Nevin Manimala

Curr Opin Psychiatry. 2025 Nov 28. doi: 10.1097/YCO.0000000000001056. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Accurate dementia risk prediction is critical for prevention, yet it remains unclear which predictors add meaningful value beyond chronological age. This review evaluates the extent to which multivariable dementia risk models identify modifiable risk factors that enhance prediction value.

RECENT FINDINGS: We systematically reviewed cohort studies reporting both age-only and multivariable dementia prediction models in the same populations. Six age-only models across five cohorts were included. Age-only models achieved poor to good discrimination (C-statistics 0.66-0.84). Adding modifiable cardiovascular and lifestyle factors provided consistent, modest improvements of 0.02-0.05 in the UK Biobank, Atherosclerosis Risk in Communities (ARIC), and Rotterdam cohorts. Larger improvements of 0.07-0.12 were observed in models including cognitive testing or genetic factors [e.g., UK Biobank Dementia Risk Score (UKBDRS-APOE)] with the Hanley-McNeil z-test confirming the improvements were significant, indicating genuine improvement rather than random variation.

SUMMARY: While age is a significant risk factor for dementia, modifiable cardiovascular and lifestyle factors provide incremental predictive value beyond age and represent actionable targets for prevention. Despite modest statistical improvements, these factors offer the most clinically relevant targets for prevention strategies. Future efforts should prioritise interventions addressing these modifiable determinants to reduce dementia risk across populations.

PMID:41316844 | DOI:10.1097/YCO.0000000000001056

Expert Rev Hematol. 2025 Nov 29. doi: 10.1080/17474086.2025.2597360. Online ahead of print.

ABSTRACT

BACKGROUND: Pain is the most prevalent and debilitating symptom of sickle cell disease (SCD). However, there is a paucity of community-based, longitudinal data from low- and middle-income countries. This study is to systematically document phenotypic details of SCD-related pain in a cohort through a prospective, year-long study in underserved regions of five Indian states.

RESEARCH DESIGN AND METHODS: Individuals with SCD were monitored prospectively for 24 fortnights. Pain-related data, including episode frequency, intensity, anatomical distribution, quality descriptors, and patterns, were collected. Statistical analyses comprised descriptive statistics, tests of significance and the Jonckheere – Terpstra trend test, etc.

RESULTS: Across 6,048 visits to 252 patients, 2,042 pain episodes were reported, with 86.1% of patients experiencing at least one episode. Pain most frequently affected the lower legs and calves, with significantly higher rates among females (p < 0.001). Continuous and rhythmic pain patterns were associated with severe pain (p < 0.001). Sensory descriptors were more prevalent among high-intensity cases, suggesting neuropathic components.

CONCLUSION: This is the first Indian community-based longitudinal study revealing a significant prevalence of unreported pain and phenotypic variability. It contributes to the development of region-specific pain management frameworks by considering chronicity, gender, and sociocultural expressions of pain.

PMID:41316843 | DOI:10.1080/17474086.2025.2597360

Phys Sportsmed. 2025 Nov 29. doi: 10.1080/00913847.2025.2597177. Online ahead of print.

ABSTRACT

OBJECTIVES: Ultrasonography is a widely accepted imaging method for evaluating anatomical structures around the shoulder joint. However, the consistency of measurements across different devices and operators remains a critical issue for clinical and research validity. The aim of this study is to assess the inter-device and intra-operator reliability of ultrasound-based measurements of four key anatomical shoulder distances and to establish normative reference values in a healthy population.

METHODS: A total of 195 healthy volunteers (390 shoulders) underwent ultrasonographic evaluation of the acromioclavicular distance (AC), coracoclavicular distance (CC), acromiohumeral distance (AH), and coracohumeral distance (CH). Two physicians, TC (radiologist) and GB (sports medicine), performed the measurements independently using two different ultrasound machines: Siemens S3000 and C10X, respectively. To assess intra-rater temporal reliability, all measurements were repeated on the same participants after two weeks. Stratified sex-matched randomization was applied during participant recruitment.

RESULTS: AC, AH, and CH ultrasound measurements showed intra- and inter-rater reliability with minimal bias and acceptable limits of agreement, indicating good consistency and interchangeability. In contrast, CC measurements exhibited significant inter-rater differences (p = 0.034 and p = 0.023) and wide limits of agreement, reflecting greater variability and limited interchangeability.

CONCLUSION: Given their consistent performance across statistical methods, AC, AH, and CH measurements may be used interchangeably across different raters or sessions, particularly in clinical or research settings where reliable reproducibility is essential. However, due to its high inter-rater variability and broad limits of agreement, CC measurements are not recommended for interchangeable use between evaluators or devices.

