Category: Nevin Manimala

Pflege. 2025 Apr 8. doi: 10.1024/1012-5302/a001039. Online ahead of print.

ABSTRACT

Background: Incontinence-associated dermatitis (IAD) is a sequela of fecal and/or urinary incontinence with an estimated prevalence rate of 6% to 27%. To assess the severity of IAD the Ghent Global IAD Categorization Tool (GLOBIAD) was developed. A German translation of GLOBIAD (GLOBIAD-D) is available, but psychometric testing is pending. Aim: The aim of the study was to assess the interrater reliability, practicability and clinical relevance of the GLOBIAD-D. Methods: A multicenter study with cross-sectional design was conducted in four health and social care facilities in Germany and Austria including patients/residents with IAD. The overall percentage of observation agreement (POA) and interrater reliability was assessed using data from 23 observations of an IAD. Practicability and clinical relevance were assessed using a self-administered questionnaire. Data analysis was performed using descriptive statistics, Cohen’s kappa(κ), and Cramers V. Results: A high percentage of observational agreement (n = 22; POA = 68.20%) and moderate interrater reliability (n = 22; κ = 0.55; 95% CI [0.28; 0.82]) were obtained with GLOBIAD-D. Practicability and clinical relevance of GLOBIAD-D were rated as good and it was described as a simple, understandable, user-friendly, and time efficient tool. Potential for improvement was seen in image quality as well as description of category 2A. Conclusions: GLOBIAD-D shows a high overall POA and was proved to be practical and clinically relevant. Further studies are needed to make recommendations.

PMID:40196905 | DOI:10.1024/1012-5302/a001039

Eur Heart J. 2025 Apr 8:ehae812. doi: 10.1093/eurheartj/ehae812. Online ahead of print.

NO ABSTRACT

PMID:40196897 | DOI:10.1093/eurheartj/ehae812

Eur J Prev Cardiol. 2025 Apr 8:zwaf203. doi: 10.1093/eurjpc/zwaf203. Online ahead of print.

ABSTRACT

AIMS: Elevated remnant cholesterol is a causal factor for atherosclerotic cardiovascular disease (ASCVD); however, whether aggressive lowering will reduce ASCVD is unclear. In women and men, we tested the hypothesis that aggressive lowering of remnant cholesterol has the potential for substantial ASCVD reduction. This was tested using modelling of cohort data.

METHODS: From the Copenhagen General Population Study, 56 422 women and 43 952 men without a history of ASCVD were recruited from 2003 through 2015. They were subsequently followed in national Danish health registries until December 2021 for incident ASCVD.

RESULTS: During a median follow-up of 12 years, 4 946 women and 6 043 men developed ASCVD. In women at very-high cardiovascular risk, 2 mmol/L (77 mg/dL) lower levels of remnant cholesterol from 3 mmol/L (116 mg/dL) likely reduces absolute 10-year risk of ASCVD by 17% and 13% in statin users and non-users; corresponding values in men were 20% and 15%, respectively. Corresponding values by 1 mmol/L (39 mg/dL) lower remnant cholesterol were 10% and 7% in women and 11% and 9% in men, respectively. Similar values are also provided for lower starting remnant cholesterol levels, different lowering of remnant cholesterol, and for lower baseline cardiovascular risk.

CONCLUSIONS: In women and men, aggressive lowering of remnant cholesterol has the potential for substantial ASCVD reduction. Estimated absolute risk reduction was larger in statin users versus non-users and in men versus women, likely because statin users versus non-user and men versus women are at higher baseline absolute risk.

PMID:40196895 | DOI:10.1093/eurjpc/zwaf203

Cir Pediatr. 2025 Apr 7;38(2):61-67. doi: 10.54847/cp.2025.02.15.

ABSTRACT

INTRODUCTION: Anal dilations (AD) following posterior sagittal anorectoplasty (PSARP) can have a psychological impact on patients and caregivers. We present our long-term results after changing the postoperative AD protocol to improve patient selection and avoid unnecessary ADs.

MATERIAL AND METHODS: A retrospective study of patients undergoing PSARP in our institution from 2018 to 2023 was carried out. Demographic variables, ARM types, intraoperative Hegar (IH) and postoperative Hegar (PH) size after 3 weeks, need for dilations, and follow-up were reviewed. Protocol change includes outpatient measurement on postoperative week 3. If the caliber is lower than IH or than the normal caliber based on patient age, ADs are indicated.

