Nevin Manimala

Glob Health Action. 2025 Dec;18(1):2513719. doi: 10.1080/16549716.2025.2513719. Epub 2025 Jul 14.

ABSTRACT

Rising temperatures in Africa present an increasing threat to agricultural productivity and public health, particularly among subsistence farming communities reliant on rain-fed agriculture. Heat exposure can impair farmers’ work capacity, disrupt harvests, and heighten health risks, especially for young children vulnerable to undernutrition. The Heat to Harvest (H2H) study investigates how environmental heat exposure influences farmers’ physiological and behavioral responses, and how these in turn affect harvest yields and child nutrition. It also examines differences in labor performance and recovery between households with and without cool roof coatings, although this intervention is not the central focus. H2H is designed as a prospective cohort study nested within two Health and Demographic Surveillance Systems (HDSS) in Nouna, Burkina Faso, and Siaya, Kenya. The study integrates environmental monitoring (temperature and humidity sensors used to compute Wet Bulb Globe Temperature), biometric data (via wearables tracking heart rate, temperature, physical activity, energy expenditure, and sleep), and GPS tracking (capturing spatial mobility and labor duration). The study is embedded within a larger cluster-randomized controlled trial, facilitating comparative analysis under varying thermal conditions. Findings will provide evidence-based insights into how climate-related heat stress affects health and agricultural outcomes, supporting the development of targeted adaptation strategies to enhance resilience, health, and food security in vulnerable farming communities.

PMID:40654138 | DOI:10.1080/16549716.2025.2513719

Arthritis Care Res (Hoboken). 2025 Jul 14. doi: 10.1002/acr.25609. Online ahead of print.

ABSTRACT

OBJECTIVE: We evaluated trends in dermato-polymyositis (DPM) mortality relative to all-cause mortality in the United States, 1999-2022.

METHODS: We used the Center for Disease Control and Prevention’s databases (Multiple Causes of Death for 1999-2020 and Provisional Mortality Statistics for 2021 and 2022) to obtain death counts for DPM and non-DPM (all causes other than DPM). We calculated age-standardized mortality rates (ASMR) for both groups and computed the ratio of DPM-ASMR to non-DPM-ASMR for each of the 24 years. We performed joinpoint regression analysis to estimate annual percent change (APC) in DPM and non-DPM ASMRs and in the DPM-ASMR:non-DPM-ASMR ratios, overall and by sex, age, and race/ethnicity.

RESULTS: There were 12,882 DPM and 63,549,485 non-DPM deaths during 1999-2022. Mortality decreased at a higher APC (-3.8% [95% CI, -4.3%, -3.4%]) for DPM than non-DPM (-1.2% [95% CI, -1.5%, -0.9%]) until the start of the COVID-19 pandemic, when it increased for both at similar APCs. Consequently, the ratios of DPM-ASMRs to non-DPM-ASMRs decreased over these 24 years in all subgroups. The DPM-ASMR to non-DPM-ASMR ratios were higher in females than males, and in younger individuals (≤64 years) than those ≥65 years. The odds of premature death were higher for DPM than non-DPM. Non-Hispanic Black, Hispanic, and non-Hispanic others had higher DPM-ASMR to non-DPM-ASMR ratios than White individuals.

CONCLUSION: DPM mortality decreased at a higher rate than all-cause mortality until the pandemic, when it proportionately increased for both DPM and all causes. Females, younger, Black, Hispanic, and non-Hispanic other individuals had higher DPM mortality relative to all-cause mortality. Findings highlight the need for improved screening, earlier intervention, and targeted efforts to address racial/ethnic disparities in DPM outcomes.

PMID:40654129 | DOI:10.1002/acr.25609

Phytochem Anal. 2025 Jul 14. doi: 10.1002/pca.70011. Online ahead of print.

ABSTRACT

INTRODUCTION: Galls, which are abnormal or protruding tissues, form when insects bite plant cells and serve as evidence for understanding plant-insect interactions.

OBJECTIVES: This study is aimed at understanding the interactions between Chrysanthemum species and insects at the metabolomic level and to reveal the metabolic changes induced by insect galls.

METHODOLOGY: This study employed liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS), along with multivariate statistics and pathway enrichment, for metabolomic profiling of Chrysanthemum glabriusculum, including gall-infected and gall-free leaves, and reported the gall phenomenon in Chrysanthemum species for the first time.

