Nevin Manimala

Neurol Sci. 2025 Oct 16. doi: 10.1007/s10072-025-08489-w. Online ahead of print.

ABSTRACT

Charcot-Marie-Tooth (CMT) disease is one of the most common inherited neuropathies, leading progressive muscular weakness, pes cavus, loss of deep tendon reflexes, distal sensory loss, and gait impairment. Charcot Marie Tooth Neuropathy Scale (CMTNS) represents the gold standard to assess and grade the impairment in CMT patients. The aim of this retrospective study was to assess the correlation between CMTNS and functional status in CMT patients. We analyzed data of patients with diagnosis of CMT, collecting the following data: age; gender; BMI; CMT type (Demyelinating- Axonal- Other or mixed forms); Time from diagnosis; Charcot-Marie-Tooth Disease Neuropathy Score (CMTNS); MEDICAL RESEARCH COUNCIL lower limb sum-score (MRCLL-SS); MEDICAL RESEARCH COUNCIL Upper Limb Sum Core (MRCUL-SS); Manual Ability Measure-16 (MAM-16); Berg Balance Scale (BBS); Walking Handicap Scale (WHS); Walk-12; Rankin Scale; Modified Fatigue Impact Scale (MFIS); Visual Analogic Scale (VAS); 10 m Walking test. We included 235 patients with a mean age of 45.77 ± 15 years. All variables, excluded VAS and MFIS, showed a statistically significant correlation with CMTNS. In particular, a moderate negative correlation was found between CMTNS and MRCLL-SS (r = -0.47), and Berg Balance scale (r = – 0.61); A moderate positive correlation was found between CMTNS and Rankin scale (r = 0.53), and walk 12 (r = 0.41). Taken together, these findings suggest that CMTNS is a valuable tool to detect the severity of disability and limbs function in CMT patients.

PMID:41100006 | DOI:10.1007/s10072-025-08489-w

Health Econ Rev. 2025 Oct 16;15(1):83. doi: 10.1186/s13561-025-00654-3.

ABSTRACT

INTRODUCTION: Corruption is a major factor that influences health seeking behaviour. However, there is paucity of empirical evidence from research on how corruption affects different population groups when they seek healthcare services from formal healthcare facilities. The paper presents new evidence on how informal payments, which is a major form of corruption, affect health-seeking behaviour people and how household economic status has sustained it in Nigeria.

METHODS: We used a pre-tested interviewer-administered questionnaire to conduct interviews in 1,652 households in Enugu and Kano states, in the south and north of Nigeria, respectively. Descriptive statistics was used to estimate household health-seeking behaviour and Ordinary Least Square, binary logistic and multinomial logistic regression analyses to assess how experience of informal payment and economic status (quintiles: extremely poor, poor, average, rich, extremely rich quintiles) affect household health-seeking behaviour.

RESULTS: Poorer households were most likely to attend health posts and health centres, while extremely rich households disproportionately used hospitals (59%). Household economic status determines the likelihood of paying informally, with richer ones paying more (p < 0.05). Household size, age of the patient, sex, years spent on formal education and state were other identified determinants of informal payments. Experience of informal payment in public facilities significantly reduces household use of tertiary hospitals compared to primary health centres or health posts by 58% (p < 0.05). The choice of tertiary hospital compared to a primary health centre or health post is significantly reduced by 31% because of informal payments (p < 0.01).

CONCLUSION: Informal payments in public facilities negatively affect health seeking, driving the poorest households to use low-quality care services. This problem needs to be widely recognised and sufficiently tackled in order for the country to reduce the economic burden of health seeking and achieve equitable access and utilisation of high-quality health services.

PMID:41099997 | DOI:10.1186/s13561-025-00654-3

Reprod Sci. 2025 Oct 16. doi: 10.1007/s43032-025-01986-5. Online ahead of print.

