Tag: nevin manimala

Shock. 2025 Jul 25. doi: 10.1097/SHK.0000000000002676. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to systematically evaluate the risk factors associated with the development of postoperative lower extremity deep venous thrombosis (LEDVT) in patients with severe traumatic brain injury (sTBI).

METHODS: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Comprehensive searches of Chinese and English databases, including PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, and Wanfang, were conducted from inception to December 12, 2024. Two researchers independently screened articles and extracted relevant data. Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality criteria. Meta-analyses were performed using RevMan 5.3, applying a random-effects model to combine effect sizes, with subsequent sensitivity analyses and assessments for publication bias. The review was registered in PROSPERO (CRD42024629624).

RESULTS: A total of 13 studies (n = 777,327) were included, comprising 8 case-control studies, 2 cohort studies, and 3 cross-sectional studies. Eleven significant risk factors for postoperative LEDVT were identified: advanced age (odds ratio [OR] = 1.12, 95% confidence interval [CI]: 1.10-1.14), use of dehydrant (OR = 2.04, 95% CI: 1.38-3.04), mechanical ventilation (OR = 1.01, 95% CI: 1.01-1.02), elevated D-dimer level (OR = 1.19, 95% CI: 1.11-1.27), polytrauma (OR = 1.63, 95% CI: 1.29-2.03), hypertension (OR = 1.11, 95% CI: 1.07-1.15), surgical duration (OR = 1.60, 95% CI: 1.06-2.42), elevated body mass index (OR = 1.30, 95% CI: 1.16-1.45), deep venous catheterization (OR = 1.36, 95% CI: 1.15-1.60), length of hospital stay (OR = 1.36, 95% CI: 1.18-1.56), and blood transfusion (OR = 3.56, 95% CI: 1.91-6.63), with all p values <0.05. No statistically significant associations were observed for Glasgow Coma Scale score (OR = 1.12, 95% CI: 0.98-1.28) or diabetes mellitus (OR = 1.02, 95% CI: 0.97-1.07).

CONCLUSIONS: Eleven variables were identified as significant risk factors for postoperative LEDVT among patients with sTBI. These findings underscore the importance of implementing individualized preventive strategies for patients identified as high risk.

PMID:40729566 | DOI:10.1097/SHK.0000000000002676

Aging Cell. 2025 Jul 29:e70168. doi: 10.1111/acel.70168. Online ahead of print.

ABSTRACT

Strategies to slow the aging process or mitigate its consequences on health rely on the validation of minimally-invasive biomarkers of aging that can be used to track aging and test the effectiveness of antiaging interventions. Study of aging in a nonhuman primate species offers a robust translational approach to achieving these aims, avoiding wide differences in genetics and environmental exposures that confound human aging studies. As epigenetic age appears to predict biological aging, biomarkers linked to epigenetic aging should be especially valuable in identifying individual differences in aging progression and documenting the impact of antiaging strategies. Proteins are the final effectors in most signaling pathways, indicating that alteration in levels of circulating proteins potentially offers an informative and valuable quantitative index of aging. Accordingly, a proteomic analysis was conducted on matching CSF and plasma samples collected from a large group of African green monkeys, with epigenetic ages ranging from young to old as determined by differential methylation of blood DNA. In addition to analyzing the data with linear statistical models, a gradient boosting machine learning technique was employed to identify not only individual CSF and plasma proteins that correlated with aging progression but also groups of proteins that could be used as predictors of global aging and of specialized aspects of aging such as inflammation. Overall, this study identified new CSF and plasma protein targets for understanding aging biology, together with identifying biomarkers to track changes in the rate of biological aging in a translationally relevant nonhuman primate model.

PMID:40729555 | DOI:10.1111/acel.70168

J Child Psychol Psychiatry. 2025 Jul 29. doi: 10.1111/jcpp.14179. Online ahead of print.

