Category: Nevin Manimala

J Patient Rep Outcomes. 2025 Aug 21;9(1):107. doi: 10.1186/s41687-025-00938-6.

ABSTRACT

BACKGROUND: Cervical cancer remains a significant public health issue in underdeveloped regions like Xinjiang, Western China, where health literacy is low and economic disparities are prominent. While previous studies have focused on preventive measures, there is limited research on the willingness to pay (WTP) for cervical cancer treatments. This study aimed to assess patient preferences and WTP from patient perspective for quality of life improvement, unadjusted life-year extension, and targeted and immunotherapy drugs among cervical cancer patients in Xinjiang.

METHODS: A face-to-face survey was conducted using the Contingent Valuation Method (CVM) and Discrete Choice Experiment (DCE) to evaluate WTP for cervical cancer treatments. The CVM assessed patients’ WTP for two scenarios: living in perfect health for 5 or 10 years versus unadjusted life-year extension for the same durations. Health related quality of life (HRQoL) was measured using both the EQ-5D-5 L and EQ-VAS instruments. The DCE evaluated patients’ preferences and WTP for targeted therapy and immunotherapy drugs.

RESULTS: This study included 106 valid questionnaires (response rate 96.4%), primarily comprising stage III cervical cancer patients (EQ-5D-5 L 0.89, EQ-VAS 0.80) with characteristics of low income and educational attainment. Key findings revealed: (1) Patients prioritized quality of life improvement over lifespan extension, with WTP/QALY in the 10-year perfect health scenario exceeding Xinjiang’s 2024 per capita disposable income threshold while other scenarios remained below this value, and WTP/QALY being significantly higher in the 10-year scenario compared to the 5-year scenario; (2) Medication preference analysis demonstrated that quality of life improvement, cost, and incidence of adverse reactions were key decision-making factors, whereas survival extension held relatively lower importance. WTP valuations exhibited significant attribute-specific variations, with the highest WTP corresponding to quality of life improvement attributes and the lowest to survival extension attributes.

CONCLUSIONS: Cervical cancer patients in Xinjiang prioritize quality of life improvement over lifespan extension, with their preferences and WTP being influenced by treatment-related factors, disease characteristics, and socioeconomic background. Therefore, when formulating reimbursement policies and resource allocation strategies, priority should be given to interventions that can significantly improve quality of life, while implementing differentiated support policies for patient populations with varying socioeconomic statuses.

PMID:40841713 | DOI:10.1186/s41687-025-00938-6

Acta Pharmacol Sin. 2025 Aug 21. doi: 10.1038/s41401-025-01636-1. Online ahead of print.

ABSTRACT

Mitochondrial DNA (mtDNA) damage and accumulation activate the cGAS-STING DNA-sensing pathway, which promotes immune clearance of tumor cells. Maintenance of the cytosolic level of mtDNA is key to sustain immune activation. T cell malignancies (T-CMs) are a general name of diseases with abnormal clonal proliferation of T lymphocytes at various stages. Immunotherapy of T-CMs is challenged by the lack of specific antigens to discriminate T-CMs from normal T cells. As intrinsic STING activation can promote the clearance of T-CMs by immune cells, we herein explored whether isoliensinine (IsoL), a natural compound from Nelumbinis Plumula could enhance NK clearance by mtDNA-mediated immune responses in tumor cells. To investigate whether IsoL modulated immune recognition and clearance of T-CMs, we pre-treated three T-CM cell lines (Jurkat, Molt4 and Hut102) with IsoL then co-cultured with NK-92MI cells. We showed that IsoL pre-treatment promoted cytosolic mtDNA accumulation by inducing ROS-dependent mitochondrial damage and inhibiting mitophagy via peroxiredoxin 1 (PRDX1), an antioxidant enzyme. Loss of PRDX1 in T-CMs also induced ROS-dependent mitochondrial DNA damage, and blocked mitophagy by preventing accumulation of mature PINK1, which was required to initiate mitophagy via recruiting Parkin to the damaged mitochondria. Remarkably, IsoL could induce expression of activating ligands in vitro, enhance NK cell infiltrations, and increase apoptosis of T-CMs. Moreover, we demonstrated that IsoL could sensitize T-CMs for NK clearance in vitro and in vivo. These results suggest that IsoL could be a potential therapeutic agent to enhance immune therapy of T-CMs.

