Nevin Manimala

Biogerontology. 2025 Dec 13;27(1):20. doi: 10.1007/s10522-025-10369-x.

ABSTRACT

Population ageing is a global phenomenon with significant implications for public health. Research has highlighted a relationship between gut microbiota, inflammatory cytokines, and ageing, yet the underlying causal mechanisms remain elusive. This study uses Mendelian randomization (MR) analysis to investigate causal relationships between gut microbiota, inflammatory cytokines, and ageing phenotypes. We leveraged the summary statistics of gut microbiota (n = 5959), circulating inflammatory cytokines (n = 8293), and three ageing phenotypes including telomere length (n = 472,174), facial ageing (n = 423,999), and frailty index (n = 175,226). We performed bidirectional MR analyses to explore the causal effects of gut microbiota and inflammatory cytokines on ageing, and mediation analyses to discover potential mediating gut microbiota and inflammatory cytokines. Our findings suggest that there are causal interactions between gut microbiota, inflammatory cytokines, and ageing. Notably, the abundance of GCA-900066575 sp900066385 appears to mediate the M-CSF pathway to facial ageing. The current MR study provides evidence supporting causal relationships between inflammatory cytokines and ageing and potential mediating gut microbiota, which are critical to advancing our understanding of the ageing process and developing effective interventions.

PMID:41389138 | DOI:10.1007/s10522-025-10369-x

Environ Sci Pollut Res Int. 2025 Dec 13. doi: 10.1007/s11356-025-37294-3. Online ahead of print.

ABSTRACT

This study evaluates the effectiveness of metal-organic acid mordanting systems as sustainable alternatives to high-concentration metallic mordants in natural dyeing of wool yarns using Rubia tinctorum (madder) and Reseda luteola (weld). A total of 46 treatments involving single metals, organic acids, and their binary combinations were applied, and the dyed yarns were assessed for colorimetric parameters (K/S), ultraviolet protection factor (UPF), and antioxidant activity. The results demonstrated that binary mordant systems, especially those combining copper and iron salts with citric or tartaric acid, significantly enhanced color strength (K/S up to 12.05), UV protection (UPF > 90), and radical scavenging activity (up to 96.10%), often surpassing the performance of conventional 5% metal mordants. Non-parametric Kruskal-Wallis tests showed statistically significant improvements (p < 0.05) for weld-dyed samples in all functional categories, while correlation matrices revealed strong associations between K/S, UPF, and antioxidant values in weld, but weaker links in madder. These findings confirm that binary metal-acid mordanting systems can effectively reduce metallic load without compromising or even enhancing dye performance, photoprotection, and bioactivity contributing to both textile sustainability and functional innovation.

PMID:41389125 | DOI:10.1007/s11356-025-37294-3

Support Care Cancer. 2025 Dec 13;34(1):32. doi: 10.1007/s00520-025-10228-y.

ABSTRACT

BACKGROUND: Transoral endoscopic head and neck surgery is an important modality in hypopharyngeal carcinoma therapy. Minimally invasive techniques and nerve protection are important components of Enhanced Recovery After Surgery principles. However, the limited surgical space and the challenges in identifying the internal branch of the superior laryngeal nerve (ibSLN) pose difficulties during this procedure. This study investigated the effects of preserving the ibSLN during transoral laser surgery on the postoperative swallowing rehabilitation of patients diagnosed with pyriform sinus carcinoma.

METHODS: A prospective cohort study with a retrospective control group was performed, including 42 patients with pyriform sinus carcinoma who had previously undergone transoral laser surgery. The participants were categorized into the ibSLN dissection and control groups. In the ibSLN dissection group, the ibSLN was exposed and dissected without nerve lesions. Traditional transoral surgery without proactive ibSLN dissection was performed in the control group. Demographics, operative data, postoperative swallowing function, tube removal time, and postoperative hospitalization time were evaluated and compared between both groups.

RESULTS: Although the surgery time was longer in the ibSLN dissection group, the normal food intake, tube removal time, and postoperative hospitalization times were significantly shorter than those in the control group (P < 0.05). The MD Anderson Dysphagia Inventory (MDADI) scores after surgery significantly improved in the ibSLN dissection group. At 14 days post-surgery, significant improvements were observed in the four MDADI subset scores: global (P < 0.001), emotional (P < 0.05), functional (P < 0.05), and physical (P < 0.05). The postoperative water swallowing test showed a significantly faster swallowing speed in the ibSLN dissection group compared to the control group (P < 0.001). Fiberoptic endoscopic evaluation of swallowing showed a reduction in the epiglottic mobility impairment, aspiration, and residue in the pyriform fossa in the ibSLN dissection group, although the difference was not statistically significant.

