Nevin Manimala

Int J Chron Obstruct Pulmon Dis. 2025 Jul 3;20:2173-2182. doi: 10.2147/COPD.S518455. eCollection 2025.

ABSTRACT

BACKGROUND: The gut-lung axis, representing the communication between gut microbiota and the lungs, has been hypothesized to influence chronic obstructive pulmonary disease (COPD) development through modulation of the immune response. However, the causal role of gut microbiota in COPD and the potential mediating role of immune cells remain largely undetermined. This study aimed to uncover the causal relationship between gut microbiota and COPD and explore the potential mediating role of immune cells in this connection.

METHODS: This study employed a two-step Mendelian randomization (MR) analysis to investigate the causal effect of gut microbiota on COPD and explore the potential mediating role of immune cells in this relationship. The inverse variance weighted method served as the primary MR analysis method.

RESULTS: MR analyses revealed statistically significant genetic associations between 28 gut microbiota and COPD. Among these, the genus Coprococcus demonstrated the strongest causal effect on COPD risk, exhibiting a significant positive association (odds ratio (OR) = 1.18, 95% confidence interval (CI): 1.03-1.36, P = 0.03). Additionally, 15 immune cell traits displayed significant associations with Coprococcus. Notably, CD27 expressed on IgD^– CD38^– B cells emerged as a potential contributor to COPD development (OR = 1.04, 95% CI: 1.00-1.07, P = 0.03). We further explored the potential mediating effect of CD27 on IgD^– CD38^– B cells in the relationship between Coprococcus and COPD.

CONCLUSION: Our MR analysis provided evidence for a causal association between gut microbiota and COPD, potentially mediated by immune cells.

PMID:40626314 | PMC:PMC12232946 | DOI:10.2147/COPD.S518455

Front Pharmacol. 2025 Jun 23;16:1554650. doi: 10.3389/fphar.2025.1554650. eCollection 2025.

ABSTRACT

INTRODUCTION: Drug safety has increasingly become a serious public health problem that threatens health and damages social economy. The common detection methods have the problem of high false positive rate. This study aims to introduce deep learning models into the adverse drug reaction (ADR) signal detection and compare different methods.

METHODS: The data are based on adverse events collected by Center for ADR Monitoring of Guangdong. Traditional statistical methods were used for data preliminary screening. We transformed data into free text, extracted text information and made classification prediction by using the Long Short-Term Memory (LSTM) model. We compared it with the existing signal detection methods, including Logistic Regression, Random Forest, K-NearestNeighbor, and Multilayer Perceptron. The feature importance of the included variables was analyzed.

RESULTS: A total of 2,376 ADR signals were identified between January 2018 and December 2019, comprising 448 positive signals and 1,928 negative signals. The sensitivity of the LSTM model based on free text reached 95.16%, and the F1-score was 0.9706. The sensitivity of Logistic Regression model based on feature variables was 86.83%, and the F1-score was 0.9063. The classification results of our model demonstrate superior sensitivity and F1-score compared to traditional methods. Several important variables “Reasons for taking medication”, “Serious ADR scenario 4”, “Adverse reaction analysis 5”, and “Dosage” had an important influence on the result.

CONCLUSION: The application of deep learning models shows potential to improve the detection performance in ADR monitoring.

PMID:40626311 | PMC:PMC12230008 | DOI:10.3389/fphar.2025.1554650

Pediatr Discov. 2024 Jul 1;3(1):e98. doi: 10.1002/pdi3.98. eCollection 2025 Mar.

