Nevin Manimala

Nat Methods. 2025 Dec 4. doi: 10.1038/s41592-025-02896-9. Online ahead of print.

ABSTRACT

We propose a latent space-based statistical network analysis (LatentSNA) method that implements network science in a generative Bayesian framework, preserves neurologically meaningful brain topology and improves statistical power for imaging biomarker detection. LatentSNA (1) addresses the lack of power and inflated type II errors in current analytic approaches when detecting imaging biomarkers, (2) allows unbiased estimation of the influence of biomarkers on behavioral variants, (3) quantifies uncertainty and evaluates the likelihood of estimated biomarker effects against chance and (4) improves brain-behavior prediction in new samples as well as the clinical utility of neuroimaging findings. LatentSNA is broadly applicable across multiple imaging modalities and outcome measures in developing, aging and transdiagnostic cohorts, totaling 8,003 to 11,861 participants. LatentSNA achieves substantial accuracy gains (averaging 110-150%) and replicability improvements (averaging 153%) over existing approaches in moderate to large datasets. As a result, LatentSNA elucidates how network topology is implicated in brain-behavior relationships.

PMID:41345770 | DOI:10.1038/s41592-025-02896-9

Pharmacoeconomics. 2025 Dec 4. doi: 10.1007/s40273-025-01566-0. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Chimeric antigen receptor T-cell therapies have changed the treatment paradigm of relapsed or refractory large B-cell lymphoma but are among the most expensive treatments. Moreover, their comparative economic value remains uncertain in adults with relapsed or refractory large B-cell lymphoma. The objective of this study was to understand the comparative value of these therapies in this population and the main factors that influenced conclusions on which intervention was considered more cost effective than others.

METHODS: To assess the comparative cost effectiveness of chimeric antigen receptor T-cell therapies and the drivers of cost-effectiveness results, a systematic literature search of Embase, Scopus, and PubMed was conducted from inception to December 2024 and updated in October 2025. Studies were selected if they were full economic evaluations of head-to-head comparisons of chimeric antigen receptor T-cell therapies for relapsed or refractory large B-cell lymphoma. Two reviewers independently extracted data on key information such as population characteristics and model structure. Results were reported in their original format, and conclusions on cost effectiveness were evaluated based on country-specific willingness-to-pay thresholds. The reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist and the Drummond 10-Item Checklist.

RESULTS: Eight full economic evaluations across the USA, Spain, France, and Japan were included in this systematic review. All studies modeled an adult population or patients with relapsed or refractory large B-cell lymphoma who had failed two or more lines of prior therapy, were conducted over a lifetime horizon, and mostly used the payer perspective (n = 6). All studies utilized three-state partitioned survival models but relied heavily on indirect comparison methods such as matching-adjusted indirect comparison. Three chimeric antigen receptor T-cell therapies were evaluated: axicabtagene ciloleucel (axi-cel), tisagenlecleucel (tisa-cel), and lisocabtagene maraleucel (liso-cel). Axi-cel was the most frequently reported cost-effective option (n = 7) with two studies concluding it was the dominant strategy. There was substantial uncertainty in the model results given the lack of individual patient-level data for each arm and reliance on indirect comparisons.

CONCLUSIONS: In this systematic review of economic evaluations of head-to-head comparisons of chimeric antigen receptor T-cell therapies for relapsed or refractory large B-cell lymphoma, current evidence suggests that axi-cel may be the most cost-effective option. However, given the studies’ reliance on indirect comparisons and the absence of any study conducted in low- to middle-income countries, these results must be carefully interpreted until additional evaluations or clinical trials are conducted.

PMID:41345759 | DOI:10.1007/s40273-025-01566-0

Eur J Pediatr. 2025 Dec 4;184(12):819. doi: 10.1007/s00431-025-06584-w.