ABSTRACT

BACKGROUND: Persistent and/or distressing psychotic-like experiences (PLEs) during adolescence are associated with poorer subsequent psychiatric outcomes. Modifiable lifestyle factors (such as sleep quality or regular exercise) may improve mental health outcomes; however, it is unknown how lifestyle factors are linked to trajectories of PLEs.

METHODS: Using data from the Adolescent Brain Cognitive Development Study (N = 10,075, age 9-10 years at baseline), we characterized trajectories of PLEs using latent growth mixture models assessed using the Prodromal Questionnaire-Brief Child Version. We examined trajectories of Total and Distress scores. We used multinomial logistic regressions to examine associations between baseline lifestyle behaviors (including self-reported screen time, physical activity and caffeine intake, and parent-reported sleep disturbances and recreational activities) and PLE trajectories.

RESULTS: We identified four trajectories of distress-related PLEs: No Distress (27%), Rapid Decreasing (17%), Gradual Decreasing (36%), and Persistent Elevated Distress (21%). Compared with the No Distress trajectory, individuals in the Persistent Elevated Distress trajectory spent more time using screens (adjusted Odds Ratio [OR] 2.27, 95% confidence interval [CI] 2.03-2.53), had higher caffeine intake (OR 1.62, 95% CI 1.28-2.04), greater sleep disturbance (OR 1.58, 95% CI 1.45-1.73), participated in fewer recreational activities (OR 0.75, 95% CI 0.68-0.83) and less frequent physical activity (OR 0.81, 95% CI 0.74-0.89). Greater screen time and sleep disturbances further distinguished the most severe group from all other trajectories. Findings were similar when examining total scores. Results remained statistically significant when we included established risk factors of psychosis in each model.

CONCLUSIONS: Lifestyle factors associate with trajectories of PLE-related distress, providing novel tools for intervention and risk prediction.

PMID:40729543 | DOI:10.1111/jcpp.14179

J Cosmet Dermatol. 2025 Aug;24(8):e70365. doi: 10.1111/jocd.70365.

ABSTRACT

BACKGROUND: Ultrapulse CO₂ fractional lasers are increasingly used for scar treatment. However, the optimal timing for the treatment of traumatic facial scars in children is unclear.

AIM: This retrospective study evaluated the clinical efficacy of ultrapulse CO₂ fractional laser treatment for immature facial scars in pediatric patients, with a focus on identifying the optimal timing to achieve the best possible outcomes.

PATIENTS/METHODS: A total of 106 children with traumatic facial scars were divided into three groups according to when laser treatment was started post-procedure: 1 month (Group A), 3 months (Group B), and 6 months (Group C). Three months after two treatments, the therapeutic effects, adverse reactions, and satisfaction of the patients’ families were compared between the three groups.

RESULTS: After two treatments, the Vancouver Scar Scale (VSS) scores were significantly lower than before treatment in all groups (p < 0.001). Pairwise comparisons demonstrated statistically significant differences between Groups A and B, and between Groups A and C (p < 0.001). Adverse reactions were not significantly different among the three groups (p > 0.05). At the follow-up after two treatments, significantly more patients were very satisfied in Group A than in Groups B and C (p < 0.05).

CONCLUSIONS: Early intervention with an ultrapulse CO₂ fractional laser can effectively treat traumatic facial scars in children. The clinical effect and patient satisfaction were better with treatment initiated 1 month post procedure than with treatment 3-6 months post procedure. It has few adverse reactions and high safety and is worthy of clinical promotion and application.

PMID:40729539 | DOI:10.1111/jocd.70365

Am J Phys Med Rehabil. 2025 Jul 17. doi: 10.1097/PHM.0000000000002818. Online ahead of print.

ABSTRACT

OBJECTIVE: The present study aimed to compare shoulder functional ratio and bilateral strength asymmetry between overhead Para athletes and able-bodied peers, and ascertain whether those factors could be associated with shoulder injury history in Para athletes under resting and fatigued conditions.

