Nevin Manimala

J Cosmet Dermatol. 2025 Sep;24(9):e70424. doi: 10.1111/jocd.70424.

ABSTRACT

BACKGROUND: Genitourinary syndrome of menopause (GSM) is prevalent among breast cancer survivors (BCS), often exacerbated by oncologic treatments and compounded by contraindications to hormone-based therapies. Vaginal Erbium:YAG laser has emerged as a promising non-hormonal alternative, though long-term safety and efficacy data remain scarce.

METHODS: This prospective pilot study initially enrolled twelve breast cancer survivors (BCS) presenting with moderate to severe genitourinary syndrome of menopause (GSM). The study consisted of two phases: in phase 1, patients underwent 3 monthly sessions of fractional Erbium:YAG (erbium: yttrium-aluminum garnet) laser and were evaluated before the first laser and 1 month after the third session. In Phase 2, patients were evaluated 1 year after the beginning of the treatment (first laser session). Clinical evaluations were carried out at baseline and after each study phase using the Vaginal Health Index (VHI), the Female Sexual Function Index (FSFI), and a customized Symptom Intensity Questionnaire. Vaginal biopsies and cytological samples were obtained at baseline and at the end of the first phase. H&E staining, Picrosirius Red, glycogen deposits, and epithelial thickness were evaluated in all samples. A Likert scale was administered at the end of each phase to assess patient satisfaction. Statistical analyses were performed using paired t-tests, bootstrap resampling techniques, and logistic regression models to evaluate treatment outcomes and response predictors.

RESULTS: 12 patients enrolled in the study, ten completed phase one, and eight completed Phase 2. Mean VHI scores improved significantly from 10.75 ± 2.4 to 23.38 ± 3.1 (p < 0.0001). Symptom severity decreased significantly (p = 0.0078). FSFI scores showed clinical improvement (from 15.52 ± 7.20 to 25.05 ± 6.81), though not statistically significant (p = 0.0889); bootstrap and simulation analyses confirmed robustness. Histological findings indicated epithelial remodeling without adverse tissue effects. All patients gave the best satisfaction scores to the treatment (Likert = 5). No adverse events were reported.

CONCLUSIONS: Vaginal Erbium:YAG laser therapy appears to be a safe and potentially effective option for GSM management in BCS. Further randomized controlled trials are needed to validate these findings.

PMID:40937542 | DOI:10.1111/jocd.70424

Int J Comput Vis. 2025;133(9):6491-6512. doi: 10.1007/s11263-025-02492-6. Epub 2025 Jun 15.

ABSTRACT

Existing level set models employ regularization based only on gradient information, 1D curvature or 2D curvature. For 3D image segmentation, however, an appropriate curvature-based regularization should involve a well-defined 3D curvature energy. This is the first paper to introduce a regularization energy that incorporates 3D scalar curvature for 3D image segmentation, inspired by the Einstein-Hilbert functional. To derive its Euler-Lagrange equation, we employ a two-step gradient descent strategy, alternately updating the level set function and its gradient. The paper also establishes the existence and uniqueness of the viscosity solution for the proposed model. Experimental results demonstrate that our proposed model outperforms other state-of-the-art models in 3D image segmentation.

PMID:40937463 | PMC:PMC12420715 | DOI:10.1007/s11263-025-02492-6

BMJ Public Health. 2025 Sep 8;3(2):e003073. doi: 10.1136/bmjph-2025-003073. eCollection 2025.

ABSTRACT

INTRODUCTION: The WHO Housing and Health Guidelines have highlighted the impact of housing quality on cardiovascular diseases (CVDs), including pathways such as cold-induced hypertension. Major factors influencing housing quality include architectural type (detached houses vs flats) and tenure (owned vs rented), but few studies have examined their effects on CVDs.

METHODS: 46 850 occupants were included during the follow-up period from 1 January 2012 to 31 December 2017 in the Japan Gerontological Evaluation Study. By linking survey data with cause-of-death records, the Kaplan-Meier curves were constructed. Competing risk regression models were applied to calculate the subdistribution HRs (SHRs) for cardiovascular mortality risks across housing statuses, adjusted for demographics, socioeconomic factors and lifestyle behaviours. Sex-stratified analyses and Cox regression analyses were also conducted to calculate the HRs.

