Category: Nevin Manimala

J Chemother. 2025 Dec 26:1-9. doi: 10.1080/1120009X.2025.2605782. Online ahead of print.

ABSTRACT

Bevacizumab is a monoclonal antibody targeting vascular endothelial growth factor-A (VEGF-A), a key mediator of tumor angiogenesis. Among VEGF-A splice variants, VEGF-A_xxxa has proangiogenic activity, whereas VEGF-A_xxxb exerts anti-angiogenic effects. Recent methodological advances have enabled accurate quantitative assessment of the plasma VEGF-A_xxxa, defined as the proportion of VEGF-A_xxxa relative to total VEGF-A. In this study, we evaluated the predictive potential of the VEGF-A_xxxa ratio for bevacizumab efficacy in patients with non-squamous non-small cell lung cancer treated with carboplatin and paclitaxel with or without bevacizumab. A higher VEGF-A_xxxa ratio (≥0.45) was associated with significantly longer progression-free survival and overall survival in the bevacizumab-treated group, with statistically significant treatment interactions. These results suggest that the plasma VEGF-A_xxxa ratio may serve as a minimally invasive biomarker with potential utility for predicting clinical benefit from bevacizumab.

PMID:41454602 | DOI:10.1080/1120009X.2025.2605782

J Asthma. 2025 Dec 26:1-21. doi: 10.1080/02770903.2025.2610344. Online ahead of print.

ABSTRACT

Effective pediatric asthma management relies on medication adherence, correct inhaler technique, and positive parental illness perception. This study examined the levels, interrelationships, and predictive value of these factors for asthma control among children aged 7-11 years. In this cross-sectional observational study, 62 children with asthma and their caregivers were recruited from community and clinical settings in Alabama, USA. Asthma control was assessed using the Childhood Asthma Control Test (C-ACT), medication adherence via the Medication Adherence Report Scale for Asthma (MARS-A), and parental illness perception via the Asthma Illness Representation Scale (AIRS), including five subscales: Attitudes Toward Medication Use, Treatment Expectations, Facts About Asthma, and Nature of Symptoms/Emotional Aspects. Inhaler technique was evaluated using a pressurized metered-dose inhaler (pMDI) with a spacer via a 9-step checklist. Descriptive statistics summarized outcomes, and correlations and regressions explored relationships. Only 34.77% of participants demonstrated correct inhaler technique. Inhaler technique correlated positively with asthma control (r_s=.25, p=.048), and medication adherence correlated with parental attitudes toward medication (r_s=.46, p<.001). Regression showed that later age at diagnosis predicted poorer asthma control (B=-0.64, p=.008). Ordinal regression indicated that higher caregiver education (high school: B=-5.73, p=.019; college: B=-4.90, p=.027) and perceiving income as exceeding expenses (B=-4.63, p=.045) were associated with better asthma control. Despite favorable control scores, incorrect inhaler use and suboptimal adherence remain challenges. Parental perceptions and sociodemographic factors, particularly education and financial well-being, significantly influence outcomes. Findings underscore the need for family-centered educational strategies to improve pediatric asthma management.

PMID:41454597 | DOI:10.1080/02770903.2025.2610344

Med Decis Making. 2025 Dec 26:272989X251406639. doi: 10.1177/0272989X251406639. Online ahead of print.

ABSTRACT

BackgroundWhile machine learning (ML) models are increasingly used to predict outcomes in health care, their practical effect on health care operations, such as bed capacity management, remains underexplored. There is a variety of traditionally used evaluation metrics to analyze ML models; however, decision makers in health care settings require a deeper understanding of their implications for resource management. Traditional performance measures often fail to provide this practical insight.MethodsIn this work, we conduct a simulation study to evaluate the impact of ML-driven length-of-stay (LOS) predictions on intensive care unit (ICU) bed capacity management. Two classification models differing in terms of explainability and interpretability, logistic regression (LR) and extreme gradient boosting (XGB), are applied to predict ICU-LOS. We use the HiRID dataset containing high-frequency data of more than 33,000 patients. The predictions of the ML models are integrated into a simulation framework that replicates real-world ICU bed management, allowing for the assessment of the practical implications of using these algorithms in a clinical setting.ResultsThe application of both classification models results in improved capacity control regarding the key performance indicators in the simulation study, with XGB outperforming LR. While LR leads to slight overoccupancy in the ICU, slight underoccupancy can be observed when XGB is applied.ConclusionOur study bridges the gap between predictive accuracy and practical application by emphasizing the importance of evaluating ML models within the context of ICU capacity management. The simulation-based approach offers a more relevant assessment for health care practitioners, providing actionable insights that go beyond classical performance measures and directly address the needs of decision makers in clinical practice.HighlightsWe apply multiple classification models for ICU-LOS prediction using time-series data. This approach enables an update of the initial prediction resulting in the possibility of efficiently managing intensive care capacities.We present a simulation-based approach to evaluate ML algorithms and their impact on bed capacity management in real-world clinical settings.Our work provides in-depth insights into the impact of using ML techniques as decision support systems in the ICU and can lead to increased acceptance in practice.

