Nevin Manimala

BMC Pediatr. 2025 May 19;25(1):399. doi: 10.1186/s12887-025-05735-0.

ABSTRACT

BACKGROUND: To improve the nutritional management of premature infants in neonatal intensive care units (NICUs), we developed and implemented a standardized parenteral nutrition (PN) protocol aimed at optimizing early macronutrient delivery. This study evaluated the impact of the new protocol on growth parameters and clinical outcomes in preterm neonates.

METHODS: This prospective, non-randomized interventional cohort study included two groups of preterm infants born before 32 weeks of gestation or with birth weights under 1250 g. The PRE group received individualized PN formulations based on clinician discretion, while the POST group received PN guided by a newly introduced, stepwise algorithmic protocol aiming to optimize early protein and energy intake. Anthropometric data, daily energy and macronutrient intakes during the first 14 days, and weight at day 28 were collected. Clinical outcomes-including the incidence of sepsis, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH) retinopathy of prematurity (ROP) and hospitalization duration-were compared between groups.

RESULTS: A total of 139 infants were enrolled (69 PRE, 70 POST). While weight gain in the first 14 days was similar, the POST group showed significantly greater weight and weight velocity by day 28. These improvements paralleled higher mean daily energy and protein intakes during the early postnatal period. The incidence of bacterial sepsis was significantly reduced in the POST cohort, possibly reflecting better nutritional status and improved PN preparation practices. Although other complications did not differ significantly, fewer infants in the POST group required prolonged hospitalization (> 90 days).

CONCLUSION: Implementation of a standardized PN protocol improved early nutritional intake and was associated with better growth and reduced infection rates in premature infants. These findings support the use of structured PN strategies to enhance early neonatal outcomes in NICU settings.

TRIAL REGISTRATION: The Iranian Registry of Clinical Trials (http//www.irct.ir) with the identification No. IRCT20240519061838N2. Registered 24 November 2024.

PMID:40383757 | DOI:10.1186/s12887-025-05735-0

Malar J. 2025 May 18;24(1):157. doi: 10.1186/s12936-025-05353-2.

ABSTRACT

BACKGROUND: Spatial and temporal identification of malaria-endemic areas is a key component of vector-borne disease control. Strategies to target the most vulnerable populations, the periods of high transmission and the most affected geographical areas, should make vector-borne disease control and prevention programmes more cost-effective. The present study focuses on the spatial and temporal dynamics of malaria cases and the exogenous factors influencing the transmission in an area with pyrethroid-resistant mosquito vector populations.

METHODS: A prospective cohort study of 1806 children under 10 years of age was conducted over 20 months to assess the risk of malaria incidence in the Cove-Zagnanado-Ouinhi (CoZO) health zone located in southern Benin. Childhood malaria data were used to identify malaria hotspots according to months of follow-up using spatial scanning methods based on the Kulldoff algorithm. Stability scores were calculated by season to assess incidence heterogeneity. Incidence values by month were aggregated with meteorological data; and demographic data were merged to detect cross-correlation between incidence and meteorological variables. Generalized equation estimators were chosen for their ability to handle intra-group correlation, ensuring robust and interpretable results despite the complexity of the data to identify factors explaining the spatio-temporal heterogeneity of malaria incidence in the CoZO health zone.

RESULTS: Malaria incidence ranged from 1.41 (95% IC 0.96-2.08) to 13.91 (95% IC 12.22-15.84) cases per 100 child-months. Spatial heterogeneity in malaria transmission hotspots was observed over the study period, with relative risks ranging from 1.59 (p-value = 0.032) to 16.24 (p-value = 0.002). There was a significant negative association (correlation coefficient = – 0.56) between malaria incidence and temperature; and a slightly positive association (correlation coefficient = 0.58) between malaria incidence and rainfall. A significant association between malaria incidence with average house altitude (adjusted incidence rate ratio [aIRR] 1 (95% IC 0.99-1) P < 0.001), soil type aIRR 0.54 (0.39-0.75) p < 0.001 and temperature (incidence rate ratio [IRR] 0.69 (0.66-0.73) p < 0.001).

CONCLUSION: This study uses innovative technologies such as remote sensing and geographic information systems (GIS) to analyse the environmental, meteorological and geographical factors influencing malaria transmission, thereby identifying high-risk areas and associated factors. It demonstrates that these tools improve the accuracy of control strategies, while highlighting the crucial role of the environment and human behaviour, paving the way for more targeted interventions against malaria and other vector-borne diseases.

