Nevin Manimala

Nanoscale. 2025 Aug 1. doi: 10.1039/d5nr02033f. Online ahead of print.

ABSTRACT

Advancements in disease understanding have led to a shift towards personalized medicine, which has driven the development of an approach called theranostics. This approach combines diagnostics and therapy in one integrated system. Radiopaque biomaterials allow for non-invasive imaging using X-ray and computed tomography (CT). However, conventional contrast agents like gold nanoparticles are costly and are not well-suited for drug encapsulation. In this study, new block and statistical copolymers were synthesized using reversible addition-fragmentation chain-transfer (RAFT) polymerization comprising poly(N-isopropylacrylamide) (PNIPAM) and poly(5-acrylamido-2,4,6-triiodoisophthalic acid) (PAATIPA), designed to combine radiopacity with drug delivery capabilities. PAATIPA’s high iodine content provides strong contrast in CT scans, while PNIPAM’s thermoresponsiveness allows for self-assembly at higher temperatures. The anionic nature of PAATIPA allows the efficient encapsulation of the cationic small-molecule rhodamine 6G. The copolymers exhibited an enhanced encapsulation of cationic rhodamine 6G (>90% at 35 w/w% of rhodamine) and excellent biocompatibility, as demonstrated in cytotoxicity assays. This study emphasizes the potential of PAATIPA-based copolymer materials as multifunctional, radio-opaque and stimuli-responsive materials for theranostic applications.

PMID:40748606 | DOI:10.1039/d5nr02033f

J Sports Med Phys Fitness. 2025 Aug 1. doi: 10.23736/S0022-4707.25.16844-8. Online ahead of print.

ABSTRACT

INTRODUCTION: This systematic review and meta-analysis aim to evaluate the efficacy and safety of exercise intervention in improving the rehabilitation outcomes of advanced lung cancer patients.

EVIDENCE ACQUISITION: According to PRISMA’s statement, we searched the Web of Science, Medline, Embase, Cochrane Library, and ClinicalTrials.gov databases to collect randomized controlled trials on the efficacy and safety of exercise intervention in improving rehabilitation outcomes for lung cancer patients. These studies were established from the database until their publication in September 2024. A supplementary search was conducted on October 1, 2024. Perform statistical analysis using Review Manager 5.3.

EVIDENCE SYNTHESIS: A total of 14 randomized controlled trials with 756 participants were included. The meta-analysis results showed that exercise intervention significantly improved quality of life (such as EORTC-QLQ-C30 scale MD=5.26, 95% CI: 2.41 to 8.11, P=0.0003; FACT-L scale MD-5.03, 95% CI: 0.51-9.55, P=0.03), fatigue (MD=-6.29, 95% CI: 9.94 to -2.65, P=0.0007), anxiety and depression (MD=-110, 95% CI: 1.67 to -0.54, P<0.0001; MD=1.96, 95% CI: 1.22 to 2.70, P<0.001), and exercise ability (MD=15.34, 95% CI: 4.07-26.61, P=0.008). However, exercise intervention did not improve dyspnea (MD=-0.86, 95% CI: -3.34~1.62, P=0.50 >0.05) in lung cancer patients.

CONCLUSIONS: Exercise intervention can significantly improve patients’ quality of life, alleviate symptoms of fatigue, anxiety, and depression, enhance functional status and physical function. Therefore, it is recommended to include exercise intervention as part of the comprehensive treatment plan for cancer patients and further explore its best practices and potential mechanisms in future research.

PMID:40748599 | DOI:10.23736/S0022-4707.25.16844-8

Biol Trace Elem Res. 2025 Aug 1. doi: 10.1007/s12011-025-04770-3. Online ahead of print.

ABSTRACT

The heavy metals (Cd, Cr, Cu, Fe, Mn, Ni, Pb, and Zn) were quantified in 26 roasted coffee samples (19 Arabica and 7 Robusta) consumed in Turkey using ICP-OES. Cd and Pb were not detected in any sample. Cr was found only in Robusta samples, with a mean concentration of 0.58 mg/kg. The average concentrations of Cu, Fe, Mn, Ni, and Zn were 12.34 and 13.10 mg/kg, 13.67 and 14.69 mg/kg, 23.37 and 11.66 mg/kg, 0.04 and 1.17 mg/kg, and 8.31 and 7.19 mg/kg in Arabica and Robusta coffee samples, respectively. The heavy metal concentrations were compared with international limits and literature values. To assess the human health risk posed by heavy metals in the coffee samples, the estimated daily intake (EDI), hazard quotient (HQ), and hazard index (HI) were calculated based on average coffee consumption. All the EDI values were below the oral reference doses (RfDs), and both the HQ and HI values were less than 1, indicating no significant non-carcinogenic health risk associated with coffee consumption. Descriptive statistics summarized heavy metal levels, while inferential statistical tests evaluated differences among the coffee-growing regions and between the coffee bean species.

