Nevin Manimala

BMC Pregnancy Childbirth. 2025 Oct 6;25(1):1028. doi: 10.1186/s12884-025-08233-4.

ABSTRACT

BACKGROUND: Adequate levels of vitamin D during pregnancy are essential for maintaining fetal development and reducing the risk of adverse perinatal outcomes. This study highlights the importance of improving pregnancy outcomes and promoting maternal health. It was conducted to evaluate the prevalence of serum vitamin D deficiency and its associated factors in the first trimester of pregnancy. pregnancy, given the importance of improving pregnancy outcomes and promoting maternal health.

METHODS: This cross-sectional study was carried out in 2024 with 290 pregnant women in their first trimester who attended Al-Zahra and Taleghani Hospitals. Maternal data were collected using a structured questionnaire. Blood samples were obtained from participants to measure serum levels of 25-hydroxyvitamin D3 [25(OH)D]. Data analysis was performed using SPSS version 24 with statistical tests including Chi-square, Fisher’s exact test, Mann-Whitney U test, Kruskal-Wallis test, and logistic regression. A p-value < 0.05 was considered statistically significant.

RESULTS: The prevalence of hypovitaminosis D among pregnant women was estimated at 52.8% (95% CI: 46.98-58.54). No significant association was found between the consumption of major food groups containing vitamin D and vitamin D deficiency; however, the intake levels were generally low. Occupational status, parity of three or more, vitamin D supplementation, sun protection score, and exposure to sunlight were identified as significant predictors of vitamin D deficiency.

CONCLUSION: Considering the high prevalence of hypovitaminosis D among pregnant women and its contributing factors, including vitamin D intake, sun exposure, sun protection practices, occupational status, parity greater than three, and insufficient dietary consumption of vitamin D-rich foods, there is an urgent need for nutritional education. Additionally, early prescription of vitamin D is recommended for women with hypovitaminosis D to mitigate potential adverse effects on maternal and fetal health.

PMID:41053671 | DOI:10.1186/s12884-025-08233-4

BMC Cancer. 2025 Oct 6;25(1):1513. doi: 10.1186/s12885-025-14831-4.

ABSTRACT

BACKGROUND: Patients with colorectal cancer (CRC) often experience chemotoxicity that impacts treatment adherence, survival, and quality of life. Early screening for chemotoxicity risk is vital, yet comprehensive predictive models are lacking. The objective of this study was to develop effective artificial intelligence (AI)/machine learning (ML) models, integrating racialized group, social determinants of health (SDOH) (Area Deprivation Index [ADI], employment status), and biological aging (Levine Phenotypic Age) to predict overall, gastrointestinal (GI), and hematological chemotoxicity.

METHODS: We used electronic health records data from 1,735 adult patients with CRC. Sociodemographic/clinical variables, Levine Phenotypic Age (biological aging), and SDOH (including geospatial variations measured by ADI) were analyzed using descriptive statistics. Associations with chemotoxicity (overall, GI, hematological) were evaluated via univariate tests. Significant predictors from univariate tests were selected for AI/ML modeling. Six supervised ML models were trained on 80% of cases (n = 1,388), with 20% (n = 347) reserved for testing. Performance was assessed via accuracy, area under the curve (AUC), and F1-score. Permutation feature importance ranked predictors to define the most significant predictors of chemotoxicity.

RESULTS: Support Vector Machine and XGBoost models demonstrated high accuracy in both the training and test datasets. Notably, the AUC (0.988) was highest for the Support Vector Machine model in predicting overall chemotoxicity within the training dataset. Key predictors of overall and GI toxicities included higher Levine Phenotypic Age, elevated inflammatory markers (e.g., C-reactive protein), and poor SDOH (e.g., higher ADI, unemployment). Hematological toxicity was linked to lower inflammatory markers, higher Levine Phenotypic Age, and younger chronological age. Race (non-Hispanic Black), body mass index, and lifestyle also influenced overall and GI toxicities.

CONCLUSIONS: ML-based chemotoxicity prediction models incorporating racialized group, SDOH, and biological aging had high accuracy. Greater biological aging, poor SDOH including ADI, and higher inflammation markers were common risk factors for overall and GI chemotoxicity. In contrast, chronological and biological ages and immune/inflammation markers were only linked to hematological chemotoxicity. Integrating these factors into predictive models can help clinicians identify at-risk patients and tailor interventions (e.g., anti-inflammatory, anti-aging strategies) to reduce chemotoxicity and improve survivorship outcomes.

