Nevin Manimala

Front Nutr. 2025 Feb 11;12:1530624. doi: 10.3389/fnut.2025.1530624. eCollection 2025.

ABSTRACT

BACKGROUND: Human Papillomavirus (HPV) infection is a ubiquitous sexually transmitted infection globally, frequently associated with sexual behaviors characterized by increased frequency and multiple partnerships. The relationship between varying levels of dietary iron intake and the occurrence of Human Papillomavirus (HPV) infection remains an unresolved question in the scientific community. The objective of our study was to investigate the potential relationship between the consumption of dietary iron and HPV infection.

METHODS: Our investigation drew upon comprehensive datasets from 7,819 participants enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2016. Employing a cross-sectional analytical framework, we delved into the potential correlation between dietary iron consumption and Human Papillomavirus infection. To statistically assess this relationship, we utilized weighted multivariate logistic regression models. Additionally, we implemented smooth curve fitting and threshold effect analysis, to delineate the complex, nonlinear association between iron intake and HPV infection. Furthermore, we conducted subgroup analyses.

RESULTS: After adjusting for multiple confounding variables, our results demonstrated a statistically significant inverse association between iron intake and HPV infection (OR = 0.988, 95% CI: 0.979-0.998, p = 0.018). It’s worth noting that, in comparison to individuals in the quartile with the lowest iron intake, those in the highest quartile exhibited a 23.2% reduction in the odds of HPV infection for each incremental unit of iron intake (OR = 0.768, 95% CI: 0.634 to 0.930, p = 0.009). A refined analysis employing smoothing curve fitting techniques unveiled an L-shaped correlation, delineating a specific relationship between dietary iron intake and the incidence rate of Human Papillomavirus infection. When iron intake was <16.99 mg, a higher incidence of HPV infection was associated with lower levels of iron intake. (OR = 0.968, 95% CI: 0.956-0.980, p < 0.001).

CONCLUSION: The presence of an L-shaped association between iron intake and HPV infection underscores and emphasizes the possible beneficial effect of sufficient iron intake in reducing the likelihood of HPV infection.

PMID:40008312 | PMC:PMC11850268 | DOI:10.3389/fnut.2025.1530624

Front Nutr. 2025 Feb 11;12:1532313. doi: 10.3389/fnut.2025.1532313. eCollection 2025.

ABSTRACT

BACKGROUND: The dietary index for gut microbiota (DI-GM) reflects dietary patterns that support gut microbial health and may influence kidney stone (KS) risk. The role of DI-GM and its mediation by diabetes in KS pathogenesis remains unclear.

OBJECTIVE: To investigate the association between DI-GM and KS prevalence, assess the mediation effect of diabetes, and explore subgroup-specific effects and underlying mechanisms.

METHODS: A cross-sectional analysis of NHANES (2007-2018) data was conducted using a stratified, multistage probability sampling design. A total of 19,841 participants were included in the final analysis. Data entry and statistical analysis were performed using Empower version 4.2 (X&Y Solutions, Inc., Boston, MA, United States) and R version 3.4.3 (R Foundation). Multivariable logistic regression was employed to assess the association between DI-GM and KS prevalence, with statistical significance set at p < 0.05. Mediation analysis evaluated diabetes’s contribution to this relationship, and subgroup analyses were conducted based on sex, race/ethnicity, and alcohol consumption.

RESULTS: Higher DI-GM scores were associated with lower KS prevalence (adjusted OR: 0.78, 95% CI: 0.65-0.92 per SD increase). Diabetes mediated 9.27% of this relationship. Subgroup analyses revealed stronger protective effects among females, non-Hispanic Black individuals, and heavy drinkers. Mechanistically, DI-GM may reduce KS risk through gut microbial modulation of oxalate metabolism, urinary citrate excretion, and systemic inflammation.

CONCLUSION AND RECOMMENDATIONS: Higher DI-GM scores are associated with reduced KS prevalence, partially mediated by diabetes. These findings highlight the role of dietary interventions targeting gut microbiota in KS prevention and call for longitudinal studies to confirm these results and develop tailored dietary strategies.

PMID:40008311 | PMC:PMC11852834 | DOI:10.3389/fnut.2025.1532313

Infect Prev Pract. 2025 Jan 28;7(1):100445. doi: 10.1016/j.infpip.2025.100445. eCollection 2025 Mar.

ABSTRACT

Evaluating the effectiveness of different brush types used during the cleaning and reprocessing of flexible endoscopes is challenging. This study compared the yield of microbial growth from endoscopes that had been used clinically before and after cleaning with different brush types (bristle, squeegee, and hybrid). Endoscopes used to perform a total of 91 medical procedures on 82 patients were included. Quantitative bacterial cultures yielded no statistical differences between the different brushes used. Colonoscopes and gastroscopes surveyed after rigorous cleaning steps resulted in a drop in colony counts between pre- and post-cleaning from 1.45E+8 (±5.21E+07) to 2.5 (±0.13) individual colonies suggesting that the overall cleaning process was effective regardless of the brush type used.

