Nevin Manimala

Hepatol Res. 2025 Aug 16. doi: 10.1111/hepr.70019. Online ahead of print.

ABSTRACT

BACKGROUND: Complete abstinence is the cornerstone of alcohol-related liver disease (ALD) management. However, many patients struggle to achieve or sustain abstinence, prompting growing interest in harm reduction strategies, particularly pharmacological interventions to reduce alcohol intake. Nalmefene, an opioid receptor modulator, has shown efficacy in reducing alcohol consumption among individuals with alcohol dependence. However, its effects on hepatic parameters in ALD have not been well studied in real-world settings.

OBJECTIVE: To evaluate the efficacy and safety of nalmefene in patients with ALD, focusing on changes in alcohol consumption, liver function, and hepatic reserve capacity.

METHODS: The present retrospective observational study included 21 patients with ALD who received nalmefene therapy at our institution between September 2019 and December 2023. Data on alcohol intake, liver function tests, hepatic reserve capacity, and alcohol use disorders identification test scores were collected at baseline and after 6 months of treatment. Adverse events were also recorded.

RESULTS: Within 1 month of initiating nalmefene, significant reductions in heavy drinking days and total alcohol consumption were observed. These reductions were accompanied by improvements in liver function parameters. However, no statistically significant changes in hepatic reserve capacity were noted. Most adverse events were mild to moderate (Grade 1 or 2), and no serious adverse events occurred.

CONCLUSION: Nalmefene appears to be a safe and effective pharmacological option for reducing alcohol intake and improving liver function in patients with ALD. These findings support its use as part of a harm reduction approach for those unable to achieve complete abstinence.

PMID:40818098 | DOI:10.1111/hepr.70019

Prostate. 2025 Aug 16. doi: 10.1002/pros.70034. Online ahead of print.

ABSTRACT

INTRODUCTION: Effective management of post-prostate cancer is hindered by the limitations of current prognostic tools in accurately assessing disease aggressiveness. Radical prostatectomy remains a standard treatment, but some patients develop biochemical recurrence and metastasis, underscoring the need for improved postsurgical prognostic tools.

METHODS: This investigation involved sequencing data derived from 38 matched prostate cancer patients who had undergone RP. Initial statistical analysis helped identify the most significant miRNAs, which were further subjected to unsupervised clustering and stepwise selection. A linear discriminant analysis (LDA) model was then trained and tested using a miRNA combination method to pinpoint biomarkers predictive of metastasis.

RESULTS: Out of 1123 miRNAs initially identified, 519 were selected as high-confidence candidates. Parametric analysis of these miRNAs discerned 41 that effectively distinguished between patients who developed metastasis postoperatively and those who did not. Utilizing LDA, this study harnessed 41 miRNAs in a combinatorial approach, identifying eight key miRNAs (hsa-miR-106b-3p, hsa-miR-769-5p, hsa-miR-182-5p, hsa-miR-194-5p, hsa-miR-345-5p, hsa-miR-183-3p, hsa-miR-200a-3p, hsa-miR-301a-3p) that collectively stratified the metastatic group from control with up to 91% accuracy. This model’s effectiveness was supported by a receiver operating characteristic analysis, demonstrating an area under the curve of 80% or higher for the best miRNA combinations. Notably, the performance of this eight-miRNA panel was consistent with CAPRA-based risk stratification.

CONCLUSION: Our study presents a miRNA-based machine learning model that distinguishes metastatic from non-metastatic prostate cancer patients following surgery. The panel’s alignment with CAPRA underscores its clinical relevance and highlights its potential for integration into future clinical frameworks.

PMID:40818090 | DOI:10.1002/pros.70034

Physiother Theory Pract. 2025 Aug 16:1-12. doi: 10.1080/09593985.2025.2547293. Online ahead of print.

ABSTRACT

BACKGROUND: Stroke-related balance impairments reduce independence, making accurate assessment vital for rehabilitation. However, research on the minimal clinically important difference for the Kansas University Standing Balance Scale (KUSBS) is limited.

OBJECTIVES: This study determined the minimal clinically important difference for the KUSBS based on reduced assistance in walking and daily living activities for inpatients with acute-to-subacute stroke.

METHODS: This retrospective study included 407 inpatients diagnosed with acute-to-subacute stroke who were referred to the rehabilitation department between 2016 and 2022. Clinical outcomes – including the Kansas University Standing Balance Scale (KUSBS), Berg Balance Scale (BBS), Functional Ambulation Category (FAC), and Modified Barthel Index (MBI) – were assessed at both admission and discharge. The minimal clinically important difference was determined using anchor-based methods, including receiver operating characteristic curve analysis.