RESULTS: 36 patients (24 males) aged 8.2 ± 5.8 months at PSARP were included. The most frequent types of anorectal malformation (ARM) were rectoperineal (10), rectovestibular (10), and rectobulbar (10). IH size was 12 ± 1.2 mm. 3 weeks later, the caliber decreased in 29 patients (80.6%), with ADs being initiated in all of them. In 6 patients (16.7%), there were no differences in terms of size, which means ADs were not indicated. After a 40-month (range: 16-49) follow-up period, 6 (16%) patients had mucosal prolapse, with only 2 (5%) requiring surgical repair. None of the patients developed neoanal stricture.

CONCLUSIONS: The need for ADs following PSARP can be established based on outpatient neoanal measurement, by comparing neoanal size with IH size. Most patients require dilations, but there is a small group where the latter can be avoided without increasing the risk of stricture.

PMID:40196881 | DOI:10.54847/cp.2025.02.15

Front Neurol. 2025 Mar 24;16:1565395. doi: 10.3389/fneur.2025.1565395. eCollection 2025.

ABSTRACT

OBJECTIVES: Delays in diagnosing severe carotid artery stenosis (CAS) are prevalent, particularly in low-income regions with limited access to imaging examinations. CAS is a major contributor to the recurrence and poor prognosis of ischemic stroke (IS). This retrospective cohort study proposed a non-invasive dynamic prediction model to identify potential high-risk severe carotid artery stenosis in patients with ischemic stroke.

METHODS: From July 2017 to March 2021, 739 patients with ischemic stroke were retrospectively recruited from the Department of Neurology at Liuzhou Traditional Chinese Medical Hospital. Risk factors for severe CAS were identified using the least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression (MLR) methods. The model was constructed after evaluating multicollinearity. The model’s discrimination was assessed using the C-statistic and area under the curve (AUC). Its clinical utility was evaluated through the decision curve analysis (DCA) and the clinical impact curve (CIC). Calibration was examined using a calibration plot. To provide individualized predictions, a web-based tool was developed to estimate the risk of severe CAS.

RESULTS: Among the patients, 488 of 739 (66.0%) were diagnosed with severe CAS. Six variables were incorporated into the final model: history of stroke, serum sodium, hypersensitive C-reactive protein (hsCRP), C-reactive protein (CRP), basophil percentage, and mean corpuscular hemoglobin concentration (MCHC). Multicollinearity was ruled out through correlation plots, variance inflation factor (VIF) values, and tolerance values. The model demonstrated good discrimination, with a C-statistic/AUC of 0.70 in the test set. The DCA and CIC indicated that clinical decisions based on the model could benefit IS patients. The calibration plot showed strong concordance between predicted and observed probabilities. The web-based prediction model exhibited robust performance in estimating the risk of severe CAS.

CONCLUSION: This study identified six key risk factors for severe CAS in IS patients. In addition, we developed a web-based dynamic nomogram to predict the individual risk of severe CAS. This tool can potentially support tailored, risk-based, and time-sensitive treatment strategies.

PMID:40196863 | PMC:PMC11973061 | DOI:10.3389/fneur.2025.1565395

Front Public Health. 2025 Mar 24;13:1545942. doi: 10.3389/fpubh.2025.1545942. eCollection 2025.

ABSTRACT

BACKGROUND: During recurrent large-scale influenza-like illness (ILI) crises, the factors influencing the information-seeking intentions of Chinese individuals across multiple channels during crises remain underexplored.

OBJECTIVE: Guided by the risk information seeking and processing (RISP) model, this study proposes a modified RISP model to comprehensively analyze information-seeking intentions through the lens of risk communication.

METHODS: To empirically validate the proposed research model, we conducted an online cross-sectional survey with 2,604 Chinese citizens aged 18 years and older. Structural equation modeling (SEM) and ordinary least squares regression analysis were employed to analyze the survey data.

RESULTS: Our findings revealed that during ILI crises, Chinese individuals experienced a spectrum of emotions; as perceived risk increased, negative emotions intensified while positive emotions decreased. Increased negative emotions correlated with a greater sense of information insufficiency, whereas heightened positive emotions correlated with a reduced perception of it. Consequently, Chinese individuals facing information deficiencies were more inclined to seek information from diverse sources, including interpersonal sources, traditional media, search engines, and social media. Moreover, statistical analysis indicated that stronger beliefs in channel complementary strengthened the relationship between information insufficiency and information-seeking intention across multiple channels (access to medical expertise belief, tailorability belief, convenience belief, anonymity belief).

