Nevin Manimala

Clin Rheumatol. 2025 Aug 4. doi: 10.1007/s10067-025-07620-8. Online ahead of print.

ABSTRACT

OBJECTIVES: The prevalence of sedentary behavior, hyperuricemia, and gout is increasing worldwide. However, the relationships between sedentary behavior and the risk of hyperuricemia and gout in American adults remain unclear. Therefore, we aim to investigate the association between sedentary behavior and the risk of hyperuricemia and gout.

METHODS: Adults aged ≥ 20 years from the 2007-2016 National Health and Nutrition Examination Survey (NHANES) were analyzed, with sedentary time assessed via questionnaires and serum uric acid levels measured through laboratory tests. Gout was confirmed by a physician or health professional. Hyperuricemia was defined as a serum uric acid level of ≥ 7.0 mg/dL in men and ≥ 5.7 mg/dL in women. Weighted logistic regression models and restricted cubic spline analyses were used to examine the associations between sedentary time and hyperuricemia and gout. Mediation analysis was used to explore the potential mediating role of hyperuricemia.

RESULTS: A total of 17,634 participants were included in the analysis. The prevalence of hyperuricemia was 20.24% (3569/17,634), and gout was 4.11% (725/17,634). After adjusting for multiple covariates, weighted logistic regression indicated that higher sedentary time (> 8 h/day) was associated with increased risk of hyperuricemia and gout, with adjusted odds ratios (OR) of 1.18 (95% CI: 1.01, 1.39) and 1.41 (95% CI: 1.04, 1.93), respectively. Restricted cubic spline analysis revealed a nonlinear association between sedentary time and the risks of hyperuricemia and gout. Subgroup analyses showed that chronic kidney disease (CKD) stage (P = 0.012) and sex (P = 0.04) modified the association between sedentary time and hyperuricemia, while sex alone modified the association with gout (P = 0.04). The results of the sensitivity analyses remained robust. The results of the mediation analysis showed that hyperuricemia played a mediating role between sedentary time and gout, with a mediation proportion of 15.93%.

CONCLUSION: Sedentary time increases the risk of hyperuricemia and gout in US adults, especially in men and those with advanced CKD, with hyperuricemia acting as a key mediator. Key Points • Sedentary time of more than 8 h per day is significantly associated with an 18% increased risk of hyperuricemia and a 41% increased risk of gout, compared to less than 4 h per day among US adults. • The association between sedentary time and hyperuricemia is more pronounced among males and individuals with advanced stages of chronic kidney disease, while the association with gout is significantly modified by sex, with a stronger effect observed in males. • Hyperuricemia plays a mediating role between sedentary time and gout, with a mediation proportion of 15.93%.

PMID:40758258 | DOI:10.1007/s10067-025-07620-8

J Bronchology Interv Pulmonol. 2025 Aug 4;32(4):e01022. doi: 10.1097/LBR.0000000000001022. eCollection 2025 Oct 1.

ABSTRACT

BACKGROUND: This study aimed to evaluate the trends in the use of endobronchial valve (EBV) and video-assisted thoracoscopic surgery (VATS) for bronchopulmonary fistula (BPF) between 2016 and 2021, and to compare their clinical and economic outcomes.

METHODS: We conducted a retrospective analysis of national inpatient data from 2016 to 2021 to identify patients (age ≥18 y) with BPF who underwent EBV or VATS. Patients who had both EBV and VATS were excluded. We examined the annual procedure volumes, mean costs, length of stay (LOS), and in-hospital mortality rates. Statistical analyses were performed to compare outcomes between the 2 interventions.

RESULTS: Out of 13,245 patients with BPF, 660 underwent EBV and 535 underwent VATS. The total number of yearly EBV increased from 65 to 230 (P=0.043) and the total number of yearly VATS increased from 65 to 180 (P=0.854). Mortality rate (P=0.843), total cost (P=0.735), and LOS (P=0.337) remained stable for EBV patients. We observed a reduced mortality trend for VATS patients (P=0.041), while total cost (P=0.839), and LOS (P=0.886) remained stable.

CONCLUSION: EBV has become significantly more prevalent in BPF management. This could be due to increasing expertise and demand for a procedure for patients too critical to undergo VATS. VATS was associated with a mortality reduction between 2016 and 2021, which could be attributed to more strict patient selection.

PMID:40758241 | DOI:10.1097/LBR.0000000000001022

Fam Syst Health. 2025 Jun;43(2):210-224. doi: 10.1037/fsh0000954.

