Nevin Manimala

Am J Cardiovasc Dis. 2025 Apr 25;15(2):108-114. doi: 10.62347/HQQX9117. eCollection 2025.

ABSTRACT

OBJECTIVES: Hypertension is a prevalent risk factor for cardiovascular mortality and morbidity, often leading to left ventricular hypertrophy (LVH). As ambulatory blood pressure monitoring (ABPM) gains prominence in hypertension management, it is crucial to explore its association with LVH occurrence to enhance clinical understanding and treatment strategies. This study aims to investigate the correlation between nocturnal blood pressure patterns and presence of LVH in hypertensive patients, offering insights into optimizing hypertension management strategies.

METHODS: Fifty-four patients with confirmed hypertension were included in this study. All participants underwent transthoracic echocardiography within two days of admission and 48-hour ABPM within one week of admission. Based on the presence of LVH, patients were categorized into LVH and non-LVH groups. Nocturnal systolic/diastolic BP were compared between the two groups using the appropriate statistical tests.

RESULTS: Among the 54 hypertensive patients, those with LVH (n = 22) demonstrated a significantly higher nocturnal average SBP (124.04 ± 11.92 mmHg) and DBP (76.24 ± 9.76) compared to those without LVH (n = 32, SBP = 116.78 ± 13.92 mmHg, DBP = 72.45 ± 9.76, P < 0.001).

CONCLUSION: This research shows a significant association between nocturnal BP patterns and the presence of LVH in hypertensive individuals. Nocturnal SBP and DBP were identified as independent risk factors for LVH. Further research, particularly on the timing of antihypertensive medication, is warranted to confirm causal relationships and improve management strategies.

PMID:40401275 | PMC:PMC12089019 | DOI:10.62347/HQQX9117

Matern Child Nutr. 2025 May 21:e70049. doi: 10.1111/mcn.70049. Online ahead of print.

ABSTRACT

The double burden of malnutrition (DBM), defined by the coexistence of undernutrition and overnutrition within households, poses significant public health challenges in South and Southeast Asia. While previous studies have examined the individual effects of maternal education and household wealth on DBM, findings remain inconsistent, and little is known about how these factors interact across different contexts. To address this gap, we used nationally representative Demographic and Health Survey (DHS) data from Bangladesh (2017-2018), Cambodia (2022), Nepal (2022) and Timor-Leste (2016) to analyse the interaction between maternal education and household wealth in shaping DBM risk. These countries were selected due to their ongoing nutritional transition, which has contributed to the increasing prevalence of DBM. For the analysis, we used DHS data, which employs a standardised multistage cluster sampling method and probabilistic methods to ensure representativeness. In this study, we selected mother-child pairs from the DHS survey, focusing on children aged 0-59 months and nonpregnant mothers at the time of the survey. We included those pairs for which both the mother and child had valid weight and height measurements. Maternal education and household wealth were identified as the primary exposures. To examine their interaction and the impact of other covariates on DBM, we employed multivariable logistic regression models. Our study found that DBM prevalence was higher in urban and wealthier households, with the highest rates observed in Timor-Leste and Cambodia. Multivariable logistic regression indicated that lower maternal education increased DBM risk, especially in affluent households (OR 2.07-3.29). Conversely, higher maternal education was associated with lower DBM prevalence. Additionally, breastfeeding and antenatal care visits emerged as protective factors. These findings indicate the necessity for specific interventions aimed at enhancing maternal education and promoting healthy dietary practices, particularly in rich households. Additionally, reinforcing breastfeeding practices and increasing antenatal care visits are essential strategies to mitigate the risks associated with DBM.

PMID:40400047 | DOI:10.1111/mcn.70049

BMC Res Notes. 2025 May 21;18(1):226. doi: 10.1186/s13104-025-07287-z.

