Nevin Manimala

World J Pediatr. 2025 Jan 3. doi: 10.1007/s12519-024-00861-8. Online ahead of print.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus (T2DM) poses an escalating public health challenge among adolescents and young adults worldwide. Despite the rising incidence, comprehensive data on the burden and trends of T2DM in this demographic remain scarce. This study aims to evaluate the burden of T2DM among individuals aged 10-24 years globally, regionally, and nationally from 1990 to 2021.

METHODS: Utilizing data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we assessed incidence rates, disability-adjusted life-years (DALYs), and average annual percentage changes (AAPCs) for T2DM in the specified age group. Analyses accounted for variations by age, sex, and socio-demographic index (SDI). Joinpoint regression analysis identified years of significant trend shifts.

RESULTS: The global incidence of T2DM among adolescents and young adults rose from 56.02 per 100,000 (95% UI 43.03-72.32) in 1990 to 123.86 per 100,000 (95% UI 100.43-149.79) in 2021, reflecting an AAPC of 3.01 (95% CI 2.78-3.23). Notable increases were recorded in 1995, 2002, and 2009, with joinpoints indicating significant trend stabilization post-2010 for prevalence and DALYs. The largest relative incidence increase was observed in the 15-19 age group [AAPC 2.97 (95% CI 2.71-3.24)]. Although T2DM mortality was 2.4 times higher in the 15-19 age group compared to the 20-24 age group, the latter exhibited a significantly higher overall mortality rate. Regionally, Oceania recorded the highest incidence rates in 2021, while North Africa and the Middle East showed the greatest AAPCs. High-SDI countries experienced the most substantial increase in T2DM burden, with males comprising 54.8% of cases.

CONCLUSIONS: From 1990 to 2021, the global burden of T2DM among adolescents and young adults has markedly increased, underscoring the necessity for targeted, region-specific interventions to address this issue. The observed demographic disparities in mortality rates necessitate the implementation of age-specific strategies. Furthermore, the emergent trends in T2DM indicators warrant urgent attention to mitigate the rising burden in this vulnerable population.

PMID:39752048 | DOI:10.1007/s12519-024-00861-8

Community Ment Health J. 2025 Jan 3. doi: 10.1007/s10597-024-01441-w. Online ahead of print.

ABSTRACT

Pharmacists are highly accessible healthcare professionals with presence in communities, hospitals, and clinics. They are well positioned to expand their roles in supporting individuals with mental health challenges. A cross-sectional study was conducted to identify trends in how pharmacists assess, monitor, identify, and care for patients with mental health challenges. The survey was distributed to licensed pharmacists in Washington State (n = 8,082) in 2023. Questions addressed the provision of mental health supports and services provided by pharmacists, respondents’ self-assessed preparedness in delivering services, and professional and personal demographics. Data were analyzed using descriptive statistics and logistic regression. A total of 856 responses were received (10.6%) and 810 were included in the final dataset. Most respondents held a PharmD degree (74%). Common practice environments included community (37%), hospital (27%), and clinic (21%) settings. Less than 1% were board-certified psychiatric pharmacists. The most common mental health services provided involved medication-related services, including talking to patients regarding psychiatric medication (51%), consulting with physicians (47%), and assessing side effects (45%). Over 60% of pharmacists reported being prepared to deliver these services. Less than 30% of pharmacists indicated they were prepared to conduct mental health screenings or make referrals, and provision of these services was low. A statistically significant association was found between preparedness and providing supports and services (p < 0.001). Overall, pharmacists indicated they were more prepared and frequently delivered services related to medication use for mental health indications, while preparedness and offerings for non-medication activities was low, highlighting opportunities for further professional development.

PMID:39752035 | DOI:10.1007/s10597-024-01441-w

Aging Clin Exp Res. 2025 Jan 3;37(1):18. doi: 10.1007/s40520-024-02911-7.

ABSTRACT

BACKGROUND: Many studies have developed or validated predictive models to estimate the risk of sarcopenia in dialysis patients, but the quality of model development and the applicability of the models remain unclear.