DESIGN: Sixteen sitting volleyball Para athletes and 12 able-bodied volleyball players were evaluated. The shoulder functional ratio was measured at rest and after a fatiguing shoulder internal-external rotation exercise on dominant and non-dominant shoulders. Imbalanced muscle strength profiles were identified as a functional ratio < 0.7 and bilateral peak torque asymmetry either >10% or > 15%. All injuries incurred over the past 2-months prior testing were reported.

RESULTS: No injury was surveyed in able-bodied athletes while 9 dominant shoulder overuse injuries were reported in 9 Para athletes. Functional ratio and bilateral asymmetry were not significantly different between groups at rest or after exercise in either shoulder(p > 0.05). Functional ratio < 0.7 and bilateral asymmetry of either >10% or > 15% were statistically associated with shoulder overuse injury history in the dominant limb in Para athletes(p < 0.05), but with a higher relative risk under fatiguing-conditions(p < 0.01).

CONCLUSION: External rotator muscle conditionning should be implemented in overhead Para athlete regular training to alleviate shoulder imbalance and bilateral asymmetry, especially in fatigued conditions.

PMID:40729531 | DOI:10.1097/PHM.0000000000002818

J Strength Cond Res. 2025 Jul 30. doi: 10.1519/JSC.0000000000005209. Online ahead of print.

ABSTRACT

McGlynn, ML, Rosales, AM, Collins, CW, and Slivka, DR. The influence of local cold application and resistance exercise on the mRNA response of skeletal muscle. J Strength Cond Res XX(X): 000-000, 2025-Cold application post exercise is common practice despite empirical evidence suggesting it impairs muscle growth signaling. Our purpose was to determine the effects of local cold application and resistance exercise on muscle growth/breakdown gene expression. Twelve subjects completed a bilateral resistance exercise bout to volitional fatigue (leg press, leg extension) while wearing a thermal wrap on 1 limb (10° C fluid, EX + COLD) and no wrap contralaterally (EX). Bilateral vastus lateralis biopsies, skin temperature, and intramuscular temperature were collected pre intervention, post resistance exercise (temperatures only), and 4 hours post exercise. Statistical significance was set at p < 0.05. After 4 hours of cooling, skin (p < 0.001) and intramuscular temperatures (p < 0.001) were lower in the EX + COLD (20.4 ± 0.6, 26.1 ± 0.9° C) than in the EX limb (31.7 ± 0.6, 35.1 ± 0.3° C). Despite these temperature decreases, local cooling did not differentially influence myogenic and proteolytic gene expression (p > 0.05). Resistance exercise was the primary influence on gene expression change. Favorable myogenic gene expression changes were exhibited by Myogenin (increase, p = 0.007), Myogenic Factor 6 (increase, p = 0.002), and Myostatin (decrease, p < 0.001). However, myogenic gene Myogenic Factor 5 decreased (p < 0.001). All other myogenic genes went unchanged (Myogenic Differentiation 1, p = 0.665; Myocyte Enhance Factor 2a, p = 0.074; Ribosomal Protein S3, p = 0.773; Ribosomal Protein L3-Like, p = 0.118). Proteolytic gene expression changes were exhibited by Muscle Unique Ring Finger 1 (increase, p = 0.002) and Atrogin-1 (decrease, p = 0.020). However, F-box protein 32 went unchanged (p = 0.980). Local cooling may be paired with a resistance exercise bout because of minimal influence after 4 hours of cooling on skeletal muscle growth/breakdown mRNA signaling.

PMID:40729474 | DOI:10.1519/JSC.0000000000005209

Psychooncology. 2025 Aug;34(8):e70245. doi: 10.1002/pon.70245.

ABSTRACT

BACKGROUND: When a parent is diagnosed with cancer, it often affects both family life and the couple relationship significantly. However, research on factors that influence relationship functioning over time in this population is limited.

AIMS: To investigate the development of relationship functioning and factors associated with relationship functioning over a 1-year period among parents with cancer.