PMID:40748591 | DOI:10.1007/s12011-025-04770-3

Geochem Trans. 2025 Aug 1;26(1):7. doi: 10.1186/s12932-025-00102-5.

ABSTRACT

The present research work aims to understand the geochemistry of groundwater resources of the Yamuna-Hindon interfluve region of Bagpat district, Western Uttar Pradesh, India. The region is a part of Indo-Gangetic belt, one of the world’s most fertile and intensely farmed areas. To investigate the geochemical processes governing groundwater quality, a total of 105 groundwater samples were collected during pre-monsoon season and analyzed for various physico-chemical parameters, namely, pH, electrical conductivity (EC), total dissolved solid (TDS), total hardness (TH), turbidity, major anions (HCO₃^–, SO₄^2-, F^–, Cl^–, NO₃^–)_, cations (Ca²⁺, Mg²⁺, Na⁺, K⁺) following the methods outlined in the American Public Health Association (APHA). The dissolved heavy metals (Fe, Mn, Zn, Pb, Cu, Cr, Ni, As, Se, Co, Cd and Al) in groundwater were analyzed by ICP-MS following the instrument manual. The analysis results revealed that the groundwater is pre-dominantly neutral to mildly alkaline in nature. The major cation chemistry majorly followed the occurrence pattern of Na⁺ > Mg²⁺ > Ca²⁺ > K⁺, while for anions it was HCO₃^– > Cl^– > SO₄^2- > NO₃^– > F^–. The data plotted on Piper triangular diagram indicated that Ca²⁺-Mg²⁺-HCO₃^– and Na⁺-K⁺-HCO₃^–-Cl^– were major hydrogeochemical facies. Weathering of rock-forming minerals mainly governed the groundwater geochemistry in this region, although part of the cations associated with Cl^–, F^– and NO₃^– may originate from anthropogenic sources. TDS, TH, turbidity and F^– were identified as the major parameters that violated the prescribed limits for drinking water. Most of the heavy metals were found within the drinking water prescribed limits except for Fe, Mn, Al and Se. Elevated salinity, %Na, and magnesium hazard (MH) at certain sites limit its suitability for agricultural use. The assessment of selected organochlorine and organophosphorus pesticides in five samples indicated presence of lindane, β-endosulfan and DDT isomers in few samples. However, a detailed investigation of possible pesticide contamination in this intensive agriculture area is required before drawing any final conclusions.

PMID:40748577 | DOI:10.1186/s12932-025-00102-5

Obes Surg. 2025 Aug 1. doi: 10.1007/s11695-025-08115-w. Online ahead of print.

ABSTRACT

BACKGROUND: Large language models (LLMs) can generate human-like, empathetic responses within seconds. Their potential in terms of comprehensibility, empathy, and completeness to support physician-patient communication in bariatric surgery care needs to be evaluated.

METHODS: We collected 200 real-world questions from patient support groups, initial consultations, and follow-up visits, which were answered by GPT-4o and two human bariatric experts. An independent bariatric expert then blindly evaluated the responses for their overall quality, accuracy, and comprehensiveness. If needed, the responses were corrected, and the correction time was documented. Afterwards, bariatric patients (n = 189) across Germany rated the responses, assessing each one on its clarity, empathy, and completeness.

RESULTS: The LLM required significantly less time (2.7 vs. 87.2 s, p < 0.0001) and generated longer responses (607 vs. 262 characters, p = 0.001) than human experts. LLM-generated responses were rated significantly higher by patients in terms of clarity (4.8 vs. 4.6), completeness (4.5 vs. 3.4), and empathy (4.1 vs. 3.2, all p < 0.0001). In total, 64.9% of patients preferred LLM-generated responses, while 18.5% preferred physician responses. Notably, patients with a lower degree of education showed a stronger preference for LLM responses over physician responses.

CONCLUSION: LLMs could possibly act as an assistant for physicians and help improve their response efficiency while maintaining accuracy under physicians’ oversight. This approach could optimize physician time management and enhance patient satisfaction in bariatric care communication.

PMID:40748576 | DOI:10.1007/s11695-025-08115-w

Clin Drug Investig. 2025 Aug 1. doi: 10.1007/s40261-025-01465-4. Online ahead of print.

