Category: Nevin Manimala

Cancer Causes Control. 2026 Jan 17;37(2):24. doi: 10.1007/s10552-025-02110-3.

ABSTRACT

PURPOSE: This study aimed to identify provider- and practice-level factors influencing human papillomavirus (HPV) vaccine uptake among Chinese American (CA) adolescents. Despite increasing public health efforts, HPV vaccination rates in this population remain suboptimal, and knowledge on the link between provider/practice characteristics and vaccine uptake is limited.

METHODS: We analyzed data from 1,272 CA adolescents (aged 13-17) using the National Immunization Survey-Teen (2015-2019) datasets. Key measures included HPV vaccine initiation and completion (based on proxy reporting and verification), accompanied by various multilevel factors: provider-level (recommendation, specialty), practice-level (facility type, vaccine acquisition, well-child exam), parent-level (mother’s education, marital status), and adolescent-level characteristics. Weighted descriptive statistics and stepwise multivariate logistic regression were used to examine associations.

RESULTS: Overall, 71.22% of CA adolescents initiated at least one HPV vaccine dose, while 48.14% completed the regimen. Provider’s recommendation (initiation OR = 21.50, completion OR = 8.12), having a pediatrician (initiation OR = 5.37, completion OR = 3.20), and receiving the 11-12-year-old well-child exams significantly predict both initiation and completion. Regional disparities were observed, with adolescents in the Northeast and West showing higher completion rates than those in the South. Unexpectedly, adolescents not enrolled in school and those with mothers who had less than 12 years of education or were unmarried showed higher completion rates.

CONCLUSION: Provider recommendations and pediatric care are crucial for improving HPV vaccination rates among CA adolescents. Addressing regional disparities and implementing targeted interventions, including enhanced provider training focused on culturally sensitive communication, are essential to dismantle systemic barriers and improve comprehensive vaccination coverage in this underserved population.

PMID:41546778 | DOI:10.1007/s10552-025-02110-3

Cancer Causes Control. 2026 Jan 17;37(2):32. doi: 10.1007/s10552-025-02096-y.

ABSTRACT

PURPOSE: Early menarche is a known risk factor for breast cancer, as established by the Collaborative Group on Hormonal Factors in Breast Cancer in a 2012 reanalysis of data from forty-seven global epidemiological studies. Given recent changes in the average age at menarche, it is important to re-evaluate this association in the context of the past decade. This meta-analysis aimed to examine the relationship between early menarche, particularly before age 13, and female breast cancer risk by analyzing recently published observational studies and exploring this relationship across different regions of the world.

METHODS: Case-control studies published between January 2014 and February 2025 were systematically searched in PubMed, ScienceDirect, Scopus, and Google Scholar. Early menarche was defined as < 13 years. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using common-effect models when heterogeneity was low (I² ≤ 30%) and random-effects models when heterogeneity was significant (I² > 30%). Publication bias was assessed using Egger’s test.

RESULTS: Overall, results of the present meta-analyses show an increased association between menarche age < 13 and the risk of female breast cancer (OR = 1.15 [95% CI: 1.08 – 1.24]). Also, an increased association with breast cancer risk was found in the subgroup of menarche age < 12 (OR = 1.27 [95% CI: 1.09 – 1.48]). Lower OR was found in subgroup of menarche age ≥ 13 (OR = 0.89 [95% CI: 0.85 – 0.94]). For the geographical region subgroups, increased associations between menarche age < 13 and risk of breast cancer were found in Europe (OR = 1.15 [95% CI: 1.07 – 1.25]), North America (OR = 1.07 [95% CI: 1.03 – 1.11]), Oceania (OR = 1.15 [95% CI: 1.02 – 1.30]), and West Asia (OR = 1.70 [95% CI: 1.15 – 2.52]). Both population-based and hospital-based study designs demonstrated higher ORs for the association between menarche age < 13 and the risk of female breast cancer.

CONCLUSIONS: This meta-analysis found a modest but statistically significant association between menarche before age 13 and increased breast cancer risk worldwide, while women who experienced menarche at age 13 or older had a lower risk. The association varied by region, with relatively higher odds observed in West Asia, Europe, Oceania, and North America. These results indicate an association rather than causation and are limited by the observational nature of the included studies.

PMID:41546761 | DOI:10.1007/s10552-025-02096-y

Eur J Clin Pharmacol. 2026 Jan 17;82(2):36. doi: 10.1007/s00228-025-03962-z.

ABSTRACT

PURPOSE: Antibiotics are widely used in the management of bacterial infections However; most antibiotics are not known for DRESS. Our objective is to find out the association of DRESS with available antibiotics using disproportionality analysis.