ABSTRACT

BACKGROUND: The prevalence of type 2 diabetes (T2D) is increasing globally, especially among South Asian (SA) adults, and requires innovative solutions. Traditional T2D prevention and management programs focus on lifestyle change but this is often challenging for caregivers with competing priorities and may not fit a family’s needs. Utilizing social support has been promising for supporting diabetes prevention and management. We aim to explore how the social networks of SA caregivers with diabetes can influence their health and inform interpersonal and community-level health interventions for this community.

METHOD: Participants lived in Peel Region, Ontario were diagnosed with T2D, prediabetes, or gestational diabetes and were SA caregivers of children under 24 years old. Caregivers completed a semistructured interview to discuss (a) their experiences, perceptions, and beliefs about T2D, (b) their caregiving roles in their diabetes management, (c) how the social determinants of health impact diabetes management, and (d) the individuals and resources influencing their diabetes management. We used network analysis to explore network size and composition in relation to social supports.

RESULTS: Twenty-one caregivers completed interviews. We identified three network typologies for caregivers, including (a) healthcare and community program focused, (b) isolated, and (c) family and diverse social support and explored how caregivers describe the network actors as supporting or not supporting their diabetes management.

CONCLUSION: This study advances our understanding of the social networks and supports that SA caregivers use to support diabetes management and further emphasizes the importance of leveraging existing community supports. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40758233 | DOI:10.1037/fsh0000954

Front Surg. 2025 Jul 18;12:1584238. doi: 10.3389/fsurg.2025.1584238. eCollection 2025.

ABSTRACT

OBJECTIVE: To identify specific factors predicting functional outcomes, pain reduction, and patient satisfaction following knee arthroplasty through systematic review and meta-analysis.

METHODS: A comprehensive search of multiple databases (Pubmed, Embase, OVID, Medline, Cochrane Library, CNKI, Wanfang, VIP) was conducted for studies published from database inception to December 2024. Studies reporting associations between preoperative factors and standardized outcomes after knee arthroplasty were included. Two reviewers independently screened articles, extracted data, and assessed study quality using modified Jadad scale for randomized trials and MINORS for non-randomized studies. Random-effects meta-analyses were performed for pain duration and red blood cell distribution width (RDW), with meta-regression to assess their prognostic value for functional outcomes measured by standardized knee scores. Heterogeneity was assessed using I² statistics, and publication bias was evaluated using Egger’s and Begg’s tests.

RESULTS: Eight studies were included in the final analysis: Four studies examining pain duration (n = 576 patients) and four studies examining RDW (n = 612 patients) met inclusion criteria. Significant heterogeneity was observed in both analyses (I² = 87% and I² = 91%, respectively, p < 0.01). Meta-regression revealed that shorter pain duration (<3 years) was significantly associated with better functional outcomes at 12-month follow-up [Weighted Mean Difference (WMD) = -4.532, 95%CI = (-6.439,-2.626), p < 0.001]. Normal preoperative RDW values (11.5-14.5%) were also significantly associated with improved functional outcomes [WMD = -1.742, 95%CI = (-2.371,-1.114), p < 0.001]. Subgroup analyses indicated that the predictive value of these factors was consistent across different surgical techniques (p = 0.42). Publication bias assessment showed no significant bias (Egger’s test p = 0.2094, Begg’s test p = 0.0833). The high heterogeneity limits the direct clinical application of these pooled estimates and necessitates cautious interpretation.

CONCLUSION: This meta-analysis identified shorter preoperative pain duration and normal RDW values as independent predictors of better functional outcomes following knee arthroplasty. However, the small number of included studies and high heterogeneity observed warrant cautious interpretation of these findings. These findings can help clinicians identify patients at risk of suboptimal outcomes and potentially guide personalized perioperative interventions. Further research is needed to establish optimal cutoff values and to evaluate the combined predictive power of these factors in clinical practice.

PMID:40755482 | PMC:PMC12315344 | DOI:10.3389/fsurg.2025.1584238

J Plast Reconstr Surg. 2025 Jan 24;4(3):127-136. doi: 10.53045/jprs.2024-0044. eCollection 2025 Jul 27.

ABSTRACT

OBJECTIVES: This study aimed to compare the quality of scarring of DERMABOND PRINEO (Ethicon, Inc., Somerville, NJ, USA)^Ⓡ by conducting a half-side test on the same wound to determine its superiority. If the utility of DERMABOND PRINEO^Ⓡ is established, its use can be expanded for more cases and higher quality medical care can be provided.

METHODS: Patients who underwent two-stage breast reconstruction were included. The first surgery was half closed with DERMABOND PRINEO^Ⓡ and nylon threads, and the time was measured. At the second surgery, all scars were removed, and a histopathological examination was done. Scars were evaluated with the Vancouver Scar Scale (VSS) and visual analogue scale (VAS), and statistical analysis was performed.