PMID:41053663 | DOI:10.1186/s12885-025-14831-4

BMC Oral Health. 2025 Oct 6;25(1):1532. doi: 10.1186/s12903-025-06816-3.

ABSTRACT

BACKGROUND: The purpose of this in vitro study is to compare the removal torque values of abutment screws anodized with different voltage values.

METHODS: The abutment screws were divided into 6 groups according to their surface treatment: non-treated (C) Control group (n = 24), acid etched only (A) Acidic uncolored (n = 24), anodized with 27 V and painted blue (B) Blue (n = 24), after acid etching anodized with 27 V and painted blue (AB) Acidic Blue (n = 24), anodized with 55 V and painted yellow (Y) Yellow (n = 24) and after acid etching anodized with 55 V and painted yellow (AY) Acidic Yellow (n = 24). 144 bone-level implants to which the abutments will be attached are embedded in auto polymerized acrylic resin. All abutment screws were tightened to 30 Ncm on the digital torque meter. The removal torque values of abutment screws were obtained, and A three-way ANOVA was performed for statistical analysis, and Tukey’s test was used for multiple comparisons.

RESULTS: Decreased removal torque values were observed in all groups after thermomechanical cycling. Only application anodization process to abutment screws reduces removal torques of the screws. In case of acid etching before anodization, it was observed that removal torques increased. Applying only acid etching process to abutment screws reduces removal torques of the screws. However, when the screws are anodized after acid etching, it has been observed that removal torques increase.

CONCLUSION: It was observed that anodizing the abutment screws with different voltages did not make a significant change in the removal torques.

PMID:41053662 | DOI:10.1186/s12903-025-06816-3

BMC Cancer. 2025 Oct 6;25(1):1525. doi: 10.1186/s12885-025-15042-7.

ABSTRACT

Upper tract urothelial carcinoma (UTUC) and urinary bladder cancer (UBC), though histologically similar, differ molecularly, prompting interest in their biomarker profiles for targeted therapies like antibody-drug conjugates (ADCs) enfortumab vedotin (targeting Nectin-4) and sacituzumab govitecan (targeting TROP-2). This study investigated Nectin-4 and TROP-2 expression in 87 UTUC patients, including 54 with a history of concurrent UBC (UTUC + UBC) and 33 with UTUC alone. Immunohistochemical analysis revealed widespread TROP-2 expression (98.8% of samples), with high levels linked to low-grade UTUC (p = 0.043) and intense staining (mean H-score 227 ± 63) across both cohorts. Nectin-4 was expressed in 70.1% of samples overall but was more frequent in the UTUC + UBC group (88.8% vs. 63.6% in UTUC-only patients), though this difference lacked statistical significance (p = 0.340). Notably, Nectin-4 staining intensity was weak in both groups (mean H-score 66 ± 65), suggesting biological distinctions between UTUC with and without UBC. The findings imply that ADCs targeting TROP-2 and Nectin-4 may hold therapeutic promise in UTUC without requiring prior biomarker testing. Additionally, the elevated Nectin-4 expression in UTUC + UBC patients hints at divergent molecular pathways that could influence treatment strategies, warranting further clinical exploration.

PMID:41053655 | DOI:10.1186/s12885-025-15042-7

BMC Oral Health. 2025 Oct 6;25(1):1531. doi: 10.1186/s12903-025-06794-6.

ABSTRACT

BACKGROUND: Recent studies have explored the relationship between early feeding practices and early childhood caries (ECC), with a focus on oral hygiene, fluoride exposure, and sugary food consumption. However, the risk factors for ECC are diverse, and limited prospective studies have comprehensively examined the impact of various early feeding behaviors on ECC risk in preschoolers, including breastfeeding patterns, timing of complementary feeding, dietary diversity, sugary food intake, and micronutrient supplementation. Further research is needed to provide evidence for effective early intervention strategies to reduce ECC prevalence in preschoolers.

OBJECTIVE: This study aims to examine the association between early childhood feeding practices and dental caries risk in a birth cohort of Shanghai preschoolers, with a focus on breastfeeding pattern and duration, timing and types of complementary feeding, and early dietary habits.

