Nevin Manimala

Sci Rep. 2025 Nov 29. doi: 10.1038/s41598-025-28209-w. Online ahead of print.

ABSTRACT

Health-related quality of life (HRQoL) in people living with HIV/AIDS (PLWHA) is shaped by a combination of HIV-related and non-HIV-related factors, including immunological and virological failure, HIV-associated comorbidities, and antiretroviral therapy (ART)-induced toxicity. Although HRQoL tends to improve during the first year of combination ART (cART), especially among those with advanced HIV, disparities persist. This cross-sectional analytical study assessed HRQoL in 321 PLWHA, of whom 310 were included in the final analysis. HRQoL was evaluated using the EQ-5D-5 L index. Of the participants, 121 (37.7%) had a high EQ-5D-5 L index value of 1, whereas 181 (58.9%) had an index value of less than 1. A statistically significant positive correlation was found between the EQ-5D-5 L index and the recent CD4-T cell count (rs = 0.162, p = .004). Gender-based analysis showed males (0.85 ± 0.15) had significantly higher HRQoL scores compared to females (0.77 ± 0.16). Furthermore, delayed switching to second-line regimens was associated with suboptimal recovery in HRQoL. These findings highlight the importance of timely clinical decisions in switching the ART to a more potent regimen especially in resource poor settings.

PMID:41318722 | DOI:10.1038/s41598-025-28209-w

Sci Rep. 2025 Nov 29. doi: 10.1038/s41598-025-29610-1. Online ahead of print.

ABSTRACT

A persistent mental illness, schizophrenia has a complicated etiopathogenesis that includes both environmental and genetic elements. This study examined the possibility of diagnosing schizophrenia by utilizing computed tomography (CT) images of the orbit and its structures, which were then examined by artificial neural networks (ANNs) and machine learning (ML) algorithms. A retrospective analysis of the CT scans of 90 healthy people and 90 people with schizophrenia was conducted. Prior to measurement, all CT images underwent preprocessing steps to ensure align-ment and standardization. Height, width, depth, wall length, aperture area, interorbital width, biorbital width, bimalar width, skull transverse diameter, and optic nerve sheath width were among the orbital parameters that were measured. Statistical analysis revealed significant differences between the groups in left orbital width, left orbital aperture area, right optic nerve sheath width, transverse skull diameter, bimalar width, biorbital width, and left medial wall length. ML algorithms and ANNs were applied to the data, with the Extra Tree Classifier (ETC) algorithm achieving the highest accuracy of 0.78 and the Multilayer Perceptron Classifier (MLCP) model of ANN achieving an accuracy of 0.75 after 1000 training iterations. The Random Forest algorithm’s SHAP analyzer determined that the left orbital width had the biggest impact on the final outcome. These results add to the expanding field of machine learning applications in psychiatry by indicating that AI-based models that analyze orbital morphometry may be useful instruments for detecting schizophrenia.

PMID:41318706 | DOI:10.1038/s41598-025-29610-1

Neurosurg Rev. 2025 Nov 29;49(1):34. doi: 10.1007/s10143-025-03943-x.

ABSTRACT

Expandable interbody cages have gained popularity in posterior lumbar fusion due to their ability to restore disc height and segmental alignment with minimal surgical exposure. However, concerns remain regarding their long-term durability, particularly the risk of implant subsidence. This study evaluates radiographic outcomes and subsidence rates over a 12-month period following posterior lumbar fusion with a novel expandable cage. We conducted a retrospective cohort study of 40 consecutive adult patients who underwent posterior lumbar fusion using a posteriorly placed expandable cage (Calibrate PSX) at a single academic institution. Radiographic parameters-including anterior disc height, posterior disc height, segmental lordosis, and global lumbar lordosis (L1-S1)-were measured preoperatively, immediately postoperatively, and at 3 and 12 months. Subsidence was graded according to the classification proposed by Levy et al. (2024). Generalized estimating equations were used for longitudinal analysis, with statistical significance set at p < 0.05. Among 44 implanted levels, 16 levels (36.4%) demonstrated subsidence at 3 months, increasing to 20 (45.5%) by 12 months. No surgical revisions were required at 12 months. Anterior disc height increased significantly in the immediate postoperative period (+ 8.6 mm, p < 0.0001) but declined over time, with greater loss in the subsidence group (-7.1 mm vs. – 1.9 mm, p = 0.013). Posterior disc height followed a similar trend. However, segmental and global lumbar lordosis remained stable, with no significant differences between subsidence and non-subsidence groups. Minor intraoperative complications occurred in 6 patients (13.6%) and resolved without sequelae. Expandable interbody cages provide substantial immediate postoperative improvements in disc height and alignment. While subsidence can occur over time, segmental and global lordosis are generally maintained. The overall subsidence rate was modest and not associated with adverse clinical outcomes. These findings support the cautious use of expandable cages in posterior lumbar fusion, with attention to patient selection, surgical technique and implant selection to mitigate the risk of subsidence.

