Nevin Manimala

Arch Public Health. 2025 Apr 15;83(1):105. doi: 10.1186/s13690-025-01593-5.

ABSTRACT

BACKGROUND & OBJECTIVES: Smokeless tobacco (SLT) use is a global burden, and its long-term use can result in health issues like oral cancers, oral potentially malignant disorders, etc. This review assessed the effectiveness of behavioural and pharmacological interventions for SLT cessation, adding new dimensions to the evidence found earlier in the literature, including recent trials.

SEARCH METHODS: Four electronic databases were used in the search: PubMed, Scopus, Cochrane, and Web-of-Science. Study Selection included randomized control trials (RCTs) comparing pharmacological and behavioural interventions with or without placebo to help users quit SLT with 3 & 6 months follow-up. Two review writers who separately evaluated abstracts for possible inclusion extracted data from included trials. Mantel-Haenszel’s random-effect method was used to assess pooled effects for trial subgroups. Furthermore, the effectiveness of the intervention was evaluated from the reported odds ratios, confidence intervals and quit rates.

RESULTS: Nineteen, consisting of 4575 participants, fulfilled the requirements to be listed in the review. A significant difference was observed at 6 months for pharmacological versus behavioural intervention with a low heterogeneity at a 95% confidence interval. Pooling the fifteen pharmacotherapy-versus-behavioural modification studies in adults, we discovered that pharmacotherapy had a statistically significant impact on raising quit rates by the conclusion of the follow-up period (OR 1.21, 95% CI 1.03 to 1.43; 3271 participants) with low heterogeneity (I² = 19%).

CONCLUSION: Worldwide, there has been minimal data on interventions for SLT cessation, yet the pharmacological interventional methods have been found to be comparatively effective than behavioural intervention. Adequate awareness, health care professionals training, and law implementation are necessary to achieve habit cessation.

CLINICAL TRIAL NUMBER: Not Applicable. The present systematic review is registered in PROSPERO’s International Prospective Register of Systematic Reviews (registration number CRD42023399178 dated 13th Feb 2023).

PMID:40235012 | DOI:10.1186/s13690-025-01593-5

Arch Public Health. 2025 Apr 15;83(1):107. doi: 10.1186/s13690-025-01579-3.

ABSTRACT

BACKGROUND: Self-medication with antibiotics (SMA) is increasingly occurring worldwide, yet it is a process that can lead to inappropriate use of antibiotics, with potentially multiple adverse consequences such as an increased risk of antibiotic resistance.

OBJECTIVE: The objective of this study is to assess the prevalence of self-medication with antibiotics among the Chinese population and investigate the factors associated with this behavior.

METHODS: A multi-stage sampling method was employed to carry out a national cross-sectional questionnaire survey among Chinese individuals aged 18 years and above from July 10, 2021, to September 15, 2021. Following the statistical analysis of the collected data, binary logistic regression was applied to identify the factors associated with respondents’ self-medication with antibiotics. Model robustness testing was also performed using best subset regression.

RESULTS: From a total of 11,031 questionnaires, 9,344 qualified samples were selected. The prevalence of self-medication with antibiotics among Chinese residents was found to be 34.63% (3,237/9,344). The most important factor considered in SMA was the advice of medical professionals, accounting for 89.00%, including recommendations from doctors (2,524/3,237, 77.97%) and pharmacists (1,905/3,237, 58.85%). The results of the binary stepwise logistic regression analysis showed that female, people older than 36 years, with higher education, had consumed alcohol in the past month, with mild depression, having residential or employee health insurance as the primary form of health coverage, having commercial insurance, having better family health status, and perceiving higher levels of social support were more likely to practice SMA (P < 0.05). Conversely, individuals diagnosed with major depressive disorder were found to be less likely to engage in self-medication with antibiotics (P < 0.05). The best subset regression method and stepwise regression method gave the same results.

CONCLUSION: The SMA issue of Chinese residents is still relatively serious. Residents’ SMA was associated with their demographic and sociological characteristics, depression, family health, and perceived level of social support. The primary consideration for resident SMA is the advice of medical staff. The problem of SMA in China should be improved through antibiotic management, education on antibiotic knowledge, and medical staff’s correct guidance.

PMID:40234996 | DOI:10.1186/s13690-025-01579-3

Mol Autism. 2025 Apr 15;16(1):24. doi: 10.1186/s13229-025-00657-1.