ABSTRACT

To provide a new minimally invasive treatment for children with benign thyroid nodules, and to provide clinical data for applying microwave ablation (MWA) to children. A retrospective analysis was conducted on the clinical data of 21 pediatric patients with benign thyroid nodules who underwent ultrasound-guided MWA at the Children’s Hospital affiliated with Chongqing Medical University from July 2022 to August 2023. The safety, clinical efficacy, volume reduction ratio and prognostic value of the treatment were evaluated. The participants were followed for at least 4 months (median 7 months, range 4-16 months). The average (range) ablation time for the 21 patients was only(233.90 ± 184.97) (40-660)seconds, with intraoperative bleeding less than 0.5 mL. No complications such as hoarseness, seizures or coughing during drinking water were observed after ablation treatment. All the participants’ hormone reflecting thyroid function remained in the normal ranges after treatment. Besides, these hormones at 12 h after surgery and 1 month after surgery were not statistically different from those before surgery. Immediate postoperative ultrasound imaging showed a significant decrease in volume of benign thyroid nodules, the volume of nodules at 1 month postoperatively (M, 1.39), and the volume of nodules at 4 months postoperatively (M, 0.40) significantly smaller than that before surgery (M, 4.94). Ultrasound-guided MWA is a new option for the treatment of benign thyroid nodules in children, with advantages such as minimal invasiveness, good clinical effect, high safety, little damage to thyroid function, short operation time, less intraoperative bleeding, low pain sensation and aesthetic appearance.

PMID:40626292 | PMC:PMC12118115 | DOI:10.1002/pdi3.98

Pediatr Discov. 2024 Aug 13;3(1):e2503. doi: 10.1002/pdi3.2503. eCollection 2025 Mar.

ABSTRACT

Undernutrition in children remains a public health concern. Despite the global efforts to address undernutrition, Lesotho continues to bear the highest burden of childhood undernutrition. The study assessed the anthropometric measurements and dietary intake of children aged 6-24 months. A descriptive cross-sectional study was conducted among 113 mother-child dyads attending clinic visits at Makoanyane Military Hospital (Maseru district); n = 50 and Motebang Hospital (Leribe district); n = 63. A structured sociodemographic and feeding practices questionnaires based on adapted World Health Organization (WHO) questionnaires were used. The usual food consumption was collected using an unquantified food frequency questionnaire. Anthropometric measurements and z scores computation were done as per WHO standard guidelines. Statistics included percentages for categorical variables and means for continuous variables. The percentage of continued breastfeeding was 54.0% in Maseru and 28.6% in Leribe districts. Complementary feeds were introduced at the mean age of 5.3 ± 1.0 (Maseru) and 5.2 ± 1.3 months (Leribe). In Leribe, 84.1% of children were consuming maize porridge every day while in Maseru, 68.0% of children were consuming commercial baby cereal every day. The prevalence of wasting was 10.0% (Maseru) and 20.6% with 14.3% of severe wasting (Leribe). A higher percentage of stunting was observed in Leribe (36.5%) than in Maseru (20.0%) (p < 0.001). The prevalence of moderate and severe stunting was 8.0% and 12.0% in Maseru and 20.6% and 15.9% in Leribe, respectively. The prevalence of stunting is alarmingly high in Leribe. The findings suggest an urgent need to strengthen maternal and child health and nutrition programs to ameliorate feeding practices and nutritional status.

PMID:40626290 | PMC:PMC12118112 | DOI:10.1002/pdi3.2503

Pediatr Discov. 2024 Dec 5;3(1):e2511. doi: 10.1002/pdi3.2511. eCollection 2025 Mar.

ABSTRACT

Due to the lack of studies examining suicide trends and its implications on pediatric populations, this study aimed to address the gap in research and to identify the magnitude and the impact of suicide by exploring trends in suicide among Mississippians from 2012 to 2022. The study uses data from the Mississippi Statistically Automated Health Resource System, which is an online database with data collected from vital statistics. Joinpoint regression models were used to calculate annual percentage change (APC) and average annual percentage change (AAPC) as an indicator of trends. The overall age-adjusted suicide rate increased from 9.4 deaths per 100,000 in 2012 to 10.8 deaths per 100,000 in 2022 for pediatric and adolescent patients aged 15-24 years (14.9% increase). There are upward trends for females (AAPC, 6.33%, 95% CI, -0.82%-16.82%), Blacks (AAPC, 7.72%, 95% CI, 2.19%-16.47%), and other races (AAPC, 7.59%, 95% CI, -0.83%-21.47%). Males had a downward trend from 2015 to 2022 (APC, -1.46%, 95 CI, -14.05%-1.35%). Whites also had a downward trend from 2017 to 2022 (APC, 4.74%, 95% CI, -15.42% to -0.96%). This study identified an overall increase in suicide. However, trends varied by gender, race, and age. Based on the findings, Mississippi needs more initiatives aimed toward equitable prevention of suicide among youth and the implementation of gun control policies. By implementing these measures, Mississippi could tremendously benefit and improve mental health outcomes and reduce suicide within the state.

