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Nevin Manimala Statistics

High-risk human papillomavirus positivity and associated factors among women living with HIV in public health facilities of Mekelle, Northern Ethiopia

Infect Agent Cancer. 2026 May 30. doi: 10.1186/s13027-026-00769-0. Online ahead of print.

ABSTRACT

BACKGROUND: Worldwide, it is believed that high-risk human papillomavirus (hr-HPV) strains are the root cause of many types of cancers, including cervical cancer, anorectal cancers, vaginal cancers, and penile cancers, with an estimated 922, 728 females diagnosed with HPV-related cancer in 2022. Particularly, in sub-Saharan Africa, the majority of women (55.13%) were affected by hr-HPV, and human immunodeficiency virus (HIV)-positive women have had double-fold higher risk of hr-HPV infection. Evidence is scarce in the study area; therefore, the current study aimed to assess the prevalence of hr-HPV and associated factors among HIV-positive women in public health facilities of Mekelle, Tigray, northern Ethiopia.

METHODS: A health facility-based cross-sectional study was conducted in five conveniently selected public health facilities of Mekelle, northern Ethiopia, from December 10, 2024, to July 10, 2025. The study included 390 consecutively recruited HIV-positive women, from whom questionnaire-based interviews were made, and provider-collected cervical brush specimens were processed using the Abbot cervi-collect kit in accordance with standard procedures. Following automated deoxyribonucleic acid (DNA) extraction using the Abbot m2000sp, the presence of 14 hr-HPV genotypes was detected using the m2000rt real-time polymerase chain reaction (RT-PCR) assay. Bivariate and multivariate logistic regression analyses were performed to assess the statistical association between the potential factors and hr-HPV status. Finally, statistical significance was declared at p < 0.05, along with the corresponding 95% confidence interval.

RESULT: The mean ± SD age of the respondents was 42 years (42.82 ± 9.55). The majority, 231/390 (59.2%) of the respondents, were of a normal weight, and with an overall mean Body Mass Index (BMI) of 21.77 ± 3.86 kg/m2. According to the RT-PCR, the overall prevalence of hr-HPV DNA positivity was 39.7% (155/390); [95% CI: 34.9-44.9%]. Specifically, the prevalence of HPV-16, HPV-18, and collectively the other hr-HPV types was 10.8% [95% CI: 7.7-13.8%], 3.6% [95% CI: 1.8-5.6%], and 32.7% [95% CI: 27.9-37.2%], respectively. In multivariable logistic regression analysis, condom use was assocatied with lower odds of hr-HPV infection [AOR = 0.23; 95%CI: 0.06-0.89; p = 0.034], whereas oral contraceptive use [AOR = 4.47; 95%CI: 1.39-14.28; p = 0.012], history of vaginal discharge [AOR = 2.61; 95%CI: 1.01-6.70; p = 0.046], genital ulcer disease [AOR = 4.09; 95%CI: 1.12-14.59; p = 0.030], history of unprotected sex before marriage [AOR = 2.20; 95%CI: 1.14-4.24; p = 0.017], lack of awareness about HPV-linked cervical cancer [AOR = 2.23; 95%CI: 1.18-4.24; p = 0.013], duration ( less than or equal to11 years) since ART initiation [AOR = 2.05; 95%CI: 1.13-3.74; p = 0.018], a history of 3 or more documented ART interruption events [AOR = 4.37; 95CI: 1.06-17.99; p = 0.041], and having detectable recent HIV viral load (40 copies/mL or greater) [AOR = 6.89; 95%CI: 2.75-17.28; p < 0.001] were independently associated with higher odds of hr-HPV infection.

CONCLUSION: The findings of the current study indicate a high burden (39.7%) of oncogenic HPV strains among HIV-positive women, though lower than the pooled estimates in sub-Saharan Africa. Notably, HPV-16 and the non-HPV-16/18 high-risk genotypes collectively accounted for the majority of infections. Factors that influenced the presence of high-risk HPV included a history of unprotected sex before marriage, oral contraceptive use, vaginal discharge, genital ulcer disease, lack of awareness regarding HPV and cervical cancer, a shorter duration since ART initiation, frequent ART interruptions, and detectable recent HIV viral loads.

