Nevin Manimala

JSES Int. 2025 Dec 1;10(2):101411. doi: 10.1016/j.jseint.2025.101411. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: A common concern of patients after rotator cuff repair is when they can drive. The purpose of this study is to evaluate the activation of the rotator cuff while driving to help guide surgeon recommendations.

METHODS: A computerized driving simulator was used by 16 volunteers who performed a series of turns with their hands in different positions on the steering wheel. Muscle activity of the supraspinatus, infraspinatus, and biceps was recorded using electromyography. Muscle activity was also recorded while closing the door, fastening the seat belt, and turning a key in the ignition and quantified by a board-certified electromyographer.

RESULTS: For the right supraspinatus, infraspinatus, and biceps muscles, there was statistically significant higher level of activation when the right hand was in the 12 o’clock position and the 3 o’clock position as compared with the 6 o’clock positions. This was the same for the left side with the left hand in the 12 o’clock and 9 o’clock positions compared to the 6 o’clock positions (P < .003). Activity of all muscles was minimal when the car door was closed with the opposite hand. Fastening the seat belt and turning the key in the ignition also demonstrated rotator cuff activation.

CONCLUSION: Rotator cuff activity during driving can be minimized by closing the door using the nonoperative arm and driving with the nonoperative arm in the 12 o’clock position with the operative arm at the side and holding the wheel at the 6 o’clock position.

PMID:41562106 | PMC:PMC12814054 | DOI:10.1016/j.jseint.2025.101411

Front Immunol. 2026 Jan 5;16:1717935. doi: 10.3389/fimmu.2025.1717935. eCollection 2025.

ABSTRACT

INTRODUCTION: The manipulation of the gut microbiota of disease vectors has emerged as a new approach to use in the integrated control of vector-borne diseases. For this purpose, a deep knowledge of their gut microbial communities is essential. To our knowledge, to date, no study has documented the gut microbiome dynamics of Phlebotomus duboscqi sand flies over the entire time-period required for the maturation of a Leishmania infection. Here, we address this limitation.

METHODS: P. duboscqi midguts were dissected both before and at different days after L. major infection and subjected to genomic DNA extraction followed by amplification of the V3-V4 hypervariable regions of the 16S rRNA, sequencing, and metagenomics analysis.

RESULTS: We observed a decrease in the number of Amplicon Sequence Variants (ASVs) early after infection, at D2, and late after infection, at D12. More so Sphingomonas, Ochrobactrum, and Serratia emerged as the most prevalent genera in relative terms, before, early after, and late after infection, respectively. These results translated into a separation between the 3 groups in the context of a beta diversity analysis, with statistical relevance. Importantly, we were able to establish Corynebacterium spp. and Enterococcus spp. as potential markers of non-infected and infected sand flies, respectively, as well as Streptococcus spp., Sphingomonas spp., Ralstonia spp., and Abiotrophia spp. as potential specific markers of late infections (ANCOM-BC analysis).

DISCUSSION: Overall, we show that the composition of the gut microbiota of P. duboscqi sand flies changes significantly over the course of an infection with L. major parasites.

PMID:41562094 | PMC:PMC12812887 | DOI:10.3389/fimmu.2025.1717935

Front Immunol. 2026 Jan 5;16:1698271. doi: 10.3389/fimmu.2025.1698271. eCollection 2025.

ABSTRACT

INTRODUCTION: Long COVID (LC) is an infection-associated chronic condition and illness (IACCI) with no currently approved treatments. In order to address SARS-CoV-2 persistence and herpesvirus reactivation, which have been implicated as drivers of LC, sustained use of antiviral combinations may be useful in treating patients with the illness.

METHODS: A convenience sample of patients undergoing an extended course of antiviral therapy was studied. Patients received either 120 days of IMC-2 only (IO) or 120 days of IMC-2 with the addition of 15 days of Paxlovid (IP), prescribed off-label at an outpatient clinic for people with LC. The Patient Global Impression of Change (PGIC) was used to measure therapy response over time, with primary focus on fatigue and secondary focus on brain fog and dysautonomia. Visual analog scales (VAS) were also used to track perceived symptom improvements.