OBJECTIVE: To systematically review and critically evaluate currently available predictive models for sarcopenia in dialysis patients.

METHODS: We systematically searched five databases until March 2024. Observational studies that developed or validated predictive models or scoring systems for sarcopenia in dialysis patients were considered eligible. We included studies of adults (≥ 18 years of age) on dialysis and excluded studies that did not validate the predictive model. Data extraction was performed independently by two authors using a standardized data extraction table based on a checklist of key assessments and data extraction for systematic evaluation of predictive modeling research. The quality of the model was assessed using the Predictive Model Risk of Bias Assessment Tool.

RESULTS: Of the 104,454 studies screened, 13 studies described 13 predictive models. The incidence of sarcopenia in dialysis patients ranged from 6.6 to 34.4%. The most commonly used predictors were age and body mass index. In the derivation set, the reported area under the curve or C-statistic is between 0.81 and 0.95. The area under the curve reported by the external validation set is between 0.78 and 0.93. All studies had a high risk of bias, mainly due to poor reporting in the outcome and the analysis domains, and three studies had a high risk of bias in terms of applicability.

CONCLUSION: Future research should focus on validating and improving existing predictive models or developing new models using rigorous methods.

PMID:39752019 | DOI:10.1007/s40520-024-02911-7

Clin Exp Med. 2025 Jan 3;25(1):28. doi: 10.1007/s10238-024-01545-3.

ABSTRACT

Sepsis is a major cause of morbidity and mortality worldwide. Among the various types of end-organ damage associated with sepsis, hepatic injury is linked to significantly higher mortality rates compared to dysfunction in other organ systems. This study aimed to investigate potential biomarkers of hepatic injury in sepsis patients through a multi-center, case-control approach. We enrolled three matched cohorts: 37 sepsis patients with hepatic dysfunction (S-HD), 37 sepsis patients without hepatic dysfunction (S-CON), and 18 healthy controls (HC). We measured five proposed biomarkers of hepatic dysfunction-ARG1, MDH1, GSTα, 5-NT, and SDH-using multiplex immunoassays. These biomarkers were compared to traditional markers of hepatic dysfunction, including albumin, bilirubin, ALT, AST, and GGT, across the cohorts using both conventional statistical methods and machine learning techniques. The median age of participants was comparable across cohorts: S-HD (65.0 years, IQR 49.5-82.5), S-CON (65.0 years, IQR 48.0-81.5), and HC (62.5 years, IQR 53.0-65.0; P = 0.794). Patients with hepatic dysfunction (S-HD) exhibited higher illness severity scores compared to those without hepatic dysfunction (S-CON): MODS scores were median 7.0 (IQR 4.0-10.0) in S-HD versus median 4.0 (IQR 2.0-7.0) in S-CON (P = 0.005), and SOFA scores were median 7.0 (IQR 4.0-11.0) in S-HD versus median 3.0 (IQR 2.0-6.0) in S-CON (P < 0.001). Hemoglobin and platelet counts were lower, while creatinine levels were higher in S-HD compared to S-CON (P < 0.05). On ICU Day 1, bilirubin, ALT, AST, GGT, and INR were significantly elevated in S-HD relative to S-CON (P ≤ 0.001), and albumin levels were lower (P < 0.05). Additionally, ARG1, GSTα, 5-NT, and SDH were significantly higher in S-HD patients on ICU Day 1 compared to S-CON (P < 0.05). ARG1, MDH1, and SDH showed positive correlations with AST, ALT, and MODS (P < 0.01). From ICU Day 1 to Day 7, ARG1, GSTα, SDH, and AST levels significantly decreased in S-HD patients (P < 0.05), whereas MDH1 and 5-NT levels did not. Among the proposed biomarkers, GSTα and 5-NT did not correlate with traditional hepatic dysfunction markers but were significant in identifying S-HD patients (feature importance 0.131 and 0.097, respectively) in a random forest classification model. This comprehensive model demonstrated excellent performance in distinguishing sepsis patients with hepatic injury, with sensitivity 0.93, specificity 0.94, NPV 0.94, PPV 0.94, and AUC 0.94. The biomarkers ARG1, MDH1, GSTα, 5-NT, and SDH show promise as novel indicators of hepatic dysfunction associated with sepsis. This study provides a foundational basis for subsequent research aimed at characterizing and clinically validating these markers. Future investigations should focus on integrating these potential biomarkers into routine laboratory assessments for sepsis and related hepatic injury.

