Nevin Manimala

Gastroenterol Res Pract. 2025 Dec 22;2025:5054381. doi: 10.1155/grp/5054381. eCollection 2025.

ABSTRACT

BACKGROUND: Transoral incisionless fundoplication (TIF) presents a minimally invasive, endoscopic treatment for the management of gastroesophageal reflux disease (GERD), known for its efficacy and safety in patients with normal esophageal motility. However, the use of TIF in ineffective esophageal motility (IEM) remains largely unexplored. This study examined the outcomes of TIF in IEM patients.

METHODS: Retrospective data from 164 patients, including 29 with IEM and refractory GERD, were analyzed to obtain assessments of disease-specific quality of life through the Gastroesophageal Reflux Disease Health-Related Quality of Life Questionnaire (GERD-HRQL) and proton pump inhibitor usage.

RESULTS: Statistically significant improvements were seen in total, heart burn, and regurgitation GERD-HRQL scores (p < 0.001, p < 0.001, p < 0.001) and reduction in PPI use (0 < 0.001) after TIF, with no significant difference in dysphagia risk (p < 0.2).

CONCLUSION: This study underscores durable improvements that TIF can provide in quality of life in patients with both GERD and IEM, without compromising the increased risk of dysphagia. Although some patients resume antisecretory medications within 3-6 months, most stopped taking PPI after the procedure.

PMID:41477667 | PMC:PMC12752835 | DOI:10.1155/grp/5054381

F1000Res. 2025 Aug 22;14:813. doi: 10.12688/f1000research.167793.1. eCollection 2025.

ABSTRACT

AIM & BACKGROUND: Women with autoimmune diseases usually require contraception. Various factors influence women with autoimmune diseases who do not use contraceptive methods. However, there has been no research on the unmet need for contraception in patients with autoimmune diseases. Therefore, this study aimed to determine the relationship between sociodemographic factors and unmet need for contraception in patients with autoimmune diseases.

METHODS: This was a cross-sectional study of female patients aged 15-49 years who had autoimmune diseases at the Internal Medicine Clinic of Dr. Cipto Mangunkusumo Hospital. The subjects were then asked to complete the informed consent form and questionnaire. Statistical analyses were performed using the chi-square test for bivariate analyses.

RESULTS: We included 92 subjects with a mean age of 35.6±6.26 years old, with an age range was 25-48 years old. Twenty (21.7%) subjects had an unmet need for contraception, while 72 (69.4%) used contraception or were planning for pregnancy. We found that education level (p=0.017) and Internet usage frequency (OR 3.42; 95%CI 1.02-11.45; p=0.037) were significantly associated with unmet need contraception in females with autoimmune disease.

CONCLUSION: This study found that education level and Internet usage frequency were significantly associated with unmet need contraception in females with autoimmune disease.

CLINICAL SIGNIFICANCE: The findings emphasize that education and Internet access are vital for meeting the contraceptive needs of women with autoimmune diseases.

PMID:41477650 | PMC:PMC12749561 | DOI:10.12688/f1000research.167793.1

Front Cardiovasc Med. 2025 Dec 16;12:1692351. doi: 10.3389/fcvm.2025.1692351. eCollection 2025.

ABSTRACT

PURPOSE: The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) has recently been identified as a novel lipid marker for assessing the risk of atherosclerosis-related diseases. However, the relationship between NHHR and the risk of retinal vein occlusion (RVO) has not yet been thoroughly investigated. The objective of this study was to investigate the correlation between NHHR and patients with RVO.

METHODS: This retrospective study examined 54 patients diagnosed with RVO and 57 age- and gender-matched control subjects. Comprehensive ocular examinations and hematological assessments were conducted for all participants. Logistic regression analysis was employed to evaluate the association between lipid markers and the risk of RVO. The receiver operating characteristic (ROC) curve was utilized to analyze and determine the predictive value and optimal threshold of the NHHR, triglyceride-glucose (TyG) index, and other conventional lipid parameters for RVO.