RESULTS: The minimal clinically important difference for the KUSBS was 0.5 for both anchors; for the BBS, it ranged from 5.5 to 9.5. Subgroup analysis demonstrated statistical significance for patients requiring assistance with activities. Multivariate analysis indicated that functional improvements varied according to the initial functional levels.

CONCLUSION: The minimal clinically important difference for the KUSBS was 0.5 for patients requiring walking assistance and 1.5 for those needing maximal assistance with daily activities. Alternative balance assessment tools may be more suitable for patients who do not require assistance. Our study findings emphasize the importance of incorporating qualitative balance assessment tools, such as the KUSBS, alongside traditional quantitative measures, such as the BBS, to provide a more comprehensive evaluation of post-stroke balance function.

PMID:40818071 | DOI:10.1080/09593985.2025.2547293

J Evid Based Med. 2025 Aug 16:e70060. doi: 10.1111/jebm.70060. Online ahead of print.

ABSTRACT

AIM: Tongxinluo (TXL) capsule, a traditional Chinese medicine compound, has proven effective in acute myocardial infarction (AMI), but its cost-effectiveness is unclear.

METHODS: This economic evaluation utilized individual data from clinical trials to compare major adverse cardiac and cerebrovascular events (MACCEs) at 30 days and quality-adjusted life years (QALYs) at 1 year between an intervention group (TXL combined with conventional therapy) and the control group (placebo plus conventional therapy), from a healthcare perspective. A lifetime cost-utility analysis (CUA) was conducted using a Markov model, and sensitivity analyses were performed to evaluate the robustness of the results.

RESULTS: A total of 3777 patients (TXL: 1889; placebo: 1888) were included in the analysis. The 30-day total costs for the TXL and placebo groups were ¥38,561 ($5399) and ¥39,217 ($5490), respectively, showing no statistical difference. The 30-day MACCEs rates were 3.39% for the TXL group and 5.24% for the placebo group (p < 0.006), indicating TXL’s superiority in effectiveness at 30 days. Over a lifetime, the TXL group incurred higher total costs (¥97,108 [$13,595] vs. ¥92,033 [$12,885]) and gained more QALYs (6.70 vs. 6.30). The incremental cost-effectiveness ratio for TXL was ¥12,421/QALY ($1739), below the 1 Gross Domestic Product per capital threshold which was ¥89,358 ($12,510) in 2023 in China. Sensitivity analysis confirmed robust results, revealing that TXL was more likely to be accepted over the placebo when the willingness to pay exceeds ¥12,500 ($1739).

CONCLUSIONS: TXL is a cost-effective option compared to placebo in AMI.

PMID:40818069 | DOI:10.1111/jebm.70060

J Behav Addict. 2025 Aug 16. doi: 10.1556/2006.2025.00059. Online ahead of print.

ABSTRACT

BACKGROUND: Compulsive sexual behavior disorder (CSBD) is a mental health condition that has attracted significant research attention, especially following its inclusion in the eleventh revision of the International Classification of Diseases (ICD-11) by the World Health Organization. Despite this recognition, the field remains fragmented with ongoing debates about its classification and a lack of comprehensive cross-cultural research. In this study, bibliometrics was used to characterize the development status of CSBD over the past 25 years and to identify key research hotspots and future trends.

METHODS: This study collected data from the Web of Science Core Collection and analyzed the literature related to CSBD from 2000 to 2024. A total 2,261 publications were examined for their characteristics, including annual publication volume, countries/regions, institutions, authors, journals, references, and keywords. Several bibliometric and visualization tools (e.g., VOSviewer, CiteSpace, Scimago Graphica, and Pajek) were used to conduct the analysis of co-authorship, co-citation, co-occurrence and descriptive.

RESULTS: The analysis identified a consistent upward trend in research interest in CSBD, particularly after its inclusion in ICD-11. Co-occurrence analysis of 82 author keywords with frequencies of more than 12 resulted in 5 clusters: (1) competing conceptualizations of CSBD; (2) comorbidity of CSBD with other psychiatric disorders; (3) assessment, risk factors, and treatment; (4) gender differences and sexual health; (5) CSB caused by neurological diseases. Moreover, the findings of countries/regions analysis indicate that publications are mainly from Western, educated, industrialized, rich, and democratic (WEIRD) countries/regions, and collaborative networks mainly connect countries from the North America and Europe. Despite its growing recognition, the field still lacks interdisciplinary collaboration and comprehensive studies from non-WEIRD contexts, highlighting a need for broader, cross-cultural research.

