Nevin Manimala

Sleep Breath. 2025 Aug 11;29(5):271. doi: 10.1007/s11325-025-03436-7.

ABSTRACT

PURPOSE: OSA is a potentially serious medical condition associated with metabolic and cardiovascular hazards. The Saudi population remains inadequately informed, despite its increasing prevalence. The purpose of this study is to evaluate Saudi Arabian public awareness about OSA.

METHODS: 992 people from all around Saudi Arabia participated in a descriptive cross-sectional study using a validated online questionnaire. Descriptive statistics were used to assess the demographic, health, and OSA knowledge data, and Pearson’s Chi-Square test was used to look for correlations with the demographic characteristics.

RESULTS: The survey indicated that just 39% of participants were aware of OSA. Age, geographic location, healthcare profession, and familial medical history shown significant correlations with awareness (p < 0.05). The signs, ramifications, and therapies of OSA were inadequately comprehended.

CONCLUSION: The research indicated that 39% of Saudi Arabians lacked enough knowledge of OSA. Targeted programs that focus on symptoms, dangers, and treatments are critical for improving early diagnosis and results. These efforts should focus specifically on marginalized populations and non-healthcare sectors.

PMID:40789989 | DOI:10.1007/s11325-025-03436-7

Dig Dis Sci. 2025 Aug 11. doi: 10.1007/s10620-025-09230-5. Online ahead of print.

ABSTRACT

BACKGROUND: The development of liver cancer in China is mainly caused by HBV, HCV infection, and exposure to aflatoxin. Especially in warm and humid southern regions, aflatoxin pollution poses a threat to health, emphasizing the urgency of research on related liver cancer.

METHODS: Firstly, through in vivo experiments, the important role of AFB1 in mediating changes in the immune microenvironment of liver cancer has been preliminarily validated. In addition, statistical and mIHC analysis were conducted on clinical specimens collected from patients exposed and non-exposed to aflatoxin. Transcriptome sequencing technology enabled us to further explore the specific molecular mechanisms underlying the occurrence of HCC caused by AFB1 exposure. Finally, the synergistic effect of targeting IL-6 on PD1 therapy was validated through an in vivo animal tumor model.

RESULTS: We found that AFB1 indirectly influences M2-like macrophage polarization by upregulating IL-6 expression in tumor cells through the NF-κB signaling pathway. To address this challenge, we evaluated the efficacy of targeting IL-6 in combination with PD1 antibody therapy in a subcutaneous tumor model. Our results demonstrate that the combination treatment significantly reduces tumor growth, decreases the number of M2-like macrophages, and enhances CD8 + T cell infiltration compared to monotherapy with PD1 antibody alone.

CONCLUSIONS: Overall, our study highlights the potential of targeting IL-6 as a therapeutic strategy and suggests avenues for further research and clinical studies to validate and translate these findings into clinical applications, ultimately leading to improved outcomes for patients with AFB1-associated hepatocellular carcinoma.

PMID:40789982 | DOI:10.1007/s10620-025-09230-5

Eur Spine J. 2025 Aug 12. doi: 10.1007/s00586-025-09124-0. Online ahead of print.

ABSTRACT

PURPOSE: The Brace Adolescent Idiopathic Scoliosis Trial (BrAIST) reported a bracing dose-response curve in AIS for brace-wearing time (BWT) up to 18 h/day (h/d) on the outcome end-of-treatment < 50°. We aimed to examine the dose-response curve for this and other relevant outcomes in cases of BWT > 18 h/d.

METHODS: Design: Retrospective secondary analysis of consecutively collected data.

PARTICIPANTS: braced AIS patients with curves < 45° and a subgroup with BrAIST inclusion criteria.

TREATMENT: different braces, prescribed 18 to 24 h/d, according to curve topography, Cobb angle and a shared decision-making approach. We divided patients into BWT quartiles and developed dose-response curves using the BrAIST methodology for the end-of-growth outcomes END < 50°, END < 30°, avoidance of progression, and improvement.

