Nevin Manimala

Diabetol Metab Syndr. 2025 Jun 18;17(1):231. doi: 10.1186/s13098-025-01810-9.

ABSTRACT

PURPOSE: To examine the association between dietary fiber intake and mortality risks (all-cause and cardiovascular) among U.S. adults with diabetes or prediabetes, and to evaluate the dose-response patterns of these associations.

MATERIALS AND METHODS: This longitudinal cohort study analyzed data from 3259 adults with diabetes or prediabetes from the 2011-2018 National Health and Nutrition Examination Survey (NHANES). Dietary fiber intake was assessed using two 24-hour dietary recall interviews. Mortality data were obtained through December 31, 2019. Multiple Cox proportional hazards models were used to evaluate associations between fiber intake and mortality outcomes, adjusting for demographic and health-related covariates.

RESULTS: Higher dietary fiber intake was significantly associated with reduced all-cause mortality risk (HR = 0.98, 95% CI: 0.97-0.99, P = 0.0039). For cardiovascular mortality, a non-linear relationship was identified with a threshold at 26.2 g/day. Below this threshold, each gram increase in fiber intake was associated with a 3% reduction in cardiovascular mortality risk (HR = 0.97, 95% CI: 0.94-0.99, P = 0.0352), while no significant benefit was observed above this threshold.

CONCLUSIONS: Dietary fiber intake shows a protective effect against all-cause mortality in U.S. adults with diabetes or prediabetes. For cardiovascular mortality, moderate fiber intake up to 26.2 g/day appears beneficial, while higher intake may not provide additional cardiovascular benefits. These findings provide important evidence for developing targeted dietary recommendations in diabetes management.

PMID:40533827 | DOI:10.1186/s13098-025-01810-9

Eur J Med Res. 2025 Jun 18;30(1):489. doi: 10.1186/s40001-025-02778-y.

ABSTRACT

BACKGROUND: To compare the demographic characteristics, maternal and perinatal outcomes and hemoglobin parameters according to stages diagnosed with placental abruption.

METHODS: Patients who underwent cesarean delivery due to clinical suspicion of placental abruption after the 20th week of gestation were included in the study. We eliminated patients with persistent hematological disorders, those on anticoagulant medications, and individuals with uterine deformities. Demographic information, body mass index, initial laboratory results, duration of hospitalization, fetal APGAR scores, and transfers to maternal and neonatal critical care units were all documented from the data system. Patients were categorized into categories based on the stages of placental abruption as outlined in the 2022 emergency obstetric care guide. Stage 0: Asymptomatic patient. Stage I: There is vaginal bleeding, clinical pain in abdomen, no signs of maternal shock or fetal distress. Stage II: There may be vaginal bleeding, no maternal shock. Fetal distress is present. Stage III: There may be maternal shock, intrauterine fetal demise is present. Presence of coagulopathy (30%). The patients were categorized as follows: Group 1 stage 0-I; Group 2 stage II; and Group 3 stage III, and the gathered data were compared among the groups.

RESULTS: A total of 150 patients were involved, with 50 patients in group 1. Group 2 comprised 59 patients, whereas Group 3 had 41 patients. Abruptions were most prevalent in group 3. The neutrophil/lymphocyte ratio (NLR) was statistically significantly elevated in groups 2 and 3. The platelet/lymphocyte ratio (PLR) was statistically significantly reduced in group 1. Hemoglobin and fibrinogen levels were deemed statistically significantly reduced in group 3. In group 2, the Apgar scores at 1 min and 5 min were the lowest, and the demand for newborn intensive care was the highest.

CONCLUSIONS: The analysis of hemogram parameters at the initial assessment may aid in the diagnosis of abruption, complementing ultrasonography, particularly in cases of early clinical suspicion. We believe that commonly conducted, cost-effective, and straightforward hemogram parameters, when augmented by artificial intelligence, can provide therapeutic support through the interpretation of data such as PLR and NLP in instances of ambiguous laboratory diagnoses, such as placental abruption.

PMID:40533823 | DOI:10.1186/s40001-025-02778-y

Diabetol Metab Syndr. 2025 Jun 18;17(1):222. doi: 10.1186/s13098-025-01760-2.

ABSTRACT

BACKGROUND: Icariin (ICA), a bioactive flavonoid derived from Epimedium species, has demonstrated anti-inflammatory and anti-fibrotic properties in preclinical studies, suggesting potential therapeutic effects on diabetic nephropathy (DN). However, systematic evaluation of its efficacy remains unclear.

OBJECTIVE: The purpose of this study is to evaluate the efficacy of Icariin on DN by preclinical evidence and meta-analysis. Meanwhile, the main possible action mechanisms of Icariin against DN were also summarized.