ABSTRACT

OBJECTIVE: This study assesses the comparative performance of Isotope Ratio Mass Spectrometry (IRMS) and conventional techniques in detecting honey adulteration. Standard analytical methods, in accordance with ISIRI guidelines, were evaluated alongside δ¹³C isotopic analysis via IRMS across a dataset of 20 honey samples. Conventional analytical techniques were employed to evaluate parameters such as pre-hydrolysis reducing sugars, sucrose content, the fructose-to-glucose ratio, proline, and hydroxymethylfurfural (HMF). The advanced IRMS technique was utilized to determine δ¹³C values for glucose with high accuracy and sensitivity. The carbohydrate profile of honey, including glucose, fructose, disaccharides, and trisaccharides, was analyzed using LC/IRMS. A comparative assessment of both methods was conducted on twenty honey samples, following ISIRI guidelines.

RESULTS: While conventional methods met ISIRI criteria in 18 out of 20 samples, IRMS produced contrasting findings-only 2 samples were identified as genuine and free from adulteration. Statistical evaluation using Prism software revealed a significant discrepancy between the two techniques, with a p-value < 0.05, indicating stronger confidence in IRMS results. The findings highlight the necessity of reconsidering current protocols for honey adulteration detection in order to preserve the purity and credibility of this high-value natural product.

PMID:40400041 | DOI:10.1186/s13104-025-07287-z

Ital J Pediatr. 2025 May 21;51(1):149. doi: 10.1186/s13052-025-02001-y.

ABSTRACT

BACKGROUND: The transition from intrauterine to extrauterine life presents challenges for neonates, who are at increased risk of cardio-respiratory instability. Although electrocardiogram monitoring is recommended for neonatal resuscitation after birth, its ability to assess cardiovascular function is limited. Measuring arterial blood pressure (ABP) is feasible in neonates during the immediate transition period, though its interpretation is complex. This study analyses ABP values during the immediate transition in preterm neonates.

METHODS: Data from neonates born at the Medical University of Graz between 2009 and 2023 were analysed. All preterm neonates who survived without intraventricular haemorrhage grade II or higher, and who had ABP measured non-invasively at 15 min after birth, were eligible for inclusion. Statistical analyses were employed to evaluate ABP values for each gestational week, ranging from 23 to 36 weeks of gestation.

RESULTS: Out of 305 eligible neonates, 267 preterm neonates met the inclusion criteria. The median (IQR) systolic ABP ranged from 46 (43-51) to 64 (56-68) mmHg showing a gradual increase with advancing gestational age. The mean ABP ranged from 30 (27-36) to 45 (37-47) mmHg, also exhibiting a gradual increase with higher gestational age. Similarly, the diastolic ABP ranged from 22 (19-29) to 34 (29-41) mmHg, again showing a gradual increase with advancing gestational age.

CONCLUSION: The findings indicate that ABP values during the immediate transition may be higher than those described after immediate transition in large cohort studies. Moreover, the gradual increase in ABP in preterm neonates with advancing gestational age underscores the necessity for tailored approaches to neonatal cardiovascular management during immediate transition.

PMID:40400033 | DOI:10.1186/s13052-025-02001-y

BMC Psychol. 2025 May 21;13(1):539. doi: 10.1186/s40359-025-02722-z.

ABSTRACT

BACKGROUND: Male juvenile offenders, a high-risk group with elevated recidivism and violent crime rates, face significant mental health problems, particularly with a high prevalence of psychotic experiences. Childhood abuse is known to play a key role in such experiences. Evidence suggests that insomnia and depressive symptoms may mediate the relationship between childhood abuse and psychotic experiences. This study explores how childhood abuse relates to psychotic experiences in male juvenile offenders, with a focus on the mediating roles of insomnia and depressive symptoms.

METHODS: This is a convenience sampling survey, a total of 500 juvenile male offenders in a correctional facility in southwestern China were recruited. Assessment tools included the Childhood Trauma Screener (CTS) for childhood abuse, the Athens Insomnia Scale (AIS-8) for insomnia, the Patient Health Questionnaire-2 (PHQ-2) for depressive symptoms, and the Community Assessment of Psychic Experiences-8 (CAPE-8) for psychotic experiences. Data were analyzed using descriptive statistics, hierarchical regression, and SEM with SPSS 26.0 and Mplus 8.0.