PMID:40383756 | DOI:10.1186/s12936-025-05353-2

Clin Rheumatol. 2025 May 19. doi: 10.1007/s10067-025-07489-7. Online ahead of print.

ABSTRACT

INTRODUCTION: Sjögren’s syndrome (SjS) is a systemic autoimmune disease that predominantly affects the exocrine salivary and lacrimal glands, leading to the manifestation of classic symptoms-dry mouth and eyes. This study aims to analyze cancer risk by site among patients diagnosed with SjS using a Lithuanian population-based dataset.

METHODS: The study cohort comprised all patients with an initial entry of Sjögren’s syndrome (International Classification of Diseases Australian modification, ICD-10-AM diagnosis code M35.0) in the National Health Insurance Fund (NHIF) database, with the record of at least one prescription for antirheumatic medications in the NHIF database, recorded between 1 January 2012 and 31 December 2019. To determine cancer incidence within the cohort, we linked SjS records to the Lithuanian National Cancer Registry, incorporating data from the beginning of 2012 up to 31 December 2019, using personal identification numbers assigned to all Lithuanian citizens.

RESULTS: In total, 29 males and 280 females diagnosed with SjS were included in the final analysis. The study found an increased risk of several cancers among female patients diagnosed with SjS. Notably, there was a statistically significant higher incidence rate of non-melanoma skin cancer (SIR 3.20, 95% CI [1.52-6.71]) and non-Hodgkin lymphoma (SIR 33.11, 95% CI [17.23-63.64]). Overall, the incidence of all cancers combined was also elevated (SIR 2.11, 95% CI [1.44-3.07]).

CONCLUSIONS: Our study shows that there is a statistically significant increased risk of non-melanoma skin cancer and non-Hodgkin lymphoma among female patients diagnosed with Sjögren’s syndrome compared to the general Lithuanian population. Key Points • The study found an increased risk of melanoma and non-Hodgkin lymphoma among female patients diagnosed with SjS. • The incidence of all cancers among female patients diagnosed with SjS was elevated. • There was an increased SIR for cancer diagnosis among patients exposed to bDMARDs during the follow-up period compared to those not exposed.

PMID:40383746 | DOI:10.1007/s10067-025-07489-7

Sci Rep. 2025 May 18;15(1):17250. doi: 10.1038/s41598-025-01361-z.

ABSTRACT

India is the tenth most polluted nation in the world, according to the World Health Organization (WHO) 2022 assessment. Approximately 1.67 million deaths are caused by lung, cardiovascular, stroke, and chronic pulmonary obstruction worldwide (WHO 2024). In 2019, 1.36% of GDP was reported to be lost because of air pollution and related issues. The results presented in this article demonstrate the efficacy of UBREATHE RAIN. Ambient (outside), untested enclosure (reception), and tested enclosure (breathing lounge with 3 Ubreathe Rain) were the 3 test venues that were found based on proximity and interaction to the stubble burning site. The Air Quality Index (AQI) was recorded as the highest sub-index of pollutants involved (CO, PM, SO₂, NO_2, and O₃) through grab sampling. Throughout the studies, the AQI in the tested enclosure was ~ 35% lower than that in the ambient environment and ~ 30% lower in the untested enclosure. Statistical analysis also supported this finding, as the p-value remains < 5% throughout (p-value ≈ 2%). Additionally, temperature and relative humidity changes were examined and demonstrated to represent significantly less of a challenge to the effectiveness of the proposed technology. The experiment’s duration and demographics may have limited the given results and their importance.

PMID:40383745 | DOI:10.1038/s41598-025-01361-z

Br J Cancer. 2025 May 18. doi: 10.1038/s41416-025-03050-0. Online ahead of print.

ABSTRACT

BACKGROUND: Endometrial cancer (EC) is the 6th most common cancer among women worldwide. No effective non-invasive screening methods or approved blood biomarkers for EC exist. Previous research explored Attenuated Total Reflection-Fourier Transform Infrared (ATR-FtIR) and Raman spectroscopies, using dried blood plasma. Fresh, ‘wet’, blood samples, that might provide faster results, have not been investigated. This study compared ATR-FtIR and Raman spectroscopies on ‘wet’ and dry blood plasma samples for EC detection. It also conducted a preliminary exploration into their diagnostic potential for EC in high-risk individuals with polycystic ovary syndrome (PCOS).

METHODS: ‘Wet’ and dry blood plasma samples from participants with EC, PCOS and healthy controls were analysed using ATR-FtIR and Raman spectroscopies. Machine learning algorithms and multivariate statistical analyses assessed spectral variance across datasets to evaluate the techniques’ diagnostic performance.

