Nevin Manimala

J Ovarian Res. 2025 Apr 16;18(1):79. doi: 10.1186/s13048-025-01665-8.

ABSTRACT

BACKGROUND: Mosaic embryos have been proven to be capable of resulting in live births and have become an option for embryo transfer under certain circumstances. Recent guidelines suggested that embryo morphological scoring should be taken into consideration when selecting mosaic embryos for transfer. Therefore, we introduce a hypothesis that a high morphological scoring mosaic embryo is a better choice compared to a low morphological scoring euploid embryo.

MATERIALS AND METHODS: This retrospective cohort study included 1641 embryo transfer cycles following next-generation sequencing (NGS)-based preimplantation genetic testing for aneuploidy (PGT-A). Participants were categorized into a mosaic group (87 cycles) and an euploid group (1554 cycles) based on the PGT-A results of the transferred embryos. Statistical methods including multivariate logistic regression analysis and propensity score matching (PSM) were employed to compare the pregnancy outcomes between mosaic and euploid embryo transfer cycles.

RESULTS: Multivariate logistic regression analysis showed that the transfer of mosaic embryos was a prognosis for the reducing live birth rate (P = 0.043). Furthermore, when comparing the pregnancy outcomes of the high morphological scoring mosaic embryo transfer group with the low morphological scoring euploid embryo transfer group, no significant differences were observed (P > 0.05). Additionally, no significant differences in pregnancy outcomes were found between both the high morphological score low proportion and segmental mosaic group and the low morphological score euploid group (P > 0.05).

CONCLUSION: Our study indicated that morphological scoring has reference value when choosing between euploid and mosaic embryo transfers. Specifically, when the morphological score of euploid embryos is poor, mosaic embryos with high morphological scores could be a viable option after comprehensive prenatal consultation.

PMID:40241198 | DOI:10.1186/s13048-025-01665-8

BMC Psychol. 2025 Apr 16;13(1):390. doi: 10.1186/s40359-025-02724-x.

ABSTRACT

BACKGROUND: Previous research predominantly focused on burnout’s proximal antecedents, with less known about distant influences such as cultural values. Confucian values, integral to Chinese culture, advocate for diligence and long-term commitment, potentially safeguarding against burnout by enhancing resilience and a robust work ethic. This study aims to examine the impact of Confucian Work Dynamism on teacher burnout through two facets of grit, which encompasses interest consistency and perseverance of effort.

METHOD: Utilizing a cross-sectional survey, 304 valid responses were collected from primary and secondary school teachers in China. The study employed descriptive statistics, correlation analysis, and Structural Equation Modeling (SEM) for data analysis.

RESULTS: Findings indicate a positive correlation between Confucian Work Dynamism and the perseverance of effort facet of Grit, while no significant correlation was found with interest consistency. Both facets of Grit were negatively associated with burnout, with perseverance of effort mediating the relationship between Confucian Work Dynamism and burnout.

CONCLUSION: Confucian Work Dynamism, particularly through perseverance of effort, serves as a protective factor against burnout. This study highlights the importance of cultural values in occupational well-being and suggests that interventions in collectivist cultures should continue to encourage a high level of persistence of effort while promoting greater consistency of interests.

PMID:40241197 | DOI:10.1186/s40359-025-02724-x

Arthritis Res Ther. 2025 Apr 16;27(1):88. doi: 10.1186/s13075-025-03542-7.

ABSTRACT

BACKGROUND: Hydroxychloroquine (HCQ) is commonly used to treat Sjögren syndrome (SS). Glucocorticoids, which are commonly applied for managing primary SS (pSS), can disrupt glucose metabolism and increase diabetes mellitus (DM) risk. HCQ reduces DM risk in systemic lupus erythematosus and rheumatoid arthritis.

OBJECTIVE: This study aimed to investigate the relationship between HCQ and glucocorticoids in the incidence of new-onset diabetes in pSS.

METHODS: This nationwide population-based cohort study identified patients diagnosed with pSS from the Taiwan’s National Health Insurance Research Database from 2006 to 2015. Multivariate and stratified analyses, Kaplan-Meier method, and Cox proportional hazard regression were used to evaluate DM risk associated with the use of HCQ and glucocorticoid, both individually and in combination.

