Category: Nevin Manimala

Front Cell Dev Biol. 2025 Mar 7;13:1530953. doi: 10.3389/fcell.2025.1530953. eCollection 2025.

ABSTRACT

BACKGROUND: Endometrial thickness (EMT) is a crucial indicator of endometrial receptivity in assisted reproductive technology (ART). However, its relationship with pregnancy outcomes remains unclear, especially across different cycle types such as fresh in vitro fertilization-embryo transfer (IVF-ET), frozen-thawed embryo transfer (FET), and preimplantation genetic testing for aneuploidy embryo transfer (PGT-ET). The clinical significance of EMT and its optimal range for improving ART outcomes remain subjects of debate.

METHODS: This retrospective cohort study analyzed data from 80,585 ART cycles conducted between July 2008 and December 2022 at a private reproductive center, including 25,683 fresh IVF-ET, 33,112 FET, and 1,071 PGT-ET cycles. EMT was measured via ultrasound on the day of HCG administration and grouped into ranges for comparison. Primary outcomes included live birth rates (LBR) and clinical pregnancy rates (CPR) across EMT ranges. Statistical analyses, including chi-square tests, receiver operating characteristic (ROC) analysis, and adjusted risk ratio (aRR) calculations, were performed to evaluate the association between EMT and pregnancy outcomes.

RESULTS: The relationship between EMT and LBR was non-linear, with no single cutoff value. LBR varied significantly across EMT ranges, peaking at approximately 12 mm in fresh IVF-ET cycles and around 10 mm in FET and PGT-ET cycles. Higher EMT was generally associated with improved LBR and CPR, but predictive power was limited (AUC: 0.56-0.60). Compared to an EMT of 10-11.9 mm, fresh IVF-ET cycles with EMT <10 mm had significantly lower LBR (aRR: 0.60-0.86), while those with EMT ≥12 mm had higher LBR (aRR: 1.12-1.17). Similar trends were observed in FET and PGT-ET cycles, although sensitivity to EMT variations was lower, particularly in PGT-ET cycles. Miscarriage rates (MR) showed no significant differences across EMT groups.

CONCLUSION: This study demonstrates that EMT has a non-linear association with LBR and CPR across fresh IVF-ET, FET, and PGT-ET cycles, with no single cutoff value. While higher EMT generally correlates with improved outcomes, its overall predictive value for LBR is limited. The findings underscore the need for individualized evaluation of EMT based on cycle type to optimize reproductive outcomes in ART.

PMID:40123852 | PMC:PMC11925890 | DOI:10.3389/fcell.2025.1530953

Health Equity. 2025 Jan 29;9(1):100-105. doi: 10.1089/heq.2024.0117. eCollection 2025.

ABSTRACT

INTRODUCTION: Children with a language for care other than English (LOE) are at risk for inequitable care. We examined the association of isolation precautions in the care of hospitalized children with LOE through the frequency of professional interpreter use and timing of in-person consultation.

METHODS: Retrospective cohort study of children in a strict isolation unit (SIU) between 2/2020 and 12/2021. Negative binomial regression was used to assess both differences in interpretation rates between SIU and non-SIU, and within 72-h/in-person consultation rates within the SIU between English-speaking and LOE encounters.

RESULTS: We identified 487 encounters in the SIU; 126 (26%) involved patients with LOE. The median interpretations per day were 4.5 (Interquartile Range [IQR]: 2.0-6.7). Among patients with LOE, there was an observed difference in median interpretations per day in the SIU (3.9, IQR: 1.7-6.4) versus encounters in non-SIU acute care units (5.0, IQR: 1.2-8.2). However, this difference was not statistically significant (Incidence Rate Ratio [IRR]: 0.89; 95% confidence interval [CI]: 0.70-1.13). Sub-specialty consultations were requested for 410 (84%) encounters within the SIU; 282 (69%) were completed in person within 72 h. A small difference between the percentage of completed consultations for encounters with LOE (n = 61, 64%) and English-speaking patients’ encounters (n = 221, 70%) was noted, which again was not statistically significant (IRR: 0.93; 95% CI: 0.71-1.21).

CONCLUSION: Despite the increased barriers of strict isolation, we exceeded institutional standards for interpretations per day and had similar rates of interpretation for encounters with LOE admitted to medical units regardless of isolation status.

PMID:40123837 | PMC:PMC11848053 | DOI:10.1089/heq.2024.0117

Internet Interv. 2025 Feb 18;40:100814. doi: 10.1016/j.invent.2025.100814. eCollection 2025 Jun.