PMID:42218531 | DOI:10.1186/s13027-026-00769-0

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Pyrethroid-resistance in Anopheles gambiae s.l (Culicidae) populations from the Sudan Savannah ecoregion in Nigeria is partly mediated by knockdown mutation

BMC Res Notes. 2026 May 30. doi: 10.1186/s13104-026-07877-5. Online ahead of print.

ABSTRACT

OBJECTIVE: Anopheles gambiae s.l. is the major malaria vector in sub-Saharan Africa, and increasing pyrethroid resistance threatens vector control. This study investigated the prevalence of knockdown resistance (kdr) mutations and pyrethroid susceptibility in An. gambiae s.l. populations from Kwara State, North-Central Nigeria.

RESULTS: A total of 250 An. gambiae s.l. mosquitoes were collected from three Local Government Areas. Molecular analysis identified An. coluzzii (31.2%, 95% CI: 25.7-37.3%), An. gambiae s.s. (16.8%, 95% CI: 12.6-22.0%), and An. arabiensis (13.6%, 95% CI: 9.9-18.4%), while 38.4% failed amplification. All populations were resistant to permethrin, deltamethrin, and alphacypermethrin (mortality < 90%), with mortality ranging from 23% to 64% across locations. Knockdown times were fastest with deltamethrin (KDT₅₀: 32.75-52.80 min) and slowest with permethrin (KDT₅₀: 39.41-93.34 min). Kdr genotyping showed 41.6% homozygous resistant (RR) and 58.4% homozygous susceptible (rr) mosquitoes; no heterozygotes were detected. These findings indicate widespread pyrethroid resistance partially mediated by kdr mutations, with significant variation among locations and sibling species. The absence of heterozygotes suggests strong selection pressure, emphasizing the need for resistance monitoring and strategic vector control interventions.

PMID:42218529 | DOI:10.1186/s13104-026-07877-5

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Psychological readiness to return to sport in elite female football players in Kosovo: a PRIA-RS cross-sectional study

BMC Sports Sci Med Rehabil. 2026 May 30. doi: 10.1186/s13102-026-01770-1. Online ahead of print.

ABSTRACT

BACKGROUND: Injury is an inevitable component of competitive football and has a significant influence on the psychological and physical well-being of the athletes. Psychological readiness to return to sport following injury is a multidimensional construct encompassing emotional, cognitive and contextual factors that influence an athlete’s transition back to training and competition.

OBJECTIVE: This study aims to evaluate the level and multidimensional structure of psychological readiness to return to sport in elite female football players using the Psychological Readiness of Injured Athletes to Return to Sport (PRIA-RS) questionnaire.

METHODS: A cross-sectional questionnaire-based study was conducted, which included 84 elite and semi-professional female football players who were undergoing the final stages of rehabilitation or preparing to return to full training post a sports-related injury. The psychological readiness of these athletes was assessed using the PRIA-RS instrument. Descriptive statistics and exploratory factor analysis (EFA) were performed to identify the underlying psychological dimensions associated with the return-to-sport readiness.

RESULTS: Most athletes reported positive perceptions of rehabilitation progress, mood, functional recovery, and overall readiness to return to training. Approximately 64.3% of the respondents rated rehabilitation progression as “very good,” while 70.2% reported having a very positive attitude at the end of rehabilitation. However, a substantial proportion reported anxiety (29.8%) and uncertainty risk towards a reinjury (23.8%) related to returning to sport. Exploratory factor analysis identified four components explaining 61.2% of total variance, representing emotional confidence, fear and anxiety, perceived functional safety, and external pressure.

CONCLUSION: Elite female football players generally report a high level of psychological readiness to return to sport following an injury, although anxiety and fear of reinjury remain prevalent in a meaningful portion of the athletes. Inclusion of psychological tools such as PRIA-RS into return-to-sport decision-making alongside physical rehabilitation provides the necessary psychological support to the athletes before them to return to full training and competition. The findings support the importance of evaluating psychological readiness as a multidimensional construct alongside physical recovery when making return to sport decisions.