ABSTRACT

Research on the infection-related etiologies of neonatal acute respiratory distress syndrome (NARDS) remains limited. This study aimed to investigate mortality risk differences in NARDS attributed to distinct infection origins (sepsis of extrapulmonary origin or pulmonary infection origin). Subjects were derived from a multicenter retrospective study organized by the Jiangsu Provincial Neonatal Respiratory Failure Collaboration Network. It included neonates with NARDS who initiated invasive mechanical ventilation (IMV) within 72 h of birth. A total of 268 from 1275 NARDS cases with infectious etiologies were enrolled. Multivariate Cox regression found a significant difference in the survival prognosis (sepsis of extrapulmonary origin, adjusted hazard ratio (HR): 3.93, 95% CI 1.79-8.62, log-rank test: P < 0.001]. Further multi-model and sensitivity analysis confirmed the robustness. Between early-onset and late-onset NARDS, the subgroup analysis showed no significant differences in the mortality risk, whether it was pulmonary infection origin (HR 1.69, 95% CI 0.61-4.64) or sepsis of extrapulmonary origin (HR 0.50, 95% CI 0.17-1.51). Restricted cubic spline also exhibited that the onset time of NARDS was not related to the mortality risk.

CONCLUSION: This study suggests that for sepsis of extrapulmonary origin, we should be more vigilant about the mortality risk it brings and deal with the risk factors more actively and prudently.

WHAT IS KNOWN: • Limited research has systematically investigated the association between infection origin and mortality risk in neonatal acute respiratory distress syndrome (NARDS).

WHAT IS NEW: • Our study found that sepsis of extrapulmonary origin was associated with an increased mortality risk in neonates with gestational age > 34 weeks, with robust results from multivariate Cox modeling and sensitivity analyses. • It highlights the need for heightened vigilance and proactive management of extrapulmonary sepsis-related NARDS to mitigate mortality risk in neonates.

PMID:41345740 | DOI:10.1007/s00431-025-06584-w

Microbiome. 2025 Dec 4. doi: 10.1186/s40168-025-02291-8. Online ahead of print.

ABSTRACT

BACKGROUND: Aflatoxin B₁ (AFB₁), a highly carcinogenic and hepatotoxic mycotoxin frequently contaminating animal feed, presents serious health risks to both humans and livestock. Although AFB₁‘s hepatotoxicity and other organ damage are extensively characterized, how this mycotoxin influences ruminal microbiota dynamics and functional activities in ruminants remains underexplored. Although some studies suggest that AFB₁ reduces nutrient digestibility and performance in ruminants, the underlying mechanisms are unclear. To aid in developing effective mitigation strategies for aflatoxicosis in ruminants, this study randomly divided Saanen goats into three groups. The CON group received the standard ration without additives, whereas LD and HD groups were provided identical basal diets fortified with 50 or 500 μg/kg AFB₁. Throughout the study, alterations in ruminal fermentation parameters, microbiome, and metabolome profiles were analyzed.

RESULTS: With increasing AFB₁ levels, ruminal pH, the concentration of total volatile fatty acids (VFA), acetate, and propionate decreased quadratically, while butyrate decreased linearly. Metagenomic profiling indicated suppressed populations of Pelagibacter and Flavobacterium following AFB₁ exposure, contrasting with promoted growth of Cryptobacteroides. Additionally, seven carbohydrate-active enzymes (CAZymes), specifically GT92, GT20, CE7, GT32, GT35, GT57, and GT50, were found to be more prevalent in the rumen of the CON group. Statistically higher viral loads characterized the HD group when benchmarked against CON group. Metabolomics analysis identified 1197 differential metabolites among the CON, LD, and HD groups, including cytochalasin Ppho and chrysophanol, both known for their teratogenic properties and their ability to induce cell death.

CONCLUSIONS: This study indicates that dietary AFB₁ exposure can alter the ruminal microbial and metabolomic profiles, induce prophage activation, and impact carbohydrate degradation and microbial protein turnover. These alterations may contribute to reductions in ruminal pH and volatile fatty acid concentrations, thereby impairing feed digestibility and animal performance. The findings provide valuable insights into AFB₁‘s effects on rumen health, and further investigations of these metabolic pathways may help develop precision interventions to mitigate AFB₁-induced rumen dysfunction and productivity losses. Video Abstract.

PMID:41345737 | DOI:10.1186/s40168-025-02291-8

BMC Psychol. 2025 Dec 5. doi: 10.1186/s40359-025-03767-w. Online ahead of print.

ABSTRACT

BACKGROUND: Healthcare workers are often exposed to traumatic events and as a result, they may experience post-traumatic stress disorder (PTSD) and other mental illnesses. The prevalence of these issues is high among healthcare professionals. Positive transformation (i.e., PTG) can emerge after struggles related to a stressful life event.

