Nevin Manimala

Foodborne Pathog Dis. 2025 Nov 21. doi: 10.1177/15353141251394945. Online ahead of print.

ABSTRACT

Camel milk is an essential nutritional resource in arid and semiarid regions and has been gaining commercial importance, particularly in the Middle East. Concerns over mycotoxin contamination, particularly aflatoxins (AFs), pose potential health risks and may affect milk quality. Understanding the role of feeding systems on the occurrence of AFs and on milk quality is vital for safeguarding public health and improving dairy industry practices. This study aimed to evaluate the impact of different feeding systems on the chemical and microbiological quality of camel milk and to detect aflatoxin M1 (AFM1) in milk and AF B1 (AFB1) in camel feed. A total of 80 samples were collected from 40 camels across Riyadh and Dammam, Saudi Arabia, between March and May 2024. Camels were divided into two groups based on feeding systems: natural grazing (grasses and legumes) and semi-intensive farm-based feeding (concentrates). Milk samples were analyzed for chemical composition and microbiological quality. Statistical comparisons were made between groups. AFB1 was detected in 1 (5%) of the natural grazing feed samples and in 3 (15%) of the farm-based feed samples; all values were below the Saudi national MRL for AFM1 in milk (0.5 μg/kg), as well as the stricter European Union’s limit of 0.05 μg/kg and the Codex Alimentarius standard of 0.5 μg/kg. AFM1 was below the detection limit in all samples, and consequently, no significant differences between feeding systems could be observed. There was no significant difference in AFM1 levels between the two feeding systems. However, milk from naturally grazed camels exhibited significantly lower microbial counts. Samples from Riyadh showed no AF contamination. The absence of AFM1 in all milk samples suggests minimal public health risk. However, higher AFB1 occurrence in farm-based feed underscores the need for stringent feed monitoring. These findings inform management practices to enhance milk safety in camel dairy systems.

PMID:41313587 | DOI:10.1177/15353141251394945

J Magn Reson Imaging. 2025 Nov 28. doi: 10.1002/jmri.70176. Online ahead of print.

ABSTRACT

BACKGROUND: MRI contrast agents enhance lesion characterization by altering tissue relaxation properties. However, quantitative assessment of contrast enhancement is limited by variability in contrast administration parameters, and lack of efficient and precise contrast concentration independent relaxivity (r₁, r₂) measurement techniques. MR Fingerprinting (MRF) rapidly, simultaneously and accurately measures T₁ and T₂, enabling for the first time efficient clinical estimation of relaxivity ratios (r₁/r₂).

PURPOSE: To introduce an MRF-derived delta-relaxometry method for mapping contrast-specific relaxivity ratios (r₁/r₂) by accurately measuring ΔR₁/ΔR₂. We hypothesize that delta-relaxometry ratios offer dose-independent, reproducible measures of tissue enhancement, with potential advantages over conventional contrast-enhanced MRI.

STUDY TYPE: Prospective, observational.

POPULATION: Phantom studies and 29 patients (15 glioblastoma, 14 brain metastases).

FIELD STRENGTH/SEQUENCE: 3 T; pre- and post-contrast 3D whole-brain MR Fingerprinting.

ASSESSMENT: Mathematical derivations established a relationship between ΔR₁/ΔR₂ and r₁/r₂. Phantom studies assessed the concentration-dependency of ΔR₁/ΔR₂ compared to ΔT₁ and ΔT₂. Reproducibility was assessed by the inter-subject coefficient of variation (CoV). In vivo tumor type differentiation was assessed with whole-lesion histograms.

STATISTICAL TEST: Coefficient of variation; coefficient of determination; Mann-Whitney U tests with Benjamini-Hochberg correction.

