Nevin Manimala

Eur J Emerg Med. 2025 Aug 1;32(4):278-287. doi: 10.1097/MEJ.0000000000001229. Epub 2025 Jun 24.

ABSTRACT

BACKGROUND: Undiagnosed HIV-infected patients are mainly responsible for viral transmission in Western countries. Emergency departments (EDs) could represent a strategic point in healthcare systems to uncover HIV infection.

OBJECTIVE: This study aimed to analyze the time trends of HIV testing in EDs in Barcelona (Spain) and investigate if EDs have changed HIV screening patterns after the implementation of a targeted opt-in strategy for HIV testing.

DESIGN: This is a quasiexperimental (pre/post) study.

SETTING AND PARTICIPANTS: Monthly HIV tests performed by Microbiology Departments of four hospitals in Barcelona were recorded over 78 months, classified as ordered by ED or at other healthcare levels. Monthly ED attendances were compiled, along with new HIV diagnoses.

INTERVENTION: Implementation of an opt-in strategy to test every ED patient with targeted conditions (community-acquired pneumonia, herpes zoster, mononucleosis syndrome, chemsex, postexposure prophylaxis, sexually transmitted diseases) in addition to other classical reasons for HIV testing.

OUTCOME MEASURES AND ANALYSIS: Determination of trends over time in HIV screening and new diagnoses in EDs during the 60-month preintervention and 18-month postimplementation periods, and estimation of the impact of intervention using interrupted time series analyses.

MAIN RESULTS: A total of 659 885 HIV tests were performed, with 11 442 (1.7%) being ordered by EDs (0.29% of ED comers were tested), and 287 new HIV diagnoses made (positivity rate: 2.8%). During the preintervention period, HIV testing increased over time (overall and in EDs), new HIV diagnoses in EDs remained stable, and the rate of positive HIV tests decreased. The intervention increased the monthly average of HIV tests ordered in the ED by 106 (95% CI = 86-125), proportion of ED comers screened by 0.075% (95% CI = 0.032-0.118), and proportion of HIV tests made in Barcelona performed by EDs by 0.728% (95% CI = 0.424-1.032), but had no impact on new HIV diagnoses and rate of positive HIV tests in the EDs.

CONCLUSION: In the last years, HIV screening in Barcelona increased, with EDs having a significant and increasing role in the overall HIV testing in Barcelona. The implementation of a targeted opt-in strategy for HIV screening in EDs increased the number of HIV tests performed, but not the number of HIV diagnoses made in EDs.

PMID:40557507 | DOI:10.1097/MEJ.0000000000001229

Pest Manag Sci. 2025 Jun 25. doi: 10.1002/ps.70017. Online ahead of print.

ABSTRACT

BACKGROUND: Plant Protection Products (PPPs) consist not solely of active ingredients. Some of the other ingredients of the finished formulations are intended to enhance the efficacy of the main active ingredient. The PPPs’ effects impact honeybees that pollinate crops by exposing them to a complex of numerous chemical compounds. Depending on their composition, PPPs affect these insects in various ways. The present study estimated the effect of sublethal doses of insecticide (Active Ingredient (AI): indoxacarb) and commercial adjuvant (AI: alkylbenzene sulphonic acid sodium salt) applied individually and as a combination of these two formulations, on thermal preference and CO₂ emission rate of bees, and expression of the genes CYP9Q1, CYP9Q2, and CYP9Q3 involved in detoxification processes of these insects.

RESULTS: Aqueous solutions of adjuvant and a mixture of both formulations statistically significantly altered honeybee thermal preferences (a decrease in the selected ambient temperature by 1.4 and 0.9°C, respectively). CO₂ emissions levels also changed (a drop of 1.7% for the insecticide-treated group, 10% for those treated with adjuvant and 15.4% for those treated with both formulations applied together). The levels of the transcripts of the genes CYP9Q1, CYP9Q2, and CYP9Q3 were significantly elevated only in the head of the honeybee, but not in its abdomen.

CONCLUSION: Our results indicate that ready-made PPP formulations, their adjuvants, and their mixtures determine the physiological status of honeybees, although the direction of changes might vary depending on the analyzed parameter. © 2025 Society of Chemical Industry.

PMID:40557483 | DOI:10.1002/ps.70017

Vet Ophthalmol. 2025 Jun 25. doi: 10.1111/vop.70045. Online ahead of print.