METHODS: As of October 1, 2024, we conducted a systematic search across seven prominent Chinese and English databases (CNKI, Wanfang, CBM, PubMed, Cochrane Library, Embase, and Web of Science) to identify studies investigating the therapeutic effects of icariin on DN. PROSPERO has released a summary protocol (registration number: CRD42024564001).

RESULTS: This meta-analysis encompassed nine studies, involving a total of 308 animals, and revealed that icariin significantly reduced blood glucose, SCR, BUN, 24 h UP, 24 h UV, KI, MDA, and IL-1β levels, while augmenting antioxidant enzyme activities (SOD and GPX). Furthermore, ICA lowered TG and TC, indicative of its potential in mitigating risk factors. However, direct comparisons between ICA and angiotensin II receptor blockers (ARB) yielded no statistically significant differences in DN treatment outcomes (p > 0.05). The greatest effects were recorded in high-dose (> 30 mg/kg/day) groups rather than in low-dose (< 30 mg/kg/day) groups. For time-response effects, subgroup analysis indicated that intervention duration of ICA can influence the treatment effect, and more beneficial effects were observed when studies had a drug administration time of < 8 weeks.

CONCLUSION: Based on an analysis of existing experimental evidence, icariin displays promise in slowing the progression of diabetic nephropathy. To validate its anti-diabetic nephropathy efficacy with greater precision and ensure its readiness for clinical translation, further confirmatory animal studies are warranted.

PMID:40533818 | DOI:10.1186/s13098-025-01760-2

Virol J. 2025 Jun 18;22(1):199. doi: 10.1186/s12985-025-02830-7.

ABSTRACT

BACKGROUND: Cervical cancer ranks as the fourth most common cancer among women globally, mainly linked to persistent high-risk HPV infection. In China, significant challenges persist, notably the low rates of HPV vaccination and a substantial case burden. This study retrospectively examined HPV-related cervical cancer data from a tertiary hospital spanning the years 2013 to 2020, to evaluate annual and age-specific incidence trends and offer insights for prevention and treatment strategies.

METHODS: The retrospective analysis encompassed patients who utilized the gynecological outpatient and inpatient services at the Third Affiliated Hospital of Sun Yat-sen University from 2013 to 2020. HPV genotyping, covering 21 subtypes, was conducted using hybrid capture-based assays. The assessment of cervical biopsy disease etiology was performed by a senior pathologist.

RESULTS: During the study period, a total of 9,194 cases of HPV-positive individuals were identified, among which 479 cases (5.21%) were diagnosed with cervical cancer. From 2013 to 2020, there was a statistically significant decline in the overall incidence of HPV-positive cervical cancer (Z=-4.061, P < 0.001), as well as in the incidence of squamous cell carcinoma (Z=-4.595, P < 0.001). However, the incidence of adenocarcinoma did not exhibit a significant change (Z = 0.118, P = 0.906). Regarding age distribution, a significant decrease in cervical cancer incidence was observed in patients aged 36 to 64 years (Z=-2.658, P = 0.008). In contrast, the incidence remained relatively stable in patients aged 65 years and older (Z = 0.071, P = 0.943). The incidence of squamous cell carcinoma increased with age, peaking at 27.06% in individuals over 65 years.

CONCLUSION: The decline in HPV-positive cervical cancer cases highlights the success of China’s screening and post-2016 vaccination efforts. However, rising HPV infections in younger women and ongoing cancer risks in older groups emphasized the need to broaden adolescent vaccinations, sexual health education, and lifelong screening.

PMID:40533808 | DOI:10.1186/s12985-025-02830-7

Trials. 2025 Jun 18;26(1):212. doi: 10.1186/s13063-025-08903-w.

ABSTRACT

BACKGROUND: No formal assessment of a method to measure the carbon emissions from a clinical trial has been undertaken in the low- and middle-income country setting. We aimed to evaluate the UK-based National Institute of Health Research (NIHR) method for tracking trial emissions for applicability and adaptability to the South African context. Objectives included to (1) identify gaps in trial activity data, (2) locate local emission factor sources, (3) quantify emissions and (4) investigate modifications required to ensure the method was locally applicable.

METHOD: We adopted an application and implementation approach. We established a formal stakeholder structure focused on sustainable clinical trials to guide and support our approach. We selected a large cluster-randomised trial of a health service delivery intervention conducted across multiple urban and rural sites as an exemplar typical of local conditions to test the NIHR method. We created a trial process map outlining ten recommended activity stages for carbon emissions and an Excel workbook to calculate emissions for each stage. We prioritised calculations of those activities for which we had the most complete data: paper usage and printing, local travel between sites, and electricity consumption at the trial head office and at trial sites. We extracted activity data from organisational financial instruments.