METHODS: Retrospective pharmacovigilance disproportionality analysis based on the FDA Adverse Event Reporting System (FAERS) database from a period of 2004 Q1- 2022 Q3 was conducted using OpenVigil 2.1 tool. Disproportionality measures like Proportional reporting Ratio with associated Chi- square values (PRR ≥ 2 with associated χ2 ≥ 4), ROR with a 95% confidence interval (lower limit of 95% C.I. of ROR is greater than 1), and the number of cases of co-occurrence (n) were used for the identification of novel signals.

RESULTS: A total of 13,918 cases of DRESS were reported, out of which 5,455 cases were found with various classes of antibiotics. The signal of DRESS was identified with a total of 40 antibiotics. Sub groups analysis results have shown variation in the strength of signal based on gender, age groups and geographical locations. The sensitivity analysis results have shown a decrease in the strength of signal after removal of cases of concomitant drugs.

CONCLUSION: 22 antibiotics were identified which can be associated with DRESS; however, further causality assessment is required to confirm the association.

PMID:41546760 | DOI:10.1007/s00228-025-03962-z

Eur J Pediatr. 2026 Jan 17;185(2):87. doi: 10.1007/s00431-026-06752-6.

ABSTRACT

While early-life growth patterns are thought to be pivotal for long-term cardiovascular health, their specific links to adolescent blood pressure (BP) and potential mediators remain unclear. We aimed to examine the associations of growth trajectories from birth to age two with systolic and diastolic BP in adolescence, and to quantify the proportion mediated by concurrent adolescent BMI. In a prospective birth cohort in rural China, we repeatedly measured infant weight and length at birth and at 1, 3, 6, 9, 12, 18, and 24 months of age. Adolescent BP was measured and converted into percentiles. We used group-based trajectory modeling to identify early-life weight-, length-, BMI- and weight-for-length z-score trajectories and examined their associations with adolescent BP. A general causal mediation estimated the natural indirect effects and corresponding proportions mediated through adolescent BMI. Among the 1388 infants enrolled, 741 (60.9% male; mean age, 11.26 (SD, 0.57) years old) were followed at adolescence. Greater and rapid BMI and weight-for-length growth trajectories were statistically associated with elevated adolescent BP and BP percentiles, with adjusted mean differences ranging from 2.32 to 5.29 mmHg. Adolescent BMI mediated a substantial portion (up to 85%) of the association with systolic BP, but it showed no significant mediating effect for diastolic BP.Conclusion: Rapid adiposity growth in infancy predicts elevated adolescent BP. Since adolescent BMI did not fully explain this association, especially for diastolic BP, preventive interventions within the first 1000 days may be critical for lifelong cardiovascular health beyond managing later childhood weight. Trial registration: ISRCTN08850194, retrospectively registered December 14, 2006. https://www.isrctn.com/ISRCTN08850194?q=ISRCTN08850194&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10 . What is Known • Childhood body mass index (BMI) is positively associated with blood pressure at later life. What is New • This study identifies distinct weight, length, BMI, and weight-for-length growth trajectories from birth to two years of age and links rapid weight-related growth trajectories to elevated blood pressure in early adolescence. • Using causal mediation analysis, it shows adolescent BMI largely mediates the association for systolic, but not diastolic, blood pressure, highlighting interventions within the first 1000 day for lifelong cardiovascular health beyond managing later childhood weight.

PMID:41546755 | DOI:10.1007/s00431-026-06752-6

Cancer Causes Control. 2026 Jan 17;37(2):26. doi: 10.1007/s10552-025-02114-z.

ABSTRACT

PURPOSE: Breast cancer characteristics and outcomes vary by tumor subtype, poverty, race, and geography. Persistent poverty (> 20% residents in poverty for 30+ years) has been associated with breast cancer risk, but whether associations differ by subtype is unknown. We examined subtype-specific breast cancer incidence by persistent poverty, stratified by rurality and race.

METHODS: Using county-level Surveillance, Epidemiology, and End Results data from 2017 to 2021 (excluding 2020), we calculated Luminal A, Luminal B, HER2-enriched, and triple-negative breast cancer (TNBC) incidence rates. We estimated rate differences (RDs) by persistent poverty using age-adjusted and multivariable linear regression models, with stratification by rurality and county racial composition.

RESULTS: In age-adjusted models, persistent poverty counties had lower incidence of Luminal A (RD – 13.58, 95% CI = – 19.8, – 7.4) and higher TNBC (RD = 3.82, 95% CI = 2.0, 5.6) compared to non-persistently poor counties. Differences were not significant in multivariable models. In stratified analysis, higher TNBC rates were observed in persistently poor rural (multivariable RD =1.70, 95% CI = 0.3, 4.8) but not urban (multivariable RD = – 1.07, 95% CI = – 4.7, 2.5; p_int = 0.09) areas. In counties with > 5% non-Hispanic Black population, Luminal B rates were lower in persistently poor vs. non-persistently poor counties (multivariable RD = – 3.96, 95% CI = – 6.7, – 1.2; p_int = 0.03).