PMID:42218527 | DOI:10.1186/s13102-026-01770-1

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Client perceptions and satisfaction with HIV care clinic services in post-conflict Tigray, Ethiopia: a cross-sectional study

Confl Health. 2026 May 30. doi: 10.1186/s13031-026-00807-z. Online ahead of print.

ABSTRACT

BACKGROUND: The 2020-2022 Tigray conflict affected health infrastructure, antiretroviral therapy (ART) supply chains, and continuity of HIV care. Assessing patient satisfaction during the recovery period is important to monitor service quality and inform service improvement. This study aimed to (i) measure the level of patient satisfaction among people living with HIV (PLHIV) receiving ART in post-conflict Mekelle City, (ii) model the relationships between four service-quality dimensions and overall satisfaction, and (iii) identify determinants of overall satisfaction with HIV care clinic services.

METHODS: The study was conducted from October to November 2024 in Mekelle City, Tigray (eight public facilities and three operated by non-governmental organizations (NGOs)). Eligible participants were adults (≥ 18 years) on ART for at least 12 months. Patient satisfaction was measured using a 21-item, 5-point Likert-scale questionnaire covering four domains: provider-client relationship (PCR), availability and accessibility of care (AAC), quality of care services (QCS), and facility and service environment (FSE). Confirmatory factor analysis (CFA) was used to validate the four-factor measurement model, a second-order structural equation model (SEM) examined associations between the four domains and overall satisfaction, and binomial logistic regression identified determinants of dichotomised overall satisfaction (mean composite score > 3.69 = satisfied).

RESULTS: Of 631 eligible patients, 569 consented (90.17%); 521 were retained after exclusions. Mean age was 42.4 years and 60.7% female. Overall, 62.4% reported satisfaction with HIV care clinic services. Domain-level satisfaction was: 64.5% for PCR, 31.5% for AAC, 57.2% for QCS, and 57.4% for FSE. The second-order SEM showed strong, statistically significant standardised associations between overall satisfaction and each domain (PCR β = 0.920; AAC β = 0.963; QCS β = 0.925; FSE β = 0.985; all p < 0.001). In multivariable logistic regression, clients at tertiary-level facilities (OR = 0.50, 95% CI 0.37-0.67) and at public facilities (OR = 0.64, 00195% CI 0.54-0.76) had significantly lower odds of satisfaction; sociodemographic and clinical variables were not independently associated with satisfaction.

CONCLUSIONS: Overall satisfaction with HIV care clinic services in post-conflict Mekelle City was 62.4%, below Ethiopia’s Health Sector Transformation Plan-II (HSTP-II) target of 80% and at the lower end of the Ethiopian pooled estimate of 69.7% (95% CI 63.8-75.5%). All four service-quality domains were strongly associated with overall satisfaction, and tertiary-level and public facilities had lower odds of satisfaction. Targeted quality improvement is warranted across access, environment and quality-of-care dimensions, particularly at tertiary and public facilities. Whether changes in satisfaction translate into ART interruption, virologic failure, or drug resistance was outside the scope of this cross-sectional analysis and should be examined in longitudinal research.

PMID:42218526 | DOI:10.1186/s13031-026-00807-z

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Transfusion and mortality after major trauma in patients on direct oral anticoagulants: a multicentre cohort study

Scand J Trauma Resusc Emerg Med. 2026 May 30;34(1):99. doi: 10.1186/s13049-026-01640-2.

ABSTRACT

BACKGROUND: Major trauma in patients with direct oral anticoagulants (DOACs) is increasing as treatment with DOACs is becoming more prevalent. DOACs add complexity to trauma due to increased risk of bleeding. The primary aim of this study was to compare the likelihood of packed red blood cell (PRBC) transfusion and PRBC volumes in patients with DOACs to non-anticoagulated controls after major trauma. Secondary aims were to compare mortality rates between these groups.

METHODS: This was a multicentre retrospective cohort study with four participating hospitals. Inclusion criteria were age ≥ 18 years and admission for trauma with New Injury Severity Score (NISS) > 15 from Jan 1, 2019, to Dec 31, 2023. The Swedish Trauma Registry and medical records were used to identify patients and to retrieve data. For primary weighted analyses, propensity scores for DOACs were estimated using sex, age, injury mechanism, ASA class, antiplatelet treatment, and NISS. Non-weighted adjusted regression models were used for complementary analyses.