CONCLUSION: This study outlines a pathway for advancing the RISP model and offers practical strategies for effective risk communication to mitigate risks and enhance public perception and behavior. It also discusses implications for health communication, promotion, and behavior change.

PMID:40196858 | PMC:PMC11973319 | DOI:10.3389/fpubh.2025.1545942

Front Public Health. 2025 Mar 24;13:1545295. doi: 10.3389/fpubh.2025.1545295. eCollection 2025.

ABSTRACT

INTRODUCTION: The COVID-19 pandemic and the preventive measures led to a change in the health behaviour among the population. Medical students were particularly affected by this. Previous studies primarily focused on few health behaviours, were mostly conducted in 2020-2021, and did not assess the persistence of these behaviours post-pandemic.

METHODS: A combined cross-sectional and longitudinal approach were applied to examine changes in physical activity, screen time, sleep duration and consumption of unhealthy foods, alcohol and of tobacco. Data from Medical Students at the Technical University of Dresden were collected online as part of the multicenter study “Medical Student Health Survey” in 2020 and 2022. Descriptive and inferential statistical methods were applied.

RESULTS: Medical students (N = 575) reported reduced physical activity and increased screen time due to the COVID-19 pandemic, citing lockdown and changed habits as main reasons. Longitudinal analysis of medical students (N = 66) between 2020 and 2022 revealed increased physical activity (p = 0.018) and decreased unhealthy food consumption (p = 0.009) after the end of the pandemic. Screen time, sleep duration and consumption of alcohol and of tobacco products remained unchanged. Changes in health behaviours were not intercorrelated.

DISCUSSION: The COVID-19 pandemic led to change in health behaviour of medical students. However, intra-pandemic changes differing from pre-post pandemic changes and interindividual variations in health behaviour change were found. The rise in physical activity, the decreased consumption of unhealthy foods, and the low tobacco use reflect a health-aware cohort. The findings should inform the development of future preventive measures and further research is needed to understand the sustainability and broader impact of these health behaviour changes.

PMID:40196856 | PMC:PMC11973085 | DOI:10.3389/fpubh.2025.1545295

Front Cell Dev Biol. 2025 Mar 24;13:1554705. doi: 10.3389/fcell.2025.1554705. eCollection 2025.

ABSTRACT

INTRODUCTION: MYD88 (myeloid differentiation primary response 88) is a key adaptor protein mediate immune responses, primarily through Toll-like receptors (TLRs) and interleukin-1 receptor (IL-1R) signaling. The TLR/MYD88 pathway plays a critical role in dendritic cells (DC) maturation and function, contributing to the body’s innate immunity. Recent studies have further highlighted MYD88’s pivotal role in intrinsic immunity and its regulatory influence on the tumor microenvironment (TME) in hepatocellular carcinoma (HCC). The expression of MYD88 in DCs and its regulatory role in the TME have gained increasing attention.

METHODS: RNA-sequencing data retrieved from the TCGA and GEO databases were utilized for both the training and validation of our signature. Single-cell RNA transcriptome data from GEO were analyzed to investigate the correlation among subclusters of T cells, myeloid cells, and dendritic cells (DCs) within the HCC tumor microenvironment (TME). A combination of bioinformatics and machine learning approaches was employed to perform statistical analyses.Additionally, flow cytometry was conducted to quantify T cell subtypes and assess biomarker expression in DCs. A BALB/c-derived xenograft mouse model was established to evaluate the functional role of MyD88 in tumor progression and immunotherapy response. Furthermore, immunohistochemical (IHC) staining was performed to reassess the biological effects of MyD88 in HCC patients undergoing immune checkpoint inhibitor (ICI) therapy.

RESULTS: Our pan-cancer data analysis further highlights the significant impact of MYD88 on clinical outcomes in HCC. Analysis of TCGA and GEO databases confirms that MYD88 serves as a key signaling molecule in DCs, reinforcing its critical role in immune regulation. Our in vitro experiments demonstrates that MyD88 modulates T cell function through DCs. In vivo, H22 tumor cells exhibited accelerated growth in MyD88 knockout mice and a reduced response to anti-PD-1 treatment, whereas wild-type mice showed the opposite trend.