RESULTS: A total of 27 people with LC were approached for treatment, of whom 24 completed one or both protocols. Twelve received the IO protocol, and 12 received the continuous IP combination. Both groups reported reductions in fatigue on the PGIC, but participants receiving IP experienced a statistically significant improvement compared with those receiving IO (p < 0.0001). Similarly, using a VAS, patients in the IP group reported an average 55.3% (p < 0.0001) greater reduction in fatigue than the IO group. Participants who completed the IP intervention demonstrated durable clinical benefit, with symptom improvements remaining consistent at 120-, 305-, and 731-day follow-ups.

DISCUSSION: This small, open-label case series provides pilot evidence supporting the need for a larger trial of combination antivirals for people living with LC. Based on these results, a larger, controlled trial of IMC-2 paired with Paxlovid is recommended.

PMID:41562079 | PMC:PMC12812670 | DOI:10.3389/fimmu.2025.1698271

Front Immunol. 2026 Jan 5;16:1641260. doi: 10.3389/fimmu.2025.1641260. eCollection 2025.

ABSTRACT

AIM: This study aimed to evaluate serum visfatin levels in treated patients with Relapsing-Remitting Multiple Sclerosis (RRMS) (PwMS) receiving disease-modifying therapy (DMT) and in naive MS patients (nMS), and to investigate their association with clinical characteristics, treatment status, and disease activity, including NEDA-3 status.

METHODS: A total of 45 PwMS under treatment at least 1 year, 20 nMS patients, and 44 age- and sex-matched healthy controls (HC) were included. Clinical and demographic data were recorded. Serum visfatin, lipid profiles, inflammatory markers, and vitamin levels were measured. Visfatin levels were compared not only between treated and naive MS patients but also within the treated group according to NEDA-3 status and treatment type (first-line vs. second-line disease-modifying therapy). Statistical analyses were performed to assess group differences and correlations.

RESULTS: Visfatin levels differed significantly across the three groups (Kruskal-Wallis H = 19.701, p < 0.001). Pairwise comparisons revealed significant differences between all groups: the control group had higher visfatin levels than both the nMS (p < 0.001) and PwMS (p = 0.006). The treated group also showed higher visfatin levels compared to the naive MS group (p = 0.014). Among PwMS visfatin levels were lower than in healthy controls (p = 0.006). Among PwMS patients, those meeting the NEDA-3 criteria had lower visfatin levels and EDSS scores compared with non-NEDA patients (p = 0.008 and p = 0.006, respectively). No significant correlation was found between visfatin and relapse count or EDSS. LDL and total cholesterol levels were significantly higher in patients receiving fingolimod.

CONCLUSION: Across the three groups, visfatin levels differed significantly, with healthy controls showing the highest levels, followed by PwwMS, and the lowest levels observed in nMS patients. Lower serum visfatin levels in stable treated MS patients may reflect reduced inflammatory burden and effective immunomodulation. These findings suggest that visfatin could serve as a potential biomarker for treatment response in MS. Nevertheless, longitudinal studies including larger cohorts of naive patients are needed to clarify visfatin’s regulatory role in MS pathophysiology and its interaction with disease-modifying therapies.

PMID:41562070 | PMC:PMC12812522 | DOI:10.3389/fimmu.2025.1641260

Ann Appl Stat. 2025 Dec;19(4):3372-3393. doi: 10.1214/25-aoas2112. Epub 2025 Dec 5.