PMID:41317307 | DOI:10.1007/s10143-025-03943-x

Ir J Med Sci. 2025 Nov 29. doi: 10.1007/s11845-025-04199-6. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the association between iron metabolism-related parameters and in-hospital mortality in patients presenting to the emergency department (ED) with symptoms and signs of acute heart failure (AHF), and to determine the prognostic value of iron metabolism-related subgroups.

METHODS: This prospective observational case series was conducted in the ED of a tertiary hospital between May 1, 2023, and February 29, 2024. A total of 941 patients who presented with AHF and met the inclusion criteria were evaluated. Demographic, clinical, and laboratory data were recorded, and their associations with short-term mortality were analyzed statistically. Serum ferritin levels and transferrin saturation (TSAT) values were classified to define subgroups of iron metabolism.

RESULTS: In-hospital mortality occurred in 13.8% of the patients (n = 130). Logistic regression analysis identified ferritin levels as an independent predictor of mortality. Patients with ferritin levels of 100-299 ng/mL had a 5.8-fold increased risk of mortality, while those with ferritin ≥ 300 ng/mL had a 13.6-fold increased risk (both p < 0.001). In ROC analysis, ferritin was the strongest biomarker for predicting mortality, with an AUC of 0.811 (95% CI: 0.774-0.848). At the determined cut-off value of 102.8 ng/mL, ferritin demonstrated a sensitivity of 74.5% and specificity of 75.2%. In Group 3 (ferritin ≥ 300 ng/mL + TSAT < 20%), the mortality rate was 42.5% (p < 0.001).

CONCLUSION: Elevated ferritin levels provide additional prognostic value for early risk stratification and may help identify high-risk subgroups among patients presenting to the emergency department with acute heart failure.

PMID:41317296 | DOI:10.1007/s11845-025-04199-6

Ir J Med Sci. 2025 Nov 29. doi: 10.1007/s11845-025-04198-7. Online ahead of print.

ABSTRACT

BACKGROUND: Melanocyte death in the pathogenesis of vitiligo is thought to be associated with ROS/RNS accumulation, but the interaction of miRNAs with oxidative and nitrosative stress is not yet clear.

AIM: This study aimed to evaluate the role of miRNAs associated with oxidative stress, apoptosis, and melanogenesis in the pathogenesis of vitiligo and to determine the relationship between these miRNAs and plasma levels of oxidative/nitrosative stress biomarkers.

METHODS: The study included 30 vitiligo patients and 30 healthy individuals. Expression levels of 34 specific miRNAs were measured by quantitative real-time PCR in plasma samples obtained from patients and controls. Catalase (CAT), superoxide dismutase (SOD), malondialdehyde (MDA), 3-nitrotyrosine (3-NT), and nitric oxide (NO) levels were measured to determine plasma and erythrocytic oxidative/nitrosative stress levels.

RESULTS: While there was no significant difference in the levels of 5 miRNAs analyzed in vitiligo patients compared to the control group, expression levels of 29 miRNAs were up- or down-regulated, and the differences were statistically significant. Especially, changes in miR-34a-5p, miR-373-3p, miR-196a-5p, miR-25-3p, miR-26a-5p, miR-193a-5p, miR-146a-5p, and miR-223-3p were found to be statistically significant (p < 0.001). In addition, plasma MDA, NO, and 3-NT levels were significantly higher, and SOD and CAT enzyme activities were significantly lower in the vitiligo group.

CONCLUSIONS: Our findings revealed significant changes in miRNA levels associated with melanocyte apoptosis, inflammation, oxidative stress, and melanogenesis, which play a role in the pathogenesis of vitiligo. Furthermore, increased oxidative and nitrosative stress responses support their role in the physiopathology of the disease.

PMID:41317295 | DOI:10.1007/s11845-025-04198-7

J Gastrointest Cancer. 2025 Nov 29;56(1):230. doi: 10.1007/s12029-025-01352-3.

ABSTRACT

PURPOSE: Neoadjuvant chemoradiotherapy (NACRT) is standard for locally advanced rectal cancer. Accurate response assessment is essential, particularly to identify complete responders eligible for organ-preserving strategies. While MRI is widely used, 18 F-FDG PET-CT has been proposed as a complementary modality. This study compared MRI-based Tumor Regression Grade (mrTRG) and PET-CT parameters in predicting pathological response.