ABSTRACT

BACKGROUND: Keratoconjunctivitis sicca (KCS) results from a deficiency in the pre-corneal tear film, causing persistent ocular discomfort and a predisposition to ocular surface diseases. Current treatments, including topical lacrimostimulants and lacrimomimetics, primarily offer symptomatic relief without restoring lacrimal gland function. Mesenchymal stem cell (MSC) therapy, with its regenerative and immunomodulatory properties, has been investigated in preclinical and veterinary studies but remains critically underexplored for its clinical relevance in treating KCS.

METHODS: A systematic review was conducted on April 24, 2024, using Medline, Embase, Web of Science, and CABI databases. Studies evaluating MSC therapy in dogs and cats with KCS were included. Data collected included demographic information, baseline and post-treatment Schirmer tear test (STT) values, and ocular symptoms such as discharge, conjunctival hyperemia, and corneal changes. The risk of bias was assessed using validated tools, and the quality of evidence was graded using the Oxford Centre for Evidence-Based Medicine (OCEBM). Statistical analyses were performed with STATA to compare STT values at baseline and after 1- and 6-month follow-ups.

RESULTS: Six studies involving 151 eyes from 98 dogs were included. Studies demonstrated low to moderate risk of bias, and evidence quality was graded as level C. MSC therapy significantly increased tear production and improved ocular comfort, with mean STT increases of 0.68 mm/min at 1 month and 1.51 mm/min at 6 months.

CONCLUSION: MSC therapy offers statistically significant improvements in tear production in dogs with KCS and is considered a safe treatment option. However, the modest clinical significance highlights the need for further research to confirm its efficacy.

PMID:40557470 | DOI:10.1111/vop.70045

Anat Rec (Hoboken). 2025 Jun 25. doi: 10.1002/ar.70010. Online ahead of print.

ABSTRACT

Repair of volumetric muscle loss (VML) lesions tends to be poor, leading to fibrosis and functional loss. Here we investigated the effectiveness of fresh versus cryopreserved autologous adipose tissue transplantation to facilitate repair. Wistar rats were distributed into four experimental groups: normal control, VML lesions, VML lesions treated with a fresh autologous adipose tissue graft, and VML treated with a cryopreserved autologous adipose tissue graft. At 60 days post-intervention, a histological, histochemical, and immunohistochemical analysis was performed to assess changes related to the degree of fibrosis, vascularization, and innervation. These changes were quantified and statistically analyzed. The changes generated by the two types of adipose tissue implanted in the VML lesion were highly similar, with some significant differences favoring the use of cryopreserved adipose tissue. Compared with the VML group, the following outcomes were observed: (1) significant presence of regenerated muscle fibers; (2) significant reduction of fibrosis, albeit with a higher proportion of type III collagen; (3) significant increase in the microvascular pattern; and (4) significant reduction in the number of angulated atrophic muscle fibers and increase in cytoarchitectural changes indicative of reinnervation. This study suggests that autologous adipose tissue transplantation in VML lesions promotes reintegrative processes, facilitating the regeneration and formation of new muscle fibers. Furthermore, the freezing did not diminish outcomes in the CAAT group, highlighting its potential for preservation in tissue banks and applications in regenerative medicine.

PMID:40557468 | DOI:10.1002/ar.70010

Fam Pract. 2025 Jun 4;42(4):cmaf033. doi: 10.1093/fampra/cmaf033.

ABSTRACT

BACKGROUND: The 2024 Final Rule for physician fee schedule under the Medicare Prospective Centers for Medicare & Medicaid Services (CMS) has sunset and combined seven screening and quality measures for traditional Medicare Merit-Based Incentive Payment System (MIPS) reporting with a single composite clinical quality process measure, Preventive Care and Wellness (PCW). While composites offer benefits including statistical efficiency and increased stability over time, the contextless nature of composite scores may result in disadvantaging low-resource primary care health centers (“health centers”) serving medically underserved communities that face healthcare access and outcome challenges.

OBJECTIVE: Evaluate the CMS composite score metric in health centers to identify characteristics that are associated with higher versus lower composite scores.

METHODS: We conducted a 4-year (2019-2022) retrospective data analysis with more than 1.5 million patients from 191 primary care health centers within the OCHIN national network of community health organizations (CHOs). The primary outcome is a modified version of the PCW. Generalized linear mixed models assessed clinic factors associated with score variation, accounting for repeated measures.

RESULTS: Our analysis demonstrated that prepandemic scores started to recover by the end of 2022 (0.6644 vs. 0.6153) and that five factors (pediatric or 65+ patients, Hispanic adults, uninsured patients, and clinic encounter volumes in Q2 and Q4) significantly affected clinic score variation over time.

CONCLUSIONS: Our analyses show that preventive service delivery in health centers has nearly recovered from pandemic declines. Differences in subpopulations highlight the importance of context in interpreting health centers’ score variation.