CONCLUSIONS: Identification and dissection of the ibSLN can be successfully performed during transoral laser surgery in patients with pyriform sinus carcinoma. ibSLN dissection during transoral laser surgery has the potential to mitigate the risk of ibSLN damage, thereby facilitating enhanced recovery after surgery.

PMID:41389118 | DOI:10.1007/s00520-025-10228-y

CVIR Endovasc. 2025 Dec 13;8(1):112. doi: 10.1186/s42155-025-00621-3.

ABSTRACT

PURPOSE: To determine whether there is a significant decrease in intimal hyperplasia post percutaneous transluminal angioplasty (PTA) of AV access stenosis. Comparing drug-coated balloon (DCB) angioplasty with plain uncoated balloon (PUB) angioplasty by examining B-mode ultrasound measurements of percentage intimal medial thickening (%IMT) in stenotic lesions pre and post PTA.

METHODS: One hundred ninety-one consecutive PTA procedures for AV access dysfunction were screened retrospectively for inclusion. Those procedures where there was an ultrasound prior to and following PTA with measurements of IMT were included.

RESULTS: Ninety-nine stenotic lesions were included in a total of 87 patients. A total of 26/99, 26%, were treated by DCB angioplasty, and a total of 73/99, 74%, were treated by PUB angioplasty. The difference between the pre-PTA and post-PTA %IMT was calculated and defined as the delta-%IMT for each group. There was a greater reduction in %IMT in the DCB group (mean delta-%IMT = – 22.35%) when compared with the PUB group (mean delta-%IMT = – 5.94%), p = 0.0005. Delta-%IMT for those lesions where there was a baseline pre-PTA %IMT of greater than 25% was examined. The mean delta-%IMT reduced in the PUB group from – 5.94% to – 2.20% and remained similar in the DCB group at – 20.05%, p = 0.0003. A Kaplan-Meir survival analysis examining primary patency over 24 months did not demonstrate any significant difference between the 2 groups.

CONCLUSION: The statistically significant decrease in %IMT post PTA using a DCB compared with PUB angioplasty appears to demonstrate an anti-proliferative drug effect on lesion intimal hyperplasia. However, this did not translate into a sustained difference in target lesion primary patency.

PMID:41389108 | DOI:10.1186/s42155-025-00621-3

Lasers Med Sci. 2025 Dec 13;40(1):523. doi: 10.1007/s10103-025-04774-4.

ABSTRACT

Onychomycosis is a persistent nail infection often caused by dermatophytes or yeasts, with conventional treatments limited by long durations, poor compliance, and resistance. The long-pulsed Nd: YAG 1064 nm laser (NDYL) has emerged as a potential adjunct; however, its effects in combination with antifungals against yeast-related cases are unclear. This study examined the in vitro synergistic effect of NDYL with four antifungal agents-Ketoconazole (KET), Itraconazole (ITK), Voriconazole (VRC), and Terbinafine(TRB)-on clinical yeasts isolates from patients with onychomycosis. Yeast isolates were identified through ITS PCR sequencing. Susceptibility testing was conducted using the CLSI disk diffusion method (document M44-A2). Two experimental series-vital nail scrapings and cultured colonies-were exposed to standardized NDYL laser parameters. Antifungal activity was assessed by measuring inhibition zone diameters, and statistical comparisons were performed using paired t-tests. NDYL significantly enhanced antifungal activity, with the most pronounced effects observed for KET and ITC (p < 0.05). KET achieved up to 100% sensitivity improvement in nail scraping samples. VRC and TRB demonstrated moderate but consistent enhancements. Recorded irradiation temperatures remained below 42 °C, suggesting primarily non-thermal mechanisms. The relative frequencies of increased inhibition zone diameters in nail scrapings, yeast colonies, and combined datasets were: ITC (83.3%, 50.0%, 66.7%), VRC (66.7%, 50.0%, 58.3%), TRB (33.3%, 16.7%, 25.0%), and KET (100%, 66.7%, 83.3%). These findings support NDYL as a potential adjunctive tool for enhancing antifungal efficacy in yeast-associated onychomycosis. Further in vivo research is warranted to confirm clinical applicability and refine treatment protocols.

PMID:41389091 | DOI:10.1007/s10103-025-04774-4

Eur Radiol. 2025 Dec 13. doi: 10.1007/s00330-025-12165-0. Online ahead of print.

