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Nevin Manimala Statistics

Therapeutic role of nifedipine in threatened preterm labor: Current evidence and future perspectives

Int J Gynaecol Obstet. 2026 Jan 19. doi: 10.1002/ijgo.70816. Online ahead of print.

ABSTRACT

Preterm birth occurs in approximately 10% of all pregnancies, and is not only the leading cause of neonatal mortality but also a major contributor to short- and long-term morbidities due to immaturity. Preterm birth has also been linked to an increased risk of maternal cardiovascular and cerebrovascular diseases, making it a critical concern in both perinatal medicine and women’s lifelong health. Effective treatment requires interventions during threatened preterm labor, and several tocolytic agents have been developed and used in clinical practice. However, no pharmacological agent has been shown to prolong gestation and improve neonatal outcomes. Nifedipine, a calcium channel blocker, is widely used as a first-line tocolytic agent because of its oral administration route and relatively favorable safety profile compared with other drugs. Evidence from randomized controlled trials, meta-analyses, and Cochrane reviews suggests that nifedipine can delay delivery for a short period; however, robust evidence demonstrating sustained prolongation of pregnancy or improved neonatal survival is still lacking. Moreover, data on maternal hemodynamic changes and fetal effects are limited, highlighting the need for optimal dosing strategies and monitoring protocols. In this study, we discuss the clinical significance and limitations of nifedipine in the management of threatened preterm labor and outlined future directions. Future studies should involve large and homogeneous populations, continuous assessment of maternal hemodynamics, and application of novel biomarkers to support individualized therapy. Accumulation of such evidence is expected to optimize the management of threatened preterm labor and ultimately improve outcomes for mothers and infants.

PMID:41549889 | DOI:10.1002/ijgo.70816

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Ambulatory Assessment of Suicidal Desire, Wish to Live, and Wish to Die: A Comparison of Bisexual and Heterosexual College Students

Suicide Life Threat Behav. 2026 Jan;56(1):e70077. doi: 10.1111/sltb.70077.

ABSTRACT

INTRODUCTION: Bisexual individuals face elevated suicide risk, yet relatively little is known about short-term fluctuations in suicidal ideation (SI) and related constructs within this population. This study compared the frequency and variability of SI facets among bisexual and heterosexual college students.

METHOD: Sixty-two students (38 heterosexual; 24 bisexual) completed ambulatory assessments five times daily for 10 days, rating suicidal desire, wish to live (WTL), and wish to die (WTD). Analyses included generalized linear models and descriptive and variability statistics.

RESULTS: Bisexual participants reported lower WTL and higher suicide desire and WTD than heterosexual peers, with the most robust effects observed for WTD. Bisexual participants were also more likely to endorse non-zero suicidal desire and WTD and experienced more frequent large moment-to-moment changes in these constructs. Models revealed similar variability in suicidal desire and WTD across groups, whereas bisexual individuals exhibited modestly higher variability in WTL.

CONCLUSION: Findings suggested that bisexual individuals not only reported higher levels of suicidal desire and WTD but also experienced these states more frequently, with more frequent acute shifts over time. These results highlighted the importance of monitoring short-term fluctuations in suicidal thoughts and behaviors when assessing suicide risk in bisexual populations.

PMID:41549887 | DOI:10.1111/sltb.70077

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Associations Between Metabolic Heterogeneity of Obesity and Chronic Multimorbidity Progression: A Nationwide Prospective Cohort Study

Diabetes Metab Res Rev. 2026 Jan;42(1):e70125. doi: 10.1002/dmrr.70125.

ABSTRACT

AIM: To explore the impact of BMI-metabolic phenotypes and their changes on chronic multimorbidity.

METHODS: Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS), with participants aged ≥ 45. Analysing the metabolic heterogeneity of obesity through four BMI-metabolic phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy overweight/obesity (MUOO), metabolically healthy overweight/obesity (MHOO), and metabolically unhealthy normal weight (MUNW). Transition of BMI-metabolic phenotype was assessed between 2011 and 2015. Chronic multimorbidity refers to the coexistence of ≥ 2 chronic diseases among 14 specified diseases. The association between changes in BMI-metabolic phenotypes and chronic multimorbidity was applied using Cox regression.