PMID:40557464 | DOI:10.1093/fampra/cmaf033

Eur J Paediatr Dent. 2025 Jun 1:1. doi: 10.23804/ejpd.2025.2403. Online ahead of print.

ABSTRACT

AIM: To evaluate the association between dietary consistency, masticatory patterns, and the presence of posterior crossbite in growing patients, and to explore potential preventive strategies.

BACKGROUND: Maxillary constriction, frequently associated with posterior crossbite, presents challenges to craniofacial development. Modern dietary habits, characterised by softer food textures, reduce masticatory demand, potentially contributing to maxillary hypoplasia. However, the translational impact of dietary consistency on general health and craniofacial development remains underexplored.

METHODS: A case-control study was conducted with 106 participants divided into two groups: case (posterior crossbite) and control (non-crossbite). Dietary habits were assessed through a validated questionnaire that categorised foods by consistency. Masticatory cycles were analysed using a kinesiograph to identify normal, reverse, and atypical patterns. Statistical analyses included chi-square tests and regression models, with significance set at p < 0.05.

CONCLUSION: This study confirms a significant association between dietary consistency, masticatory patterns, and posterior crossbite. The findings underscore the role of dietary texture in craniofacial development, highlighting the importance of preventive dietary strategies to support both craniofacial growth and general health. Further longitudinal studies are recommended to validate these findings and guide translational orthodontic interventions.

PMID:40557459 | DOI:10.23804/ejpd.2025.2403

Int J Surg. 2025 Jun 24. doi: 10.1097/JS9.0000000000002645. Online ahead of print.

ABSTRACT

BACKGROUND: Peripheral nervous system tumors are abnormal proliferations originating from neural tissues (such as the nerve sheath and nerve fibers), classified as either benign or malignant. Common subtypes encompass schwannomas, neurofibromas, and malignant peripheral nerve sheath tumors. Notably, malignant peripheral nerve sheath tumors are characterized by their high malignancy potential and have demonstrated a concerning rise in both incidence and mortality rates in recent epidemiological studies.

METHODS: Based on the Global Burden of Disease (GBD) 2021 database, we conducted a statistical analysis of the trends of incidence, disability-adjusted life years (DALYs) per 100,100 population along with 95% uncertainty intervals(UIs), as well as deaths among adults aged 70 years and older from 1990 to 2021 in peripheral nervous system tumors. The date were subjected to stratified analyses across age, sex, socio-demographic index (SDI), 21 regions, and 204 countries. A Bayesian age- period- cohort (BAPC) model incorporating integrated nested Laplace approximations was applied to forecast the disease burden up to 2050. On a global scale, all stratified analyses demonstrated a consistent trajectory trend in incidence, DALYs, and deaths among older adults, with projections indicating this trend is likely to persist until 2050.

RESULTS: Over the past three decades (1990-2021), the incidence rates of peripheral nervous system tumors have risen by 185%, with disability-adjusted life years (DALYs) rates increasing by 164% and deaths rates climbing by 167%. Notably, high SDI regions exhibited declining trends in incidence rates (-10.1%), DALYs rates (-14.3%), and mortality rates (-11.6%) after 2003, low- and middle SDI regions maintained annual increases. A significant gender reversal occurred in 2021, where male incidence numbers, DALYs and deaths numbers surpassed female rates. Bayesian age-period-cohort (BAPC) modelling predicts a 2.0-fold increase in ASIR by 2050 relative to 2021 levels, with DALY and mortality burdens projected to rise 2.2-fold and 1.8-fold respectively under current trajectories.

CONLUSION: The analysis results revealed that there were pronounced disparities across SDI regions, with high-middle SDI regions shouldering the greatest burden. These findings underscore the urgent need for region-specific prevention and control strategies to address the growing epidemiological and socioeconomic impacts of these malignancies in aging populations.

PMID:40557436 | DOI:10.1097/JS9.0000000000002645

Neuroradiol J. 2025 Jun 25:19714009251351290. doi: 10.1177/19714009251351290. Online ahead of print.