ABSTRACT

Gadolinium-based contrast agents (GBCAs) have been fundamental to head and neck cancer (HNC) imaging, enabling effective detection, characterization, treatment response assessment, and disease progression monitoring of lesions. Additionally, perfusion-weighted imaging (PWI) utilizing dynamic contrast enhancement (DCE) has been evaluated for its ability to provide insights into microvascular parameters concerning blood flow within tumor tissue. Nevertheless, increasing worries regarding gadolinium accumulation within the central nervous system and its effects on the environment have led to a reconsideration of its application. This narrative review explores the current role of GBCAs in HNC imaging, the primary sequences used after GBCA administration, their interpretation, and potential alternative imaging approaches. Currently, GBCA administration is a cornerstone of multiparametric MRI for the diagnosis, staging, and monitoring of HNCs, commonly involving a 3D T1-weighted sequence with fat saturation during the equilibrium phase. While PWI shows potential for clinical application in HNCs, its broader clinical adoption requires further standardization. Notably, DCE can visually aid in detecting subtle tumors, and its application in the differential diagnosis of solid parotid lesions is yielding promising results. Arterial spin labeling is emerging as a compelling alternative for PWI, eliminating the need for GBCA administration. Other promising strategies for reducing or even avoiding GBCA use include hybrid PET/MRI examinations, the development of novel contrast agents (including high-relaxivity GBCAs and gadolinium-free contrast agents), and the implementation of artificial intelligence tools. KEY POINTS: Question When should GBCAs be administered to patients undergoing MRI for HNCs? Findings GBCA injection is a cornerstone of multiparametric MRI for the diagnosis, staging, and monitoring of HNCs. Clinical relevance GBCAs are recommended for HNC MRIs, with a possible exception for patients with no clinical or radiological evidence of recurrence after 27 months of follow-up. DCE is useful for identifying small carcinomas and characterizing parotid lesions.

PMID:41389084 | DOI:10.1007/s00330-025-12165-0

Eur Radiol. 2025 Dec 13. doi: 10.1007/s00330-025-12200-0. Online ahead of print.

ABSTRACT

OBJECTIVES: Coronary artery calcium (CAC) scoring is a well-established marker of atherosclerotic burden in the general population. Limited research has examined CAC progression and clinical implications in heart transplant (HT) recipients. We evaluated CAC progression in HT patients during long-term follow-up.

MATERIALS AND METHODS: We included adult HT recipients (≥ 5 years post-HT) from a retrospective single-center cohort undergoing annual cardiac CT with ≥ 4 years of follow-up. CAC scores were assessed using non-contrast CT. Patients were classified into two groups: no CAC progression (CAC = 0 across all CT scans) or any increase in CAC during follow-up. Generalized linear mixed models evaluated temporal changes in CAC; logistic regression identified variables associated with CAC progression.

RESULTS: Among 116 patients (median age at baseline CT: 52 [38-63] years, 62% male), 65 showed CAC progression. From baseline to final CT, the proportion of patients with cardiac allograft vasculopathy (CAV) score 0 declined (90-83%), while CAV 1 and 3 increased (3-6%; 8-11%). CAC scores showed an annual increase in Ln(CAC + 1) of 0.4 (95% CI: 0.4-0.5; p < 0.001), corresponding to a 55% relative yearly increase. Significant interactions were found with recipient age at baseline CT (p = 0.008), donor heart age (p < 0.001), sex (p = 0.024), and recipient ischemic cardiomyopathy (p < 0.001). Only donor heart age was independently associated with CAC progression (p < 0.001).

CONCLUSION: CAC progression is common post-HT, with donor heart age showing the strongest association. Younger recipient and donor heart age, male sex, and ischemic cardiomyopathy were associated with faster CAC progression, suggesting the need for closer surveillance and more aggressive cardiovascular management.

KEY POINTS: Question Longitudinal changes in CAC score were assessed in HT recipients to provide insights into cardiovascular risk and disease progression. Findings Over half of HT recipients showed CAC progression, which was significantly associated with donor age. Recipient age, sex, and primary diagnosis influenced progression rate. Clinical relevance Routine CAC monitoring may help identify patients at higher risk of cardiovascular events after heart transplantation, allowing for closer surveillance and more aggressive cardiovascular management, which in turn might improve long-term outcomes.

PMID:41389083 | DOI:10.1007/s00330-025-12200-0

JACC Heart Fail. 2025 Dec 11:102841. doi: 10.1016/j.jchf.2025.102841. Online ahead of print.

ABSTRACT

BACKGROUND: The preCARDIA device is a novel intervention designed to mechanically reduce cardiac filling pressures in patients with acute decompensated heart failure (ADHF) by regulating flow through the superior vena cava.

OBJECTIVES: The VENUS-HF Early Feasibility Study (SVC Occlusion in Subjects With Acute Decompensated Heart Failure; NCT03836079) tested the safety and feasibility of the next-generation preCARDIA system, which includes updates to the sheath, catheter, and console.

