Nevin Manimala

BMC Med. 2025 Feb 21;23(1):106. doi: 10.1186/s12916-025-03942-1.

ABSTRACT

BACKGROUND: Cardiometabolic disorders are the leading cause of mortality and contribute substantially to the First Nations Health Gap in Australia. Central obesity is the major contributor to metabolic syndrome. We investigated factors associated with central obesity and how normal-weight central obesity is associated with cardiometabolic disorders among Aboriginal and Torres Strait Islander Australians (hereafter respectfully referred to as ‘Indigenous Australians’).

METHODS: This study used the 2018-2019 Australian Bureau of Statistics (ABS) National Aboriginal and Torres Strait Islander Health Survey dataset. A total of weighted 4864 Indigenous adults (18 + years) were included. Normal-weight central obesity refers to individuals with a normal body mass index (BMI) but with an elevated waist circumference (WC ≥ 102 cm for males and ≥ 88 cm for females). Main outcomes included self-reported type 2 diabetes, hypertension, high cholesterol and heart disease. Multi-level logistic regression models were used to examine the relationship between explanatory variables and outcomes.

RESULTS: The overall prevalence of central obesity was 46.2% (95% confidence interval [CI]: 42.8, 49.72) in males and 67.7% (95% CI: 64.90, 70.4) in females. Physical inactivity increased the risk of central obesity in males (odds ratio [OR] = 1.34; 95% CI: 1.09, 1.65), while daily consumption of soft drinks was associated with central obesity in females (OR = 1.35; 95% CI: 1.12, 1.62). Males living in very remote areas had a lower risk of central obesity, while females in very remote areas had a higher risk. Our findings also showed that females with normal-weight central obesity had a higher risk of hypertension (OR = 3.29; 95% CI: 1.95, 9.62) and higher total cholesterol (OR = 4.62; 95% CI: 2.22, 9.62). Similarly, males with normal-weight central obesity were associated with a higher risk of type 2 diabetes (OR = 4.13; 95% CI: 1.23, 13.94).

CONCLUSIONS: This was the first study to report that approximately 12% of Indigenous Australians with normal BMI have central obesity. Relying solely on BMI to identify such high-risk individuals may be inadequate for early intervention. Public health initiatives targeting obesity should include individuals with a normal BMI and central obesity.

PMID:39984922 | DOI:10.1186/s12916-025-03942-1

BMC Med Educ. 2025 Feb 21;25(1):287. doi: 10.1186/s12909-025-06804-9.

ABSTRACT

BACKGROUND: Palliative care training at the undergraduate level is poor in India. With the need for palliative care rising in India and globally, it is possible to train physicians in resource-limited settings in palliative care via online training programs owing to ease of access and convenience. However, there is limited evidence available from India on the development and implementation of such a training program. This study aims to describe the development of an online training program offered by the Trivandrum Institute of Palliative Sciences (TIPS), Kerala, and the impact of the program on the confidence of physicians in managing various palliative care needs of their patients.

METHODS: The course was developed by an interdisciplinary expert team from TIPS. The course content was made keeping in mind the local sociocultural factors in India and was peer-reviewed by two external experts. The program was started in 2018 and updated and revised over the years. Currently, the program has 20 sessions, each lasting for 90 min. The course content was disseminated using project-ECHO’s (Extension of Community Health Outcomes) telementoring model. To assess the impact of the training program, self-reported change in confidence from twenty-two batches of physicians, trained from January 2020 to August 2023. Feedback from participants was also assessed to identify areas of improvement in the training program.

RESULTS: A total of 1159 physicians were trained during the study period. At the end of the course, 51.2% of the participants completed the evaluation survey and had a statistically significant (p < 0.05) improvement in confidence in pain, gastrointestinal symptoms and breathlessness management, morphine prescription, and psychosocial communication. The duration of each session and the entire course was reported to be ideal by 88.6% and 87.9% of participants, respectively.

CONCLUSION: Our results show that online training can be effectively used to build confidence in physicians in managing various palliative care needs.

TRIAL REGISTRATION: Not applicable.

PMID:39984918 | DOI:10.1186/s12909-025-06804-9

Malar J. 2025 Feb 21;24(1):55. doi: 10.1186/s12936-025-05289-7.