ABSTRACT

This study sought to categorize anatomical variations of the septum pellucidum (SP), cavum vergae (CV), and cavum veli interpositi (CVI), as well as to examine potential correlations between these variations and psychiatric disorders. A total of 2949 patients were retrospectively analyzed utilizing brain MRIs. Variations were categorized into nine types according to the coexistence of CSP and CVI in either mild or moderate manifestations. The prevalence of CSP, CV, and CVI in the study population was 7.9%, 1.4%, and 9.0%, respectively, with an overall occurrence of variation at 13.8%. A chi-square test indicated a significant correlation between moderate CSP with mild CVI (Type VIII) and a reduced prevalence of psychiatric disorders (p = .007), implying a possible protective effect. Nevertheless, the majority of SP variations exhibited no statistically significant correlation with psychiatric diagnoses, including schizophrenia, OCD, or bipolar disorder. Logistic regression analysis revealed a significant interaction between gender and SP variations in predicting psychiatric disorders, with females exhibiting a higher overall prevalence. The interaction term was statistically significant (p < .001), suggesting that variations in SP and gender collectively affect the probability of psychiatric disorders. The findings offer valuable insights; however, limitations including the retrospective design, small subgroup sizes, and absence of genetic data necessitate caution in result interpretation. This study enhances comprehension of SP variations and their possible involvement in psychiatric disorders, emphasizing the necessity for additional research to clarify the underlying neurobiological mechanisms and clinical ramifications.

PMID:40557431 | DOI:10.1177/19714009251351290

J Saudi Heart Assoc. 2025 Jun 12;37(3):3. doi: 10.37616/2212-5043.1439. eCollection 2025.

ABSTRACT

Olezarsen emerged as a novel promising Apo-C3 inhibitor for dyslipidemia. However, its dose-response relationship remains uncertain. This review aims to evaluate the lipid-lowering effect of olezarsen, safety measures, and dose-response effects to determine the optimal dose. A systematic search was conducted across Scopus, PubMed, Science-Direct, and CENTRAL on January 2, 2025. Randomized controlled trial (RCT) comparing olezarsen with placebo in dyslipidemia was included. The Rob 2.0 tool was implemented to assess quality. R-studio and STATA were used to conduct statistical analysis. From a total of 194 documents at initial search, four RCTs involving 361 patients were included in the present analysis. Olezarsen significantly reduces plasma Apo-C3 across all dosage cohorts, including a 50 mg dose (MD: -70.31 %; 95 % CI: -83.89 to -56.74; p < 0.01) and an 80 mg dose administered every four weeks. It also significantly lowered triglycerides at any dose level, with reductions observed at 50 mg (MD: -49.84 %; 95 % CI = -70.42 to -22.37; p = 0) and 80 mg (MD: -52.32 %; 95 % CI: -58.25 to -46.40; p < 0.01). Olezarsen has minimal effect on low-density lipoprotein (LDL) but significantly increases high-density lipoprotein (HDL). Dose-response meta-analysis modeling suggests that 50 mg administered every four weeks may represent the optimal dose, beyond which added benefits diminish. Safety analysis revealed tolerability in liver, renal, and hematological parameters. In conclusion, olezarsen is an effective Apo-C3 inhibitor that improves lipid profiles with a favorable safety profile. This modeling-based insight refines previous findings by delineating a clearer therapeutic window.

PMID:40557417 | PMC:PMC12186734 | DOI:10.37616/2212-5043.1439

J Curr Ophthalmol. 2025 Jun 5;36(3):291-295. doi: 10.4103/joco.joco_107_24. eCollection 2024 Jul-Sep.

ABSTRACT

PURPOSE: To assess the safety and efficacy of the 4-year administration of 0.01% atropine following a 1-year observation period in high myopic children.

METHODS: The RAMCOM-II study continues the RAMCOM study, designed as an interventional nonrandomized study. Participants were observed for 1 year without any intervention to establish a baseline. Subsequently, children were divided into two arms: participants in the intervention group received one drop of 0.01% atropine daily at bedtime from years 1 to 5, while the control arm received no treatment and was monitored with routine clinical examinations. Annual assessments captured myopia progression, visual acuity, adverse events, and compliance. Statistical analyses compared outcomes between the two groups, considering demographic factors.

RESULTS: At the 4-year follow-up, myopia progression from baseline in the intervention group (atropine-treated eyes) was significantly lower than in the control group (2.0 ± 2.0 diopter [D] vs. 3.2 ± 1.9 D, P = 0.01). Axial elongation also favored the intervention group. At the 5-year follow-up, similar trends persisted, underscoring the sustained efficacy of 0.01% atropine. Myopia progression remained significantly reduced in the intervention group compared to the control group (2.2 ± 2.0 D vs. 3.4 ± 1.9 D, P = 0.01). Although differences in axial elongation were less pronounced, these findings highlight the long-term benefits of 0.01% atropine in managing high myopia in children.

CONCLUSION: The RAMCOM-II study supports the efficacy of 0.01% atropine in controlling myopia progression over 5 years, emphasizing its promising role in pediatric high myopia management.

PMID:40557415 | PMC:PMC12184860 | DOI:10.4103/joco.joco_107_24