Nevin Manimala

Complement Ther Med. 2025 Oct 30:103280. doi: 10.1016/j.ctim.2025.103280. Online ahead of print.

ABSTRACT

OBJECTIVE: Heart failure (HF) remains a significant health burden around the world, and Baduanjin is an effective intervention for patients with HF. This study aimed to objectively evaluate the effects of Baduanjin on exercise tolerance, cardiac function, and quality of life in patients with HF.

METHOD: From the time the database was constructed to May 8, 2025, we searched eight databases and two registry systems. Clinical randomized controlled trials (RCTs) of Baduanjin in treating HF were retrieved. The primary outcomes were the 6-minute walk test (6MWT) and left ventricular ejection fraction (LVEF). Secondary outcomes were left ventricular end-diastolic dimension (LVDD), left ventricular end-systolic dimension (LVSD), N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP), BNP levels, Minnesota Living with Heart Failure Questionnaire (MLHFQ), Anaerobic threshold (AT), Metabolic equivalent of task (MET), peak oxygen consumption (VO₂ peak), and Maximal oxygen consumption (VO₂ max). Two researchers performed rigorous data extraction and quality assessment. The quality of the included RCTs was evaluated using the Cochrane Risk of Bias assessment tool, version 2.0 (RoB 2), and statistical analyses were performed using RevMan 5.4 and Stata 17.0 software.

RESULT: A total of 46 RCTs involving 3597 people were included in this study. Meta-analysis showed that Baduanjin could improve the 6MWT [ MD=50.71, 95% CI (37.48, 63.94), P<0.01], LVEF [ MD=3.57, 95% CI (2.70, 4.45), P<0.01], LVDD [ MD = -2.33, 95% CI (-2.82, -1.84), P<0.01], LVSD [ MD = -1.83, 95% CI (-2.31, -1.36), P < 0.01], NT-proBNP levels [ MD = -139.49, 95% CI (-204.08, -74.89), P < 0.01], BNP levels [ MD = -77.68, 95% CI (-110.80, -44.56), P < 0.01], MLHFQ [ MD = -8.15, 95% CI (-12.31, -3.99), P < 0.01], MLHFQ-E [ MD = -3.23, 95% CI (-3.71, -2.74), P < 0.01], MLHFQ-P [ MD = -3.23, 95% CI (-4.17, -3.29), P < 0.01], MLHFQ-G [ MD = -3.56, 95% CI (-4.76, -2.35), P < 0.01], AT [ MD= 1.65, 95% CI (1.22, 2.09), P <0.01], MET [ MD=0.65, 95% CI (0.12, 1.19), P ＜0.05], VO₂ peak [ MD= 1.36, 95% CI (0.40, 2.31), P ＜0.01], and VO₂ max [ MD= 2.21, 95% CI (1.05, 3.37), P < 0.01] when compared to control groups, and the subgroup analyses showed that the efficacy of 3 months of continuous intervention with Baduanjin was the best.

CONCLUSION: Our study is the first comprehensive meta-analysis to evaluate the treatment of HF with Baduanjin. The results suggest that Baduanjin improves exercise tolerance, cardiac function, and quality of life in patients with HF.

PMID:41176179 | DOI:10.1016/j.ctim.2025.103280

J ISAKOS. 2025 Oct 30:101027. doi: 10.1016/j.jisako.2025.101027. Online ahead of print.

ABSTRACT

INTRODUCTION/OBJECTIVES: This study aimed to investigate variables associated with increased odds of anterior cruciate ligament (ACL) re-tear and re-operation after ACL reconstruction (ACLR) using hamstring autograft. We hypothesised that a proximal and/or distal graft diameter smaller than 8.5 mm would be associated with higher odds of re-tear.

MATERIALS AND METHODS: Patients who underwent primary ACLR between 2019 and 2022 were prospectively followed and retrospectively analyzed. Patients were excluded in cases of multi-ligament knee injury, bilateral ACLR, or age under 18 years old. ACL re-tear was assessed at a minimum follow-up of 24 months (mean 42 months, range 24 to 60 months). Baseline characteristics, as well as intraoperative and postoperative data, were collected. Clinical outcomes and knee laxity were assessed 12 months postoperatively. Univariate logistic regression was performed to identify associations with re-tear and re-operation. P values <0.05 were considered statistically significant.

