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Nevin Manimala Statistics

The effect of different exercise types on migraine frequency in individuals with migraine: A pilot study

Headache. 2025 May 20. doi: 10.1111/head.14951. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to evaluate the effects of different types and combinations of exercise on migraine attacks and accompanying comorbidities.

BACKGROUND: Combining aerobic and resistance exercises may yield more significant improvements in patients with migraine.

METHODS: This parallel-group randomized controlled study included 24 participants, who were then divided equally into three groups: an aerobic exercise group, a combined exercise group (aerobic and resistance exercises), and a control group. It was conducted at Ege University Hospital between September 2022 and March 2024. Following a 1-month baseline headache diary period, both intervention groups participated in the same aerobic exercises 3 days a week for 12 weeks. The combined exercise group performed five resistance exercises targeting the neck, upper back, and shoulder muscles alongside the aerobic exercises 3 days a week for 12 weeks. Measurements were taken at baseline, after the 3-month intervention period, and after a 2-month follow-up period. The primary outcome was the number of migraine headache days per month. Secondary outcomes included anxiety and depression levels, aerobic capacity, physical activity status, and migraine-related quality of life.

RESULTS: The number of migraine days per month significantly decreased in both the aerobic and combined exercise groups during the post-intervention period, while no significant change was observed in the control group (p < 0.001 for aerobic and combined exercise groups, p = 0.166 for control group). Migraine headache frequency showed a statistically significant decrease in the combined exercise group compared to the aerobic exercise group (p = 0.027). Additionally, both exercise groups showed significant improvements in aerobic capacity (p < 0.001 for both) and physical activity levels (p < 0.001 and p = 0.001, respectively) post-intervention, which were not observed in the control group (p = 0.747 for aerobic capacity, p = 0.05 for physical activity levels). Although no significant effect on depression scores was observed in either exercise group, anxiety scores significantly decreased in the combined exercise group from pre- to post-intervention (p = 0.037). Significant improvements in migraine-related quality of life were observed in both intervention groups (p = 0.018 and p = 0.001, respectively), with no significant difference (p = 0.934). Neither significant change was observed in depression and anxiety scores nor migraine-related quality of life in the control group (p = 0.593, p = 0.438 and 0.081 respectively).

CONCLUSIONS: Aerobic and combined exercise groups showed a reduction in monthly migraine headache frequency without any side effects, with the reduction being statistically more significant in the combined exercise group.

PMID:40391488 | DOI:10.1111/head.14951

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Nevin Manimala Statistics

Bioregenerative autologous scaffold made from bone marrow aspirate concentrate, cancellous bone autograft, platelet-rich plasma, and autologous fibrin to treat non-unions of the femur, humerus, and forearm bones: a case series

Regen Med. 2025 May 20:1-9. doi: 10.1080/17460751.2025.2507504. Online ahead of print.

ABSTRACT

AIM: To evaluate the effectiveness of a bioregenerative scaffold created from bone marrow aspirate, cancellous bone autograft, platelet-rich plasma, and autologous fibrin in treating complicated non-unions of the supracondylar femur, humeral shaft, and radius and ulna.

METHODS & MATERIALS: Three patients with non-unions resulting from multiple surgical failures underwent bone stabilization along with the application of a novel bioregenerative scaffold. X-rays and subjective assessments were collected prior to surgery and at 6- and 12-months post-surgery.

RESULTS: All non-unions demonstrated healing with adequate callus formation, as confirmed by radiological assessments. By 12 months, all patients were able to resume full weight-bearing activities or regain full range of motion and physical strength without pain. Statistical analysis revealed improvements across all assessment scales compared to pre-surgical values.

CONCLUSION: This approach offers a viable option for treating complex long bone non-unions after multiple surgical interventions.

PMID:40391486 | DOI:10.1080/17460751.2025.2507504

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Nevin Manimala Statistics

Long-Term Safety and Efficacy of Renal Denervation: 24-Month Results From the SPYRAL HTN-ON MED Trial

Circ Cardiovasc Interv. 2025 May 20:e015194. doi: 10.1161/CIRCINTERVENTIONS.125.015194. Online ahead of print.

ABSTRACT

BACKGROUND: Six-month results from the SPYRAL HTN-ON MED trial demonstrated that renal denervation (RDN) reduced office blood pressure (BP), and not 24-hour ambulatory systolic BP, compared with sham control in hypertensive patients. In this prespecified analysis of the ON MED trial, long-term changes in BP, antihypertensive drug use, and safety outcomes through 24 months are compared between RDN and sham control groups.