ABSTRACT

Major depressive disorder (MDD), a leading cause of disability and mortality, is associated with reward-processing abnormalities and concentration issues. Motivated by the probabilistic reward task from the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study, we propose a novel framework that integrates the reinforcement learning (RL) model and drift-diffusion model (DDM) to jointly analyze reward-based decision-making with response times. To account for emerging evidence suggesting that decision-making may alternate between multiple interleaved strategies, we model latent state switching using a hidden Markov model (HMM). In the engaged state, decisions follow an RL-DDM, simultaneously capturing reward processing, decision dynamics, and temporal structure. In contrast, in the lapsed state, decision-making is modeled using a simplified DDM, where specific parameters are fixed to approximate random guessing with equal probability. The proposed method is implemented using a computationally efficient generalized expectation-maximization (EM) algorithm with forward-backward procedures. Through extensive numerical studies, we demonstrate that our proposed method outperforms competing approaches across various reward-generating distributions, under both strategy-switching and non-switching scenarios, as well as in the presence of input perturbations. When applied to the EMBARC study, our framework reveals that MDD patients exhibit lower overall engagement than healthy controls and experience longer responses when they do engage. Additionally, we show that neuroimaging measures of brain activities are associated with decision-making characteristics in the engaged state but not in the lapsed state, providing evidence of brain-behavior association specific to the engaged state.

PMID:41562021 | PMC:PMC12814034 | DOI:10.1214/25-aoas2112

Res Vet Sci. 2026 Jan 13;202:106064. doi: 10.1016/j.rvsc.2026.106064. Online ahead of print.

ABSTRACT

Eucoleus aerophilus is a ubiquitous zoonotic nematode found in the tracheobronchial mucosa of the definitive hosts, described in wild and domestic canids, including the red fox (Vulpes vulpes). To assess E. aerophilus occurrence and intensity in red foxes, the respiratory system of 126 foxes from Region of Murcia (SE, Spain) were examined. Statistical analyses were performed to investigate the influence of biotic and abiotic factors on the parasite’s occurrence. The occurrence of E. aerophilus was 28.6% (95% CI: 20.6-36.4), with a mean intensity of 3.1 nematodes per parasitised fox. The infection rate and parasite intensity were higher in forested areas, suggesting that earthworm abundance and a longer survival of infective E. aerophilus eggs increase the risk of transmission and maintenance in the environment. Moreover, an inverse relationship between E. aerophilus occurrence and temperature (p < 0.05) was observed. Results demonstrated that foxes participate in maintaining the cycle of E. aerophilus in semi-arid Mediterranean environments. This should be taken into account at the wild-domestic-human interface. The development of a predictive model of E. aerophilus infection risk in red foxes will allow the design of future strategies for the prevention of capillariosis, especially in areas where contact between foxes, domestic carnivores, and humans exists.

PMID:41558101 | DOI:10.1016/j.rvsc.2026.106064

J Neurol Sci. 2026 Jan 17;481:125762. doi: 10.1016/j.jns.2026.125762. Online ahead of print.

ABSTRACT

Identifying accessible and reliable biomarkers for Alzheimer’s disease (AD) remains a major challenge, particularly in low- and middle-income countries. Phosphorylated tau at threonine 181 (p-tau181) measured in plasma has shown strong diagnostic performance, but its potential in saliva, a truly noninvasive biofluid, remains uncertain. This study compared plasma and salivary p-tau181 levels, assessed their agreement, and evaluated their diagnostic accuracy in a Latin American cohort. Eighty participants were clinically classified as cognitively unimpaired (CU, n = 25), mild cognitive impairment (MCI, n = 22), or Alzheimer’s dementia (AD, n = 33). Plasma and salivary p-tau181 concentrations were quantified using Single Molecule Array (Simoa) assays. Salivary p-tau181 levels were markedly higher than plasma levels (900.26 vs. 26.67 pg/mL; p < 0.001) but showed no correlation. Bland-Altman analysis revealed a mean bias of -1.56 with significant proportional bias (β = 0.73; p < 0.001), and Passing-Bablok regression confirmed the absence of a linear relationship between matrices. Plasma p-tau181 showed a numerical increase across the cognitive continuum, reaching statistically significant differences only when AD was compared with CU and MCI (AUC = 0.82; 95% CI 0.73-0.92), whereas salivary p-tau181 failed to discriminate clinical groups (AUC = 0.55, ns). These results demonstrate that plasma and salivary p-tau181 are not interchangeable and that current saliva-based quantification methods lack clinical reliability. This study provides the first evidence from Latin America supporting the diagnostic validity of plasma, but not salivary, p-tau181, and highlights the need for further investigation into pre-analytical and biological determinants of salivary biomarker variability.