ABSTRACT

BACKGROUND: The study focused on the full population of children from Nigeria, where the dataset was obtained from the demographic and health surveys (DHS). About 10245 children were selected for the current study and based on the rapid diagnostic test (RDT) results, there is about 37% prevalence of malaria in children under 5 years old in Nigeria. Malaria is the leading public health concern, that contributes to child mortality in the African region.

METHODS: The Nigeria Malaria Indicator Survey (NMIS) 2021 was utilized in this investigation. For the 2021 NMIS, a two-stage sampling technique was used. According to the NIMS study, the children chosen for anaemia and RDT testing were under 5 years of age.

RESULTS: A generalized linear mixed model (GLMM) was used to examine malaria RDT findings in conjunction with demographic, geographic, and socioeconomic characteristics. The following underlying risk factors for malaria in children were discovered in the study: altitude, anaemia level, age in months, fever status in the past 2 weeks, toilet facility, main wall material, main roof material, household wealth index, type of place of residence, sex of the child, mother’s education level, and knowledge of the preventative measures that can be used to prevent malaria.

CONCLUSION: Missing data were not deleted in this investigation; instead, multiple imputations utilizing chained equations were used to approximate the missing observation. Based on the results found by using the GLMM, the findings of this study may influence how the government combats malaria in Nigeria. The novelty of this study is that the missing values were not dropped. However, imputation techniques were explored, and multiple imputation by chained equations was used.

PMID:39984916 | DOI:10.1186/s12936-025-05289-7

BMC Cancer. 2025 Feb 21;25(1):313. doi: 10.1186/s12885-025-13570-w.

ABSTRACT

OBJECTIVES: This study aimed to assess the effectiveness and safety of conventional transarterial chemoembolization (c-TACE) followed by irreversible electroporation (IRE) for the treatment of hepatocellular carcinoma (HCC).

METHODS: From January 2019 to September 2019, 12 patients with HCC who received c-TACE followed by IRE comprised the study group. The control group comprised 15 patients who received c-TACE followed by radiofrequency ablation (RFA). The 1-month, 3-month, 6-month, and 12-month local control rates and median progression-free survival (PFS) were compared between the two groups. Additionally, postoperative complications were assessed.

RESULTS: The study group comprised 12 patients (median age: 57.5 years; range: 46-68 years), while the control group consisted of 15 patients (median age: 56 years; range: 31-69 years). Local control rates at 1, 3, 6, and 12 months were 91.7%, 91.7%, 83.3%, and 33.3%, respectively, for the study group, and 73.3%, 66.7%, 66.7%, and 20.0% for the control group. Statistical analysis revealed no significant differences between the two groups. In terms of survival, 9 patients (75%) in the study group and 11 patients (73.3%) in the control group were still alive at the last follow-up. The median PFS was 8 months in the study group and 7 months in the control group, with no significant difference between the two groups (p = 0.96). Notably, no severe surgery-related side effects were observed in either group, and also no significant differences were found in postoperative complications between the two groups (p = 0.64).

CONCLUSIONS: The long-term therapeutic outcomes of c-TACE followed by IRE were found to be similar to those of c-TACE followed by RFA in the study. The research suggests that c-TACE followed by IRE offered an effective and safe treatment option for HCC.

PMID:39984913 | DOI:10.1186/s12885-025-13570-w

BMC Neurol. 2025 Feb 21;25(1):72. doi: 10.1186/s12883-025-04061-3.

ABSTRACT

BACKGROUND: Guillain-Barré syndrome (GBS) is a group of immune-mediated peripheral neuropathies that causes acute flaccid paralysis. The global incidence of GBS was 0.6-4/100 000, and the incidence in China was 0.698/100 000. Although the diagnosis and treatment of GBS has made rapid progress, approximately 20% of patients with GBS are still unable to walk alone within 6 months after the onset of GBS, and 40% of patients have sequelae, such as weakened strength, limb pain, and numbness, seriously affecting their life and work. We aimed to retrospectively analyze the clinical characteristics of patients with GBS in Shenzhen, China and analyze the factors affecting disease severity to provide a reference for the precise treatment of GBS.

METHODS: Clinical data of inpatients diagnosed with GBS in several hospitals in Shenzhen from April 2010 to October 2021 were obtained from an electronic medical record system (HIS system). The clinical characteristics of patients with GBS and the factors affecting disease severity were analyzed.