PMID:39751971 | DOI:10.1007/s10238-024-01545-3

Lasers Med Sci. 2025 Jan 3;40(1):6. doi: 10.1007/s10103-024-04275-w.

ABSTRACT

To assess and compare two techniques of low-level laser application-transgingival (TLLLT) and intrasulcular (ILLLT)-used in photobiomodulation as an adjunct to basic periodontal therapy (BPT) in patients with periodontitis. A randomized, split-mouth, double-blind clinical trial was conducted, selecting three diseased periodontal sites from different quadrants in each patient. These sites were assigned to one of three treatment groups: SRP (control), SRP + TLLLT (test 1), and SRP + ILLLT (test 2). Low-level laser therapy in the test groups was applied at 48 h, 7 days, and 14 days after full-mouth SRP. Clinical parameters such as probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were assessed at baseline (T0), 3 months (T1), and 6 months (T2). Standardized periapical radiographs were used to assess radiographic bone density (RBD) 6 months post-treatment. Statistical analyses included repeated measures ANOVA for continuous variables and chi-square tests for categorical variables, with significance set at p < 0.05 and a 95% confidence interval. Significant reductions in PD (p < 0.001) and CAL (p < 0.001) were observed across all groups at 3 and 6 months, with no significant differences between groups. There were also no significant changes in BOP and RBD between groups at the follow-up intervals. Adjunctive photobiomodulation did not provide additional clinical or radiographic benefits over SRP alone, regardless of the laser application technique employed.

PMID:39751964 | DOI:10.1007/s10103-024-04275-w

Oral Maxillofac Surg. 2025 Jan 3;29(1):23. doi: 10.1007/s10006-024-01319-x.

ABSTRACT

PURPOSE: This study aimed to evaluate the dental and skeletal stability one year after Miniscrew-Assisted Rapid Palatal Expansion (MARPE) by using 3D image data.

METHODS: Patients with transverse maxillary deficiency from the age of 16 onwards were enrolled consecutively in this prospective longitudinal cohort study. The MARPE appliance was digitally and individually designed and fabricated. Cone-beam computed tomography (CBCT) scans and intra-oral scans (IOS) were acquired before the start of MARPE treatment (T0), immediately after active expansion (T1) and one-year post-expansion (T2). Nasal floor width (NFW), palatal alveolar width at the first molar (M1) and first premolar (P1) (PAW), nasal cavity width (NCW), intermolar width (IMW) and interpremolar width (IPW) were measured to assess the immediate (ΔT0-T1) and net (ΔT0-T2) skeletal and dentoalveolar expansion and relapse (ΔT1-T2). Potential correlations with age, sex and midpalatal suture maturation (MSM) stage were also investigated.

RESULTS: Thirty-one patients (6 men, 25 women, mean age: 26.2 years) were included. The mean follow-up time (T0-T2) was 12.2 months. The initial NFW increase demonstrated a relapse of 0.6 ± 1.2 mm, or 11.6% of the initial expansion (p < 0.01). Expansion at the alveolar level remained stable during the follow-up. IPW also remained stable during the follow-up (4.2 ± 1.3 mm at T1; 4.4 ± 2.6 mm at T2). IMW exhibited a relapse of 3.8 ± 2.1 mm, or 60.2% of the initial expansion (p < 0.001) during T1-T2. There was no statistically significant correlation between stability and age, sex and MSM stage.

CONCLUSIONS: MARPE is an effective therapy for the correction of transverse maxillary discrepancy in late adolescents and adults, achieving a clinically stable skeletal outcome one year after expansion.