ABSTRACT

BACKGROUND: Divergent age-related functional brain connectivity in autism spectrum disorder (ASD) has been observed using resting-state fMRI, although the specific findings are inconsistent across studies. Common statistical regression approaches that fit identical models across functional brain networks may contribute to these inconsistencies. Relationships among functional networks have been reported to follow unique nonlinear developmental trajectories, suggesting the need for flexible modeling. Here we apply generalized additive models (GAMs) to flexibly adapt to distinct network trajectories and simultaneously describe divergent age-related changes from childhood into mid-adulthood in ASD.

METHODS: 1107 males, aged 5-40, from the ABIDE I & II cross-sectional datasets were analyzed. Functional connectivity was extracted using a network-based template. Connectivity values were harmonized using COMBAT-GAM. Connectivity-age relationships were assessed with thin-plate spline GAMs. Post-hoc analyses defined the age-ranges of divergent aging in ASD.

RESULTS: Typically developing (TD) and ASD groups shared 15 brain connections that significantly changed with age (FDR-corrected p < 0.05). Network connectivity exhibited diverse nonlinear age-related trajectories across the functional connectome. Comparing ASD and TD groups, default mode to central executive between-network connectivity followed similar nonlinear paths with no group differences. Contrarily, the ASD group had chronic hypoconnectivity throughout default mode-ventral attentional (salience) and default mode-somatomotor aging trajectories. Within-network somatomotor connectivity was similar between groups in childhood but diverged in adolescence with the ASD group showing decreased within-network connectivity. Network connectivity between the somatomotor network and various other functional networks had fully disrupted age-related pathways in ASD compared to TD, displaying significantly different model curvatures and fits.

LIMITATIONS: The present analysis includes only male participants and has a restricted age range, limiting analysis of early development and later life aging, years 40 and beyond. Additionally, our analysis is limited to large-scale network cortical functional parcellation. To parse more specificity of brain region connectivity, a fine-grained functional parcellation including subcortical areas may be warranted.

CONCLUSION: Flexible non-linear modeling minimizes statistical assumptions and allows diagnosis-related brain connections to follow independent data-driven age-related pathways. Using GAMs, we describe complex age-related pathways throughout the human connectome and observe distinct periods of divergence in autism.

PMID:40234995 | DOI:10.1186/s13229-025-00657-1

Breast Cancer Res. 2025 Apr 15;27(1):55. doi: 10.1186/s13058-025-01995-x.

ABSTRACT

BACKGROUND: Among premenopausal women, higher body mass index (BMI) is associated with lower breast cancer risk, although the underlying mechanisms are unclear. Investigating adiposity distribution may help clarify impacts on breast cancer risk. This study was initiated to investigate associations of central and peripheral adiposity with premenopausal breast cancer risk overall and by other risk factors and breast cancer characteristics.

METHODS: We used individual-level data from 14 prospective cohort studies to estimate hazard ratios (HRs) for premenopausal breast cancer using Cox proportional hazards regression. Analyses included 440,179 women followed for a median of 7.5 years (interquartile range: 4.0-11.3) between 1976 and 2017, with 6,779 incident premenopausal breast cancers.

RESULTS: All central adiposity measures were inversely associated with breast cancer risk overall when not controlling for BMI (e.g. for waist circumference, HR per 10 cm increase: 0.92, 95% confidence interval (CI): 0.90-0.94) whereas in models adjusting for BMI, these measures were no longer associated with risk (e.g. for waist circumference: HR 0.99, 95% CI: 0.95-1.03). This finding was consistent across age categories, with some evidence that BMI-adjusted associations differed by breast cancer subtype. Inverse associations for in situ breast cancer were observed with waist-to-height and waist-to-hip ratios and a positive association was observed for oestrogen-receptor-positive breast cancer with hip circumference (HR per 10 cm increase: 1.08, 95% CI: 1.10-1.14). For luminal B, HER2-positive breast cancer, we observed an inverse association with hip circumference (HR per 10 cm: 0.84, 95% CI: 0.71-0.98), but positive associations with waist circumference (HR per 10 cm: 1.18, 95% CI: 1.03-1.36), waist-to-hip ratio (HR per 0.1 units: 1.29, 95% CI: 1.15-1.45) and waist-to height ratio (HR per 0.1 units: 1.46, 95% CI: 1.17-1.84).

