Tag: nevin manimala

Aerosp Med Hum Perform. 2025 Apr;96(4):279-286. doi: 10.3357/AMHP.6530.2025.

ABSTRACT

INTRODUCTION: Warning information is mainly transmitted to pilots through visual and auditory forms in flight, with only a small portion transmitted through vibration. Poorly designed flight deck warnings have negative effects on pilot performance and safety. This study aimed to give insights into how different encoding forms of warnings act on pilot performance from a cognitive modeling perspective.

METHODS: Four encoding forms were designed using voice prompts and flashing messages. An Adaptive Control of Thought-Rational based model was built to simulate the perception process. Flight simulator tests were carried out with four types of warnings triggered randomly for comparison with simulation results and thereby performed model validation. Statistical tests were performed to examine the significant differences and effect sizes.

RESULTS: Both cognitive models (response time 0.82 ± 0.06 s with voice vs. 1.37 ± 0.09 s without voice in static forms; 1.35 ± 0.56 s with voice vs. 1.83 ± 0.32 s without voice in flashing forms) and subjects’ response time (1.42 ± 0.37 s with voice vs. 1.53 ± 0.42 s without voice in static forms; 1.43 ± 0.44 s with voice vs. 1.65 ± 0.43 s without voice in flashing forms) suggest the benefits of using voice prompts to improve performance, while flashing forms of warnings may impose an extra burden on cognition even though they bring the benefit of attracting attention.

DISCUSSION: By carrying out a joint analysis with cognitive modeling and flight simulator tests, this work shows that designers can make use of alternative sensory channels for achieving a timely transfer of attention, but with a risk of increasing cognitive load. Zhang X, Li C, Sun Y, Yan C. Cognitive response efficiency under varying audiovisual display modalities of flight deck warnings. Aerosp Med Hum Perform. 2025; 96(4):279-286.

PMID:40642852 | DOI:10.3357/AMHP.6530.2025

Aerosp Med Hum Perform. 2025 Apr;96(4):356-359. doi: 10.3357/AMHP.6590.2025.

ABSTRACT

INTRODUCTION: We previously published a model of how calcium from resorbing bone can enter and persist in the circulation with consequent precipitation in coronary arteries. The model was based on chronic inflammation as the source of continued bone resorption. We asked whether other forms of resorptive bone loss such as microgravity (disuse) might also be associated with bone calcium accumulation in coronary arteries.

METHODS: We analyzed a de-identified database provided by NASA consisting of 52 astronauts who had flown a space mission around two determinations of coronary artery calcium (CAC) scores at 5-yr intervals and bone density determinations in the year prior to and 10 d and 1 yr following a space mission.

RESULTS: We found that in 38.5% of the astronauts, their CAC scores changed between pre- and postflight, with 95% of the CAC scores increasing. These astronauts were significantly older than the 61.5% whose CAC scores did not change, although the mission length was not different between the groups. Both groups lost bone acutely but had partial recovery over the year postflight.

DISCUSSION: Due to lack of uniform sampling times, we could not correlate changes in CAC score with bone loss and would advocate for synchronous determinations of CAC and bone density pre- and postflight. Klein GL, Jupiter DC. Elevated coronary artery calcium scores in astronauts. Aerosp Med Hum Perform. 2025; 96(4):356-359.

PMID:40642848 | DOI:10.3357/AMHP.6590.2025

Telemed J E Health. 2025 Jul 11. doi: 10.1089/tmj.2024.0468. Online ahead of print.

