Nevin Manimala

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

Cir Cir. 2025;93(6):659-668. doi: 10.24875/CIRU.23000532.

ABSTRACT

OBJECTIVE: Different from physiological pain, post-operative pain is caused by surgical trauma. We aimed to systematically assess the effects of ropivacaine alone or in combination with dexmedetomidine on cesarean section and to conduct a meta-analysis.

METHODS: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and Cochrane intervention system review manual, retrieval software and data analysis tools were used for literature retrieval, screening, exclusion and inclusion, data extraction, analysis and statistics, and risk assessment. A total of 37 literatures were retrieved, and 11 literatures were left after 26 duplicates were excluded.

RESULTS: A total of 37 literatures were retrieved in all databases, of which 11 literatures were left and finally 7 all published in English were obtained. They were seven randomized controlled trials on ropivacaine alone or in combination with dexmedetomidine applied in 502 parturients receiving cesarean section. The results of meta-analysis on main outcome indices showed that the number of parturients in need of rescue (c² = 28.62, p < 0.001, I² = 93%), incidence rate of adverse reactions (c² = 28.66, p = 0.007, I² = 55%), satisfaction (c² = 7.97, p = 0.05, I² = 62.3%), visceral respiratory response (c² = 19.26, p < 0.001, I² = 89.6%), satisfaction with muscle relaxation (c² = 6.92, p = 0.03, I² = 71.1%), and spinal anesthesia grade (c² = 25.89, p < 0.01, I² = 92.3%).

CONCLUSIONS: Ropivacaine combined with dexmedetomidine has a better prognostic effect on cesarean section and causes fewer adverse reactions.

PMID:41558045 | DOI:10.24875/CIRU.23000532

Cir Cir. 2025;93(6):620-627. doi: 10.24875/CIRU.24000285.

ABSTRACT

OBJECTIVE: We aimed to evaluate the role of attenuation values of perirenal fat calculated by computed tomography (CT) in differentiating aggressive renal masses.

METHODS: The data of 83 patients with histologically confirmed local stage renal cell carcinoma (RCC), who were treated with nephrectomy in our center, and 78 control group cases were analyzed. All measurements including renal mass volume, abdominal subcutaneous fat area and subcutaneous fat area pelvic subcutaneous fat area, and perirenal fat thickness and Hounsfield unit (perirenal fat tissue thickness [PFT]-hounsfield unit of perirenal fat [PFHU]) were performed on CT by the same radiologist.

RESULTS: In the statistical analysis of PFT and PFHU measurements between the groups, fat thickness was found to be lower in the patient group compared with the control group. However, hounsfield unit measurements were statistically significantly higher in the patient group (p < 0.0001). A cutoff value of -98.1 for the PFHU can identify the patient group with a sensitivity of 89.2% and a specificity of 84.6% (area under the curve = 0.9; 95% confidence interval: 0.86-0.95 p < 0.0001). In the multivariate logistic regression analysis, a PFHU ≥ -98.1 was independently associated with RCC after accounting for clinical and radiologic parameters.

CONCLUSION: We believe that measurement of the HU values of perirenal adipose tissue with the CT may be useful in differentiating aggressive renal masses and therefore in determining the appropriate treatment selection.

PMID:41558043 | DOI:10.24875/CIRU.24000285

Stat Methods Med Res. 2026 Jan 20:9622802251414594. doi: 10.1177/09622802251414594. Online ahead of print.

ABSTRACT

The identification of latent profile trajectories in longitudinal studies represents an important challenge for specialists since they could provide insights to better understand their problem of interest. The majority of the statistical methodologies for cluster analysis for longitudinal data are based on growth curve or mixed-effects models, and often incorporate covariates for a better adjustment. In particular, for Bayesian nonparametric methods, Dirichlet process mixture models are widely used together. We propose a clustering methodology for longitudinal data based on mixture models generated by a discrete random probability measure whose weights are decreasingly ordered by construction. Additionally, data is modeled without making use of covariates and assuming independence across time for individual measurements. Our approach also provides a straightforward procedure to merge some estimated groups, since it could happen that there are many of them, to be easily explained by experts. Our results suggest that, at least for a first analysis, this framework is enough to effectively detect groups in the data; further exploration of each group could incorporate extra information. We apply our methodology for detecting adiposity trajectories in Mexican children in a secondary analysis of the “Prenatal Omega-3 fatty acid Supplementation and Child Growth and Development” study (POSGRAD) cohort.

PMID:41558037 | DOI:10.1177/09622802251414594