METHODS: This analysis draws on data from the Shanghai Maternal-Child Pairs Cohort (MCPC), a well-established prospective cohort designed to examine early life exposures and child health outcomes, including 3,505 maternal-child pairs aged 3 to 5 years. Dental caries status, including presence and severity (dmft), was assessed through clinical examinations. Data on early feeding practices, including breastfeeding, complementary feeding, and dietary habits, were collected via structured parent-reported questionnaires. Statistical analyses were performed using R4.3.3 and IBM SPSS Statistics 20, with adjusted Poisson regression models to assess associations and survival analysis to explore time-dependent effects.

RESULTS: Children with caries were more likely to have mothers with lower education levels, lower perceived family economic status, exposure to tobacco during pregnancy, and primary caregivers with dental caries. They also exhibited delayed tooth brushing initiation and behaviors such as eating after brushing and sleeping with a bottle. Our findings suggest that breastfeeding is not a risk factor for ECC. At 12 months of age, the consumption of sweets (aRR = 1.041, 95%CI: 1.020, 1.063) and sugar-sweetened beverages (aRR = 1.122, 95%CI: 1.080, 1.166) in the past 24 h significantly increased caries risk. Early introduction of complementary foods (< 6 months) also elevated the risk (aRR = 1.234, 95% CI: 1.019, 1.494). In contrast, consistent vitamin D supplementation (0-2 years) was protective (aRR = 0.980, 95% CI: 0.961, 0.998), and greater dietary diversity at 12 months was associated with lower dmft (β = -0.222, 95% CI: -0.442, -0.003). Survival analysis showed that sweet intake at 12 months shortened the caries-free survival time, whereas consistent vitamin D supplementation from birth to 2 years prolonged it.

CONCLUSION: Scientific early feeding strategies, including limiting sugar intake, ensuring an appropriate timing for complementary feeding, maintaining consistent vitamin D supplementation, and promoting dietary diversity, play a key role in preventing ECC.

PMID:41053654 | DOI:10.1186/s12903-025-06794-6

BMC Pediatr. 2025 Oct 6;25(1):775. doi: 10.1186/s12887-025-06170-x.

ABSTRACT

BACKGROUND: Neonatal hyperbilirubinemia is a frequent metabolic complication in newborns. The available treatment methods may bring about adverse consequences; therefore, finding new modalities to decrease the duration of treatment is a major concern. The aim of this study was to compare the effect of massage or chicory bath on bilirubin levels in term newborns undergoing phototherapy.

METHODS: This randomized clinical trial study was conducted on 90 newborns with hyperbilirubinemia at Imam Ali Hospital of Amol on October 26, 2024 to February 6, 2025. Two intervention groups received chicory bath or massage as an adjuvant intervention in addition to standard phototherapy treatment, and the control group only received phototherapy. A custom-designed data collection form was used in this study. All newborns who met the inclusion criteria were selected and informed consent was obtained from their parents. Then, using a computerized random number table, the newborns were randomly assigned to three groups. Sampling continued until the intended number was reached. Descriptive and analytical statistical tests including analysis of variance, chi-square, Tukey’s post hoc test, and repeated measures ANOVA were used to analyze the data using SPSS software (version 26). A significance level of 0.05 was considered acceptable.

RESULTS: There was no significant difference between the three groups in terms of neonatal age, gender, birth weight, gestational age, and type of delivery. There was no significant difference between the three groups regarding average bilirubin levels on the second, third, and fourth days of hospitalization. The change in bilirubin levels over time was significant regardless of the group (P=0.000), and the trend of bilirubin change over time was not significant among the three groups. There was no significant difference in the rate of complications including skin rashes, drug sensitivity, and phototherapy sensitivity among the three groups. There was a significant difference between the three groups in terms of the frequency of defecation on the third and fourth days (P=0.02), which was higher in the massage group. There was a statistically significant difference in the number of hospitalization days among the chicory (3 ±0. 91) (Length of stay: 2-5), massage (2.77±0.73) (Length of stay: 2-4), and control groups (3.37±0.93) (Length of stay: 2-5) (p=0.03). This significant difference was observed between massage and control groups (P=0.02) concerning the rate of hospitalization, and the newborns in the massage group were discharged earlier.

CONCLUSION: Based on the results of the present study, Field massage combined with phototherapy was more effective in increasing the frequency of defecation and reducing the length of hospitalization in infants with hyperbilirubinemia compared to those in the chicory bath group and the control group who received phototherapy only.

TRIAL REGISTRATION: This trial was registered on https://irct.behdasht.gov.ir (trial ID 77302).

PMID:41053652 | DOI:10.1186/s12887-025-06170-x

BMC Oral Health. 2025 Oct 6;25(1):1547. doi: 10.1186/s12903-025-06707-7.