RESULTS: A total of 38 731 participants (46.6% men) were analysed, with a mean age of 73.6 years and a median follow-up period of 2091 days. The cardiovascular mortality rate was 3.97 per 1000 person-years, with 2.3% experiencing CVD-related deaths. The Kaplan-Meier curve indicated higher cardiovascular mortality for those living in rental flats and owned detached houses compared with those in owned flats. Competing risk regression models indicated a significantly higher risk of cardiovascular deaths among occupants living in rental flats compared with those in owned flats (SHR=1.78; 95% CI 1.05-3.02). For men, the risk was notably higher (SHR=2.32; 95% CI 1.13-4.75), though not statistically significant in women. Sensitivity analyses using Cox regression supported these findings, showing higher risk estimates for men (HR=2.36; 95% CI 1.16-4.82).

CONCLUSIONS: Rental housing and detached houses are likely to have lower temperatures and greater temperature instabilities, raising blood pressure and increasing CVDs. Improving housing quality can contribute to cardiovascular health at the population level.

PMID:40937432 | PMC:PMC12421178 | DOI:10.1136/bmjph-2025-003073

BMJ Public Health. 2025 Sep 8;3(2):e002828. doi: 10.1136/bmjph-2025-002828. eCollection 2025.

ABSTRACT

INTRODUCTION: The UK has promoted increased availability of alcohol-free and low-alcohol drinks (no/lo, ≤1.2% alcohol by volume) as a public health strategy. To be effective, no/lo beverages must replace, and not supplement, standard alcoholic drinks. Emerging evidence suggests that the reasons people drink alcohol may be an important determinant of the potential public health impact of these drinks. This study aimed to determine whether alcohol drinking motives were associated with no/lo consumption after accounting for sociodemographic characteristics and alcohol consumption.

METHODS: A cross-sectional sample of adults residing in Great Britain (aged 16-93) who had drunk alcohol in the past year were recruited via the Alcohol Toolkit Study (N=2555; 49.0% female). The dependent variable was frequency of no/lo consumption (less than vs at least monthly). Five questions captured respondents’ alcohol drinking motives (enhancement, social, conformity, coping-anxiety, and coping-depression), derived from the Drinking Motives Questionnaire-Revised. Sociodemographic characteristics, including age, gender, social grade, education, Index of Multiple Deprivation (a UK-wide measure of relative deprivation for small geographic areas), and hazardous alcohol use (Alcohol Use Disorder Identification Test), were also assessed. Descriptive analysis presents the proportion of respondents drinking no/lo at least monthly among low endorsement (ie, drinking for a motive less than half the time) versus high endorsement (ie, drinking for a motive at least half the time) of each drinking motive. Quasibinomial regression modelling explored relationships between alcohol drinking motives and no/lo consumption, accounting for sociodemographic characteristics and hazardous drinking.

RESULTS: Drinking alcohol to conform was associated with an increased likelihood of at least monthly no/lo consumption after accounting for sociodemographic characteristics and hazardous drinking (OR 1.10, 95% CI 1.00 to 1.21, p=0.041).

CONCLUSIONS: No/lo drinks may facilitate reduced alcohol consumption by offering an alternative for individuals wishing to participate in alcogenic environments. However, those who drink alcohol to conform are not typically higher-risk drinkers, which may limit the public health benefit of no/lo drinks. Further research is needed to explicitly explore substitution effects.

PMID:40937431 | PMC:PMC12421153 | DOI:10.1136/bmjph-2025-002828

Front Endocrinol (Lausanne). 2025 Aug 27;16:1572675. doi: 10.3389/fendo.2025.1572675. eCollection 2025.

