Nevin Manimala

J Health Popul Nutr. 2025 May 14;44(1):156. doi: 10.1186/s41043-025-00914-2.

ABSTRACT

BACKGROUND: Metabolic Score for Visceral Fat (METS-VF) is commonly used as an indicator for assessing visceral fat metabolism. However, the relationship between METS-VF, Bone Mineral Density (BMD), and osteoporosis remains unclear in the American population.

METHODS: This study utilized cross-sectional data from the National Health and Nutrition Examination Survey (NHANES), including participants aged 20 years and older, from the survey cycles conducted between 2005 and 2010, 2013-2014, and 2017-2018. Multivariable weighted linear regression and logistic regression analyses were first applied to investigate the associations between the METS-VF, femoral BMD, and osteoporosis. In addition, subgroup interaction analyses were performed to evaluate the robustness of these associations. To address potential non-linear relationships, restricted cubic spline regression was employed. All statistical analyses were conducted using R software version 4.3.3. P values were two-tailed, with P < 0.05 considered statistically significant.

RESULTS: After adjusting for all covariates, the positive correlations between METS-VF and BMD measurements at all sites remained statistically significant (p < 0.001 & p for trend < 0.001). Multivariable logistic regression analysis indicated that, after adjusting for covariates related to osteoporosis, each one-unit increase in METS-VF was associated with a 63.1% reduction in the risk of developing osteoporosis. Moreover, the direction of the associations between METS-VF and both BMD and osteoporosis remained consistent across all subgroups, while restricted cubic spline (RCS) analyses suggested nonlinear relationships. The 5.82-7.35 METS-VF range yielded a mean 51.9% osteoporosis risk reduction (sustained ≥ 30% peak efficacy in 66.7% of participants).

CONCLUSIONS: METS-VF demonstrated a nonlinear positive association with BMD and a nonlinear inverse relationship with osteoporosis risk. Future studies should establish optimal biological thresholds of METS-VF for skeletal health.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40369619 | DOI:10.1186/s41043-025-00914-2

Head Face Med. 2025 May 14;21(1):39. doi: 10.1186/s13005-025-00501-0.

ABSTRACT

BACKGROUND: After surgical procedures involving bone and soft tissue, such as impacted tooth extraction, profen and diclofenac derivatives are commonly prescribed. Diclofenac sodium (DS) and dexketoprofen trometamol (DT), derivatives of diclofenac and profen, exhibit clinical differences from their parent compounds. Despite their widespread use, comparative studies of their effects on postoperative complications remain limited. This randomized controlled trial was performed to compare the analgesic and anti-inflammatory effects of DS and DT following impacted tooth extraction.

METHODS: This split-mouth, randomized clinical study included healthy individuals aged 18 to 40 years with bilaterally impacted third molars. Left and right teeth were randomly assigned to either the DT or DS group. Participants took 25 mg of DS or 36.9 mg of DT twice daily for 7 days, beginning 1 h before extraction. Postoperative pain was assessed using a visual analogue scale at 4, 8, 12, and 24 h postoperatively, as well as on days 2 through 7. Trismus was evaluated by the interincisal distance, and edema was anatomically measured preoperatively and on postoperative days 2 and 7. The surgical duration and rescue analgesic use were also recorded.

RESULTS: In total, 35 patients (28 women, 7 men) aged 18 to 31 years (mean, 21.31 ± 3.19 years) participated. The mean operation duration was 12.94 ± 2.26 min for the DT group and 13.26 ± 2.19 min for the DS group (p > 0.05). No statistically significant difference was observed between the groups regarding pain, edema, or trismus development (p > 0.05). However, from days 2 to 7, the DS group exhibited a greater reduction in edema than did the DT group (p < 0.05). Additionally, the DS group required 10% more frequent use of rescue analgesics than the DT group.

CONCLUSION: Following impacted tooth extraction, administering DT during the initial days-when pain is more intense and the inflammatory response is developing-followed by DS in the later recovery phase may enhance postoperative comfort.

TRIAL REGISTRATION: This clinical trial was retrospectively registered on 03.10.2023 with the number TCTR20231003006.

PMID:40369617 | DOI:10.1186/s13005-025-00501-0

BMC Nutr. 2025 May 14;11(1):96. doi: 10.1186/s40795-025-01079-1.

ABSTRACT

BACKGROUND: Anaemia is a significant global health issue, with adolescents being a particularly vulnerable group. In developing countries, 27% of adolescents are affected by anaemia, compared to a much lower prevalence of 6% in developed countries. This scoping review aims to investigate the intake of junk food and the development of anaemia, providing a foundation for future research in this field.