RESULTS: We included 884 patients (85% female), with a mean age of 13.0 ± 1.3 years and a mean Cobb angle of 28 ± 7°. In the higher BWT quartiles, we found larger scoliosis curves but also better final Cobb angle results. The dose-response curves showed statistically significant improvements for the outcomes END < 30° and improvement (outcomes improvements ranging 45-60% and 25-35%, respectively). The outcomes END < 50° and avoiding progression showed a ceiling effect due to a very high success rate (range 97-98% and 85-87%, respectively).

CONCLUSION: BWT > 18 h/d is associated with avoiding surgery (END < 50°), reduced progression, and increased improvement rates, and achieving END < 30°, which is particularly relevant because it reduces the risk of problems in adulthood. Decisions on daily BWT should be based on the desired outcomes and an honest conversation with the patients and parents.

PMID:40789981 | DOI:10.1007/s00586-025-09124-0

Metabolomics. 2025 Aug 11;21(5):107. doi: 10.1007/s11306-025-02304-5.

ABSTRACT

BACKGROUND: Tuberculous meningitis (TBM) is a disease caused by Mycobacterium tuberculosis (M. tb) infection of the brain. Alkanes and other volatile organic compounds (VOCs) are biologically important metabolites that are used by infectious mycobacteria species for growth and survival strategies.

OBJECTIVE: This study investigated the altered alkanes and other VOCs in the urine from paediatric cases with TBM.

METHOD: We used untargeted gas chromatography coupled with time-of-flight mass spectrometry (GC-TOFMS) to analyse and compare all volatile, underivatised compounds present in the urine from 27 confirmed cases of paediatric TBM over a treatment period of six months, as well as a control group (n = 13).

RESULT: Four elevated alkanes (pentadecane, 5,7-dimethyl-undecane, 4,7-dimethyl-undecane, and 2,6-dimethyl-undecane), three alkenes (decreased 2,5-dimethyl-2-hexene and 4,4-dimethyl-1-pentene, and increased 3-methoxy-1-pentene), and three other VOCs of biological interest (decreased 2-butenoic acid methyl ester and 3-heptanone, and increased 2-pyrrolidinone) were identified as statistically significant. These volatile compounds remained perturbed during the TBM treatment.

CONCLUSION: This study discovered new systemic metabolic information about M. tb in the host and the role of alkanes and VOCs in the potential persistence of M. tb. We demonstrate the value of targeting alkanes and other VOCs for future metabolomics studies of M. tb.

PMID:40789978 | DOI:10.1007/s11306-025-02304-5

Environ Monit Assess. 2025 Aug 11;197(9):1007. doi: 10.1007/s10661-025-14467-8.

ABSTRACT

Establishing soil element background values and risk thresholds is crucial for pollution control in fragile ecosystems. However, defining local standards for elements lacking national guidelines remains challenging. This study focuses on Yushu City, Qinghai Province, which has a complex geological background and minimal anthropogenic disturbance. We analyzed the spatial heterogeneity of 17 soil elements (As, Ba, Cd, Co, Cr, Cu, I, La, Pb, Rb, Sb, Sn, Th, Tl, U, V, and W) using multifractal theory. For elements without national standards, such as La, Rb, and Th, we calculated risk screening values. Through multifractal analysis of the 17 soil elements, we established local background values (mg/kg) for key elements: As (17.78), Cd (0.20), Cr (66.07), La (33.88), and Rb (104.71). The fractal dimension values for Cd (D2 = 3.95), As (D2 = 4.63), Cr (D2 = 4.66), and other elements were low, indicating spatially heterogeneous distributions and a critical pollution diffusion trend. Furthermore, the study shows that multifractal theory can accurately identify the superposition characteristics of natural background and anthropogenic pollution in complex geological environments. It can also effectively differentiate geological high values from polluted inputs, providing a scientific basis for soil risk classification and control in alpine, ecologically fragile areas.

PMID:40789969 | DOI:10.1007/s10661-025-14467-8

Environ Monit Assess. 2025 Aug 11;197(9):1006. doi: 10.1007/s10661-025-14393-9.