PMID:41316842 | DOI:10.1080/00913847.2025.2597177

Appl Psychol Health Well Being. 2025 Dec;17(6):e70086. doi: 10.1111/aphw.70086.

ABSTRACT

Physical activity can improve mental health by improving mood and by lowering depressive symptoms. This systematic review uses a structured narrative synthesis to summarise within-person associations between physical activity and affect in naturalistic settings, and how these associations may differ by level of depressive symptomatology. We also reviewed the methodological choices that could influence these outcomes and provide a methodological roadmap as a recommendation for future studies. A systematic review was conducted up to December 2024 of studies that addressed within-person associations between daily physical activity and affect using ambulatory assessment techniques in individuals aged 4-65 years and assessed depressive symptoms. Our selection yielded 32 eligible studies. A consistent finding was the positive within-person association between physical activity and concurrent or subsequent positive affect, while results were mixed for negative affect. Results were further inconclusive regarding the role of depression in this relationship. Common challenges affecting replicability include an often-inadequate assessment of measurement reliability and validity, and insufficient controls for relevant (contextual) factors in these analyses, such as the length of the time-lag and mode of physical activity. Future studies should employ emerging best practices regarding study design, analysis and reporting of ambulatory assessment data. Such rigorous research practice will strengthen our understanding of these relationships and further inform more effective, personalised physical activity interventions to improve mood and depressive symptoms.

PMID:41316836 | DOI:10.1111/aphw.70086

Clin Chem Lab Med. 2025 Dec 1. doi: 10.1515/cclm-2025-0179. Online ahead of print.

ABSTRACT

OBJECTIVES: Dehydroepiandrosterone sulfate (DHEAS), the sulfate ester of dehydroepiandrosterone, is one of the most common steroid hormones in the human body and the precursor of several other androgens. It is primarily used as a diagnostic or prognostic indicator in adrenal and reproductive disorders. Present immunoassays for DHEAS lack sensitivity and specificity, being vulnerable to cross-reactivity with endogenous interferences. Therefore, an isotope dilution-liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS)-based candidate reference measurement procedure (RMP) was developed to quantify DHEAS in human serum/plasma.

METHODS: We ensured traceability to the International System of Units by using quantitative nuclear magnetic resonance to characterize a commercially available DHEAS reference material used for assay calibration. To mitigate matrix effects and prevent interference co-elution, a two-dimensional heart-cut LC method was employed for LC-MS/MS, in combination with a solid phase extraction sample preparation protocol. Selectivity was determined by spiking the prepared internal standard with the interferences testosterone, epi-testosterone, dehydroepiandrosterone, 5α-dihydrotestosterone, and estrone, in analyte free matrix. A post-column infusion experiment and comparison of standard line slopes were performed to evaluate matrix effects. Precision and accuracy were assessed via a multi-day validation experiment, and variability components estimated using analysis of variance-based variance-components analysis. Measurement uncertainty (MU) was evaluated in compliance with current guidelines.

RESULTS: This RMP was suitable for analyzing DHEAS within the 0.800 to 8,400 ng/mL (2.17-22,800 nmol/L) range, demonstrating selectivity, sensitivity, and matrix-independence. Trueness and accuracy assessment revealed a relative bias (n=6) between -1.9 and 0.3 % for surrogate matrix samples (except for 5.9 % at the lowest level), -2.3 to 3.6 % for Li-heparin plasma samples and sample dilutions, and an overall bias between 0.7 and 1.8 % (n=60), indicating no statistically significant bias. The measurement process resulted in standard measurement uncertainties (MUs) ranging from 4.0 to 5.6 % for the low range and 3.5-4.2 % for the high range. At a 95 % confidence level (k=2), these uncertainties expanded to 7.9-11.1 % and 7.1-8.3 %, respectively. Reference values, determined from six measurements over multiple days (n=6), had standard MUs between 1.6 and 2.1 % for the low range and 0.9-1.7 % for the high range, with expanded MUs of 3.2-4.3 % and 1.9-3.5 %.

CONCLUSIONS: This RMP exhibited high analytical performance for DHEAS quantification and met requirements for measurement uncertainty. Additionally, it enabled differentiation between the DHEAS and other androgens. Consequently, this RMP is suitable for routine assay standardization and clinical sample evaluation.

PMID:41316814 | DOI:10.1515/cclm-2025-0179

Cancer Sci. 2025 Nov 28. doi: 10.1111/cas.70269. Online ahead of print.