ABSTRACT

Objective: The purpose of this study is to explore the prevalence of and factors associated with telehealth utilization in a medically underserved, ambulatory care diabetes population during COVID-19 pandemic. Methods: A retrospective chart review was conducted using electronic medical records from January 2020 to January 2021 at an ambulatory care diabetes clinic within an urban teaching hospital. Descriptive statistical analysis was conducted for all study variables. Simple and multiple logistic regression analyses were conducted to assess predictive factors of telehealth utilization during the COVID-19 pandemic. All statistical analysis was conducted using SPSS version 28 at an alpha level of 0.05. Results: A total of 325 patients were included in the study. The mean age of the study population was 58.2 ± 15.9 years, and the majority was female (67.6%) and Black/African American (92.6%). The average number of medications prescribed was 4.9 ± 2.6 medications, and the average A1C was 8.1% ± 2.4%. A high proportion of patients utilized telehealth (88.3%). Findings from the multivariable analysis showed that females were more likely to use telehealth compared to males, adjusting for other factors (OR_adjusted 2.14 (95% CI: 1.06-4.32). Ward, as a proxy for low income and high medically underserved status, was not a significant predictor of telehealth utilization (p = 0.89). Conclusion: Findings showed that telehealth was widely acceptable at the height of the COVID-19 pandemic even for participants who are low income and have high medically underserved status. Telehealth should continue to be championed as a viable option of care delivery for these vulnerable patients.

PMID:40642808 | DOI:10.1089/tmj.2024.0468

Quintessence Int. 2025 Jul 11;0(0):0. doi: 10.3290/j.qi.b6362487. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the causal relationship between metabolites and periodontitis using Mendelian randomization (MR) and validate findings through gingival crevicular fluid (GCF) metabolomic profiling.

METHODS AND MATERIALS: A two-sample MR analysis used genetic data from 486 metabolite Genome-Wide Association Study (GWAS) and periodontitis statistics, with IVW as the primary method, supported by MR-Egger, weighted median, and weighted mode. Sensitivity analyses included Cochran’s Q, MR-Egger, and MR-PRESSO tests. GCF metabolomics compared 5 periodontitis patients and 5 controls, identifying differential metabolites via t-tests and PLS-DA, with KEGG pathway enrichment.

RESULTS: MR analysis identified 17 metabolites causally linked to periodontitis, spanning amino acids, lipids, energy metabolism, and cofactors/vitamins. Protective metabolites included betaine (OR: 0.478, 95% CI:0.235-0.975), laurate (0.51, 0.267-0.974), and glycerol 3-phosphate (0.312, 0.105-0.926), while phenylalanine (39.651, 2.173-723.565), pelargonate (2.527, 1.059-6.03), and 3-methylhistidine (1.481, 1.074-2.042) increased risk. Sensitivity analyses confirmed minimal heterogeneity, no pleiotropy (except 4-acetamidobutanoate), and no reverse causation. GCF metabolomics revealed 75 upregulated and 245 downregulated metabolites, with pathway enrichment in lipid, amino acid, and vitamin metabolism. Notably, betaine-protective in MR analysis-was significantly reduced in periodontitis, aligning with its anti-inflammatory role.

CONCLUSION: This study indicates that some circulating metabolites (e.g., betaine) may protect against periodontitis. Integrating MR and GCF analyses, we identified key metabolic risk factors. Clinically, metabolites like betaine and glycerol 3-phosphate could serve as non-invasive early biomarkers, providing new avenues for personalized periodontitis prevention and treatment.

PMID:40642796 | DOI:10.3290/j.qi.b6362487

Euro Surveill. 2025 Jul;30(27). doi: 10.2807/1560-7917.ES.2025.30.27.2400748.