PMID:40008272 | PMC:PMC11851223 | DOI:10.1016/j.infpip.2025.100445

Gynecol Oncol Rep. 2025 Feb 3;57:101687. doi: 10.1016/j.gore.2025.101687. eCollection 2025 Feb.

ABSTRACT

BACKGROUND: Women living with HIV (WLWH) are at increased risk of persistent HPV infection and HPV-related cancers than persons without HIV. We aimed to describe the utilization of primary and secondary prevention strategies for HPV-related cancers among women by HIV status in Puerto Rico (PR).

METHODS: We performed a secondary data analysis of women aged 21+ years (n = 469) evaluated at the Anal Neoplasia Clinic (ANC) of the University of Puerto Rico Comprehensive Cancer Center between 2014 and 2023. The outcomes were history of HPV vaccination, anal Pap screening, and cervical Pap screening in the past 3 years. Descriptive statistics were employed to characterize the study population and comparisons were made by HIV status.

RESULTS: Women’s mean age in our study was 50.2 ± 12.1 years; 75.7 % were living with HIV. Among women who were age-eligible for HPV vaccination, 21.7 % reported receiving the HPV vaccine; WLWH were less likely vaccinated than women without HIV (14.7 % vs. 38.7 %, p < 0.01). Prevalence of cervical and anal Pap screening were significantly higher among WLWH (98.6 % and 89.9 %, respectively) than in women without HIV (94.4 % and 47.7 %, respectively). Several risk factors for HPV-related disease were more common among WLWH, such as age at first sexual encounter (≤ 16 years) (54.7 %), more than six lifetime sexual partners (43.1 %), and being a current smoker (23.6 %).

CONCLUSIONS: Although we observed high uptake of cervical and anal Pap screening in this clinic-based sample, HPV vaccination was deficient. Future studies should involve developing tailored cancer prevention strategies for WLWH to increase HPV vaccination uptake.

PMID:40008257 | PMC:PMC11851177 | DOI:10.1016/j.gore.2025.101687

BMC Psychiatry. 2025 Feb 25;25(1):169. doi: 10.1186/s12888-025-06598-6.

ABSTRACT

BACKGROUND: In university students with depressive symptoms, inhibitory control dysfunctions strongly contribute to functional impairments, yet they are not adequately addressed in current therapies. This study aims to investigate the intervention effect of an 8-week Taekwondo exercise program on inhibitory control in individuals with depressive symptoms.

METHODS: A total of 41 university students with depressive symptoms were randomly divided into a Taekwondo group and a control group. The Taekwondo group participated in an 8-week intervention. Behavioral and ERP measures were collected before and after the intervention during a response inhibition task.

RESULTS: 1.The 8-week Taekwondo exercise intervention significantly improved depressive symptoms in the exercise group (P < 0.05), while depressive symptoms in the control group worsened, although the difference was not statistically significant;2.The results from the behavioral task showed a statistically significant difference in accuracy between the Taekwondo group and the control group in the Go condition during the post-test stage (P < 0.05). In the Nogo condition, there was also a significant difference in accuracy between the two groups (P < 0.05). Notably, only the Taekwondo group exhibited a significant improvement in Nogo condition accuracy from pre-test to post-test (P < 0.001);3.The event-related potential (ERP) results revealed a significant time × group interaction effect for N2 amplitude, F(1, 39) = 4.821, P = 0.034, ƞ_p²=0.110. Additionally, there was a significant condition × electrode interaction effect, F(3, 117) = 18.368, P < 0.001, ƞ_p²= 0.320. For N2 latency, the time × group interaction effect was significant, F(1, 39) = 13.028, P < 0.001, ƞ_p²=0.250, and a significant time × condition × electrode interaction effect was also observed, F(3, 117) = 3.199, P = 0.026, ƞ_p² = 0.076.

CONCLUSION: Regular moderate-intensity Taekwondo exercise can effectively improve response inhibition in university students with depressive symptoms, along with improvements in depressive symptoms. The changes in N2 amplitude and latency at the Fz, Cz, and Pz electrode sites under task conditions may represent the cognitive neural processing mechanism through which Taekwondo enhances response inhibition in students with depressive symptoms.

PMID:40001105 | DOI:10.1186/s12888-025-06598-6

Int J Behav Nutr Phys Act. 2025 Feb 25;22(1):22. doi: 10.1186/s12966-025-01720-z.