RESULTS: Overall, 255 patients were included, with a mean age of 30.3 ± 10.6 years. A hamstring graft was used in all cases. Intraoperative meniscal treatment was performed in 47.1% of cases (121 knees), and lateral extra-articular tenodesis in 15% (37 of 255 knees). The re-tear rate was 7.1% (18 knees). A proximal graft size <8.5 mm was statistically significantly associated with ACL re-tear (odds ratio [OR] 3.1, p=0.023). Male gender and graft size showed a statistically significant interaction effect with ACL re-tear (p=0.016). In total, 30 patients (12%) underwent re-operation at a mean follow-up of 42 months (range 24 to 60 months). A medial meniscal (MM) tear was associated with increased odds of re-operation (OR 2.8, p=0.010). The re-operation rate was higher in cases of MM repair (27%) compared with MM debridement (5%, p=0.040). Lateral meniscal tears were not associated with an increased re-operation rate (p=0.496).

CONCLUSIONS: A proximal graft diameter <8.5 mm in hamstring autograft ACLR is associated with increased odds of re-tear, particularly in young, active male patients. Meniscal tears are associated with higher odds of subsequent surgery on the same knee, especially following medial meniscal repair.

LEVEL OF EVIDENCE: IV.

PMID:41176162 | DOI:10.1016/j.jisako.2025.101027

Int J Infect Dis. 2025 Oct 30:108167. doi: 10.1016/j.ijid.2025.108167. Online ahead of print.

ABSTRACT

BACKGROUND: Congenital cytomegalovirus (CMV) infection can cause sensorineural impairment in children. Our primary objective is to estimate the proportion of women in France who received counselling from health-care providers about preventing CMV transmission during pregnancy, and our secondary objective to identify factors associated with their receiving this counselling.

METHODS: Using data collected at childbirth in France from women included in the 2021 national perinatal survey (ENP), we first estimated the proportion of women who received counselling about preventing CMV infection during pregnancy and then used univariate and multivariate analyses to compare maternal characteristics between women who reported such counselling and those reporting not being counselled or not remembering.

FINDINGS: Among the 10 866 women interviewed, 1737 (16·0%) reported being counselled about CMV during pregnancy. Those less likely to have been counselled were born in North African or Sub-Saharan countries (respectively, adjusted odds ratio 0·49, 95%CI 0·34-0·71 and 0·58, 95%CI 0·37-0.89) compared to women born in France, and those with a low educational level (0·56, 95%CI, 0·48-0·66 for women with high-school level, compared to women with 3 years or more postsecondary schooling). Primiparous, compared with multiparous, women were less likely to have been counselled (ORa 0·61, 95%CI 0·53-0·69).

INTERPRETATION: Too few women receive counselling about CMV prevention during pregnancy. The women least informed were less educated and more socially vulnerable. They are probably also the women who have the least access to preventive health information.

FUNDING: The French ENP were supported by the Ministry of Health and Santé Publique France.

PMID:41176151 | DOI:10.1016/j.ijid.2025.108167

Respir Med. 2025 Oct 30:108460. doi: 10.1016/j.rmed.2025.108460. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the clinical effectiveness and feasibility of the structured ST-OSA-PS-OMT model for adults with Obstructive Sleep Apnea and Primary Snoring, focusing on changes in excessive daytime sleepiness and patient-reported effectiveness within an AI-enhanced telemedicine framework.

MATERIALS AND METHODS: Retrospective observational cohort study from November 2021 to November 2022 with 87 adults with OSA and PS. They received OMT through the Smart Therapy for Obstructive Sleep Apnea and Primary Snoring with Orofacial Myofunctional Therapy (ST-OSA-PS-OMT) program. Demographic variables, clinical data, orofacial myofunctional examination, and satisfaction were evaluated using the Perception Scale of Effectiveness of Orofacial Myofunctional Therapy in Sleep-Disordered Breathing -Patient Reported Outcome Measures (EPE-TMO-TRS-PROMs), type 1 (83%)/type 3 (17%) polysomnography, and the Epworth Sleepiness Scale (ESS).

RESULTS: 87 patients with Sleep-Disordered Breathing (SDB) (mean age 49.71 ± 13,28 years, 60.9% female) received OMT. Improvement was observed in ESS (9.41 ± 5.65 to 7.26 ± 5.43). Snoring (28.7%), endocrine-metabolic comorbidities (50.6%), and cardiovascular comorbidities (36.8%) were prevalent. Erythematous palatine pillars (93.1%) and descended soft palate (90.8%) were found, with the latter showing a significant relationship (X²=37.3373p=1.5^-7). The majority rated OMT as effective. Descriptive analysis revealed that patients with psychiatric comorbidities tended to perceive treatment as more effective, while those with Class III malocclusion showed a tendency toward lower treatment favorability.