ABSTRACT

FLAURA2 has demonstrated that third-generation epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) plus chemotherapy brought a significant survival benefit over EGFR-TKI monotherapy. This suggests that EGFR-TKIs combined with chemotherapy may be a viable therapeutic strategy. Our study aimed to evaluate the efficacy, safety, and progression pattern of third-generation EGFR-TKIs combined with chemotherapy in advanced EGFR-mutant (EGFRm) non-small cell lung cancer (NSCLC) in the real world. This study designed as an observational, retrospective, single-center, real-world project enrolled 382 NSCLC individuals receiving third-generation EGFR-TKIs combined with platinum-based chemotherapy as first-line therapy. The primary end point was progression-free survival (PFS), and secondary end points included overall survival (OS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs). From July 2016 to May 2024, 382 patients were retrospectively included for the analysis. Of these patients, 120, 165, and 97 patients received osimertinib, aumolertinib, and furmonertinib plus chemotherapy as first-line therapy, respectively. Overall, the median follow-up duration was 34.6 months (95% CI: 32.2-35.6), the median PFS was 30.9 months (95% CI: 27.5-39.3), and the median OS was 53.9 months (95% CI: 46.2-NR). Overall, the ORR was 76.4% and the DCR was 98.2%. One hundred thirty-seven (35.9%) individuals experienced Grade 3 or higher AEs. Different third-generation EGFR-TKI groups show no statistically significant difference in PFS (HR = 0.75; 95% CI: 0.51-1.10; p = 0.25) after inverse probability of treatment weighting (IPTW), nor in AEs or severe AEs (p = 0.852; p = 0.502). First-line third-generation EGFR-TKI combined with pemetrexed-based chemotherapy demonstrated a favorable ORR and PFS benefit in advanced EGFRm NSCLC.

PMID:41316804 | DOI:10.1111/cas.70269

Huan Jing Ke Xue. 2025 Nov 8;46(11):7131-7141. doi: 10.13227/j.hjkx.202410133.

ABSTRACT

Exploring the coupling and coordination relationship and driving factors of the functions of regional production-living-ecological spaces (hereinafter referred to as “Three Spaces”) is of great significance for revealing the interaction mechanism among different spatial types within a region and achieving the efficient and sustainable utilization of territorial space. Taking Guizhou Province, which is typically distributed with karst landforms, as the research area and county-level regions as the analytical units, by using the coupling and coordination level model, spatial autocorrelation model, and geographical detector model and selecting the land use types and statistical data in 2005, 2010, 2015, and 2020, research on the function identification, relationship exploration, and driving factor analysis of the “Three Spaces” in Guizhou Province was carried out. The results are as follows: ① From 2005 to 2020, the functions of the production space and the living space in Guizhou Province generally showed a gradual growth trend, with a spatial pattern characterized by being higher in the central area and lower in the marginal areas. In contrast, the function value of the ecological space was on a downward trend, and its spatial pattern was the opposite. ② The improvement of the functions of the production and living spaces promoted the growth trend of the coupling and coordination degree of the “Three Spaces.” However, the overall coupling and coordination degree was low, and the imbalance in the coordinated development of the “Three Spaces” among various counties was intensifying. ③ The spatial correlation analysis showed that from 2005 to 2020, there was a significant spatial correlation in the coupling and coordination degree of the “Three Spaces” at the county level in Guizhou Province. The spatial agglomeration trend was continuously strengthening, presenting a clustered spatial distribution feature with higher values in the central area and lower values in the marginal areas. ④ The main single factor influencing the coupling and coordination of the functions of the “Three Spaces” in Guizhou Province was population density. Moreover, there were two-factor and non-linear enhancement relationships among various factors. Among them, the interaction between population density and normalized difference vegetation index (NDVI) had the strongest influence on the coupling and coordination degree. The social and economic development based on natural geographical conditions played a driving role in the development of the coupling and coordination relationship of the functions of the “Three Spaces.” Therefore, to achieve the green, low-carbon, and ecologically efficient development of the economy in the karst ecologically fragile areas, it is necessary to rationally optimize the layout of the production-living-ecological spaces and develop the economy based on natural endowments.

PMID:41316776 | DOI:10.13227/j.hjkx.202410133

Huan Jing Ke Xue. 2025 Nov 8;46(11):7106-7118. doi: 10.13227/j.hjkx.202407278.