ABSTRACT

INTRODUCTION: Elderly population is more susceptible to both hypothyroidism and chronic kidney disease (CKD) independently and it is very crucial to assess kidney function in elderly hypothyroid patients in relation to autoimmunity. There are previous studies showing a correlation between eGFR and TSH, T3, and T4 in the elderly population but no such studies correlating the estimated GFR (eGFR) with the anti-thyroid antibodies of elderly hypothyroid patients are available. This study aimed to assess renal function in newly diagnosed elderly hypothyroid patients and correlate findings with anti-thyroid peroxidase (anti-TPO) levels.

METHODS: We conducted a cross-sectional study with 128 participants aged 60 years and above after obtaining ethics committee approval. All cases were newly diagnosed patients of hypothyroidism whether clinical or subclinical. The control group consisted of age and sex matched individuals with normal thyroid profile status. Fasting blood samples were collected and serum thyroid parameters, glycemic and renal markers were evaluated, and statistical analyses were performed.

RESULTS: Hypothyroid patients exhibited elevated anti-TPO levels and markers of renal dysfunction, including increased urea, uric acid, and urine albumin/creatinine ratio. Multiple regression analysis identified anti-TPO as an independent predictor of kidney function. Subgroup analysis revealed significantly lower eGFR and elevated renal markers in anti-TPO positive patients.

DISCUSSION: The interplay between thyroid dysfunction and renal impairment is particularly significant in the elderly, who are more vulnerable to both conditions. Elevated anti-TPO levels are associated with renal dysfunction in elderly hypothyroid patients, suggesting a potential role for anti-TPO in renal impairment.

PMID:40937419 | PMC:PMC12420214 | DOI:10.3389/fendo.2025.1572675

Front Endocrinol (Lausanne). 2025 Aug 27;16:1599423. doi: 10.3389/fendo.2025.1599423. eCollection 2025.

ABSTRACT

BACKGROUND: Diabetic nephropathy (DN) is a major complication of diabetes, contributing significantly to end – stage renal disease. Irisin, an exercise – induced myokine, has been linked to metabolic disorders, but its relationship with DN remains unclear. This study aims to comprehensively and accurately explore the association between serum irisin levels and DN through a systematic review and meta – analysis.

METHODS: The research was conducted following the Meta – analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Multiple electronic databases, including Cochrane Library, Embase, Web of Science, PubMed, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), and Wanfang Database, were systematically searched using relevant keywords related to irisin and DN. Studies were included if they were randomized controlled trials (RCTs) or observational studies that stratified Type 2 diabetes mellitus (T2DM) patients based on the presence or absence of DN, measured serum irisin levels in both groups, and provided data in a suitable format. Two independent reviewers performed literature screening, data extraction, and quality assessment. The Jadad scale was used for RCTs, and the Newcastle – Ottawa Scale (NOS) was applied for cohort and case – control studies. Statistical analysis was carried out using RevMan 5.3 software, with heterogeneity evaluated by Q and I² tests, and appropriate models (fixed – effects or random – effects) selected accordingly. INPLASY registration number:202530056.

RESULTS: A total of seven studies, comprising 453 DN patients and 346 non-DN controls, were included in the final meta-analysis. The pooled results demonstrated that serum irisin levels were significantly lower in patients with diabetic nephropathy, particularly those with more advanced stages of albuminuria. Specifically, irisin levels were significantly reduced in patients with microalbuminuria (MD = 30.84, 95% CI: 7.81 to 53.87, I² = 96%) and macroalbuminuria (MD = 30.84, 95% CI: 7.81 to 53.87, I² = 98%) compared to those with normoalbuminuria. Furthermore, a direct comparison between microalbuminuria and macroalbuminuria also revealed significantly lower irisin levels in the latter group (MD = 12.53, 95% CI: 3.46 to 21.59, I² = 89%). In terms of renal function, patients with eGFR < 60 mL/min/1.73 m² exhibited lower irisin concentrations than those with preserved renal function (MD = 3.43, 95% CI: -2.90 to 9.75, I² = 90%), though this difference was not statistically significant. Given the substantial heterogeneity among the included studies, random-effects models were applied for all analyses. Funnel plot assessment showed general symmetry in most comparisons, indicating a low to moderate risk of publication bias, although asymmetry was observed in the microalbuminuria vs. macroalbuminuria subgroup, suggesting potential small-study effects.