PMID:40841706 | DOI:10.1038/s41401-025-01636-1

Infect Dis Poverty. 2025 Aug 21;14(1):88. doi: 10.1186/s40249-025-01356-y.

ABSTRACT

BACKGROUND: Loiasis affects millions in Central Africa and, though historically considered benign, emerging data suggest possible renal involvement. This study investigated the association between Loa microfilaremia and renal function.

METHODS: We conducted a cross-sectional study in the Republic of Congo in May-June 2022. Renal function was assessed via estimated glomerular filtration rate (eGFR) using Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) and European Kidney Function Consortium (EKFC) equations, and proteinuria and/or haematuria (renal abnormalities, RAb). Multinomial logistic regression assessed associations between microfilarial density (MFD) and chronic kidney disease (CKD), using EKFC with Dubois correction. Population attributable fractions were estimated from a logistic model including Loa microfilaremia as a binary variable (present versus absent).

RESULTS: Among 986 participants, CKD prevalence ranged from 13.4% [95% confidence interval (CI) 11.4-15.7%, CKD-EPI] to 17.6% (95% CI 15.3-20.1%, EKFC) for KDIGO stages 1-5, and from 3.0% (95% CI 2.1-4.3%, CKD-EPI) to 7.6% (95% CI 6.1-9.4%, EKFC) for stages 3-5. Loa MFD was associated with higher odds of CKD, particularly in individuals with RAb. Compared to amicrofilaremic participants, those with Loa MFD ≥ 20 000 mf/ml had significantly increased risk: adjusted relative risk ratio (aRRR) for CKD severity categories (≤ 2nd, 2nd-10th, 10th-50th, > 50th eGFR percentile) with RAb were 8.67 (95% CI 2.62-28.64, P = 0.021), 14.26 (95% CI 3.41-59.68, P < 0.001), 5.50 (95% CI 0.55-61.78, P = 0.145), and 26.21 (95% CI 1.64-417.84, P = 0.021). Population attributable fractions of CKD stages 1-5 to Loa microfilaremia was 14.7% (95% CI 4.3-24.0) and 30.1% (95% CI 16.2-42.8) for CKD stages 1-5 with RAb.

CONCLUSIONS: This study provides the first epidemiological evidence linking loiasis to renal impairment, likely via glomerular damage. Given loiasis high endemicity in Central Africa, it may contribute to the burden of unexplained nephropathies. Longitudinal studies and renal biopsies are warranted to clarify underlying mechanisms.

PMID:40841693 | DOI:10.1186/s40249-025-01356-y

Eur J Med Res. 2025 Aug 21;30(1):783. doi: 10.1186/s40001-025-03038-9.

ABSTRACT

OBJECTIVES: Disruption of redox homeostasis and ferroptosis have been increasingly implicated in the pathogenesis of inflammatory lung injury. Glutathione peroxidase 4 (GPX4) and the ratio of reduced to oxidized glutathione (GSH/GSSG) are key regulators in this process. However, the clinical significance of ferroptotic factors in severe community-acquired pneumonia (CAP) is still lacking. This study investigated the prognostic value of serum glutathione peroxidase 4 (GPX4) and the GSH/GSSG ratio in severe CAP.

METHODS: A prospective cohort of 267 ICU-admitted severe CAP patients (2021-2023) was analyzed. Serum GPX4 and GSH/GSSG were measured within 24 h of admission. Patients were grouped by 30-day survival. Statistical analyses included comparative tests, Spearman correlation, ROC curves, Kaplan-Meier survival, and multivariate logistic regression.