ABSTRACT

BACKGROUND: This research explores the prevalence of fimA genotype variants of Porphyromonas gingivalis (P. gingivalis) in individuals with periodontitis and healthy controls within the United Arab Emirates (UAE). It seeks to examine the relationship between these genotypes and both periodontal health and disease. The study aims to improve our understanding of the involvement of P. gingivalis in periodontal diseases among the UAE population.

METHODS: This research involved 127 individuals diagnosed with periodontitis and 127 healthy participants matched for age and gender. Subgingival plaque samples were collected and examined for fimA genotypes (types I, II, III, IV, and V) employing polymerase chain reaction (PCR). A statistical evaluation using the chi-squared test was conducted to explore the relationship between fimA genotypes and periodontal condition, providing insights into the relationship between microbial profiles and periodontal health and disease.

RESULTS: The study found a significant link between specific fimA genotypes and periodontitis. The fimA genotype II was most common in periodontitis patients (41.7%) compared to healthy individuals (7.1%), with a strong association (p < 0.001). fimA genotype type IV was also more frequent in patients (15.0%) than in controls (2.4%), showing a significant correlation (p < 0.001). Other genotypes, such as fimA I, III, and V, were more frequently observed in patients, suggesting their involvement in disease development.

CONCLUSION: This study highlights a significant link between specific P. gingivalis fimA genotypes, particularly types II and IV fimA genotype combinations, and periodontitis in the UAE population. These findings provide insights into the prevalence of genotypes and suggest future research into their pathogenic mechanisms, potentially leading to new therapeutic interventions for periodontitis.

PMID:41053650 | DOI:10.1186/s12903-025-06707-7

BMC Public Health. 2025 Oct 6;25(1):3355. doi: 10.1186/s12889-025-24287-7.

ABSTRACT

BACKGROUND: Foodborne diseases are a serious public health problem that cause a heavy burden of illness. We aimed to analyze the characteristics of foodborne disease outbreaks (FBDOs) in Jiaxing and provide scientific support for foodborne disease prevention and control.

METHODS: Descriptive epidemiological methods were used to statistically analyze the data reported by seven county-level Centers for Disease Control and Prevention (CDCs) in Jiaxing City through the Foodborne Disease Outbreak Surveillance System (FDOSS) from 2013 to 2023.

RESULTS: During the study period, 128 FBDOs were reported, which resulted in 900 cases, 117 hospitalizations, and one death. Bacteria accounted for the highest proportion of outbreaks (58 outbreaks, 45.31%) and cases (623 cases, 69.22%), followed by poisonous mushrooms (28 outbreaks and 70 cases). Households were the setting for the highest proportion of outbreaks (57.03%). Poisonous mushrooms were the most common single food reported (28 outbreaks, 21.88%), followed by aquatic products (17 outbreaks, 13.28%) and meat and meat products (13 outbreaks, 10.16%). In the 58 bacterial FBDOs, the most important setting was households (20 outbreaks, 34.48%), followed by restaurants (15 outbreaks, 25.86%) and rural banquets (13 outbreaks, 22.41%). Outbreaks caused by poisonous mushrooms occurred mainly in households (27 outbreaks, 96.43%). Different types of bacteria tended to be responsible for outbreaks involving different food categories, e.g., Vibrio parahaemolyticus was mainly found in aquatic products (64.71%). From 2018 to 2023, the proportion of outbreaks caused by poisonous mushrooms increased from 22.22 to 76.92%. From 2021, poisonous mushrooms became the predominant factor for FBDOs in Jiaxing City.

CONCLUSIONS: Households are the most important settings for FBDOs. Poisonous mushrooms and microbial pathogens are the main factors causing FBDOs. Since 2018, the proportion of FBDOs caused by poisonous mushrooms has been increasing annually. Food safety policies targeting high-risk settings and pathogens identified by surveillance data should be formulated to reduce the risk of FBDOs.

PMID:41053642 | DOI:10.1186/s12889-025-24287-7

J Psychiatr Res. 2025 Oct 3;191:491-500. doi: 10.1016/j.jpsychires.2025.09.081. Online ahead of print.

ABSTRACT

OBJECTIVE: Clozapine (CZP) is not commonly prescribed mainly because of the risk of serious adverse effects, particularly neutropenia. It can also cause blood disorders, ranging from mild to severe, affecting different blood cell types. The aim of this study was to investigate the incidence of hematological abnormalities in a Pakistani cohort of patients treated with antipsychotics using a comprehensive hematological monitoring program.

