Tag: pubmed

Chin Med J (Engl). 2025 Feb 21. doi: 10.1097/CM9.0000000000003549. Online ahead of print.

ABSTRACT

BACKGROUND: Visual input significantly influences cerebral activity related to locomotor navigation, although the underlying mechanism remains unclear. This study aimed to analyze the effects of chronic visual impairment and its rehabilitation on sensorimotor integration during level walking in patients with age-related cataract.

METHODS: This prospective case series enrolled 14 female patients (68.4 ± 4.7 years) with age-related cataract, scheduled for consecutive cataract surgeries at the Department of Ophthalmology in Peking University Third Hospital from June 2019 to June 2020. Electroencephalogram (EEG) signals during level walking were recorded using a portable EEG system before and 4 weeks after visual restoration. Walking speed was assessed using the Footscan system. Spectral power of the theta and alpha bands was analyzed with repeated-measures analysis of variance, with Assignment (rest and walking), Phase (preoperative and postoperative), and Electrode sites (F3, Fz, F4, O1, and O2) as within-subject factors.

RESULTS: Compared to the visual impairment state, theta band power significantly decreased after visual restoration (13.16 ± 1.58 μV2vs. 23.65 ± 3.48 μV2, P = 0.018). Theta activity was notably reduced during walking (17.24 ± 2.43 μV2vs. 37.86 ± 6.62 μV2, P = 0.017), while theta power at rest was not statistically significant difference between the two phases (9.44 ± 1.24 μV2vs. 9.08 ± 1.74 μV2, P = 0.864). Changes in walking speed were correlated with alterations in theta power at O1 (r = -0.574, P = 0.032) and O2 (r = -0.648, P = 0.012) during rest. Alpha band power remained stable during walking and was unaffected by visual status.

CONCLUSIONS: Chronic visual impairment from age-related cataract triggers enhanced cerebral activation of sensorimotor integration to compensate for visual decline during locomotion. This cerebral over-activation is effectively alleviated by visual restoration.

PMID:39981564 | DOI:10.1097/CM9.0000000000003549

Ecol Evol. 2025 Feb 20;15(2):e71013. doi: 10.1002/ece3.71013. eCollection 2025 Feb.

ABSTRACT

Chronic wasting disease (CWD) is a prion disease that infects cervid species by direct and environmental transmission and is invariably fatal. CWD spread can be promoted by the attraction of animals to “hotspots” such as hay bales and grain bags stored in fields and at farm sites. The density and location of hotspots may impact contact rates. We used an individual-based movement model of mule deer (Odocoileus hemionus) to investigate the effects of density and configuration of hotspots (hereafter artificial attractants, AA) on contact rates at a constant density of 1 deer/km² during winter. The model tracks when two deer from the same or different groups come into contact under 6 AA densities (0-1 AA/km²) and 6 AA configurations. We compared placing AA randomly versus clustered around farms, and removing them randomly versus biased by proximity to preferred habitat. Overall, the number of unique contacts per individual and the number of unique deer visiting an AA increased, and the number of AAs used by each deer decreased as AA density declined. Selectively removing field attractants near preferred habitat resulted in a larger increase in contacts per deer, with deer contacting more and different individuals, fewer deer using the remaining AA, and fewer visits per AA than random removal. There was a greater increase in contact rates when reducing AA density at farms by randomly removing all AA at a farm compared to randomly removing individual AA across farms. Deer responses to AA removal may not be as straightforward as originally believed. Deer contacts may increase, not decrease, with AA removal because deer are attracted to the remaining AA. Under moderate deer densities, AA removal may require a broad-scale, “all or nothing” approach to prevent deer from concentrating at remaining AA, but concomitantly lowering deer density needs further assessment.

PMID:39981545 | PMC:PMC11840243 | DOI:10.1002/ece3.71013

J Am Coll Emerg Physicians Open. 2025 Jan 31;6(2):100034. doi: 10.1016/j.acepjo.2024.100034. eCollection 2025 Apr.

ABSTRACT

OBJECTIVES: Changes to the Current Procedural Terminology (CPT) evaluation and management (E/M) documentation guidelines implemented on January 1, 2023, were primarily meant to address dissatisfaction with the prior system; however, it was not known how the changes might alter billing distributions. In this study, we compare the proportion of visits for each E/M code before and after the enactment of the changes across 5 emergency departments (EDs) to determine the effects on billing.

