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Nevin Manimala Statistics

White Matter Fiber Bundle Alterations Correlate with Gait and Cognitive Impairments in Parkinson’s Disease based on HARDI Data

Curr Med Imaging. 2025 Jan 14. doi: 10.2174/0115734056330364250109072154. Online ahead of print.

ABSTRACT

BACKGROUND: The neuroanatomical basis of white matter fiber tracts in gait impairments in individuals suffering from Parkinson’s Disease (PD) is unclear.

METHODS: Twenty-four individuals living with PD and 29 Healthy Controls (HCs) were included. For each participant, two-shell High Angular Resolution Diffusion Imaging (HARDI) and high-resolution 3D structural images were acquired using the 3T MRI. Diffusion-weighted data preprocessing was performed using the orientation distribution function to trace the main fiber tracts in PD individuals. Clinical characteristics between the two groups were compared, and the correlation between the FA value and behavioral data was analyzed. Quantitative gait and clinical parameters were recorded in PD at ON and OFF states, respectively.

RESULTS: The mean tract-specific FA values of the right Cingulum Cingulate (rCC) were statistically different between the PD group and the HC group (p =0.047). The FA value of 34-58 equidistant nodes in rCC was positively correlated with Mini-Mental State Examination (MMSE) (r=0.527, p=0.024), Berg Balance Scale (BBS)-OFF (r=0.480, p =0.040), and BBS-ON (r=0.528, p =0.024) scores, while it was negatively correlated with the MDS-UPDRS-III-ON score (r=-0.502, p =0.030). Regarding the gait analysis, the FA value was significantly correlated with velocity, cadence, and stride time of the pace and rhythm domains in both ‘ON’ and ‘OFF’ states, respectively (p<0.05).

CONCLUSION: This study served as an initial exploration to establish that HARDI sequences could be employed as a robust tool for analyzing microstructural alterations in white matter fiber bundles among PD patients, although the sample size was small. We confirmed microstructural integrity impairment of rCC to be significantly associated with both gait and cognitive deficits in patients with PD. Early detection of microstructural changes in rCC and targeted treatment can help improve behavioral disorders. In the future, we intend to further integrate multimodal data with assessments of patient behavior both prior to and following intervention. We will validate our findings within an independent cohort to monitor disease progression and evaluate the efficacy of therapeutic interventions.

PMID:39817395 | DOI:10.2174/0115734056330364250109072154

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Micronutrient status and risk of Mycobacterium tuberculosis infection in Indonesian tuberculosis case contacts

Trans R Soc Trop Med Hyg. 2025 Jan 16:trae140. doi: 10.1093/trstmh/trae140. Online ahead of print.

ABSTRACT

BACKGROUND: Certain micronutrient levels have been associated with the risk of developing TB disease. We explored the possible association of selected at-risk micronutrient levels with the development of Mycobacterium tuberculosis (M.tb) infection.

METHODS: This cohort study in Bandung, Indonesia, followed Interferon Gamma Release Assay (IGRA) negative TB case contacts with a repeat IGRA test at 3 mo. At baseline, blood was analysed for haemoglobin, 25-hydroxyvitamin D, retinol-binding protein, C-reactive protein, alpha-1-acid glycoprotein, serum transferrin receptor (sTfR), ferritin, zinc and selenium. Total body iron was calculated using ferritin and sTfR status. Associations between case contact micronutrient concentration and IGRA conversion were estimated using Poisson regression.

RESULTS: Of 430 contacts, 115 (27%) underwent IGRA conversion. Ferritin concentration (adjusted for inflammation) was positively associated with risk of IGRA conversion (incidence rate ratio [IRR] for ferritin=1.17; 95% CI 1.01 to 1.35; p=0.03), but other select micronutrients were not. This association held for ferritin in the final multivariable model (IRR=1.27; 95% CI 1.09 to 1.47; p=0.002).

CONCLUSIONS: The risk of developing M.tb infection, as defined by IGRA conversion, is associated with increasing ferritin. Interventions in TB case contacts to temporarily reduce iron levels, including considering withholding any iron supplementation, may be worthy of evaluation.

PMID:39817357 | DOI:10.1093/trstmh/trae140

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Effects of a Behavior Intervention Based on the Recurrence Risk Perception and Behavioral Decision Model for Ischemic Stroke Patients: A Randomized Controlled Trial

Res Nurs Health. 2025 Jan 16. doi: 10.1002/nur.22445. Online ahead of print.