RESULTS: Among 2528 individuals, the median age was 56.00 years, and 1244 (49.21%) had chronic multimorbidity. After adjusting for all variables at baseline, participants in the MUOO phenotype exhibited a 1.66-fold increased risk of chronic multimorbidity compared with the MHNW phenotype (95% CI: 1.42-1.94, p < 0.001), followed by the MUNW phenotype with a 1.25-fold increased risk (95% CI: 1.06-1.47, p = 0.008). However, in the MHOO phenotype, no statistically significant association was found (p > 0.05), which may reflect its heterogeneity and instability as a transient rather than benign metabolic state. In addition, obesity or unhealthy metabolism can also increase the risk of chronic multimorbidity.

CONCLUSIONS: Overall, for individuals aged ≥ 45, especially those with the MUOO phenotype, managing body weight and improving metabolic health are crucial for preventing chronic multimorbidity.

PMID:41549374 | DOI:10.1002/dmrr.70125

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A Scalable Sampling Approach for Artificial Intelligence-Based Alcohol Content Estimation in Movies

Drug Alcohol Rev. 2026 Jan;45(1):e70098. doi: 10.1111/dar.70098.

ABSTRACT

INTRODUCTION: The growing accessibility of movies through streaming platforms has expanded audience reach, but also increases exposure to alcohol portrayals, which is an established risk factor for alcohol use. Hence, estimating alcohol depictions is important yet challenging due to the time and labor involved. Artificial Intelligence offers a scalable solution for analysing movie frames; however, processing every frame of a full-length movie at 25 frames per second (fps) requires extensive computational resources. Thus, we aimed to test whether lower-frequency sampling would affect the accuracy of alcohol exposure estimates.

METHODS: We analysed 20 feature-length movies with varying known alcohol visibility and analysed each frame using zero-shot predictions from a LLaVA v1.6 model (accuracy = 95%) as our baseline. We applied uniform downsampling from 25 fps (full-framerate) to 1 fps and sparse interval sampling of 1 frame per N seconds (N = 1,2,…,10), measuring both alcohol-proportion estimates and execution time. To assess the sampling-induced error, we computed the difference score, as the difference between sampled and full-frame alcohol proportions.

RESULTS: A sampling frequency of 1 fps yielded an average difference score below 0.10 compared to the full-frame analysis, while reducing execution time by 25-fold. Error increased at sparser intervals, reaching a difference score of 0.46 at one frame per 10 s.

DISCUSSION AND CONCLUSION: Reducing the sampling frequency from 25 to 1 fps resulted in only a minimal loss of accuracy but a substantial reduction in execution time. This finding supports 1 fps as a practical and scalable sampling frequency for large-scale movie alcohol exposure estimation.

PMID:41549361 | DOI:10.1111/dar.70098

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A Prospective Multicenter Observational Study Investigating the Concordance Between Patient-Reported Hearing Loss and Commonly Used Ototoxicity Grading Systems in Patients Treated with Platinum-Based Chemotherapy

Ann Otol Rhinol Laryngol. 2026 Jan 18:34894251408705. doi: 10.1177/00034894251408705. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to compare the accuracy of the TUNE, American Speech-Language-Hearing Association (ASHA), and Common Terminology Criteria for Adverse Events (CTCAE) grading systems in reflecting the severity of treatment-related hearing loss, as measured by pure-tone audiometry and patient-reported hearing loss using the Speech, Spatial, and Qualities of Hearing scale compare questionnaire (SSQ).

METHODS: This study is a prospective, multicenter, cross-sectional, and observational study from 2018 to 2024 conducted at the Netherlands Cancer Institute – Antoni van Leeuwenhoek Amsterdam, Leiden University Medical Center, and University Medical Center Utrecht. In this trial, 109 patients with an indication for curative platinum-based chemotherapy (dose ≥ 200 mg/m2) were included, of whom 74 were eligible for analysis. Standard frequency and extended high-frequency pure tone audiometry were measured at baseline and follow-up. The SSQ was administered at follow-up to assess patient-reported outcome measures for hearing loss. The TUNE, ASHA, and CTCAE criteria were derived from audiometry. Concordance and Spearman’s correlations were evaluated between all 3 grading systems and the SSQ.

RESULTS: The concordance of TUNE with the SSQ was 81%. The concordance of CTCAE and ASHA with the SSQ was 73% and 68%, respectively. A statistically significant Spearman’s correlation coefficient of -.35 (P = .01) was found between TUNE and the SSQ. The Spearman’s correlation coefficient with CTCAE or ASHA and SSQ was -.10 (P = .10) and .04 (P = .75), respectively.