METHODS: The study included 288 patients categorized into three clinical groups based on antipsychotic treatment: Group TA (typical antipsychotics), Group AA (atypical antipsychotics), and Group CZP. During the initial 20-week treatment period, patients were regularly monitored hematological to assess changes in their blood profiles. The occurrence of various hematological abnormalities was investigated and analyzed using statistical models.

RESULTS: Blood dyscrasias were observed more frequently in patients in the CZP group than in the other groups. Specifically, neutropenia was seen in a few patients in group CZP. Notably, a positive clinical response to CZP treatment was significantly correlated with transient leukocytosis, transient neutrophilia, and persistent anemia. In contrast, poor clinical response to CZP medication was associated with transient leukopenia.

CONCLUSION: CZP treatment resulted in more blood disorders than TA or AA treatments. While blood abnormalities were common with CZP, severe neutropenia was rare. Certain blood changes were linked to better treatment outcomes. Therefore, regular blood monitoring is recommended to optimize treatment effectiveness and manage side effects.

PMID:41052486 | DOI:10.1016/j.jpsychires.2025.09.081

JMIR Form Res. 2025 Oct 6;9:e79032. doi: 10.2196/79032.

ABSTRACT

BACKGROUND: The high prevalence of type 2 diabetes (T2D) and associated complications disproportionately affect low-income Latino populations, who also experience disparities in diabetes self-management (DSM), including poor medication adherence, physical activity, diet, and glycemic control.

OBJECTIVE: This study examined, through an academic-community partnership, the effectiveness of ¡Salud, Salud! (an evidence-based, family-centered diabetes self-management education and support [DSMES] program) on primary (glycemic control and quality of life) and secondary (social, psychological, and behavioral factors related to T2D management) outcomes among low-income Latino adults with T2D or prediabetes.

METHODS: In total, 81 adults (mean age 48.90 years, SD 12.57; n=57, 70.4%, female; n=66, 81.5%, Latino) with T2D or prediabetes were enrolled in a 12-week, single-arm quasi-experimental study conducted in two Central Texas Young Men’s Christian Association (YMCA) locations. ¡Salud, Salud! incorporated individual coaching by community health workers (CHWs), online family-centered DSMES training lessons, and a YMCA family membership. The delivery of ¡Salud, Salud! was supported and facilitated by digital technologies, including a dashboard to deliver intervention content and monitor participants’ engagement in intervention activities. Outcomes measured at baseline and 12 weeks (ie, postintervention) included hemoglobin A1c (HbA1c); quality of life; anthropometrics; self-reported physical activity and diet; mindfulness; perceived stress; and diabetes-related knowledge, self-efficacy, and support. Participant engagement in program activities was assessed via four index variables that underlay multiple dimensions of influences on ¡Salud, Salud! uptake: family engagement and support, participation in self-management education, program support and facilitation, and participation in self-monitoring. Paired t-tests and McNemar chi-square tests were used to examine the change in outcomes from baseline to 12 weeks. The number of program activities participants completed for each engagement index variable was converted to percentages to estimate the mean proportion of activities completed.

RESULTS: In total, 48 (59.3%) participants completed the 12-week posttest. At the end of the program, participants demonstrated a marginally significant reduction in HbA1c (-0.30%, P≤.09) and a significant increase in participants reporting good-to-excellent health from baseline (n=19, 39.6%) to posttest (n=28, 58.3%; P≤.003). There were significant reductions in body weight (-1.30 kg, P=.02), body fat percentage (-1.26%, P=.01), perceived stress (-0.28, P=.02), added sugar intake (-2.15 teaspoons/day, P=.001), and time spent sedentary per week (-70.27 minutes, P=.003) from baseline to posttest. Mindfulness increased significantly (2.21, P=.01). Participant engagement in ¡Salud, Salud! varied, with participants exhibiting a high completion rate in program support and facilitation activities (88%) and a moderate-to-low completion rate in self-management training (66%), self-monitoring (56%), and family engagement and support (49%) activities.

CONCLUSIONS: ¡Salud, Salud! shows promising preliminary effects on key diabetes-related outcomes. Future research should investigate how to enhance participant engagement and optimize uptake of evidence-based T2D self-management practices among low-income Latino adults with diabetes.

PMID:41052435 | DOI:10.2196/79032