ABSTRACT

Behavioral management is essential to preventing recurrence after stroke, but its adherence is limited worldwide. We aimed to assess the impact of the behavior intervention based on the Recurrence risk perception and Behavioral decision Model for ischemic stroke patients’ health behavior. This study was a single-blind, randomized, controlled trial with a 3-month follow-up. The outcome measures were the perception of the risk of stroke recurrence, behavioral decision, and health behavior. A total of seventy participants were randomized to the intervention group (n = 35) or control group (n = 35). The former received a twelve-week theory-based intervention in addition to the routine education, while the control group received only the routine education. The generalized estimating equations results indicated that the intervention group had significantly greater improvements in perception of the risk of stroke recurrence compared to the control group at all T1 (B = 0.13, 95% CI: 0.03 to 0.23), T2 (B = 0.18, 95% CI: 0.07 to 0.28), and T3 (B = 0.16, 95% CI: 0.07 to 0.25) after adjusting for stroke frequency. Statistically significant improvements were found in behavioral decision for the intervention group compared with the control group at T2 (B = 0.25, 95% CI: 0.09 to 0.41) and T3 (B = 0.26, 95% CI: 0.10 to 0.43). Results also showed a significantly higher increase in health behavior at T1 (B = 0.29, 95% CI: 0.09 to 0.48) and T2 (B = 0.22, 95% CI: 0.04 to 0.40). The intervention can improve the perception of the risk of stroke recurrence, behavioral decision, and health behavior in ischemic stroke patients. IMPLICATIONS: This study provides a reference point for promoting healthy behaviors in patients with ischemic stroke. A recurrence risk perception and behavioral decision model-based intervention was deemed to be feasible and useful in practice. PATIENT OR PUBLIC CONTRIBUTION: Patients and their caregivers agreed to participate in the study and shared their experiences of participating in research with us.

PMID:39817355 | DOI:10.1002/nur.22445

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A systematic review of variables associated with snakebite risk in spatial and temporal analyses

Trans R Soc Trop Med Hyg. 2025 Jan 16:trae131. doi: 10.1093/trstmh/trae131. Online ahead of print.

ABSTRACT

BACKGROUND: Snakebite is a priority neglected tropical disease, but incidence data are lacking; current estimates rely upon incomplete health facility reports or ad hoc surveys. Spatial analysis methods harness statistical associations between case incidence and spatially varying factors to improve estimates. This systematic review aimed to identify variables associated with snakebite risk in spatial and temporal analyses for inclusion in geospatial studies to improve risk estimation accuracy.

METHODS: We searched MEDLINE, Global Health, PubMed and Web of Science in January 2023 for studies published since 1980 assessing snakebite outcomes and spatially varying factors at the setting level. Study quality was assessed using an adapted Joanna Briggs Institute tool. The results are presented by narrative synthesis.

RESULTS: Thirty-five studies were eligible; the majority were from Central and South America (18), then Asia (11). Climate and environment were most frequently assessed, with temperature, humidity and tree cover predominantly positively associated with snakebite risk, drought negatively associated and altitude negative/mixed. Crop and livestock variables mostly showed positive associations; population density and urban residence overwhelmingly displayed negative associations.

CONCLUSIONS: This review identifies key variables that should be considered in future snakebite risk research. Limitations include low research availability from the highest risk regions. There is an evident need for greater research into snakebite risk variation, particularly in sub-Saharan Africa.

PMID:39817354 | DOI:10.1093/trstmh/trae131

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Efficacy and safety of triple hormone receptor agonist retatrutide for the management of obesity: a systematic review and meta-analysis

Expert Rev Clin Pharmacol. 2025 Jan 16. doi: 10.1080/17512433.2025.2450254. Online ahead of print.

ABSTRACT

INTRODUCTION: Retatrutide is a novel triple hormone receptor agonist which has shown great promise in tackling obesity in preliminary trials. We did this systematic review and meta-analysis to pool the results of all available trials and ascertain its safety and efficacy in the treatment of obesity.

MATERIAL AND METHODS: A literature search was conducted in PubMed, Cochrane Central and Embase using appropriate search terms and randomized control trials (RCTs) were identified which reported the safety and efficacy of retatrutide. Data was pooled using mean differences for continuous variables and risk ratios for the safety profile in RStudio.

RESULTS: After the initial search four RCTs were included in the analysis which compared the safety and efficacy of retatrutide versus placebo. Retatrutide showed a dose dependent relationship with the 12 mg dose causing the maximum reductions across all the outcomes considered. The safety profile of retatrutide was found to be comparable to the control group.