CONCLUSIONS: This study comprehensively maps global research trends in CSBD, identifies critical knowledge gaps, and provides a foundation for future research. By synthesizing the current research status, it aims to guide researchers toward emerging topics and foster a more cohesive understanding of CSBD.

PMID:40818055 | DOI:10.1556/2006.2025.00059

Psychooncology. 2025 Aug;34(8):e70258. doi: 10.1002/pon.70258.

ABSTRACT

BACKGROUND: This study investigates psychosocial and lifestyle factors to improve survival outcomes in prostate cancer patients.

METHODS: From the UK Biobank cohort, 13,110 male prostate cancer subjects were analysed to examine the relationship between psychosocial and lifestyle factors and survival with a mean follow-up of 14.2 years from recruitment.

RESULTS: Participation in sports club or gym (HR = 0.82, 95% CI 0.74-0.91, p < 0.005), religious groups (HR = 0.83, 95% CI 0.73-0.94, p < 0.005) and other group activity (HR = 0.87, 95% CI 0.78-0.97, p = 0.01) were associated with lower mortality risk in our analysis, after adjusting for age, deprivation and comorbidities, followed by. In contrast, neither the pub or social club nor the adult education class demonstrated a statistically significant survival benefit. A modest dose-response relationship between the number of social activities engaged in and mortality risk reduction is observed. There were no differential benefits in alcohol intake, while smoking demonstrated a graded risk increase in mortality (HR = 1.74, 95% CI 1.51-2.0, p < 0.005 in current smokers; HR = 1.21, 95% CI 1.1-1.32, p < 0.005 in previous smokers) compared to never smokers. Having close and frequent confidants (HR = 0.83, 95% CI 0.75-0.92, p < 0.005 for daily) also confers benefits to survival.

CONCLUSIONS: This study demonstrates that participation in sports club or gym, engaging in religious groups and other group activities, forming good health habits such as smoking cessation, and having people to confide in regularly is associated with reduced mortality risk in prostate cancer patients. These findings highlight the importance of integrating psychosocial resilience, health behaviour optimisation, and spiritual engagement into survivorship care. The hierarchical risk reduction profile supports prioritising interventions targeting modifiable health behaviours, spiritual/social support, and group activities. While religious participation is associated with notable survival benefits, this study recognises the complex interplay of cultural, social, and personal factors influencing engagement in such activities. These findings advocate for stratified survivorship care models prioritising engagement modalities with dual physiological, psychosocial, and spiritual benefits.

PMID:40818052 | DOI:10.1002/pon.70258

J Fluoresc. 2025 Aug 16. doi: 10.1007/s10895-025-04514-5. Online ahead of print.

ABSTRACT

This study introduces an innovative spectrofluorimetric method for determining fimasartan, a pharmaceutical compound, at low concentrations in drug formulations and human blood samples. The method incorporates several key features that enhance its effectiveness and sustainability. It utilizes eco-friendly solvents (water and ethanol) and reduces analysis time, making it both cost-effective and environmentally friendly. The integration of Quality by Design (QbD) principles ensures consistent quality throughout the analytical process. The method employs a microwave-assisted Hantzsch reaction for derivatization, which modifies the compound for improved detection. To optimize critical variables, the Placket-Burman design, a statistical tool, was implemented. The method demonstrates high performance with linearity in the range of 50-250 ng/mL, a Limit of Detection (LOD) of 10 ng/mL, and a Limit of Quantification (LOQ) of 50 ng/mL. It achieves excellent accuracy, with 99.61-100.58% recovery in pharmaceutical formulations and 91.67-94.94% in human plasma. The rapid analysis time of 30 s for derivatization further enhances its efficiency. Mass spectrometry confirmation verified the formation of a fluorescent Mannich base product. Notably, this method outperforms existing LC-MS and HPLC techniques based on RGB12, AGREE, and modified-GAPI assessments, demonstrating superior environmental performance. By successfully combining analytical quality, environmental sustainability, and cost-effectiveness, this new spectrofluorimetric method presents a valuable tool for researchers and pharmaceutical professionals in the analysis of fimasartan. Its ability to provide accurate measurements at very small nano-scale concentrations while maintaining eco-friendly practices makes it a significant advancement in pharmaceutical analysis techniques.

PMID:40818015 | DOI:10.1007/s10895-025-04514-5

Sports Med. 2025 Aug 16. doi: 10.1007/s40279-025-02298-z. Online ahead of print.