PMID:39751963 | DOI:10.1007/s10006-024-01319-x

Mol Genet Genomics. 2025 Jan 3;300(1):12. doi: 10.1007/s00438-024-02221-7.

ABSTRACT

Precursors of microRNAs (pre-miRNAs) are less used in silico to mine miRNAs. This study developed PmiR-Select^® based on covariance models (CMs) to identify new pre-miRNAs, detecting conserved secondary structural features across RNA sequences and eliminating the redundancy. The pipeline preceded PmiR-Select^® filtered 20% plant pre-miRNAs (from 38589 to 8677) from miRBase. The second filter reduced pre-miRNAs by 7% (from 8677 to 8045) through length limit to pre-miRNAs (70-300 nt) and miRNAs (20-24 nt). The 80% redundancy threshold was statistically the best, eliminating 55% pre-miRNAs (from 8045 to 3608). Angiosperms retained the highest number of pre-miRNAs and their families (2981 and 2202), followed by gymnosperms (362 and 271), bryophytes (183 and 119), and algae (82 and 78). Thirty-seven conserved pre-miRNA families happened among plant land clades, but none with algae. The PmiR-Select^® was applied to the rice genome, producing 8536 pre-miRNAs from 36 families. The 80% redundancy threshold retained 3% pre-miRNAs (n = 264) from 36 families, valuable experimental and computational research resources. 14% (n = 1216) of 8536 were new pre-miRNAs from 19 new families in rice. Only 16 new sequences from six families overlapped (39 to 54% identities) with rice pre-miRNAs and five species on miRBase. The validation against mature miRNAs identified 8086 pre-miRNAs from 13 families. Eleven ones have already been recorded, but two new and abundant pre-miRNAs [miR437 (n = 296) and miR1435 (n = 725)] scattered in all 12-rice chromosomes. PmiR-Select^® identified pre-miRNAs, decreased the redundancy, and discovered new miRNAs. These findings pave the way to delineating benchtop and computational experiments.

PMID:39751956 | DOI:10.1007/s00438-024-02221-7

Daru. 2025 Jan 3;33(1):11. doi: 10.1007/s40199-024-00554-7.

ABSTRACT

BACKGROUND: The inappropriate use of antibiotics increases the costs of treatment, antibiotic resistance, increased disease length and duration of hospital stay.

OBJECTIVES: The aim of this study was investigating the pattern of use and effectiveness of the Linezolid in COVID-19 hospitalized patients.

METHODS: In this retrospective cross-sectional analytical study was carried out from February 2020 (from the beginning of the pandemic in Iran) to the end of September 2020, 32 COVID-19 patients that used Linezolid were included. The data retrieved from medical document’s unit and analysis was performed by SPSS statistical software version 20.

RESULTS: According to the three elements of the 1- culture of resistant bacteria 2-the correct daily dose and 3-adequate duration of the drug, consumption pattern of Linezolid was irrational in 24 (75%) COVID-19 patients and it was rational only in 8 (25%) patients. Twenty-three (71.9%) patients received sufficient doses of the drug and 9 (28.1%) patients did not receive the required minimum dose. Four (50%) patients who rationally received Linezolid improved and the remaining 4 died. Leukopenia occurred in 1 patient (3.1%), anemia appeared in 24 individuals (75%), and 15 patients (46.9%) developed thrombocytopenia.

CONCLUSION: We suggest that the prescription of Linezolid is in accordance with the standard instructions and the stewardship antibiotic program to reduce the medication costs, drug side effects, and the prevalence of antibiotic resistance.

PMID:39751953 | DOI:10.1007/s40199-024-00554-7

Clin Oral Investig. 2025 Jan 3;29(1):43. doi: 10.1007/s00784-024-06125-z.

ABSTRACT

AIMS: Our goal is to perform a meta-analysis to investigate the risk of periodontitis associated with specific dietary patterns.