RESULTS: Among 267 patients, 79 (29.6%) died within 90 days. Deceased patients had significantly lower GPX4 and GSH/GSSG (both P < 0.001). GPX4 was lower in COVID-19 cases (P = 0.022), while GSH/GSSG showed no such difference. GPX4 and GSH/GSSG were moderately correlated (r = 0.301, P < 0.001). ROC analysis showed good predictive accuracy for 30-day mortality, with an AUC of 0.778 for GPX4, 0.780 for GSH/GSSG, and 0.841 for their combination. Kaplan-Meier analysis indicated lower survival with reduced GPX4 or GSH/GSSG (P < 0.01). Multivariate analysis identified lower GPX4, GSH/GSSG, COVID-19, higher SOFA scores, prolonged ICU stay, and mechanical ventilation as independent mortality risk factors.

CONCLUSIONS: Lower serum GPX4 and GSH/GSSG ratios are associated with increased mortality in severe CAP.

PMID:40841690 | DOI:10.1186/s40001-025-03038-9

Cancer Imaging. 2025 Aug 21;25(1):105. doi: 10.1186/s40644-025-00928-3.

ABSTRACT

BACKGROUND: Accurate preoperative assessment of occult lymph node metastasis (OLNM) plays a crucial role in informing therapeutic decision-making for lung cancer patients. Computed tomography (CT) is the most widely used imaging modality for preoperative work-up. The aim of this study was to develop and validate a CT-based machine learning model integrating intra-and peri-tumoral features to predict OLNM in lung cancer patients.

METHODS: Eligible patients with peripheral lung cancer confirmed by radical surgical excision with systematic lymphadenectomy were retrospectively recruited from January 2019 to December 2021. 1688 radiomics features were obtained from each manually segmented VOI which was composed of gross tumor volume (GTV) covering the boundary of entire tumor and three peritumoral volumes (PTV3, PTV6 and PTV9) that capture the region outside the tumor. A clinical-radiomics model incorporating radiomics signature, independent clinical factors and CT semantic features was established via multivariable logistic regression analysis and presented as a nomogram. Model performance was evaluated by discrimination, calibration, and clinical utility.

RESULTS: Overall, 591 patients were recruited in the training cohort and 253 in the validation cohort. The radiomics signature of PTV9 showed superior diagnostic performance compared to PTV3 and PTV6 models. Integrating GPTV radiomics signature (incorporating Rad-score of GTV and PTV9) with clinical risk factor of serum CEA levels and CT imaging features of lobulation sign and tumor-pleura relationship demonstrated favorable accuracy in predicting OLNM in the training cohort (AUC, 0.819; 95% CI: 0.780-0.857) and validation cohort (AUC, 0.801; 95% CI: 0.741-0.860). The predictive performance of the clinical-radiomics model demonstrated statistically significant superiority over that of the clinical model in both cohorts (all p < 0.05).

CONCLUSIONS: The clinical-radiomics model was able to serve as a noninvasive preoperative prediction tool for personalized risk assessment of OLNM in peripheral lung cancer patients.

PMID:40841689 | DOI:10.1186/s40644-025-00928-3

BMC Pharmacol Toxicol. 2025 Aug 21;26(1):152. doi: 10.1186/s40360-025-00984-2.

ABSTRACT

BACKGROUND: Iron deficiency anemia (IDA) remains a prevalent global health issue. While oral iron therapy is the first-line treatment, the optimal dosing strategy-daily versus alternate-day-remains debated, especially for general population use. Therefore, this review aimed to compare the efficacy and tolerability of daily versus alternate-day oral iron supplementation for IDA in the general population.

METHODS: Searches were conducted across major databases through March 2025. Risk of bias was evaluated utilizing the Cochrane RoB 2 tool, and the certainty of evidence was graded using GRADE. The primary outcome was change in hemoglobin concentration; secondary outcomes included serum iron, ferritin, transferrin saturation, TIBC, MCV, and adverse events. R Studio software, version 4.2.3, and RevMan used for all analyses.