ABSTRACT

Opp is a universal mental health-promoting mobile application (app) developed for adolescents, with the aim of promoting mental health and well-being and preventing mental health problems. In this randomized controlled trial, the effectiveness of Opp was tested among Norwegian adolescents aged 13 to 25 years. Mental health, well-being, self-efficacy, self-esteem, help-seeking behavior, and sleep quality were assessed at two measurement points (T1 and T2), that were approximately 11 weeks apart. Only the participants that answered at both measurement points were included in the main analyses (N = 399; 75 % girls; Mage = 16.90 years, SD = 1.40). The results demonstrated a statistically significant effect of the app on mental health, as measured by the SDQ Total Difficulties scale (F(1,790) = 4.35, p = .037), while no statistically significant effects were observed on the other outcomes. These results provide important insights, and a broader understanding of how mental health apps can influence the mental health and well-being of a general sample of adolescents.

PMID:40123821 | PMC:PMC11929045 | DOI:10.1016/j.invent.2025.100814

Int J Gen Med. 2025 Mar 17;18:1481-1495. doi: 10.2147/IJGM.S507375. eCollection 2025.

ABSTRACT

OBJECTIVE: Tuberous Sclerosis Complex (TSC) is a rare autosomal dominant genetic disorder primarily characterized by neurological symptoms. This study aimed to evaluate the current disease burden in Chinese patients with TSC and to identify the potential influencing factors.

METHODS: A cross-sectional study design was employed using an online questionnaire survey. The questionnaire covered demographics, diagnosis and treatment status, medication use, and disease burden. Descriptive statistics were used to summarize the data, and multivariate logistic regression analysis was performed to examine factors influencing the disease burden in pediatric and adult patients with TSC.

RESULTS: The survey involved a total of 840 patients or their caregivers, comprising 691 pediatric and 149 adult patients, with an average age at diagnosis of 1.77 years for pediatric patients and 15.28 years for adult patients. The most prevalent clinical manifestations were seizures (75.1% in pediatric, 43.6% in adult), brain calcification spots/nodules (87.8% pediatric, 82.5% adult), and hypomelanotic macules (89.5% pediatric, 72.4% adult). Intellectual disability (ID) was reported in 29.6% of pediatric patients and 19.4% of adult patients. Catastrophic health expenditure (CHE) was reported by 29.6% of patients. Factors influencing the disease burden included ID, misdiagnosis, and use of anti-seizure medications (ASMs) and mammalian target of rapamycin (mTOR) inhibitors for pediatric patients or educational attainment, medication use (such as ASMs and mTOR inhibitors), and ID for adult patients.

CONCLUSION: The study demonstrated that Chinese patients with TSC are confronted with a considerable disease burden. Comprehensive care strategies, tailored educational support for pediatric patients, and multidisciplinary approaches for early diagnosis are crucial for managing TSC.

PMID:40123818 | PMC:PMC11927571 | DOI:10.2147/IJGM.S507375

Int J Gen Med. 2025 Mar 18;18:1543-1553. doi: 10.2147/IJGM.S511426. eCollection 2025.

ABSTRACT

OBJECTIVE: This study examined CXCR4 expression in primary lesions of recurrent metastatic breast cancer patients, analyzing its association with clinicopathological features, chemotherapy efficacy, and prognosis.

METHODS: Eighty-five early surgical specimens of advanced BCa were examined for CXCR4 expression using immunohistochemical staining. The relationships between CXCR4 expression and clinical pathological factors, such as tumor size, lymph node metastasis, tumor stage, and metastatic site, were statistically analyzed, along with their effect on the efficacy of platinum-based chemotherapy and prognosis in patients with advanced BCa.

RESULTS: Significant associations were found between high CXCR4 levels in primary lesions of recurrent metastatic BCa and more frequent visceral metastases (p = 0.010), along with a higher rate of lymph node metastases (p = 0.022). Patients with advanced BCa showing high CXCR4 expression had lower efficacy with platinum-based chemotherapy (p = 0.002). Patients with high CXCR4 expression exhibited shorter disease-free survival (DFS) and overall survival (OS) compared to those with low expression, though the differences lacked statistical significance.

CONCLUSION: Patients with recurrent metastatic BCa with high expression of CXCR4 in primary lesions have poor efficacy with platinum-based chemotherapy, shorter DFS and OS, and poor prognosis. CXCR4 may be an important biomarker in metastatic BCa. It can be used not only as a predictor of metastasis and prognosis, but also as a therapeutic target and a tool to monitor treatment efficacy.