RESULTS: 475 valid samples were analyzed for demographic variables such as family structure, residence, education, and substance use. Correlation analysis revealed significant positive associations between childhood abuse, insomnia, depressive symptoms, and psychotic experiences, with the strongest correlations observed between insomnia and depressive symptoms (r = 0.44) and between depressive symptoms and psychotic experiences (r = 0.44). Hierarchical regression and structural equation modeling confirmed that childhood abuse significantly predicts psychotic experiences (β = 0.22, p < 0.001), with insomnia (β = 0.42, p < 0.001) and depressive symptoms (β = 0.44, p < 0.001) serving as partial mediators. Mediation analysis indicated that insomnia and depressive symptoms jointly accounted for 28.40% of the variance in psychotic experiences, supporting the proposed chain mediation effect. These findings highlight the interactive mediating roles of insomnia and depressive symptoms in the relationship between childhood abuse and psychotic experiences among male adolescent offenders.

CONCLUSIONS: Insomnia and depressive symptoms mediate the childhood abuse and psychotic experiences among male juvenile offenders. This finding provides valuable insights for mental health interventions aimed at reducing recidivism in this population. Specifically, the results highlight the importance of implementing mental health interventions targeting insomnia and depression within the correctional system, which not only helps improve the mental health of juvenile offenders but also effectively reduces the risk of recidivism.

PMID:40400021 | DOI:10.1186/s40359-025-02722-z

Allergy Asthma Clin Immunol. 2025 May 21;21(1):25. doi: 10.1186/s13223-025-00969-0.

ABSTRACT

BACKGROUND: Hereditary angioedema (HAE) is a rare genetic disorder characterized by painful and potentially life-threatening tissue swelling due to a deficiency or dysfunction of the C1 esterase inhibitor protein. Despite the availability of comprehensive on-demand treatment guidelines, compliance to guideline recommendations remains suboptimal, resulting in persisting unmet need.

METHODS: This observational, online survey was conducted between September 6, 2022, and October 19, 2022 to understand the behaviors and perspectives of individuals in the US with hereditary angioedema (HAE). Participants were recruited by the US Hereditary Angioedema Association and were eligible if they were US residents with clinician-diagnosed HAE type I or II and had experienced at least one HAE attack. The survey included multiple-choice, rank-order, and scale-based responses using a 5-point Likert scale for agreement and an 11-point Likert scale for anxiety. Statistical analysis was performed using Microsoft Excel, summarizing continuous variables as means, medians, and ranges, and categorical variables as frequency distributions and percentages.

RESULTS: A total of 107 out of 155 participants completed the survey (mean age = 41 years; 80.4% female). Half of the respondents used both prophylaxis and on-demand therapy, while the other half used on-demand therapy only. Icatibant was the most commonly used on-demand treatment (78.5%). The survey revealed that 57% of respondents did not treat all HAE attacks, and only 14% treated attacks immediately. Delays in treatment were common, with a mean time to treatment of 2.4 h, and younger patients were less likely to carry on-demand treatment. Reasons for delaying treatment included the perceived severity of the attack, lack of on-demand treatment availability, and pain associated with treatment. Additionally, 32.7% of respondents experienced the return of an HAE attack after initial treatment, with those delaying treatment more likely to experience recurrence. The survey also found that delayed treatment led to more severe attacks and longer recovery times, impacting work, social activities, and overall quality of life.

CONCLUSIONS: Although guidelines recommend early treatment of HAE attacks, many respondents do not treat immediately. This finding underscores the importance of incorporating open patient-physician communication to improve guideline compliance and the management of HAE.

PMID:40400016 | DOI:10.1186/s13223-025-00969-0

Breast Cancer Res. 2025 May 21;27(1):87. doi: 10.1186/s13058-025-02030-9.

ABSTRACT

BACKGROUND: Carriers of germline pathogenic variants (PVs) in the BRCA1 and BRCA2 genes are at higher risk of developing breast and ovarian cancer than the general population. It is unclear if these PVs influence other breast or ovarian cancer risk factors, including age at menopause (ANM), age at menarche (AAM), menstrual cycle length, BMI or height. There is a biological rationale for associations between BRCA1 and BRCA2 PVs and reproductive traits, for example involving DNA damage and repair mechanisms. The evidence for or against such associations is limited.