METHODS: This was a retrospective, observational analysis of all ED visits for patients over 18 years across 5 EDs from January 1 to March 31 in the years 2021, 2022, and 2023. In the primary analysis, we compared the distribution of visits for each of the studied CPT E/M codes in the 3 months before and after the enactment of the changes, utilizing a multivariate mixed-effect Poisson regression model. In our secondary analysis, we aimed to determine if the results differed when looking at academic and community sites separately.

RESULTS: Across all hospitals, visits coded as level 4 and level 5 comprised a significantly higher proportion of all visits in the postimplementation period (relative risk = 1.40 for level 4 and relative risk = 1.17 for level 5). The proportion of visits coded as levels 1, 2, and 3 significantly decreased in the postimplementation period, while those coded as critical care did not change. The same general trends were found in both academic and community settings separately, although with less statistical significance, particularly at the academic sites.

CONCLUSION: In this observational analysis, we found that overall CPT E/M levels increased after the implementation of the new documentation guidelines, relieving apprehension that the documentation changes may lead to a decrease in reimbursement.

PMID:39981504 | PMC:PMC11841088 | DOI:10.1016/j.acepjo.2024.100034

J Nonlinear Sci. 2025;35(2):44. doi: 10.1007/s00332-025-10140-z. Epub 2025 Feb 18.

ABSTRACT

An instationary drift-diffusion system for the electron, hole, and oxygen vacancy densities, coupled to the Poisson equation for the electric potential, is analyzed in a bounded domain with mixed Dirichlet-Neumann boundary conditions. The electron and hole densities are governed by Fermi-Dirac statistics, while the oxygen vacancy density is governed by Blakemore statistics. The equations model the charge carrier dynamics in memristive devices used in semiconductor technology. The global existence of weak solutions is proved in up to three space dimensions. The proof is based on the free energy inequality, an iteration argument to improve the integrability of the densities, and estimations of the Fermi-Dirac integral. Under a physically realistic elliptic regularity condition, it is proved that the densities are bounded.

PMID:39981502 | PMC:PMC11836105 | DOI:10.1007/s00332-025-10140-z

Cureus. 2025 Jan 21;17(1):e77785. doi: 10.7759/cureus.77785. eCollection 2025 Jan.

ABSTRACT

OBJECTIVES: This study aimed to evaluate the effect of rapid weight regain on the fight outcomes in professional mixed martial arts (MMA) athletes competing in Bellator.

MATERIALS AND METHODS: Twenty fighters (16 male and four female fighters) were included in the analysis. Official weigh-in and fight-night weights were recorded, and percentage weight regain was calculated. Fighters were divided into groups based on their percentage weight regain (<10% vs. ≥10%). Descriptive statistics were calculated, and independent t-tests and logistic regression were employed.

RESULTS: The results indicated that while fighters significantly regained weight between weigh-ins and fight-night, this weight gain did not significantly (p ≥ 0.05) predict fight outcomes.

CONCLUSION: These findings suggest that weight regain may not provide a competitive advantage in Bellator MMA athletes.

PMID:39981492 | PMC:PMC11842001 | DOI:10.7759/cureus.77785

Cureus. 2025 Jan 21;17(1):e77757. doi: 10.7759/cureus.77757. eCollection 2025 Jan.

ABSTRACT

This systematic review and meta-analysis aimed to evaluate the effects of digital cardiac rehabilitation (DCR) encompassing application-based telehealth compared to traditional cardiac rehabilitation onmajor adverse cardiovascular events (MACE), rehospitalisation, costs, quality of life (QoL), and physical activity levels in patients with coronary artery disease (CAD). From 2014 to May 2024, a systematic search of the MEDLINE, PubMed, Web of Science, and Scopus databases was conducted using relevant keywords to identify randomised controlled trials (RCTs) or randomised cross-over trials. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) scale and risk of bias tool. The included articles were then subjected to qualitative synthesis and meta-analysis. Thirteen studies involving 1850 participants were included in the study. Meta-analysis revealed statistically significant improvements in QoL (mean deviation (MD) = 0.10, 95% CI: 0.05-0.15, p = 0.0002). DCR compared with centre-based rehabilitation (CBR). These improvements in QoL likely translated to enhanced daily functioning, such as the increased ability to perform activities of daily living. However, no significant differences were found for physical activity levels (MD = 1.69, 95% CI: 1.49-4.87, p = 0.30), rehospitalisation (relative risk (RR) = 0.86, 95% CI: 0.66-1.11, p = 0.25) or MACE (RR = 0.67, 95% CI: 0.42-1.07, p = 0.09). High heterogeneity was observed in QoL, likely due to variations in DCR modalities, study populations, and intervention content. The results of this study, therefore, must be interpreted with caution. DCR may offer significant benefits in terms of improving the QoL in patients with CAD. While promising trends were observed for rehospitalisation and MACE, further research is needed to confirm these findings. Potential reasons for the observed benefits of DCR over centre-based rehabilitation plausibly include improved accessibility, enhanced patient engagement, and greater flexibility. However, it is important to acknowledge the presence of heterogeneity among the included studies and potential gender imbalances within the study populations, which may have influenced the results. Future research should prioritize long-term outcomes, cost-effectiveness, real-world effectiveness in diverse populations, and the development of standardized DCR protocols.