RESULTS: A total of 1817 patients were admitted for major trauma during the study period, of which 756 patients were included in the analytic cohort. PRBC was administered to 30.8% of patients with DOACs and to 20.7% of controls. PRBC likelihood was higher among patients with DOACs (OR 1.73, 95% CI 1.03-2.91). The number of PRBC units among patients who received transfusions was not significantly higher for DOACs (GMR 1.11, 95% CI 0.79-1.56). Mortality rates within 24 h and 30 days did not differ significantly in primary analyses (OR 1.82, 95% CI 0.78-4.23 and OR 1.34, 95% CI 0.80-2.24, respectively).

CONCLUSIONS: Patients with DOACs were more likely to receive PRBC transfusion, but PRBC volumes were not significantly different among transfused patients. Mortality did not differ significantly in the primary weighted analyses.

PMID:42218522 | DOI:10.1186/s13049-026-01640-2

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Laparoscopic liver biopsy in buffaloes with tru-cut needle yields superior liver samples

BMC Vet Res. 2026 May 30. doi: 10.1186/s12917-026-05595-5. Online ahead of print.

ABSTRACT

BACKGROUND: Liver biopsy is a valuable diagnostic tool for diagnosing hepatobiliary diseases in ruminants. Although laparoscopic biopsy is established in cattle and small animals, there is no standardised comparison of the biopsy instruments for buffaloes (Bubalus bubalis).

OBJECTIVES: This study aimed to compare the quality of liver samples obtained by laparoscopy using three instruments: Babcock forceps (B1), laparoscopic biopsy forceps (B2) and a 14G truss cut needle (B3). We hypothesised that the tru-cut needle would provide superior samples with fewer artefacts.

STUDY DESIGN: Prospective experimental study.

METHODS: To understand sedation and epidural anaesthesia, laparoscopic liver biopsies were performed on five healthy female buffaloes. Using a right intercostal approach, three sequential samples were collected from each animal with B1, B2, and B3. The samples were histologically evaluated for quality (presence of portal /central veins), sufficiency, and artefacts (edge squeeze and detachment). The area was measured digitally. Statistical analysis used Cochran’s Q and post-hoc McNemar tests (α = 0.05).

RESULTS: The truss truss cut needle (B3) produced adequate quality samples in 100% of cases, compared to 80% for B2 and 60% for B1. Sample sufficiency was higher for B2 and B3 (80% each) than for B1 (0%; P = 0.0408). Edge detachment was significantly lower for B3 (20%) than for B2 (40%) and B1 (100%; P = 0.0388). Crush artifact was absent in B3 samples but present in 60% of B1 and B2 samples.

MAIN LIMITATIONS: The small sample size (n = 5) of healthy animals limits statistical power and generalisability to clinical cases. The fixed order of the instrument may have introduced a sequence bias.

CONCLUSIONS: Laparoscopic liver biopsy with a truss cut needle yields diagnostically superior samples with significantly fewer artefacts compared to forceps-based techniques in buffaloes, recommending it as the instrument of choice for this species.

PMID:42218513 | DOI:10.1186/s12917-026-05595-5

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Return to Sport After Surgical Treatment of Capitellar Osteochondritis Dissecans Lesions in Baseball Players: A Systematic Review and Meta-analysis

Am J Sports Med. 2026 May 30:3635465261443986. doi: 10.1177/03635465261443986. Online ahead of print.

ABSTRACT

BACKGROUND: Because of the difficulty of baseball players with capitellar osteochondritis dissecans (OCD) lesions to return to sport (RTS), multiple operative strategies have been used for these lesions. However, there has yet to be a systematic review of RTS outcomes in specifically baseball players.

PURPOSE/HYPOTHESIS: The purpose of this study was to compare the RTS rates between surgical procedures for capitellar OCD lesions in youth baseball players, with a secondary purpose of comparing improvements in elbow range of motion (ROM) and improvements in Timmerman-Andrews scores between surgical procedures. The authors hypothesized that RTS rates would not differ based on the surgical procedure for capitellar OCD lesions in youth baseball players.