PMID:40626287 | PMC:PMC12118103 | DOI:10.1002/pdi3.2511

Int J Breast Cancer. 2025 Jun 30;2025:5542692. doi: 10.1155/ijbc/5542692. eCollection 2025.

ABSTRACT

Introduction: The practice of mammography has transitioned from analog to digital with improved accuracy and significant changes to findings. This study was aimed at investigating the current patterns of breast diseases among women presenting for mammography at a major hospital in the Volta region of Ghana. Methods: This descriptive retrospective study reviewed 508 mammography and complimentary breast ultrasound reports conducted between October 2019 and May 2023. Because they were incomplete and had essential patient data missing, 28 reports (n = 28) were excluded. Data extracted from the reports included patients’ age, clinical indication, breast density, imaging impression, and BI-RADS classification for each breast. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 26, and results are presented using descriptive and inferential statistics. Results: The study involved 480 women, aged 40-86 years (mean = 54.6 ± 10.1). The distribution of the breast densities of the women was as follows: almost entirely fatty (n = 79, 16.46%), scattered areas of fibroglandular density (n = 226, 47.08%), heterogeneously dense (n = 145, 30.21%), and extremely dense (n = 30, 6.25%). There was a statistically significant association between age and breast density (p < 0.01). While 30 (6.25%) of the women presented for screening, 450 (93.75%) presented for diagnostic mammography. Breast pain (n = 189, 39.38%), breast lump/mass (n = 155, 32.29%), and suspected breast cancer (n = 47, 9.79%) were the most common clinical indications. The study recorded a total of 960 BI-RADS classifications of which 261 (27.19%) were negative and 699 (72.81%) were positive. Most of the positive findings (n = 521, 74.54%) were BI-RADS 2 and 3. Both benign and suspicious for malignancy or highly suggestive of malignancy lesions were common across women aged 40-50 years. There was a statistically significant association between age and BI-RADS classification (p < 0.01). Conclusion: This study showed that most of the women presented for diagnostic mammography. Attendance for screening mammography was poor among women presenting for mammography at the hospital; hence, women should be encouraged through health education and other campaign strategies to undergo screening mammography more regularly to facilitate more timely detection and diagnosis of breast diseases. A third of the women in our study had dense breasts. The vast majority of the women had positive findings, but the majority of these findings were indicative of benign breast diseases.

PMID:40626282 | PMC:PMC12234167 | DOI:10.1155/ijbc/5542692

Front Endocrinol (Lausanne). 2025 Jun 23;16:1600936. doi: 10.3389/fendo.2025.1600936. eCollection 2025.

ABSTRACT

PURPOSE: This study aims to create and validate a clinical prediction model to determine the optimal gonadotropin (Gn) starting dose in controlled ovarian stimulation (COS) protocols for normal ovarian response (NOR) patients undergoing their first IVF/ICSI-ET cycle.

METHODS: A retrospective analysis was conducted based on the data of the first IVF/ICSI-ET cycles of 535 patients from the Reproductive Medicine Department of the Fourth Hospital of Hebei Medical University between January 2017 and June 2024. The patients were randomly divided into a training group (n=317) and a validation group (n=218) in a 6:4 ratio. Linear regression analysis was applied to screen out the potential factors influencing the Gn starting dose, and the statistically significant factors were selected to construct a nomogram for Gn dosage. We used an internal verification method to ensure the reliability of the nomogram.