METHODS: In this longitudinal study, 180 parents with cancer, aged 24-60 years, with dependent children completed online surveys at 2 time-points: at inclusion (T1) and 1 year later (T2). Data included self-reported sociodemographic, physical health and psychological factors, and relationship functioning. The outcome was relationship functioning at T2 assessed using 4 subscales (Dyadic cohesion, Dyadic satisfaction, Sensuality, and Sexuality) of the validated self-assessment scale Quality of Dyadic Relationship Scale-36 (QDR). Linear regression analyses were conducted to identify factors associated with the outcome.

RESULTS: All aspects of relationship functioning statistically declined over time, except sexuality. After adjusting for multiple T1 factors, completion of cancer treatment predicted higher Dyadic cohesion; poor self-rated health predicted lower Dyadic satisfaction; higher age, being a mother and attachment-related anxiety predicted lower Sensuality; and lower age of youngest child, anxiety and attachment-related anxiety predicted lower Sexuality.

CONCLUSIONS: Cancer significantly impacts relationship functioning among parents with cancer who have dependent children, with significant declines in Dyadic cohesion, Dyadic satisfaction, and Sensuality over time. A number of sociodemographic, physical health and psychological factors were shown to predict lower relationship functioning. Addressing these factors may help identify and support parents with cancer who are at risk of, or who perceive, difficulties in their couple relationship.

PMID:40729468 | DOI:10.1002/pon.70245

Haemophilia. 2025 Jul 29. doi: 10.1111/hae.70095. Online ahead of print.

ABSTRACT

INTRODUCTION: Haemophilia treatment centres (HTCs) coordinate multidisciplinary care, yet the European HTC standards on which global accreditation systems really do not reflect the wide resource gradient found in India.

AIM: To assess HTC capacities across India and explore a tiered stratification model suited to diverse settings.

METHODS: A nationwide, self‑administered survey (February 2021-April 2022) was e‑mailed to all 291 HTCs registered with the Indian Association of Haemophilia and Allied Disorders. It captured infrastructure, laboratory capability and clinical services. Descriptive statistics and Spearman correlation were applied.

RESULTS: Ninety centres (30%) responded from 24 states/UTs. Only 34% fulfilled European HTC (EHTC) criteria and 11% met comprehensive‑care (EHCCC) criteria; 55% were unclassified despite providing haemophilia care. Laboratory‑to‑clinical functionality showed a moderate correlation (r = 0.61, p < 0.001). Twenty‑seven percent of centres operated without an onsite coagulation laboratory, whereas 40% lacked full‑time nurses and 60% lacked multidisciplinary teams. Factor VIII/IX supplies were uninterrupted at 31% of sites; 38% offered prophylaxis to at least one patient.

CONCLUSION: Rigid European categories mask the stepwise growth of Indian HTCs. A four‑tier model-anchored in predefined criteria for clinical and laboratory services could guide incremental upgrading while preserving patient safety.

PMID:40729467 | DOI:10.1111/hae.70095

Eur J Haematol. 2025 Jul 29. doi: 10.1111/ejh.70002. Online ahead of print.

ABSTRACT

BACKGROUND: Patient-reported outcomes (PROs) are now frequently incorporated into multiple myeloma (MM) randomized controlled trials (RCTs) to help inform clinical decision making. Although the quality of PRO components in cancer RCT protocols is generally recognized as suboptimal, there are limited data on adherence to international quality standards in MM RCT protocols.

METHODS: We performed a systematic review to identify MM RCTs published between January 2014 and June 2023 that utilized the EORTC QLQ-C30 questionnaire. The quality of PRO-specific protocol content was evaluated using the SPIRIT-PRO guidelines, which establish key requirements for PRO inclusion in protocols. The framework consists of 16 items: 5 elaborations of the existing SPIRIT checklist and 11 PRO-specific extensions items. The quality of PRO reporting was evaluated using CONSORT-PRO Extension, which comprises 14 items to improve the reporting of PRO data in clinical trials.