RESULTS: LC-MS metabolomics analysis identified 105 marker metabolites, with 61 upregulated and 42 downregulated. Organic acids were the most abundant (20.00%), followed by carbohydrates (16.19%) and flavonoids (14.29%). KEGG analysis revealed significant pathway enrichment in flavone and flavonol biosynthesis, the TCA cycle, and galactose metabolism (p < 0.05). GC-MS metabolomics analysis revealed 27 volatile secondary metabolites, predominantly terpenoids (16 types), followed mainly by alcohol (4 types) and ketone compounds (three types). VIP > 1 analysis revealed 13 differentially signature metabolites; gall tissue (CgCa) presented elevated levels of β-phellandrene, camphene, and 1,8-Cineole, whereas γ-Muurolene, α-Farnesene, and Copaene were downregulated in CgCa.

CONCLUSIONS: During gall induction, C. glabriusculum plays an important role in energy metabolism through the regulation of key metabolic pathways, such as galactose metabolism and the TCA cycle, and their products; moreover, by regulating the biosynthesis of flavonoids and flavonols and the corresponding accumulation of secondary metabolites (terpenoids, ketones, and alcohols), it defends against insect-induced galls.

PMID:40654123 | DOI:10.1002/pca.70011

J Indian Prosthodont Soc. 2025 Jan 1;25(1):22-29. doi: 10.4103/jips.jips_369_24. Epub 2025 Jan 3.

ABSTRACT

PURPOSE: When compared to conventional freehand procedures, the development of computer-assisted techniques in dental implant insertion surgery has significantly changed traditional practices, bringing about a movement toward improved precision and predictability. The purpose of this study was to evaluate the efficiency of traditional freehand methods versus static-dynamic computer-assisted dental implant placement procedures in terms of accuracy and precision.

METHODOLOGY: This study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, screening 438 articles from databases such as PubMed, Embase, Scopus, and Web of Science. The inclusion criteria were randomized and nonrandomized control trials, case controls and retrospective case studies, focusing on platform deviation, angular deviation, and apical deviation in dynamic, static, and freehand surgeries. Eleven studies were selected for a review, with nine studies included in the meta-analysis. Heterogeneity was analyzed using appropriate statistical models to ensure robust findings and reliability of the results.

RESULTS: The meta-analysis included nine studies comparing dental implant accuracy across dynamic, static, and freehand placement techniques. Dynamic systems showed superior accuracy, with platform deviations of 0.64-1.73 mm, angular deviations of 2.49°-5.75°, and apical deviations of 0.89-1.86 mm. Static systems showed slightly greater variability, with platform deviations of 0.97-2.34 mm and angular deviations of 2.2°-4.98°. Freehand techniques demonstrated the highest deviations, with platform deviations up to 3.48 mm and angular deviations up to 10.09°. Prediction intervals indicated consistent superiority of dynamic guidance across metrics.

CONCLUSION: When compared to static and freehand methods, dynamic computer-assisted dental implant surgery provides more accuracy and precision. In implant dentistry, adopting dynamic guided systems is essential to attaining the best clinical results and raising patient satisfaction.

PMID:40654119 | DOI:10.4103/jips.jips_369_24

J Med Econ. 2025 Jul 14:1-25. doi: 10.1080/13696998.2025.2530862. Online ahead of print.

ABSTRACT

AIM: To assess the cost-effectiveness of adjuvant pembrolizumab (Keytruda) versus routine observation of adult patients with stage IB (T2a ≥ 4 cm) -IIIA with programmed cell death ligand 1 (PD-L1) tumor proportion score (TPS) <50% who have undergone complete resection and platinum-based chemotherapy from the Canadian public healthcare payer perspective.

MATERIALS AND METHODS: A Markov model was constructed to capture clinical and economic outcomes across four health states: disease-free (DF), local-regional recurrence (LR), distant metastases (DM) and death. Transition probabilities (TPs) from the DF state were populated using clinical trial data from KEYNOTE-091. TPs from the LR state were from real-world evidence (RWE). Clinical trial and network meta-analysis output populated transitions from DM. TPs from LR and DM were calibrated to fit the KEYNOTE-091 survival data. Costs were reported in 2023 Canadian dollars and utilities were based on data from KEYNOTE-091 and metastatic NSCLC clinical trials.

RESULTS: Pembrolizumab extended life years (LYs) (1.55) and quality-adjusted life years (QALYs) (1.19). Costs increased by $84,050, resulting in an incremental cost-effectiveness ratio (ICER) per additional LY of $54,219 and per additional QALY of $70,725, below the willingness-to-pay threshold of $100,000. Survival gains associated with pembrolizumab were attributed to more time spent in the DF health state. Higher costs for pembrolizumab were due to adjuvant treatment costs but were partially offset by lower subsequent treatment costs in downstream health states, reflecting a lower risk of recurrence associated with pembrolizumab. The model results remained robust across scenario and sensitivity analyses.