ABSTRACT

Rapid urbanization and poor sewage infrastructure are intensifying mosquito breeding in Indian cities, heightening the risk of vector-borne diseases. This study investigates the relationship between sewage-contaminated environments and mosquito proliferation across four urban sites in Coimbatore, Tamil Nadu. Entomological indices-House Index (HI 24.7-31.8%), Container Index (CI 28.5-38.1%), and Breteau Index (BI 34.2-46.7%)-revealed high larval prevalence. Water bodies in polluted areas exhibited critical quality degradation, including elevated biological oxygen demand (BOD up to 12.6 mg/L) and low dissolved oxygen (DO as low as 1.2 mg/L). Molecular identification using polymerase chain reaction (PCR) confirmed the dominance of Culex quinquefasciatus and Aedes aegypti. Statistical analysis showed strong correlations between larval density and water quality parameters (e.g., r = 0.82 for BOD, r = -0.76 for DO). Larval density was negligible in treated wastewater zones, highlighting the protective role of proper sanitation. Although the study is limited to pre- and post-monsoon sampling within Coimbatore, the findings offer actionable insights for integrated vector management (IVM) and GIS-based surveillance strategies to guide urban mosquito control policies.

PMID:40789962 | DOI:10.1007/s10661-025-14393-9

Lasers Med Sci. 2025 Aug 12;40(1):332. doi: 10.1007/s10103-025-04578-6.

ABSTRACT

To evaluate the safety and efficacy of fractional carbon dioxide (CO₂) laser combined with recombinant bovine basic fibroblast growth factor (rb-bFGF) gel for treating mature scars secondary to facial scald burns. In this retrospective cohort study, we analyzed 123 patients with mature facial scald burn scars treated with fractional CO₂ laser. According to whether the rb-bFGF gel was used during the treatment, patients were divided into CO₂ + rb-bFGF group (n = 56) and CO₂ group (n = 67). The modified Patient and Observer Scar Assessment Scale (POSAS) scar score was used to evaluate the clinical effect. Patient satisfaction and adverse events were also assessed. At the last follow-up visit, the PSAS score (mean ± SD) was statistically different between the two groups (7.74 ± 2.15 vs. 9.41 ± 1.97; P < 0.01), including color (1.79 ± 0.77 vs. 2.80 ± 1.15; P < 0.01), stiffness (1.75 ± 0.62 vs. 2.00 ± 0.50; P < 0.01), and thickness (1.96 ± 0.48 vs. 2.16 ± 0.51; P < 0.01); the OSAS score (mean ± SD) was statistically different between the two groups (11.34 ± 3.21 vs. 12.96 ± 3.12; P < 0.01), including pigmentation (1.75 ± 0.78 vs. 2.61 ± 1.20; P < 0.01), thickness (1.92 ± 0.51 vs. 2.10 ± 0.42; P < 0.05), relief (1.64 ± 0.60 vs. 1.86 ± 0.50; P < 0.05), and pliability (1.96 ± 0.62 vs. 2.24 ± 0.52; P < 0.05). For patient satisfaction and adverse events, the CO₂ + rb-bFGF group demonstrated accelerated wound healing (4 days vs. 7 days, P < 0.01), reduced incidences of persistent erythema (5.36% vs. 19.40%, P < 0.05) and hyperpigmentation (0% vs. 8.96%, P < 0.05), and higher patient global assessment score (8.09 ± 0.60 vs. 7.02 ± 1.01; P < 0.01). Combination therapy with fractional CO₂ laser and rb-bFGF gel demonstrates superior clinical outcomes compared to laser monotherapy for mature facial scald burn scars, with significant improvements in scar characteristics, fewer complications, and better patient acceptance.

PMID:40789953 | DOI:10.1007/s10103-025-04578-6

Eur J Pediatr. 2025 Aug 11;184(9):545. doi: 10.1007/s00431-025-06374-4.