CONCLUSION: Results from this study suggest that differences in breast cancer subtypes by persistent poverty status are largely explained by other measures of more recent disadvantage including recent poverty, unemployment, uninsurance, and race. Targeted strategies are needed to address breast cancer disparities within socioeconomically disadvantaged communities.

PMID:41546752 | DOI:10.1007/s10552-025-02114-z

Neuroradiology. 2026 Jan 17. doi: 10.1007/s00234-025-03882-w. Online ahead of print.

ABSTRACT

PURPOSE: To assess the diagnostic performance of tumor blood volume (TBV) derived from T1 dynamic contrast-enhanced (DCE) MRI and compare it with ADC and SUV_max in distinguishing recurrence from post-treatment changes.

METHODS: This retrospective study included 73 patients with 75 focal contrast-enhancing lesions identified on surveillance MRI. Normalized TBV (nTBV_mean) was calculated from high temporal resolution DCE-MRI using the spinal cord as a reference. The 3D ROI analysis of ADC_mean and SUV_max values were obtained from DWI and ¹⁸F-FDG-PET/CT, respectively. Diagnostic performances were evaluated using multivariate logistic regression analyses, with area under the receiver operating characteristic curve (AUROC) comparisons.

RESULTS: Among the 75 lesions, 38 were recurrence and 37 were post-treatment changes. ADC_mean and SUV_max were significantly different between groups (p < 0.001), while nTBV_mean was higher in recurrence without statistical significance (p = 0.11). The AUROC of ADC_mean, SUV_max, and nTBV_mean were 0.94, 0.88, and 0.60 respectively. The combination of ADC_mean and SUV_max yielded the highest AUROC (0.99), with ADC_mean remaining the most robust predictor. TBV offered complementary value when ADC maps were degraded by susceptibility artifacts.

CONCLUSIONS: ADC_mean and SUV_max showed excellent performance in differentiating recurrence from post-treatment changes. TBV maps may offer complementary diagnostic value in cases with compromised ADC quality due to artifacts.

PMID:41546724 | DOI:10.1007/s00234-025-03882-w

Neurol Sci. 2026 Jan 17;47(1):173. doi: 10.1007/s10072-025-08732-4.

ABSTRACT

INTRODUCTION: The percentage of women neurologists is steadily increasing globally. Nevertheless women still face lower and slower levels of career progression and are less likely to reach leadership positions. In order to obtain a better understanding of the gender gap in the area of neurology in Italy, the Gender Equality Committee of the Italian Society of Neurology (SIN) conducted a survey among the society members.

METHODS: Members of the SIN were invited to complete an anonymous online survey. The questions were grouped into different sections covering work environment, research, academic career, scientific societies, work/life balance and gender equality perception. The questions were structured using Likert-type scales.

RESULTS: A total of 237 subjects (64.1% women; mean age 42.5 ± 13.6 years), representing 6.4% of the SIN members, participated in the survey. A significantly higher percentage (p < 0.0001) of women than men reported that gender influences career progression (51.5% vs 5%), academic career (91.8% vs 57.1%), access to research facilities (37.5% vs 17.1%), authorship of scientific articles (34.2% vs 8.6%), selection of contributions and speakers within scientific societies (37.9% vs 16.2%), and work-life balance (76% vs 37.5%). Overall, women felt that gender equality was poor in all the different sections.

CONCLUSIONS: In Italy women neurologists face a wide range of gender disparities affecting their professional and personal lives in the hospital and academic settings. Even if the low response rate could have affected the results, improving gender equality should be a priority in the near future.

PMID:41546722 | DOI:10.1007/s10072-025-08732-4

Eur J Clin Pharmacol. 2026 Jan 17;82(2):34. doi: 10.1007/s00228-025-03958-9.

ABSTRACT

BACKGROUND: Levosimendan and Milrinone are commonly used inotropic agents in patients undergoing cardiac surgery; there is a lack of evidence regarding the comparative safety and efficacy of both drugs. We aim to compare the clinical efficacy and safety of levosimendan versus Milrinone in these patients.

METHODS: We conducted a systematic review and meta-analysis following PRISMA guidelines. PubMed, Scopus, Web of Science, and Cochrane Central were searched up to November 30, 2024, for studies comparing levosimendan and Milrinone in adult and pediatric cardiac surgery patients. We used R statistical software to pool dichotomous data using odds ratio (OR) and continuous data using mean difference (MD) with a 95% confidence interval (CI).