ABSTRACT

BACKGROUNDSurveillance of severe acute respiratory infections (SARI) using ICD-10 codes from electronic health records (EHR) lacks consensus on optimal case-defining codes.AIMWe determined codes that maximise sensitivity (Se) and positive predictive value (PPV) for SARI associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza virus and respiratory syncytial virus (RSV) in Denmark, Iceland, Malta, Norway and Spain.METHODSWe included hospitalisations from week 21/2021 to 39/2023, with ICD-10 diagnostic codes for respiratory disease (three-character codes J00-J99) or COVID-19 (U07.1, U07.2, country-specific codes for Denmark). We assessed Se and PPV of individual codes against laboratory results. Based on Se and PPV rank-sum, we selected the top 10 codes and combined them into 10 sets per pathogen. We identified sets that maximised the clinical utility index (CUI = Se × PPV), categorised as excellent (≥ 0.81), good (0.64-0.80), satisfactory (0.49-0.63) and poor (< 0.49).RESULTSWe assessed 395,163 hospitalisations for SARI-SARS-CoV-2, 313,418 for SARI-influenza and 192,936 for SARI-RSV, all tested. For SARI-SARS-CoV-2, code U07.1 (B34.2A, B97.2A for Denmark) had excellent utility in Denmark, Malta, Norway, Spain (≥ 0.82), and good utility in Iceland (0.79). For SARI-influenza, J09, J10 and J11 performed excellently in Denmark, Norway, Spain (≥ 0.83), satisfactorily in Malta (0.52), and poorly in Iceland (0.43). For SARI-RSV, J12, J20 and J21 achieved highest CUI but had poor utility (0.17-0.34).CONCLUSIONSCOVID-19- and influenza-specific three-character ICD-10 codes accurately identified SARI associated with SARS-CoV-2 and influenza virus. For SARI-RSV, four-character codes should be explored. We recommend context-specific assessments in countries adopting EHR-based surveillance.

PMID:40642769 | DOI:10.2807/1560-7917.ES.2025.30.27.2400748

Euro Surveill. 2025 Jul;30(27). doi: 10.2807/1560-7917.ES.2025.30.27.2400820.

ABSTRACT

BACKGROUNDDanish women vaccinated with the 4-valent human papillomavirus (HPV) vaccine (HPV types: 6/11/16/18) at age 14 in 2008 reached screening age in 2017, allowing assessment of long-term effects on prevalence, persistence and incidence of HPV infections.AIMTo examine the HPV status of cervical samples over time among women vaccinated as girls.METHODSBetween February 2017 and February 2024, residual material from cytology-analysed samples collected through the ‘Trial23’ study, part of the national screening programme, was tested for HPV16/18 and non-vaccine high-risk (HR) HPV types. Prevalence in first, second and third samples, and persistence and incidence between samples were calculated.RESULTSOver 7 years, 8,659 women provided at least one sample, 5,835 at least two and 2,461 at least three. In 7,800 vaccinated women, HPV16/18 prevalence was 0.4% (95% confidence interval (CI): 0.2-0.5), 0.3% (95% CI: 0.1-0.4) and 0.2% (95% CI: 0.0-0.4) in three consecutive samples. Prevalence of non-vaccine HR HPV was 32% (95% CI: 31-33), 28% (95% CI: 27-29) and 31% (95% CI: 29-33). Persistence of HPV16/18 and non-vaccine HPV among vaccinated women was 40% and 53%. In adjusted analyses comparing vaccinated vs unvaccinated women, incidence was significantly lower for HPV16/18 (adjusted relative risk (aRR) < 0.10) while incidence of non-vaccine HR HPV types was higher (aRR: 1.66; 95% CI: 1.12-2.45). No significant difference was observed for persistence.CONCLUSIONOur study provides real-world evidence of stable protection against HPV16/18 infections in women vaccinated as girls. Less intensive screening seems reasonable until women vaccinated with the 9-valent vaccine reach screening age, when screening should be reconsidered.

PMID:40642768 | DOI:10.2807/1560-7917.ES.2025.30.27.2400820

Cureus. 2025 Jun 10;17(6):e85708. doi: 10.7759/cureus.85708. eCollection 2025 Jun.

ABSTRACT

INTRODUCTION: Charcot foot is a debilitating complication of diabetes mellitus (DM), characterized by joint destruction, deformity, and instability due to neuropathy-induced microtrauma. Despite its severe impact on mobility and quality of life, Charcot foot remains underdiagnosed. This study aims to determine the prevalence of Charcot foot among diabetic patients at two major referral hospitals in Malaysia and identify associated risk factors.