ABSTRACT

Exercise-based injury prevention programmes (EIPPs) need a certain period of consistent practice to achieve the expected efficacy. Therefore, as with many other biomedical interventions, EIPPs can be characterised by a dose-response relationship. In this Current Opinion, we aim to present the concept of the dose-response relationship and explore the research and clinical implications stemming from it. First, we introduce its origins from pharmacology and define the terms dose and response in the context of EIPPs. Specifically, we describe how the dose is dependent on the duration of EIPP practice and how the response can be quantified from injury-related epidemiological outcomes. Then, we highlight that the vast majority of research studies examining the efficacy of EIPPs neglect their dose-response relationship, which can lead to a potential underestimation of the EIPP effect. To overcome this problem, we present two statistical approaches that were applied to a previous study, providing a practical way to estimate the dose-response relationship of an EIPP. Finally, we discuss how researchers can integrate this concept in their study designs and analyses and how practitioners can plan the implementation of EIPPs on the basis of the time needed for the EIPPs to gain efficacy according to the dose-response relationship.

PMID:40818011 | DOI:10.1007/s40279-025-02298-z

Int Urol Nephrol. 2025 Aug 16. doi: 10.1007/s11255-025-04706-9. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the efficacy and safety of pressure- and volume-controlled balloon dilation in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) and to compare it with traditional bladder hydrodistension to explore a superior therapeutic approach.

METHODS: A prospective randomised-controlled trial was conducted, enrolling 50 women with IC/BPS aged 52-77 years, treated between July 2013 and June 2023. Patients were randomly assigned to a pressure- and volume-controlled balloon dilation group (experimental group, n = 25) or a traditional bladder hydrodistension group (control group, n = 25). The primary outcome measures included interstitial cystitis symptom index and interstitial cystitis problem index (ICSI/ICPI) scores, pelvic pain and urinary frequency (PUF) scores, bladder capacity, nocturnal urination frequency, maximum voided volume, and postoperative complications (bleeding and bladder rupture). Statistical analyses were performed using t tests, Wilcoxon rank-sum tests, and Chi-square tests, with P < 0.05 indicating statistical significance.

RESULTS: At 6 months post-treatment, the experimental group showed significantly lower ICSI/ICPI scores than the control group (P < 0.05). The experimental group also exhibited significantly lower PUF scores at all time points (P < 0.05). Under non-anaesthetic conditions, the experimental group demonstrated significantly greater bladder capacity (P < 0.05), whereas no significant difference was observed under anaesthetic conditions (P > 0.05). The experimental group experienced significantly fewer episodes of nocturnal urination from 2 weeks to 6 months post-treatment (P < 0.05).

CONCLUSION: Pressure- and volume-controlled balloon dilation demonstrated superior efficacy in alleviating IC/BPS symptoms and improving bladder function compared with traditional hydrodistension. Additionally, it was associated with a lower complication rate, offering a safer and more effective therapeutic option for patients with IC/BPS.

CLINICAL TRIAL REGISTRATION: ID:ISRCTN25030604, https://www.isrctn.com/ISRCTN25030604.

PMID:40818007 | DOI:10.1007/s11255-025-04706-9

Int J Implant Dent. 2025 Aug 16;11(1):54. doi: 10.1186/s40729-025-00642-6.

ABSTRACT

PURPOSE: Implant dentistry is an established therapy option with sufficient long-term success for the replacement of missing teeth. Education in implant dentistry should not only focus on theory but also on practical courses. The purpose of the current examination was to assess the accuracy of fully guided and pilot-drill guided implant insertion applying plotted static guides in a cohort of undergraduate dental students.

METHODS: Matching a three-dimensional set of radiographic data and surface scans of 51 artificial mandibular models, 51 surgical templates were produced by plotting. Metal sleeves allowing either a pilot-drill or fully guided implant insertion were inserted alternatively in region 36 and 46. A total of 102 implants were inserted by 51 undergraduates. Subsequently, the positions of the implants were analyzed radiographically considering the accuracy. Additionally, the time required for implant insertion was recorded and a questionnaire was completed. Statistical analysis followed.

RESULTS: In general, the accuracy of fully guided implant insertion was higher compared to pilot-drill guided. Mean three-dimensional deviation was 2.24 ± 0.38 degrees for fully guided vs. 4.51 ± 2.20 degrees for pilot-drill guided implant insertion. Time required for fully guided implant insertion was statistically significant higher compared to pilot-drill guided (15:22 ± 5:22 vs. 9:35 ± 3:58 min, p < 0.01). The returned questionnaires reported a high interest but a self-assessed minor previous knowledge in implant dentistry.

CONCLUSION: The examination could show that inexperienced undergraduates benefited from fully guided implant insertion in a laboratory set-up. Based on the questionnaires there is a distinct demand for an extended education in implant dentistry among undergraduate students.

PMID:40818001 | DOI:10.1186/s40729-025-00642-6