METHODS: A retrospective analysis was conducted at Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, from January 2013 to May 2024. A total of 268 patients underwent MRI and PET-CT before and after NACRT, followed by surgery. Response was categorized using mrTRG and pathological TRG (pTRG). PET-CT response was assessed by changes in SUVmax. Diagnostic accuracy of mrTRG and PET-CT was evaluated using statistical tests, kappa agreement, and ROC curves.

RESULTS: Of 268 patients, 27.2% were classified as good responders (mrTRG 1-2), whereas 46.2% had good pathological response (pTRG 0-1). The correlation between mrTRG and pTRG was weak (kappa = 0.215). PET-CT showed a mean SUVmax reduction of 58.2%, with greater decline in responders. However, ROC analysis demonstrated poor discriminative ability (AUC = 0.502), indicating no advantage over MRI. Combining MRI and PET-CT imaging slightly improved accuracy in matching pathological grading (κ = 0.36).

CONCLUSION: MRI remains the preferred modality for post-NACRT response assessment in rectal cancer, showing moderate predictive accuracy. PET-CT, despite reflecting metabolic changes, is not reliable in distinguishing complete responders. A combined multimodal approach may improve evaluation and support individualized treatment planning.

PMID:41317281 | DOI:10.1007/s12029-025-01352-3

Sleep Breath. 2025 Nov 29;29(6):371. doi: 10.1007/s11325-025-03483-0.

ABSTRACT

PURPOSE: To investigate the association between multidimensional sleep health (MDSH) and psychological distress in Japanese community residents.

METHODS: A self-administered questionnaire survey was conducted from December 2022 to February 2023 among residents of Kyoto City aged 40 years or older. MDSH was assessed using the RU_SATED, which evaluates six dimensions of sleep health-regularity, satisfaction, alertness, timing, efficiency, and duration-and generates a total score. Psychological distress was measured using the Kessler 6 (K6) scale and a single-item question about perceived stress. Associations between sleep health and psychological distress were analyzed using multivariable logistic regression.

RESULTS: Data from 661 respondents (57.9% female; mean age: 64.9 years; 68.4% urban residents) were analyzed. The prevalence of K6-5 distress, K6-13 distress, and perceived stress was 28.9%, 3.0%, and 20.0%, respectively. K6 scores were negatively correlated with total RU_SATED scores (rs = -0.252, p < 0.001). Each 1-point increase in the RU_SATED score was associated with a 0.325-point decrease in the K6 score. Multivariable logistic regression showed that K6-5 distress was associated with all six RU_SATED dimensions (odds ratios [OR] = 0.309-0.671), while K6-13 distress was associated with satisfaction (OR = 0.176). Perceived stress was associated with regularity, satisfaction, and duration (OR = 0.246-0.653).

CONCLUSION: Higher RU_SATED scores were negatively associated with psychological distress, with each sleep dimension showing a distinct relationship. Further research is warranted to examine these associations in more diverse populations.

PMID:41317241 | DOI:10.1007/s11325-025-03483-0

Eat Weight Disord. 2025 Nov 29;30(1):92. doi: 10.1007/s40519-025-01800-w.

ABSTRACT

OBJECTIVE: Despite several studies assessing the impact of resveratrol on obesity indices, previous meta-analyses show conflicting results. Therefore, we conducted this critical umbrella review of interventional meta-analyses on the effect of resveratrol supplementation on body mass index (BMI), body weight (BW), waist circumference (WC), and body fat.

METHODS: Searches were conducted across multiple databases to identify all relevant meta-analyses up to September 30th, 2025. Reported pooled effect sizes (ESs) and 95% confidence intervals (CIs) were extracted from each included study and synthesized using a random-effects model. Methodological quality was assessed using the AMSTAR 2 tool.

RESULTS: Ultimately, 18 meta-analyses were included, with results showing a small but statistically significant reduction in BW (ES: – 0.18 kg, 95% CI – 0.32 to – 0.03, p = 0.02), BMI (ES: – 0.14 kg/m², 95% CI – 0.2 to – 0.08, p < 0.001), WC (ES – 0.43 cm, 95% CI – 0.64 to – 0.22, p < 0.001), and body fat (ES: – 0.3 kg, 95% CI – 0.48 to – 0.12, p = 0.001) in the resveratrol group compared to the control group, with subgroup analysis revealing statistical significance only in subgroups with doses > 400 mg/day and study duration ˃ 12 weeks.