METHODS: A cross-sectional study was conducted at the Integrated Diabetic Centers (IDCs) of Hospital Kulim and Hospital Raja Permaisuri Bainun (HRPB). Diabetic patients aged ≥18 years attending follow-ups at these centers were recruited via convenient sampling. Data collection included structured interviews, clinical examinations, laboratory investigations, and radiographic assessments. The diagnosis of Charcot foot was confirmed based on clinical findings, imaging, and laboratory parameters. Statistical analyses, including Fisher’s exact test, were conducted using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, New York, United States), with significance set at p<0.05.

RESULTS: A total of 675 diabetic patients were included, with a mean age of 56.1 years (SD±13.96). Men comprised 58.2% (n=393/675) of participants, while 41.8% (n=282/675) were women. The overall prevalence of Charcot foot among diabetic patients in this study was 1.8% (n=12/675). Gender was significantly associated with Charcot foot (p=0.005), with a higher prevalence among women (3.5%; n=10/282) than men (0.5%; n=2/393). The mean DM duration among Charcot foot patients was 19.67 years (SD±7.34), with 66.7% (n=8/12) having DM for 11-20 years. Poor glycemic control was prevalent, with a mean HbA1c of 9.21% (SD±1.87) and 75% (n=9/12) of Charcot foot patients having HbA1c ≥7%. Additionally, 50% (n=6/12) had a history of diabetic foot ulcers, and 16.7% (n=2/12) had undergone prior amputation.

CONCLUSION: Charcot foot is a significant but often underdiagnosed complication in diabetic patients, particularly in women and those with long-standing, poorly controlled DM. Early detection and multidisciplinary management are crucial to reducing morbidity. Future research should focus on longitudinal studies to assess disease progression and intervention effectiveness.

PMID:40642735 | PMC:PMC12244756 | DOI:10.7759/cureus.85708

Cureus. 2025 Jun 9;17(6):e85657. doi: 10.7759/cureus.85657. eCollection 2025 Jun.

ABSTRACT

INTRODUCTION: Kessler Psychological Distress Scale (K6) is a self-administered and short screening instrument for non-specific psychological distress and is used internationally in epidemiological studies because of its good psychometric properties. K6 can be feasibly used to screen for mental health problems in settings with limited mental health professionals, such as in low- and middle-income countries. This study aims to examine the psychometric validity, construct validity, and internal consistency of the Filipino version of K6.

METHODS: The participants were recruited from the community in Muntinlupa City, Philippines, and from patients in a psychiatric unit run by the local government in Muntinlupa. A structured questionnaire was used to collect data from both groups. The questionnaire assessed sociodemographic characteristics and included the K6 scale. For outpatients, in addition to the items used for community members, Patient Health Questionnaire-9 (PHQ-9), World Health Organization-Five Well-Being Index (WHO-5), and World Health Organization Quality of Life – BREF (WHOQOL-BREF) were employed to examine construct validity. Depression severity and diagnosis were determined by a psychiatrist or a resident doctor based on an unstructured clinical interview with three options: mild, moderate, and severe, and diagnostic criteria, respectively. Internal consistency and psychometric validity were assessed using Cronbach’s α and an unpaired t-test for the total K6 score between patients assessed as having mild depression and those with moderate or severe depression, respectively. K6 scores of community people and patients from the psychiatric unit were compared using a Mann-Whitney U test.

RESULTS: In total, 95 people from the psychiatric unit (27 male patients, 77 female patients, and one gender-diverse) and 405 people from the community (178 male participants, 226 female participants, and one gender-diverse) participated in the study. Cronbach’s α of K6 was 0.88. Patients in the psychiatric unit had higher K6 total scores (median 14.00) than the participants from the community (median 3.00). Coefficient correlation analysis showed that K6 was strongly and positively correlated with PHQ-9 (r = 0.74, p < 0.01) and moderately and negatively correlated with WHO-5 (r = -0.51, p <0.01) and Psychosocial health in WHOQOL-BREF (r = -0.59, p < 0.01). The optimal cutoff points for moderate and serious psychological distress were 6/7 and 11/12, respectively, based on the distribution of scores. Patients assessed as having moderate or severe depression had a statistically higher K6 score (Mean 15.60) than those assessed as having mild depression (Mean 12.96).