METHODS: SPYRAL HTN-ON MED is a prospective, randomized, sham-controlled, blinded trial enrolling 337 patients globally from 56 clinical centers. Eligible patients had an office systolic BP of 150 to 180 mm Hg, a diastolic BP ≥90 mm Hg, and a 24-hour ambulatory systolic BP of 140 to 170 mm Hg. Patients were randomized to RDN or a sham control procedure and were prescribed a stable regimen of 1 to 3 antihypertensive medications through 6 months. After 6 months, patients and physicians were unblinded with permitted changes to antihypertensive therapy, and control patients were permitted to crossover. Crossover patients had their last observations carried forward as part of the control group. Statistical analyses were conducted on the population as a randomized.

RESULTS: At 24 months, the RDN group experienced significantly greater mean reductions in ambulatory systolic BP (-12.1±15.3 mm Hg [n=176] versus -7.0±13.1 mm Hg [n=33]; difference: -5.7 mm Hg; P=0.039) and office systolic BP (-17.4±16.1 mm Hg [n=187] versus -9.0±19.4 mm Hg [n=35]; difference: -8.7 mm Hg; P=0.0034) compared with sham controls. At 24 months, antihypertensive medications increased significantly more in the sham group (1.7-2.7) compared with the RDN group (1.8 versus 2.4; P=0.046). Sensitivity analyses accounting for missing sham patient BP values due to crossover yielded consistent results in favor of RDN for 24-hour ambulatory (P=0.023) and office systolic BP (P<0.0001). Clinically adverse events were rare, with no instances of renal artery stenosis through 24 months.

CONCLUSIONS: RDN produced significantly greater ambulatory and office systolic BP reductions at 24 months compared with sham control, despite higher antihypertensive medication use in the control group.

REGISTRATION: URL: https://clinicaltrials.gov/study; unique identifier: NCT02439775.

PMID:40391448 | DOI:10.1161/CIRCINTERVENTIONS.125.015194

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Validation of a Novel Risk Prediction Score for Sudden Cardiac Death in the Framingham Heart Study

Circ Arrhythm Electrophysiol. 2025 May 20:e013647. doi: 10.1161/CIRCEP.124.013647. Online ahead of print.

ABSTRACT

BACKGROUND: We have previously reported a novel clinical risk score (risk prediction score for shockable sudden cardiac arrest [VFRisk]) for the prediction of shockable sudden cardiac arrest, discovered and validated in 2 US west coast communities. We hypothesized that VFRisk predicts sudden cardiac death (SCD) risk in the geographically distinct FHS (Framingham Heart Study).

METHODS: We performed a nested case-referents study in the FHS to test VFRisk. Cases were participants who experienced SCD among the original and offspring FHS cohorts. Referents were randomly selected from FHS participants frequency-matched (ratio of 1:3) to cases on age, sex, cohort, and exam. VFRisk was the sum of 12 risk factors, each multiplied by its respective points.

RESULTS: Among 312 cases and 935 referents, mean ages were 69.5 and 69.7 years with 70.8% male in both groups. SCD cases had significantly higher prevalence of diabetes, heart failure, stroke, atrial fibrillation, and myocardial infarction compared with the referents group. The VFRisk score was validated with good discrimination (C-statistic, 0.71 [95% CI, 0.66-0.77]) for SCD. Cases had higher VFRisk scores than referents (3.8±2.8 versus 1.8±1.7; P<0.001). A 1-unit increase in VFRisk score was associated with a 48% increase in odds of SCD (odds ratio, 1.48 [95% CI, 1.34-1.64]). The highest VFRisk quartile had 7.8-fold higher odds of SCD than the lowest quartile.

CONCLUSIONS: The VFRisk score successfully predicted SCD in the FHS. The differences in discrimination between the 2 studies could partially be explained by the inability to distinguish shockable versus nonshockable events in the FHS.

PMID:40391444 | DOI:10.1161/CIRCEP.124.013647

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Occurrence and predictors of food insecurity in a sample of pregnant women recruited from an Australian hospital

Nutr Diet. 2025 May 20. doi: 10.1111/1747-0080.70021. Online ahead of print.

ABSTRACT

AIMS: The aim of this study is to explore the occurrence of food insecurity among pregnant women in Australia.

METHODS: This cross-sectional, self-reported study included two measures of food insecurity (the US Department of Agriculture Household Food Security Survey Module and single item measure), use of emergency and community food assistance, health conditions, eating habits during pregnancy, and professional nutritional advice and health seeking behaviours. Participants were recruited using (1) an advertisement posted on social media and (2) flyers with a QR code linked to the online survey, made available for women to take from clinic rooms at a hospital in Melbourne, Victoria. Data were analysed using basic statistics, spearman’s rho correlation coefficients, and linear regression to identify factors that may be associated with food insecurity among pregnant women in Australia; the study was open between May 2021 and March 2022.