CONCLUSIONS: Our analyses did not support an association between central adiposity and overall premenopausal breast cancer risk after adjustment for BMI. However, our findings suggest associations might differ by breast cancer hormone receptor and intrinsic subtypes.

PMID:40234955 | DOI:10.1186/s13058-025-01995-x

J Health Popul Nutr. 2025 Apr 15;44(1):119. doi: 10.1186/s41043-025-00858-7.

ABSTRACT

INTRODUCTION: Several epidemiological studies have reported inconsistent findings on the association between carotenoid intake and fracture risk. This study aimed to determine the association between individual carotenoid intake and fracture risk.

METHODS: A cross-sectional study based on data from the National Health and Nutrition Examination Survey (NHANES), 2013-2018. This study identified elderly individuals with valid and complete data on carotenoid intake and fracture risk. The average dietary intakes of α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein + zeaxanthin was taken based on the two 24-hour recall interviews. Matching was done based on age, sex, and body mass index (BMI). Logistic regression models were used to test the associations between carotenoids and fracture risk. All analyses were performed by using R (version 3.4.3; R Foundation for Statistical Computing, Vienna, Austria).

RESULTS: A total of 5491 (1140 cases and 4351 control) subjects were included in this study. The average age of the subjects was 55.62 ± 14.84 years old. In the adjusted model, the risk of osteoporotic fracture was decreased by 6.2% (odd ratio (OR): 0.938; 95% confidence interval (CI): 0.699 to 0.989) and 1.4% (OR 0.986; 95% CI: 0.975 to 0.997) for dietary intake of beta-carotene and lycopene, respectively.

CONCLUSIONS: Dietary intakes of beta-carotene and lycopene have significantly reduced the risk of osteoporotic fracture among the elderly population in the United States of America.

PMID:40234943 | DOI:10.1186/s41043-025-00858-7

Lipids Health Dis. 2025 Apr 15;24(1):139. doi: 10.1186/s12944-025-02560-3.

ABSTRACT

IMPORTANCE: Visceral adiposity index (VAI) vividly reflects body fat distribution through comprehensively integrating body mass index, sex, waist circumference, triglycerides, and high-density lipoprotein cholesterol. While VAI is an established predictor of various clinical outcomes, its relationship with premature mortality and life expectancy remains unclear.

OBJECTIVE: To explore the association between VAI and premature mortality or life expectancy in a nationally representative cohort of US adults.

METHODS: This study included adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, linked to the National Death Index through December 31, 2019. Data were analyzed from August to October, 2024. VAI was categorized into quartiles from the lowest Q1 to the highest Q4. Primary endpoints were premature mortality (death before 80 years of age) and life expectancy.

RESULTS: A total of 43,672 participants (women: 22,164; men: 21,508) aged > 20 years were included. Over a median follow-up of 9.2 years (IQR: 4.9-13.8), 3,187 premature deaths were documented. Higher VAI quartiles were significantly associated with increased multi-adjusted premature mortality risk compared to Q1 (Q3 vs. Q1: hazard ratio [HR], 95% confidence interval [CI]: 1.30, 1.05 to 1.61; Q4 vs. Q1: 1.68, 1.34 to 2.11). This association was particularly pronounced in women (Q3 vs. Q1: 1.53, 1.01 to 2.30; Q4 vs. Q1: 2.36, 1.52 to 3.68), with significant linear trends (P < 0.001). Estimated life expectancy at age 40 years was 41.45 (95% CI: 41.24 to 41.66), 41.32 (41.11 to 41.53), 40.55 (40.35 to 40.75), and 39.26 (39.08 to 39.45) years in Q1, Q2, Q3, and Q4 of VAI, respectively. By sex, estimated life expectancy at age 40 in Q4 was reduced by 3.33 years in women and 1.24 years in men, compared to Q1. By race and ethnicity, it was shortened by 3.90 years in Black participants and 1.68 years in White participants in Q4 group, compared to Q1.

CONCLUSIONS: In this nationwide cohort study, higher VAI was significantly associated with an increased risk of premature mortality and reduced life expectancy at age 40 among US adults. These associations we heterogeneous by sex, race and ethnicity, more pronounced in women and Black participants.

PMID:40234930 | DOI:10.1186/s12944-025-02560-3

J Orthop Surg Res. 2025 Apr 16;20(1):381. doi: 10.1186/s13018-025-05791-3.

