Nevin Manimala

Br J Nutr. 2025 Nov 7:1-46. doi: 10.1017/S0007114525105400. Online ahead of print.

ABSTRACT

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a serious disease and increasingly prevalent in children. MASLD is associated with health consequences such as type 2 diabetes, and cardiovascular disease. While, vitamin E is a potent antioxidant that has been proposed to improve liver function and cardiometabolic health including liver markers, lipid profile, glycemic control, and anthropometric measurements. A comprehensive search was conducted up to March 2025. Data on anthropometric measures, liver enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT)), glycemic indices (fasting blood sugar (FBS), insulin, homeostatic model assessment for insulin resistance (HOMA-IR)), lipid profiles (total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)), and serum vitamin E levels were extracted. Statistical analyses were performed using a random-effects model. Eleven RCTs involving 665 participants were included in this study. Vitamin E significantly reduced ALT (weighted mean difference (WMD)= -5.23 U/L;95% confidence interval (CI): -7.72, -2.75; P< 0.001) and AST (WMD= -3.00 U/L;95% CI: -4.59, -1.41; P< 0.001), reflecting improved liver function. It also decreased TC (WMD= -5.77 mg/dL;95% CI: -11.46, -0.09; P= 0.04) and HOMA-IR (WMD= -0.82;95% CI: -1.28, -0.37; P< 0.001), while significantly increasing serum vitamin E levels (WMD= 9.16 mg/L;95%CI: 3.29, 15.03; P=0.002). No significant changes were observed in the BMI, GGT, FBS, insulin, LDL, HDL, or TG levels. Vitamin E supplementation in pediatric MASLD appears to favorably influence key liver enzymes such as ALT, AST and certain metabolic factors including TC, and HOMA-IR levels, supporting its potential role as adjunctive therapy.

PMID:41199412 | DOI:10.1017/S0007114525105400

J Forensic Sci. 2025 Nov 6. doi: 10.1111/1556-4029.70214. Online ahead of print.

ABSTRACT

The hypothesis of fingerprint individuality continues to be debated due to limited empirical verification, impacting the scientific foundation of fingerprint identification. This study proposed a quantitative model for fingerprint individuality and investigated the three-dimensional (3D) distribution of minutiae. This model considered the position and direction of minutiae as 3D feature variables. We extracted 3D feature data from 56,812,114 known fingerprints based on the automatic fingerprint identification system (AFIS). Following data calibration, translation, and error correction, we statistically analyzed the distribution density of minutiae. We developed the algorithm to calculate the individuality score of a single fingerprint through the individuality model. The experimental results showed that the minutiae distribution followed distinct patterns. The distribution density of minutiae exhibited symmetry between corresponding fingers on left/right hands. Significant variations in minutiae distribution density and central point distribution were observed across the five pattern types (whorl, left loop, right loop, arch, accidental). Minutiae with different directions exhibited symmetry along the Y-axis in both positional and quantitative distribution. Minutiae within diagonally opposite angular ranges showed similar distribution trends. The individuality scores were robust to distinguish different fingerprints. We preliminarily applied the individuality score to provide a basis for modifying the AFIS scoring mechanism, and we found that the individuality score of same-source fingerprints was greater than that of close nonmatches (CNMs). This work provides novel insights into fingerprint individuality and establishes a statistical foundation for refining AFIS scoring mechanisms and likelihood-ratio evidence evaluation frameworks.

PMID:41199411 | DOI:10.1111/1556-4029.70214

BMC Glob Public Health. 2025 Nov 7;3(1):99. doi: 10.1186/s44263-025-00219-w.

ABSTRACT

BACKGROUND: Stigma is a deleterious force that is associated with poor health outcomes among people with HIV (PWH). The Finding Respect and Ending Stigma around HIV (FRESH) intervention is designed to combat HIV and related stigmas about PWH and their care providers. To evaluate the effects of the Spanish-language FRESH in the Dominican Republic, our team conducted a pilot trial, informed by the stepped-wedge model, at two HIV clinics to ascertain signals of potential value for PWH.

METHODS: Clinics were randomized to first and second receipt of the intervention; the intervention was delivered over 2 days. In-person tablet-based digital surveys, including validated measures of stigma and discrimination, were administered to PWH (2021-2022, N = 419) every 6 months aggregated to pre- and post-intervention periods for analysis. Analysis of variance (ANOVA) and general linear modelling were used to evaluate differences in stigma scores. All data collection occurred after an HIV clinic visit. Statistical analyses were performed using SPSS.