ABSTRACT

Obesity is associated with low fertility potential. Ca2 + oscillations are known to be triggered after sperm oocyte membrane fusion, which allows entry of a sperm-specific phospholipase C-zeta (PLCζ), into the oocyte cytoplasm. We aimed to examine sperm PLCζ expression changes in obese and non-obese men along with sperm parameters. The demographic characteristics of the patients were analysed. The patients included in the study were divided into two groups:Non-obese patients (BMI < 30)(Control)(n:49) and the Obese Patient Group (BMI ≥ 30)n = 18). Semen analysis of the groups was evaluated. Rt-PCR analysis and histopathologic evaluation by immunohistochemistry for PLCζ expression were performed. Testosterone levels in the control group were statistically higher than in the obese group (4.8 ± 1.28 μg/L;3.6 ± 1.61 μg/L, respectively) (p < 0.05). Prolactin levels were 12.6 ± 7.2 μg/L in the control group and 17.15 ± 9.28 μg/L in the obese group, which was statistically significant (p = 0.03). No significant difference was detected between the groups in sperm concentration, motility, morphology, or viability, although semen pH was significantly higher in obese patients (p = 0.024).. Although no statistically significant was observed, PCR analysis revealed that PLCζ expression was elevated by a factor of 1.69 in obese patients. Immunohistochemical staining results showed that PLCζ expression was decreased in obese patients compared to the control group. Although PLCζ mRNA expression was higher in the obese group compared to the control group, immunohistochemical staining results demonstrated weak staining of sperm cells in the obese group. These results indicated that PLCζ protein synthesis pauses at some point in obese patients. The discrepancy between mRNA expression and protein localization may indicate translational or post-translational regulation, though this was not directly assessed in our study. This study highlights the complex relationship between obesity and male fertility, suggesting that obesity may disrupt the translation of PLCζ protein, which is crucial for successful fertilization.

PMID:41099980 | DOI:10.1007/s43032-025-01986-5

Environ Sci Pollut Res Int. 2025 Oct 16. doi: 10.1007/s11356-025-37044-5. Online ahead of print.

NO ABSTRACT

PMID:41099977 | DOI:10.1007/s11356-025-37044-5

Geroscience. 2025 Oct 16. doi: 10.1007/s11357-025-01940-y. Online ahead of print.

ABSTRACT

Biological aging exhibits significant heterogeneity across individuals, and a precise evaluation at scale is urgently needed. Here, we developed a PCAge, based on common clinical, physiological, and laboratory indices routinely collected in primary healthcare, in the CHARLS. PCAge demonstrated strong correlations with chronological age (r = 0.86-0.88, P < 0.001) and robust performance in the prediction of mortality (C-index = 0.798) over a 10-year follow-up. Biologically older individuals (PCAge > chronological age) suffered from substantially higher risk of age-related diseases, including cardiovascular disease (HR = 1.30, P < 0.001), heart disease (HR = 1.35, P = 0.003), stroke (HR = 2.38, P < 0.001), hypertension (HR = 1.28, P = 0.007), and diabetes (HR = 1.51, P < 0.001). Furthermore, the generalizability of PCAge was validated in the South China Cohort (SCC, n = 68,920). Biologically older individuals were more likely to have hypertension, diabetes, cardiovascular disease, and respiratory diseases. Being female (proportion ratios [PR] = 1.94, P < 0.001), lower education attainment (PR = 1.18, P < 0.001), higher income (PR = 1.47, P < 0.001), and unfavorable lifestyles (PR = 1.41, P < 0.001) were associated with a higher probability of having accelerated aging. PCAge identified aging trajectories up to a decade before clinical disease onset, offering a cost-effective tool for population-level aging surveillance. Our findings underscore the potential of PCAge as a highly accessible tool for the evaluation of aging status, especially in resource-limited areas.

PMID:41099967 | DOI:10.1007/s11357-025-01940-y

Geroscience. 2025 Oct 16. doi: 10.1007/s11357-025-01939-5. Online ahead of print.

ABSTRACT

Redox signaling is a key mechanism of exercise-induced adaptation. However, studies have demonstrated impaired responses to acute exercise in older organisms. Adjunctive therapies to augment exercise effects may overcome these deficits. Sulforaphane (SFN), a phytochemical from cruciferous vegetables, stimulates NRF2. This study tested the hypothesis that combining acute exercise (in vivo stimulus) with ex vivo SFN treatment would induce greater NRF2 activation and signaling in older adults compared to either treatment alone. Twenty-five older adults (12 men, 13 women; mean age: 67 ± 5 years) performed 30-min cycling exercise (AET). Blood was drawn before and immediately after the AET to isolate PBMCs and incubate with and without SFN (5 µM) treatment (four conditions: DMSO (CON), SFN, exercise (EX), and EX + SFN). PBMCs were harvested after 2-h or 5-h incubation for measures of NRF2 or gene expression for NQO1, HO-1, GR, and GCLC targets, respectively. All treatments (SFN, EX, EX + SFN) increased NRF2 activation compared to CON (p < 0.05). The response to EX + SFN was significantly greater than either SFN or EX alone (2.1-fold versus 1.5-fold, p = 0.01). SFN stimulation resulted in a significant upregulation of all four genes compared to control (p < 0.001). EX + SFN treatment stimulated a greater increase in gene expression compared to EX (p < 0.05); however, SFN did not differ statistically from EX + SFN, suggesting a possible ceiling effect of the SFN concentration in terms of gene expression. There were no significant sex differences in any of the responses. These data suggest that combining exercise with SFN may amplify the strength of NRF2/ARE redox signaling in older adults. ClinicalTrials.gov ID: NCT04848792.