LIMITATIONS: Due to lack of transition probabilities starting from the LR and DM states from the KEYNOTE-091 trial, TPs from the LR and DM states were estimated using non-trial sources.

CONCLUSIONS: Adjuvant pembrolizumab was found to be cost-effective compared to routine observation from the public healthcare payer perspective in Canada.

PMID:40654114 | DOI:10.1080/13696998.2025.2530862

Arthritis Care Res (Hoboken). 2025 Jul 14. doi: 10.1002/acr.25613. Online ahead of print.

ABSTRACT

BACKGROUND: In complex diseases, it is challenging to assess a patient’s disease state, trajectory, treatment exposures, and risk of multiple outcomes simultaneously, efficiently and at the point of care.

METHODS: We developed an interactive patient-level data visualization and analysis tool (VAT) that automates illustration of a scleroderma patient’s trajectory across multiple organs and illustrates this relative to a reference population, including patient subgroups who share risk factors with the index patient, to improve estimation of disease state. We conducted VAT usability testing with patients and clinicians. We then embedded results from internally cross-validated, Bayesian multivariate mixed models that calculate an individual’s risk of critical events, utilizing baseline risk factors, patient-level information in past trajectories in multiple dimensions, and known outcomes from the entire population and relevant subgroups.

RESULTS: The web-based application aggregates complex, longitudinal data to illustrate patient-, subgroup- and population-level health trajectories across multiple organ systems. Patients (N=7) exposed to the VAT reported increased knowledge about their disease and confidence in medical decision-making. Rheumatologists (N=4) were able to access 8.6-times more data in 81.5% of the time using 2/3 fewer clicks using the VAT compared to the EMR. Statistical modeling was successfully embedded in the VAT, enabling real-time estimation of a patient’s risks of multiple complications.

CONCLUSIONS: Systematic analysis and visualization of individual- and population-level data in a complex disease has potential to improve medical decision-making and warrants further study. Individualized risk estimation disseminated at the point of care may enable targeted screening and early intervention in high-risk patients.

PMID:40654109 | DOI:10.1002/acr.25613

J Yeungnam Med Sci. 2025;42:41. doi: 10.12701/jyms.2025.42.41. Epub 2025 Jul 13.

ABSTRACT

BACKGROUND: Accurate detection of Helicobacter pylori is essential for the diagnosis and management of gastritis and related gastrointestinal disorders. This study aimed to evaluate the diagnostic performance of the rapid urease test (RUT) and immunohistochemistry (IHC) using four antibodies (from BioGenex, Tokyo Medical and Dental University [TMDU], Cell Marque, and Dako), with a focus on bacterial localization (surface vs. subepithelial) and associated mucosal changes.

METHODS: Gastric biopsy specimens from patients who underwent upper endoscopy at Vajira Hospital between June and December 2022 were retrospectively analyzed. Histological evaluations included hematoxylin and eosin staining, RUT, and IHC. The sensitivity of each antibody for detecting H. pylori was compared, with special attention paid to subepithelial colonization and histopathological patterns.

RESULTS: The BioGenex antibody exhibited the highest sensitivity in detecting H. pylori, followed by TMDU, Cell Marque, and Dako antibodies. RUT demonstrated the lowest sensitivity, particularly in cases of chronic nonactive gastritis or minimal mucosal changes. Among the IHC antibodies, BioGenex detected the greatest number of subepithelial H. pylori cases, many of which were missed by the other antibodies and RUT. Subepithelial colonization typically presented as dot-like signals suggestive of coccoid forms or bacterial remnants. The BioGenex antibody identified all subepithelial cases detected by the TMDU antibody, highlighting the former’s superior sensitivity. Statistical analysis confirmed the significantly higher diagnostic accuracy of the BioGenex antibody across multiple histological subgroups (p<0.05).

CONCLUSION: Subepithelial H. pylori colonization is clinically relevant and often undetected by RUT or less sensitive IHC antibodies. The BioGenex antibody was the most effective in identifying H. pylori in both surface and subepithelial regions. Patients with suspected subepithelial infection, particularly those without detectable surface bacteria, should undergo further evaluation using urea breath tests or stool antigen assays, in accordance with current clinical guidelines.

PMID:40654104 | DOI:10.12701/jyms.2025.42.41

J Radiol Prot. 2025 Jul 14;45(3). doi: 10.1088/1361-6498/ade68e.