RESULTS: ΔR₁/ΔR₂ is theoretically equivalent to r₁/r₂, showing contrast-dose independence in phantom studies. ΔR₁/ΔR₂ showed no dependence on injected dose or timing (p > 0.05), unlike ΔT₁ and ΔT₂. Delta-relaxometry ratios were highly reproducible, selectively elevated in tumors versus normal tissue, and showed a difference between tumor core and edema (p < 0.05). ΔR₁/ΔR₂ showed higher intra-subject reproducibility (median CoV: GBM = 27.3%, MET = 22.0%) as compared to ΔT₁ (GBM = 57.1%, MET = 106.2%; p < 0.001). Whole-lesion histogram analysis of delta-relaxometry ratios demonstrated GBM versus metastasis differentiation (p < 0.05). “DATA” CONCLUSIONS: In this proof-of-concept study, MRF-derived ΔR₁/ΔR₂ ratios show potential for reproducible, clinically feasible, dose-independent relaxivity quantification. Delta-relaxometry ratios may offer a novel approach to tissue characterization with minimal background enhancement, distinct from perfusion imaging. Our results suggest delta-relaxometry as a tumor imaging marker worthy of further investigation.

EVIDENCE LEVEL: 3 (retrospective cohort study with imperfectly applied reference standard).

TECHNOLOGY EFFICACY: 1 (feasibility study with quantitative assessment, requires a comparison with standard of care).

PMID:41313583 | DOI:10.1002/jmri.70176

J Autism Dev Disord. 2025 Nov 28. doi: 10.1007/s10803-025-07168-1. Online ahead of print.

ABSTRACT

PURPOSE: Family navigation (FN) is a promising intervention for reducing barriers and addressing inequities in healthcare, but engaging families in FN can be challenging. This study assessed FN engagement for historically underserved families of children newly diagnosed with autism. Objectives were to (1) describe FN engagement rates across four stages: recruitment, enrollment, retention, and involvement; (2) examine family characteristics influencing recruitment, enrollment, and retention; and (3) evaluate the receipt of autism-specific services based on family characteristics and number of interactions with navigators.

METHODS: This descriptive cohort study included families who were Medicaid recipients or self-identified as Hispanic/Latino or Black/African-American. Spanish-English bilingual, bicultural navigators provided FN through semi-structured sessions and brief contacts with participants. Descriptive statistics analyzed family demographics and engagement rates. Regression analyses examined family characteristics predictive of successful engagement and service receipt.

RESULTS: Of 292 eligible families, 210 (71.9%) were recruited, 155 of whom (73.8%) enrolled. Caregivers preferring a language besides English (85% of whom preferred Spanish) were five times more likely to enroll (OR = 5.15) and participated in significantly more interactions with navigators. Each additional FN session and contact increased the probability of obtaining autism-specific services by 61% and 17%, respectively.

CONCLUSION: About half of eligible families enrolled in this FN program. Families preferring a language besides English had higher engagement rates at multiple stages. Brief contacts complemented semi-structured sessions, each contributing to an increased likelihood of children receiving autism-specific services. Once families enroll, FN may increase service access for historically underserved families.

PMID:41313578 | DOI:10.1007/s10803-025-07168-1

Patient. 2025 Nov 28. doi: 10.1007/s40271-025-00793-z. Online ahead of print.

ABSTRACT

BACKGROUND: Early pregnancy loss (EPL) is associated with significant emotional burden. While multiple management options exist, psychological aspects are often underrepresented in decision-making support. The objective of this study is to identify criteria that are important to women when choosing between expectant, medical, and surgical management of EPL, with particular attention to psychological aspects.

METHODS: A mixed-methods study using the Analytic Hierarchy Process (AHP) was conducted. Criteria were identified via literature review and a focus group. Thirty-seven women with EPL history completed structured telephone interviews with pairwise comparisons. Quantitative data were analyzed to calculate criterion weights and assess consistency. Logistic regression explored factors associated with inconsistent responses.

RESULTS: Among 37 participants, ‘Minimizing psychological distress’ emerged as the most important criterion (local weight = 0.381), with sub-criteria such as ‘Experiencing miscarriage as a natural process’ (0.384; 0.252) and ‘Avoiding hospital treatment’ (0.355; 0.425) ranked most important for women preferring expectant and medical management, respectively. Women preferring surgical management prioritized ‘Short time to miscarriage completion’ (0.389). Sixty-five percent of participants demonstrated acceptable preference consistency (consistency ratio ≤ 0.2). Lower education showed the greatest and statistically significant negative influence on the consistency of the preferences in the regression models.

