Nevin Manimala

J Transl Med. 2025 Nov 6;23(1):1237. doi: 10.1186/s12967-025-07296-3.

ABSTRACT

BACKGROUND: This study examined the relationship between maternal preeclampsia (PE) and gut microbiota colonization in preterm infants and analyzed the effects of prenatal Bifidobacterium supplementation.

METHODS: This observational study included 45 preterm infants categorized according to their mothers’ exposure status during pregnancy. Group A (healthy controls, n = 15) included infants born to healthy mothers who received no supplementation; Group B (PE+Bifidobacterium, n = 15) included infants whose mothers had PE and received Bifidobacterium supplementation as part of routine clinical management; and Group C (PE only, n = 15) included infants born to mothers with PE who did not receive Bifidobacterium supplementation. All enrolled infants were followed from birth for subsequent analyses. The initial postnatal fecal samples of the infants were collected and analyzed using 16S rRNA gene sequencing. Microbial diversity within the intestinal microbiota was evaluated using alpha diversity (within-sample) and beta diversity (between-sample) analyses. To identify taxon-specific differences among groups, we performed linear discriminant analysis effect size and differential abundance analysis, with statistical significance set at p < 0.05. The functional potential of the gut microbiota was inferred based on Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways via the PICRUSt2 algorithm.

RESULTS: Alpha diversity analysis revealed significantly greater microbial diversity in the fecal microbiota of preterm infants born to healthy mothers (Group A) than in those delivered by mothers with PE, regardless of prenatal Bifidobacterium exposure. Taxonomic profiling revealed distinct microbial community structures across groups: Group A exhibited significant enrichment of Bacteroides at all taxonomic levels, along with an elevated abundance of Clostridium at the class and order levels. Group B showed a markedly greater relative abundance of Actinobacteria at the phylum level and Rothia at the genus level, whereas Group C was dominated by Proteobacteria (phylum level) and Streptococcus (genus level). All intergroup differences were statistically significant following Benjamini‒Hochberg correction (q < 0.05). A functional analysis of the gut microbiota revealed 53 KEGG pathways with significant overall group differences (p < 0.05), among which 23 pathways were significantly different in at least two groups (q < 0.05). Notably, the activity of the LPS biosynthesis pathway was significantly upregulated in Group C compared with Group A (q = 0.001). Although LPS biosynthesis activity was reduced in Group B relative to Group C (q = 0.018), it remained elevated compared to Group A (q = 0.001), suggesting incomplete mitigation of endotoxin risk. Additionally, glycolytic activity was significantly impaired in Group C relative to Group A (q = 0.003) but was partially restored in Group B compared to Group C (q = 0.022).

CONCLUSIONS: Maternal PE impaired early-life gut microbiota establishment in preterm infants, manifesting in reduced microbial diversity, enrichment of pathogenic Proteobacteria and Streptococcus, and consequent functional dysbiosis characterized by elevated endotoxin biosynthesis potential and compromised energy metabolism. Although prenatal supplementation with Bifidobacterium partially restored the microbial compositional balance, promoting beneficial bacteria, reducing LPS synthesis activity, and partially improving glycolytic function, it failed to fully reverse endotoxin-related risks, indicating the need to develop more effective microbiota-targeted strategies to comprehensively optimize metabolic and immune homeostasis.

PMID:41199330 | DOI:10.1186/s12967-025-07296-3

Arch Public Health. 2025 Nov 6;83(1):265. doi: 10.1186/s13690-025-01758-2.

ABSTRACT

BACKGROUND: High-quality immunization data is critical for making evidence-based decisions, ensuring effective program implementation, and achieving intended outcomes. Conversely, low-quality data hinders program monitoring and evaluation activities. Despite efforts to improve data quality in the health sector, the status of immunization data quality in Ethiopia is not well-known. This national study examined immunization data quality status and its challenges in Ethiopia.

METHODS: A mixed-method study was conducted on health facilities and all levels of administrative units, including the Ministry of Health, 12 regional health bureaus, 51 zonal health departments, 233 district health offices, 395 health facilities, and 267 health posts from April 15 to July 30, 2023. In-depth interviews were conducted with 74 purposefully selected key informants across these levels. The quality of immunization data was assessed based on accuracy, timeliness, and completeness. Open Data Kit (ODK) was used to collect quantitative data, and STATA statistical software was used for analysis. Qualitative data were analyzed using the thematic analysis approach with ATLAS.ti.