CONCLUSIONS: This meta-analysis provides evidence for an association between serum irisin levels and DN. Lower serum irisin levels were related to more severe albuminuria and decreased eGFR in T2DM patients. However, considering the limitations of this study, such as potential missing data and methodological differences, further large – scale, multi-center, and high-quality RCTs are needed to validate these findings and elucidate the underlying mechanisms.

SYSTEMATIC REVIEW REGISTRATION: INPLASY.COM, identifier 202530056.

PMID:40937412 | PMC:PMC12420281 | DOI:10.3389/fendo.2025.1599423

Indian J Clin Biochem. 2025 Oct;40(4):683-690. doi: 10.1007/s12291-024-01235-7. Epub 2024 May 25.

ABSTRACT

This study delves into the exploration of exosomal transfer RNA-derived fragments (tRFs) as potential diagnostic markers for cervical cancer (CC). Employing plasma-derived exosomes isolated through ultracentrifugation and confirmed via transmission electron microscopy (TEM), qNano, and western blot analysis, we extracted total RNA from CC and adjacent tissues (n = 48), alongside exosomes from cervical cancer patients (n = 140) and healthy donors (n = 140) using Trizol reagents. The expression of exosomal tRFs was assessed through quantitative polymerase chain reaction (qPCR) and subjected to statistical analysis using Mann-Whitney U or t-tests, along with receiver operating characteristic (ROC) analysis. The findings unveiled a significant downregulation of exosomal tRF-Phe-GAA-001 and tRF-Gly-GCC-037 in both CC tissues and plasma samples from early-stage patients compared to healthy controls. Remarkably, these two exosomal tRFs exhibited promising capabilities as circulating biomarkers for both the diagnosis and early detection of CC, as evidenced by their high area under the curve (AUC) values of 0.9337 and 0.9432, respectively. Consequently, exosomal tRF-Phe-GAA-001 and tRF-Gly-GCC-037 were downregulated in CC and early-stage CC, indicating their potential as innovative non-invasive biomarkers for early CC diagnosis.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12291-024-01235-7.

PMID:40937397 | PMC:PMC12420557 | DOI:10.1007/s12291-024-01235-7

J Biol Methods. 2025 Aug 20;12(3):e99010069. doi: 10.14440/jbm.2025.0002. eCollection 2025.

ABSTRACT

BACKGROUND: Holmium laser enucleation of the prostate (HoLEP) has emerged as an effective surgical treatment for benign prostatic hyperplasia (BPH). This study evaluated how the adoption of HoLEP in a general urology clinic influenced clinical and procedural volume.

OBJECTIVE: To better understand the practice ramifications of HoLEP adoption, we analyzed the changes to a general urologist’s patient demographics and practice patterns after the addition of HoLEP to their surgical repertoire.

METHODS: We retrospectively reviewed the electronic health records 30 months before and after the introduction of HoLEP to examine changes in a general urologist’s patient population. Pearson’s Chi-squared test and Student’s t-test were used for statistical analysis.

RESULTS: A total of 4390 unique patients were seen over a period of 5-years, with 2052 seen before and 2338 after the introduction of HoLEP. The mean distance from patients’ residence zip codes to the treatment center remained statistically unchanged (pre-HoLEP: 32.52 ± 152.42 miles, post-HoLEP: 29.65 ± 141.79 miles, p=0.9896). Among those who underwent HoLEP, prostate sizes were comparable between patients residing in the same county and those coming from different counties (96.42 ± 3.24 cc vs. 104.52 ± 4.34 cc, p=0.141). Surgical volume rose from 355 to 1018 cases with a concordant increase in other BPH-related surgeries, marked by an inflection point at the time of HoLEP’s introduction.

CONCLUSION: There was an increase in clinical and surgical volume to an established general urologist’s practice after HoLEP was offered. Most patients continued to be drawn from the initial catchment area, potentially reflecting previously unmet treatment needs for patients with large prostate glands.

