Nevin Manimala

Cell Commun Signal. 2025 Aug 4;23(1):363. doi: 10.1186/s12964-025-02354-1.

ABSTRACT

BACKGROUND: Pancreatic fibrosis is a key pathological feature of chronic pancreatitis and pancreatic cancer, driven by the persistent activation of pancreatic stellate cells. These cells, normally quiescent, undergo profound phenotypic changes in response to environmental cues, yet the interplay between mechanical forces and metabolic reprogramming during this transition remains poorly understood. As the stromal microenvironment actively communicates with epithelial and vascular compartments, understanding this mechano-metabolic signalling axis is critical for uncovering novel mechanisms of tissue remodelling.

METHODS: To investigate the biomechanical and biochemical alterations during stellate cell activation, we employed atomic force microscopy and Raman spectroscopy to measure changes in cell stiffness, morphology, and molecular composition. These data were complemented by transcriptomic analyses to evaluate gene expression profiles related to lipid metabolism and autophagy. Quantitative statistical tests, including ANOVA and Kruskal-Wallis tests with appropriate post hoc corrections, were applied.

RESULTS: Activation of human pancreatic stellate cells led to progressive cytoskeletal remodelling, increased cellular stiffness, and a flattened morphology. Raman spectroscopy revealed an expansion of the cytoplasmic area, changes in nucleic acid signal, and significant increases in lipid content, particularly in unsaturated lipids and triacylglycerols. Gene expression analysis demonstrated upregulation of lipid elongation and desaturation pathways, along with enhanced autophagy, suggesting a coordinated metabolic adaptation. These changes support the myofibroblast-like phenotype and may influence intercellular signalling by altering extracellular matrix composition, mechanical tension, and the release of signalling molecules that affect the surrounding microenvironment.

CONCLUSIONS: Our findings reveal that pancreatic stellate cell activation involves a tightly coupled shift in mechanical and metabolic states, highlighting an integrated signalling process that may modulate stromal-vascular and stromal-epithelial communication. This mechano-metabolic axis represents a potential therapeutic target in fibrotic and neoplastic pancreatic diseases, where aberrant stromal signalling contributes to disease progression.

PMID:40759959 | DOI:10.1186/s12964-025-02354-1

BMC Endocr Disord. 2025 Aug 4;25(1):191. doi: 10.1186/s12902-025-02005-z.

ABSTRACT

BACKGROUND: Carotid artery calcifications and pulpal stones are radiopaque findings that may be found accidentally in panoramic views. The risk of affliction with atherosclerotic events in diabetic patients with dystrophic calcification is questionable. This study aimed to investigate the relative frequency of carotid calcifications and pulp stones in panoramic radiographs of diabetic patients.

METHODS: This retrospective observational study employed a convenience sampling method involving 107 diabetic patients. For comparison, 300 panoramic views from individuals estimated to be healthy in the community were included. The samples were randomly selected from the statistical population using a random numbers table. Data analysis was conducted using descriptive statistics, including mean and standard deviation, as well as analytical tests such as the chi-square test, all performed with SPSS 17 software (Chicago, USA).

RESULTS: In this study, panoramic radiographs of 107 diabetic patients (67 women and 40 men) and 300 healthy individuals (196 women and 104 men) were evaluated. The age range was 25 to 64 years, with a mean age of 49.7. The frequency of carotid artery calcification was 42 (14%) in healthy individuals and 44 (41.1%) in diabetic patients. Furthermore, the relative frequency of unilateral and bilateral carotid artery calcification in diabetic patients was significantly higher than in healthy subjects (P < 0.05). The Relative Risk (RR) of pulp stones in the diabetic patient group compared to healthy individuals was 1.8. With a 95% confidence interval, the relative risk ranged from 1.3 to 2.48, which was statistically significant (P < 0.05).