METHODS: We used data on 3,046 BRCA1 and 3,264 BRCA2 PV carriers, and 2,857 non-carrier female relatives of PV carriers from the Epidemiological Study of Familial Breast Cancer (EMBRACE). Associations between ANM and PV carrier status was evaluated using linear regression models allowing for censoring. AAM, menstrual cycle length, BMI, and height in carriers and non-carriers were compared using linear and multinomial logistic regression. Analyses were adjusted for potential confounders, and weighted analyses carried out to account for non-random sampling with respect to cancer status.

RESULTS: No statistically significant difference in ANM between carriers and non-carriers was observed in analyses accounting for censoring. Linear regression effect sizes for ANM were -0.002 (95%CI: -0.401, 0.397) and -0.172 (95%CI: -0.531, 0.188), for BRCA1 and BRCA2 PV carriers respectively, compared with non-carrier women. The distributions of AAM, menstrual cycle length and BMI were similar between PV carriers and non-carriers, but BRCA1 PV carriers were slightly taller on average than non-carriers (0.5 cm difference, p = 0.003).

CONCLUSION: Information on the distribution of cancer risk factors in PV carriers is needed for incorporating these factors into multifactorial cancer risk prediction algorithms. Contrary to previous reports, we found no evidence that BRCA1 or BRCA2 PV are associated with hormonal or anthropometric factors, except for a weak association with height. We highlight methodological considerations and data limitations inherent in studies aiming to address this question.

PMID:40399999 | DOI:10.1186/s13058-025-02030-9

Chiropr Man Therap. 2025 May 21;33(1):20. doi: 10.1186/s12998-025-00584-1.

ABSTRACT

BACKGROUND: Contextual factors influence clinicians’ delivery of force-based manipulation (FBM), like spinal manipulative therapy (SMT). It is particularly important to discern how contextual factors interact with therapeutic forces delivered to an older adult population, to minimize risk and identify ideal dosage. This study aimed to determine whether contextual factors pertaining to aging result in the modulation of kinetic and kinematic parameters used by experienced clinicians when delivering SMT.

METHODS: Participants were randomly presented with a series of 12 AI-generated patient vignettes, featuring both visual and auditory content and representing varying age-related contextual factors. Factors included chronological (35-, 65- and 85-year-old), pathological (“healthy” vs degenerative spine), and felt (perceived as “young” vs. “old”) age. Participants delivered SMT to a human analogue manikin based on each vignette, presented six times in randomized order. Kinetic and kinematic parameters were collected and analyzed for differences between “young” and “old” contextual factors of age, using a 3-way repeated measures ANOVA model.

RESULTS: Sixteen licensed chiropractors (8 female, 8 male) participated, with an average age of 45.4 (SD = 9.7, range 34-64) years and 18.3 (SD = 10.8, range 5-39) years of experience. A main effect in peak force was found for both chronological (F(_2,30) = 26.18; p <.001, η_p² = 0.636) and pathological age (F(_1,15) = 11.58; p =.004, η_p² = 0.436), following a stepwise progression of decreased force with increased age and with pathology. No statistically significant differences were found in peak force based on felt age, or in time to peak force for any factor. A main effect was found for chronological age with peak acceleration (F(_2,20) = 9.50; p <.001, η_p² = 0.487) and peak velocity (F(_2,20) = 7.20; p =.004, η_p² = 0.419), but not for pathological or felt age. There was a significant difference in time to peak velocity for felt age (F(_1,10) = 12.23; p =.006, η_p² = 0.550), with a shorter time to peak velocity in response to vignettes with older felt age.

CONCLUSION: Contextual factors of aging modulated certain kinetic and kinematic characteristics when delivering SMT. This provides evidence that practitioners differentially discern aspects of aging to inform how they deliver FBM dosage. Future research is needed to identify ideal kinetic and kinematic characteristics based on considerations of aging.