RESULTS: This SRMA (systematic review and meta-analysis) included 11 RCTs involving 1014 participants. The pooled analysis found a small, statistically non-significant increase in hemoglobin with daily dosing over alternate-day (MD: 0.28, 95% CI: -0.01 to 0.56, p = 0.06, z = 1.91). Secondary outcomes revealed no significant differences among groups for serum iron, ferritin, transferrin saturation, TIBC, and MCV. Adverse effects were similar between groups (RR: 1.07, 95% CI: 0.86 to 1.34), though metallic taste was more frequent with daily dosing. Risk of bias was low to moderate across studies. Certainty of evidence was rated very low for most outcomes due to heterogeneity and imprecision.

CONCLUSION: Both daily and alternate-day oral iron supplementation are comparably effective for treating IDA, with alternate-day dosing showing better tolerability. Due to low certainty in evidence, treatment decisions should be individualized pending further high-quality research.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40841680 | DOI:10.1186/s40360-025-00984-2

Int Breastfeed J. 2025 Aug 21;20(1):66. doi: 10.1186/s13006-025-00761-1.

ABSTRACT

BACKGROUND: Breast milk is widely recognized as the optimal source of infant nutrition, with the World Health Organization recommending exclusive breastfeeding for the first six months. However, breastfeeding rates remain suboptimal worldwide and in Taiwan. The six-month exclusive breastfeeding rate in Taiwan, defined as the percentage of infants aged six months who received only breast milk and no other foods or liquids in the previous 24 h, declined from 46.2% in 2018 to 37.9% in 2020. One barrier to continued breastfeeding is the discomfort or hesitation some mothers feel when breastfeeding in public. While qualitative research has indicated that conservative values may inhibit public breastfeeding, few quantitative studies have examined the simultaneous influence of traditionality and modernity. This study investigates how traditionality and modernity affect public breastfeeding behavior in Taiwan, using the Theory of Planned Behavior (TPB) as a framework.

METHODS: A cross-sectional online survey was conducted from 4 to 15 March 2024, recruiting 358 Taiwanese mothers with prior breastfeeding experience via social media. Validated instruments measured traditionality, modernity, TPB constructs (attitudes, subjective norms, perceived behavioral control, and intention), and frequency of public breastfeeding. Data were analyzed using descriptive statistics, bivariate correlations, and structural equation modeling.

RESULTS: Traditionality was negatively associated with attitudes (β = -0.30), perceived control (β = -0.11), intention (β = -0.14), and public breastfeeding behavior (β = -0.14). Modernity indirectly promoted public breastfeeding through positive links with attitudes (β = 0.12), subjective norms (β = 0.23), and perceived control (β = 0.26). Intention strongly predicted behavior (β = 0.60). The model explained 42% of the variance (CFI = 0.99, SRMR = 0.05).

CONCLUSIONS: The study confirms that traditionality may hinder public breastfeeding, while modernity enhances it by shaping attitudes, norms, and control beliefs. These findings have important implications for public health policy and practice. Since traditionality and modernity influence behavior through distinct psychological pathways, interventions should be culturally tailored. For mothers with high traditionality, mobilizing family and community support may reinforce positive norms. For those with strong modern values, strategies should focus on autonomy, self-efficacy, and informed decision-making to support breastfeeding in public spaces.

PMID:40841677 | DOI:10.1186/s13006-025-00761-1

Biopsychosoc Med. 2025 Aug 22;19(1):15. doi: 10.1186/s13030-025-00337-9.

ABSTRACT

BACKGROUND: Obesity is a chronic disease influenced by genetic, cultural, environmental, and psychosocial factors, making it difficult to manage through individual effort alone. Despite this complexity, obesity is often attributed to a lack of willpower and poor control over eating behaviors, contributing to stigma. However, research on this issue remains limited. This study quantified the extent to which multidimensional eating behaviors statistically explained the association between obesity and grit, which shared characteristics with self-control.