METHODS: We employed the PRISMA methodology in a meta-analysis to examine the correlation between dietary patterns and the risk of periodontitis. We systematically searched three online databases from inception to November 2024 to identify relevant studies. Summary estimates with 95%CI were calculated to assess the relationship between specific dietary patterns and the risk of periodontitis. Cumulative estimates were synthesized using random-effects or fixed-effects models. Heterogeneity among studies was evaluated using Cochran’s Q and I² statistics.

RESULTS: In total, we included 19 articles that analyzed 5 dietary patterns The study showed that a diet high in inflammation-promoting foods significantly raised the likelihood of periodontitis (OR = 1.39, 95% CI, 1.09-1.77), in contrast, dietary patterns like the mediterranean diet (OR = 0.96, 95% CI, 0.94-0.98), plant-based diet (OR = 0.92, 95% CI, 0.86-0.98), or dairy-rich diet (OR = 0.76, 95% CI, 0.66-0.87) lowered the risk of periodontitis. The analysis revealed no statistically significant association between a western diet (OR = 1.07; 95% CI, 0.86-1.33) and the risk of periodontitis.

CONCLUSIONS: As dietary diversity and complexity continue to expand, there has been a concomitant increase in the prevalence of periodontal disease. This study has identified specific dietary patterns associated with the risk of periodontitis, particularly highlighting the heightened risk linked to pro-inflammatory diets. These findings emphasize the importance of implementing targeted dietary practices to reduce the incidence of this condition.

PMID:39751926 | DOI:10.1007/s00784-024-06125-z

Cancer Immunol Immunother. 2025 Jan 3;74(2):72. doi: 10.1007/s00262-024-03905-0.

ABSTRACT

BACKGROUND: Immune checkpoint inhibitors (ICIs) show optimal treatment effects on recurrent or metastatic nasopharyngeal carcinoma(R/M NPC). Nonetheless, whether metastatic sites impact ICIs efficacy remains unclear.

METHODS: We performed a secondary analysis of R/M NPC patients treated with KL-A167, a programmed cell death-ligand 1(PD-L1) inhibitor, based on a multicenter, single-arm, phase II study from China between 2019 and 2021 years, which represents the first and most comprehensive analysis of the effectiveness of a PD-L1 inhibitor in patients who have been previously treated. The Cox proportional hazard model was utilized to evaluate the association between sites and PFS and OS. Sensitivity analysis and subgroup analysis were carried out to confirm the reliability of our findings.

RESULTS: A total of 153 R/M NPC patients were included. The mean age was 47 years and 81% of patients were males. All patients in our study had distant metastasis, with a majority (n = 69) presenting with more than 2 sites of distant metastasis upon admission. The collected sites of metastasis included liver, lung, lymph and bone. Among the 153 patients, 37.9% (58 patients) received anti-PD-L1 treatment for a minimum of 6 months, and 17.6% (27 patients) were treated for at least 12 months. By conducting multivariate analysis, R/M NPC patients with non-liver metastases presented significantly longer progress-free survival (PFS, HR:1.67, CI:1.09-0.2.55, p = 0.018) and overall survival (OS, HR:2.52, CI:1.49-4.28, p < 0.001) compared with those with liver metastasis. The median PFS (72 vs. 144 days, p < 0.0001) and OS (730 vs. 305 days, p < 0.0001) were significantly longer for patients with non-liver metastases. However, lung, bone and lymph node metastasis had no statistical significance on PFS and OS (p > 0.005). Our sensitive analysis showed liver metastases patients with less other site metastases (0 or 1) had shorter OS compared to non-liver metastases patients with more other metastases(≥ 2). Furthermore, subgroup analysis indicated the robustness evidence liver metastasis indeed a valuable prognostic factor for survival.

CONCLUSIONS: Compared to patients with other metastatic sites, R/M NPC patients with liver metastasis have poor survival patterns when receiving anti-PD-L1 therapy. Our study provides rational evidence for the urgent need to explore more efficacy treatment modalities for NPC patients with liver metastasis.

PMID:39751901 | DOI:10.1007/s00262-024-03905-0