METHODS: A systematic search was conducted across Scopus, PubMed, EBSCO, CINHAL, WOS and ProQuest using specific keywords. Inclusion criteria comprised all quantitative studies examining the association between nutrition and the development of anaemia. Articles selected for analysis were restricted to those published in English Language between 2014-2024 and available as full-text articles.

RESULTS: Among the articles that were screened, 20 articles met the criteria for data extraction. Four studies did not reveal statistically significant correlations between nutrition and the development of anaemia, while two studies provided evidence for significant associations. The findings indicated increased anaemia was associated with (a) fast food intake, western pattern of diet, poor eating habits, omission of breakfast and (b) diminished consumption of fruits and vegetables, iron intake, seafood, nuts, and seeds.

CONCLUSION: The existing evidence suggests a link between the consumption of junk food and the prevalence of anaemia among adolescents. However, there is a lack of comprehensive studies that thoroughly explore this connection. This gap in research underscores the urgent need for more in-depth studies to understand how modifiable risk factors like junk food consumption contribute to anaemia in adolescents, with the goal of improving prevention and management strategies. Addressing this issue aligns with Sustainable Development Goal (SDG) 3, which aims to ensure healthy lives and promote well-being for all at all ages, which focuses on ending preventable deaths of children and addressing adolescent health. Additionally, this research also contributes to end hunger, achieve food security, and improve nutrition.

PMID:40369615 | DOI:10.1186/s40795-025-01079-1

World J Surg Oncol. 2025 May 14;23(1):189. doi: 10.1186/s12957-025-03845-8.

ABSTRACT

BACKGROUND: Increasing evidence indicates that psychological factors play a role in tumor progression. This study aims to explore the impact of anxiety disorder on the prognosis of hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) who underwent hepatic arterial infusion chemotherapy (HAIC).

METHODS: A propensity score-matching cohort study was conducted in 68 HCC patients with PVTT who underwent HAIC between January 2020 and December 2023. The anxiety situation was evaluated using the Hamilton Anxiety Rating Scale before HAIC. The objective response rate, overall survival (OS), progression-free survival, and adverse events were compared between the different anxiety score groups. Using Cox proportional hazards models for univariate and multivariate analysis to explore the risk factors of OS.

RESULTS: No statistical difference was found in the tumor response, treatment-related adverse events, and PFS between the two groups before and after PSM. Compared with low anxiety scores patients, the OS of obvious anxiety patients was shorter (hazard ratio [HR] = 1.606; 95%CI: 0.868-2.973; P = 0.116). The univariate and multivariate analysis showed that BMI (HR = 1.174, 95%CI: 1.044-1.320; P = 0.007), high anxiety score (HR = 2.769, 95%CI: 1.289-5.947; P = 0.007), and serum ammonia (HR = 1.059; 95%CI: 1.032-1.086; P < 0.001) were independent risk factors of OS.

CONCLUSIONS: Our study reveals that elevated anxiety scores in HCC patients with PVTT correlated with poor prognosis, indicating that it’s a potential prognostic marker. The high anxiety score, BMI, and serum ammonia were independent risk factors of OS.

PMID:40369614 | DOI:10.1186/s12957-025-03845-8

BMC Health Serv Res. 2025 May 14;25(1):697. doi: 10.1186/s12913-025-12749-y.

ABSTRACT

OBJECTIVES: This study aims to identify the dimensions and evolutionary pathways of China’s high-performing national healthcare system, as well as the interaction mechanisms between the digital and traditional healthcare dimensions.

METHODS: This study first constructs a high-performing healthcare evaluation index comprising four dimensions: digital healthcare, healthcare resource allocation, healthcare output, and healthcare effectiveness. It next presents a multilevel structural dynamic factor model to examine the evolutionary pathway of China’s national healthcare system. It then analyses the interaction mechanism of each healthcare dimension based on the impulse response function.

RESULTS: First, the upward trend in the overall performance of China’s high-performing national healthcare system demonstrates that it is significantly improving. Second, the overall performance of China’s high-performing national healthcare system has been most impacted by healthcare effectiveness and least impacted by healthcare output. The performance is trending upward for digital healthcare and healthcare resource allocation but downward for healthcare output and effectiveness. Third, increasing healthcare resource allocation and output promotes digital healthcare. The improvement in digital healthcare performance significantly and positively impacts healthcare effectiveness, while having weaker effects on healthcare resource allocation and healthcare output.

CONCLUSIONS: The performance of China’s high-performing national healthcare system is improving. However, healthcare resource allocation and health outcomes require further optimisation, and the integration capacity of traditional healthcare with digital healthcare must be strengthened.

PMID:40369605 | DOI:10.1186/s12913-025-12749-y

Exp Hematol Oncol. 2025 May 14;14(1):73. doi: 10.1186/s40164-025-00666-z.