RESULTS: Mean age of participants was 33.86 (standard deviation [SD] = 9.14; range = 18-70); respondents predominantly identified as male (N = 396, 94.5%) and multiracial (N = 330, 90.5%). Significant differences were observed across time, with decreases from pre- to post-intervention in public stigma (mean [M] = 3.92, SD = 1.25 to M = 3.47, SD = 1.41, p < .001) and perceived sexual orientation discrimination (M = .23, SD = .27 to M = .10, SD = .18, p < .001). Significant differences between clinics were also evident, with higher scores in clinic A compared to clinic B in disclosure concerns (M = 4.31, SD = .84 vs. M = 3.68, SD = 1.26, p < .001), perceived sexual orientation discrimination (M = .17, SD = .22 vs. M = .12, SD = .22, p = .030), and perceived discrimination related to race/ethnicity (M = .11, SD = .19 vs. M = .05, SD = .15, p = .002). The viral suppression rate in these clinics improved between pre-intervention and post-intervention periods, from 78 to 82%, but did not reach statistical significance.

CONCLUSIONS: Substantive differences in clinics could have impacted the intervention’s delivery and impacts. While there were significant associations of intervention experience with reductions in some forms of stigma among PWH, results should be extended cautiously considering the small size of this pilot. Data collection procedures were feasible and acceptable, and evidence was found to warrant full-scale testing of the intervention.

TRIAL REGISTRATION: NCT04491539, https://clinicaltrials.gov/study/NCT04491539?cond=NCT04491539&rank=1.

PMID:41199402 | DOI:10.1186/s44263-025-00219-w

Equine Vet J. 2025 Nov 6. doi: 10.1111/evj.70114. Online ahead of print.

ABSTRACT

BACKGROUND: Assessment of equine metabolic and locomotory responses to quantified levels of physical exercise is needed to support the creation of tailored protocols for optimal training adaptation. The locomotory response to exercise in horses is not fully understood.

OBJECTIVES: To investigate the effect of a standardised exercise test (SET) on upper-body and limb kinematics and stride-to-stride variability in Standardbred Warmblood trotters.

STUDY DESIGN: Experimental repeated-measures field study.

METHODS: Thirteen Standardbred trotters, equipped with nine inertial measurement units (IMUs), performed an incremental SET on an oval track. Heart rate and lactate data were collected to identify internal workload. Two 30-s segments of jog on the straight (at the beginning and at the end of the SET) were used for statistical analysis of the effect of the SET on locomotion parameters.

RESULTS: Upper-body kinematics revealed a decrease in head and withers range of motion (ROM; -12.3 mm; p = 0.04 and -8.5 mm; p = 0.01, respectively). Front limb sagittal ROM (16.1°; p = 0.001) increased explained by increased maximal protraction and retraction (6.9°, p = 0.002 and 9.1°, p = 0.002, respectively). Stride-to-stride variability (i.e., coefficient of variation) was reduced for stride duration (-0.7%; p = 0.01), front limb sagittal ROM (-7.3%; p = 0.04), front limb maximal protraction (-6.9%; p = 0.01) and maximal retraction (-7.4%; p = 0.03). No effects were found on sagittal hindlimb angles and none of the absolute asymmetry parameters changed (p > 0.05).

MAIN LIMITATIONS: Horses were of different ages and training statuses, and full orthopaedic examinations were not performed.

CONCLUSIONS: Several kinematic parameters were affected by the SET. Head and withers ROM were reduced, while front limb sagittal ROM increased. Stride-to-stride variability showed a decrease. The results indicate that exercise in Standardbred trotters produces both a metabolic and locomotory response. Additionally, these findings highlight the efficacy of IMUs as a non-invasive tool for detecting exercise-induced changes in limb and upper-body kinematics.

PMID:41199399 | DOI:10.1111/evj.70114

Arch Public Health. 2025 Nov 6;83(1):266. doi: 10.1186/s13690-025-01716-y.

ABSTRACT

BACKGROUND: Health care providers (HCPs) are at a higher risk of being accidentally exposed to infectious agents while providing care to their clients and patients. Despite the presence of individual studies, there is limited evidence on the overall burden and predictors of accidental exposure to infectious agents among HCPs in Ethiopia. The present comprehensive meta-analysis aimed to highlight the pooled prevalence of accidental exposure to infectious agents among HCPs in Ethiopia.