ABSTRACT

BACKGROUND: Memantine is an N-methyl-D-aspartate (NMDA) receptor antagonist with favorable safety and side effect profiles. There is a growing body of evidence for memantine as an adjunctive therapy for the positive, negative, and cognitive symptoms of schizophrenia.

OBJECTIVE: This meta-analysis examined the efficacy of memantine as an add-on to treatment with antipsychotic(s) for the primary negative symptoms (PNS) of schizophrenia.

METHODS: We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched for relevant publications in PubMed, Cochrane Library, PsycINFO, Embase, and China Journal Net databases from inception using the following search terms: memantine, schizophrenia, randomized controlled trials (RCTs), RCT, and clinical trial. Searches were limited to English- and Chinese-language articles to date. Standardized mean differences (SMDs) with 95% confidence intervals were calculated using RevMan 5.4 to assess the effect size. Risk of bias was assessed using RoB 2.0.

RESULTS: In total, 13 RCTs were identified (N = 681). Memantine was superior to placebo in treating negative symptoms, with an SMD of 0.79 (p = 0.0001, N = 631, 12 RCTs). Analysis of three studies whose corresponding authors provided original datasets showed an SMD of 2.16 (p = 0.25, N = 97) after adjusting for change in psychosis, depression, and extrapyramidal symptoms, suggesting that memantine is efficacious in treating PNS. Additionally, cognitive testing significantly improved, with an SMD of 0.66 (p = 0.0001, N = 395, eight RCTs). Positive symptoms were not significantly improved (SMD = 0.24, p = 0.1, N = 631, 12 RCTs).

CONCLUSIONS: To our knowledge, this is the first study showing a large effect size for treating PNS with memantine. Although statistical significance was not reached because of the small sample size (N = 97), the results were as expected because drugs such as memantine that act at NMDA receptors are unlikely to be effective as stand-alone treatments. Future RCTs should evaluate NMDAergic drugs in combination with complementary medications to optimize therapeutic effects for all three domains of schizophrenia psychopathology.

PMID:40748569 | DOI:10.1007/s40261-025-01465-4

J Assist Reprod Genet. 2025 Aug 1. doi: 10.1007/s10815-025-03604-4. Online ahead of print.

ABSTRACT

PURPOSE: To identify provider-level differences in the role of body mass index (BMI) in in vitro fertilization (IVF).

METHODS: A cross-sectional survey was distributed electronically to Society of Reproductive Endocrinology and Infertility members (n = 827). Analysis implemented descriptive statistics and Fisher’s exact tests.

RESULTS: One hundred eighty-seven responses were received from practices across the USA (22% response rate). Eighty-four percent of responders turned away at least one patient, in the past year, due to either BMI (82%) or a medical comorbidity other than obesity (68%). Eighty-six percent of respondents implement a cutoff. Implementation of cutoffs did not differ significantly by practice setting or geographic region. The most common reported BMI cutoff was ≥ 40. 95% cited anesthesia requirements as the primary reason for cutoffs. Only 11% of respondents perform hospital retrievals, where all 20 providers were academically affiliated. Those not performing retrievals cited lack of access to a mobile embryology lab (60%), patient cost (39%), and scheduling difficulties (55%) as common barriers.

CONCLUSIONS: Most surveyed REIs said they had excluded a patient due to BMI or a medical comorbidity in the past year, likely due to surgical and anesthetic concerns. Very few providers have access to hospital retrievals, but even outpatient retrievals for women with BMI ≥ 40 are considered safe. We agree with avoidance of a universal BMI cutoff; rather, we advocate for streamlined referral systems for otherwise excluded women, and further work in weight loss management interventions and cost effectiveness of IVF.

PMID:40748566 | DOI:10.1007/s10815-025-03604-4

Mol Biol Rep. 2025 Aug 1;52(1):777. doi: 10.1007/s11033-025-10864-x.

ABSTRACT

BACKGROUND: Gabapentin is the pharmacologic treatment of choice for symptom relief in diabetic neuropathy. However, its effect on high glucose (HG)-induced neurotoxicity and genotoxicity under diabetic neuropathy conditions remains unclear. The aim of this study was to investigate the effects of gabapentin on cytogenotoxicity in HG-induced neuropathy in dorsal root ganglion (DRG) neurons.

METHODS: DRG neurons were isolated from neonatal Sprague-Dawley rats (n = 10). After treatment of these neurons with HG (45 mmol/L) and gabapentin (1,10, 100, and 1000 µM), cell viability was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2 H-tetrazolium bromide (MTT) assay. Furthermore, the effects on DNA damage in DRG neurons exposed to HG (45 mmol/L) and gabapentin (10 and 100 µM) were investigated by comet assay.