ABSTRACT

Diagnosis-to-treatment interval (DTI) is an important prognostic factor in patients with newly diagnosed aggressive lymphomas, however the impact of DTI on outcomes in marginal zone lymphoma (MZL) is unknown. In this multicenter retrospective cohort study, we included adult patients with MZL who received first-line immunochemotherapy within 120 days of diagnosis at 10 US medical centers. Patients who received treatment within 60 days from their diagnosis were classified into the short DTI group and those who received treatment beyond 60 days into long DTI group. The primary objective was progression-free survival (PFS), while secondary objectives included overall survival (OS) and cumulative incidence of histologic transformation (HT) between the two groups. Of the 870 patients with newly diagnosed MZL, 177 patients met the inclusion criteria and were included in this analysis. Among these 144 (81%) were in the short DTI group and 33 (19%) in the long DTI group. In the univariable analysis, presence of B symptoms was associated with short DTI and remained significantly associated with short DTI in the multivariable analysis (OR = 11.91, p = 0.017). Short DTI was not associated with a statistically different PFS or OS compared to long DTI in the univariable or in multivariable analysis. The cumulative incidence of HT was not significantly different between the two groups. This is the first study to-date to report on the association of DTI on outcomes in MZL patients. This lack of prognostic utility of DTI in newly diagnosed MZL, in contrast to aggressive B-cell lymphomas, may be intrinsically linked to the underlying disease biology.

PMID:40369604 | DOI:10.1186/s40164-025-00666-z

BMC Nurs. 2025 May 14;24(1):526. doi: 10.1186/s12912-025-03201-x.

ABSTRACT

BACKGROUND: Nursing students often encounter ethical dilemmas throughout their professional training, which can pose challenges to their development. These dilemmas may lead to questioning professional values, hesitation during clinical practice, and even emotional fatigue. Therefore, reliable and valid tools are essential to assess and enhance their ethical decision-making abilities.

METHODS: Conducted as a methodological study, this research involved 233 nursing students from Manisa Celal Bayar University during November and December 2024. Data collection tools included the Ethical Decision-Making Competence Scale and the Inclination to Ethical Values Scale. Structural validity was analyzed using principal component analysis and confirmatory factor analysis, while internal consistency was assessed with Cronbach’s alpha.

RESULTS: The scale demonstrated acceptable model fit indices [χ2 (129) = 234.701, χ2/df = 3.295, GFI = 0.841, CFI = 0.900, IFI = 0.901, RMSEA = 0.096 (0.087-0.105)], with all factor loadings exceeding 0.4 and achieving statistical significance. Cronbach’s alpha values for the four dimensions were 0.865, 0.867, 0.868, and 0.886, indicating strong internal consistency. Furthermore, the test-retest analysis confirmed the scale’s stability over time, validating its use for repeated measurements.

CONCLUSION: Given its psychometric strengths, this tool can be effectively employed in future studies focusing on ethical decision-making competencies in nursing education.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40369595 | DOI:10.1186/s12912-025-03201-x

Reprod Biol Endocrinol. 2025 May 14;23(1):69. doi: 10.1186/s12958-025-01408-w.

ABSTRACT

BACKGROUND: The role of follicular fluid phosphate for reproductive health and oocyte maturation is unclear. This study investigates the relationship between follicular fluid vs serum phosphate concentrations and the possible link with sex steroids during in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) at a Danish fertility clinic.

METHODS: A prospective cohort of infertile women who attended Danfert Fertility clinic (Copenhagen, Denmark) and received IVF or ICSI treatment between June 2015 and February 2017. Correlation analyses were performed with Spearman’s Rank or Pearson’s correlation, while categorical variables were analyzed with Chi-squared test.

RESULTS: In total, 110 participants were included in the study, and 33 of these achieved a live birth. Phosphate concentrations were higher in the follicular fluid compared to corresponding serum samples (1.16 mmol/L vs. 1.06 mmol/L, p = 0.002) and there was a positive correlation between serum and follicular fluid phosphate concentrations (r = 0.43, p = 0.007). A positive trend was also found for calcium concentrations, though not statistically significant (r = 0.31, p = 0.060). Correlation analysis also showed a positive correlation between concentrations of phosphate and calcium in follicular fluid (r = 0.41, p < 0.001). A positive correlation was observed between concentrations of phosphate and testosterone in follicular fluid (r = 0.34, p < 0.001). When stratified into tertiles, we found no significant differences between live birth rates in follicular fluid phosphate (p = 0.624), calcium (p = 0.207), or testosterone (p = 0.841).

CONCLUSIONS: This study found that follicular fluid phosphate concentrations are higher than serum phosphate concentrations, suggesting possible local regulation. However, no significant association was found between follicular phosphate and ART outcomes. Further research is needed to explore its potential role in reproductive physiology.