RESULTS: Time to closure was significantly shorter in the DERMABOND PRINEO^Ⓡ group. Postoperative VSS scores for pliability were significantly lower in the suture group, and the total VSS score was significantly lower in the suture group from 3 to 6 months postoperatively. Patients rated postoperative wound pain, itching, appearance, and satisfaction with the VAS, but no significant differences were observed between the two groups. The scars were compared with hematoxylin-eosin staining and Elastica van Gieson staining. Differences were seen in the increase of elastic fibers in the dermal reticular layer, a characteristic difference between the two groups.

CONCLUSIONS: The use of DERMABOND PRINEO^Ⓡ leads to a reduction in operative time and impacts the maturity of the scar. It is expected that the indications for DERMABOND PRINEO^Ⓡ can be further expanded in the future.

PMID:40755474 | PMC:PMC12310342 | DOI:10.53045/jprs.2024-0044

Drug Alcohol Rev. 2025 Aug 4. doi: 10.1111/dar.70011. Online ahead of print.

ABSTRACT

INTRODUCTION: Understanding the experiences of women participating in residential alcohol and other drug (AOD) treatment is important in ensuring treatment effectively meets women’s needs. Patient-reported experience measures aid in assessing women’s experiences of treatment but are often used to quantify women’s treatment satisfaction without additional context regarding specific treatment experiences. This study examined the relationship between the domains of the Patient Reported Experience Measure for Addiction Treatment (PREMAT) and overall treatment satisfaction, including whether relationships differed by gender.

METHODS: N = 138 participants (30.9% women) from a not-for-profit residential AOD treatment service completed a survey regarding their experiences of and satisfaction with treatment, including the PREMAT. Descriptives, chi-square and Mann-Whitney U statistics examined gender differences in demographics. A generalised linear model assessed the relationship between PREMAT domain scores and overall treatment satisfaction (Client Satisfaction Questionnaire), controlling for age and weeks in treatment, including whether relationships differed by gender. Relative weight statistics examined the relative statistical importance of each PREMAT domain to overall satisfaction.

RESULTS: There were no gender differences on PREMAT item, domain or total scores. Controlling for age and weeks in treatment, significant predictors of overall treatment satisfaction were the PREMAT ‘self-determination and empowerment’ and ‘personal responsibility’ domains. The impact of ‘personal responsibility’ on overall satisfaction was weaker for women compared to men.

DISCUSSION AND CONCLUSIONS: Fostering individualised care and support, self-determination, empowerment and personal responsibility for care, are important aspects of residential treatment for both men and women. Further development of women-specific PREMs that address gendered experiences of treatment is warranted.

PMID:40755442 | DOI:10.1111/dar.70011

Vet Ophthalmol. 2025 Aug 4. doi: 10.1111/vop.70057. Online ahead of print.

ABSTRACT

PURPOSE: To determine if serum α2-macroglobulin (A2M) concentration varies based on donor species-canine or equine-and signalment.

METHODS: Serum A2M concentration ([A2M]) was measured in healthy dogs (n = 30) and horses (n = 31) using species-specific ELISAs.

RESULTS: Canine and equine [A2M] median (IQR; range) were 98.70 ng/mL (92.79 ng/mL; 34.33-696.18 ng/mL) and 557 000 ng/mL (437 900 ng/mL; 62 600-3 042 900 ng/mL), respectively. Equine [A2M] was significantly higher than canine [A2M]. Depending on the statistical analysis performed, sex had either no statistical (p = 0.17) or medium practical (η² = 0.07) effect on canine serum [A2M], with male dogs having higher [A2M] practically. There was no association between serum [A2M] and duration of serum storage at -80°C.

CONCLUSIONS: Equine serum [A2M] was exponentially higher than that of dogs. Sex may affect [A2M] in dogs. Further study is needed to evaluate how this difference affects antiprotease activity.

PMID:40755436 | DOI:10.1111/vop.70057

Eur Heart J Qual Care Clin Outcomes. 2025 Aug 4:qcaf075. doi: 10.1093/ehjqcco/qcaf075. Online ahead of print.

ABSTRACT

BACKGROUND: The role of female sex in stroke risk and oral anticoagulant (OAC) use in atrial fibrillation (AF) remains controversial. This study evaluates sex-specific differences in OAC prescription, residual risk of stroke/TIA and thromboembolism (STE), and the predictive performance of CHA₂DS₂-VASc vs. CHA₂DS₂-VA scores.

METHODS: We analyzed data from a European prospective cohort. The association between female sex and OAC prescription was assessed in patients with CHA₂DS₂-VA score ≥1. We analyzed the residual STE risk in OAC-treated patients and compared the predictive performance of CHA₂DS₂-VASc and CHA₂DS₂-VA scores.