RESULTS: A total of 146 patients were identified for this study, and 13 were lost during follow-up. During the follow-up period, three patients had acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP). One hundred and thirty patients with complete data, comprising 90 males (69.23%) and 40 females (30.77%) with a median age of 39.50 ± 23.75 years, were included in the statistical analyses. Acute inflammatory demyelinating polyneuropathy (AIDP) was the most common electrophysiological variant (106 cases [81.54%]). Miller-Fisher syndrome (MFS), acute motor axonal neuropathy (AMAN), and acute motor-sensory axonal neuropathy (AMSAN) were noted in 21 (16.15%), 2 (1.54%), and 1 (0.77%) patients, respectively. The clinical course of the disease was mainly mild in 95 cases (73.08%), while 35 patients (26.92%) experienced severe disease. Logistic multivariate regression analysis showed that age ≥ 60 years old and having pneumonia may be associated with the severity of the disease.

CONCLUSIONS: AIDP is the most common electrophysiological variant of GBS in Shenzhen. Most cases of GBS in our setting are mild, and the long-term prognosis is favorable. Old age (≥ 60 years) and having pneumonia are independent risk factors for severe GBS.

PMID:39984908 | DOI:10.1186/s12883-025-04061-3

Poult Sci. 2025 Feb 6;104(3):104886. doi: 10.1016/j.psj.2025.104886. Online ahead of print.

ABSTRACT

Heat stress is a potent modulator of the avian neuroendocrine system with concomitant impact on the gut microbiome. As an interkingdom signaling molecule, serotonin is largely derived from the gut and found in large concentrations in the avian gut lumen. Despite the role of serotonin in animal stress physiology and related host-microbe interactions, whether heat stress alters avian enteric concentrations of serotonin is unknown. As such, the present study sought to determine whether acute or chronic exposure to moderate heat stress alters both enteric serotonin concentrations and the microbiome in the chicken gut. Chickens were, or were not, subjected to an acute (1 day), repeated acute (2 days) or chronic (6 days) moderate ambient cyclic heat stress (12h per day, 31°C). Enteric concentrations of serotonin were significantly decreased in the acute heat stress group (P < 0.05), and rebounded to become elevated in the chronic heat stress group (P < 0.05). Shotgun metagenomic sequencing revealed heat stress caused both functional and taxonomic changes in the cecal microbiome. Abundances of bacterial taxa that are known to interact with the host via the serotonergic system, including Lactobacillus spp., and Bifidobacterium spp., were significantly (P < 0.05) altered by heat stress. As these findings demonstrate that heat stress can alter serotonin concentrations in the chicken intestinal tract, with distinct outcomes depending on duration of the stressor, serotonergic signaling may serve as potential leverageable point of intervention in host-microbe interactions including foodborne pathogen colonization in the chicken gut. In addition, this study provides novel insight into the impact of acute and chronic heat stress on the avian microbiome, and its relationship to stress-driven changes in the enteric serotonergic system.

PMID:39983259 | DOI:10.1016/j.psj.2025.104886

Surgery. 2025 Feb 20;181:109258. doi: 10.1016/j.surg.2025.109258. Online ahead of print.

ABSTRACT

BACKGROUND: The role of prophylactic central compartment lymph node dissection in clinically node-negative papillary thyroid carcinoma is debated. This study presents the findings from a 10-year follow-up of a single-institution randomized controlled trial assessing the role of prophylactic central compartment lymph node dissection in clinically node-negative papillary thyroid carcinoma.

METHODS: Between 2008 and 2010, a total of 196 patients with clinically node-negative papillary thyroid carcinoma were randomly assigned to 2 groups in a 1:1 ratio to undergo total thyroidectomy (group A) or total thyroidectomy with prophylactic central compartment lymph node dissection (group B). Patients received low-dose radioactive iodine treatment (30 mCi) postoperatively, with additional doses as needed. Monitoring included serum thyroglobulin, thyroglobulin antibodies, and neck ultrasound imaging.