RESULTS: Among pSS patients (4,874 HCQ users and 2,437 HCQ nonusers), 497 patients developed DM over an average follow-up of 4.89 years. Multivariate analysis revealed significantly lower adjusted hazard ratios (aHRs) for DM in HCQ users in the 151-350 cumulative defined daily dose (cDDD) and ≥ 351 cDDD subgroups (0.600, 95% CI: 0.454-0.794 and 0.326, 95% CI: 0.246-0.433, respectively) compared with HCQ nonusers. High-dose glucocorticoids (≥ 151 cDDD) were linked to increased DM risk (aHR: 1.833, 95% CI: 1.410-2.383). However, high-dose HCQ (> 350 cDDD) mitigated this risk, even the risk caused by the use of high-dose glucocorticoids (≥ 151 cDDD) (aHR: 0.632, 95% CI: 0.421-0.948, P < 0.01).

CONCLUSIONS: Our study demonstrated that HCQ exposure significantly reduces the risk of developing diabetes in patients with pSS. While higher doses of glucocorticoids are associated with an increased diabetes risk, concurrent HCQ use mitigates this risk in a dose-dependent manner.

PMID:40241193 | DOI:10.1186/s13075-025-03542-7

Respir Res. 2025 Apr 16;26(1):151. doi: 10.1186/s12931-025-03225-6.

ABSTRACT

BACKGROUND: Destruction of alveoli structure and lung function are interrelated, however, their correlation and clinical significance have been not well defined in patients with lung cancer. Thus, this study aimed to examine the association among radiographic, pathological emphysema and spirometric airway obstruction in patients with resectable lung cancer as well as explore their impact on postoperative pulmonary complications (PPCs) and long-term prognosis.

METHODS: Lung adenocarcinoma (LUAD) patients who performed chest CT, spirometry, and curative resection were included from a prospective three-institution database. CT-defined emphysema at baseline was assessed visually and quantitatively, pathological emphysema was reviewed on postoperative specimen. Multivariable regression models, propensity score matching, stratified analysis, and subgroup analysis were adopted to reduce selection bias.

RESULTS: Our cohort included 902 patients, with a median follow-up of 5.6 years. CT-defined emphysema was present in 163 patients (18.1%) and most of them (86.5%) were validated with pathological evidence. 169 had spirometric airway obstruction, while only 29.6% patients overlapped with CT-defined emphysema. Multivariable logistic regression models showed CT-defined emphysema, not airway obstruction, was associated with an increased risk of PPCs (adjusted odds ratio, 2.35; 95% CI, 1.40-3.93; P = 0.001). After adjusting for age, sex, body mass index, smoking history, tumour stage, vascular invasion, pleural invasion, multivariate cox analysis identified CT-defined emphysema, not airway obstruction, as an independent prognostic factor for OS (adjusted hazard ratio, 1.44; 95%CI, 1.05-1.97; P = 0.022). Patients with both radiographic and pathological emphysema experienced worse OS (log-rank P < 0.001). In the propensity score-matched cohort, stratified analysis, and never-smokers subgroup analysis, CT-defined emphysema remained a strong and statistically significant factor related to poor survival.

CONCLUSIONS: The presence of radiological and pathological emphysema in resectable LUAD was associated with frequent PPCs and decreased survival.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40241184 | DOI:10.1186/s12931-025-03225-6

Lipids Health Dis. 2025 Apr 16;24(1):143. doi: 10.1186/s12944-025-02551-4.

ABSTRACT

BACKGROUND AND AIMS: The uric acid-to-HDL-cholesterol ratio (UHR), a novel marker of metabolism and inflammation, has been investigated in various diseases. However, its potential associations with the incidence of cardiovascular disease (CVD) and dyslipidemia remain unclear. This study aimed to examine the relationships between the UHR and the incidence of CVD and dyslipidemia. The primary objective was to evaluate the role of the UHR in predicting CVD and dyslipidemia, whereas the secondary objective was to analyze the predictive effects of the UHR in different subgroups.