CONCLUSIONS: Based on the findings, the frequency of carotid artery calcification and pulp stones was higher in diabetic patients. Panoramic radiographic screening in diabetic patients is useful for early detection of carotid artery calcification and timely referral of patients to endocrinologists to prevent adverse sequelae.

PMID:40759953 | DOI:10.1186/s12902-025-02005-z

BMC Public Health. 2025 Aug 4;25(1):2647. doi: 10.1186/s12889-025-22701-8.

ABSTRACT

BACKGROUND: Ensuring housing interventions can contribute to improved living conditions which are strong socioeconomic determinants of leprosy. We estimated the association between the social housing programme Minha Casa Minha Vida (MCMVP) and leprosy new cases.

METHODS: We followed families registered in the 100 Million Brazilian Cohort linked with MCMVP receipt and nationwide registries of leprosy between 2010 and 2015. We used Cox regression weighted by stabilized inverse probability of treatment weighting (IPTW) to assess the hazard ratio (HR) for the effect of MCMVP on leprosy. Weights were obtained by propensity score using demographic and socioeconomic covariates at baseline. Sensitivity analyses were done considering potential delays to receiving MCMVP, municipality of residence population size and by controlling by the baseline risk of leprosy among potential recipients.

RESULTS: We followed up 24,584,768 individuals, of which 618,883 (2.5%) were MCMVP recipients, and detected 8,874 new leprosy cases during the study period. Leprosy incidence was higher among MCMVP recipients (13.32/100,000 pyr; 95%CI = 11.45-15.49) compared to non-recipients (11.72/100,000 pyr; 95%CI = 11.47-11.97). MCMVP recipients had higher leprosy incidence (HR = 1.66; 95%CI = 1.34-2.06), compared to non-recipients. Point estimates were lower when considering a delay of 6 or 12 months to moving into the new household (HR = 1.53; 95%CI = 1.20-1.95 and HR = 1.37; 95%CI = 1.05-1.78, respectively), in small/medium municipalities (≤ 300,000 inhabitants) (HR = 1.95; 95%CI = 1.51-2.52), and higher among individuals who subsequently became MCMVP beneficiaries before receiving the benefit (HR = 2.29; 95%CI = 1.93-2.72).

CONCLUSIONS: This study found a higher risk of leprosy associated with MCMVP that may reflect reverse causality. Our findings suggest the programme is, in fact, reaching the most vulnerable individuals, as intended in its objectives. Besides, the higher risk of leprosy among MCMVP beneficiaries even before receiving the benefit observed in sensitivity analysis may reflect residual confounding factors related.

PMID:40759946 | DOI:10.1186/s12889-025-22701-8

J Psychiatr Res. 2025 Jul 30;190:47-51. doi: 10.1016/j.jpsychires.2025.07.021. Online ahead of print.

ABSTRACT

INTRODUCTION: Randomized controlled trials demonstrating the efficacy of theta burst stimulation (TBS) for bipolar depression have been accumulating. However, the previous meta-analysis failed to detect a significant difference in efficacy compared to sham stimulation.

METHODS: A comprehensive search for randomized controlled trials was carried out using multiple databases, including PubMed, the Cochrane Library, CINAHL, and ClinicalTrials.gov. A random-effects meta-analysis was employed to assess and compare the antidepressant efficacy, tolerability, and acceptability of TBS versus sham stimulation.

RESULTS: A total of 7 randomized sham-controlled trials, encompassing 168 participants, met the inclusion criteria. TBS demonstrated superior antidepressant efficacy over sham stimulation, with a standardized mean difference of 0.67 (95 % confidence interval [CI]: 0.03 to 1.31). The odds ratio (OR) for clinical response favored TBS (OR = 2.93, 95 % CI: 1.32-6.52), while the OR in remission was not statistically significant (OR = 2.12, 95 % CI: 0.85-5.27). Acceptability, assessed by all-cause discontinuation, was comparable between groups (OR = 0.48, 95 % CI: 0.12-1.96).