PMID:40399997 | DOI:10.1186/s12998-025-00584-1

Scand J Trauma Resusc Emerg Med. 2025 May 21;33(1):94. doi: 10.1186/s13049-025-01410-6.

ABSTRACT

BACKGROUND: Accurate dispatch prioritization for emergency medical services (EMS) is essential for optimizing resource allocation and ensuring timely emergency response. In the Province of Quebec, Canada, a locally adapted dispatch system was implemented using the standardized codes of the Medical Priority Dispatch System (MPDS) but with regional priority definitions. Despite periodic reviews, the system’s performance has not been formally assessed. This study evaluates the effectiveness of this prioritization system by comparing priority levels assigned at call-taking with on-scene paramedic assessments and by examining how the system’s performance has evolved over three years and across chief complaints.

METHODS: In this retrospective observational study, we analyzed EMS dispatches in the Capitale-Nationale administrative region of the Province of Quebec, Canada, between July 15 and December 15 over three consecutive years (2021, 2022, and 2023). We assessed system performance using sensitivity, specificity, overtriage, undertriage, predictive values, and accuracy. Statistical analyses included chi-square tests for priority consistency and pairwise t-tests for performance changes over time. Additionally, we examined variations across chief complaints to identify high overtriage and undertriage medical conditions.

RESULTS: This study analyzed 96,099 EMS dispatches over a three-year period. While 61.8% of these dispatches were classified as urgent at call-taking, paramedics later determined that 79.7% of all cases were stable and required non-urgent transport, indicating a high level of overtriage. Conditions such as abdominal pain, falls, and psychiatric issues were the chief complaints that showed high overtriage rates (> 90%), whereas allergic reactions, diabetic problems, and heart conditions had the highest undertriage rates (> 10%). Over the three-year period, priority modifications led to a 2.5% decrease in undertriage but a 3.7% increase in overtriage (p < 0.05), highlighting the ongoing challenge of balancing accuracy with an adequate response in dispatch prioritization.

CONCLUSION: The studied prioritization system effectively identifies non-urgent dispatches but exhibits a high overtriage rate, which strains EMS resources. The recent priority modifications further increased overtriage, underscoring the challenge of balancing resource allocation with timely intervention. Refining dispatch criteria and integrating secondary triage or AI-based decision support could potentially improve accuracy and system efficiency.

PMID:40399996 | DOI:10.1186/s13049-025-01410-6

J Biomed Sci. 2025 May 21;32(1):50. doi: 10.1186/s12929-025-01137-7.

ABSTRACT

BACKGROUND: Type 2 diabetes is an increasingly prevalent metabolic disorder with moderate to high heritability. Glycemic indices are crucial for diagnosing and monitoring the disease. Previous genome-wide association study (GWAS) have identified several risk loci associated with type 2 diabetes, but data from the Taiwanese population remain relatively sparse and primarily focus on type 2 diabetes status rather than glycemic trait levels.

METHODS: We conducted a comprehensive genome-wide meta-analysis to explore the genetics of glycemic traits. The study incorporated a community-based cohort of 145,468 individuals and a hospital-based cohort of 35,395 individuals. The study integrated genetics, transcriptomics, biological pathway analyses, polygenic risk score calculation, and drug repurposing for type 2 diabetes.

RESULTS: This study assessed hemoglobin A1c and fasting glucose levels, validating known loci (FN3K, SPC25, MTNR1B, and FOXA2) and discovering new genes, including MAEA and PRC1. Additionally, we found that diabetes, blood lipids, and liver- and kidney-related traits share genetic foundations with glycemic traits. A higher PRS was associated with an increased risk of type 2 diabetes. Finally, eight repurposed drugs were identified with evidence to regulate blood glucose levels, offering new avenues for the management and treatment of type 2 diabetes.

CONCLUSIONS: This research illuminates the unique genetic landscape of glucose regulation in Taiwanese Han population, providing valuable insights to guide future treatment strategies for type 2 diabetes.

PMID:40399988 | DOI:10.1186/s12929-025-01137-7