PMID:41454594 | DOI:10.1177/0272989X251406639

Cancer Med. 2026 Jan;15(1):e71491. doi: 10.1002/cam4.71491.

ABSTRACT

BACKGROUND: Paracentesis temporarily relieves malignant ascites but causes hypoalbuminemia. Cell-free and concentrated ascites reinfusion therapy (CART) reinfuses autologous proteins to prevent hypoalbuminemia and has been increasingly used in Japan. However, CART has not been widely adopted outside of Japan, and its benefit remains unclear. We evaluated the clinical outcomes and healthcare costs of CART compared with paracentesis in metastatic cancer.

METHODS: This retrospective cohort study included hospitalized patients with metastatic solid cancer receiving CART or paracentesis across Japan (April 2016-March 2023). Baseline characteristics were balanced using overlap propensity-score weighting. Primary outcomes were in-hospital mortality, functional disability, and 30-day unplanned readmission. Secondary outcomes were length of stay (LOS), albumin administration or re-drainage rates, and costs. Mortality risk was assessed using a modified Poisson regression. The composite primary outcomes were assessed using a win-ratio approach.

RESULTS: Among 1159 patients (CART: 457, paracentesis: 702) from 51 hospitals, the CART group had lower mortality than the paracentesis group (28.6% vs. 36.7%; risk ratio: 0.78, 95% confidence intervals [95% CI]: 0.64-0.94). The win-ratio analysis also favored the CART group over the paracentesis group (win ratio: 1.34, 95% CI: 1.09-1.64). Additionally, CART was associated with lower mortality and better composite outcomes than paracentesis, particularly among males, patients with serum albumin ≤ 2.5 g/dL, and those with non-gastrointestinal cancer. Despite higher procedural costs, CART was associated with shorter median LOS (14.1 vs. 19.0 days), lower albumin administration (11.6% vs. 17.3%) and re-drainage (32.7% vs. 52.7%) rates, and lower total median costs (4490.9 [interquartile range: 2042.3-7054.5] vs. 5084.1 [interquartile range: 3054.7-8659.7] USD) than paracentesis.

CONCLUSIONS: CART was associated with improved clinical outcomes and healthcare costs over paracentesis among hospitalized patients with metastatic cancer, particularly in males, patients with serum albumin ≤ 2.5 g/dL, and those with non-gastrointestinal cancer. These findings may support clinical decision-making and resource allocation.

PMID:41454579 | DOI:10.1002/cam4.71491

J Food Sci. 2026 Jan;91(1):e70794. doi: 10.1111/1750-3841.70794.

ABSTRACT

The growing interest in natural alternatives to synthetic additives has driven research into essential oils (EOs) for antimicrobial and antioxidant applications. Statistical mixture design approaches provide effective tools to optimize multi-component EO blends for enhanced bioactivity. This review presents an overview of recent advances in applying mixture design methodologies, such as simplex lattice and simplex centroid designs, to develop EO combinations with improved antimicrobial and antioxidant activity. We summarize key findings on blend synergies, discuss mechanisms underlying enhanced efficacy, and highlight case studies where optimized mixtures outperform the action of individual EOs. Current patents and practical applications of optimized EO blends are reviewed, and future research directions are proposed, including multi-component formulations, encapsulation approaches, and machine learning-driven optimization. By synthesizing these insights, this review highlights mixture design as a sustainable and innovative approach to developing eco-friendly, effective EO-based antimicrobial and antioxidant formulations.

PMID:41454556 | DOI:10.1111/1750-3841.70794

J Environ Sci Health A Tox Hazard Subst Environ Eng. 2025 Dec 26:1-11. doi: 10.1080/10934529.2025.2607921. Online ahead of print.