PMID:41099966 | DOI:10.1007/s11357-025-01939-5

J Relig Health. 2025 Oct 16. doi: 10.1007/s10943-025-02473-6. Online ahead of print.

ABSTRACT

This study aimed to examine the level of spiritual experience and the impact of socio-demographic and clinical features, anxiety and depression, and spiritual well-being on the spiritual experiences of hospitalized patients with gynecological cancer. This cross-sectional study was conducted with 192 patients in a university-affiliated hospital in the west of Turkey. The participants completed self-assessment tools, including the Daily Spiritual Experience Scale, the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale, and the Hospital Anxiety and Depression Scale. According to the results of the hierarchical linear regression analysis, the statistically significant factors affecting spiritual experience among patients with gynecologic cancer were age (β = -.219), anxiety (β = .208), depression (β = .172), and faith (β = -.312). Meaning and peace subdimensions of spiritual well-being were not found to be a significant predictor of spiritual experience. This indicates that when the subdimensions contaminating the construct of spiritual well-being are removed, the faith subdimension predicts spiritual experience more strongly. Gynecological cancer patients may have spiritual issues, so health professionals should provide spiritual support.

PMID:41099947 | DOI:10.1007/s10943-025-02473-6

J Med Syst. 2025 Oct 16;49(1):140. doi: 10.1007/s10916-025-02273-1.

ABSTRACT

Cancer treatments might lead to several long-term effects. In this work we investigate their causal role on ischemic heart disease and their potential precursors (i.e. hypertension and dyslipidemia) of the ovarian suppression therapy in adolescent and young adult (AYA) breast cancer (BC) survivors. Additionally, we assess the external validity of our findings through comparative analysis of regional data. We take advantage of a causal network model that leverage on observational data on 1-year AYA BC survivors living the Lombardy region in Italy. Using a structural causal model (SCM) and counterfactual analysis within Pearl’s causal inference framework, we estimate the Average Causal Effect (ACE), Probability of Necessity (PN), and Probability of Sufficiency (PS) for the cause-effect relationships. Data of a regional cohort of AYA BC patients living in the Veneto region were used to externally validate results. Ovarian suppression was found to be a necessary but not sufficient cause for ischemic heart disease (PN > 97.8%; PS < 1.97%). While PN is high for both hypertension and dyslipidemia, PS varied suggesting ovarian suppression alone could induce hypertension in about 30% of cases but was rarely sufficient for dyslipidemia onset. External validation confirmed the robustness of findings across regions. Our experimental results may be of interest for clinicians who aim at personalizing the follow-up of AYA BC survivors, with particular attention to be paid in monitoring the hypertension onset or in its prevention. The study demonstrates the value of counterfactual reasoning and causal inference when working with real-world data.

PMID:41099942 | DOI:10.1007/s10916-025-02273-1

Atherosclerosis. 2025 Oct 10;410:120545. doi: 10.1016/j.atherosclerosis.2025.120545. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: The atherogenic index of plasma (AIP) has been linked to hypertension in general populations. However, the existing evidence concerning its association with preeclampsia risk remains limited. This study aimed to assess the relationship between first-trimester AIP level and preeclampsia risk.

METHODS: 6028 singleton pregnant women from a birth cohort, all under 14 weeks of gestation and without a history of hypertension, were included. AIP was calculated as log₁₀ (triglycerides/high-density lipoprotein cholesterol). Generalized linear models and restricted cubic spline regression were utilized to estimate the associations between AIP and preeclampsia risk. A random forest model was employed to determine the relative importance of parameters for predicting preeclampsia risk.

RESULTS: 235 (3.90%) incident preeclampsia cases were confirmed. A linear relationship was found between AIP and preeclampsia risk, and each 1-standard deviation increase in AIP was associated with a 21% higher risk of preeclampsia (RR: 1.21, 95% CI: 1.06-1.38). A significant interaction was identified between AIP and uric acid (UA) level (P for interaction = 0.009). Elevated AIP was linked to an increased preeclampsia risk (RR: 1.32, 95% CI: 1.13-1.54) when UA level exceeded 198 μmol/L, and the highest combined level indicated the greatest risk. Moreover, AIP was identified as the strongest predictor among all variables in the prediction model.

CONCLUSIONS: Elevated first-trimester AIP was associated with an increased preeclampsia risk, particularly at the higher UA level. These findings highlight the clinical significance of pro-atherogenic dyslipidemia as both a risk marker and a potential target for early screening in preeclampsia prevention strategies.

PMID:41092517 | DOI:10.1016/j.atherosclerosis.2025.120545