ABSTRACT

INTRODUCTION: Systemic lupus erythematosus (SLE) can lead to avascular necrosis (AVN) of the femoral head, often requiring total hip arthroplasty (THA). However, outcomes and complications of THA in SLE patients remain unclear. This study aims to analyze the differences in clinical outcomes and complications between SLE and non-SLE patients undergoing THA.

METHODS: This study adhered to the PRISMA guidelines and was registered in PROSPERO (CRD42024564792). Literature was retrieved from the Cochrane Library, Web of Science, PubMed, and Embase databases, supplemented by manual searches of relevant references. Studies meeting specific diagnostic criteria were included, with eligible study types comprising case-control and cohort studies. The intervention of interest was THA surgery, and primary outcome measures included adverse events and clinical outcomes. Risk of bias was assessed using the Cochrane Risk of Bias tool for randomized trials and the Newcastle-Ottawa Scale for observational studies. Statistical analyses were performed using RevMan 5.4 software. Dichotomous variables were analyzed using relative risk (RR), while continuous variables were assessed using the mean difference (MD) or standardized mean difference (SMD), both with 95% confidence intervals for effect size estimation. Heterogeneity was assessed via the X² test and I² statistic, with P ≤ 0.05 considered statistically significant.

RESULTS: No significant difference in Harris Hip Scores (HHS) (MD= -0.69, 95% CI: -2.11 to 0.73, I²=0%, P = 0.34) was observed between SLE and non-SLE patients. However, compared to non-SLE patients, SLE patients had higher risks of prosthesis dislocation (RR = 2.44, 95% CI: 1.74 to 3.42, I²=52%, P<0.01), wound infection (RR = 2.30, 95% CI: 1.87 to 2.83, I²=0%, P<0.01), and blood transfusion (RR = 2.50, 95% CI: 2.14 to 2.92, I²=0%, P<0.01), as well as longer hospital stays (MD = 1.64, 95% CI: 1.44 to 1.64, I²=100%, P<0.01).

DISCUSSION: In conclusion, although SLE patients show similar improvements in hip function postoperatively compared to non-SLE patients, they face a significantly higher risk of complications, including prosthetic dislocation, blood transfusion requirements, DVT, and wound infections. These patients also experience longer hospital stays and slower recovery, likely due to their underlying health conditions and preoperative treatments. Personalized management strategies and risk assessments are crucial to minimize complications and optimize recovery outcomes for SLE patients undergoing THA. However, the included studies exhibit significant heterogeneity, including variations in prosthesis types, fixation methods, sample sizes, and study designs, which may introduce potential bias and affect the generalizability of the findings. Further high-quality research is needed to address these issues.

PMID:40234929 | DOI:10.1186/s13018-025-05791-3

Orphanet J Rare Dis. 2025 Apr 15;20(1):180. doi: 10.1186/s13023-025-03695-3.

ABSTRACT

BACKGROUND: Fibrosing mediastinitis is a rare benign disease frequently complicated by pulmonary hypertension. A definitive diagnosis for fibrosing mediastinitis-associated pulmonary hypertension (FM-PH) and its etiologies necessitates mediastinal biopsy and subsequent pathological assessment. Endobronchial ultrasound (EBUS)-guided transbronchial mediastinal cryobiopsy is a recently developed technique that provides diagnostic advantages over standard needle biopsy, particularly in benign mediastinal disorders. Nevertheless, their safety and efficacy in diagnosing FM-PH remain elusive.

METHODS: We retrospectively studied patients with mediastinal lesion and pulmonary vascular compression who underwent both transbronchial needle aspiration and mediastinal cryobiopsy with EBUS guidance. Diagnostic yields of FM-PH and its etiologies, along with procedure-related adverse events, were analyzed. Immunohistochemical study was conducted to identify immunological properties of FM-PH.

RESULTS: Of the 529 patients with mediastinal lesions, 80 exhibited pulmonary vessel compression, including 10 who were ultimately diagnosed with FM-PH following mediastinal biopsy and right heart catheterization. Cryobiopsy showed a higher diagnostic yield for FM-PH compared to needle aspiration (100% versus 40%, p = 0.011). Disease etiologies included pneumoconiosis in 5 cases, tuberculosis in 3, and idiopathic FM-PH in the remaining 2. Cryobiopsy appeared to be superior to needle biopsy for etiological diagnosis, although this difference was not statistically significant (80% versus 60%, p = 0.628). Immunohistochemical analyses of cryosamples revealed mixed inflammatory infiltrates of B and T lymphocytes, as well as macrophages, surrounding or within FM-PH lesions. There was no significant bleeding or other complications.

