Nevin Manimala

Indian J Gastroenterol. 2025 Sep 12. doi: 10.1007/s12664-025-01849-6. Online ahead of print.

ABSTRACT

BACKGROUND: Acute pancreatitis (AP) is a common gastrointestinal emergency with variable clinical course. Early identification of severe AP (SAP) is crucial for optimizing patient management. The triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, has been implicated in various metabolic disorders, but its role in predicting AP severity remains underexplored.

METHODS: In this single-center, prospective study, 138 patients diagnosed with AP were enrolled between January 2022 and December 2024. The severity of AP was classified as per the Revised Atlanta Classification. TyG index was calculated at admission and compared with established severity scores, including the computed tomography severity index (CTSI) and bedside index of severe acute pancreatitis (BISAP). Statistical analyses were performed to assess the correlation of TyG index with disease severity, hospital stay, intensive care unit (ICU) admission and mortality.

RESULTS: Among the enrolled patients, 17% developed SAP. The mean TyG index was significantly higher in the SAP group compared to the non-SAP group (5.01 ± 0.33 vs. 4.69 ± 0.22, p < 0.001). Higher TyG index values correlated with prolonged hospital stay (p = 0.009), increased ICU admissions (p < 0.001) and greater mortality (p = 0.004). The predictive accuracy of the TyG index for SAP, as assessed by the area under the curve (AUC), was 0.902, higher than BISAP 0.696 and CTSI 0.751.

CONCLUSION: The TyG index is a simple and accessible biomarker that correlates with AP severity and prognosis. Its predictive value is higher than BISAP and CTSI.

PMID:40938547 | DOI:10.1007/s12664-025-01849-6

Med Biol Eng Comput. 2025 Sep 12. doi: 10.1007/s11517-025-03424-9. Online ahead of print.

ABSTRACT

Middle-aged people generally experience greater work pressure but higher health risks. However, the existing EEG-based cognitive load monitoring research has paid less attention to this segment of the population. We investigated high temporal resolution decoding of cognitive load from EEG signals in middle-aged individuals during inhibition and updating tasks. In this paper, we employed publicly available EEG data from Multi-Source Interference Task (MSIT) and Sternberg Memory Task (STMT) paradigms to examine variations in brain activation modes and cognitive load under low and high cognitive demands. This analysis was conducted using time courses of event-related potential (ERP) scalp maps. To validate the effect of the method, we conducted multivariate pattern recognition and statistics analysis. The point-by-point classification accuracy sequences obtained from decoding were assessed for significance above chance levels using one-tailed t-tests, with corrections for multiple comparisons made via the false discovery rate (FDR) method. After comparative analysis, we found that the decoder was more effective in categorizing different tasks, while the MSIT was better than STMT’s in categorizing cognitive loads. In addition, we also analyzed the spatio-temporal properties of brain activation under different conditions, which is instrumental in developing more powerful classifiers. Additionally, group-level statistical comparisons were performed to explore how AD risk may influence cognitive load decodings. The study results show that this program is feasible and can be used in the future to monitor the workload of high-risk job operators in real time and longitudinal observation in medical diagnostics.

PMID:40938543 | DOI:10.1007/s11517-025-03424-9

Arch Osteoporos. 2025 Sep 12;20(1):125. doi: 10.1007/s11657-025-01606-4.

ABSTRACT

This retrospective cohort found that osteoporosis (defined by T-score) or FRAX score is linked to a higher risk of non-fatal stroke. Additionally, a high FRAX score combined with T-score increases the risk of both major adverse cardiovascular events (MACE) and non-fatal stroke.

PURPOSE: This study examined the relationship between osteoporosis and major adverse cardiovascular events (MACE) in Thai older adults and evaluated the predictive capacity of the FRAX score for cardiovascular risk.

METHODS: A retrospective cohort study followed 348 individuals aged 60-75 Years for over 13 years (2005-2021) after their initial bone mineral density (BMD) assessment. Osteoporosis was defined by BMD T-scores ≤ -2.5 at the lumbar spine or femoral neck, or fragility fracture. High hip fracture risk was defined as a FRAX score ≥ 3%. The primary outcome was a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke (3P-MACE). Cox proportional hazards models were used to calculate hazard ratios (HR). Statistical significance was set at p < 0.05.

RESULTS: While overall MACE was not significantly higher in the osteoporosis group, the stroke findings were increased (adjusted HR 2.46, 95% CI 1.12-5.39, p = 0.024). Utilizing FRAX score in conjunction with T-scores (FRAX-T ≥ 3%) was independently associated with an elevated risk of 3P-MACE (adjusted HR 1.88, 95% CI 1.05-3.38, p = 0.034) as well as non-fatal stroke risk (adjusted HR 3.04, 95% CI 1.38-6.69, p = 0.006).