RESULTS: Compared to the control group, patients with RVO exhibited significantly higher levels of triglyceride (TG), TyG index, and NHHR (P = 0.0004, P = 0.0006, and P < 0.0001, respectively). Additionally, the high-density lipoprotein cholesterol (HDL-C) index was significantly lower in the RVO group compared to the control group (P < 0.0001). Univariate analysis indicated that NHHR (OR: 3.41, P < 0.001), TyG index (OR: 3.32, P = 0.001) and TG (OR: 2.64, P = 0.003) were significantly associated with RVO. Multivariate analysis revealed that NHHR was remarkably associated with RVO (OR: 2.09, P = 0.037). After further adjustment for hypertension, TG, and the TyG index, this association remained statistically significant (OR: 3.13, P = 0.003). The areas under the ROC curve for TyG index, TG, HDL-C, and NHHR were 0.679, 0.692, 0.739, and 0.752, respectively. Notably, the AUC value for NHHR demonstrated a moderate sensitivity (50.88%) and high specificity (87.04%), indicating its potential as a promising biomarker for the diagnosis and prognosis of RVO.

CONCLUSION: The NHHR was significantly elevated in patients with RVO, suggesting that this novel lipid marker may play a crucial role in the risk of developing RVO.

PMID:41477647 | PMC:PMC12748148 | DOI:10.3389/fcvm.2025.1692351

Front Genet. 2025 Dec 16;16:1605675. doi: 10.3389/fgene.2025.1605675. eCollection 2025.

ABSTRACT

Almost half the mammalian genomes consist of transposable elements (TEs) and their derivatives. The distribution density of TEs can be associated with genomic regions of chromosomal rearrangements in different mammalian species and with the genomic localization of protein-coding genes that differ in length and function. To evaluate these characteristics at the local genomic level, an analysis of the distribution of various TEs (retrotransposons and DNA transposons) was performed in three mammalian species (human, cattle, and domestic rabbit) in genes with different functions and chromosomal localizations and their flanking regions. In humans and rabbits, melanophilin (MLPH) and myostatin (MSTN) are syntenic, but not in cattle. In the latter, MLPH and the leptin receptor (LEPR) are syntenic, but not in humans and rabbits. The alpha-thalassemia gene is always located on chromosome X. The results indicate that the frequencies of different TEs are species-specific and do not depend on the length of genes, their function, or chromosomal localization. There were also species-specific differences in the ratio of “ancient” and “young” short interspersed nuclear elements (SINEs) and long interspersed nuclear elements (LINEs). There was a statistically significant positive correlation between ancient SINE + LINE and LTR-ERV (p < 0.01) and a significant negative correlation between young SINE + LINE and DNA transposons (p < 0.05). Competitive relationships between TEs are probably defined by the presence of identical regulatory motifs in different TEs, associated with the reliance of TE amplification on the host’s own regulatory systems.

PMID:41477637 | PMC:PMC12748216 | DOI:10.3389/fgene.2025.1605675

Eur J Radiol Open. 2025 Dec 10;16:100716. doi: 10.1016/j.ejro.2025.100716. eCollection 2026 Jun.

ABSTRACT

INTRODUCTION: Optimizing the diagnostic approach to thyroid nodules remains a crucial challenge. Ultrasound-based risk stratification systems such as EU-TIRADS have shown reasonable sensitivity and specificity. Therefore, we conducted a systematic review and meta-analysis to assess the diagnostic performance of Artificial Intelligence (AI) models in differentiating benign from malignant thyroid nodules on ultrasound data.

METHODS: A comprehensive search of PubMed/MEDLINE, Scopus, and Web of Science was performed up to January 1, 2025. Eligible studies included patients with thyroid nodules undergoing ultrasound, where AI-based models were validated against cytological or histological findings. The AI algorithms were developed using different types of ultrasound-derived data, including B-mode images, radiomics features. Pooled sensitivity, specificity, and area under the curve (AUC) were estimated using a hierarchical summary receiver operating characteristic (HSROC) model.

RESULTS: Twenty-seven studies comprising 146,332 patients and over 600,000 ultrasound images met inclusion criteria. Overall, pooled sensitivity was 87 % (95 % CI: 84-89 %) and specificity 83 % (95 % CI: 79-86 %). The summary operating point indicated a sensitivity of 88 % and specificity of 83 %, with an AUC of 91.9 % (95 % CI: 90.0-93.2 %). Although subgroup analysis suggested higher accuracy when cytology was used as the reference standard compared to histology, the mixed-effects meta-regression did not confirm a statistically significant association (p = 0.238 for sensitivity; p = 0.188 for specificity).