METHODS: We conducted a cross-sectional analysis using data from the 2001-2018 National Health and Nutrition Examination Survey (NHANES), which included 6,370 adults aged 18-80 years. Weighted binary logistic regression and subgroup analyses were performed to evaluate the independent associations between the UHR and the risk of various cardiovascular conditions, including overall CVD, congestive heart failure, myocardial infarction, angina, coronary heart disease, and dyslipidemia. To investigate potential nonlinear relationships between the UHR and these outcomes, restricted cubic spline modeling was applied to further elucidate the associations.

RESULTS: Among the 6,370 participants included in the study, 559 were diagnosed with CVD. Elevated UHR values were strongly associated with a greater incidence of CVD and its subtypes, including congestive heart failure, myocardial infarction, angina, and coronary heart disease (all P < 0.001). After accounting for weighted factors, participants in the higher UHR quartiles presented progressively higher rates of CVD: Quartile 1 (4.7%), Quartile 2 (6.3%), Quartile 3 (7.4%), and Quartile 4 (11%). A nonlinear relationship between the UHR and the risk of developing CVD was identified through restricted cubic spline (RCS) analysis. Among the subgroup of 4,117 participants with dyslipidemia, multivariable linear regression analysis demonstrated a significant positive association between the UHR and dyslipidemia (OR 17.38, 95% CI 16.24-18.60). This association remained robust even after adjusting for covariates (OR 11.65, 95% CI 8.995-15.17). RCS analysis further confirmed the nonlinear nature of this relationship. Subgroup analysis revealed no significant interaction between the UHR and overall CVD or CVD-related variables, such as congestive heart failure, myocardial infarction, angina, or coronary heart disease. However, for dyslipidemia, BMI showed a significant interaction, indicating that the positive association between the UHR and dyslipidemia risk is influenced by participants’ BMI.

CONCLUSION: A high UHR is associated with an increased risk of various cardiovascular conditions and dyslipidemia. The incorporation of routine UHR monitoring into clinical practice can support the early identification of high-risk individuals, facilitate timely interventions, and reduce the burden of cardiovascular and metabolic diseases.

PMID:40241174 | DOI:10.1186/s12944-025-02551-4

Ann Gen Psychiatry. 2025 Apr 16;24(1):24. doi: 10.1186/s12991-025-00561-1.

ABSTRACT

INTRODUCTION: Borderline Personality Disorder (BPD) is a complex neuropsychiatric condition characterized by four main symptom domains: emotion dysregulation, behavioral dysregulation, self-image disturbances, and interpersonal instability. While psychotherapy remains the primary treatment, there is a need for additional effective interventions. Given the neuromodulatory effects of non-invasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), these methods may hold potential for addressing BPD symptoms.

METHODS: A systematic review and network meta-analysis were conducted following PRISMA guidelines. A literature search (PubMed, Scopus, Web of Science, Cochrane CENTRAL) identified comparative studies assessing the effects of NIBS in BPD. The primary outcome was impulsivity, measured by the Barratt Impulsivity Scale (BIS-11). Secondary outcomes included Depressive symptoms, which were evaluated using different scales such as the Hamilton Depression Rating Scale (HAMD) and the Beck depression Inventory (BDI) scale, and anxiety symptoms were evaluated using the Hamilton Anxiety Rating Scale (HAMA).

RESULTS: Five studies with a total of 103 patients were included. Regarding impulsivity, tDCS 2 mA showed a significant reduction compared to the control group (MD = -11.67, 95% CI [-21.44, -1.90]). For depressive symptoms, TMS 20 Hz ranked highest (SMD = -1.97, 95% CI [-3.51, -0.43]), followed by tDCS 2 mA (SMD = -1.65, 95% CI [-2.97, -0.34]). In terms of anxiety, both TMS 5 Hz (MD = -12.29, 95% CI [-24.57, -0.01]) and tDCS 2 mA (MD = -11.81, 95% CI [-17.39, -6.23]) showed significant differences.

CONCLUSION: Preliminary evidence suggests potential efficacy of non-invasive brain stimulation for BPD, with well-tolerated side effects with well-tolerated side effects. Although there are noticeable statistically significant differences between the interventions and control groups, the results are inconclusive due to the small sample.

PMID:40241170 | DOI:10.1186/s12991-025-00561-1

BMC Nutr. 2025 Apr 16;11(1):80. doi: 10.1186/s40795-025-01067-5.