PMID:41558095 | DOI:10.1016/j.jns.2026.125762

Cir Cir. 2025;93(6):599-607. doi: 10.24875/CIRU.24000235.

ABSTRACT

OBJECTIVE: This study was conducted to investigate the levels of nuclear factor (erythroid derivative 2)-like 2 (NRF-2), kidney injury molecule 1 (KIM-1), and heme oxygenase-1 (HO-1) in pericardial fluid (PF) and systemic circulation of patients undergoing cardiac surgery.

METHODS: This study included 40 patients undergoing cardiac surgery and 40 healthy individuals. PF and venous blood samples were obtained from the patients and renal function tests, HO-1, KIM-1, NRF-2, antioxidant, and oxidative stress parameters were studied.

RESULTS: A statistically significant difference was found in the NRF-2, KIM-1, HO-1, total antioxidant status, total oxidant status, and oxidative stress index measurements in the plasma of the patient and control groups and in the PF of the patients (p < 0.01). Compared to the control group, NRF-2, KIM-1, and HO-1 were found to be lower in the patient’s plasma and PF. In the patient group, NRF-2, KIM-1, HO-1, and KIM-1 were higher in PF compared to plasma.

CONCLUSIONS: In the future, intrapericardial drug administration may improve cardiac function and prevent the adverse cardiorenal syndrome on the kidney.

PMID:41558054 | DOI:10.24875/CIRU.24000235

Cir Cir. 2025;93(6):678-684. doi: 10.24875/CIRU.24000278.

ABSTRACT

OBJECTIVE: Determine the level of inclusion in hospital disaster risk management of the Mexican Social Security Institute.

METHODS: The methodology Disability Inclusion in Hospital Disaster Risk Management (INGRID-H) of the Pan American Health Organization was adapted for self-assessment in 276 hospitals. Expert advice sessions were conducted using a cascade format, including verification visits, and 180 days between each evaluation.

RESULTS: In the first self-assessment, 220 hospitals submitted their reports, and in the second, 236. 186 met inclusion criteria and were selected for analysis. In the first self-assessment the mean obtained for the level of inclusion was 36.70%, and in the second was 52.03%, with a correlation of 0.410 and p < 0.001, with a confidence interval of 95%, being statistically significant.

CONCLUSIONS: The adaptation of the INGRID-H tool using self-assessments and tutorials with experts made it possible to obtain a national diagnosis and increase the level of inclusion for disaster risk management in hospitals.

PMID:41558050 | DOI:10.24875/CIRU.24000278

Cir Cir. 2025;93(6):608-612. doi: 10.24875/CIRU.25000107.

ABSTRACT

OBJECTIVE: The objective of this study was to determine whether there is a change in feto-maternal circulation after amniocentesis (AS) using Doppler ultrasonography.

METHODS: In this prospectively designed study, fetuses with singleton pregnancies between 16 and 22 weeks of gestational age with an indication for invasive testing and a healthy AS result were included. Twin pregnancies, fetuses with major anomalies as determined by ultrasound evaluation, and fetuses with chromosomal or genetic diseases resulting from AS were excluded from the study.

RESULTS: A total of 73 patients who underwent AS according to the risky screening result were included in the study. Fetal Doppler measurements were performed at three different time periods. The parameters that were analyzed included the fetal umbilical artery, the ductus venosus, and the maternal right and left uterine arteries. The analysis revealed no statistically significant differences between the measurements.

CONCLUSIONS: It has been observed that AS, the most commonly used invasive diagnostic procedure in clinical practice, does not affect feto-maternal circulation and fetal heart function.

PMID:41558047 | DOI:10.24875/CIRU.25000107