RESULTS: The study took place between December 2023 and March 2024. We identified a lack of publicly available local emission factor sources. Paper usage and printing activities took place at trial set-up and during intervention delivery and emitted 2274.88 kgCO₂e. Field staff travel between trial sites during intervention delivery and follow-up resulted in approximately 80,000 km travelled between 2016 and 2019 contributing 17,891 kgCO₂e. Electricity consumption was based on full-time equivalent staff and yielded 12,515 kgCO₂e during the 4-year period. We observed large differences between UK and available SA emission factors with SA emission factors far higher than those in the UK.

CONCLUSION: We found that with minor modifications, the NIHR guidance is applicable to the SA context. It is a highly adaptable framework permitting tracking of activities across trial stages. A lack of locally available emission factors reduces accuracy and emission results should be viewed as indicative.

PMID:40533806 | DOI:10.1186/s13063-025-08903-w

Genome Biol. 2025 Jun 18;26(1):170. doi: 10.1186/s13059-025-03585-8.

ABSTRACT

Here we introduce KPop, a novel versatile method based on full k-mer spectra and dataset-specific transformations, through which thousands of assembled or unassembled microbial genomes can be quickly compared. Unlike MinHash-based methods that produce distances and have lower resolution, KPop is able to accurately map sequences onto a low-dimensional space. Extensive validation on simulated and real-life viral and bacterial datasets shows that KPop can correctly separate sequences at both species and sub-species levels even when the overall genomic diversity is low. KPop also rapidly identifies related sequences and systematically outperforms MinHash-based methods.

PMID:40533801 | DOI:10.1186/s13059-025-03585-8

J Orthop Surg Res. 2025 Jun 18;20(1):601. doi: 10.1186/s13018-025-06018-1.

ABSTRACT

BACKGROUND: In arthroscopic rotator cuff repair, satisfactory postoperative outcomes can be achieved by simplifying the surgical procedure and ensuring proper integration of the deep rotator cuff tissue with the footprint area for tendon reconstruction. The purpose of this study was to evaluate the short-term efficacy of arthroscopic spinal needle sutures for the repair of rotator cuff tears.

METHODS: This retrospective study included a cohort of 81 patients with rotator cuff tears who underwent arthroscopic suture repair using a spinal needle between January 2021 and March 2021, with a minimum follow-up duration of 27 months. Pre- and postoperative Constant-Murley Score (CMS), University of California-Los Angeles Shoulder Score (UCLASS), Visual Analog Scale (VAS) scores, and range of motion (ROM) measurements, including active forward flexion, abduction, and lateral rotation angles, were compared to assess shoulder anatomy, function, strength, and subjective patient satisfaction.

RESULTS: Statistically significant improvements were observed in CMS, UCLASS, VAS, and ROM postoperatively (P = 0.000). The excellent or good outcome rate was 81.48%. Age and preoperative ROM significantly influenced outcomes (P = 0.039 and P = 0.006), respectively, whereas gender and pain duration did not show a significant effect (P > 0.05). Patients older than 30 years demonstrated significantly better results (P < 0.001).

CONCLUSION: The use of a spinal needle for rotator cuff tear repair under direct arthroscopic visualization is a safe, efficient, and clinically effective technique.

LEVEL OF EVIDENCE: IV CLINICAL/CONTROLLED TRIALS: Not applicable.

PMID:40533792 | DOI:10.1186/s13018-025-06018-1

J Cardiothorac Surg. 2025 Jun 18;20(1):264. doi: 10.1186/s13019-025-03508-5.

ABSTRACT

OBJECTIVE: Non-small cell lung cancer (NSCLC) poses great mortality globally. Aberrant microRNA (miRNA/miR) expression is linked to the progression of many cancers. Herein, this study explored the association of miR-196b-5p in NSCLC tissues with the clinical features and prognosis of patients.

METHODS: Totally 166 NSCLC patients were retrospectively enrolled. Cancer and normal adjacent tissues (NAT) were attained for miR-196b-5p expression measurement. Clinical baseline data were attained, followed by the analysis of the relation of miR-196b-5p expression with clinical pathological features of NSCLC patients. The 3-year postoperative mortality risk was assessed in NSCLC patients with different miR-196b-5p levels, and independent risk factors (IRFs) for 3-year postoperative mortality were screened using Kaplan-Meier curves and Cox multivariate regression analysis.

RESULTS: miR-196b-5p levels were higher in cancer tissues than in NAT. Compared with stage I-II patients, miR-196b-5p in cancer tissues was upregulated in stage III patients. Patients with high/low miR-196b-5p expression showed statistically significant differences in age, capsule invasion, lymph node metastasis (LNM), maximum tumor diameter, and clinical staging. The survival and death groups were markedly different regarding age, capsule invasion, LNM, and clinical TNM staging. High miR-196b-5p expression in cancer tissues in NSCLC patients increased 3-year postoperative mortality risk. Age, clinical TNM stage, and miR-196b-5p expression in cancer tissues were IRFs for 3-year postoperative mortality in NSCLC patients.