CONCLUSIONS: Theta burst stimulation appears to be a promising, effective, and safe treatment for bipolar depression. Further large-scale and long-term randomized controlled trials are warranted.

PMID:40759064 | DOI:10.1016/j.jpsychires.2025.07.021

J Tissue Viability. 2025 Jul 14;34(4):100938. doi: 10.1016/j.jtv.2025.100938. Online ahead of print.

ABSTRACT

BACKGROUND: We surveyed primary and secondary care health professionals to describe the care and referral pathways for treatment, including surgical reconstruction (SR), for patients with a severe pressure ulcer (SPU).

METHODS: We administered three online surveys comprising closed and open-ended questions (free text comment boxes) to healthcare professionals working in primary care, nurses who look after patients with severe PUs in any setting and surgeons (11, 30 and 22 questions, respectively). Participants were recruited through professional organisations, contacts of study team members and through social media. We calculated descriptive statistics for the closed questions and used principles of thematic analysis to analyse the free text comments.

RESULTS: There were 59 primary care (76 % GPs), 146 nurse and 45 surgeon respondents. Most nurses worked in hospitals (60 %) or the community (55 %) and almost all (93 %) were trained in wound care. Most surgeons were plastic surgeons (79 %) in consultant roles (81 %). Over half of primary care respondents did not know SR is a treatment option to close SPUs and had never referred patients with SPUs to secondary care for a surgical opinion. Nearly three quarters of nurses (72 %) considered SR for a SPU and over half (54 %) believed that SR to close a SPU should be more widely available. Surgeons reported that SR was not performed for most referred SPU patients; but two thirds (68 %) believed that SR should be more widely available. There was good agreement about which patients are suitable for SR. The free-text analysis identified both system-level (e.g. lack of care pathways, dedicated multidisciplinary teams, resources) and patient-level (e.g. patient lifestyle, behaviour and preferences) factors influencing patients’ access to SR.

CONCLUSIONS: Our surveys highlighted that nurses and surgeons agree about which SPU patients are suitable for SR but lack of awareness, the absence of an established referral pathway and lack of multidisciplinary teams are barriers to access to SR.

PMID:40759061 | DOI:10.1016/j.jtv.2025.100938

Comput Biol Med. 2025 Aug 3;196(Pt B):110890. doi: 10.1016/j.compbiomed.2025.110890. Online ahead of print.

ABSTRACT

In diploid organisms, genes typically exhibit balanced expression of maternal and paternal alleles. However, exceptions exist, such as autosomal genes with allele-specific expression, where genetic and epigenetic variations can lead to the exclusive or preferential expression of a particular allele. In this context, allele-specific expression analysis serves as a powerful tool for understanding gene regulation, with significant functional and clinical implications. Despite their increasing importance, current analysis pipelines face notable limitations including a lack of end-to-end solutions, restricted options for multi-omics integration, and insufficient support for single-cell sequencing technologies. This review critically assesses 26 cutting-edge pipelines for allele-specific expression analysis, focusing on their input requirements, capabilities, and applications in the field. Pipelines are categorized based on their ability to handle various data types, support haplotype phasing, employ statistical approaches, and provide graphical outputs. Most pipelines fail to automate preprocessing, integrate multi-omic data, and support high-throughput single-cell sequencing. Future advancements should prioritize the development of automated multi-omic workflows, implementing visualization options, and enhancing compatibility with single-cell technologies. By addressing these gaps, next-generation allele-specific expression pipelines will offer insights into the mechanisms of allele-specific expression regulation, thereby advancing our understanding of its biological and clinical significance.

PMID:40759060 | DOI:10.1016/j.compbiomed.2025.110890

J Am Acad Orthop Surg. 2025 Aug 4. doi: 10.5435/JAAOS-D-24-01502. Online ahead of print.