STUDY DESIGN: Systematic review; Level of evidence, 4.

METHODS: The authors performed a literature search in February 2025 to identify studies evaluating postoperative outcomes for the treatment of capitellar OCD lesions in youth baseball players. Surgical procedures were grouped into debridement/loose-body removal ± microfracture, fixation procedures, bone peg grafting, and autologous osteochondral transplantation. Preoperative and postoperative elbow flexion and extension ROM, Timmerman-Andrews scores, and RTS rate and time were collected. Meta-analysis included pooled effect estimates for improvements in flexion ROM, extension ROM, and Timmerman-Andrews scores, as well as the proportion of RTS, applying a common effect model.

RESULTS: Overall, 462 studies were screened and 16 studies were included. There were 389 total youth baseball players and 89% of lesions were unstable. RTS after autologous osteochondral transplantation (175/182; 96%) was more likely than after fixation (68/76; 89%), bone peg grafting (27/31; 87%), or debridement/loose-body removal ± microfracture (59/70; 84%) (P = .022). Overall, 31 of 60 (52%) pitchers were able to return to pitching. Fixation procedures were associated with greater improvements in elbow extension ROM (8° vs 3°; P = .013) than autologous osteochondral transplantation. Fixation procedures (score, 71) and autologous osteochondral transplantation (score, 58) also had greater improvements in Timmerman-Andrews scores than bone peg grafting (score, 26; P < .001); however, there was significant heterogeneity across studies and large differences in preoperative Timmerman-Andrews scores across groups.

CONCLUSION: Overall, 92% of youth baseball players RTS after operative management of capitellar OCD lesions, with the highest RTS rates after autologous osteochondral transplantation; however, almost half of pitchers are unable to return to pitching. Clinicians can counsel injured youth baseball players that capitellar OCD lesions indicated for autologous osteochondral transplantation can have similar or better RTS outcomes than OCD lesions indicated for fixation or debridement ± microfracture.

PMID:42216683 | DOI:10.1177/03635465261443986

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Compassion Fatigue and Spiritual Care Competence Amongst Palliative Care Nurses: A Moderated Mediation Model of Care Quality and Job Satisfaction

J Clin Nurs. 2026 May 30. doi: 10.1111/jocn.70381. Online ahead of print.

ABSTRACT

AIMS: To examine the association between compassion fatigue and spiritual care competence amongst palliative care nurses, investigate the mediating role of palliative care quality and determine the moderating effect of job satisfaction.

BACKGROUND: Palliative care nurses face intense emotional demands and end-of-life stressors, increasing their risk of compassion fatigue and potentially affecting care delivery. Spiritual care competence is central to holistic palliative nursing; however, its association with compassion fatigue and the organisational factors shaping this relationship remain unclear.

DESIGN: A cross-sectional, correlational study.

METHODS: Using a convenience sampling approach, 141 nurses working in palliative care units across hospitals in different regions of Türkiye were recruited. Data were collected between April and August 2024 via an online questionnaire including demographic variables and validated instruments measuring compassion fatigue, palliative care quality, spiritual care competence and job satisfaction. Data were analysed using SPSS and PROCESS macro.

RESULTS: The mean spiritual care competence score was 107.9 ± 14.7. Compassion fatigue was negatively associated with palliative care quality and spiritual care competence, whereas palliative care quality was positively associated with spiritual care competence. Mediation analysis indicated a significant indirect association between compassion fatigue and spiritual care competence through palliative care quality. Moderated mediation analysis indicated that this indirect effect was significant only amongst nurses reporting higher job satisfaction.

CONCLUSIONS: Compassion fatigue was negatively associated with palliative care nurses’ spiritual care competence. Mediation analysis suggested that this association was statistically explained by palliative care quality, whilst job satisfaction moderated the relationship between compassion fatigue and care quality.

RELEVANCE TO CLINICAL PRACTISE: Addressing compassion fatigue as a critical occupational risk in palliative care nursing is essential. Organisational strategies that enhance job satisfaction and support high-quality care delivery may help sustain nurses’ spiritual care competence and promote high-quality palliative nursing practise.