RESULTS: Raman analysis of ‘wet’ plasma achieved 82% accuracy in detecting EC, while ATR-FtIR spectroscopy reached 78%. When combined, diagnostic accuracy reached 86%. In comparison, dry plasma analysis with ATR-FtIR detected EC with 83% accuracy. Spectral similarities were found between EC and PCOS.

CONCLUSIONS: Our study suggests that ATR-FtIR and Raman spectroscopies could revolutionise early diagnosis of EC. More research is required to validate these promising findings.

PMID:40383740 | DOI:10.1038/s41416-025-03050-0

J Neurol. 2025 May 18;272(6):407. doi: 10.1007/s00415-025-13146-5.

ABSTRACT

BACKGROUND AND PURPOSE: Post-stroke cognitive impairment (PSCI) is one of the serious complications of stroke, which profoundly influences the quality of life of stroke survivors. The Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) are the two cognitive screening tools most widely used in stroke settings. Previous studies investigated the diagnostic accuracy of MoCA and MMSE but yielded controversial results. We conducted this study to compare the diagnostic accuracy of MoCA with MMSE for PSCI.

METHODS: Embase, PubMed, CINAHL, Web of Science, and The Cochrane Library were searched until August 17, 2024 for diagnostic accuracy studies comparing MoCA and MMSE. Data extraction was performed by two independent researchers. Risk of bias and applicability assessment was evaluated by the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Coupled forest plots and hierarchical summary receiver operating characteristic (hsROC) curves were created in R statistical software.

RESULTS: 9 studies with 1,135 patients were included in this review. Most studies were at high risk of bias. MoCA displayed a pooled sensitivity of 0.80 (95% CI 0.72 to 0.86) and specificity of 0.79 (95% CI 0.71 to 0.85). MMSE displayed a sensitivity and specificity of 0.76 (95% CI 0.71 to 0.81) and 0.78 (95% CI 0.73 to 0.83), respectively. No difference was shown between these modalities (SEN p = 0.36, SPE p = 0.80).

CONCLUSION: No difference was observed between MoCA and MMSE in the detection of PSCI. We recommend both screeners be considered for the detection of PSCI based on the purpose of the test and by other metrics, such as acceptability and feasibility. Although it should be noted MoCA and MMSE were cognitive screening tools in stroke settings and not a substitute for detailed clinical assessment.

PMID:40383729 | DOI:10.1007/s00415-025-13146-5

Sci Rep. 2025 May 18;15(1):17258. doi: 10.1038/s41598-025-02096-7.

ABSTRACT

Colorectal cancer (CRC) progression involves complex molecular alterations, including the dysregulation of long non-coding RNAs (lncRNAs). In this study, we identified key progression-related lncRNAs in CRC by integrating transcriptomic data from TCGA and single-cell RNA sequencing (scRNA-seq). Differential expression analysis revealed numerous lncRNAs associated with CRC progression. To systematically prioritize these lncRNAs, we developed a scoring system incorporating multiple progression-related signatures, differential expression, and survival analysis. This approach identified 198 key lncRNAs, including both known (e.g., LINC01615) and novel candidates (e.g., AC007998.3). Experimental validation confirmed that LINC01615 was significantly upregulated in CRC tissues, whereas AC007998.3 was downregulated. Further analyses indicated that these lncRNAs influence CRC progression through cis-, trans-, and post-transcriptional regulation. Patients were classified into distinct molecular subgroups based on lncRNA expression, exhibiting significant differences in prognosis and immune microenvironment composition. The enrichment of progression-related lncRNAs among differentially expressed lncRNAs was statistically significant, reinforcing their functional relevance. Validation across independent datasets demonstrated the robustness of our findings. Our research provides novel insights into the molecular mechanisms underlying CRC progression and highlights the potential of progression-related lncRNAs as prognostic biomarkers and therapeutic targets.

PMID:40383716 | DOI:10.1038/s41598-025-02096-7

J Matern Fetal Neonatal Med. 2025 Dec;38(1):2505083. doi: 10.1080/14767058.2025.2505083. Epub 2025 May 18.

ABSTRACT

BACKGROUND: This scoping review explores the need for labor induction in adolescent pregnancies (≤19 years). It aims to identify and synthesize evidence on adolescent motherhood’s unique challenges and implications on maternal and neonatal outcomes.