CLINICAL TRIAL: Clinicaltrials.gov (NCT02437578; registration date 2015/04/16).

PMID:40369590 | DOI:10.1186/s12958-025-01408-w

Cardiovasc Diabetol. 2025 May 14;24(1):209. doi: 10.1186/s12933-025-02770-0.

ABSTRACT

BACKGROUND: Recent basic biological research found that obesity accelerates biological aging and increases cardiovascular disease (CVD) risk. However, there is still a lack of real-world population evidence. This study aimed to explore the potential mediation roles of biological age acceleration in the associations between different dimensions of obesity characterization and incident CVD.

METHODS: This international multi-cohort study included participants aged over 45 years with 3 waves longitudinal data from China Health and Retirement Longitudinal Study (CHARLS). China Health and Nutrition Survey (CHNS) was used to develop Klemera-Doubal method-biological age (KDM-BA), and the validation analysis was performed in UK Biobank (UKB) and Hongguang Elderly Health Examination Cohort (HEHEC). Obesity indices including body mass index (BMI), waist circumference (WC), waist height ratio (WtHR), body roundness index (BRI) for body shape; Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP) for visceral fat accumulation; triglyceride-glucose index (TyG) and its derivatives (TyG-BMI, TyG-WC, TyG-WtHR) for metabolic function were used to measure obesity across different dimensions. Biological age acceleration was evaluated by the classic KDM-BA acceleration (KDM-BAacc). Causal mediation analyses assessed the role of biological age acceleration in mediating obesity and incident CVD.

RESULTS: In CHARLS, the median follow-up period was 9.00 years, with a baseline age of 58 (52, 65) years. Obesity, KDM-BAacc, and CVD were all significantly associated with each other. For each 1-year increase in KDM-BAacc, the risk of incident stroke, heart disease and CVD increased by 68% (OR 1.68, 95% CI 1.35-2.09), 35% (OR 1.35, 95% CI 1.15-1.59), and 44% (OR 1.44, 95% CI 1.25-1.65), respectively. KDM-BAacc mediated the associations between BMI, WC, WtHR, BRI, CVAI, LAP, TyG-BMI, TyG-WC, TyG-WtHR, with CVD, with the mediation proportions ranging from 10.03 to 25.46%. However, the mediating effect was significant mostly in middle-aged individuals aged 45-65 years. Furthermore, sex differences existed in the mediation mechanisms. Biological age acceleration strongly mediated body shape indices and incident CVD in males, whereas in females, it predominantly mediated visceral fat accumulation and metabolic function dimensions with incident CVD. Similar main results were found in UKB and HEHEC.

CONCLUSIONS: Biological age acceleration partially mediates the relationship between obesity and incident CVD. This temporal evidence firstly validated the mediation pathway based on international cohorts, emphasizing the importance of addressing biological aging processes in population aged 45-65 years while providing sex-specific obesity intervention strategies to prevent CVD.

PMID:40369582 | DOI:10.1186/s12933-025-02770-0

BMC Health Serv Res. 2025 May 14;25(1):693. doi: 10.1186/s12913-025-12842-2.

ABSTRACT

BACKGROUND: Although Japan has successfully mitigated HIV infections, several issues related to the disease remain to be addressed. As the people living with HIV are aging, their medical care needs are expected to become more diversified and regionalized. Those residing beyond the boundaries of specialized hospitals will rely on general physicians for medical services. Hence, general physicians must have a non-discriminatory medical attitude toward people living with HIV and give more ethical consideration than for other diseases, such as privacy protection. Therefore, a nationwide survey was conducted to clarify the attitudes of general physicians, who do not specialize in HIV treatment, toward HIV and people living with HIV.

METHODS: An online questionnaire-based quantitative survey (February 14-16, 2022) yielded 212 valid responses. Questions covered proactivity in HIV care, attitudes toward ethical issues, and awareness of HIV in the context of stigmas. Although the sample size was small due to limited feasibility, similar populations were obtained in terms of distribution of mean age, gender, and type of practice, compared to official physician statistics.

RESULTS: Approximately 20% of respondents answered that refusing medical care due to HIV infection is acceptable. Younger physicians tended to be more negative toward HIV treatment, and, regardless of age, the negative attitude is correlated with aversion toward HIV infection itself.

CONCLUSIONS: The findings aligned with concerning situations in Japan highlighted by other studies. They also suggested that more careful attitudes may be needed regarding the protection of the privacy of people living with HIV. However, research has also suggested that some physicians could become more positive by providing specialist support for the treatment and prevention of HIV infection. Large-scale and ongoing surveys are imperative to continuously implement effective and reliable interventions that could change the attitudes of general physicians toward people living with HIV.

PMID:40369576 | DOI:10.1186/s12913-025-12842-2