METHODS: In a multicenter, prospective, single-arm safety and feasibility study, 60 subjects with ADHF received preCARDIA support for up to 24 hours. Primary and secondary endpoints testing the safety and technical feasibility of the device were analyzed.

RESULTS: Freedom from device- or procedure-related major adverse events was observed in 98.3% (n = 59/60), and successful device deployment and removal in all subjects (n = 60/60). No statistically significant difference in major adverse events was observed between recipients of the original (0%, n = 0/30) and newest (3.3%, n = 1/30) generation preCARDIA devices. In subjects with 24 ± 3 hours of preCARDIA duration (n = 52), paired right atrial and pulmonary capillary wedge pressures decreased by 23% (18 ± 6 vs 11 ± 6 mm Hg, P < 0.0001) and 18% (30 ± 8 vs 24 ± 9 mm Hg, P < 0.0001), respectively, from baseline to end of device use. Compared with 24 hours before device initiation, net urine output increased during the 24-hour period during device use (-1.5 ± 0.9 vs -3.4 ± 2.4 L, P < 0.001).

CONCLUSIONS: Use of the preCARDIA system in patients with ADHF was feasible and well tolerated, with early exploratory signals of significantly reduced cardiac filling pressures and increased urine output. These findings provide a foundation for larger, prospective studies, such as the upcoming COR-ADHF (Cardiovascular UnlOading with preCARDIA in Acute Decompensated Heart Failure) trial, to determine clinical efficacy.

PMID:41389079 | DOI:10.1016/j.jchf.2025.102841

J Emerg Nurs. 2025 Dec 12:S0099-1767(25)00471-4. doi: 10.1016/j.jen.2025.11.016. Online ahead of print.

ABSTRACT

Pediatric emergency nurses play a central role in mass casualty incident response, yet persistent gaps in readiness remain. This quality improvement project evaluated baseline mass casualty incident readiness among registered nurses in a large pediatric emergency department and assessed the impact of an educational intervention combining didactic review and simulation-based functional exercises. Using a pre-/postintervention design, nurses completed a readiness survey and participated in timed functional tasks to assess knowledge, confidence, and efficiency. The intervention comprised a didactic review of institutional protocols, a practical review of supply locations, and 30-minute functional simulation drills focused on zone leader responsibilities. A total of 63 nurses completed preassessments, and 64 completed postassessments. After the intervention, 92% accurately identified supply locations, 98% described zone leader roles, and 100% reported feeling at least neutral in preparedness. Knowledge gains in this project were statistically significant (P < .001). The results indicate that structured education combined with simulation improved pediatric emergency nurses’ readiness for mass casualty incidents within this setting. The intervention’s effectiveness was further demonstrated when it was applied successfully during an actual mass casualty incident. Incorporating pediatric-focused mass casualty incident training into ongoing ED education may continue to enhance nurse competence, support team performance, and strengthen institutional disaster preparedness.

PMID:41389075 | DOI:10.1016/j.jen.2025.11.016

Clin Neuropsychol. 2025 Dec 13:1-12. doi: 10.1080/13854046.2025.2601744. Online ahead of print.

ABSTRACT

Objective: Teleneuropsychology (TeleNP) shows promise as an alternative visit type for patients in which face-to-face (FTF) neuropsychological evaluation is not a viable option. Undergoing FTF presurgical deep brain stimulation (DBS) neuropsychological evaluations may represent a hardship for some patients with movement disorders, yet comparison of performance for TeleNP and FTF for the commonly used Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has not been studied in this population. The current study aimed to examine RBANS performance of FTF and TeleNP administration in a cohort of movement disorders patients in a clinical setting, hypothesizing similar performance regardless of modality. Method: Four hundred six patients with Parkinson’s disease or essential tremor completed the RBANS between two medical centers between 2020 and 2024 as part of standard clinical care within their presurgical assessment for candidacy for DBS or High-Intensity Focused Ultrasound thalamotomy. Results: The TeleNP sample was significantly older than the FTF sample (p = .02). There were no statistical differences in gender (p = .18) or education (p = .66) between the samples. After controlling for age and motor diagnosis differences between the two groups, 9 of the 11 RBANS subtests were comparable, with the TeleNP group performing significantly better on the Picture Naming subtest and the FTF group performing significantly better on the Figure Recall subtest. The effect size of these differences were small, indicating relatively low clinical meaningfulness. Conclusions: The findings of the current study suggest the two methods of administration were associated with broadly comparable performances in this movement disorder population, suggesting TeleNP may be a viable option for presurgical evaluation.

PMID:41389068 | DOI:10.1080/13854046.2025.2601744