ABSTRACT

INTRODUCTION: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder affecting women of reproductive age, characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. This study aims to investigate the association between adherence to the Mediterranean Diet (Med-Diet) and the Prime Diet Quality Score (PDQS) and the risk of PCOS.

METHOD: This case-control study included 472 women aged 18-45, with 180 PCOS cases and 292 controls. PCOS diagnosis was based on the Rotterdam criteria. Dietary intake was assessed using a validated food frequency questionnaire, and adherence to the Med-Diet and PDQS was calculated. Statistical analyses included logistic regression to examine associations between diet quality and PCOS.

RESULTS: Higher adherence to both the Med-Diet and PDQS was significantly associated with lower odds of PCOS. Participants in the highest quartile of the Med-Diet score had a 41% reduced risk of PCOS in the crude model (OR = 0.59, 95% CI: 0.48-0.67) and a 32% reduced risk in the fully adjusted model (OR = 0.68, 95% CI: 0.57-0.79), after adjusting for potential confounders, including age, body mass index (BMI), physical activity, and total energy intake. Similarly, those in the highest PDQS quartile showed a 53% reduced risk in the crude model (OR = 0.47, 95% CI: 0.35-0.56) and a 43% reduced risk in the fully adjusted model (OR = 0.57, 95% CI: 0.44-0.68), accounting for the same confounders.

CONCLUSION: The findings suggest that higher adherence to the Med-Diet and PDQS is associated with a reduced risk of developing PCOS. Further research is warranted to explore the underlying biological mechanisms and to establish causality through prospective cohort studies and randomized controlled trials.

PMID:40241157 | DOI:10.1186/s40795-025-01067-5

Ital J Pediatr. 2025 Apr 16;51(1):119. doi: 10.1186/s13052-025-01961-5.

ABSTRACT

BACKGROUND: Post-COVID Condition (PCC), emerging as a significant long-term consequence of SARS-CoV-2 infection, affects not only adults but also the pediatric population. Despite ongoing research, the precise pathophysiology of PCC remains elusive. However, several putative mechanisms have been identified, leading to the exploration of various therapeutic strategies. Notably, in the adult population, there has been substantial interest in the potential efficacy of nutritional supplements. Regrettably, information regarding the use of such supplements in the pediatric population is currently lacking.

METHODS: The present study was conducted to assess the impact of nutritional supplements on alleviating long COVID symptoms in children. To achieve this, we conducted a retrospective analysis of nutrient supplements administered by parents to children with Post-COVID Condition (PCC) between February 2020 and October 2022. Statistical analyses were employed to determine associations between categorical variables.

RESULTS: A total of 1243 children were enrolled following documented SARS-CoV-2 infection, with 940 (76.2%) diagnosed as recovered and 294 (23.8%) diagnosed with Long COVID. Among Long COVID patients experiencing disabling symptoms, treatment with oral lactoferrin and/or a Multi-Element Product (MEP) with antioxidant and anti-inflammatory properties was initiated. The correlation analysis between the use of supplements and persistence of long COVID at the next follow-up showed that the use of MEP alone (OR 5.7, 95% CI 3.8-8.5), or the combination of MEP and lactoferrin (OR 5.06, 95% CI 3.3-7.6) three months after the initial infection and for the following three months, were associated with a lower risk having long covid at six months following initial infection, when compared with the use of lactoferrin alone (OR 7.6 95% CI 5.1-11.4).

CONCLUSIONS: This proof-of-concept study revealed that MEP and lactoferrin, when administered three months after initial infection in patients with a new diagnosis of long covid, may have a positive impact on improving Long COVID symptoms in children during follow-up evaluations. This positive trend toward reducing Post-COVID Condition (PCC) exhibited by MEP and lactoferrin suggested a potential benefit worthy of exploration in future randomized controlled trials.

PMID:40241147 | DOI:10.1186/s13052-025-01961-5

Cardiovasc Diabetol. 2025 Apr 16;24(1):168. doi: 10.1186/s12933-025-02732-6.