RESULTS: Among 10,080 patients (41.8% women; mean age 69.7 [SD 10.7] years) with CHA₂DS₂-VA ≥1, women had higher burden of comorbidities and less likely to receive OACs than men (OR 0.79, 95% CI: 0.69-0.90). In OAC-treated patients, STE rates were higher in women (IR 1.33 vs. 0.94 per 100 person-years). After adjusting for confounders and the competing risk of death, female sex was not statistically significantly associated with an increased risk of STE (sHR 1.24, 95% CI 0.89-1.74, P=0.210). CHA₂DS₂-VA and CHA₂DS₂-VASc scores had similar predictive performance (AUC 0.603 vs. 0.605, P=0.665). CHA₂DS₂-VA showed worse (ie. negative) reclassification compared to CHA₂DS₂-VASc (net reclassification index -0.088, 95% CI -0.164 to -0.001), with no significant differences in discrimination or net benefit.

CONCLUSIONS: In AF patients treated with OAC, the increased residual risk of STE associated with female sex was non-significant after adjusting for confounders and the competing risk of death. Both scores had similar predictive performance but CHA₂DS₂-VA showed worse reclassification compared to CHA₂DS₂-VASc.

PMID:40755396 | DOI:10.1093/ehjqcco/qcaf075

Artif Organs. 2025 Aug 4. doi: 10.1111/aor.15066. Online ahead of print.

ABSTRACT

BACKGROUND: Kidney machine perfusion (MP) prevents delayed graft function (DGF). Whether this benefit translates into improved long-term graft survival (LGS) remains uncertain. We evaluated the association between MP and LGS and its potential mediation by DGF.

METHODS: UNOS analysis of adult deceased donor kidney transplant recipients (KTRs) from January 2010 to June 2019. We selected KTRs with cold ischemia time (CIT) > 12 h and on tacrolimus maintenance. We included KTRs from dual-kidney donors and compared outcomes where one mate kidney received MP and the other did not. The primary endpoint was all-cause graft failure (GF) analyzed using a stratified multivariable Cox proportional hazards model. We assessed the association of MP and DGF with conditional logistic regression. We evaluated the mediation effect of DGF by combining the predictor and outcome models and bootstrapping with 1000 iterations to calculate 95% confidence intervals (CI).

RESULTS: We included 2355 mate-kidney pairs with 5.8 years (IQR 4-8) median follow-up. MP was associated with lower GF risk (aHR 0.86, 95% CI 0.75-0.98) and DGF odds (aOR 0.41, 95% CI 0.34-0.51) than no MP. DGF fully mediated the association between MP and GF, as the effect was no longer statistically significant after adjusting for DGF (aHR 0.89, 95% CI 0.78-1.03). DGF explained 76.8% of the association between MP and GF.

CONCLUSIONS: In mate-kidney pairs with discordant MP use and CIT > 12 h, MP was associated with decreased GF risk, mediated by decreased DGF likelihood. MP both mate kidneys with CIT > 12 h should be considered to potentially improve LGS.

PMID:40755387 | DOI:10.1111/aor.15066

Histol Histopathol. 2025 Jul 15:18967. doi: 10.14670/HH-18-967. Online ahead of print.

ABSTRACT

INTRODUCTION: For the last three decades, bariatric/metabolic surgeries have highlighted the relevance of certain gastrointestinal hormones in controlling and regulating glucose metabolism. The incretins have been a significant focus in developing therapies against Type 2 Diabetes Mellitus (T2DM). Glucagon-like peptide-1 (GLP-1) has been a primary focus in this field, leading to the development of analogues with high therapeutic potential and efficiency, such as semaglutide. However, recently another incretin, glucose-dependent insulinotropic polypeptide (GIP), has become a key target in T2DM drug development due to its complex pleiotropic effects, which include modulating insulin/glucagon secretion, acting on adipose tissue, and regulating appetite. The description of GIP properties as dual can be ambiguous, as this may refer either to its capacity to regulate both insulin and glucagon or to its distinct actions at the central versus peripheral level. Connecting this multifaceted activity was the rationale for developing combined GIP/GLP-1 analogues, like tirzepatide, and has culminated in triple-receptor agonists such as retratutide, which also engages the glucagon receptor (LY3437943). These multi-agonists potentially enhance the therapeutic potential of GLP-1 analogues.

COMMENTARIES: This review covers GIP physiology, its role within the context of T2DM, and the properties of GIP analogues, which represent a new line of drugs against T2DM. This field includes not only GIP analogues, since some are dual or triple agonists that also target GLP-1. We aim to elucidate the future perspectives offered by the use of these drugs.

PMID:40755350 | DOI:10.14670/HH-18-967