ABSTRACT

A recent commentary on epidemiological studies of nuclear workers notes that these studies can provide radiation risk estimates that complement those derived from the study of Japanese atomic bomb survivors. The author asserts that the results from some nuclear worker studies are difficult to interpret due to the fact that ERR/Gy estimates vary across subcohorts, and subcohort-specific estimates are not always equal to estimates obtained in the overall study population. We discuss settings in which it is reasonable to expect that an estimate of association in a subcohort should be similar to an estimate obtained in the full cohort and settings in which a subcohort analysis may differ from the estimate obtained in a full cohort analysis. Focusing on the INWORKS study, we describe some of the steps taken to understand variation in estimates of ERR/Gy between subgroups and upon restrictions, as well as interpretation of estimates of external dose-mortality associations in the total study population.

PMID:40654101 | DOI:10.1088/1361-6498/ade68e

J Cosmet Dermatol. 2025 Jul;24(7):e70197. doi: 10.1111/jocd.70197.

ABSTRACT

BACKGROUND: Hybrid cooperative complex hyaluronic acid (HCC HA) is a novel, widely used injectable developed using the patented NAHYCO Hybrid Technology for the treatment of the face and body, respectively.

AIM: To examine the safety profile of HCC HA from global post-marketing surveillance data.

METHODS: Post-marketing adverse events (AEs) reported for HCC HA injected to the face (Profhilo, HCC-HA_PROF, IBSA Farmaceutici Italia Srl, Italy) from January 1, 2018 to October 31, 2023 and to the body (Profhilo Body, HCC-HA_PROF-B, IBSA Farmaceutici Italia Srl, Italy) from January 1, 2020 to October 31, 2023 were analyzed. Patient exposure and the proportion of exposed patients with a safety complaint were also estimated.

RESULTS: The total number of patients exposed to HCC-HA_PROF and HCC-HA_PROF-B globally was projected to be 1 091 956 and 27 692, respectively. There was a total of 371 AEs recorded for HCC-HA_PROF, and 11 AEs reported for HCC-HA_PROF-B, corresponding to 0.034% and 0.040% of the patients, respectively. The most common AEs were edema, erythema, and discomfort, which are consistent with the manner and location of administration, and the AEs are frequently reported following treatment. The proportion of exposed patients with a safety complaint was low, with 0.026%-0.050% and 0%-0.013% of patients exposed to HCC-HA_PROF or HCC-HA_PROF-B experiencing a safety complaint, respectively.

CONCLUSIONS: Post-marketing surveillance indicated favorable safety profiles for HCC-HA_PROF and HCC-HA_PROF-, with the most common AEs expected and/or related to the method or site of administration.

PMID:40654100 | DOI:10.1111/jocd.70197

J Pediatr Orthop. 2025 Jul 14. doi: 10.1097/BPO.0000000000003056. Online ahead of print.

ABSTRACT

BACKGROUND: For patients with adolescent idiopathic scoliosis (AIS), full-time scoliosis braces are effective in preventing curve progression but are a source of stress for patients and families. Nighttime hypercorrective braces have minimal impact on daily life, but there is little evidence to guide prescription. It is not known how providers with expertise in scoliosis incorporate nighttime bracing into their routine clinical practice. The aim of this study is to assess provider perspectives and recommendations regarding the use of nighttime and full-time scoliosis bracing for patients with AIS.

METHODS: Providers engaged in nonoperative scoliosis management were invited to complete an online survey that included 12 scoliosis case scenarios. For each case scenario, respondents were asked to indicate their bracing recommendation and their willingness to randomize each case into a hypothetical clinical trial. The survey also queried respondents’ use of nighttime and full-time bracing in their practice. Descriptive statistics were used to summarize findings; a linear mixed effects model was used to determine patient characteristics related to bracing recommendations and willingness to randomize.

RESULTS: A total of 214 respondents completed the survey; most had been in practice for >15 years (58%) and dedicate the majority of their practice to pediatric spine (57%). Just over half (54%) currently prescribe nighttime braces. Across case scenarios, most respondents recommended full-time bracing (70% to 92%); recommendations varied by curve type, curve magnitude, and skeletal maturity. For providers who use nighttime braces, the most important factors that led providers to prescribe nighttime over full-time braces were patient willingness to wear the brace (58%), skeletal maturity (57%), and curve type (56%).

CONCLUSIONS: Most providers preferred to prescribe full-time over nighttime braces. Providers were more willing to recommend a nighttime brace for patients with lumbar/thoracolumbar curves and those who were at lower risk for curve progression (ie, more skeletally mature and smaller curve magnitudes). Ultimately, results provide insights into current practice and will inform eligibility criteria and feasibility for a future study comparing nighttime and full-time braces.

LEVEL OF EVIDENCE: Expert opinion.

PMID:40654097 | DOI:10.1097/BPO.0000000000003056