ABSTRACT

INTRODUCTION: Dislocation is a known risk after total hip arthroplasty (THA), occurring in approximately 2% of cases. Although the posterolateral approach is the most commonly used approach to the hip, the disruption of posterior soft tissue is a concern for implant stability. The introduction of robotic assistance in arthroplasty has demonstrated improved implant positioning, although the effect on outcomes is still being assessed. The purpose of our study was to assess the 90-day dislocation rate between robotic-assisted and manual primary THA through the PL approach.

METHODS: Data were collected from two board-certified adult reconstruction surgeons who performed THA through a PL approach from 2014 to 2023. These two surgeons had high-volume arthroplasty practices and transitioned from manual to robotic-assisted surgery within this period. Variables including patient demographic information, use of robotic assistance, total 90-day complications, and Hip Disability and Osteoarthritis Outcome Score were collected and analyzed. Statistical analysis for numerical values was conducted using Student t-test and categorical variables with chi-square analysis, with alpha set at 0.05.

RESULTS: Two thousand five hundred forty-eight patients underwent a THA through the PL approach at our institution from 2014 to 2023. One thousand seven hundred twenty-seven patients had a manual THA, and 821 patients had a robotic-assisted THA. No significant difference was noted in total complication rates (n = 59, 3.4% vs. n = 18, 2.2%, P = 0.092) or dislocation rates (n = 7, 0.4% vs. n = 3, 0.4%, P = 0.88) between the manual and robotic-assisted groups, respectively. No statistical difference was found in the Hip Disability and Osteoarthritis Outcome Score at any of the postoperative time points. Total surgical time was markedly longer for the robotic-assisted group (88 minutes) compared with the manual group (74 minutes).

CONCLUSION: This study demonstrated no notable difference in 90-day dislocation rates for high-volume arthroplasty-trained surgeons when comparing manual versus robotic-assisted THA when using the PL approach.

PMID:40758989 | DOI:10.5435/JAAOS-D-24-01502

Sex Transm Dis. 2025 Aug 4. doi: 10.1097/OLQ.0000000000002227. Online ahead of print.

ABSTRACT

AIM: Human Papillomavirus (HPV) is a common sexually transmitted infection that often affects the reproductive system. HPV infection can cause various cancers and clinical symptoms in women, impacting their sexual activity and quality of life. Hence, this study aimed to assess the impact of motivational interviewing on the sexual function of women with HPV.

METHODS: This randomized controlled study utilized a pretest-posttest research design with a control group and involved 62 HPV patients from healthcare centers affiliated with Babol University of Medical Sciences, Iran. The study was registered on the Iranian Registry of Clinical Trials (IRCT20230531058348N1) in 2023.06.11 after we received ethics code. The patients were divided into two groups: an experimental and a control group. The allocation to these groups was determined using the blocked randomized allocation technique based on pretest scores. The experimental group received the motivational intervention over five sessions, while the control group received routine intervention. All participants completed the Female Sexual Function Index (FSFI) questionnaire before and immediately after the interventions. Data were entered into SPSS 24 and analyzed. Descriptive statistics included means and standard deviations for quantitative data and frequency percentages for qualitative variables. Chi-square tests and independent t-tests were used to examine relationships and compare initial variables. ANCOVA was used to compare questionnaire scores between the two groups. The significance level was set at 0.05.

RESULTS: The intervention (N = 31) and control (N = 31) groups had similar ages (33.58 ± 6.14 vs 34.96 ± 7.04 years, P = 0.412). Sexual dysfunction occurred in 74.2% of HPV-positive women. Covariance analysis showed that motivational interviewing had a significant positive effect on overall sexual function in women with HPV (η2 = 0.717, P < 0.001). Motivational interviewing with a large effect size also led to improved sexual desire (η2 = 0.566), increased arousal (η2 = 0.728), increased wetness (η2 = 0.531), increased orgasm (η2 = 0.525), increased sexual satisfaction (η2 = 0.563), and reduced sexual pain (η2 = 0.680) (P = 0.001).