PMID:39981488 | PMC:PMC11840654 | DOI:10.7759/cureus.77757

Cureus. 2025 Jan 21;17(1):e77762. doi: 10.7759/cureus.77762. eCollection 2025 Jan.

ABSTRACT

INTRODUCTION: The standard of care after resection of a single brain metastasis is to treat the cavity with stereotactic radiation therapy (SRT) to minimize the risk of recurrence. However, a prospective randomized trial of SRT demonstrated higher than expected rates of local recurrence, possibly due to geographic miss. Conformal partial brain (CPB) irradiation using conventional fractionation is an alternate technique that allows a larger margin of healthy tissue to be safely irradiated, potentially decreasing the risk of tumor recurrence. We performed a retrospective chart review to compare the results between CPB and SRT treatments.

METHODS AND MATERIALS: Patients receiving postoperative cranial radiotherapy within two months of a brain metastasis resection from 2015 to 2022 were eligible for this retrospective single-institution analysis. Fifty-seven patients met the eligibility criteria (SRT: n=32; CPB: n=25). SRT patients were treated using a robotic linear accelerator with a median dose of 24 Gy in 3 fractions. The median prescribed dose for the CPB group was 33 Gy in 11 fractions.

RESULTS: The mean follow-up was 19.9 months. The crude rate of local recurrence rate was 21.9% (SRT) versus 0% (CPB) (p<0.013). The crude rate of radiation necrosis (RN) was 21.9% (SRT) versus 0% (CPB) (p<0.013). The mean cavity volume was 13 cc (SRT) versus 73 cc (CPB) (p<0.001). Most cases of RN were asymptomatic, although one patient suffered grade 4 status epilepticus.

CONCLUSION: In this single-institution cohort, CPB radiation therapy was statistically associated with a lower risk of both local failure and radiation necrosis as compared to SRT. Despite the cavity being much larger, none of the CPB patients suffered either local failure or radiation necrosis. Postoperative CPB irradiation may be beneficial for large cavity sizes or when it is difficult to delineate the tumor bed.

PMID:39981481 | PMC:PMC11841999 | DOI:10.7759/cureus.77762

Cureus. 2025 Jan 20;17(1):e77749. doi: 10.7759/cureus.77749. eCollection 2025 Jan.

ABSTRACT

OBJECTIVES: This study aimed to evaluate the incidence of new-onset diabetes mellitus (NODM) in statin users versus non-users and identify associated risk factors. Retrospective cohort studies leverage real-world data to address gaps in controlled trials, particularly in regions like Thailand, where local factors may affect this association.

MATERIALS AND METHODS: This study was a retrospective cohort study conducted at Phramongkutklao Hospital in Bangkok, Thailand. Using historical medical records, we identified two distinct cohorts – statin users and non-users – and followed them over time (2013-2022) to evaluate the incidence of NODM. A total of 113,850 patients aged over 20 years were included, with 14,120 (12.4%) statin users and 99,730 (87.6%) non-users. The annual incidence of NODM was calculated for each year of the study period, with statistical analyses (chi-square tests and Poisson regression) performed to identify risk factors.

RESULTS: Statin users had a significantly higher incidence of NODM, with 2,957 cases (20.94%) occurring during the follow-up period, compared to 1,643 cases (1.65%) among non-users. Older age, hypertension, and hypercholesterolemia were significantly associated with an increased risk of NODM in statin users. Multivariable analysis showed that statin use increased the risk of NODM by 3.86 times (95% CI: 3.58-4.17, p < 0.001) compared to non-users. The use of non-statin lipid-lowering drugs, as well as obesity, also contributed to the elevated diabetes risk among statin users.

CONCLUSIONS: Statin use is associated with a significantly higher risk of NODM, particularly in older adults and those with pre-existing cardiovascular risk factors. These findings emphasize the need for careful glucose monitoring in statin users and suggest a potential role for lifestyle interventions in mitigating this risk. Further studies are needed to explore strategies for balancing the cardiovascular benefits of statins with their potential metabolic risks.