PMID:40123816 | PMC:PMC11929416 | DOI:10.2147/IJGM.S511426

Int J Gen Med. 2025 Mar 17;18:1529-1542. doi: 10.2147/IJGM.S496799. eCollection 2025.

ABSTRACT

INTRODUCTION: Foodborne disease outbreaks (FBDOs) pose a significant threat to public health globally, leading to substantial morbidity, mortality, and economic losses. However, the underlying causes and impacts of FBDOs often remain underexplored in specific regions, limiting the effectiveness of targeted prevention strategies.

METHODS: This study aimed to investigate the epidemiological characteristics, causes, and economic burden of FBDOs in Jinhua city, Zhejiang province, China, between 2018 and 2022. Data were collected from the national surveillance system, encompassing 63 FBDOs with 305 cases. FBD cases were defined as patients with diarrhea, vomiting, or toxic symptoms suspected to be caused by food consumption, with outbreaks referring to incidents where two or more individuals presented similar symptoms after consuming the same food. Descriptive statistics were used to analyze numerical and categorical variables, focusing on outbreak sources, pathogenic factors, and economic consequences.

RESULTS: Data analysis revealed that catering services were the most common source of FBDOs, likely due to the widespread consumption of prepared meals and potential lapses in hygiene. Approximately 50% of the outbreaks were linked to unidentified pathogens. The reported microorganisms, including Norovirus, Nontyphoidal Salmonella, and Vibrio parahaemolyticus, were among the target pathogens of the national surveillance system and are also recognized as common causes of FBDOs globally. Among the identified causes, Mushroom toxin (19.05%) was the leading factor, followed by Norovirus (12.70%) and Nontyphoidal Salmonella (6.35%). Norovirus caused the highest number of cases (52). The total economic burden of FBDOs was estimated at 228,078.74 yuan, with a median cost of 648.29 yuan per case. Two fatalities were attributed to wood ear and nitrite consumption.

DISCUSSION: The findings highlight high-risk foods and vulnerable populations, underscoring the significant public health and economic impacts of FBDOs. To address these challenges, enhanced surveillance systems, the establishment of regional laboratory centers, and the application of new diagnostic technologies are crucial. Collaborative efforts among governments, the food industry, and consumers are essential to strengthening food safety and reducing the burden of foodborne diseases.

PMID:40123815 | PMC:PMC11928438 | DOI:10.2147/IJGM.S496799

Int J Gen Med. 2025 Mar 17;18:1497-1507. doi: 10.2147/IJGM.S506941. eCollection 2025.

ABSTRACT

BACKGROUND: Coronary microvascular dysfunction (CMD) after percutaneous coronary intervention (PCI) is a critical prognostic factor in acute coronary syndrome (ACS). This study aimed to evaluate the combined predictive value of the triglyceride-glucose index (TyG) and non-HDL-C/HDL-C ratio (NHHR) for CMD in ACS patients post-PCI.

METHODS: A retrospective analysis of 542 ACS patients undergoing PCI (2021-2023) was conducted. Patients were classified into CMD (n=273) and non-CMD (n=269) groups based on CMD presence post-PCI. Baseline characteristics and biochemical markers were analyzed. TyG index and NHHR were calculated, and univariate and multivariate analyses were performed to identify predictors of CMD. ROC curves evaluated the predictive value of TyG combined with NHHR, while net reclassification index (NRI) and integrated discrimination improvement (IDI) assessed incremental predictive value.

RESULTS: CMD patients exhibited significantly higher levels of TyG and NHHR compared to non-CMD patients. Multivariate logistic regression indicated that TyG (OR = 1.89, 95% CI: 1.24-2.88, P = 0.003) and NHHR (OR = 1.34, 95% CI: 1.11-1.62, P = 0.011) were independent predictors of CMD. The combined model showed significant improvement in discrimination (C-statistic increased from 0.750 to 0.782, P < 0.001) and reclassification (NRI = 0.458, IDI = 0.051, both P < 0.001).

CONCLUSION: TyG and NHHR are novel predictors of CMD post-PCI, with combined use improving risk stratification. Given the retrospective nature of the study, further multicenter prospective research is required to validate these findings.

PMID:40123809 | PMC:PMC11928440 | DOI:10.2147/IJGM.S506941

Prenat Diagn. 2025 Mar 23. doi: 10.1002/pd.6776. Online ahead of print.

ABSTRACT

OBJECTIVE: Outcomes in pregnancies with rare autosomal aneuploidies (RAAs) are poorly characterized, with most studies having small sample sizes. Here, we describe outcomes and management in a large cohort of pregnancies that screened positive for an RAA (RAA+).