ABSTRACT

Land use changes are the product of the dynamic interplay between human activities and natural ecosystems. The study of land use change characteristics and their driving factors in the Weihe River Basin can provide a direction for regional development coordination and formulation of basin development policies. Drawing on land use data from 1985 to 2020 in the Weihe River Basin and employing a blend of mathematical and spatial analysis methodologies, this study meticulously scrutinized the structural and spatial pattern shifts in land utilization within the basin. Key findings shed light on several critical aspects: ① The predominant land types in the Weihe River Basin consisted of arable land, forest land, and grassland, with average proportions of 41.24%, 22.1%, and 34.6%, respectively. Arable land exhibited a prominent presence both upstream and downstream of the Weihe River, while forested areas were primarily concentrated in the Beiluo River region, and grasslands thrived along the Jinghe River. ② Noteworthy transformations in land use occurred between 1995 and 2010 within the Weihe River Basin, marked by a substantial 2.5-fold surge in comprehensive land use dynamics. Particularly noteworthy was the conversion trend between grassland and arable land, as evidenced by the land use transfer matrix. ③ Between 1985 to 2020, the Weihe River Basin witnessed a significant shift characterized by an increase in urban land and forests, while farmland decreased. Urban land expanded by 2 911 km², mainly in the urban agglomeration of Guanzhong in the lower reaches of the Weihe River; forests increased by 6 430 km², mainly in the watershed of Jinghe River and Beiluo River and in the lower reaches of the Weihe River along the tributaries of the Qingling Mountain and the Qianhe River; farmland decreased by 7 157 km², with the reduced area being more dispersed, affecting the whole watershed. ④ Climate change, socio-economic, and governmental policies emerged as pivotal influencers of land use changes within the Weihe River Basin. Statistical analysis revealed that social-economic factors were the main factors affecting land use changes in the Weihe River Basin.

PMID:41316774 | DOI:10.13227/j.hjkx.202407278

Huan Jing Ke Xue. 2025 Nov 8;46(11):6870-6879. doi: 10.13227/j.hjkx.202410203.

ABSTRACT

Ziyang County, located in the Qinba Mountains area, relies on groundwater as its primary water source, which is crucial for local health and social development. Using statistical analysis, Piper diagrams, Gibbs diagrams, ion ratios, and the Absolute Principal Component Scores-Multiple Linear Regression (APCS-MLR) receptor model, this study analyzed the hydrochemical characteristics, controlling factors, and chemical component sources of groundwater. The results indicated that the primary hydrochemical type of groundwater in Ziyang County was HCO₃-Ca type, with a weakly alkaline pH. The chemical composition was primarily controlled by weathering and dissolution of carbonate rocks (e.g., calcite and dolomite), cation exchange, and human activities. The APCS-MLR model results revealed that the main controlling factors were water-rock interaction (43.6%), industrial and agricultural (3.9%), agricultural and domestic sewage (10.5%), and unknown source (42%). These findings provide a scientific basis for the sustainable development and effective management of regional groundwater resources.

PMID:41316753 | DOI:10.13227/j.hjkx.202410203

Huan Jing Ke Xue. 2025 Nov 8;46(11):6796-6805. doi: 10.13227/j.hjkx.202410003.

ABSTRACT

Using energy consumption and other statistical data of a region in Qinghai Province from 2016 to 2022, this study examines the historical energy consumption structure and CO₂ emissions of the region. Three scenarios of baseline, energy-saving, and low-carbon were constructed based on the LEAP model to predict and analyze the energy demand and CO₂ emissions of the region from 2023 to 2035 under different scenarios. The results showed that: Under the baseline scenario, the total regional energy demand continued to grow, while CO₂ emissions showed a trend of increasing and then decreasing and were expected to peak around 2025. Under the conditions of fully tapping the potential of energy conservation and emission reduction in the region and accelerating the green transformation of the industrial and energy consumption structure, the energy demand and carbon emissions in the region could achieve a significant decline in the future. Considering the contributions of the various secondary scenarios, the improvement in end-use energy efficiency will be the most effective option for controlling the total energy demand in both the short and long term. The release of energy-saving potentials on the demand side will effectively reduce the energy intensity of the GDP unit, with an expected energy-saving contribution rate of 59.1% in 2035. Optimizing of the energy consumption structure is the key to controlling the continuous decline in total carbon emissions. Therefore, natural resources should be used to vigorously develop clean energy and improve the electrification level to achieve clean and low-carbon supply side, and the carbon emission intensity per unit of GDP in 2035 is expected to be reduced by approximately 70% compared with that in 2020 under the low-carbon scenario.

PMID:41316746 | DOI:10.13227/j.hjkx.202410003