RESULTS: Three hundred and three valid responses were received from pregnant women in Australia. Food insecurity was determined to be 14.5% (US Department of Agriculture Household Food Security Survey Module) and 6.3% (single item used). Food insecurity was significantly associated with income, education level and age.

CONCLUSIONS: Results indicate a high prevalence of food insecurity among pregnant women. Routine screening and referral of food insecure pregnant women should be considered in antenatal care settings.

PMID:40391424 | DOI:10.1111/1747-0080.70021

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Exploring Social Isolation Among Patients With Colorectal Cancer and Their Spousal Caregivers in China: An Actor-Partner Interdependence Model

Nurs Health Sci. 2025 Jun;27(2):e70137. doi: 10.1111/nhs.70137.

ABSTRACT

This cross-sectional study aimed to investigate dyadic effects of micro-level (physical [PCS]/mental [MCS] health) and meso-level (dyadic coping/social support) factors on both subjective and objective social isolation in patient-spousal caregiver dyads with colorectal cancer (CRC), with hypothesized actor-partner interdependence effects. Data from 220 patient-caregiver dyads with CRC collected using validated instruments (General Alienation Scale, Lubben Social Network Scale-6, Medical Outcomes Study 12-item Short-Form version 2, Dyadic Coping Inventory, and Perceived Social Support Scale) were analyzed using the Actor-Partner Interdependence Model. Findings substantiated dyadic interdependence between subjective/objective social isolation and variables within dyads across micro- and meso-levels. Both micro-level (PCS/MCS) and meso-level (dyadic coping/social support) factors demonstrated significant actor effects on both subjective and objective social isolation experienced by patients and their partners. Patients’ both micro-level (PCS/MCS) and meso-level (dyadic coping/social support) factors negatively influenced their partners’ subjective and objective social isolation. No partner effect was identified from variables associated with spousal caregivers on patients’ social isolation. These findings suggest that interventions targeting these variables could be effectively designed for patient-spousal caregiver dyads with CRC to address social isolation.

PMID:40391397 | DOI:10.1111/nhs.70137

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Nevin Manimala Statistics

Extended fiducial inference for individual treatment effects via deep neural networks

Stat Comput. 2025;35(4):97. doi: 10.1007/s11222-025-10624-8. Epub 2025 May 17.

ABSTRACT

Individual treatment effect estimation has gained significant attention in recent data science literature. This work introduces the Double Neural Network (Double-NN) method to address this problem within the framework of extended fiducial inference (EFI). In the proposed method, deep neural networks are used to model the treatment and control effect functions, while an additional neural network is employed to estimate their parameters. The universal approximation capability of deep neural networks ensures the broad applicability of this method. Numerical results highlight the superior performance of the proposed Double-NN method compared to the conformal quantile regression (CQR) method in individual treatment effect estimation. From the perspective of statistical inference, this work advances the theory and methodology for statistical inference of large models. Specifically, it is theoretically proven that the proposed method permits the model size to increase with the sample size n at a rate of O ( n ζ ) for some 0 ζ < 1 , while still maintaining proper quantification of uncertainty in the model parameters. This result marks a significant improvement compared to the range 0 ζ < 1 2 required by the classical central limit theorem. Furthermore, this work provides a rigorous framework for quantifying the uncertainty of deep neural networks under the neural scaling law, representing a substantial contribution to the statistical understanding of large-scale neural network models.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11222-025-10624-8.

PMID:40391382 | PMC:PMC12085359 | DOI:10.1007/s11222-025-10624-8

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Modulation of the human fecal metabolome – Effect of polyphenols depends on the BMI

Curr Res Food Sci. 2025 Apr 27;10:101060. doi: 10.1016/j.crfs.2025.101060. eCollection 2025.

ABSTRACT

Health effects associated with microbial metabolites are influenced by dietary compounds and other environmental factors. Polyphenols derived from plant-based foods reach the large intestine mostly undigested, where they can interact with the gut microbiota. This explorative study investigated the metabolic responses of gut microbiota to the polyphenols rutin and genistein. Ex vivo anaerobic incubations with pooled fecal samples from volunteers with a BMI <25 (n = 7) and a BMI >40 (n = 7) were analyzed by ESI DI-FT-ICR-MS. Differences in metabolic diversity were observed between the two BMI groups, with the obese group showing a less diverse metabolic response. Metabolomic profiling identified 361 metabolites in 35 substance classes, with notable effects of the polyphenols on amino acid, carbohydrate, nucleotide, and lipid metabolism. Both BMI groups showed increased levels of dipeptides and amino acids and decreased levels of biogenic amines. Among the key findings, glutamine levels increased, which has been associated with obesity-related metabolic processes, while tryptophan levels were also elevated, a factor previously associated with obesity-related pathways. Glycine levels increased in both groups. Additionally, histamine, cadaverine, putrescine, and trimethylamine were reduced after exposure to the polyphenols. Changes in metabolites related to carbohydrate metabolism suggest an influence of rutin and genistein on sugar transport and cell wall synthesis. Furthermore, in the obese group, rutin exposure was associated with increased butyrate levels and decreased lactate levels. These findings contribute to a better understanding of how rutin and genistein interact with the gut microbiota metabolome, with potential implications for metabolic health and obesity-related research.