ABSTRACT

BACKGROUND: The associations between atherogenic index of plasma (AIP) and cardiovascular disease (CVD) have been widely reported; However, such association to the incidence of stroke in the population with Cardiovascular-Kidney-Metabolic (CKM) syndrome remains ambiguous.

METHODS: A total of 7754 participants with CKM syndrome stages 0-3 from the China Health and Retirement Longitudinal Study were enrolled in this study. The incidence of new-onset stroke events was the primary outcome of this study. We used Kaplan-Meier survival curves and Cox proportional hazards models to explore the association between baseline AIP levels and the risk of stroke in the population with CKM syndrome stages 0-3. Additionally, we utilized restricted cubic spline plots to analyze the form of this association.

RESULTS: During a median follow-up of 6.8 years, 455 participants (5.9%) with CKM syndrome experienced their first stroke events. AIP was positively associated with the risk of stroke in the population with CKM syndrome stages 0-3. Kaplan-Meier curves analysis demonstrated a significant difference in stroke incidence across the AIP groups among the entire cohort. In the fully adjusted Model 3, the results revealed a significantly elevated risk of stroke for participants in the Q2, Q3, and Q4 groups compared to those in the Q1 group, with respective HR (95% CI) value of 1.352 (1.009-1.811), 1.421 (1.064-1.897), and 1.414 (1.052-1.900). Restricted cubic spline plots revealed the association of AIP and stroke risk was nonlinear (P-overall < 0.05, P-non-linear < 0.05), with inflection points of 0.32.

CONCLUSION: This study provides evidence that baseline AIP levels were significantly positively associated with the risk of stroke in individuals with CKM syndrome stages 0-3, and AIP may serve as an effective risk marker for early identification of high-risk individuals prone to stroke within the CKM stages syndrome 0-3 population.

PMID:40241126 | DOI:10.1186/s12933-025-02732-6

BMC Womens Health. 2025 Apr 16;25(1):185. doi: 10.1186/s12905-025-03722-2.

ABSTRACT

BACKGROUND: Women of all ages are susceptible to abnormal uterine bleeding (AUB), a relatively frequent gynecological issue. In the gynecology outpatient department, abnormal uterine bleeding is a problem that affects one-third of the patients, making them feel less financially secure and have a lower quality of life. Our study aimed to determine the endometrial histological patterns and factors associated with abnormal uterine bleeding among women seeking gynecological services from referral hospitals in western Uganda.

METHODS: A cross-sectional study was conducted from June 2023 to September 2023. We systematically enrolled 361 participants after getting consent. A structured questionnaire was used to collect information needed for analysis. The endometrial samples were collected immediately from eligible patients with Abnormal Uterine bleeding and taken to the histopathology laboratory for examination. Descriptive statistics followed by binary logistic regression were conducted to achieve the study objectives.

RESULTS: The study enrolled 361 participants with the mean age was 32.7 years (SD = 12.5). Of the total participants, 54(14.96%) had Abnormal Uterine bleeding. The common endometrial histological patterns among women with Abnormal uterine bleeding were; proliferative endometrium 21(38.9%), simple endometrial hyperplasia without atypia 11(20.4%), and secretory Endometrium 6 (11.1%). Women with BMI ranging between 25 and 29.9 [aOR = 5.61 (1.42-22.19), p = 0.014], those with a history of genital infection in the past 1 year [aOR = 2.49 (1.2-5.13),p = 0.013], those who were nulliparous [ aOR = 13.31( 4.94-35.82), p = 0.001], Primiparous [aOR = 4.32( 1.83-10.16), p ≤ 0.001] and women who reported HIV positive serostatus [aOR = 3.65(1.74-7.66), p = 0.001] were independently associated with Abnormal Uterine Bleeding at Fort portal Regional Referral hospital.

CONCLUSIONS AND RECOMMENDATIONS: The prevalence of AUB was within the global range. Simple endometrial hyperplasia without atypia and chronic endometritis were the commonest pathological patterns. BMI, History of genital infection, nulliparity, primiparity, and HIV serostatus were the factors that were independently associated with abnormal uterine bleeding. There is a need for routine endometrial sampling for all eligible women with abnormal uterine bleeding at FRRH.

PMID:40241115 | DOI:10.1186/s12905-025-03722-2