CONCLUSION: This study found that the TUNE is better in reflecting platinum-related patient-reported hearing loss compared to the CTCAE and ASHA.

PMID:41549346 | DOI:10.1177/00034894251408705

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Identifying the state of cerebrovascular autoregulation using the pressure reactivity index versus the mean flow index: Why metric matters

J Cereb Blood Flow Metab. 2026 Jan 18:271678X251406516. doi: 10.1177/0271678X251406516. Online ahead of print.

ABSTRACT

Cerebral autoregulation maintains stable cerebral blood flow despite fluctuations in cerebral perfusion pressure (CPP), through mechanisms that alter vascular diameter and resistance. Two commonly used indices, pressure reactivity index and mean flow index, reflect different aspects of this regulation, namely changes in cerebral blood volume and blood flow velocity. However, their interchangeability, particularly in the context of traumatic brain injury (TBI), remains questionable. This study investigates the frequency and physiological basis of discordance between these indices. Using 96 simultaneous recordings of intracranial pressure (ICP) and transcranial Doppler-derived flow velocity in TBI patients, 501 non-overlapping 20-minute segments were extracted. Each segment was classified based on autoregulatory state, and physiological parameters, including ICP, CPP, end-tidal CO₂, cerebral compliance, critical closing pressure, and vascular dynamics, were analysed. Discordance between indices occurred in 26% of segments. Statistical and machine learning models identified vessel stability metrics (e.g. wall tension, vascular resistance, time constant) and intracranial dynamics (e.g. compliance, compensatory reserve) as the most predictive features of discordance. These findings suggest that the two indices capture distinct physiological processes and should not be used interchangeably. Instead, their combined interpretation may enhance assessment of cerebrovascular autoregulation and provide a more nuanced understanding of cerebral physiology in TBI.

PMID:41549342 | DOI:10.1177/0271678X251406516

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Augmented reality and pain during botulinum neurotoxin A injections in children with cerebral palsy: A randomized controlled trial

Dev Med Child Neurol. 2026 Jan 18. doi: 10.1111/dmcn.70143. Online ahead of print.

ABSTRACT

AIM: To assess the effect of the augmented reality application called Minidocs on pain reduction during botulinum neurotoxin A (BoNT-A) injections in children with cerebral palsy (CP).

METHOD: Children with CP aged 3 to 8 years undergoing BoNT-A injection were randomized to usual pain management alone (n = 41) or combined with Minidocs (n = 39). Minidocs is an augmented reality application on a digital device offering several games including active distraction, hypnotic suggestion, and counter-aggression features. The primary outcome was the child’s pain during BoNT-A injection, combining patient-reported (Faces Pain Scale [FPS]) and observer-reported (Face, Legs, Activity, Cry, Consolability scale [FLACC]) outcomes. Secondary outcomes included anxiety of children (Modified Yale Preoperative Anxiety Scale) and parents (State-Trait Anxiety Inventory Form Y-1), and satisfaction with Minidocs.

RESULTS: In total, 14 out of 41 (34.1%) children in the control group and 7 out of 39 (17.9%) children in the experimental group experienced pain (i.e. FPS or FLACC scores ≥4). The difference between groups was not statistically significant (odds ratio 0.36; 95% confidence interval 0.11-1.16; p = 0.087). Changes in anxiety scores from before to after injection did not differ between groups. Satisfaction with the use of Minidocs was high.

INTERPRETATION: This study did not demonstrate the benefit of augmented reality on pain reduction. The counter-aggression feature is an innovation of Minidocs worth exploring. Further studies are needed to identify profiles of children who respond to non-drug therapies.

PMID:41549339 | DOI:10.1111/dmcn.70143

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Oral Tongue Squamous Cell Carcinoma in Young Adults in Brazil: Temporal Trends From 2013 to 2023

Oral Dis. 2026 Jan 18. doi: 10.1111/odi.70203. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to analyze the temporal trends of oral tongue squamous cell carcinoma (OTSCC) in Brazil from 2013 to 2023, comparing young adults (20 to 44 years) to older adults (≥ 45 years).

METHODS: Sex, age, staging, year, and Federative Unit of diagnosis were evaluated for all cases registered under the ICD-C02 code in a public nationwide database. Statistics encompassed the Dickey-Fuller and Mann-Kendall tests, Kendall’s Tau coefficient, and Sen’s Slope Estimator.