ABSTRACT

BACKGROUND: In a stepped wedge design, schools are randomised to a sequence of measurements, with each sequence transitioning to intervention status at a different time. There are several advantages to such designs, including increased statistical power, logistical benefits and the ability to explore change over time. However, stepped wedge designs have not previously been used to evaluate school-based physical activity interventions in children. This paper aimed to explore the feasibility of this design, by identifying school constraints, balancing these with statistical considerations and exploring the power of this chosen design under different scenarios.

METHODS: We conducted three interlinked studies, with the results from one informing the next. Study 1 was a qualitative study to identify school constraints that inform the choice of stepped wedge configuration. Study 2 used simulation to choose a configuration that balanced these school constraints and statistical properties. Study 3 explored the statistical power for the chosen design for different school and pupil sample sizes, using an open cohort design (a mixture of new and repeated pupils).

RESULTS: School staff considered the proposed data collection feasible, and supported a maximum of 3-4 measurements per year and an implementation period of one school term. Study 2 therefore considered incomplete stepped wedge designs with five steps. Statistically, the best designs had a mix of control and intervention measurements in terms 2-4 and a spread of measurements across the whole study duration. Power depended on a combination of the overall recruitment rate and the retention rate. For 20 schools with an eligible class size of 30 pupils, we would be able to detect a 6 min difference in average weekday moderate-to-vigorous physical activity with 80% power, provided there were > 50% of pupils measured per school at each time. A similarly powered cluster randomised controlled trial would require 42 schools.

CONCLUSION: Stepped wedge trials are a viable design for evaluating school-based physical activity interventions. Incomplete designs, where not all schools are measured at each point, offer the flexibility to work around practical constraints.

PMID:40001100 | DOI:10.1186/s12966-025-01720-z

BMC Ophthalmol. 2025 Feb 25;25(1):95. doi: 10.1186/s12886-025-03928-w.

ABSTRACT

BACKGROUND: We examined the relationship between contrast sensitivity (CS) and visual field stage/severity in patients with open-angle glaucoma (OAG), and correlated CS with Quality of Vision (QOV) scores.

METHODS: CS was measured under photopic (100 cd) and mesopic (10 cd) conditions in 218 eyes of 109 patients with OAG aged < 60 years. The glaucoma stages were divided into four groups according to the mean deviation (MD) of the Humphrey Field Analyzer (HFA) 24 – 2 or 10 – 2 Swedish Interactive Thresholding Algorithm (SITA) standard, and their relationship with CS was examined.

RESULTS: The results of the Japanese version of the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) in 79 patients were converted into Rasch scores and correlated with CS. Both HFA24-2 and 10 – 2 showed statistically significant improvements in all items except 10.2 cycles per degree (cpd) under mesopic conditions where CS decreased significantly (p < 0.05). Correlations between CS and NEI VFQ-25 Rasch scores were stronger in the worse eye (WE) at HFA24-2, 10 – 2, and foveal sensitivity thresholds. The measurement results strongly correlated under photopic conditions. Comparing the correlations at HFA24-2, 10 – 2, and foveal sensitivity thresholds, the correlation was strongest at the foveal sensitivity threshold.

CONCLUSIONS: CS declines with progression in the visual field stage or severity. QOV score tends to decreases with a decline in CS.

PMID:40001099 | DOI:10.1186/s12886-025-03928-w

BMC Psychiatry. 2025 Feb 25;25(1):168. doi: 10.1186/s12888-025-06612-x.

ABSTRACT

OBJECTIVE: This study investigates the association between the Weekend Warrior (WW) pattern and the risk of anxiety among American adults, offering insights into a more flexible exercise strategy for individuals with limited time for regular exercise during weekdays.

METHODS: We analyzed data from the 2007-2012 National Health and Nutrition Examination Survey (NHANES) to examine the relationship between different physical activity (PA) patterns and the risk of anxiety. Multivariate logistic regression, subgroup interaction, restricted cubic spline analysis (RCS), and sensitivity analyses were conducted to assess this association.

RESULTS: Compared to inactive individuals, those engaging in WW pattern (OR = 0.65, 95% CI: 0.48-0.90, p = 0.010), insufficiently active (OR = 0.71, 95% CI: 0.62-0.82, p < 0.001), or regularly active pattern (OR = 0.75, 95% CI: 0.65-0.87, p < 0.001) showed significantly lower risk of anxiety. Subgroup interaction analyses revealed significant effect modification in the poverty income ratio (PIR) and diabetes subgroups (P for interaction < 0.05), while no significant interactions were observed for other variables. RCS analysis showed a significant nonlinear relationship between recreational moderate to vigorous intensity physical activity and risk of anxiety (P for nonlinear < 0.001). Sensitivity analyses further confirmed the stability of the findings.