METHODS: In this cross-sectional study utilizing structural equation modeling (SEM), a sample of Iranian healthcare workers (nurses and pre-hospital emergency personnel from Ardabil) completed a battery of self-report questionnaires. These measures included a demographic information form, the Life Events Checklist (LEC-5), the Core Beliefs Inventory (CBI), the PTSD Checklist for DSM-5 (PCL-5), the Posttraumatic Growth Inventory (PTGI), scales assessing intrusive and deliberate rumination, and a social support questionnaire.

RESULTS: In examining the direct coefficient paths, all paths were statistically significant with the exception of the path of core belief disruption to deliberate rumination, social support to intrusive rumination, and PTSD to PTG. Similarly, in the examination of the coefficient of indirect paths, all paths were not statistically significant except for the paths of intrusive rumination to PTG through deliberate rumination and social support to PTG through deliberate rumination.

CONCLUSION: The study’s findings suggest that disruptions in core beliefs can result in both post-traumatic growth (PTG) and post-traumatic stress disorder (PTSD) and that social support plays a crucial role in promoting PTG. Clinical interventions that address disruptions in core beliefs and promote social support, such as mindfulness practices and purposeful thinking, may be effective in promoting mental health and well-being among healthcare professionals. Based on the results of the study, clinical interventions that address disruptions in core beliefs and promote social support may be effective in promoting mental health and well-being among healthcare professionals who have experienced traumatic events. As such, these findings can inform the development of evidence-based clinical interventions that can improve the mental health outcomes of healthcare professionals and, ultimately, enhance patient care.

PMID:41345734 | DOI:10.1186/s40359-025-03767-w

Eur J Med Res. 2025 Dec 4. doi: 10.1186/s40001-025-03593-1. Online ahead of print.

ABSTRACT

BACKGROUND: Diabetic ketoacidosis emergencies are serious acute complications of diabetes mellitus, and their health and economic impacts have been increasing among adult diabetic patients. Despite the growing burden of emergencies from diabetic ketoacidosis among adults with diabetes, its outcomes and factors of treatment have not been well studied in Ethiopia.

OBJECTIVE: To assess the prevalence of poor treatment outcomes of diabetic ketoacidosis and associated factors among adult diabetic patients admitted to the Debre Markos comprehensive specialized hospital, northwest Ethiopia.

METHODS: A hospital-based retrospective cohort study was conducted at Debre Markos comprehensive specialized hospital from April 8, 2025 to April 28, 2025. A total of 360 patients with diabetic DKA who were admitted from August 28, 2019 to September 30, 2024 participated in the study. A simple random sampling technique was used to select study participants. Data were extracted using a pre-tested data collection tool adapted from different literatures. The data were entered into epi-data version 4.6.0 and exported to SPSS version 26 for analysis. Both bivariable and multivariable binary logistic regression analysis were done. Statistical significance was declared at a p-value < 0.05 with an odds ratio of 95% confidence interval.

RESULTS: The prevalence of poor treatment outcomes was 15.5% (95%, CI: 11.5%, 19.3%). Factors, such as severe DKA (AOR: 1.482, 95% CI: 1.324, 4.872), the presence of comorbidities (AOR: 1.752, 95% CI: 1.215, 3.865), and underlying infections (95% CI: 1.362, 4.125), discontinuation of drugs (AOR: 2.115, 95% CI: 1.245, 3.865), treatment complications (AOR: 1.356, 95% CI: 1.253, 4.125), ketone levels > 3 (AOR: 1.213, 95% CI: 1.052, 2.876), and hospital stays of less than 5 days (AOR: 1.29, 95% CI: 1.022, 3.254) were also significant factors associated with poor outcomes in patients with DKA.

CONCLUSIONS: This study found that a high number of patients with DKA in the Debre Markos comprehensive specialized hospital experienced poor treatment outcomes. Significant factors included severe DKA, comorbidities, infections, drug discontinuation, treatment complications, high ketone levels and short hospital stays. To improve treatment outcomes, early identification and proactive management of high-risk DKA patients, particularly those who present with severe illness, comorbidity conditions, or infections, shall be prioritized.

PMID:41345728 | DOI:10.1186/s40001-025-03593-1

BMC Nutr. 2025 Oct 24;11(1):197. doi: 10.1186/s40795-025-01177-0.