RESULTS: At the end of the follow-up, 151 patients were analyzed, after 28 from group A and 17 from group B were excluded. The 2 groups were similar in age at diagnosis (P = .643), sex distribution (P = .735), body mass index (P = .134), ultrasound-estimated thyroid volume (P = .650), and histologic tumor features. After >10 years (12.9 ± 2 years), no significant differences were observed in surgical and oncologic outcomes. The mean thyroglobulin levels were 0.1 ± 0.1 ng/mL in group A and 0.3 ± 1.3 ng/mL in group B (P = .146). Both groups showed similar findings in the need for further surgery (P = .917), for additional radioactive iodine (P = .979), and mean radioactive iodine dosage (P = .822). No difference was documented in permanent recurrent laryngeal nerve palsy (P = .640), permanent hypocalcemia (P = .238), and serum calcium level (P = .181). The only observed distinction was more parathyroid removal in prophylactic central compartment lymph node dissection cases based on histologic examination (P = .005).

CONCLUSION: Prophylactic central compartment lymph node dissection does not significantly affect surgical and oncologic outcomes in patients with clinically node-negative small papillary thyroid carcinoma after long-term follow-up.

PMID:39983243 | DOI:10.1016/j.surg.2025.109258

Phys Rev Lett. 2025 Feb 7;134(5):050801. doi: 10.1103/PhysRevLett.134.050801.

ABSTRACT

Understanding the thermalization dynamics of quantum many-body systems at the microscopic level is among the central challenges of modern statistical physics. Here we experimentally investigate individual spin dynamics in a two-dimensional ensemble of electron spins on the surface of a diamond crystal. We use a near-surface nitrogen-vacancy center as a nanoscale magnetic sensor to probe correlation dynamics of individual spins in a dipolar interacting surface spin ensemble. We observe that the relaxation rate for each spin is significantly slower than the naïve expectation based on independently estimated dipolar interaction strengths with nearest neighbors and is strongly correlated with the timescale of the local magnetic field fluctuation. We show that this anomalously slow relaxation rate is due to the presence of strong dynamical disorder and present a quantitative explanation based on dynamic resonance counting. Finally, we use resonant spin-lock driving to control the effective strength of the local magnetic fields and reveal the role of the dynamical disorder in different regimes. Our work paves the way towards microscopic study and control of quantum thermalization in strongly interacting disordered spin ensembles.

PMID:39983194 | DOI:10.1103/PhysRevLett.134.050801

Phys Rev Lett. 2025 Feb 7;134(5):058202. doi: 10.1103/PhysRevLett.134.058202.

ABSTRACT

Adhesion of soft particles with mobile linkers is of importance in colloidal self-assembly, the binding of vesicles, and tissue organization in biology. Here we derive and experimentally test an equilibrium theory that captures the adhesion of DNA-coated emulsion droplets. Notably, we identify a transition from spherical to deformed droplet binding at a characteristic DNA coverage that depends on molecular properties and surface tension. Fitting the data reveals a weak effective binding strength of 3.7±0.3K_{B}T owing to entropic costs of confinement, crowding, and stretching. Our results pave the path to materials design informed by the choice of molecular-scale parameters.

PMID:39983165 | DOI:10.1103/PhysRevLett.134.058202

J Med Internet Res. 2025 Feb 21;27:e50708. doi: 10.2196/50708.

ABSTRACT

Despite excitement around artificial intelligence (AI)-based tools in health care, there is work to be done before they can be equitably deployed. The absence of diverse patient voices in discussions on AI is a pressing matter, and current studies have been limited in diversity. Our study inquired about the perspectives of racial and ethnic minority patients on the use of their health data in AI, by conducting a cross-sectional survey among 230 participants who were at least 18 years of age and identified as Black, Latinx, Indigenous, or Asian. While familiarity with AI was high, a smaller proportion of participants understood how AI can be used in health care (152/199, 76.4%), and an even smaller proportion understood how AI can be applied to dermatology (133/199, 66.8%). Overall, 69.8% (139/199) of participants agreed that they trusted the health care system to treat their medical information with respect; however, this varied significantly by income (P=.045). Only 64.3% (128/199) of participants felt comfortable with their medical data being used to build AI tools, and 83.4% (166/199) believed they should be compensated if their data are used to develop AI. To our knowledge, this is the first study focused on understanding opinions about health data use for AI among racial and ethnic minority individuals, as similar studies have had limited diversity. It is important to capture the opinions of diverse groups because the inclusion of their data is essential for building equitable AI tools; however, historical harms have made inclusion challenging.

PMID:39983116 | DOI:10.2196/50708