CONCLUSION: AI-based algorithms show excellent diagnostic performance in distinguishing benign from malignant thyroid nodules, with robust validation across external datasets. These findings support the potential integration of AI into clinical thyroid nodule management, although further multicenter, non-Asian, and histology-based studies are warrantee.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD420251108149).

PMID:41477624 | PMC:PMC12752752 | DOI:10.1016/j.ejro.2025.100716

J Vitreoretin Dis. 2025 Dec 29:24741264251404735. doi: 10.1177/24741264251404735. Online ahead of print.

ABSTRACT

Purpose: To investigate differences in gaze behavior among vitreoretinal surgeons of varying experience levels during simulated pars plana vitrectomy with epiretinal membrane peeling using a 3-dimensional heads-up display (HUD) system with integrated eye-tracking. Methods: Twenty-six ophthalmologists-postgraduate year 4 residents (n = 10), vitreoretinal fellows (n = 9), and attending surgeons (n = 7)-performed simulated vitrectomy on model eyes using a 3-dimensional HUD system with eye-tracking. Gaze metrics (fixations, saccades, field awareness, HUD focus, and tear angle) and surgical performance (International Council of Ophthalmology, Ophthalmology Surgical Competency Assessment Rubric vitrectomy score) were evaluated. Statistical analysis included Pearson correlation, analysis of variance (ANOVA), and post hoc Tukey tests. Results: Surgical performance increased with experience (postgraduate year 4: 26.6 ± 1.3; attending: 42.5 ± 1.6; P < .0001). Attendings demonstrated fewer fixations (3454.0 ± 548.0 vs postgraduate year 4: 6114.0 ± 1349.0; P < .0001), shorter fixation durations (0.21 ± 0.015 seconds vs 0.277 ± 0.034 seconds; P < .05), and smaller saccade lengths (0.168° ± 0.082° vs 0.325° ± 0.094°; P < .01). They also showed greater HUD utilization (76.3% ± 7.3% vs postgraduate year 4: 45.0% ± 8.9%; P < .01), broader visual field awareness (51.3% ± 9.7% vs 17.3% ± 5.7%; P < .001), and more controlled membrane peel angles (7.1° ± 2.6° vs postgraduate year 4: 89.5° ± 22.6°). Novices primarily focused on instrument tips, whereas experts exhibited feed-forward gaze strategies with anchored fixation and situational awareness. Conclusions: Expert vitreoretinal surgeons demonstrate distinct visual strategies characterized by efficient gaze behavior, broad field awareness, and HUD-focused attention. These gaze patterns correlate with surgical proficiency and may serve as benchmarks for training. Eye-tracking integrated with HUD systems may enhance surgical education by allowing trainees to model expert gaze behavior and improve operative performance.

PMID:41477619 | PMC:PMC12747874 | DOI:10.1177/24741264251404735

Front Psychol. 2025 Dec 16;16:1712176. doi: 10.3389/fpsyg.2025.1712176. eCollection 2025.

ABSTRACT

BACKGROUND: In the context of heightened social competition and increasing academic pressure, promoting the healthy development of adolescents has become a critical concern. This study investigates the impact and mechanisms through which adolescents’ social and emotional skills influence their health behavior. Specifically, we hypothesized that social and emotional skills would positively affect health behavior, with test and class anxiety mediating and satisfaction with interpersonal relationships moderating this relationship.

METHODS: Using data from the 2023 OECD Survey on Social and Emotional Skills, this study employed a moderated mediation model to analyze the relationships between variables. The sample consisted of 6,737 adolescents, comprising 3,454 10-year-olds (51.3%) and 3,283 15-year-olds (48.7%); 3,484 were boys (51.7%) and 3,253 were girls (48.3%). Key variables assessed included social and emotional skills (e.g., task performance, emotional regulation), health behaviors (e.g., diet, exercise, sleep), test and class anxiety, and satisfaction with interpersonal relationships. Statistical analyses included Harman’s single-factor test for common method bias, correlation analysis, regression analysis, and PROCESS macro in SPSS to test mediation and moderation effects.