CONCLUSION: Transbronchial mediastinal cryobiopsy might be a safe and effective diagnostic tool for FM-PH, offering valuable information for personalized treatment.

PMID:40234923 | DOI:10.1186/s13023-025-03695-3

BMC Oral Health. 2025 Apr 15;25(1):570. doi: 10.1186/s12903-025-05748-2.

ABSTRACT

BACKGROUND: To assess the effect of indirect ultrasonic activation on the root canal obturation with a premixed calcium silicate cement (CSC).

METHODS: Twenty-six single-rooted premolars were sectioned to the length of 11 mm. All the roots were instrumented using ProTaper Next instruments and randomly assigned to either the control (n = 4) or experimental (n = 22) groups according to root canal obturation methods. Root specimens allocated to experimental groups were obturated with Endocem MTA, with (group EMU) or without (group EM) indirect ultrasonic activation (n = 11/group). Root specimens obturated with gutta-percha served as positive and negative (after nail varnish coating) controls. Intraoral radiograph images were used to assess the presence or absence of voids in the coronal, middle, and apical thirds of each specimen. The specimens were connected to a nanoscale fluid filtration device to measure quantitative leakage data. Data was statistically analyzed with a significance level of 0.05.

RESULTS: There was no significant difference in the voids formation between the two groups (p > 0.05), but specimens in group EMU presented significantly higher quantitative leakage than those in group EM (p < 0.05).

CONCLUSIONS: Within the limitation of this study, indirect ultrasonic activation of premixed CSC did not affect the void formation but presented higher quantitative leakage. Future research incorporating micro-CT imaging would enable a more precise and comprehensive analysis, providing valuable insights into the root canal obturation with premixed CSCs.

PMID:40234919 | DOI:10.1186/s12903-025-05748-2

Diabetol Metab Syndr. 2025 Apr 15;17(1):128. doi: 10.1186/s13098-025-01693-w.

ABSTRACT

OBJECTIVE: To explore the relationship between body fat mass/muscle mass ratio (F/M) and thyroid hormone sensitivity in the euthyroid population.

METHODS: Body compositions of 845 check-up individuals were determined using bioelectrical impedance analysis (BIA). Biochemical indexes including blood glucose, blood lipids, liver and kidney functions and thyrotropic hormones (THs) were detected. Free triiodothyronine to free thyroxine ratio (FT3/FT4), Thyroid Feedback Quantile-based Index (TFQI), Thyrotropin Thyroxine Resistance Index (TT4RI) and TSH Index (TSHI) were calculated for analysis.

RESULTS: TT4RI and TSHI showed increased trends with statistical difference, while FT3/FT4 and TFQI showed no difference among F/M quartile groups. After adjusting for confounding factors, F/M exhibited no correlation with FT3/FT4, but positive correlations with TFQI, TT4RI and TSHI. Gender subgroup analysis showed that F/M exhibited positive relationship with TFQI in females; exhibited positive correlations with TFQI, TT4RI and TSHI before the inflection points, but no correlations thereafter in males. Age subgroup analysis showed that F/M exhibited positive correlations with TFQI, TT4RI and TSHI, but no correlation with FT3/FT4 in age < 65 years group; exhibited no relationship with thyroid hormone sensitivity in age ≥ 65 years group. BMI subgroup analysis showed that F/M exhibited no relationship with thyroid hormone sensitivity in BMI < 25 kg/m² group; exhibited positive correlations with TFQI, TT4RI and TSHI before the inflection points, but no correlations thereafter in BMI ≥ 25, < 30 kg/m² group; exhibited positive correlation with TFQI before the inflection point, but no correlation thereafter in BMI ≥ 30 kg/m² group; exhibited no correlations with TT4RI and TSHI before the inflection points, but negative correlations with them thereafter in BMI ≥ 30 kg/m² group.

CONCLUSION: Impaired central, but not peripheral sensitivity to thyroid hormones was associated with increased body fat mass/muscle mass ratio (F/M), this association was obvious in males, individuals with age < 65 years and BMI ≥ 25 kg/m², with different inflection points. Maybe F/M independently affects thyroid hormone sensitivity, we need more clinical and basic studies in the future.

PMID:40234912 | DOI:10.1186/s13098-025-01693-w