PMID:40937374 | PMC:PMC12422107 | DOI:10.14440/jbm.2025.0002

Nurs Res Pract. 2025 Sep 3;2025:6934650. doi: 10.1155/nrp/6934650. eCollection 2025.

ABSTRACT

Background: Infertility is a reproductive disorder affecting either the male or female reproductive system, characterized by the inability to achieve pregnancy after 12 months or more of regular, unprotected sexual intercourse. It may result from male, female, or idiopathic factors, with certain etiologies being preventable. Management of infertility frequently involves assisted reproductive technologies, including in vitro fertilization (IVF). Objective: This quantitative cross-sectional study aimed to discover the traditional practices used for infertility treatment among females in Albaha City. Materials and Methods: This study was conducted with 251 infertile women between the ages of 50 or beneath who had primary or secondary infertility because of personal reasons or male infertility in the maternity outpatient departments of Albaha City hospitals in Saudi Arabia. The study period lasted from May 30, 2021, until January 2022. The research obtained approval from the Faculty of Nursing ethical committee at King Abdulaziz University Jeddah before participants granted their consent. Results: A total of 251 participants indicated that 51.0% found traditional infertility treatment successful and 45.8% had no previous knowledge about the approach, while 3.2% viewed it negatively. Among the participants, 39.5% revealed that they got pregnant after using traditional treatments, whereas 60.5% said they did not get pregnant. About 29.0% of women who got pregnant achieved it within 6 months and 11.0% of them conceived over 6 months to 1 year. Two-thirds of participants reported no side effects from traditional healing treatment, and half of the respondents planned to repeat their experience. The research conducted on pregnancy and herb consumption demonstrated a lack of statistical importance expressed through the data values (p > 0.05). Conclusion: Many participants believed in using traditional practices and visiting traditional healers instead of attending medical facilities and the care services provided by health professionals due to their actions on physiological systems and low cost. Further investigation is required to support the outcomes of this study.

PMID:40937363 | PMC:PMC12422851 | DOI:10.1155/nrp/6934650

Ther Adv Psychopharmacol. 2025 Sep 9;15:20451253251367591. doi: 10.1177/20451253251367591. eCollection 2025.

ABSTRACT

BACKGROUND: Poor adherence to antipsychotic medications is the leading cause of relapses and hospitalizations in patients with schizophrenia, resulting in worse functional outcomes and quality of life. Long-acting injectable (LAI) antipsychotics are an effective therapeutic option to improve adherence, but they are often underutilized, particularly during inpatient care.

OBJECTIVE: To investigate the predictive factors for LAI utilization among inpatients with schizophrenia and to assess whether initiating a LAI antipsychotic treatment during hospitalization reduces the risk of readmission.

DESIGN: Observational prospective study.

METHODS: Patients were evaluated at admission, discharge, and after 3 months. Two comparisons were performed: patients who initiated a LAI during the hospitalization versus those who continued with oral antipsychotics, and readmitted versus not-readmitted patients within 3 months. Factors statistically associated with LAI initiation or readmission were entered as independent variables in two backward logistic regression models, having “LAI initiation” and “rehospitalization at three months” as outcomes.

RESULTS: One hundred two patients were included. Twelve were lost at follow-up. Forty-two (44%) initiated an LAI during the admission. Subjects who received LAI were significantly younger, more educated, and less adherent to treatment. Thirty (33%) patients were readmitted within 3 months after discharge. Re-hospitalized subjects had more psychiatric hospitalizations in the past and a lower rate of LAI antipsychotic treatment initiation during the studied hospitalization: 5/39 (13%) patients prescribed a LAI antipsychotic were readmitted within 3 months, compared with 25/51 (49%) prescribed an oral antipsychotic medication (OR = 0.19; p = 0.002).

CONCLUSION: Introducing LAI antipsychotic treatment during a psychiatric hospitalization may reduce the risk of early readmissions, thus facilitating the improvement of the course of the illness and the patient’s quality of life.

PMID:40937358 | PMC:PMC12420969 | DOI:10.1177/20451253251367591