RESULTS: Out of 4062 immunization data elements expected to be reported in the months under review, only 2413 (59.4%) were available. One-third of health facilities had acceptable reporting accuracy, while 27% had inaccurate reports. 41% of health facilities had inadequate documentation for verifications. Complete documentation and accuracy of reporting were better in hospitals than in health centers and health posts, but lower in pastoralist settings and some regions. Report timeliness ranged from 94% in the Oromia region to 37% in Gambella. The main reasons for low immunization data quality were inadequate skilled data management personnel, lack of standard data management and data quality assessment tools, and irregular data quality assessments at health facilities.

CONCLUSIONS: The study identified a significant immunization data quality problem in Ethiopia’s health institutions, with data accuracy, timeliness and completeness rates falling far below the standard. To improve immunization data quality and informed decision-making, it is crucial to strengthen data quality improvement strategies starting from the point of data collection.

PMID:41199326 | DOI:10.1186/s13690-025-01758-2

BMC Sports Sci Med Rehabil. 2025 Nov 6;17(1):320. doi: 10.1186/s13102-025-01408-8.

ABSTRACT

BACKGROUND: Sitting volleyball relies heavily on upper-body strength and anaerobic capacity. Serve, spike, and speed-endurance are decisive skills, yet the ergogenic potential of low-dose caffeine in this Paralympic sport remains unclear.

PURPOSE: To examine the acute effects of low-dose caffeine (3 mg/kg) supplementation on serve speed, spike speed, and speed-endurance in elite sitting volleyball players.

METHODS: Using a randomized, double-blind, crossover design, 13 elite male athletes from the Turkish National Sitting Volleyball Team completed serve speed, spike speed, and speed-endurance tests under caffeine (CAF) and placebo (PLA) conditions.

RESULTS: Caffeine intake produced a moderate improvement in serve speed (p = 0.028, d = 0.460); however, this effect did not remain statistically significant after Bonferroni correction (adjusted p = 0.084). No significant effects were observed for spike speed (p = 0.547, d = 0.166) or speed-endurance performance (p = 0.709, d = 0.111). Perceived exertion during the speed-endurance test was similarly high in both conditions.

CONCLUSIONS: Low-dose caffeine may offer a trend toward improved serve performance, but the effect was not robust after statistical adjustment, and no benefits were observed for spike speed or speed-endurance. These findings highlight that caffeine’s ergogenic effects are context-dependent and shaped by task complexity and sport-specific motor demands. Further research with larger and more diverse samples, genotype-based subgroups, and varied dosing strategies is warranted to clarify caffeine’s role in adaptive sports.

TRIAL REGISTRATION: The randomized controlled trial was retrospectively registered on 21/06/2025 at ClinicalTrials.gov, under the registration number NCT07056231.

PMID:41199325 | DOI:10.1186/s13102-025-01408-8

Trop Med Health. 2025 Nov 6;53(1):153. doi: 10.1186/s41182-025-00832-3.

ABSTRACT

BACKGROUND: Hepatic cystic echinococcosis (HCE) remains a significant public health issue in endemic countries. Although recurrence is a recognized challenge, its independent impact on adverse clinical outcomes such as postoperative complications (POC), mortality, and length of hospital stay (LHS) remains poorly studied in Latin America. This study aimed to assess the risk of POC, mortality, and LHS in patients with recurrence of HCE.

METHODS: We conducted a retrospective cohort study of patients who underwent surgery for HCE between 1993 and 2019 at two centers in southern Chile. Patients with recurrence (exposed group) were compared to those undergoing primary surgery (non-exposed group). The primary outcome was the presence of POC; secondary outcomes included mortality and LHS. Crude and adjusted relative risks (RR) with 95% confidence intervals were estimated using Poisson regression with robust errors. Linear regression models were applied to assess the effect of recurrence on LHS.