ABSTRACT

BACKGROUND: Climate variability and air pollution adversely affect stroke, yet comprehensive global assessments are lacking. This study investigates their impact on age-standardized stroke mortality rates (ASMR) from 2000-2020.

METHODS: We analyzed 179 countries using the Global Burden of Disease Study 2021 (GBD 2021) data for stroke ASMR, European Center for Medium-Range Weather Forecasts Reanalysis v5 (ERA5) climate data, and air pollution data (nitrogen dioxide [NO₂], fine particulate matter [PM₂.₅], ground-level ozone [O₃]). Climate variability indicators included temperature and humidity deviance percentages, extreme weather events, and variability measures. Linear mixed-effects models examined associations between stroke ASMR and climate variability indicators, air pollution, Socio-Demographic Index (SDI), smoking, and alcohol consumption.

RESULTS: Global stroke ASMR substantially decreased from 2000-2020, driven by increased SDI and reduced smoking. Each 2.34% decrease in negative humidity deviance increased ASMR by 0.98/100,000 (95% CI: 0.21-1.76; p < 0.05). Each 13.16-day increase in extreme hot days raised ASMR by 0.59/100,000 (95% CI: 0.14-1.04; p < 0.05). Each 14.01-day increase in extreme cold days elevated ASMR by 0.67/100,000 (95% CI: 0.24-1.11; p < 0.05). Each 9.7 ppb ozone increase statistically significantly raised ASMR by 7.41/100,000 (95% CI: 6.02-8.80; p < 0.05).

CONCLUSION: These associations suggest potential benefits from addressing climate variability mitigation, air pollution control, and stroke prevention to reduce global stroke mortality burden.

PMID:41454553 | DOI:10.1080/10934529.2025.2607921

Ann Med. 2026 Dec;58(1):2603036. doi: 10.1080/07853890.2025.2603036. Epub 2025 Dec 26.

ABSTRACT

BACKGROUND/OBJECTIVE: Although once-weekly and once-daily DPP-4 inhibitors have gained widespread market recognition, patient preference differences remain a key focus. This meta-analysis compares treatment preferences for once-weekly versus once-daily DPP-4 inhibitors in T2DM, offering evidence to guide clinical decisions and healthcare policies.

METHODS: PubMed, OVID, EBSCO, Web of Science, CNKI, Wanfang, and clinical trial registries were searched up to June 30, 2025. After screening literature against predefined criteria, a systematic review was conducted to compare the effects of once-weekly and once-daily DPP-4 inhibitors on the treatment preferences of patients with T2DM.

RESULTS: 8 RCTs with 1,575 participants were analyzed. No significant difference in medication adherence and DTSQ total score between the once-weekly and once-daily groups (p > 0.05). HbA1c percentage (MD = -0.21, 95% CI [-0.42, -0.01], p < 0.05) decreased significantly with once-weekly dosing, while GA and FPG showed no change (p > 0.05), this suggests greater improvement in HbA1c percentage levels following a switch to once-weekly DPP-4 inhibitors. Once-weekly DPP-4 inhibitors showed higher musculoskeletal/connective tissue disorder risk (RR = 2.63; 95% CI [1.18, 5.83]), but no significant differences in other adverse events (p > 0.05). No significant differences in treatment burden between both groups (p > 0.05).

CONCLUSION: No statistically significant association between treatment preferences for once-weekly versus once-daily DPP-4 inhibitors among T2DM patients and medication adherence, treatment satisfaction, glycemic level changes, safety, or treatment burden for these two dosing regimens. Further research is needed to elucidate the influence of physician prescribing behavior on these preferences.

PMID:41454522 | DOI:10.1080/07853890.2025.2603036

Psychophysiology. 2026 Jan;63(1):e70213. doi: 10.1111/psyp.70213.