CONCLUSION: In conclusion our analysis found retatrutide to be clinically and statistically better than placebo in the various studies outcomes. We eagerly await the conduction of further trials for more robust and substantial results.

PROTOCOL REGISTRATION: www.crd.york.ac.uk/prospero identifier is CRD42024566153.

PMID:39817343 | DOI:10.1080/17512433.2025.2450254

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Examining Healthy Lifestyles as a Mediator of the Association Between Socially Determined Vulnerabilities and Incident Heart Failure

Circ Cardiovasc Qual Outcomes. 2025 Jan 16:e011107. doi: 10.1161/CIRCOUTCOMES.124.011107. Online ahead of print.

ABSTRACT

BACKGROUND: Increased burden of socially determined vulnerabilities (SDV), which include nonmedical conditions that contribute to patient health, is associated with incident heart failure (HF). Mediators of this association have not been examined. We aimed to determine if a healthy lifestyle mediates the association between SDV and HF.

METHODS: We included adults aged 45 to 64 years old across the United States from the REGARDS cohort study (Reasons for Geographic and Racial Differences in Stroke) without evidence of HF at baseline. The primary exposure was a count of SDV based on the Healthy People 2030 framework. The primary outcome was incident HF. We assessed the role of a healthy behavior score (HBS range, 0-8) and its components (adherence to a Mediterranean diet, physical activity, lack of sedentary lifestyle, and smoking abstinence) as potential mediators of the association between SDV and incident HF.

RESULTS: We included 13 on 525 participants. The median HBS was 4, with 16% with low HBS (0-2), 55% with moderate HBS (3-5), and 29% with high HBS (6-8). Increasing burden of SDV was associated with a stepwise increase in incident HF (adjusted hazard ratio, 1.84 [95% CI, 1.32-2.52] for 1 SDV, 2.59 [95% CI, 1.87-3.60] for 2 SDV, and 4.20 [95% CI, 3.08-5.73] for ≥3 SDV). There was no statistically significant mediation of HBS for the association of SDV count of 1 and incident HF. HBS score mediated 10.6% of the association between SDV count of 2 and incident HF and 11.1% of the association for those with ≥3 SDV. This increased to 10.8% and 18.3%, respectively, in the complete case analysis. Regarding individual components of HBS as mediators, only avoidance of a sedentary lifestyle was statistically significant (8.6% mediation) for the association of SDV count of 2 and incident HF.

CONCLUSIONS: A healthy lifestyle plays a small role in mediating the association between high SDV count and incident HF.

PMID:39817332 | DOI:10.1161/CIRCOUTCOMES.124.011107

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Inflammatory Potential of the Diet and Risk of Crohn’s Disease and Ulcerative Colitis

Aliment Pharmacol Ther. 2025 Jan 16. doi: 10.1111/apt.18497. Online ahead of print.

ABSTRACT

BACKGROUND: Association between dietary factors and the risk of developing inflammatory bowel disease (IBD) has been studied extensively. However, identification of deleterious dietary patterns merits further study.

AIM: To investigate the risk of developing Crohn’s disease (CD) and ulcerative colitis (UC) according to the inflammatory score of the diet (ISD) in the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

METHODS: We used validated food frequency questionnaires collected at baseline to compute ISD scores. We estimated the association between ISD score and risks of CD and UC risks using Cox models stratified by centre, sex and age. We adjusted for smoking status, BMI, physical activity, energy intake, educational level and alcohol intake.

RESULTS: We included 394,255 individuals including 184 incident cases of CD and 459 of UC after median follow-up of 13.6 years (4,889,910 person-years). High ISD scores were associated with a higher risk of CD (fourth vs. first quartile-adjusted HR: 1.88, 95% CI: 1.14-3.10; p-trend < 0.01) but not of UC (adjusted HR: 0.85, 95% CI: 0.63-1.15; p-trend 0.21). For CD, this association was mainly observed for women (adjusted HR: 2.14, 95% CI: 1.17-3.91; p-trend < 0.01). On subgroup analyses, those differences were mainly driven by low intakes of fibre, mono-unsaturated fatty acids, vitamin C, magnesium, onion and alcohol.

CONCLUSIONS: A high ISD score is associated with a higher risk of developing CD but not UC. These results should be taken into account in high-risk populations.

PMID:39817326 | DOI:10.1111/apt.18497

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Situational assessment of physical rehabilitation services in Zambia: issues and challenges

Disabil Rehabil. 2025 Jan 16:1-11. doi: 10.1080/09638288.2024.2438256. Online ahead of print.