CONCLUSION: The WW pattern was associated with a lower risk of anxiety. For individuals unable to exercise consistently throughout the week, the WW pattern offers a practical alternative for reducing the risk of anxiety, particularly among those with lower income levels or diabetes.

PMID:40001092 | DOI:10.1186/s12888-025-06612-x

J Transl Med. 2025 Feb 25;23(1):226. doi: 10.1186/s12967-024-06030-9.

ABSTRACT

BACKGROUND: Osteonecrosis (ON) is a debilitating orthopedic condition characterized by bone cell death due to impaired blood supply, leading to structural changes and disability. Osteoporosis (OP), a systemic skeletal disease, results in reduced bone density and quality, making bones fragile and prone to fractures. Although distinct, OP and ON share several risk factors such as corticosteroid use and smoking. This study aims to investigate the causal relationships between OP, bone mineral density (BMD), and ON using a bidirectional two-sample Mendelian randomization (MR) approach.

METHODS: This study utilized genome-wide association study (GWAS) data for OP from the FinnGen database, and BMD data for the lumbar spine and femoral neck from the Genetic Factors for Osteoporosis (GEFOS) consortium. ON data were also obtained from the FinnGen database. All participants were of European descent. Genetic instruments were selected based on genome-wide significance, linkage disequilibrium, and strength (F-statistic). Bidirectional MR analysis was performed using inverse-variance weighted (IVW), MR-Egger regression, and weighted median methods to assess causality. Sensitivity analyses, including Cochran’s Q test and MR-PRESSO, were conducted to evaluate heterogeneity and pleiotropy.

RESULTS: MR analysis demonstrated a positive causal effect of OP on ON using the IVW method, with an odds ratio (OR) of 1.223 (95% CI: 1.026-1.459, P = 0.025). The weighted median method also confirmed this result with an OR (95% CI) 1.290 (1.021-1.630), P = 0.033. No significant causal effects were found between BMD (lumbar spine and femoral neck) and ON. Furthermore, ON did not exhibit a causal effect on OP or BMD. Sensitivity analyses confirmed the robustness of the results, showing no evidence of heterogeneity or pleiotropy.

CONCLUSION: This study provides evidence of a unidirectional causal relationship between OP and ON, suggesting that individuals with a genetic predisposition to OP have an increased risk of developing ON. These findings highlight the importance of early OP detection and management to potentially reduce ON incidence. The lack of a significant causal relationship between BMD and ON indicates that factors other than bone density, such as vascular health, may play a crucial role in ON development. Future research should explore these mechanisms further to inform clinical interventions.

PMID:40001090 | DOI:10.1186/s12967-024-06030-9

BMC Musculoskelet Disord. 2025 Feb 25;26(1):190. doi: 10.1186/s12891-025-08392-7.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness and cost-effectiveness of physiotherapy, chiropractic care, and the combination of physiotherapy and chiropractic care compared with information and advice for the treatment of patients with nonspecific chronic low-back pain (CLBP) in Sweden.

DESIGN: A multicentre pragmatic randomized controlled trial.

SETTING: Ten primary care rehabilitation units in Sweden.

PARTICIPANTS: Eighty-eight participants with nonspecific CLBP.

INTERVENTIONS: The participants were randomly assigned to receive physiotherapy, chiropractic care, combination treatment, or information and advice.

MAIN OUTCOME MEASURES: This study measured the Oswestry Disability Index (ODI), health-related quality of life (HRQoL), quality-adjusted life-years (QALYs), working status, and costs.

RESULTS: The study revealed no statistically significant differences in any of the outcome measures when physiotherapy, chiropractic care, and combination treatment with information and advice were compared (p > 0.05). The ODI changes between baseline and the 6-month follow-up ranged from 6.13 to 12.56 across the treatment groups, indicating reduced disability in all groups. Compared with the other treatment options, the combination treatment resulted in the greatest QALY gain (0.418) and lowest cost (SEK 3,081).

CONCLUSION: Compared with alternative standalone treatment options, the combination treatment strategy resulted in greater QALY gain and lower costs from a heath care perspective. Although the study did not detect statistically significant differences in outcomes or costs among the treatment options, the combination treatment showed promising potential for cost-effectiveness. Given the small sample size and low statistical power of the study, further clinical trials with fewer treatment arms and a focus on the combination group are warranted to confirm these findings. The insights gained from this study are important for informing the design and conduct of future clinical studies investigating the effectiveness, costs and cost-effectiveness of treatments for CLBP.

TRIAL REGISTRATION: The study is registered in the ISRCTN registry (2017-02-20: ISRCTN15830360).

PMID:40001085 | DOI:10.1186/s12891-025-08392-7