CONCLUSION: Preferences varied by treatment choice, indicating that psychological distress is defined differently across women. The AHP method enabled nuanced insights into individual decision-making. Emotional factors may influence preference patterns and should be considered in clinical counselling. These findings support the need for individualized counselling and shared decision-making. The results may inform the development of clinical tools and guidelines.

PMID:41313573 | DOI:10.1007/s40271-025-00793-z

Qual Life Res. 2025 Nov 28. doi: 10.1007/s11136-025-04088-6. Online ahead of print.

ABSTRACT

PURPOSE: To assess the possible effect of anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) on the health-related quality of life (HRQoL) in patients with ALK-positive non-small cell lung cancer (NSCLC).

METHODS: A systematic search was performed in PubMed, Web of Science, Embase, and ClinicalTrials.gov to identify literature published between January 2010 and January 2025. Publications reported quantitative assessments of HRQoL in ALK-positive NSCLC patients treated with ALK-TKIs were included. Meta-analyses were performed using random effect models.

RESULTS: A total of 805 records were identified, of which 21 were analyzed in the meta-analysis. Compared to crizotinib, next-generation ALK-TKIs showed statistically significant delayed time to deterioration (TTD) in global health status measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) (hazard ratio [HR]: 0.80; 95% confidence interval [CI]: 0.67 to 0.96). Brigatinib and alectinib demonstrated superior TTD in fatigue symptom score of EORTC QLQ-C30 compared to crizotinib (HR: 0.71; 95% CI: 0.54 to 0.92). Regarding between-arm comparisons from baseline, brigatinib and lorlatinib outperformed crizotinib in global health status, physical and emotional functioning, and symptoms scores of nausea and vomiting, fatigue, constipation, and appetite loss using EORTC QLQ-C30.

CONCLUSIONS: This study is by far the most comprehensive systematic review and meta-analysis on HRQoL among ALK-positive NSCLC patients treated with ALK-TKIs. These findings extended prior literature by conducting a granular comparison of all available ALK-TKIs across multiple endpoints and highlighted the improved performance of next-generation ALK-TKIs in enhancing HRQoL for ALK-positive NSCLC patients.

PMID:41313568 | DOI:10.1007/s11136-025-04088-6

Breast Cancer. 2025 Nov 28. doi: 10.1007/s12282-025-01806-3. Online ahead of print.

ABSTRACT

BACKGROUND: The safety of postmastectomy radiation therapy (PMRT) after autologous breast reconstruction remains unclear. Therefore, we conducted a systematic review and meta-analysis to investigate the effects of PMRT on patients with breast cancer who underwent autologous breast reconstruction.

METHODS: A comprehensive literature search of English and Japanese articles until March 2021 was performed using PubMed/MEDLINE, the Cochrane Library, and Ichushi-Web. We included studies that compared the outcomes of patients with breast cancer who underwent immediate autologous breast reconstruction with and without PMRT. Outcomes including major complications, fat necrosis, and cosmetic results were assessed. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random effects model.

RESULTS: Ten studies (two retrospective case-controlled and eight retrospective cohort studies) comprising 3,123 cases were included. The rate of major complications was slightly higher in the PMRT group compared to the no PMRT group, but the difference was not statistically significant (13.2% vs. 12.2%, OR 1.58, 95% CI 0.93-2.68, P = 0.09). In contrast, the rate of fat necrosis was significantly increased in the PMRT group (17.2% vs. 8.1%, OR 2.71, 95% CI 1.58-4.65, P = 0.0003). Data on cosmetic outcomes were limited and not pooled for the meta-analysis.

CONCLUSIONS: PMRT following autologous breast reconstruction was associated with a higher risk of fat necrosis, but not with a significantly increased rate of major complications. With careful patient selection and monitoring, PMRT after autologous breast reconstruction can be considered a safe and acceptable treatment option.