RESULTS: Our systematic review identified 35 RCTs encompassing 20,612 patients, with 24 trials (69%) having publicly accessible protocols. The median protocol compliance was 7.5 SPIRIT-PRO items. Analysis of 24 protocols showed strong compliance in assessment schedules (96%), PRO domains/instrument justification (79%), and PRO objectives (71%). Intervention deviation procedures were described in 62% of protocols. Half included comprehensive data collection plans, while 58% addressed missing data methods and 42% outlined PRO research questions or multiplicity controls. Notably weak areas included strategies for preventing missing data (38%), and only 8% of protocols detailed PRO monitoring plans, personnel specifications, or eligibility criteria. CONSORT-PRO scores varied across all 35 RCTs (median 11, range 0.5-14). Among the 35 RCTs, while trials showed strong reporting of statistical elements (94% precision estimates, 91% subgroup analyses, 89% intention-to-treat, 86% timepoint completion) and results (80% hypothesized domains, 71% PRO validity, 69% clinical implications, 66% limitations), key PRO-specific components were reported by less than two-thirds of RCTs: only 11% stated PRO hypotheses, 31% specified administration mode, 43% identified domains, 60% addressed missing data, and 63% provided PRO rationale. Two factors were associated with higher reporting quality, both potentially reflecting publication bias: having a secondary PRO-focused paper (p < 0.001) and finding statistically significant EORTC QLQ-C30 differences (p = 0.024). Our multivariable analysis showed no significant association between SPIRIT-PRO scores and CONSORT-PRO scores.

CONCLUSION: Despite some foundational strengths of existing MM RCT protocols, gaps exist in PRO methodological specifications, statistical analysis, and clinical interpretation. Our findings may help to better inform PRO implementation in future MM RCT protocols. For example, since missing PRO data can be due to informative censoring, there should be increased attention on considering how to minimize missing data, already at the stage of protocol writing. Our findings regarding predictors of higher reporting quality suggest that trials with significant PRO differences receive systematically better reporting, possibly introducing bias in the available evidence base.

PMID:40729465 | DOI:10.1111/ejh.70002

J Vet Emerg Crit Care (San Antonio). 2025 Jul 29:e70000. doi: 10.1111/vec.70000. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the accuracy of a point-of-care thoracic ultrasound examination for the evaluation of the pulmonary parenchyma in rabbits without lower respiratory signs using thoracic radiography or computed tomography (CT) as the reference standard. An additional objective was to establish a baseline frequency and number of B-lines in rabbits without pulmonary disease.

DESIGN: Prospective, multicenter, clinical study from December 2021 to July 2023.

SETTING: University teaching hospital and an emergency and specialty referral center.

ANIMALS: Sixty-three pet rabbits (Oryctolagus cuniculus) without lower respiratory signs and with lungs verified to be healthy with radiography or CT.

INTERVENTIONS: Rabbits were screened for signs of respiratory disease. A modified point-of-care thoracic ultrasound examination was performed on each conscious rabbit, followed by a thoracic radiography or CT study. The frequency and number of B-lines were statistically compared based on signalment, body condition score, and health status.

MEASUREMENTS AND MAIN RESULTS: The overall frequency of B-lines was 33.3% (21/63) in rabbits without pulmonary disease. Most B-lines were categorized as single discrete artifacts. A single region was positive for B-lines in 17 of 21 rabbits, with 14 of them having a single B-line, two having two B-lines, and one having three B-lines. Two and three regions were positive in three and one rabbit, respectively. Cranial thoracic ultrasound revealed mediastinal tissue rather than pulmonary parenchyma in 61 of 63 rabbits.

CONCLUSIONS: This study evaluated a modified point-of-care thoracic ultrasound, including B-line frequency and distribution, and described what can be expected as a normal thoracic ultrasound in rabbits without pulmonary disease. Findings indicate that isolated B-line artifacts can be detected within the lungs of rabbits without pulmonary disease. Additional studies are needed to describe the pulmonary ultrasonographic features in rabbits with respiratory conditions and to determine the clinical use of this diagnostic technique in those cases.

PMID:40729450 | DOI:10.1111/vec.70000