PMID:39981479 | PMC:PMC11840273 | DOI:10.7759/cureus.77749

Cureus. 2025 Jan 20;17(1):e77739. doi: 10.7759/cureus.77739. eCollection 2025 Jan.

ABSTRACT

Background Diabetic ketoacidosis (DKA) is a common and serious complication of diabetes, often requiring hospitalization and intensive care. Fluid resuscitation is a cornerstone of DKA management, with traditional guidelines recommending isotonic normal saline (NS) for initial volume replacement. Recent studies, however, suggest that large volumes of NS may lead to undesirable outcomes such as hyperchloremic metabolic acidosis. This study investigates the effects of large-volume NS resuscitation on clinical outcomes in DKA management, comparing it to other fluids, such as lactated Ringers (LR). Objective To evaluate whether large-volume resuscitation with isotonic normal saline (NS) is associated with prolonged ICU length of stay (LOS), increased time on insulin infusion, and higher rates of non-anion gap metabolic acidosis in patients with DKA. Materials and methods This was a single-center, retrospective, observational study conducted at Naples Comprehensive Healthcare System. We reviewed electronic medical records of patients diagnosed with DKA, defined by pH <7.3, bicarbonate <18, and anion gap >12. The primary outcome was ICU LOS, and secondary outcomes included overall length of stay, insulin infusion duration after DKA resolution, and incidence of non-anion gap metabolic acidosis after DKA resolution. Patients were grouped by the amount of NS received during resuscitation: 0L, 1L, 2L, and ≥3L. Statistical analyses included analysis of variance (ANOVA), t-tests, and chi-square tests to compare outcomes between groups. Results A total of 109 patients were included in the study. The mean age was 51.34 years, and the cohort consisted of 43.1% females and 56.9% males. There was no significant difference in ICU LOS between patients who received 0L and 1L of NS. However, patients who received 2L (p=0.0249) and ≥3L (p=0.00065) had significantly longer ICU LOS compared to those who received 0L of NS. No significant difference in overall LOS was also observed across all groups (p=0.894). Patients who received ≥3L of NS had a significantly longer duration of insulin infusion compared to those who received 0L (p=0.0101) after DKA anion gap closure while a significant increase in the incidence of non-anion gap acidosis after DKA resolution was observed in patients receiving ≥2L of NS (p=0.0000). Conclusion This study suggests that large-volume resuscitation with isotonic NS in DKA patients is associated with increased ICU length of stay, prolonged insulin infusion, and a higher incidence of non-anion gap metabolic acidosis. These findings support the use of balanced crystalloids, such as lactated Ringers, for initial resuscitation in DKA patients, as they may reduce the risk of complications related to hyperchloremia and improve clinical outcomes. Further prospective studies are needed to confirm these findings and guide fluid management protocols in DKA.

PMID:39981474 | PMC:PMC11839305 | DOI:10.7759/cureus.77739

Personal Ment Health. 2025 Feb;19(1):e70010. doi: 10.1002/pmh.70010.

ABSTRACT

This paper examines the prevalence and comorbidity of complex post-traumatic stress disorder (CPTSD) and borderline personality disorder (BPD) among individuals with probable personality disorder, using baseline data from the Structured Psychological Support clinical trial. The clinical characteristics and personality functioning of participants are summarised and compared between those meeting criteria for BPD, CPTSD, both or neither condition. Among 292 participants, 97% reported significant trauma exposure, and over half met the criteria for CPTSD. Those with CPTSD exhibited higher levels of social dysfunction and depression compared with those with BPD, despite both groups showing elevated emotion dysregulation and anxiety. Comorbidity of CPTSD and BPD was high, with 50% of the sample meeting criteria for both conditions. Participants with comorbid CPTSD and BPD displayed poorer baseline scores across all measures of mental health and functioning than those who met criteria for BPD alone. No statistically significant differences were found in suicidal behaviour or treatment-seeking between groups. There were no significant differences in International Classification of Diseases-11 personality trait domains between participants with CPTSD and BPD, but people with comorbid CPTSD and BPD displayed higher levels of trait negative affectivity than those with BPD alone. The findings highlight the need for trauma-informed assessments in clinical settings and a better understanding of the impact of CPTSD on treatment outcomes for people with personality disorder, including how existing treatments may need to be modified to better meet the needs of people with these highly comorbid conditions. TRIAL REGISTRATION: Current controlled trials ISRCTN13918289 (registered 11/11/2022).

PMID:39980078 | DOI:10.1002/pmh.70010