RESULTS: When HG + Gabapentin (1 µM), HG + Gabapentin (10 µM), HG + Gabapentin (100 µM), and HG + Gabapentin (1000 µM) groups were compared with the HG group, no statistically significant change in cell viability was determined (p > 0.05). HG + Gabapentin (10 µM) and HG + Gabapentin (100 µM) groups were not statistically significant in genotoxicity compared to HG group (p > 0.05).

CONCLUSIONS: Our results suggest that gabapentin does not modulate HG-induced cytogenotoxicity in HG-exposed DRG neurons. Our findings, which emphasize the safety of gabapentin in diabetic neuropathy, need more detailed studies.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40748554 | DOI:10.1007/s11033-025-10864-x

Jpn J Ophthalmol. 2025 Aug 1. doi: 10.1007/s10384-025-01253-9. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to investigate the vascular characteristics of pediatric patients with familial Mediterranean fever (FMF) with homozygous c.~(p.M694V) mutations in the MEFV gene by comparing their retinal vascular densities with those of healthy controls by use of optical coherence tomography angiography (OCTA).

STUDY DESIGN: Prospective observational study.

METHODS: A total of 80 participants, 35 FMF pediatric patients and 45 healthy controls, were included in the study. The baseline demographic and clinical characteristics were examined, and OCTA was used to assess vascular densities in various regions of the superficial and deep capillary plexus (DCP) and optic disc. Statistical analyses were performed to identify significant differences between the groups.

RESULTS: The study demonstrated that patients with FMF exhibited a significant reduction in vascular density within the parafoveal deep capillary plexus (DCP) (P = 0.047). Additionally, vascular density in the inferior and temporal subregions of the perifoveal DCP was significantly lower in the FMF group than in the controls (P = 0.038 and P = 0.027, respectively), with a similar trend observed for the overall perifoveal DCP vascular density (P = 0.025). In addition, optic disc vascular density was significantly lower in the FMF patients than in the healthy controls (P = 0.026). Approximately 60% of the FMF patients had severe disease symptoms, whilst 40% of them had mild symptons.

CONCLUSIONS: The findings suggest significant reductions in deep capillary plexus and optic disc vascular density in children with FMF, further suggesting an underlying vascular pathology related to this autoinflammatory disease. Regular ophthalmic evaluations are necessary to monitor potential effects on retinal health in pediatric FMF patients, even when anterior segment examination findings are normal.

PMID:40748552 | DOI:10.1007/s10384-025-01253-9

JAMA Health Forum. 2025 Aug 1;6(8):e251988. doi: 10.1001/jamahealthforum.2025.1988.

ABSTRACT

IMPORTANCE: While community pharmacies provide many valuable prescription and professional services, they are also retail businesses. Evaluating pharmacy closures through the lens of a retail business framework may provide more context on what is happening in this industry and identify potential solutions to address closures and/or shortages.

OBJECTIVE: To evaluate community pharmacy turnover (openings and closings) in the US over time and by ownership type.

DESIGN AND SETTING: This cross-sectional analysis of all community pharmacy openings and closings in the US from 2010 to 2023 used pharmacy-level data from the US National Council for Prescription Drug Programs database. National-, state-, and county-level turnover was assessed using economic indicators of business dynamics, such as total population, population growth, household income, total firm changes for all industries, and net job creation.

EXPOSURES: Pharmacy class type defined as either a chain pharmacy (4 or more pharmacies under common ownership) or an independent or franchise pharmacy using the US National Council for Prescription Drug Programs classifications.

MAIN OUTCOMES AND MEASURES: Pharmacy turnover rate from 2010 to 2023, calculated as the sum of pharmacy openings and closings over the full study period divided by the total pharmacies in the market at the beginning of the period (2010).

RESULTS: The analyses found that US pharmacy market turnover rate for this 14-year period was 86.8% (52 974 total openings and closures of 61 054 total pharmacies in 2010) or 6.2% annually. When comparing across pharmacy types, independent pharmacy turnover was substantially higher (152.7%) than chain pharmacy turnover (49.9%) across the entire US. Counties with high turnover were associated with net increases in pharmacies from more independent pharmacy openings over the period. Turnover rates for all businesses were higher in counties with both low and high pharmacy turnover, even when adjusting for population size.

CONCLUSIONS AND RELEVANCE: This cross-sectional study found that the community pharmacy market in the US has an annual turnover rate of approximately 6.2%, with independent pharmacies opening and closing more frequently than chain pharmacies.

PMID:40748545 | DOI:10.1001/jamahealthforum.2025.1988