RESULTS: The study found that adolescents’ social and emotional skills positively influence their health behavior, with a significant direct effect (β = 0.375, p < 0.001) and an indirect effect mediated by test and class anxiety [6.68% of total effect, 95% CI (0.017, 0.033)]. Satisfaction with interpersonal relationships moderated both the direct effect of social and emotional skills on health behavior and the reduction of test anxiety by these skills. Higher relationship satisfaction strengthened the direct effect (β = 0.340 vs. β = 0.250 for low vs. high satisfaction) and amplified the anxiety-reduction effect (β = -0.262 vs. β = -0.168 for high vs. low satisfaction).

CONCLUSION: This study highlights the critical role of social and emotional skills in promoting healthy behaviors among adolescents and underscores the importance of interpersonal relationships in moderating these effects. The results provide insights for policymakers and educators to design interventions that foster both social and emotional skills and supportive relational environments to enhance adolescent wellbeing.

PMID:41477605 | PMC:PMC12747996 | DOI:10.3389/fpsyg.2025.1712176

J Pharm Pharm Sci. 2025 Dec 16;28:15527. doi: 10.3389/jpps.2025.15527. eCollection 2025.

ABSTRACT

INTRODUCTION: Azathioprine (AZA) is an immunosuppressant approved for renal transplant rejection and rheumatoid arthritis. Recent FDA alerts have raised concerns about its link to intrahepatic cholestasis of pregnancy (ICP), a condition with serious maternal and fetal risks. This study used disproportionality analysis as a hypothesis-generating approach to evaluate the reporting association between AZA and ICP during pregnancy and to compare AZA with other drugs previously implicated in ICP.

METHODS: A retrospective pharmacovigilance study was conducted using the FDA Adverse Event Reporting System (FAERS) reports from 1968 to Q2 2024. Disproportionality analysis was performed using reporting odds ratios (RORs), with statistical significance defined as a lower limit of the 95% confidence interval (CI) >1 and at least three unique cases. Subgroup analyses were conducted by pregnancy status and underlying autoimmune indications, and comparative analyses were performed against drugs previously reported to induce ICP.

RESULTS: Among 35,576 AZA-related reports, 67 specifically documented ICP. A strong signal was detected for ICP ROR025 = 153.0; IC025 = 5.8; EBGM05 = 144.37), ranking among the highest AZA-associated adverse events. In pregnant women, ICP also showed a significant signal (ROR025 = 5.46; IC025 = 1.93; EBGM05 = 5.31). Subgroup analyses by indication revealed elevated risks in Crohn’s disease (ROR025 = 66.99; IC025 = 4.8; EBGM05 = 64.73), and Colitis ulcerative (ROR025 = 9.01; IC025 = 1.95; EBGM05 = 9.95). Comparative analyses demonstrated that AZA had a higher proportion of ICP cases than other drugs reported to induce ICP.

CONCLUSION: This pharmacovigilance analysis identifies a disproportionality signal suggesting a possible association between AZA and intrahepatic cholestasis of pregnancy. These hypothesis-generating findings underscore the importance of cautious use and clinical vigilance when prescribing AZA to women of reproductive age.

PMID:41477595 | PMC:PMC12748001 | DOI:10.3389/jpps.2025.15527

J Virus Erad. 2025 Oct 25;11(4):100614. doi: 10.1016/j.jve.2025.100614. eCollection 2025 Dec.

ABSTRACT

BACKGROUND: The HIV/AIDS epidemic remains a critical public health challenge in Bangladesh, with complex epidemiological trends and sex-specific disparities requiring detailed investigation to guide effective interventions. This study comprehensively analyzes the temporal dynamics of HIV/AIDS burden from 1990 to 2021 and employs advanced statistical modeling to forecast future trends up to 2050, aiming to inform targeted public health strategies.

METHODS: Data on Disability-Adjusted Life Years (DALYs), deaths, incidence, prevalence, Years Lived with Disability (YLDs), and Years of Life Lost (YLLs) were sourced from a robust epidemiological database for Bangladesh. Joinpoint regression analysis was utilized to detect significant trend changes, calculating the average annual percent change (AAPC) and annual percent change (APC) with 95 % confidence intervals (CIs). Sex-stratified analyses elucidated disparities between males and females. Autoregressive Integrated Moving Average (ARIMA) models were applied to project age-standardized rates (ASRs) for each metric through 2050, incorporating historical trends and variability to ensure robust predictions.