CONCLUSIONS: Osteoporosis demonstrates a significant association with increased stroke risk in Thai older adults. Utilizing FRAX-T may improve cardiovascular risk stratification. Further large-scale prospective studies are needed to elucidate the underlying mechanisms and establish a definitive link between osteoporosis and broader cardiovascular outcomes in this population.

PMID:40938492 | DOI:10.1007/s11657-025-01606-4

AIDS Behav. 2025 Sep 12. doi: 10.1007/s10461-025-04851-3. Online ahead of print.

ABSTRACT

Prospective memory (PM) deficits are common among people with HIV (PWH) and are linked to poor clinical outcomes. Risk factors for PM deficits in PWH are poorly understood. While cannabis use is associated with worse PM in people without HIV, it is unclear whether this association generalizes to PWH. Three hundred and seven PWH (79% with regular cannabis use) completed the Memory for Intentions Test (MIST). Associations between regular use (vs. no/minimal lifetime use) and MIST score were evaluated. Among participants with regular use, bivariate associations were evaluated between MIST score and self-reported cumulative 30-day THC dose, use frequency, duration of heaviest lifetime use, age of first use, and use motivation (predominantly-recreational, predominantly-therapeutic, or combined). Confounding was addressed with linear regressions adjusted for age and Wechsler Test of Adult Reading. Cannabis use (vs. non-use) was not significantly associated with MIST score in unadjusted or adjusted models (β = – 0.04, 95% CI = – 0.29, 0.21, p = 0.74). After confounder adjustment, no associations between cannabis variables and MIST score reached statistical significance. The largest (albeit nonsignificant) effect in adjusted models was found for use motivation: participants with combined use showed better MIST performance vs. predominantly-recreational use (β = 0.28, 95% – 0.02, 0.57, p = 0.067). Participants reporting predominantly-therapeutic use vs. predominantly-recreational use performed similarly (β = 0.03, 95% CI = – 0.30, 0.37, p = 0.85). PM was not significantly associated with cannabis use in PWH. Associations between motivation for use and PM in PWH warrant further investigation.

PMID:40938490 | DOI:10.1007/s10461-025-04851-3

AIDS Behav. 2025 Sep 12. doi: 10.1007/s10461-025-04870-0. Online ahead of print.

ABSTRACT

Georgia has one of the highest HIV diagnosis rates in the U.S., yet only 33% of Pre-Exposure Prophylaxis (PrEP) users in the Deep South live there. This study aims to determine the potential mediational role of internalized homonegativity and attitudes towards PrEP between gay community connectedness and PrEP use among men who have sex with men (MSM) living in Georgia. Participants (N = 121) completed an online survey in June 2020. PrEP use (yes/no) was defined by the question “the last time you had sex, were you taking PrEP, like Truvada?” The study also used the “8-item Identification and Involvement with the Gay Community scale”, “9-item internalized homophobia scale”, and a “3-item PrEP attitude scale”. Path analysis was performed using Stata 17.0. After adjusting for sociodemographic characteristics, positive associations were observed between attitudes towards PrEP and PrEP use (β = 0.11; p = < 0.001), and gay community connectedness (GCC) and PrEP attitudes (β = 0.17, p < 0.001). Conversely, negative associations were found between GCC and internalized homonegativity (β=-0.71, p < 0.001), and internalized homonegativity and PrEP use (β=-.01, p = 0.031). GCC was not significantly associated with PrEP use (β=-.01; p = 0.196). However, the indirect effects of GCC on PrEP use through PrEP attitudes (β = 0.01, p < 0.001) and internalized homonegativity (β = 0.02, p = 0.041) were statistically significant. These findings indicate that PrEP attitudes and internalized homonegativity mediate the relationship between GCC and PrEP use among MSM. Thus, improving attitudes toward PrEP and reducing internalized homonegativity through fostering GCC among MSM may improve PrEP use and persistence.

PMID:40938489 | DOI:10.1007/s10461-025-04870-0

Bull Math Biol. 2025 Sep 12;87(10):149. doi: 10.1007/s11538-025-01514-1.