PMID:40391378 | PMC:PMC12088750 | DOI:10.1016/j.crfs.2025.101060

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Effects of sevoflurane and propofol for elderly patients: A systematic review and meta-analysis

J Res Med Sci. 2025 Apr 30;30:22. doi: 10.4103/jrms.jrms_154_24. eCollection 2025.

ABSTRACT

BACKGROUND: To evaluate the safety of propofol and sevoflurane for general anesthesia in elderly.

MATERIALS AND METHODS: All studies on sevoflurane, propofol, and hyperamylasemia from the establishment of Embase, Ovid, Cochrane Library, and Google Scholar from database establishment to December 2024 were searched. Literatures were screened, and data were extracted on the grounds of inclusion and exclusion criteria. Review Manager (RevMan) (Version 5.4. The Cochrane Collaboration.) was used for statistical analysis. Outcomes assessed included time to spontaneous eye opening, extubation time, incidence rate of postoperative cognitive dysfunction (POCD), postoperative delirium, agitation, nausea and vomiting.

RESULTS: Fourteen trials were identified and included in this meta-analysis. The results showed no significant difference in time to spontaneous eye opening (P = 0.54), the incidence of POCD (P = 0.07), postoperative delirium (P = 0.37), and postoperative nausea and vomiting (P = 0.8) between the sevoflurane and propofol groups. Compared with propofol groups, extubation time (P < 0.0001) was significantly shortened by sevoflurane groups. Conversely, compared with sevoflurane, the incidence of postoperative agitation in the propofol group was significantly reduced (P = 0.04).

CONCLUSION: There was no difference in time to spontaneous eye-opening, the incidence of POCD, postoperative delirium, postoperative nausea, and vomiting between the sevoflurane and propofol groups. However, compared with propofol, sevoflurane can significantly shorten intubation time. The incidence of postoperative agitation (P = 0.04) was significantly lower in the propofol group compared with sevoflurane.

PMID:40391341 | PMC:PMC12087908 | DOI:10.4103/jrms.jrms_154_24

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Derivation and Validation of Prediction Models for Prolonged Length of Stay and 30-Day Readmission in Elderly Patients With Type 2 Diabetes Mellitus: A Multicenter Study

J Diabetes Res. 2025 May 12;2025:3148242. doi: 10.1155/jdr/3148242. eCollection 2025.

ABSTRACT

Background: Elderly patients with Type 2 diabetes mellitus (T2DM) often experience prolonged length of stay (LOS) and 30-day readmission. This study was aimed at identifying factors influencing these outcomes and develop predictive models for them. Methods: The least absolute shrinkage and selection operator (LASSO) combined with logistic regression was utilized to construct the prediction models, which were subsequently visualized through nomograms. The performance of these models was comprehensively evaluated in terms of discrimination, calibration, and clinical utility. Specifically, the discrimination capacity was assessed using the area under the receiver operating characteristic curve (AUROC), while calibration was evaluated via calibration curves and the Brier score. Clinical utility was examined through decision curve analysis (DCA) and clinical impact curve (CIC). Additionally, to verify the robustness and generalizability of the developed prediction models, subgroup analyses were conducted across various strata of the study population. Results:A total of 24 variables for 8800 patients were included for predicting prolonged LOS, and 38 variables were used for 30-day readmission prediction. In the training set, 28.42% of patients had prolonged LOS and 13.68% were readmitted within 30 days. The prolonged LOS model had an AUROC of 0.720 (95% CI: 0.703-0.737), while the 30-day readmission model achieved 0.766 (95% CI: 0.745-0.787). The Brier scores were 0.174 (95% CI: 0.168-0.180) and 0.102 (95% CI: 0.096-0.108), respectively. Both models showed good clinical utility in DCA and CIC analyses. Subgroup validation across different age groups showed consistent performance, with all AUROCs above 0.60. Albumin was identified as the most significant predictor in both models. Conclusion: The predictive models developed in this study demonstrated robust performance in forecasting common outcomes in elderly patients with T2DM. Moreover, albumin level was strongly associated with both prolonged LOS and 30-day readmission, making it a key factor in patient management.

PMID:40391336 | PMC:PMC12088840 | DOI:10.1155/jdr/3148242