RESULTS: The patient’s age, body mass index (BMI), basal follicle-stimulating hormone (bFSH), antral follicle count (AFC), and anti-Müllerian hormone (AMH) were predictive indicators of the Gn starting dose for NOR patients undergoing IVF/ICSI-ET treatment (P<0.05). A predictive model was created based on the above indicators. Finally, the accuracy of this predictive model was validated by comparing the actual Gn starting doses with the predicted doses in both the training and the validation group. The results showed no significant difference between the actual and predicted Gn starting doses in the two groups (P>0.05).

CONCLUSION: Based on age, BMI, bFSH, AMH, and AFC, a clinician could determine the patient’s appropriate Gn starting dose for NOR patients undergoing IVF/ICSI-ET.

PMID:40626242 | PMC:PMC12229836 | DOI:10.3389/fendo.2025.1600936

Front Endocrinol (Lausanne). 2025 Jun 23;16:1548780. doi: 10.3389/fendo.2025.1548780. eCollection 2025.

ABSTRACT

OBJECTIVE: To examine the expression levels of miR-144-3p in the plasma of patients with gestational diabetes mellitus (GDM) and to construct a nomogram for predicting and evaluating factors influencing adverse pregnancy outcomes (APO) in GDM based on plasma miR-144-3p levels.

METHODS: This study included 442 pregnant women, comprising 216 diagnosed with GDM (GDM group) and 226 with normal glucose tolerance (NGT group). Plasma miR-144-3p levels in both groups were measured using reverse transcription real-time polymerase chain reaction (RT-qPCR). The diagnostic performance of plasma miR-144-3p for GDM was assessed by receiver operating characteristic (ROC) curve analysis. During pregnancy, the GDM group was followed, and outcomes were categorized into two groups: 132 with favorable pregnancy outcomes (FPO) and 84 with APO. A random number table method was applied to divide the GDM group into a training set (n=151) and a validation set (n=65) using a 7:3 ratio. Differences in variables across pregnancy outcome subgroups in the training set were examined. Univariate and multivariate logistic regression analyses were performed to identify risk factors for APO in GDM. Based on these factors, a nomogram prediction model was developed to estimate the risk of APO in GDM. The model’s performance was evaluated using area under the curve (AUC) analysis, calibration curve analysis, and decision curve analysis (DCA).

RESULTS: The expression of miR-144-3p was significantly higher in the GDM group than in the NGT group (p < 0.05). miR-144-3p showed an AUC of 0.877, with a sensitivity of 81.09% and a specificity of 91.20% for diagnosing GDM. No statistically significant differences were observed in general clinical characteristics between the training and validation sets. In the training set, gestational weight gain (GWG), the number of OGTT abnormalities, glycaemic control (GC), and miR-144-3p expression varied significantly between the APO and FPO subgroups (p < 0.05). Multivariate logistic regression analysis identified increased GWG, the number of OGTT abnormalities, poor GC, and higher miR-144-3p levels as independent risk factors for APO in GDM. The AUC of the nomogram based on these variables was 0.881 in the training set and 0.855 in the validation set. Calibration curves indicated good agreement between predicted and actual outcomes in both sets. The DCA showed a clear net clinical benefit and stable predictive utility.

CONCLUSION: Elevated plasma miR-144-3p levels in pregnant women with GDM may contribute to the occurrence of APO. The number of OGTT abnormalities and glycaemic control were also identified as independent risk factors. A nomogram incorporating miR-144-3p and these clinical indicators displays strong predictive accuracy and provides a practical tool for assessing APO risk in GDM.

PMID:40626241 | PMC:PMC12229801 | DOI:10.3389/fendo.2025.1548780

Med Devices (Auckl). 2025 Jul 2;18:361-375. doi: 10.2147/MDER.S520191. eCollection 2025.

ABSTRACT

IMPORTANCE: Safety issues leading to patient harm and significant costs have been identified in several post-market medical devices. Recently, powerful learning effects (LE) have been documented in numerous medical devices. Correctly attributing safety signals to learning or device effects allows for appropriate corrective actions and recommendations to improve patient safety.

OBJECTIVE: To develop and assess the statistical performance of an analytic framework to detect the presence of LE and quantify the learning curve (LC).