RESULTS: The registry of OTSCC increased from 2013 to 2023, with a stronger and more consistent trend in young adults. OTSCC showed a stronger, more consistent, and higher rate of increase in young females than in young males. OTSCC was diagnosed at advanced stages in both age groups. OTSCC increasing trends were pronounced in the North region.

CONCLUSION: This study presented an overview of the temporal trends of OTSCC in Brazil, evidencing an increase among young women.

PMID:41549338 | DOI:10.1111/odi.70203

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Additive Effects of Angiotensin Receptor-Neprilysin Inhibitors and Sodium-Glucose Cotransporter 2 Inhibitors on Neurohormonal Inhibition Therapy in Severe HFrEF: A Systematic Review and Network Meta-analysis

Am J Cardiovasc Drugs. 2026 Jan 18. doi: 10.1007/s40256-025-00784-3. Online ahead of print.

ABSTRACT

BACKGROUND: Randomized controlled trials (RCTs) have identified the additive effects of angiotensin receptor-neprilysin inhibitors (ARNIs) and sodium-glucose cotransporter 2 (SGLT2) inhibitors on neurohormonal inhibition therapy in patients with heart failure with reduced ejection fraction (HFrEF). However, their additive effects on conventional baseline therapies in patients with severe HFrEF remain unclear.

METHODS: A systematic review was conducted using the PubMed, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases until February 2025. Our review included RCTs that evaluated the effects of ARNIs or SGLT2 inhibitors in patients with severe HFrEF. The primary outcome was the composite endpoint of cardiovascular death or hospitalization for heart failure. The pooled hazard ratio (HR) was estimated through a network meta-analysis conducted using a frequentist statistical approach.

RESULTS: Five relevant trials, or their New York Heart Association class III-IV subgroups, were identified, comprising a total of 4894 patients with severe HFrEF. For the addition of SGLT2 inhibitors to neurohormonal inhibitors, the HR was 0.87 (95% confidence interval 0.75-1.01). For the addition of ARNIs, the HR was 0.96 (95% confidence interval 0.83-1.12). The certainty of evidence was moderate for SGLT2 inhibitors and low for ARNIs according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

CONCLUSIONS: Evidence for the additive effects of SGLT2 inhibitors and ARNIs in severe HFrEF remains limited, and therefore, treatment intensification with these agents should be approached with caution.

REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) identifier no. CRD42025641240.

PMID:41549334 | DOI:10.1007/s40256-025-00784-3

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Slider Versus Tensioner Median Nerve Mobilization in Patients With Frozen Shoulder Randomized Controlled Comparative Study

Physiother Res Int. 2026 Jan;31(1):e70164. doi: 10.1002/pri.70164.

ABSTRACT

BACKGROUND AND PURPOSE: Pain and a progressive loss of glenohumeral (GH) joint mobility are the hallmarks of frozen shoulder (FS), which can seriously hinder daily activities. Limited GH mobility may be linked to increased neural mechanosensitivity, which could contribute to pain and functional limitations, though the precise mechanisms are still unclear. This study was established to compare the effectiveness of slider median nerve neural mobilization techniques (NMTs) versus the tensioner technique on pain intensity, functional disability and passive ROM of the GH joint in patients with FS.

METHODS: Sixty-two patients with FS from both genders were randomly assigned to two equal groups. Group (A) received the slider technique of median nerve mobilization, whereas group (B) received the tensioner technique. All patients in both groups received GH joint mobilization and traditional physical therapy (three sessions per week for 6 weeks). Patients were evaluated for pain intensity by Visual Analog Scale (VAS), functional disability by Shoulder Pain and Disability Index (SPADI) and passive ROM of the GH joint by conventional goniometer at baseline and after the sixth week.

RESULTS: Intergroup comparison revealed that there were statistically significant differences in the post-treatment measured outcomes: VAS (p = 0.003), SPADI (p < 0.001), passive abduction ROM (p < 0.001), passive external rotation ROM (p < 0.001), passive internal rotation ROM (p < 0.001).

DISCUSSION: Both slider and tensioner median NMTs produce better improvements in pain alleviation, functional ability, and GH mobility in patients with FS, with slider approaches providing slightly greater, although incremental, benefits.

TRIAL REGISTRATION: NCT06664437.

PMID:41549328 | DOI:10.1002/pri.70164