ABSTRACT

PURPOSE: The necessity to enhance physical rehabilitation services in Zambia has been recognised. To achieve this through expanding human resources for health in rehabilitation and increasing service coverage, it is essential to comprehensively understand the current issues and challenges in physical rehabilitation within the country. This paper aimed to conduct a situational assessment of physical rehabilitation services in Zambia.

MATERIALS AND METHODS: The World Health Organisation’s Template for Rehabilitation Information Collection, a Systematic Assessment of the Rehabilitation Situation component, was used to collect data. This template provided a specialised framework for data analysis. Data was analysed using Statistical Package for Social Scientists.

RESULTS: Zambia has weak Leadership and Governance for physical rehabilitation, with no provincial or district rehabilitation satellite offices. While 0.1% of the total health budget is reserved for rehabilitation, the budget for physical rehabilitation is unspecified. In addition, there needs to be more services at community and primary health care levels.

CONCLUSION: There is an unequal distribution of physical rehabilitation services in Zambia, a shortage of skilled physical rehabilitation professionals and a lack of policy direction. Community health workers trained to specialise in physical rehabilitation could be considered in rendering physical rehabilitation services to address coverage.

PMID:39817311 | DOI:10.1080/09638288.2024.2438256

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Reasons for retraction of clinical research articles in PubMed indexed medical journals from 2012 to 2022

Indian J Med Ethics. 2024 Oct-Dec;IX(4):296-300. doi: 10.20529/IJME.2024.067.

ABSTRACT

BACKGROUND: Misconduct in the publication of research articles is a serious concern for the scientific community. This study was conducted with the objective to assess various reasons for retraction of clinical research articles published in PubMed indexed journals from all over the world since 2012 to 2022.

METHODS: A search was performed on the PubMed database for retracted research articles using filters for “retracted publication”. A total of 314 eligible research articles were assessed for studying basic details. The study outcome measures were to evaluate the reasons for the retraction and authors’ and journal editors’ responses to retractions.

RESULTS: Of the original research articles retracted, 150/242 (61.98%) were clinical trial publications. Of the total 314 retracted research articles, the most retractions were in 2014 (47, 14.96%) and 2013 (40, 12.73%) while the fewest retractions were in 2012 (3, 0.95%) and 2022 (9, 2.86%). The most common reasons for retraction were data errors or data analysis errors (120/314, 38.21%) followed by plagiarism (37/314, 11.8%), duplicate publication (35/314, 11.1%), ethical concerns (23/314, 7.3%) and methodological flaws (22/314, 7%). These concerns were raised mainly by the editor or editor-in-chief (228/314, 72.61%), followed by authors (29/314, 9.23%). Out of 228 editorial concerns on publications, authors of only 91/228 (39.91%) agreed and 17/228 (7.45%) completely disagreed with the editorial decision.

CONCLUSION: Authors need to be more careful about data analysis errors, fabricated or falsified data, and plagiarism while submitting their research papers. On the part of editors, detecting misconduct at the submission and peer review stages will help lower the retraction rate and avoid citation of such articles by other authors.

PMID:39817295 | DOI:10.20529/IJME.2024.067

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Attitudes and perceptions of undergraduate medical students about sexual harassment and gender discrimination: A survey-based study

Indian J Med Ethics. 2024 Oct-Dec;IX(4):271-277. doi: 10.20529/IJME.2024.066.

ABSTRACT

BACKGROUND: Sexual harassment (SH) and Gender discrimination (GD) faced by medical students have been neglected areas of study in India. Only a few recent studies could be found, despite frequent media reports on SH and GD. This study aimed to assess the attitudes and perceptions of sexual harassment and gender discrimination and evaluate the forms of SH and GD experienced by them.

METHODS: A Google form based mixed method survey tool was distributed amongst students of 28 medical colleges in Maharashtra. Participants were assured of confidentiality and anonymity.

RESULTS: Of the 308 students who were eligible for the present study, 14.3% (44) and 26.6% (82) reported incidence of sexual harassment and gender discrimination, respectively, while 133 (43.2%) of them reported having experienced some or the other form of SH/GD. A wide range of instances of SH and GD were described by the students.

CONCLUSIONS: The study highlights the need to create awareness about sexual harassment and gender discrimination amongst medical students, and to create an atmosphere where such abuses do not occur.

PMID:39817294 | DOI:10.20529/IJME.2024.066