PMID:41313567 | DOI:10.1007/s12282-025-01806-3

Sports Med. 2025 Nov 28. doi: 10.1007/s40279-025-02367-3. Online ahead of print.

ABSTRACT

BACKGROUND: Pacing strategy is a key determinant of endurance performance, enabling athletes to regulate effort to optimise outcomes. While various pacing profiles (e.g. self-selected, fast-start, even, or slow) have been proposed, their comparative effects on performance remain unclear because of conflicting findings and methodological variability across studies.

OBJECTIVE: We aimed to conduct a systematic review and network meta-analysis to compare the effects of different pacing strategies on endurance time-trial performance in healthy athletes.

METHODS: We included peer-reviewed experimental studies comparing at least one imposed pacing strategy (fast-start, even, slow) against a self-selected or alternative strategy, with performance assessed via time-trial tests based on distance. Studies involved endurance sports (e.g. cycling, running, swimming) encompassing middle- and long-duration events. Data from 24 studies (n = 302 participants; 765 observations) were analysed using a frequentist network meta-analytic framework under a random-effects model.

RESULTS: There were no differences in performance between self-selected and imposed pacing strategies across the network (standardised mean differences < 0.20, all p > 0.05). However, subgroup and meta-regression analyses revealed that the performance impact of slow-start strategies was modulated by factors such as duration of the initial start. Notably, prolonged slow starts were associated with impaired performance. No significant differences were observed in secondary outcomes (peak oxygen uptake, mean oxygen uptake, end-test lactate) across pacing strategies.

CONCLUSIONS: This review found no consistent performance advantage of any imposed pacing strategy over self-selected pacing. While average effects were comparable across strategies, the efficacy of slow-start pacing was particularly sensitive to contextual factors such as the length of the initial slow start. These findings underscore the value of self-pacing as a flexible and context-adaptive strategy, and highlight that pacing interventions must be aligned with individual, environmental, and task-specific demands to optimise endurance performance.

CLINICAL TRIAL REGISTRATION: Registered in PROSPERO with ID CRD420251011233.

PMID:41313565 | DOI:10.1007/s40279-025-02367-3

Discov Oncol. 2025 Nov 28. doi: 10.1007/s12672-025-04172-w. Online ahead of print.

ABSTRACT

BACKGROUND: The current understanding of the relationship between circulating metabolites and neuroblastoma (NB) risk is insufficient. Herein, bidirectional Mendelian randomization (MR) studies were utilized to examine the potential causal associations of metabolites and the risk of NB.

METHODS: Significant single-nucleotide polymorphisms (SNPs) associated with circulating metabolites were obtained from the genome-wide association study (GWAS) in the European population (N = 7824). Summary statistics for NB were aggregated from prior GWAS studies encompassing 1,627 patients and 3,254 cancer-free children. The causality was assessed primarily by inverse-variance weighted (IVW), along with MR-Egger regression, weighted median estimator, and weighted mode method.

RESULTS: Among the 486 metabolites analyzed, a genetically determined elevation in blood butyrylcarnitine concentration (log₁₀) was significantly correlated with a 51.5% decrease in NB risk [IVW odds ratio (OR) = 0.485, 95% confidence interval (CI): 0.285-0.826, P = 0.008]. In the reverse MR analyses, an increase in log odds of NB risk demonstrated a significant correlation with a decrease in guanosine [IVW Beta ± SE: -0.042 ± 0.015 log₁₀ change, P = 0.004] and an elevation in 3-methyl-2-oxobutyrate [IVW Beta ± SE: 0.010 ± 0.004 log₁₀ change, P = 0.011] levels. Besides, no significant causal effect of NB on butyrylcarnitine was observed.

CONCLUSIONS: This research identifies bidirectional causal relationships between circulating metabolites and NB. Increased levels of blood butyrylcarnitine are associated with a reduced risk of NB, whereas lower levels of guanosine and higher levels of 3-methyl-2-oxobutyrate are indicative of NB patients. Further investigation is required for the mechanisms.