RESULTS: Seventeen studies (15 RCTs and 2 observational) involving 890 patients were included. Across all efficacy outcomes, including cardiac index (MD 0.02, 95% CI -0.15-0.19), mean arterial pressure (MAP) (MD -0.09, 95% CI -1.97-1.79), and mPAP (mean pulmonary artery pressure) (MD -0.88, 95% CI -2.66, 0.89), no significant differences were found between the two drugs (P > 0.05). Safety outcomes, including all-cause mortality (OR 0.97, 95% CI 0.48-1.93), acute kidney injury (OR 0.89, 95% CI 0.55-1.44), and arrhythmias (OR 0.87, 95% CI 0.41-1.88), showed no statistically significant differences (P > 0.05).

CONCLUSION: Levosimendan and Milrinone showed no significant differences in efficacy or safety in cardiac surgery patients. However, wide confidence intervals indicate potential clinically relevant effects. Current evidence does not favor any single agent universally, supporting individualized use based on patient phenotype and institutional practice. Further high-quality trials are needed to confirm.

PMID:41546720 | DOI:10.1007/s00228-025-03958-9

Bioprocess Biosyst Eng. 2026 Jan 17. doi: 10.1007/s00449-025-03277-4. Online ahead of print.

ABSTRACT

Global economic burden due to plastic pollution is estimated to be over $3 trillion annually. Bioplastics derived from bacteria-synthesized biopolymers like polyhydroxyalkanoates (PHAs), are a remarkably versatile sustainable alternative. Research on optimal growth-conditions for microbial PHA-synthesis fed-on sustainable substrates, particularly by phototrophic-mixed-cultures (PMC) enriched with purple non-sulphur bacteria (PNSB) is essential. This study intends to understand the effect of nitrogen and phosphorus concentrations on PHA-production by PMC grown using fuel synthesis wastewater (FSW) (organic by-product of Fischer-Tropsch process) as substrate. Stoichiometric quantification and 16 S metagenomic sequencing followed by statistical and bioinformatic analysis were done. High PHA-production (65-82% of biomass) is observed to be induced by Low-Nitrogen conditions enriching Rhodopseudomonas, Paludibacter and Pleomorphomonas and a Low-Phosphorus condition enriching Rhodopseudomonas, Rhodoplanes and Lentimicrobium. Analysis of metabolic-potential revealed 16 enzymes (of 8 different PHA-synthesis-pathways) inherent within the genomes of bacteria enriched by these culture conditions. This study identifies optimal nitrogen and phosphorus concentrations and the corresponding microbial-composition of FSW substrate-grown PMC-system to maximize PHA-production in a laboratory-scale bioprocess.

PMID:41546704 | DOI:10.1007/s00449-025-03277-4

Graefes Arch Clin Exp Ophthalmol. 2026 Jan 17. doi: 10.1007/s00417-025-07110-2. Online ahead of print.

ABSTRACT

BACKGROUND: Lyme disease ophthalmic manifestations are underestimated due to a wide variety of clinical presentations and a lack of robust evidence. We performed a systematic review and meta-analysis to analyze the prevalence of ocular findings in patients diagnosed with Lyme Disease.

METHODS: This systematic review and meta-analysis was conducted following PRISMA guidelines. We systematically searched PubMed, Embase, Lilacs, and the Cochrane Central Register of Controlled Trials databases for studies enrolling patients diagnosed with Lyme disease who exhibited ocular manifestations until April 2024. The latest version of the Newcastle-Ottawa Scale (NOS) was utilized to evaluate the risk of bias. All statistical analyses were performed using RStudio statistical software version 4.3.2. Heterogeneity was assessed using I² statistics.

RESULTS: A total of 21 studies were included, comprising 859 patients. The population was mostly male (52%), with a mean follow-up of 4.6 ± 3.14 years. Diplopia and strabismus were assessed in only five studies, yet they were the most reported ocular manifestations, with a prevalence of 50.74% (CI: 36.73-65.61; I² = 10%). Anterior segment findings, including conjunctivitis, keratitis, and cataracts, had a pooled incidence of 23.76% (CI: 13.83-37.71; I² = 76%). Ten studies analyzed posterior segment findings, which included retinitis, chorioretinitis, neuroretinitis, posterior uveitis, intermediate uveitis, and retinal vasculitis, resulting in an overall prevalence of 19.66% (CI: 7.87-41.23; I² = 74%). Third cranial nerve palsy was found in 18.65% of the cases (CI: 8.91-34.95; I² = 62%), while optic nerve findings were present in 10.76% of the cases (CI: 5.43-20.22; I² = 24%).

CONCLUSION: The results of this systematic review and meta-analysis including over 859 patients suggest that ocular findings in Lyme disease such as conjunctivitis, anterior uveitis, strabismus and diplopia) are common and should raise the suspicion of infection even before serological diagnosis.

PMID:41546697 | DOI:10.1007/s00417-025-07110-2