CONCLUSION: The ST-OSA-PS-OMT model represents a viable and effective therapeutic approach for OSA/PS, as evidenced by significant ESS improvement and positive patient-reported outcomes. The AI-enhanced telemedicine framework establishes a foundation for therapeutic personalisation. Key anatomical findings, particularly the association between a descended velum and erythematous pillars, justify refined pre-treatment assessment protocols. Future research should focus on longitudinal studies and developing targeted intervention strategies for subgroups with less favourable responses, including those with Angle Class III malocclusion.

PMID:41176093 | DOI:10.1016/j.rmed.2025.108460

J Pharm Sci. 2025 Oct 30:104047. doi: 10.1016/j.xphs.2025.104047. Online ahead of print.

ABSTRACT

In recent years, quantitative structure retention relationship (QSRR) models have not only been used for predicting retention time (RT) of the newly identified molecules but also for screening their physicochemical properties, predicting multi-target properties, determining of the molecular mechanism of separation, mechanism of small molecule’s affinity to phospholipids, and the retention mechanism of isomeric separation, and optimizing chromatographic method. In addition, researchers are exploring how to integrate Analytical Quality by Design (AQbD), Quantitative Structure Retention Relationship (QSRR) modeling, and Design of Experiments (DoE) to assess the operable design region of validated chromatographic methods, rather than relying solely on empirical optimization of virtual method setups. Researchers have been trying another unique approach called transfer learning. Since the in-house project-based datasets are typically smaller and show issues to get higher accuracy, transfer learning from big data showed a lot of promise. In short, a model needs to pre-train from an established database, such as METLIN-SMRT or CMRT, followed by fine-tuning the model with the in-house dataset and then predicting the RTs of the target molecules. QSRR studies can also follow OECD (Q)SAR guidance during model development to ensure clearly defined endpoints, transparent algorithms, defined applicability domains, and reproducible validation processes. Adoption of these principles would strengthen model reliability. Two of the most crucial factors in getting better model performance are the structural diversity of the selected molecules and the relevance of chosen molecular descriptors. Careful descriptor selection, guided by mechanistic interpretability and OECD-recommended transparency, ensures robust and reproducible predictions across chemically diverse datasets. For stereoisomers, the use of 3D descriptors in conventional machine learning models, such as Random Forest, Support Vector Machines, or Partial Least Squares, which rely on predefined molecular features, or the application graph neural network (GNN)-based models is necessary to capture subtle structural differences and enable mechanistically interpretable predictions, consistent with the green and white analytical chemistry (GAC-WAC) principles of analytical performance, sustainability, and cost-efficiency.

PMID:41176062 | DOI:10.1016/j.xphs.2025.104047

Orthop Traumatol Surg Res. 2025 Oct 30:104543. doi: 10.1016/j.otsr.2025.104543. Online ahead of print.

ABSTRACT

BACKGROUND: The integration of artificial intelligence (AI) into hip and knee surgery has been evolving rapidly, with significant implications for diagnostics, surgical planning, and outcome prediction. However, there has been limited literature with comprehensive overview of AI in arthroplasty surgery. This bibliometric analysis aims to identify the 50 most cited articles on AI in hip and knee surgery, highlighting key contributors, research trends, and methodological patterns.

HYPOTHESIS: We hypothesized that AI has generated a growing body of influential research in hip and knee surgery, with specific trends in applications, geographic distribution, and methodological approaches.

MATERIAL AND METHODS: A systematic search was performed in the Web of Science Core Collection (WOSCC) on July 14, 2025, using predefined keywords related to AI and hip/knee surgery. Original research articles were screened and ranked by citation count. Descriptive statistics were used to analyze bibliometric variables including authorship, journal impact factor, country of origin, and AI techniques.

RESULTS: The 50 most cited articles, published between 2016 and 2023, accumulated a total of 7,140 citations (mean: 142.8; range: 59-735). The most cited article received 735 citations. The United States was the most prolific contributor, accounting for 27 articles (54.0%) and 2,772 citations (38.8%). Deep learning was the most frequently used AI technique (29 articles, 58% of articles). Knee-related topics were predominant, addressed in 32 articles (64.0%) while hip-related studies represented 18 articles (36.0%). Thematic focus was predominantly diagnostic with 31 articles (62.0%) centered on radiographic interpretation. There was no significant correlation between journal impact factor and citation count (Pearson’s r = 0.21; p = 0.28).

