Nevin Manimala

J Gen Intern Med. 2025 Aug 11. doi: 10.1007/s11606-025-09793-z. Online ahead of print.

ABSTRACT

BACKGROUND: Over half of Medicare beneficiaries are enrolled in Medicare Advantage (MA), with Black and Hispanic beneficiaries disproportionately in MA versus traditional Medicare (TM).

OBJECTIVE: To examine Black-White and Hispanic-White disparities in preventive and chronic disease care by MA vs. TM.

DESIGN: Cross-sectional propensity-score-weighted difference-in-disparities analyses compared Black-White and Hispanic-White disparities in MA and TM using the Medicare Current Beneficiary Survey (2015-2020).

PARTICIPANTS: Medicare beneficiaries with cardiovascular disease or risk factors (N = 68,788 person-years).

MAIN MEASURES: Influenza vaccine, pneumococcal vaccine, blood pressure check, cholesterol test, colorectal cancer screening, preventive care index (count of above; 0-5), mammogram, annual wellness visit; hemoglobin A1C and eye exam.

KEY RESULTS: Black and Hispanic, compared to white, beneficiaries were less likely to receive annual wellness visits, influenza vaccines, pneumococcal vaccines, and colorectal cancer screening. Black beneficiaries in MA vs. TM had higher overall preventive care use (preventive care index, 3.67 vs. 3.44) and higher rates of all preventive services examined. Hispanic beneficiaries in MA vs. TM had higher preventive care use (index, 3.67 vs. 3.56), including annual wellness visit, blood pressure check, colorectal cancer screening, and breast cancer screening. Preventive care use was higher among White beneficiaries in MA than TM (index, 3.88 and 3.79). Black-White disparities were smaller in MA than TM for preventive care use (difference-in-disparities: + 0.13 index points, 95% CI 0.04-0.22), blood pressure check (+ 2.2 percentage points [p.p.], 95% CI 0.1-4.4), cholesterol check (+ 2.2 p.p., 95% CI 0.2-4.2), and eye exam (+ 5.0 p.p., 95% CI 1.4-8.7). Hispanic-White disparities were not statistically different in MA vs. TM.

CONCLUSIONS: Although MA was associated with smaller Black-White disparities in preventive care compared to TM, these differences were modest, and MA was not associated with smaller Hispanic-White disparities.

PMID:40790002 | DOI:10.1007/s11606-025-09793-z

Cogn Affect Behav Neurosci. 2025 Aug 11. doi: 10.3758/s13415-025-01336-7. Online ahead of print.

ABSTRACT

Cognitive control processes, specifically interference control and error monitoring, are often impaired across neuropsychiatric disorders and have been proposed as transdiagnostic markers of psychopathology and important treatment targets. Accurately probing them, however, requires understanding the psychometric properties of the measures used to assess cognitive control, including their intra- and interindividual stability over time. Using an Eriksen Flanker Task, we tested behavioral and electrophysiological readouts of cognitive control in 36 healthy individuals (26 females, 10 males; mean age ± standard deviation = 33.18 ± 14.49, range = 19-68) and evaluated their test-retest reliability across 48 hours by calculating Spearman correlations and Intraclass Correlation Coefficients to assess group-level stability. Moreover, we assessed repeatability through Coefficients of Variation and Bland-Altman statistics to investigate the degree of change in participants’ absolute scores. We found moderate-to-excellent test-retest reliability for most cognitive control measures, with condition-specific metrics generally being more reliable than difference scores. Regarding repeatability, we observed considerable intraindividual variability in absolute scores over time, which differed widely between participants. These results demonstrate that measurements of cognitive control may display substantial intraindividual variability across sessions despite demonstrating high test-retest reliability and vice versa. Our findings expand the current literature by providing novel information about the stability of behavioral and physiological markers of cognitive control over time. Moreover, they may have important implications for the application and evaluation of clinical interventions by highlighting the usefulness of considering repeatability measures in addition to the more commonly reported test-retest reliability metrics, when tracking changes over time in clinically relevant processes within single individuals.

PMID:40790001 | DOI:10.3758/s13415-025-01336-7

J Cancer Surviv. 2025 Aug 11. doi: 10.1007/s11764-025-01879-1. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVES: Up to 75% of cancer survivors experience cognitive impairment from cancer or its treatment. No modifiable risk factor has been identified; however, a Mediterranean Diet may be protective. We sought to determine if the relationship between cognitive performance and cancer survivorship depends on Mediterranean Diet adherence.

METHODS: We used the latest data from the National Health and Nutrition Examination Survey (NHANES). Mediterranean Diet adherence was defined as the aMed score which gives 1 point for intake above/below the sample-specific median for healthful/unhealthful food groups (range 0-9). Cognitive processes assessed included processing speed, attention, working memory, learning, short-term memory, and executive function. Linear regression models adjusting for demographics, diet, and health behavior were used to determine the relationship between cognition and cancer history.

RESULTS: Among 2450 participants, 385 had cancer. Mean age was 68.9 years (SE = 0.2). The most common cancer was breast cancer (24%). Cancer history was not associated with cognition (p > 0.05). Among high aMed scores, cancer history was more negatively associated with number of Intrusions compared to low aMed scores (β (95% CI): 0.61 (0.07, 1.16), p = 0.03 for aMed*Cancer interaction term).

CONCLUSIONS: Cancer history was more negatively associated with cognition among high versus low aMed scores. Because of the cross-sectional nature of NHANES, the limited number of cancer survivors, and the lack of treatment information, larger prospective studies with treatment data are needed.

IMPLICATIONS FOR CANCER SURVIVORS: Cancer survivors may require dietary recommendations different from that of the general population. More studies, however, are needed to confirm this.

PMID:40789996 | DOI:10.1007/s11764-025-01879-1

Metabolomics. 2025 Aug 11;21(5):105. doi: 10.1007/s11306-025-02296-2.

ABSTRACT

INTRODUCTION: The metabolome is an intermediate between DNA variation and clinical phenotypes. Metabolomics have been widely used in biomedical studies for reflecting physiological changes in response to variation coming from various sources, such as diet, environment, time, and lifestyle. While lifestyle factors contribute a considerable part of the metabolic variation, current human studies lack information estimating lifestyle, mainly because it is not strictly defined.

OBJECTIVE: In this work, metabolite concentrations are measured at two time points (2007 and 2014). Additionally, SNP data together with self-reports on dietary behavior. By having measurements over time, as well as all main sources of metabolic variation (diet, genetics), both time-effects and lifestyle-effects can be estimated. Since lifestyle and time effects can be estimated under this setting, we are interested in identifying metabolites sharing similar relationships to diet and lifestyle, using network analysis.

METHODS: The correlation between repeated measurements is modeled using a random intercepts linear mixed model, with dietary preferences, genetics, and time as fixed effects. The random intercepts can be defined as the lifestyle, and represent the part of the metabolic variation which is not due to diet, genetics, and time and is subject-specific. The part of every metabolite relevant to diet and lifestyle instead of the original values is used as input values to network estimation methods.

CONCLUSIONS: This work demonstrates how correcting for several sources of metabolic variation, allows us to look for residual variation and build networks with meaningful metabolite groups sharing similar association to diet and lifestyle.

PMID:40789994 | DOI:10.1007/s11306-025-02296-2

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