ABSTRACT

Human behavior plays a pivotal role in mitigating the global spread of infectious diseases, rendering it an indispensable characteristic of effective disease control efforts. While prior research has examined behavioral changes in disease control either through the force of infection or prevalence-based recruitment, the combined effects of these approaches remain largely unexplored. To bridge this gap, we develop a mathematical model that integrates behavioral modifications from both perspectives, with a focus on resource-limited settings-a critical factor for managing re-emerging diseases. Our analytical results indicate that disease dynamics are influenced not only by the basic reproduction number ( R 0 ) but also regulated by a threshold value ( R c ), which can lead to disease persistence through backward bifurcation. The model reveals a complex dynamic view, highlighting the intricate role of behavioral modifications in suppressing multiple waves of infection. To optimize behavioral strategies, we introduce a contour-area optimization method to identify the most effective responses. Using real-world data from the Monkeypox outbreaks in the United States of America. and the Democratic Republic of Congo (spanning January 7 to August 13, 2024), we estimated critical parameters for both regions. The results highlight a significant reduction in R 0 when behavioral interventions targeted both transmission pathways, compared to focusing solely on one. Furthermore, we provide short- and long-term forecasts of the effects of these interventions, offering actionable insights for resource-constrained countries. This research underscores the importance of behavioral adaptations in strengthening disease control measures and advancing sustainable public health efforts, even in regions with sparse resources.

PMID:40938458 | DOI:10.1007/s11538-025-01514-1

Head Neck Pathol. 2025 Sep 12;19(1):109. doi: 10.1007/s12105-025-01841-8.

ABSTRACT

PURPOSE: Salivary duct carcinoma (SDC) is the most common malignancy to arise in a pleomorphic adenoma (PA). Intracapsular or non-invasive carcinoma ex PA (CXPA) is defined by the presence of malignant-appearing tumor cells within the PA that do not violate the tumor border. Knowledge regarding the possible morphologic spectrum and prognosis of intratumoral CXPA is scarce. This study aims to evaluate the morphologic, immunohistochemical, and clinical features of PAs with apocrine / salivary-duct-like intratumoral atypia.

METHODS: Surgical pathology databases were queried for in situ or intracapsular/intratumoral SDC ex PAs and PAs with atypical epithelial cells (AEC). Exclusion criteria included recurrent lesions, invasion, positive margins, atypia only in myoepithelial cells, or other morphologic variants. Chromogenic multiplex (androgen receptor (AR) and HER2) and monoplex (p40) assays were performed on all available cases, as well as on a control group of non-atypical benign PAs and overtly invasive SDCs. Clinical outcomes were recorded.

RESULTS: 96 cases were identified: 23 AEC, 6 apocrine metaplasia, 41 benign PA, 8 SDC ex PA. All AEC, apocrine metaplasia, and benign cases were treated with surgery alone, with 3 AEC cases also receiving a neck dissection. No case recurred. Five of 8 SDC ex PA recurred; 3 died of disease. AR and HER2 were respectively expressed in 96% and 22-48% of AEC; 83% and 0% of apocrine metaplasia; 51% and 0% of benign PA; and 86-100% and 38-57% of SDC ex PA. Patients had increasing average age from benign (~ 50 years) to atypical/in situ (60 years) to invasive carcinoma (~ 70 years).

CONCLUSION: The presence of epithelial atypia within a PA (ranging from isolated AR expression to apocrine metaplasia to overtly dysplastic/malignant epithelial cells) does not portend recurrence or metastasis if the atypia is confined within the borders of the adenoma and negative margins are achieved. Therefore, use of the term “in situ/intracapsular/intratumoral salivary duct carcinoma ex pleomorphic adenoma” is discouraged in light of good prognosis and potential for overtreatment by clinical teams. Nomenclature such as pleomorphic adenoma with epithelial “atypia” or “dysplasia” is recommended, followed by a comment regarding the morphologic features and likely indolent behavior.

PMID:40938457 | DOI:10.1007/s12105-025-01841-8

Arch Orthop Trauma Surg. 2025 Sep 12;145(1):447. doi: 10.1007/s00402-025-06062-w.

ABSTRACT

BACKGROUND: Shoulder dislocation is the most common major joint dislocation, with anterior dislocations accounting for 95% of cases. Accurate assessment of bony lesions, such as glenoid bone loss (GBL) and Hill-Sachs lesions, is critical for treatment planning. While computed tomography (CT) is the gold standard for evaluating bony parameters, magnetic resonance imaging (MRI) may serve as a viable alternative, offering no radiation exposure. This study aims to compare the reliability of conventional 2D (two- Dimensional)-MRI with 2D-CT in measuring bony parameters and classifying lesions as on- or off-track. It was hypothesized that there is no difference in evaluation between MRI and conventional CT scans.

METHODS: A retrospective case-control study was conducted on 61 patients (mean age 45 ± 19 years) with anterior shoulder dislocations who underwent both CT and MRI imaging. Radiographic measurements, including glenoid diameter, glenoid defect (in width), Hill-Sachs lesion and bony bridge, were obtained independently from CT and MRI scans. Patients were categorized as on- or off-track based on the glenoid track and Hill-Sachs index. Statistical analyses included correlation tests, Bland-Altman plots, interrater agreement (intraclass correlation coefficient), and sensitivity and specificity analyses for lesion classification.