RESULTS: From 1990 to 2021, the HIV/AIDS burden in Bangladesh increased significantly across all metrics, with distinct sex-specific patterns. The overall AAPC for DALYs was 19.0332 % (95 % CI: 15.8145, 23.0026, p < 0.000001), with females showing a higher AAPC (21.7252 %, 95 % CI: 18.2308, 25.7026) than males (18.4703 %, 95 % CI: 15.1896, 22.5646). Deaths exhibited a similar trend, with an overall AAPC of 18.9645 % (95 % CI: 15.7008, 23.2166), higher in females (21.8808 %, 95 % CI: 18.4195, 25.9932) than males (18.4655 %, 95 % CI: 15.1992, 22.6832). Incidence rose with an AAPC of 15.7929 % (95 % CI: 11.6467, 19.1922), slightly higher in females (16.2581 %, 95 % CI: 12.1795, 20.0487) than males (15.1639 %, 95 % CI: 11.2952, 18.4817). Prevalence increased markedly (AAPC: 18.2239 %, 95 % CI: 14.5688, 22.2078), with females at 20.2887 % (95 % CI: 16.6453, 24.3006) and males at 18.1837 % (95 % CI: 14.6734, 21.841). YLDs and YLLs followed similar patterns, with females consistently showing higher AAPCs. Joinpoint analysis identified peak APCs in the 1990s and early 2000s, followed by moderated growth and declines post-2016, particularly from 2019 to 2021, reflecting potential intervention impacts. ARIMA forecasts project a decline in DALYs, deaths, and YLLs ASRs to negligible levels by 2050 for both sexes, with wide CIs indicating substantial uncertainty (e.g., DALYs overall: negligible, 95 % CI: 0, 583.3697). Incidence ASRs are expected to stabilize (e.g., overall: 0.963899, 95 % CI: 0, 3.819279), while prevalence ASRs are projected to rise dramatically, particularly for males (614.7463, 95 % CI: 0, 695680.4), highlighting significant long-term challenges.

CONCLUSIONS: The HIV/AIDS burden in Bangladesh has escalated significantly from 1990 to 2021, with females bearing a disproportionately higher burden across all metrics. Recent declines suggest the efficacy of public health interventions, but persistent sex disparities and projected prevalence increases underscore the need for targeted, sex-specific strategies. The considerable uncertainty in long-term forecasts emphasizes the importance of sustained surveillance, adaptive interventions, and resource allocation to mitigate the epidemic’s impact by 2050, ensuring equitable health outcomes.

PMID:41477584 | PMC:PMC12750090 | DOI:10.1016/j.jve.2025.100614

Hong Kong Physiother J. 2025 Dec;45(2):157-167. doi: 10.1142/S1013702525500131. Epub 2025 Nov 25.

ABSTRACT

OBJECTIVE: To investigate the effectiveness of the standardised stroke upper extremity rehabilitation program with stratification using shortened Fugl-Meyer assessment (S-FM).

METHODS: A new stroke upper extremity rehabilitation program was designed. Participants were randomly allocated to standardised program group or conventional training group. Both groups received training for 60-90 min/session, 5 sessions/week and 5-20 sessions in total. Outcome measures, including S-FM, functional test for the hemiplegic upper extremity (FTHUE) and modified Barthel index (MBI), were taken before and after training.

RESULTS: Outcomes of 19 participants in standardised program group and 20 participants in conventional training group were analysed. Both groups showed improvements in S-FM, FTHUE and MBI after training but there were no statistically significant interactions between the groups, upper extremity impairment levels and time. In participants with severe upper extremity impairment, the standardised program group showed greater improvements in S-FM and FTHUE compared to the conventional training group, with the change in S-FM exceeding the minimal clinically important difference. However, these differences did not reach statistical significance.

CONCLUSION: The standardised stroke upper extremity rehabilitation program with S-FM stratification may have slightly better upper extremity functional outcomes in people with stroke having severe upper extremity impairment when compared to the conventional training.Clinical trial registration number: NCT06902948.

PMID:41477567 | PMC:PMC12752676 | DOI:10.1142/S1013702525500131