CONCLUSION: The Filipino version of K6 is appropriate for measuring psychological distress in clinical and community settings. The Filipino version of K6, including cutoff points, will be a useful tool in the local context in practice and can be used as a measurement tool in studies to promote mental health in various settings.

PMID:40642729 | PMC:PMC12240876 | DOI:10.7759/cureus.85657

Cureus. 2025 Jun 10;17(6):e85710. doi: 10.7759/cureus.85710. eCollection 2025 Jun.

ABSTRACT

BACKGROUND: Most ureterovaginal fistulas (UVFs) are caused by gynecologic, urologic, or colorectal surgeries. Urine leaks, renal failure, and infections lower patients’ quality of life. Minimally invasive endoscopic double-J (DJ) stenting has become popular. There is insufficient research on the effects of DJ stenting on fistula size, diagnostic timeliness, and patient comorbidities.

OBJECTIVE AND METHODS: This study examines the efficacy of endoscopic DJ stent implantation in treating UVFs and addresses aspects such as fistula size, diagnosis timing, and comorbidities. This is a five-year retrospective study (2019 to 2024) conducted in Bhopal, India, comprising 31 patients with UVF who received endoscopic DJ stenting as the main treatment. Analyses included patient demographics, clinical presentation, fistula features, treatment outcomes, and complications. Statistical analysis includes chi-square tests for categorical variables and logistic regression for risk factor assessment, with a p-value < 0.05 considered significant.

RESULTS: DJ stenting showed a success rate of 77.4% (24/31 cases), with higher rates for early diagnosis (<4 weeks) and small fistula size (<5 mm) (p=0.038 and 0.032, respectively). Late diagnosis (>4 weeks), large fistula size (>5 mm), diabetes, and elevated creatinine (>1.2 mg/dL) were independent predictors of treatment failure in multivariate analysis. Minor issues included dysuria (16.1%, n=5) and hematuria (9.7%, n=3). One patient (3.2%) needed surgery due to a forgotten DJ stent.

CONCLUSION: If the UVF is minor and detected early, endoscopic DJ stenting can work. Renal failure, diabetes, larger fistulas, and delayed diagnosis reduce treatment success. Early prognostic identification and patient selection are crucial to maximize results and minimize surgery.

PMID:40642728 | PMC:PMC12244284 | DOI:10.7759/cureus.85710

Cureus. 2025 Jun 9;17(6):e85652. doi: 10.7759/cureus.85652. eCollection 2025 Jun.

ABSTRACT

Individuals with steatotic liver disease who consume significant amounts of alcohol and meet at least one cardiometabolic criterion are classified as having metabolic and alcohol-associated liver disease (MetALD). The efficacy of saroglitazar and simvastatin in this population remains unclear. In this single-center retrospective cohort study, 102 patients with MetALD were included. The reduction in CAP score was greater in the saroglitazar group (-40 (-109 to 3) dB/m) compared to the simvastatin group (-33 (-100 to 36) dB/m), although this difference did not reach statistical significance (P = 0.08). However, a significant difference was observed in the change in liver stiffness measurement (LSM) scores, with the saroglitazar group showing a greater reduction (-1.9 (-19.5 to 26.3) kPa) than the simvastatin group (-0.8 (-12.2 to 9) kPa) (P = 0.01). Saroglitazar also demonstrated a more pronounced effect on glycosylated hemoglobin (HbA1c), with a median decrease of -0.61 ± 0.96 compared to -0.1 ± 0.4 in the simvastatin group (P = 0.02). Saroglitazar is more effective than simvastatin in reducing CAP, LSM, and HbA1c over six months. Further prospective, well-controlled randomized studies are warranted to validate these findings.

PMID:40642726 | PMC:PMC12240681 | DOI:10.7759/cureus.85652