RESULTS: MRI showed good agreement with CT across most parameters, with mean differences of less than 1 mm for glenoid defect, glenoid diameter, and Hill-Sachs lesions. Correlation coefficients ranged from 0.62 (bony bridge) to 0.93 (glenoid defect). Bland-Altman plots revealed good agreement for glenoid parameters but higher variance for the Hill-Sachs lesion and bony bridge. MRI correctly classified 89% of on-track lesions (sensitivity) and 76% of off-track lesions (specificity). Interrater agreement was excellent for glenoid defect measurements (ICC = 0.962) and lower for the bony bridge (ICC = 0.848).

CONCLUSION: Conventional MRI demonstrates high reliability in measuring bony parameters and good accuracy in classifying on- and off-track lesions compared to CT. MRI is a viable alternative for preoperative evaluation, particularly in cases with minor bony defects. However, in indeterminate defects, a CT scan is recommended to ensure accurate measurements, classification and treatment planning.

LEVEL OF EVIDENCE: Level III.

PMID:40938433 | DOI:10.1007/s00402-025-06062-w

Psychopharmacology (Berl). 2025 Sep 12. doi: 10.1007/s00213-025-06894-9. Online ahead of print.

ABSTRACT

BACKGROUND: The dysregulation of prefrontal synaptic transmission accompanied by γ-aminobutyric acid (GABA) deficit, is crucial in depression. Previously, we have demonstrated that Baihe Dihuang decoction with verbascoside (VB) as one of the main active ingredients attenuates prefrontal interneurons deficits through synthesis and release of GABA negatively regulated by miR-144-3p, but the potential mechanism through which VB reverses the dysfunction of stress-induced aberrant prefrontal GABAergic neurons through miRNAs/Gad-67/VGAT signaling remains elusive.

METHODS: The antidepressant effects and neuroprotective function of VB were observed by a chronic stress-induced depression and corticosterone (CORT)-stimulated nerve cell injury model, respectively. Specific changes in prefrontal GABAergic miR-144-3p expression were used to assess the action of VB acting on GABA release.

RESULTS: High-expression prefrontal miR-144-3p was associated with depression-like behaviors caused by long time stress, reflected by altered GABA tone. Supplementation with VB attenuated chronic stress-induced prefrontal cortex neuron injury and prefrontal GABAergic deficit by downregulating miR-144-3p expression, as well as obviously improved the relative abundance of beneficial GABA-producing bacteria. However, antidepressant-like effects by VB were antagonized by overexpressed miR-144-3p in frontal cortex GABAergic neurons. Similarly, VB administration caused reduced expression of miR-144-3p against impaired GABA production. In the CORT-induced nerve cell injury model, The pharmacological effect of VB promoting GABA release ability and exerting neuroprotection is strongly reversed by overexpression of miR-144-3p.

CONCLUSION: This study elucidated that miR-144-3p down-regulated GABAergic neurons activation in the medial prefrontal cortex was sufficient and necessary for VB antidepressant responses.

PMID:40938419 | DOI:10.1007/s00213-025-06894-9

Disabil Rehabil Assist Technol. 2025 Sep 12:1-15. doi: 10.1080/17483107.2025.2558215. Online ahead of print.

ABSTRACT

PURPOSE: This scoping review aimed to explore and map wheelchair outcome measurement instruments for children in the literature.

MATERIALS AND METHODS: A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology. The review focused on children (≤18 years) manual or motorised wheelchair users, and included primary sources of literature on wheelchair outcome measurement instruments. A search was conducted in nine electronic databases, including grey literature. Data on general characteristics, psychometric properties (validity, reliability, responsiveness) were extracted and analysed descriptively.

RESULTS: A total of 27 studies and 33 instruments were included, mostly focused on manual wheelchair users (n=23). Performance-based outcomes instruments were the most common (n=15). Construct validity (n=19) and test-retest (n=19) were the most assessed psychometric property. Responsiveness (n=3) and intra-rater (n=3) were the least reported. The most frequently conducted statistical analyses were: minimal detectable difference (MDD) (n=12), standard error of measurement (SEM) (n = 12), intraclass correlation coefficient (ICC) (n=16) and Pearson correlation (n=9). The most common construct was propulsion perfomance in a manual wheelchair (n=6).

CONCLUSION: Wheelchair outcome measurement instruments for children mainly assess manual wheelchairs, emphasising propulsion perfomance as the primary outcome. Responsiveness and intra-rater are underreported, highlighting a gap for future research. Standardised methodologies and detailed reporting, including sample size specifications, are essential for advancing research and clinical practice.

PMID:40937612 | DOI:10.1080/17483107.2025.2558215