METHODS: This review includes articles published between January 4, 2014, and April 29, 2023, using electronic databases (PubMed, EMBASE, SCOPUS, Cochrane Library, and Google Scholar). Studies that explore blood and/or sharp device exposure among HCPs in Ethiopia were included, and the Joanna Briggs Institute (JBI) critical appraisal checklist was utilized to assess the quality of included studies. The data was extracted and analyzed using Excel and STATA version 14, respectively. The association between each variable is explained using Odds ratio (OR). The Cochrane Q test and I² test statistics assessed study heterogeneity, and a random effects model was used.

RESULTS: The final analysis included 34 observational studies with a total of 10,859 study participants, which revealed that the pooled prevalence of accidental exposure to infectious agents among HCPs in Ethiopia was 11.48% (95% CI: 2.6, 20.35). Not taking training (OR = 1.88; 95% CI: 1.03, 3.43), being male (OR = 1.46; 95% CI: 1.03, 2.06), inconsistent use of personal protective equipment (OR = 1.68; 95% CI: 1.06, 2.68), and recapping needles after use (OR = 4.64; 95% CI: 2.46, 8.76) were positively associated with accidental exposure to infectious agents among HCPs.

CONCLUSIONS: These findings suggest that accidental blood and sharp device exposure among HCPs remain a significant public health concern in Ethiopia, and interventions should be implemented to address the identified risk factors, such as proper training on infection prevention and control measures and discouraging the recapping of needles, and, moreover, strategies to improve the consistent use of personal protective equipment should be implemented to reduce exposure.

PMID:41199388 | DOI:10.1186/s13690-025-01716-y

Diabetol Metab Syndr. 2025 Nov 6;17(1):419. doi: 10.1186/s13098-025-01970-8.

ABSTRACT

BACKGROUND: The AI-CVD initiative aims to maximize the value of coronary artery calcium (CAC) scans for cardiometabolic risk prediction by extracting opportunistic screening information. We investigated whether artificial intelligence (AI)-derived measures from CAC scans are associated with new-onset Type 2 diabetes mellitus (T2DM) in adults without obesity or hyperglycemia.

METHODS: Baseline CAC scans and up to 23 years of follow-up data were analyzed for participants without obesity (body mass index < 30 kg/m²) and hyperglycemia (fasting plasma glucose < 100 mg/dL) from the Multi-Ethnic Study of Atherosclerosis (MESA). AI-derived measures included liver attenuation index (LAI), subcutaneous fat index (SFI), total visceral fat index (TVFI), epicardial fat index (EFI), skeletal muscle index, and skeletal muscle mean density. Cox regression models compared highest vs. lowest quartiles of each AI-derived metric for T2DM risk. Multivariable models assessed adjusted predictive value using Wald chi-squared statistics. Subgroup analyses stratified participants by demographic and clinical factors.

RESULTS: During a median follow-up of 19.7 years among 2,993 participants (baseline mean age 61.9 ± 10.5 years, 53% women), 257 participants (8.6%) developed T2DM. Key predictors included LAI (HR: 3.13, 95% CI: 2.15-4.55), SFI (HR: 2.85, 95% CI: 1.93-4.21), TVFI (HR: 2.49, 95% CI: 1.72-3.60), and EFI (HR: 1.59, 95% CI: 1.09-2.32). LAI remained the most robust predictor after adjusting for all metrics (Wald χ² = 38.24). Subgroup analyses confirmed LAI’s consistent predictive performance.

CONCLUSION: AI-derived adiposity measures from CAC scans-especially liver fat-can identify adults without obesity or hyperglycemia at elevated risk for developing T2DM. These findings underscore the potential of AI-enabled opportunistic screening during CAC imaging to support early T2DM risk stratification in individuals not captured by current clinical guidelines.

PMID:41199381 | DOI:10.1186/s13098-025-01970-8

Trials. 2025 Nov 6;26(1):473. doi: 10.1186/s13063-025-09209-7.

ABSTRACT

BACKGROUND: According to the WHO, more than 50% of patients do not take their medications as prescribed. Nonadherence is caused by several variables, including social and economic factors, issues with the healthcare team and system, problems related to specific diseases, characteristics of those diseases, and their treatments.

OBJECTIVE: To study the effectiveness of the PARTICIPATE intervention at the community level regarding medication adherence among adults with diabetes and/or hypertension in rural India.

STUDY DESIGN: This is a multicentre cluster randomised trial implemented across 4 blocks (64 villages) of 4 districts in East, West, North, and South India, covering 2880 randomly selected participants. A nested economic evaluation will measure the effectiveness of community-based participatory research (CBPR). The intervention will be delivered by peer educators identified from the community for a duration of 12 months, with the first 6 months followed by monthly sessions for the next 6 months. The control group will continue to receive all aspects of standard care offered by healthcare providers (public or private).