CONCLUSION: The results of the study suggested that offering counseling to women with HPV could improve their sexual functioning, leading to a better overall sexual experience, mental and emotional well-being, and ultimately strengthening their quality of life and marital connections. Moreover, this could influence how healthcare providers support and aid people with HPV.

PMID:40758983 | DOI:10.1097/OLQ.0000000000002227

Acad Med. 2025 Jul 31. doi: 10.1097/ACM.0000000000006180. Online ahead of print.

ABSTRACT

PURPOSE: An increasing body of evidence reports on the training, development, implementation, operationalization, and outputs of clinical competency committees (CCCs). However, there is a paucity of syntheses on this existing evidence, contributing to a limited understanding of the factors that influence optimal CCC functioning. This scoping review maps studies that investigated and reported on CCC faculty development, structures and processes, and barriers, facilitators, and recommendations to optimize CCC functioning.

METHOD: The authors searched MEDLINE, Embase, Education Source, and Web of Science on January 31, 2023, and April 1, 2024, using subject headings and search terms such as clinical competency committee, resident, and faculty development. The searches were restricted to articles published between July 30, 2013, and April 1, 2024. The authors used a quasi-statistical content analysis to quantify and draw meaning from the evidence on CCC faculty development, structures, processes, and factors that influence optimal CCC functioning.

RESULTS: Data were extracted from 39 full-text articles. Four key thematic categories describe the focus of the findings: (1) faculty development, including the topics and delivery of the training for individuals involved in CCCs; (2) CCC structures, including the various sizes and compositions and meeting frequencies and durations; (3) CCC processes, including procedures before, during, and after the meetings; and (4) barriers, facilitators, and recommendations for optimal CCC functions.

CONCLUSIONS: This review demonstrates extensive variability in the ways in which CCCs are structured and run across programs. The findings reveal multiple key barriers and facilitators related to the sufficiency of collected assessment data, CCC composition, pre-CCC meeting work, understanding and interpretation of performance data, and presence of biases during decision-making. Postgraduate programs, CCC leaders, and accrediting bodies can use the findings and implications in this review to inform strategic thinking and future research agendas for local CCC development, implementation, operationalization, and optimization efforts.

PMID:40758982 | DOI:10.1097/ACM.0000000000006180

J Craniofac Surg. 2025 Aug 4. doi: 10.1097/SCS.0000000000011789. Online ahead of print.

ABSTRACT

To quantitatively evaluate the effect of corrective surgery for involutional entropion on tear film parameters-specifically lipid layer thickness (LLT), meibomian gland dysfunction (MGD), and incomplete blinking (IB)-using interferometry and meibography. A retrospective analysis was performed on 24 patients (48 eyes) diagnosed with involutional entropion who underwent corrective surgery. Tear film LLT, blinking patterns, MGD grade, Schirmer test, tear break-up time (BUT), and best-corrected visual acuity (BCVA) were measured pre- and postoperatively using the LipiView II Ocular Surface Interferometer. Comparisons before and after surgery were conducted, and statistical analyses were performed. Of the 24 patients, 11 had bilateral and 13 had unilateral entropion, with a mean age of 64.67±16.98 years. In entropionic eyes, BCVA improved from 0.17±0.22 to 0.11±0.13 (P=0.047), and LLT significantly increased from 66.74±26.94 nm to 81.37±21.42 nm (P<0.001). Meibomian gland dysfunction grade improved from 1.60±1.06 to 1.29±0.96 (P<0.001). No significant changes were observed in blinking rate, Schirmer score, or BUT. No statistically significant correlation was found among BCVA, LLT, and MGD grade. In conclusion, involutional entropion is associated with reduced tear film LLT and MGD. Surgical correction leads to significant improvements in LLT, MGD grade, and visual acuity. These findings highlight the role of entropion repair in restoring ocular surface health and suggest potential benefits in managing meibomian gland-related tear film dysfunction.

PMID:40758961 | DOI:10.1097/SCS.0000000000011789