METHODS: Results of prenatal cell-free DNA screening were linked to de-identified insurance claims data. Diagnosis and procedure codes were used to estimate pregnancy outcomes and management. Relevant covariates in comparative analyses were adjusted using propensity-score matching. Outcomes were statistically compared using Mantel-Haenszel and McNemar’s tests.

RESULTS: Among 682 RAA+ pregnancies, the rate of live birth was significantly lower (56.7% vs. 78.7%; p < 0.001), and the rates of miscarriage and preterm birth were significantly higher (14.8% vs. 3.2%, p < 0.001; 18.5% vs. 8.9%, p < 0.001; respectively), compared to pregnancies with RAA- results. In pregnancies that screened positive for a rare autosomal trisomy (RAT+) and in which the RAT+ results were known, ultrasounds (mean: 3.7 vs. 2.5, p = 0.002), and pregnancy-specific visits (mean: 6.6 vs. 5.1; p = 0.007) were more frequent compared with pregnancies in which the RAT+ result was unknown.

CONCLUSION: Pregnancies with RAA+ results had higher rates of adverse outcomes compared with those with RAA- results, and awareness of RAA+ results was associated with more intensive monitoring.

PMID:40122782 | DOI:10.1002/pd.6776

Psychooncology. 2025 Mar;34(3):e70135. doi: 10.1002/pon.70135.

ABSTRACT

OBJECTIVE: Pancreatic cancer (PaCa) patients face a 5-year survival rate of just 13%. Most patients present with unresectable disease and endure aggressive treatments with significant chronic and debilitating side effects. PaCa patients also experience significant unmet supportive care needs (e.g., physical, psychological, informational/educational); however, limited qualitative studies have explored the specific needs of racially and ethnically diverse PaCa populations.

AIMS: This study identified supportive care needs in a racially and ethnically diverse sample of PaCa survivors.

METHODS: As part of a larger project to develop a psychosocial symptom management intervention, semi-structured qualitative interviews were conducted with PaCa survivors to explore the supportive care needs at diagnosis and after treatment. Qualitative data were analyzed using Rapid Qualitative Analysis, and personal/medical characteristics were analyzed using descriptive statistics.

RESULTS: PaCa survivors (n = 18; M_age = 64) participated, with the majority identifying as female (66.7%), White (88.9%), and Hispanic (55.6%). Over one-third completed interviews in Spanish. Four themes emerged: (1) information/health system needs, including difficulty understanding complex medical concepts, limited holistic care, post-treatment symptom management, and health behaviors; (2) psychosocial needs related to quality of life and relationships with family and healthcare providers; (3) physical and functional needs, including persistent side effects and lifestyle changes; and (4) positivity and gratitude.

CONCLUSIONS: We emphasize the themes of unmet supportive care needs in a racially and ethnically diverse sample of PaCa survivors. These findings underscore the importance of developing interventions to address these gaps and improve the overall quality of life for diverse PaCa patients.

PMID:40122779 | DOI:10.1002/pon.70135

Am Surg. 2025 Mar 23:31348251329478. doi: 10.1177/00031348251329478. Online ahead of print.

ABSTRACT

Background: Advice regarding application preparation is often anecdotal; there is limited information about how programs evaluate applicants. It is unclear if holistic review is being properly used in an increasingly competitive field. This study aims to describe desirable applicant characteristics and the application review process of CRS programs. Methods: A survey was distributed to all United States CRS Program Directors (PD) during the 2022 application cycle. The survey had questions regarding number of applicants received and the review process including which screening parameters were used and which criteria were valued when evaluating applications. Descriptive statistics are reported. Results: Thirty-six responses from the 67 CRS residency PD (54%) were received. Most (72%) characterized their review process as “holistic.” The majority (58%) of PD classified their hospital setting as academic. The median number of applications reviewed per program was 100, with a median of 26% (IQR 20-31%) of applicants invited to interview. When deciding who to interview, in-training examination (ABSITE) score (92%), letter of recommendation (LOR) content (89%), LOR writer (83%), and research productivity (83%) were the most commonly considered criteria. The “Top 3 Criteria” cited by PD in choosing applicants to interview were LOR, ABSITE and Publications/Research. Discussion: CRS residencies continue to value traditional metrics such as ABSITE scores, publications, and LOR with both the content and identity writer appearing to be important. Despite many PDs claiming they use a holistic review process, our results indicate otherwise. Increased education providing the rationale behind holistic review should be provided.

PMID:40122773 | DOI:10.1177/00031348251329478