PATIENT OR PUBLIC CONTRIBUTION: No patients or members of the public were involved in this study. Palliative care nurses participated by completing online questionnaires.

REPORTING METHOD: This cross-sectional study was reported in accordance with the STROBE Statement.

PMID:42216662 | DOI:10.1111/jocn.70381

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Metabolic Brain Network Reorganization in Temporal Lobe Epilepsy With Aware or Impaired Awareness Seizures

J Integr Neurosci. 2026 May 9;25(5):47320. doi: 10.31083/JIN47320.

ABSTRACT

BACKGROUND: Temporal lobe epilepsy (TLE) is increasingly recognized as a dysfunction of the brain network. However, the topological alterations of the metabolic brain network underlying impaired awareness seizures (IAS) remain unclear. In this study, we aimed to characterize metabolic network reorganization in patients with TLE and IAS (TLE-IAS) and to preliminarily investigate the specificity of these alterations by comparing the results with those of patients with TLE and aware seizures (AS).

METHODS: This retrospective study included a total of 193 TLE-IAS patients, 30 patients with TLE-AS, and 193 controls. Metabolic brain networks were constructed for all groups, and nonparametric permutation testing was applied to compare group differences in graph-theoretical metrics and hub node distribution.

RESULTS: Compared with controls, both TLE patient groups exhibited globally weakened metabolic connectivity. Graph-theoretical analysis revealed that both groups demonstrated significant increases in characteristic path length and significant decreases in clustering coefficient (Cp). Furthermore, the TLE-AS group showed a significant decrease in local efficiency compared with controls. No statistically significant differences were found between the two patient groups across the four graph-theoretical parameters. Hub analysis revealed a convergent reorganization in both groups involving loss of default mode network hubs and a limbic/paralimbic shift, with the TLE-IAS group showing more limbic hubs, while the TLE-AS group exhibited more primary auditory hubs.

CONCLUSIONS: This study revealed alterations in graph-theoretical parameters and hub distribution in patients with TLE-IAS and TLE-AS. These findings provide preliminary metabolic imaging evidence for the neural substrates underlying impaired awareness in TLE.

PMID:42216648 | DOI:10.31083/JIN47320

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Influence of Gait Speed on Spatiotemporal Parameters in Advanced Parkinson’s Disease Following Subthalamic Nucleus Deep Brain Stimulation

J Integr Neurosci. 2026 May 25;25(5):48076. doi: 10.31083/JIN48076.

ABSTRACT

BACKGROUND: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a recognized treatment for advanced PD, yet its impact on gait parameters remains variable. The aim of this prospective study was to evaluate changes in spatiotemporal gait parameters following DBS-STN in patients with advanced PD.

METHODS: Thirty patients with advanced PD underwent bilateral DBS-STN. Gait assessments were performed preoperatively and three months postoperatively using a pressure-sensitive treadmill under three walking speed conditions (slow, optimal and fast). Spatiotemporal gait parameters (as walking speed, double-stance phase, cadence, step length, stance phase duration) and derived values, such as asymmetry of both step length and stance phase, were analyzed with respect to the clinically better and worse limbs defined in accordance with Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS).

RESULTS: No significant changes in walking speed, cadence, or double stance phase duration comparing gait characteristics pre- and postoperatively were found. Significant improvements were found in step length for the clinically worse limb at slow and optimal walking speeds and in stance phase duration for the clinically better limb at fast walking speed. Additionally, asymmetry in both step length and stance phase duration decreased at the fast walking speed after stimulation. For all other parameters evaluated in other walking speeds, the differences were not statistically significant.

CONCLUSIONS: DBS-STN combined with medication had limited overall effects on spatiotemporal gait parameters in patients with advanced PD. However, when the clinically worse and better lower limbs were analyzed separately, selective improvements in step length and stance phase duration, along with reduced gait asymmetry at higher walking speeds were observed. These findings suggest that DBS may modulate specific components of gait control rather than global gait performance, highlighting the importance of individualized assessment in postoperative gait evaluation.

PMID:42216637 | DOI:10.31083/JIN48076