PMID:41313542 | DOI:10.1007/s12672-025-04172-w

J Endocrinol Invest. 2025 Nov 28. doi: 10.1007/s40618-025-02770-7. Online ahead of print.

ABSTRACT

BACKGROUND: Endothelial dysfunction may contribute to the increased cardiovascular risk associated with thyroid diseases. This systematic review and meta-analysis aimed to assess endothelial function, evaluated by flow-mediated dilation (FMD), in both hypo and hyperthyroidism, and its response to treatment.

METHODS: We searched Embase and PubMed (until April 2025) for studies on FMD in hypo- and hyperthyroidism (PROSPERO registration number: CRD42024629806). Risk of bias was assessed using Cochrane criteria. Mean differences (MD) with 95% confidence intervals (CI) were calculated using random-effects models. Statistical heterogeneity was assessed with I² statistics. Analyses were conducted using Review Manager 5.4.1.

RESULTS: Forty-two studies (1,663 subjects with hypothyroidism, 247 with thyrotoxicosis/endogenous hyperthyroidism, and 1520 euthyroid controls) were included. FMD was significantly reduced in subjects with untreated hypothyroidism compared to euthyroid controls (MD -2.99, 95% CI, -3.83, -2.14; I² = 99%), improved with levothyroxine treatment (MD 3.06, 95% CI: 1.94, 4.19; I² = 91%) and reached values similar to controls upon restoration of euthyroidism (MD 0.22, 95% CI: -0.75, 1.18; I² = 75%). A non-statistically significant difference emerged comparing untreated hyperthyroid subjects with controls (MD – 2.55; 95% CI: -5.38, 0.28; I² = 98%), and low risk of bias studies showed reduced FMD in this subset (MD – 6.57; 95% CI: -7.53, – 5.60; I² = 45%). Subclinical hyperthyroidism was associated with FMD impairment (MD – 4.21; 95% CI: -7.07, – 1.35; I² = 97%).

CONCLUSION: Hypothyroidism is associated with endothelial impairment, reversible after restoration of euthyroidism, highlighting the importance of appropriate management. Hyperthyroidism, especially subclinical, seems associated with FMD reduction, but larger, well-designed studies are needed.

PMID:41313532 | DOI:10.1007/s40618-025-02770-7

Environ Sci Pollut Res Int. 2025 Nov 28. doi: 10.1007/s11356-025-37176-8. Online ahead of print.

ABSTRACT

Anaerobic digestion is an effective technology for converting organic waste into biogas while reducing environmental pollution. This study investigates the impact of co-digesting waste-activated sludge (WAS) with wheat straw, rice straw, and bokashi on biogas production. Nine anaerobic batch reactors were operated under mesophilic conditions (35 °C), incorporating different proportions of bokashi (1% and 2%) along with rice and wheat straw (4%). The results revealed that reactors supplemented with wheat and rice straw exhibited higher biogas production than the control reactor (sludge only). Wheat straw outperformed rice straw in improving biogas yield, total solids (TS) reduction, total volatile solids (TVS) degradation, and chemical oxygen demand (COD) removal. The addition of bokashi enhanced biogas production, confirming its role in accelerating organic matter breakdown. The maximum biogas yield was observed in the reactor containing sludge co-digested with wheat straw and 2% bokashi, which generated three times more biogas than the control. This reactor also exhibited the highest degradation rates of TS (57.83%), TVS (66.37%), and COD (71.53%). Furthermore, pH remained stable within the optimal range across all reactors, ensuring a balanced digestion process. Statistical analysis revealed significant correlations between organic matter degradation (COD, TS, TVS reduction) and biogas production, demonstrating that effective substrate decomposition improves biogas yield. The recurrent neural network (RNN) model was applied to experimental data to predict biogas production. With an exceptionally low root mean square error (RMSE) of 0.0041, R² close to 1, and MAE 0.0117, the model exhibited excellent accuracy and reliability in generating precise predictions.

PMID:41313517 | DOI:10.1007/s11356-025-37176-8