RESULTS: A total of 154 patients with 271 cysts were included. Recurrence was identified in 43 patients (27.9%). POC occurred in 18.2% of the total cohort and were significantly more frequent in the recurrence group (41.9% vs. 9.0%, p < 0.001). Adjusted RR for POC in the presence of recurrence was 5.1 (95% CI 2.7-9.9). Mortality was higher in patients with recurrence (7.0% vs. 2.7%, RR: 2.6; 95% CI 0.5-12.3), though not statistically significant. LHS was 1 day longer in the recurrence group (7.3 ± 4.5 vs. 5.6 ± 3.4; p = 0.02), but this association lost significance in regression models.

CONCLUSIONS: Recurrence of HCE increases the risk of POC. While trends toward higher mortality and prolonged LHS were observed, these did not reach statistical significance. These findings underscore the importance of long-term follow-up and the need to identify prognostic factors for recurrence to optimize outcomes in patients with HCE in endemic regions.

PMID:41199324 | DOI:10.1186/s41182-025-00832-3

Infect Dis Poverty. 2025 Nov 6;14(1):114. doi: 10.1186/s40249-025-01381-x.

ABSTRACT

BACKGROUND: Cervical cancer driven by human papillomavirus (HPV) infection remains a critical global health challenge. Co-infection with Trichomonas vaginalis, a prevalent sexually transmitted protozoan, is strongly associated with increased susceptibility to HPV, yet the molecular basis for this synergy is unclear. Here, we investigated the role of T. vaginalis adhesion protein 65 (TvAP65) in HPV entry, focusing on its interaction with host factors in epithelium.

METHODS: Using in vitro (human adult low calcium high temperature keratinocytes, HaCaT cells) and in vivo (BALB/c athymic nude mice, BALB/cA-nu mice) models, we assessed HPV infection rates and the expression of HPV entry receptors (cluster of differentiation 151, CD151 and heparan sulfate proteoglycan 2, HSPG2) under T. vaginalis exposure. TvAP65 was either knocked down or overexpressed to evaluate its functional impact. A siRNA screen targeting 12 host molecules that interact with TvAP65 identified signal peptidase complex subunit 1 (SPCS1) as a key mediator. Dual knockdown of TvAP65 and SPCS1 or HPV receptors (CD151/HSPG2) was performed to dissect mechanistic hierarchies. Statistical analyses were performed using Student’s t-test for two-group comparisons and analysis of variance (ANOVA) for comparisons involving three or more groups (P < 0.05).

RESULTS: T. vaginalis markedly enhanced HPV entry in epithelial cells by upregulating CD151 and HSPG2 (P < 0.001). TvAP65 knockdown reversed this effect, reducing HPV infection by 21.76 ± 0.12% (P < 0.001) and protein-level expression of the receptors (P < 0.001), while overexpression amplified both. Strikingly, SPCS1 knockdown alone attenuated HPV infection by 33.61 ± 0.40% and abolished T. vaginalis-driven CD151/HSPG2 upregulation. Dual knockdown of TvAP65 and SPCS1 synergistically suppressed HPV entry (54.64 ± 0.39% reduction, P < 0.001), confirming the central role of SPCS1 in TvAP65-mediated receptor activation.

CONCLUSIONS: Our study unveils a previously uncharacterized mechanism by which T. vaginalis exacerbates HPV infection: TvAP65 hijacks SPCS1 to transcriptionally upregulate CD151 and HSPG2, thereby facilitating HPV entry into host cells. This TvAP65-SPCS1-CD151/HSPG2 axis highlights potential therapeutic targets to disrupt the synergy between HPV and T. vaginalis, offering new strategies for cervical cancer prevention.

PMID:41199321 | DOI:10.1186/s40249-025-01381-x

Crit Care. 2025 Nov 6;29(1):475. doi: 10.1186/s13054-025-05712-0.

ABSTRACT

BACKGROUND: Prolonged prone positioning (PPP) for ≥ 24 h may enhance outcomes in moderate to severe acute respiratory distress syndrome (ARDS), but may also increase risks such as pressure injuries and complications. Despite clinical rationale, high-quality evidence for PPP’s safety and efficacy remains scarce.

METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) and observational studies. Trials that compared two distinct treatment groups in adult patients with ARDS were included: prone position < 24 h (standard) and ≥ 24 h (prolonged). Databases searched included MEDLINE, CENTRAL, ClinicalTrials.gov, ISRCTN, ICTRP and the Cochrane Covid-19 Study Register (last search: 3 July 2025). Risk of bias was assessed using ROB-2 for RCTs, and the ROBINS-I V2 tool for non-randomised intervention studies (NRSI). The primary outcome was mortality. Secondary outcomes included improvement of oxygenation and adverse events. Outcomes (Risk ratios and hazard ratios) were calculated using a random-effect model with 95% confidence intervals (CI). The quality of evidence was evaluated using the GRADE assessment.

RESULTS: Of 19,986 records, 9 (n = 1,045) were included in the qualitative and quantitative analysis. Four studies, including two small RCTs (n = 112) and two NRSIs (n = 581), had a low to moderate risk of bias. Most studies included patients with COVID-19 ARDS. Meta-analysis showed no significant effect on 90-day mortality (n = 641, HR 0.72; 95% CI 0.41-1.25). No heterogeneity was detected among studies (I² = 0%), but the confidence interval for I² was wide (95% CI: 0-89%), suggesting the possibility that substantial heterogeneity may exist. Similarly, no significant differences were found for secondary outcomes.

DISCUSSION: Current evidence does not support the use of PPP outside of clinical studies. Pooled data from small trials and NRSIs reveal no significant effect of PPP on mortality, oxygenation, or safety outcomes. The evidence is of low to very low certainty, limited by inconsistency and imprecision. The wide confidence intervals indicate low statistical power, therefore both harm and benefit remain plausible on the basis of the available evidence. Well-powered RCTs are needed to clarify the potential benefits and risks of PPP in ARDS.

PMID:41199320 | DOI:10.1186/s13054-025-05712-0

J Ovarian Res. 2025 Nov 6;18(1):241. doi: 10.1186/s13048-025-01847-4.

ABSTRACT

BACKGROUND: Fertility preservation is crucial for females facing gonadotoxic treatments. Controlled ovarian stimulation (COS) followed by oocyte cryopreservation is a well-established method, while ovarian tissue-derived oocyte in vitro maturation (OTO-IVM) is an emerging technique that can be used when COS is contraindicated or time is limited. However, OTO-IVM faces challenges such as low oocyte maturation rates and limited follow-up data. This study aimed to compare the clinical outcomes of COS oocyte cryopreservation and OTO-IVM, with a focus on the impact of transportation methods and the use of gonadotropin (Gn) before oophorectomy on OTO-IVM outcomes.

METHODS: This retrospective study analyzed data from 472 patients who underwent fertility preservation procedures at the Reproductive Medicine Research Center, The Sixth Affiliated Hospital, Sun Yat-sen University, from July 2012 to July 2024. Patients diagnosed with cancer or requiring gonadotoxic treatments were included. The study compared oocyte maturation, fertilization, and embryo transfer outcomes between COS and OTO-IVM groups. Statistical analyses were performed using Student’s t-test for continuous data and Chi-squared or Fisher’s exact test for categorical data, with significance defined as P < 0.05.

RESULTS: COS group resulted in a significantly higher oocyte maturation rate (86.11%) compared to OTO-IVM group (39.43%). Direct oocyte transport yielded a higher rate of denuded oocytes compared to ovarian tissue transport. The use of Gn before oophorectomy in OTO-IVM significantly improved the IVM maturation rate (51.90% vs. 38.00%, P < 0.001).

CONCLUSIONS: COS oocyte cryopreservation remains more effective than OTO-IVM. However, the study highlighted the importance of optimizing transportation methods and using Gn before oophorectomy to improve OTO-IVM outcomes. These findings could guide clinical practice in selecting appropriate fertility preservation strategies. Further research is needed to refine OTO-IVM techniques and enhance their clinical applicability.

PMID:41199301 | DOI:10.1186/s13048-025-01847-4

Nutr J. 2025 Nov 6;24(1):170. doi: 10.1186/s12937-025-01220-7.

ABSTRACT

BACKGROUND: Muscle loss is linked to multiple adverse outcomes, but its impact on rheumatoid arthritis (RA) prognosis is unclear. This study aimed to examine the association between muscle mass and mortality in RA patients.