METHODS: We conducted a cross-sectional study involving Japanese adults across a wide range of age groups. Grit was measured using the 8-item Short Grit Scale. Multidimensional eating behaviors were measured using the Japanese version of the 21-item Three-Factor Eating Questionnaire-R21, including uncontrolled eating, emotional eating, and cognitive restraint. Obesity was defined as a body mass index ≥ 25.0 kg/m². A series of logistic regression models were created to analyze the association between grit and obesity with and without eating behaviors. Mediation analyses using the Karlson-Holm-Breen method were performed.

RESULTS: Of the 1,641 adults, 26.8% had obesity. Higher grit level was associated with a lower likelihood of obesity, less uncontrolled and emotional eating, and higher cognitive restraint. Grit was positively associated with cognitive restraint and negatively associated with uncontrolled and emotional eating; these multidimensional eating behaviors statistically accounted for the association between grit and obesity. Uncontrolled and emotional eating fully accounted for the association, whereas cognitive restraint partially accounted for it. These findings are consistent with the possibility of mediation through eating behavior in the relation between grit and obesity.

CONCLUSIONS: Our findings suggest that healthcare providers and policymakers should prioritize addressing multidimensional eating behaviors that explain the link between grit and obesity rather than on grit itself. Identifying and managing impairments in eating behavior rather than attributing obesity to an individual’s lack of willpower may help reduce stigma and support effective obesity prevention strategies.

PMID:40841668 | DOI:10.1186/s13030-025-00337-9

BMC Nurs. 2025 Aug 21;24(1):1095. doi: 10.1186/s12912-025-03765-8.

NO ABSTRACT

PMID:40841666 | DOI:10.1186/s12912-025-03765-8

Orphanet J Rare Dis. 2025 Aug 21;20(1):450. doi: 10.1186/s13023-025-03968-x.

ABSTRACT

BACKGROUND: Genetic counselling for adolescents necessitates an approach distinct from that used with adults. Developing best practices is crucial, considering the growing number of disabled adolescents worldwide and increasing use of genomic testing early in life. We investigated perceptions of adolescents (10-19 years) who had been diagnosed with a genetic disorder in terms of how they describe receiving, understanding, and living with a genetic condition. We undertook a cross-sectional, qualitatively oriented mixed methods study underpinned by the pragmatic paradigm. Adolescents completed two self-report measures – the psychological adaptation scale (PAS) and the illness identity questionnaire (IIQ)-and participated in semi-structured interviews. Demographic, PAS, and IIQ data were analyzed using descriptive statistics. We used phronetic iterative analysis to interrogate interview data. Qualitative and quantitative components were integrated through abduction.

RESULTS: Eighteen participants (median age: 15.5 years; 11/18 women/girls; 13/18 typical cognition; 8/18 de novo presentation) with a variety of genetic conditions participated. Participants had a mean PAS of 3.07 ± 0.84 indicating adequate adaptation. Their IIQ profiles indicated slightly better mean adaptive scores (3.10 ± 1.06) than mean maladaptive scores (2.85 ± 0.99). We developed a conceptual model that describes disability and genetic identity development and psychological adaptation among participants composed of three interacting components: internalizing processes; variability arising from contextual factors; and external factors associated with the processes. Adolescents generally moved among four internalizing processes (initiating, minimizing, exploring, and accepting). Movement across these processes took place frequently because of contextual factors like setting and disability type. Communication and engagement with caregivers, peers, and healthcare professionals, social interactions with others who have the same or a similar condition, and the impact of ableism constituted the main external factors with which adolescents engaged in the development of these identities.

CONCLUSIONS: Our findings present a foundation upon which to develop a care model optimized for the needs of adolescents with genetic conditions. Enhancing access to genetic counselling as a means of facilitating identity development is an important component of these care models.

PMID:40841658 | DOI:10.1186/s13023-025-03968-x