DESIGN AND SETTING: We generated synthetic datasets based on observed clinical distributions and complex feature correlations among patients hospitalized at US Department of Veterans Affairs facilities. Each dataset represents a hypothetical early experience in the use of high-risk medical devices, with a device of interest and a reference device. The study blinded the analysis team to the data-generation process.

METHODS: We developed predictive models using generalized additive models and estimated LC parameters using the Levenberg-Marqualdt algorithm. We evaluated the performance using sensitivity, specificity, and likelihood ratio (LR) in detecting the presence of LE and, if present, the goodness-of-fit of the estimated LC based on the root-mean squared error.

RESULTS: Among the 2483 simulated datasets, the median (IQR) number of cases was 218,000 (116,000-353,000). LE were detected in 2065 of the 2291 datasets for which learning was specified (sensitivity: 90%; specificity: 88%; LR: 7). We adequately estimated the LC in 1632 (81%) of the 2013 datasets in which LE was detected and estimated LC.

DISCUSSION: This study demonstrated the framework to be robust in disentangling LE from device safety signals and in estimating LC.

CONCLUSION: In medical device safety evaluation, the operator-learning effects associated with the safety of medical devices can be effectively modeled and characterized. This study warrants subsequent framework validation by using real-world clinical datasets.

PMID:40626234 | PMC:PMC12230321 | DOI:10.2147/MDER.S520191

Front Nutr. 2025 Jun 23;12:1560617. doi: 10.3389/fnut.2025.1560617. eCollection 2025.

ABSTRACT

BACKGROUND: Sarcopenia is a systemic disease characterized by a decline in muscle mass and function. It is associated with adverse health outcomes, and younger patients are at higher risk. Thus, early identification and prevention of high-risk factors are crucial. The uric acid to high-density lipoprotein ratio (UHR) is a novel marker of inflammation and metabolism, but studies on its association with sarcopenia are currently lacking.

METHODS: Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were utilized. Weighted multivariate logistic regression analysis was performed to explore the association between UHR and sarcopenia. Causal mediation analysis was conducted to investigate the mediating role of oxidative stress factors and systemic inflammatory markers in the UHR-sarcopenia relationship. Subgroup analysis and interaction tests were performed to identify high-risk populations for the positive association between UHR and sarcopenia. Restricted cubic spline (RCS) explored potential non-linear relationships between UHR and sarcopenia. Weighted multivariate Cox proportional hazards regression analysis assessed the relationship between UHR and all-cause mortality in sarcopenia patients.

RESULTS: A total of 10,308 adult participants aged ≥ 20 years were included in the study, with 901 diagnosed with sarcopenia. The weighted multivariate logistic regression analysis showed a significant positive association between UHR and sarcopenia after adjusting for all confounding factors (OR = 1.057; 95% CI: 1.037-1.077; P < 0.001). Total bilirubin mediated -8.53% of the association between UHR and sarcopenia (95% CI: -13.42% to -5.91%; P < 0.001). The subgroup analysis and interaction test results indicate that the positive association between the two variables is relatively stable across different populations. RCS analysis revealed no significant non-linear relationship between UHR and sarcopenia (P = 0.167). Weighted multivariate Cox proportional hazards regression analysis showed a significant positive association between UHR and all-cause mortality in sarcopenia patients (HR = 1.053; 95% CI: 1.024-1.083; P < 0.001) in the unadjusted model. However, after adjusting for all covariates, UHR maintained a positive association with all-cause mortality in sarcopenia patients (HR = 1.023; 95% CI: 0.990-1.056), though this association did not reach statistical significance (P = 0.173).

CONCLUSION: Elevated UHR shows a significant association with sarcopenia prevalence and exhibits a positive association trend with all-cause mortality among affected individuals. These findings suggest that UHR may serve as a potential indicator for sarcopenia risk assessment. Further prospective studies are warranted to validate its clinical utility for early screening and intervention strategies.

PMID:40626224 | PMC:PMC12229869 | DOI:10.3389/fnut.2025.1560617