METHODS: This review followed the PRISMA-ScR guidelines. To identify relevant studies on labor induction in adolescent pregnancies, a comprehensive search strategy was implemented. Data were extracted from 8 eligible studies with a total population of 119,153 participants. The studies included maternal characteristics, mode of delivery, and neonatal outcomes. Both qualitative and quantitative synthesis methods were employed. The quality of the included evidence was assessed using the ROBINS-I tool.

RESULTS: Adolescents were less likely to undergo labor induction than adults (18.1% vs. 24.4%; p = 0.009). Adolescent induction showed higher success rates, with lower failure rates (1.69% vs. 2.52%; p < 0.05). Neonatal outcomes demonstrated a higher risk of low birth weight (<2500 g) (OR = 1.7, 95% CI: 1.2-2.4; p < 0.001) and stillbirth in adolescent pregnancies. Despite these risks, adolescents had higher rates of spontaneous vaginal delivery (85.0% vs. 59.5%; p < 0.001) and lower rates of cesarean sections (13.8% vs. 23.1%; p < 0.001). Maternal anemia was significantly more prevalent in adolescents (19.3% vs. 11.8%; p < 0.001).

CONCLUSIONS: Labor induction in adolescent pregnancies is less common but associated with favorable outcomes. However, adolescents face a higher risk of pregnancy and neonatal complications. These findings emphasize the significance of labor induction in this group and highlight the need for further research to establish evidence-based timing and indications for its use.

PMID:40383707 | DOI:10.1080/14767058.2025.2505083

Aust Health Rev. 2025 May 19. doi: 10.1071/AH24324. Online ahead of print.

ABSTRACT

ObjectiveAustralian Bureau of Statistics data on socio-economic status, service accessibility/remoteness and population denominators are useful in epidemiology, though complex to understand and apply. We provide information and resources to facilitate their use.MethodsWe compiled data from the Socio-Economic Indexes for Areas (SEIFA), the Accessibility/Remoteness Index of Australia (ARIA) and population estimates from across multiple years, taking into account changes in availability and formats of these data over time. Syntax was written to support use of these data in studies using administrative health data, alongside a user guide with notes and instructions.ResultsWhere research data contains an event date plus a postcode, Statistical Area Level 2 and/or Statistical Local Area, these resources can be used to attach a SEIFA score and decile, remoteness areas and age-sex-specific population denominators to each record for years 2000-2025 (population denominators to 2023). These variables can be used as cohort descriptors, as model covariates or to calculate ARIA/SEIFA stratified rates.ConclusionsThese resources are useful for individual research projects, while also contributing to building capacity in the use of geographical measures. We focused on the measures most commonly used in Australia, although the approach outlined can be applied to other geographical measures.

PMID:40383705 | DOI:10.1071/AH24324

Cancer Genet. 2025 May 12;294-295:171-180. doi: 10.1016/j.cancergen.2025.05.001. Online ahead of print.

ABSTRACT

PURPOSE: Glioma arises from glial cells and comprises ∼80 % of malignant adult brain tumors. The polymorphic mitochondrial genome plays a key role in maintaining redox homeostasis and generation of reactive oxygen species (ROS). ROS have a well-established role in glial tumors. We investigated associations between germline mtDNA variants and haplogroups with glioma grade and glioblastoma (GBM) survival.

METHODS: We conducted germline mtDNA sequencing for 388 patients (300 Caucasians, 88 African Americans [AA]) with incident glioma (105 non-GBM, 283 GBM). Across all patients we identified 1431 homoplasmic mtDNA variants, including 692 variants observed only in Caucasians, 474 only in AAs, and 265 in both groups. We estimated Odds Ratios (OR) and 95 % Confidence Intervals (CI) for mtDNA common variants, haplogroups, and gene variant burden in relation to glioma grade and tertiles of survival in GBM patients. Bonferroni and Benjamini-Hochberg correction were applied for multiple comparisons.

RESULTS: No mtDNA haplogroup was associated with glioma grade or patient survival in GBM. Common variants m.3010G>A, m.195T>C, and m.16189T>C were linked to lower-grade glioma risk. For GBM survival, m.1719G>A, m.14766T>C, m.16129G>A, and m.204T>C were associated with a poorer prognosis while variant m.73A>G was associated with an improved prognosis. A higher variant burden in MT-ND1 and MT-ND5 was associated with a better prognosis. No results remained statistically significant after correction.

CONCLUSION: This is the first comprehensive study of germline mtDNA sequence variation in relation to glioma grade at diagnosis and gliobastoma patient survival. Results warrant further study in larger populations and investigation of biologic mechanisms linking mtDNA polymorphism to these endpoints.

PMID:40382795 | DOI:10.1016/j.cancergen.2025.05.001