METHODS: The measure of drug adherence for hypertension and/or diabetes, as determined by the self-reported Morisky Medication Adherence Scale (MMAS-8) at baseline, midterm, and end, is the study’s outcome variable. The independent variables, namely socio-economic status, number of antihypertensive and/or antidiabetic drugs, their duration, self-perceived health status, systolic and diastolic blood pressure, and/or HbA1c, will be controlled for during the analysis. Secondary outcomes include improvement in health literacy using the All Aspects of Health Literacy Scale (AAHS), clinical outcomes, quality of life using the EURO-QoL (EQ-5D), cost-effectiveness, and return on investment (ROI). Process evaluations will be conducted with a sub-sample of participants to examine engagement in various intervention components. The fidelity of intervention will be monitored using the Normalisation Process Theory framework.

DISCUSSION: To the best of our knowledge, this is the first multi-centre cluster randomised controlled trial in India to assess the effectiveness of the CBPR approach for improving medication adherence among diabetics and hypertensive patients. The results of this study will contribute to the evidence base for scaling up peer-educator models for diabetes and hypertension management in India and similar low- and middle-income countries.

TRIAL REGISTRATION: The registration number for this trial is CTRI/2024/01/061939.

PMID:41199367 | DOI:10.1186/s13063-025-09209-7

Malar J. 2025 Nov 6;24(1):381. doi: 10.1186/s12936-025-05626-w.

ABSTRACT

BACKGROUND: Thrombocytopenia is a common haematological abnormality in malaria patients, increasing the risk of mortality in both children and adults with Plasmodium falciparum and Plasmodium vivax infections. In Rwanda, data on the prevalence and associated factors of severe thrombocytopenia in malaria patients are limited. This study aimed to determine the prevalence and factors associated with severe thrombocytopenia among hospitalized patients with malaria attending Kigeme District Hospital, Southern Province, Rwanda.

METHODS: A cross-sectional study was conducted from December 2023 to November 2024 among malaria patients at Kigeme District Hospital, Rwanda. Using simple random sampling, 124 patients were selected while ensuring confidentiality throughout data collection, analysis, and reporting. Data were gathered via a structured form in Kobo Toolbox and later processed in Microsoft Excel. Information on demographic, clinical characteristic and laboratory investigations considered were those collected during the time of patients admission to the hospital. Binary logistic regression was employed to assess associations, with variables showing a p-value < 0.05 in bivariate analysis included in the multivariable model. Adjusted odds ratios (AOR) with 95% confidence intervals were computed, and statistical significance was set at p-value < 0.05.

RESULTS: The study has shown that severe thrombocytopenia was 27.4% among patients with malaria. Factors associated with severe thrombocytopenia among patients with malaria were age group less or equal to 5 years old (AOR = 5.17, 95%CI 1.674-16.259, p = 0.004), type infecting Plasmodium species (AOR = 3.4, 95%CI 2.41-8.3, p = 0.04) positive C-Reactive Protein (AOR = 3.45, 95%CI 2.23-3.56, P = 0.045), jaundice (AOR = 2.875, 95% CI 1.36-26.5, p = 0.045), epistaxis (AOR = 1.84, 95% CI 1.73-2.43, p = 0.042), high serum urea (AOR = 1.73, 95% CI 1.23-1.83, p = 0.001). On the other hand, patients with coma status (cerebral malaria) (AOR = 0.189, 95% CI 0.137-0.985, p = 0.028, Delay to seek medical care (AOR = 0.393, 95% CI 0.043-1.125, p = 0.082) were less likely associated with severe thrombocytopenia.

CONCLUSION: This cross-sectional study found a 27.4% prevalence of severe thrombocytopenia in malaria patients. Key associated factors included less or equal to 5 years old, positive C-reactive protein, type of Plasmodium infecting species, jaundice, epistaxis, and high serum urea levels, while cerebral malaria linked to a lower likelihood of thrombocytopenia. This highlight the need for early identification severe thrombocytopenia among severe malaria patients who are at high likelihood suffering severe thrombocytopenia. Further longitudinal studies are recommended to better understand the predictive value of these factors and their role in guiding clinical management.

PMID:41199350 | DOI:10.1186/s12936-025-05626-w

Malar J. 2025 Nov 6;24(1):377. doi: 10.1186/s12936-025-05624-y.

