities of daily living (ADL) score, erythrocyte sedimentation rate (ESR), hematocrit (HCT), hypersensitive C-reactive protein (hs-CRP), low cut whole blood viscosity, high cut whole blood viscosity and adverse events (AE). The methodological quality of the included studies was assessed using the revised Cochrane Risk of Bias tool (ROB 2.0). For binary variables, risk ratios (RR) were calculated, while for continuous variables, mean differences (MD) or standardized mean differences (SMD) were calculated, based on 95% confidence intervals (CI).

RESULTS: A total of 29 trials involving 3,012 participants were included. Compared with the control group, the treatment group demonstrated better performance in reducing neurological impairment score [SMD = -0.99, 95% CI -1.24, -0.73], improving overall efficacy [RR = 1.22, 95% CI 1.14, 1.30] and ADL score [SMD = 2.01, 95%CI 1.55, 2.46], as well as decreasing the cerebral hematoma volume [MD = -6.98, 95% CI -8.76, -5.20] and cerebral edema volume [MD = -3.67, 95%CI -5.27, -2.06], with statistically significant differences observed. Meanwhile, the incidence of AE in the treatment group was lower than that in the control group, with a statistically significant difference [RR = 0.63, 95%CI 0.41, 0.96].

CONCLUSION: This study indicates that the combined use of SXNI and CT may be beneficial for the treatment of patients with cerebral hemorrhage compared to the use of CT alone. However, due to the moderate to very low certainty of evidence, it is advisable to conduct highquality clinical trials to validate the findings of this study.

PMID:40458793 | PMC:PMC12127381 | DOI:10.3389/fphar.2025.1537679