NO ABSTRACT

PMID:41345726 | DOI:10.1186/s40795-025-01177-0

BMC Glob Public Health. 2025 Dec 5;3(1):111. doi: 10.1186/s44263-025-00229-8.

NO ABSTRACT

PMID:41345722 | DOI:10.1186/s44263-025-00229-8

Arthritis Res Ther. 2025 Dec 4. doi: 10.1186/s13075-025-03697-3. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate maternal-fetal outcomes and therapeutic efficacy in Takayasu arteritis (TA)-complicated pregnancies through integrated retrospective analysis and meta-analytic synthesis.

METHODS: A dual-design study was conducted: (1) retrospective analysis of 20 pregnancies (17 patients) at West China Second Hospital (2012-2024), stratifying TA phases (acute/prolonged/stable); (2) systematic review with random-effects meta-analysis of 16 studies (568 pregnancies globally). Clinical data encompassed maternal-fetal profiles, TA-specific variables, laboratory metrics (hematologic/coagulation parameters), and therapies (glucocorticoids /immunosuppressants /antihypertensives). Outcomes were compared against normative standards using t-tests, Wilcoxon, chi-square, and meta-regression.

RESULTS: Among 20 pregnancies (median maternal age 28.5 years), 50% had at least one obstetric complication, with arterial stenosis (80%) and hypertension (40%) predominant. Meta-analysis revealed 42.6% adverse outcomes: gestational hypertension (26.1%), fetal growth restriction (17.7%), and preterm delivery (13.6%). Hematological analysis (n = 20) showed elevated WBC, PCT, TT, fibrinogen, urinary protein, and ALT (all P < 0.05), alongside reduced PT, albumin, and bilirubin (P < 0.05). Regarding the analysis results of inflammatory indicators, CRP (prepartum) (95%CI = 0.969-1.034, OR = 1.001), CRP (postpartum) (95%CI = 0.920-1.217, OR = 1.058), and ESR (95%CI = 0.952-1.101, OR = 1.024) showed no statistically significant association with pregnancy outcomes. Neither pre-pregnancy nor gestational glucocorticoids (prednisone vs methylprednisolone) or immunosuppressants significantly reduced complications (all RR 95% CI crossed 1; P > 0.05). Antihypertensive therapy showed no correlation with preeclampsia (P > 0.05).

CONCLUSION: TA significantly elevates maternal-fetal risks, driving hypertension, growth restriction, and preterm birth via vasculopathic-inflammatory pathways. Postpartum hypercoagulability (↑fibrinogen, ↓prothrombin time) necessitates multidisciplinary coagulation monitoring and mandatory thromboprophylaxis.

PMID:41345710 | DOI:10.1186/s13075-025-03697-3

BMC Psychol. 2025 Dec 4. doi: 10.1186/s40359-025-03780-z. Online ahead of print.

ABSTRACT

BACKGROUND: Serious complications affecting burn patients include reduced body image satisfaction, which can negatively influence their mental health. At the same time, resilience is a key factor in promoting psychological well-being. Therefore, the present study aimed to examine the relationship between body image satisfaction and resilience among burn patients in 2022-2023.

METHODS: In this descriptive cross-sectional study, 106 burn patients from Hamadan were enrolled using stratified quota sampling. The study instruments included a demographic information questionnaire, the Connor-Davidson Resilience Scale, and the Souto and Garcia Body Image Satisfaction Questionnaire. Data were analyzed using STATA version 14, employing descriptive statistics and Spearman’s correlation coefficient.

RESULTS: The results showed that the mean ± standard deviation for body image satisfaction was 59.83 ± 16.98, and for resilience, 56.26 ± 17.61. Furthermore, analysis indicated a strong, positive, and statistically significant correlation between body image satisfaction and resilience among these patients (r = 0.614, P < 0.001).

CONCLUSION: This study found that burn patients reported moderate levels of body image satisfaction and resilience. A significant positive correlation was observed between these two variables, suggesting that patients with higher body image satisfaction tend to exhibit greater resilience in coping with the physical and psychological challenges of burn injuries. These findings highlight the importance of integrating psychological care targeting body image into rehabilitation programs, as addressing body image concerns may help enhance resilience and improve overall well-being among burn survivors.

PMID:41345708 | DOI:10.1186/s40359-025-03780-z