CONCLUSION: High miR-196b-5p expression in cancer tissues of NSCLC patients was closely linked to capsule invasion, LNM, maximum tumor diameter, and clinical TNM stage and was an IRF for 3-year postoperative mortality in NSCLC patients.

PMID:40533790 | DOI:10.1186/s13019-025-03508-5

Int J Behav Nutr Phys Act. 2025 Jun 18;22(1):79. doi: 10.1186/s12966-025-01784-x.

ABSTRACT

BACKGROUND: Community-based overweight prevention programmes are widely implemented, however, little is known about their effectiveness after scale-up. This study examines the contribution of a scaled up community-based overweight prevention programme in the Netherlands: Healthy Youth, Healthy Future (JOGG) to children’s BMIz, adherence to fruit and/or vegetable consumption guidelines, and minutes of moderate to vigorous physical activity (MVPA) per week.

METHODS: In this observational study we used repeated cross-sectional data from 5 to 11- and 12-18-year-old participants in the annual Dutch national health survey (2006-2019) and applied two analytical methods for more robust inference. First, we applied linear mixed models to assess the association between JOGG exposure for at least 18 months (n = 1,008) vs. no exposure (n = 23,779) and the outcomes and assessed whether this association differed across subgroups defined by age, socioeconomic position (SEP), or migration background. Second, we compared outcome trends in JOGG and non-JOGG municipalities before and after implementation, using a difference-in-differences approach, to account for unobserved time-invariant confounders.

RESULTS: Results showed no significant association between JOGG exposure and BMIz or MVPA. However, JOGG exposure was associated with higher adherence to fruit and/or vegetable consumption guidelines in 12- to 18-year-olds (log odds 1.82, 95%CI 0.23, 3.41). We observed no differential associations across subgroups and no differences in outcome trends between JOGG and non-JOGG municipalities.

CONCLUSIONS: The scale up of JOGG in the Netherlands between 2010 and 2019 potentially contributed to higher fruit and vegetable consumption but not to BMIz or MVPA levels. Further examination of the implementation process may provide insight in underlying mechanisms and contribution of JOGG.

PMID:40533781 | DOI:10.1186/s12966-025-01784-x

Reprod Health. 2025 Jun 18;22(1):101. doi: 10.1186/s12978-025-02058-2.

ABSTRACT

BACKGROUND: Teenage pregnancy remains a pressing public health issue with profound effects on health, education, and socio-economic outcomes. Rural areas, such as parts of Teso, often face higher prevalence of teenage pregnancy due to socioeconomic challenges. This study aimed at determining the prevalence of teenage pregnancy and associated factors in Atutur sub-county, Kumi district.

METHODOLOGY: The authors employed a cross-sectional study design and sampled 444 teenage girls aged 13-19 years from 12 randomly selected villages in Atutur sub-county, Kumi district in April 2024. They were interviewed using structured researcher administered questionnaire. Data was collected using kobo collect tool, downloaded, cleaned and exported to SPPS version 27.0 for further management and analysis. Descriptive statistics was conducted to determine the prevalence of teenage pregnancy. After adjusting for covariates, multivariate analysis was conducted using modified Poisson regression to determine predictors of teenage pregnancy. Results were reported with a 95% confidence interval (CI) and factors whose CI did not contain a null (1.0), with p-value (P < 0.05) for adjusted PR, were considered statistically significant.

RESULTS: Of the 444 teenage girls, the mean age was 17 (standard deviation = 1.9) years. About one third of the participants, 132(29.7%) had ever conceived. Teenage girls in cohabitation were 3.0 times more likely to have conceived (aPR = 3.0, 95% CI: 2.23-4.10, P < 0.001) compared to those staying with their parents. Teenagers with both parents deceased were 1.9 times more likely to conceive (aPR = 1.9, 95% CI: 1.15-3.31, P = 0.032) compared to those whose parents were both alive. Teenage girls who were not satisfied with basic needs provided by parents were 3.3 times more likely to conceive (aPR = 3.3, 95% CI: 2.26-4.85, P < 0.001) compared to those satisfied with the basic needs provided by their parents.

CONCLUSION: Teenage pregnancy rates in Atutur sub-county Kumi district was higher than the national average, due to adverse socio-economic situation. Strengthening parental support of the girl child, with legal and community measures to reduce early marriages in rural settings may reduce teenage pregnancy. There is need to make deliberate efforts to provide socio-economic strengthening for the teenage girls to reduce their vulnerability.

PMID:40533780 | DOI:10.1186/s12978-025-02058-2