ABSTRACT

BACKGROUND: Climate change can influence malaria incidence directly and indirectly, impacting vector and parasite dynamics, along with socioeconomic factors influencing malaria risk. In Zimbabwe there is a paucity of research linking climate change, environmental factors, and malaria incidence, hindering coordinated efforts for malaria elimination. Accordingly, the aim of the study was to explore the link between climate change, environmental factors, and malaria incidences, from 2010 to 2022, in Chiredzi district, Zimbabwe.

METHODS: A transdisciplinary approach was applied, combining quantitative weather data from weather stations, malaria incidence data and insights from focus group discussions which were used to glean people’s perceptions and knowledge of climate change and malaria in Chiredzi District. Participatory mapping showing hot spots of malaria incidence were also utilized. Statistical analysis in MATLAB was used to analyse the weather and malaria data and a P-value of 0.0479 was obtained which is deemed as statistically significant. ATLAS.ti was used to qualitatively analyse data from the focus group discussions.

RESULTS: Key results from the study show evidence of climate change in Chiredzi district manifesting through an increase in rainfall, increase in temperature, change in seasons and extreme weather patterns. Furthermore, there is a positive relationship between changes in climate and an increase in malaria incidence. However, in some years the relation is negative, and this can be attributed to other factors. Similarly, malaria incidence is also related to other socioeconomic and environmental factors such as poverty and migration which are further exacerbated by climate change. Malaria incidence is also attributed to other environmental and socio-economic factors.

CONCLUSIONS: Further studies with extended datasets that span a longer period need to be carried out. Likewise forecasting malaria incidence based on current climate, environmental and socio-economic conditions is crucial for advocating transformative malaria prevention programs, emphasizing the importance of inclusive partnership and adaptation to a changing climate. New malaria prevention programs that consider the impact of a changing climate on malaria, local environmental and socio-economic factors are urgently needed.

PMID:41199346 | DOI:10.1186/s12936-025-05624-y

BMC Psychol. 2025 Nov 6;13(1):1231. doi: 10.1186/s40359-025-02951-2.

ABSTRACT

BACKGROUND: Emotional intelligence is a person’s ability, capacity and ability to understand, use, understand, manage, anticipate, manage and direct the emotions of oneself or others. Students with high levels of emotional intelligence express themselves better, are more resistant to stress in their lives, and are individuals who can direct their emotions. Leaders with strong emotional intelligence will create synergy for all employees. Therefore, emotional intelligence and stress management skills are important issues in the field of leadership and organizational behavior. At the same time, emotional intelligence and stress management skills interact with hormones. This study aims to examine the emotional intelligence levels and hormone (apelin, cortisol) and cerebral (Brain-derived neurotrophic factor (BDNF)) response of 4th-year students of the faculty of health sciences at the university, who are potential managers of the future in terms of some variables.

METHODS: The research was conducted using the cross-sectional data method with 167 university students aged 18-24 who were reported to be clinically healthy in Türkiye. Apelin, cortisol hormone and BDNF levels in the participants’ saliva samples were analyzed using the ELISA technique. The relationship between emotional intelligence level and total scores from the stress coping scale and salivary apelin, cortisol and BDNF levels were evaluated.

RESULTS: In the study, it was determined that the average level of apelin hormone in saliva was “2.36 ± 0.076)” ng/mL in girls and “2.57 ± 0.071” ng/mL in boys. In girls, the BDNF level was “3.19 ± 0.97” and the cortisol level was “2.04 ± 0.72”. BDNF level in boys is “3.41 ± 0.94”and cortisol level is “1.92 ± 0.59”. There is a significant difference between the participants’ allowances (income levels) and the average levels of salivary apelin hormone, BDNF and emotional intelligence scale (p < 0.01). A positive, strong and statistically significant relationship was found between the participants’ emotional intelligence level and stress management skills and apelin and BDNF levels, and a negative, strong and statistically significant relationship was found between salivary cortisol levels (p˂0.01).

CONCLUSIONS: High emotional intelligence and stress management skills are an important element of strategic importance for a successful management and professional success process in individuals who will work in fields that need people such as health, marketing, law, consultancy, medicine, teaching and the service sector. Our study determined that as university students’ emotional intelligence levels strengthened, the participants’ stress management skills, salivary apelin, and BDNF levels increased, and cortisol hormone levels decreased. As a result, monitoring and examining apelin, BDNF, cortisol hormones can be useful parameters in evaluating the interaction between individuals’ emotional intelligence level and stress management skills and hormone response.

PMID:41199340 | DOI:10.1186/s40359-025-02951-2