ABSTRACT

Hypogonadotropic hypogonadism(HH) and constitutional delay in growth and puberty (CDGP) account for the underlying aetiology of delayed puberty with overlapping clinical and hormonal features. The present study aims to evaluate the pubertal development and final height(FH) outcome in patients presenting with delayed puberty due to HH and CDGP. The hospital files of 1654 boys older than 14 years of age who were evaluated for delayed puberty between 01.01.2002 and 01.04.2022 in Hacettepe University İhsan Doğramacı Children’s Hospital Pediatric Endocrinology Department were reviewed retrospectively. 191 patients who met the inclusion criteria were included in the study. The mean age of admission was 14.6 ± 0.9 years. Of those, 149 patients had CDGP and 42 patients had HH. The mean FH-SDS of patients with HH (- 0.09 ± 1.0) was higher than those with CDGP (- 0.64 ± 0.91) (p = 0.003). In total, 118 out of 128 patients (92.2%) with CDGP and 36 out of 39 patients (92.3%) with HH had reached an FH consistent with their target height(TH). There was no statistically significant difference between the FH-SDS of patients with CDGP who received testosterone therapy for induction of puberty and those who did not receive (- 0.46 ± 0.97 SD vs. – 0.74 ± 0.87 SD; p = 0.094). Conclusion: Individuals presented with delayed puberty due to both CDGP and HH have reached an FH consistent with their TH to a large extent. Patients with HH had a higher presenting and final height than those with CDGP, which was attributed to the higher TH. Induction of puberty with testosterone in boys with CDGP seems not to have a clinically meaningful impact on the FH and long-term pubertal progression.

PMID:40789950 | DOI:10.1007/s00431-025-06374-4

Sci Rep. 2025 Aug 11;15(1):29376. doi: 10.1038/s41598-025-15057-x.

ABSTRACT

This study investigates emergent behaviors in multi-agent pursuit-evasion games within a bounded 2D grid world, where both pursuers and evaders employ multi-agent reinforcement learning (MARL) algorithms to develop adaptive strategies. We define six fundamental pursuit actions-flank, engage, ambush, drive, chase, and intercept-which combine to form 21 types of composite actions during two-pursuer coordination. After training with MARL algorithms, pursuers achieved a 99.9% success rate in 1,000 randomized pursuit-evasion trials, demonstrating the effectiveness of the learned strategies. To systematically identify and measure emergent behaviors, we propose a K-means-based clustering methodology that analyzes the trajectory evolution of both pursuers and evaders. By treating the full set of game trajectories as statistical samples, this approach enables the detection of distinct behavioral patterns and cooperative strategies. Through analysis, we uncover emergent behaviors such as lazy pursuit, where one pursuer minimizes effort while complementing the other’s actions, and serpentine movement, characterized by alternating drive and intercept actions. We identify four key cooperative pursuit strategies, statistically analyzing their occurrence frequency and corresponding trajectory characteristics: serpentine corner encirclement, stepwise corner approach, same-side edge confinement, and pincer flank attack. These findings provide significant insights into the mechanisms of behavioral emergence and the optimization of cooperative strategies in multi-agent games.

PMID:40789927 | DOI:10.1038/s41598-025-15057-x

Nat Genet. 2025 Aug 11. doi: 10.1038/s41588-025-02286-z. Online ahead of print.

ABSTRACT

Mixed-model association analysis (MMAA) is the preferred tool for performing genome-wide association studies. However, existing MMAA tools often have long runtimes and high memory requirements. Here we present LDAK-KVIK, an MMAA tool for analysis of quantitative and binary phenotypes. LDAK-KVIK is computationally efficient, requiring less than 10 CPU hours and 5 Gb memory to analyze genome-wide data for 350,000 individuals. Using simulated phenotypes, we show that LDAK-KVIK produces well-calibrated test statistics for both homogeneous and heterogeneous datasets. When applied to real phenotypes, LDAK-KVIK has the highest power among all tools considered. For example, across 40 quantitative UK Biobank phenotypes (average sample size 349,000), LDAK-KVIK finds 16% more independent, genome-wide significant loci than classical linear regression, whereas BOLT-LMM and REGENIE find 15% and 11% more, respectively. LDAK-KVIK can also be used to perform gene-based tests; across the 40 quantitative UK Biobank phenotypes, LDAK-KVIK finds 18% more significant genes than the leading existing tool. Last, LDAK-KVIK produces state-of-the-art polygenic scores.

PMID:40789918 | DOI:10.1038/s41588-025-02286-z