DISCUSSION: These findings underscore the critical role of MYD88 in DC function, suggesting its potential as a biomarker for immunoregulation in HCC. By shaping the TME, MYD88 not only regulates the immune response in HCC but also influences patient clinical outcomes. Both ex vivo and in vivo experiments further validate that MYD88 impacts DC functionality, contributing to variations in HCC progression.

PMID:40196847 | PMC:PMC11973264 | DOI:10.3389/fcell.2025.1554705

Front Cell Dev Biol. 2025 Mar 20;13:1489959. doi: 10.3389/fcell.2025.1489959. eCollection 2025.

ABSTRACT

INTRODUCTION: Ciprofloxacin (CPFX), a second-generation fluoroquinolone, is widely used as an anti-infective agent for genitourinary tract infections due to its broad-spectrum efficacy against gram-positive and gram-negative organisms. Although CPFX is considered safe at therapeutic doses, recent evidence suggests its potential biological toxicity, particularly affecting testicular histology and function. This study aimed to investigate the effects of CPFX on testicular structure and function and to evaluate the protective role of vitamin C.

METHODS: Forty adult male albino rats were divided into four groups: control, CPFX-treated, vitamin C-treated, and CPFX combined with vitamin C-treated. After 60 days of treatment, blood samples were collected for hormonal assays, while testicular and epididymal tissues were analyzed using light and electron microscopy. Oxidative stress markers, including malondialdehyde (MDA), glutathione (GSH), and catalase (CAT) enzyme activity, were assessed. Statistical analyses were conducted using SPSS software.

RESULTS: Confocal microscopy of the CPFX-treated group revealed significant reductions in germ cell populations within seminiferous tubules, accompanied by severe apoptosis and degenerative epithelial changes. Morphometric analysis confirmed a decrease in tubular diameter and epithelial height, degeneration of spermatogenic cells, and detachment of apoptotic cells from the basement membrane. CPFX treatment significantly reduced testosterone levels and induced variable changes in gonadotropin hormones (LH and FSH). Co-administration of vitamin C with CPFX restored normal testicular morphology, preserving seminiferous tubule integrity and maintaining spermatogenic cell populations and spermatozoa within the lumen.

DISCUSSION AND CONCLUSION: Vitamin C supplementation effectively mitigated CPFX-induced oxidative stress by significantly reducing MDA levels and enhancing antioxidant defenses, including increased GSH content and CAT enzyme activity. These findings highlight the therapeutic potential of vitamin C in reversing CPFX-induced testicular toxicity by alleviating oxidative stress and restoring testicular function.

PMID:40196846 | PMC:PMC11973441 | DOI:10.3389/fcell.2025.1489959

RSC Adv. 2025 Apr 7;15(14):10653-10662. doi: 10.1039/d5ra00193e. eCollection 2025 Apr 4.

ABSTRACT

Fermented jujube products are gradually becoming popular. However, few studies have focused on the relationship between the metabolites and aroma compounds in jujube during the fermentation process. Hence, in this study, jujube was fermented with the co-culture of Lactobacillus plantarum and Pichia pastoris, and the key volatile organic components (VOCs) and non-volatile organic components (nVOCs) in the fermented jujube juice (FJJ) were studied to determine the possible aromatic production pathway during microbial metabolism and propose the possibility of regulating flavor during fermentation. Headspace solid-phase microextraction-gas chromatography-mass spectrometry (HS-SPME-GC-MS) was employed to analyze and compare the VOCs in the jujube juice before and after fermentation, which showed that the fermented aroma had increased floral, winy and sour notes. Specifically, 13 key aroma compounds were found using the aroma extract dilution analysis (AEDA) and aroma recombination/omission model. Additionally, 32 differential nVOC metabolites, mainly involved in amino acid and nucleotide metabolism pathways, were screened in FJJ using liquid chromatography-tandem mass spectrometry (LC-MS/MS) combined with multivariate statistical analysis. After correlation analysis, 14 nVOCs were significantly correlated with 8 key aroma compounds. This study indicates that the combination of Lactobacillus plantarum and Pichia pastoris may supply a new mixed fermentation agent towards fermented jujube products and provides reference values for flavor regulation in the co-fermentation of jujube juice.

PMID:40196838 | PMC:PMC11973478 | DOI:10.1039/d5ra00193e