ABSTRACT

Poor sleep has been associated with cardiovascular disease (CVD). Research indicates a bidirectional relationship between stress and disrupted sleep. It is possible individual differences in cardiovascular and psychological responses to acute stress may be a pathway connecting sleep and CVD. Research has also separately found biological sex may impact sleep and CVD outcomes. While studies examining subjective sleep and cardiovascular reactivity to acute stress show mixed results, few have concurrently assessed psychological stress responses or considered the moderating role of biological sex. The current paper aimed to explore the associations between subjective sleep quality and cardiovascular and psychological responses to acute stress and the role of biological sex as a potential moderator in this relationship. In two independent studies (Study 1: N = 154, 50.6% female; Study 2: N = 212, 64.2% female), young adults completed a resting baseline period followed by standardized psychological stress tasks with cardiovascular activity measured throughout. Following the stress task, participants rated the intensity and interpretation of their stress during the task. Participants also completed a questionnaire regarding their sleep over the past month. Across both studies, subjective sleep quality was not statistically significantly associated with cardiovascular reactivity (all ps ≥ 0.286, all βs ≤ 0.08). However, worse sleep was significantly associated with increased levels of stress intensity (all ps ≤ 0.023, all βs ≤ 0.22) and more debilitative interpretations of stress during the acute psychological stress task (all ps ≤ 0.020, all βs ≥ -0.25). Biological sex did not moderate any of these relationships (all ps ≥ 0.073). Results indicate that poor subjective sleep quality is associated with psychological, not physiological, responses to stress. Perceptions of stress may be a mechanism linking poor sleep and CVD.

PMID:41454435 | DOI:10.1111/psyp.70213

Eur J Med Res. 2025 Dec 26. doi: 10.1186/s40001-025-03636-7. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to analyse the caesarean section (CS) rates in a tertiary care centre using Robson’s Ten-Group Classification System (TGCS) to identify contributing factors and inform strategies for reducing CS rates.

METHODS: This retrospective study was conducted at Tertiary care Hospital Pune India, during August-December 2023. Data were collected on all live and stillbirths with a birth weight ≥ 500 g or gestational age ≥ 28 weeks. CS rates were classified according to Robson’s 10-group classification, and statistical analysis was performed to determine the relative contribution of each group.

RESULTS: The total number of deliveries was 2493, of which 1345 were CS (53.95%). The highest contribution to CS was from Group 5 (previous CS, term, cephalic), accounting for 37.92% of all CS. Group 2 (nulliparous, induced or pre-labour CS) contributed 34.42%. The lowest CS rates were seen in Groups 1 and 3 (spontaneous labour, nulliparous and multiparous). Groups 6 to 10, representing breech, multiple pregnancies, and preterm deliveries, had near 100% CS rates.

CONCLUSION: The study highlights a high CS rate, mainly due to repeat CS and induced labours. The Robson classification proved effective in identifying key groups contributing to the CS rate. Reducing unnecessary CS, promoting vaginal birth after caesarean (VBAC), and refining induction protocols could help lower CS rates. Future efforts should also focus on improving labour management and monitoring.

PMID:41454415 | DOI:10.1186/s40001-025-03636-7

Malar J. 2025 Dec 26. doi: 10.1186/s12936-025-05735-6. Online ahead of print.

ABSTRACT

BACKGROUND: Malaria remains a significant global health challenge despite remarkable declines in incidence, in Isfahan Province, Iran, historically considered an endemic area. Although national elimination programmes have reduced transmission, imported cases continue to sustain malaria risk. This study aimed to assess the epidemiological and clinical characteristics of malaria in Isfahan Province from 2009 to 2025.

METHODS: A retrospective observational analysis was conducted using surveillance data from the Isfahan Center for Disease Control. All microscopically confirmed malaria cases reported between January 2009 and January 2025 were included. Demographic, epidemiological, and clinical data were extracted via a standardized checklist. Descriptive statistics and multivariable logistic regression were applied to identify trends and risk factors for severe malaria.

RESULTS: A total of 569 cases were reported during the study period, with incidence declining sharply after 2009, but fluctuating during subsequent years, including a resurgence in 2024. Most cases occurred in males (96.1%) and individuals aged 15-24 years (53.6%), with Afghan nationals comprising 80.8% of infections. Imported cases represented 80.8% of the total burden, underscoring migration-related risks. Plasmodium vivax accounted for 88.0% of cases, while Plasmodium falciparum (4.6%) was strongly associated with severe disease (adjusted odds ratio 22.6; 95% CI 1.24-410.8; p = 0.035). Seasonal peaks were observed in spring and summer, and per capita incidence was higher in rural counties despite absolute urban predominance.

CONCLUSIONS: Malaria incidence in Isfahan Province has markedly declined over the past 16 years; however, imported cases, predominantly among migrant workers, remain the central challenge to elimination. The dominance of P. vivax alongside the clinical severity of P. falciparum highlights the need for species-specific strategies. Strengthened cross-border collaboration, targeted interventions for migrant populations, and enhanced surveillance in high-risk rural areas are essential to sustain elimination efforts.

PMID:41454402 | DOI:10.1186/s12936-025-05735-6