CONCLUSION: Our review confirms that resveratrol supplementation reduces BW, BMI, WC, and body fat, particularly on doses > 400 mg/day and interventions lasting ˃12 weeks, with small effect sizes. Based on our findings, resveratrol supplementation could be considered as a complementary therapy in the management of obesity.

PMID:41317227 | DOI:10.1007/s40519-025-01800-w

Hernia. 2025 Nov 29;30(1):25. doi: 10.1007/s10029-025-03518-1.

ABSTRACT

INTRODUCTION: Inguinal hernia is a common occurrence affecting one in four men. Recurrence is a major clinical pitfall that affects about 10% of patients with increased recurrence and postoperative complications after a revision repair. Reoperation due to metachronous contralateral inguinal hernia is another possible outcome. The impact of minimally invasive surgery (MIS) techniques on inguinal hernia recurrence rates as compared to open surgery is less clear and further confounded by the adoption of robotic approaches. The aim of this study was to compare reoperation rates.

METHODS: Adult patients who underwent primary unilateral inguinal hernia repair (IHR) in an outpatient setting between January 2015 and December 2021 were queried from the Merative^TM MarketScan® Research Databases. Reoperation for IHR within two years was compared across surgical approaches: Open (O-IHR), Laparoscopic (L-IHR), and Robotic (R-IHR). Reoperations were further categorized and analyzed separately for recurrent and non-recurrent IHR. Secondary outcomes included all-cause total healthcare expenditures, assessed during the index operation and up to two years postoperatively, based on combined insurer and patient payments. A 1:1 propensity score matching approach was applied, with Cox proportional hazards regression used to analyze reoperation risk, and generalized linear regression models employed to evaluate expenditures.

RESULTS: A total of 73,870 patients undergoing IHR (39,591 [53.6%] O-IHR, 30,858 [41.8%] L-IHR, and 3,421 [4.6%] R-IHR) were included. As compared to O-IHR, any IHR reoperation risk at 2-years was about 42% lower with R-IHR (HR = 0.58, p = 0.002) and about 16% lower with L-IHR (HR= 0.84, p < .001). As compared to O-IHR, total expenditure for the index surgery was approximately $3,391 higher with L-IHR (p < .001) and $4,137 higher with R-IHR (p < .001). R-IHR had about $615 higher index expenditure than L-IHR (p = 0.004).

CONCLUSION: The current study demonstrates that robotic IHR is associated with a lower risk of reoperations at 2 years after an initial repair as compared to L-IHR and O-IHR, but higher index expenditure in the outpatient setting for an economically active population.

PMID:41317213 | DOI:10.1007/s10029-025-03518-1

J Neurol. 2025 Nov 29;272(12):792. doi: 10.1007/s00415-025-13455-9.

ABSTRACT

OBJECTIVE: To develop individualized nomograms integrating cortical morphometric measures with 3D multi-parametric MRI radiomics to predict disability progression (DP) and cognitive worsening (CW) in patients with relapsing-remitting multiple sclerosis (RRMS).

MATERIALS AND METHODS: In this multicenter study, 191 RRMS patients from two centers were divided into internal (training and validation sets, n = 158) and external validation (n = 33) sets. All patients underwent clinical and neuropsychological evaluations at both baseline and 2-year follow-up visits. Cortical morphometric metrics were extracted from 3D T1W images, with radiomics features were assessed within MS plaques on 3D DIR, 3D FLAIR, and 3D T1W images. Four models-clinical-only, radiomics-only, cortical morphometric-only, and a combined model-were developed. A nomogram was developed based on a multivariable logistic regression model to provide individualized probability estimates of DP and CW. Predictive performance was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis.

RESULTS: The combined nomogram outperformed models using clinical, radiomic, or cortical morphometric features alone in predicting DP, achieving an area under the curve (AUC) (95% confidence interval [CI]) of 0.950 (0.878-0.994) in the internal cohort and 0.904 (0.781-0.987) in the external cohort. Similarly, the nomogram for CW demonstrated excellent performance, with AUCs of 0.916 (0.831-0.984) and 0.889 (0.752-0.981) in the respective cohorts. Decision curve analysis confirmed the clinical utility of the nomograms.

CONCLUSION: Cortical atrophy, reduced morphological complexity, and high heterogeneity of MS lesions play significant roles in explaining DP and CW in MS. Nomograms integrating clinical indicators, cortical morphometric features, and 3D multi-parametric MRI radiomics, shows potential as a clinical tool for predicting disease progression, facilitating individualized management in RRMS patients.

PMID:41317205 | DOI:10.1007/s00415-025-13455-9