METHODS: RA patients from the NHANES database were followed for survival until December 31, 2021. Muscle mass was measured using dual X-ray absorptiometry, low muscle mass was defined as appendicular skeletal muscle mass index (ASMI) < 7.0 kg/m² in men or < 5.5 kg/m² in women. The relationship between ASMI and mortality was analyzed using weighted Cox regression.

RESULTS: The study included 892 participants (weighted mean [SE] age 52.22 [0.59] years, 57.36% female). During a median (SE) follow-up of 11.44 (0.33) years, 291 deaths (32.62%) were recorded, of which 197 (28.23%) were attributed to cardiovascular disease. In fully adjusted models, a 1 kg/m²increase in ASMI was associated with decreased all-cause and cardiovascular mortality risk by 34% (HR = 0.66, 95% CI 0.50-0.86) and 40% (HR = 0.60, 95% CI 0.38-0.93), respectively. When ASMI stratified, RA with low muscle mass had a 1.42-fold higher risk of all-cause mortality (HR = 1.42, 95% CI 1.01-2.00) and a 2.58-fold higher risk of cardiovascular mortality (HR = 2.58, 95% CI 1.18-5.62) than those with normal muscle mass. Restricted cubic spline analysis showed a nonlinear association between ASMI and cardiovascular (P_nonlinear = 0.04) but not for all-cause mortality (P_nonlinear = 0.25).

CONCLUSIONS: Muscle loss in RA patients is linked to higher mortality risk, underscoring the need to recognize its harmful effects.

PMID:41199290 | DOI:10.1186/s12937-025-01220-7

Diagn Pathol. 2025 Nov 6;20(1):124. doi: 10.1186/s13000-025-01714-2.

ABSTRACT

BACKGROUND: Long non-coding RNAs (lncRNA) H19 has drawn special attention because of its varied role in several malignancies, including OSCC. Therefore, this study was conducted to assess the association between H19-miR675-p53 by in-silico analysis, quantify the expression levels of H19, miRNA-675, and target oncogene p53 in cancerous versus normal individuals, and Correlate the Clinicopathological findings with their expression pattern.

METHODS: The secondary structure of lncRNA H19 was predicted using the RNAfold web server ( http://rna.tbi.univie.ac.at/cgi-bin/RNAWebSuite/RNAfold.cgi ). The FASTA sequence of H19 was retrieved from the NCBI database ( https://www.ncbi.nlm.nih.gov/ ). We performed molecular docking studies to analyze the interaction between miRNA-675 and p53 using the MDockPP ( https://zougrouptoolkit.missouri.edu/MDockPP/ ) web server. Real-time PCR was used to measure the amounts of H19 and miR-675, and Immunohistochemistry was used to analyse the pattern of p53 expression.

RESULT: The study successfully associated miR-675 from the first exon of H19 modulating p53 via in silico analysis. It was found that H19 and miR-675 levels were higher in OSCC patients (3.12 ± 1.16) compared to healthy patients (1.0 ± 0.0), and was statistically significant (p-value < 0.001).

CONCLUSION: The specificity of H19 expression in OSCC compared to normal presents an attractive target for cancer-specific therapies, minimizing the risk of off-target effects.

PMID:41199286 | DOI:10.1186/s13000-025-01714-2

Am J Surg. 2025 Oct 17;251:116662. doi: 10.1016/j.amjsurg.2025.116662. Online ahead of print.

ABSTRACT

BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) mandates at least six weeks of paid medical, parental, or caregiver leave for residents and fellows. The primary aim of this study is to determine the proportion of orthopaedic surgery residency programs with parental/adoption leave policies on their website. The absence of this information may dissuade female medical students from pursuing orthopaedic surgery.

METHODS: Websites of all ACGME-accredited allopathic orthopaedic surgery residency program websites reviewed. Data collected included the number of current female residents and parental/adoption leave policies.

RESULTS: Among 183 program websites, 4.4 ​% listed a parental leave policy and 3.3 ​% listed an adoption leave policy. Listing a parental leave policy on the program website was associated with a higher mean proportion of female residents, although this did not reach statistical significance.

DISCUSSION: Despite ACGME policy, very few programs list parental/adoption leave policies on their websites, highlighting an opportunity for improvement.

PMID:41197205 | DOI:10.1016/j.amjsurg.2025.116662