DISCUSSION: This bibliometric analysis outlines the foundational literature driving AI adoption in hip and knee surgery. While the field is rapidly expanding, research remains unevenly distributed, with limited focus on hip surgery and treatment-oriented AI. Future studies should emphasize clinical validation, generalizability, and the integration of explainable AI into orthopedic practice.

LEVEL OF EVIDENCE: IV.

PMID:41176060 | DOI:10.1016/j.otsr.2025.104543

Acta Trop. 2025 Oct 30:107894. doi: 10.1016/j.actatropica.2025.107894. Online ahead of print.

ABSTRACT

Landscape changes driven by human activities can alter host-pathogen interactions, favoring generalist mammal species that act as reservoirs for zoonotic pathogens, potentially leading to spillover events and outbreaks. Here, we investigated how forest cover influences viral diversity in Oligoryzomys nigripes, a generalist rodent known to harbor zoonotic viruses in the Brazilian Atlantic Forest. We employed high-throughput sequencing to explore the fecal virome of 20 specimens collected across three landscapes with varying forest cover (20%, 40%, and 60%) within Atlantic Forest fragments in São Paulo state. We identified 48 viral families, predominantly bacteriophages and vertebrate-associated viruses. Some, found for the first time in this host, exhibited zoonotic potential, including Papillomaviridae, Herpesviridae, Polyomaviridae, Adenoviridae, Alloherpesviridae, Arenaviridae, Paramyxoviridae, Peribunyaviridae, and Picornaviridae. Alpha and beta diversity indices were used to assess the viral community structure. Although alpha diversity indices did not show a statistically significant difference among landscapes, a significant compositional difference in viral community was detected through beta diversity index (Jaccard dissimilarity), indicating that forest cover may shape the composition of viral families present. The presence of a core virome shared across all landscapes, including families with pathogenic potential, reinforces O. nigripes role as a natural reservoir. While forest cover influences viral community structure, it doesn’t necessarily reflect greater ecological complexity within fragments, indicating that other landscape-related factors must also be considered. This pioneering study characterizes the fecal virome of O. nigripes, revealing how forest cover may shape viral communities in wild rodents and underscoring their potential for zoonotic virus surveillance.

PMID:41176044 | DOI:10.1016/j.actatropica.2025.107894

J Stroke Cerebrovasc Dis. 2025 Oct 30:108480. doi: 10.1016/j.jstrokecerebrovasdis.2025.108480. Online ahead of print.

ABSTRACT

Vision loss is a risk factor for dementia, but it is unknown whether stroke-related vision impairment is linked to dementia risk in stroke survivors. This secondary analysis aimed to quantify the association between stroke-related vision impairment and time to incident dementia diagnosis, from time of stroke, using the Arthrosclerosis Risk in Communities study dataset. We included participants who sustained a non-fatal probable or definite ischemic, incident stroke captured from hospital surveillance during the study period and excluded those who were diagnosed with incident dementia prior to or less than half a year after the incident stroke. The association between stroke-related vision impairment (binary) and time from incident stroke to dementia diagnosis was analyzed using a Fine-Gray survival model to account for the competing risk of death, adjusting for age at incident stroke, stroke severity, biological sex, education and race-center. Among 787 stroke survivors, 31% were diagnosed with dementia during the follow-up period and 19.5% had stroke-related vision impairment. The presence of stroke-related vision impairment was not significantly associated with dementia diagnosis (HR=1.18; 95% CI 0.85, 1.63; p = 0.32). While results suggest that stroke-related vision impairment corresponds to a higher cumulative incidence of dementia, the association was not statistically significant.

PMID:41175993 | DOI:10.1016/j.jstrokecerebrovasdis.2025.108480

JACC Basic Transl Sci. 2025 Oct 31:101390. doi: 10.1016/j.jacbts.2025.101390. Online ahead of print.

ABSTRACT

We investigate the relationship between glycemic traits-specifically type 2 diabetes mellitus, fasting glucose, fasting insulin, glycated hemoglobin, and 2-hour post-load glucose-and thoracic aortic morphology and diseases. The results indicate an inverse association between elevated glycemic traits and aortic morphology, as well as a reduced risk of thoracic aortic aneurysm. Genetic predictors related to beta-cell proinsulin mechanisms in type 2 diabetes mellitus drive these associations. Key genes such as AGER, GLRX, TCF7L2, and GCK are implicated, highlighting their potential as therapeutic targets for the prevention and treatment of thoracic aortic aneurysm, given their role in glycemic control medication.

PMID:41175115 | DOI:10.1016/j.jacbts.2025.101390