Nevin Manimala

Breast Cancer Res. 2025 Nov 5;27(1):199. doi: 10.1186/s13058-025-02145-z.

ABSTRACT

OBJECTIVES: To validate cone-beam breast computed tomography (CBBCT) for evaluating NAT response using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, and to explore correlations between multidimensional CBBCT features and pathological complete response (pCR).

METHODS: We prospectively analyzed 73 patients who underwent pre- and post-NAT CBBCT, of whom 41 also received paired magnetic resonance imaging (MRI). Inter-modality and imaging-pathology concordance were assessed using Cohen’s κ statistics. Determinants of CBBCT accuracy were identified through univariate and logistic regression analyses. Receiver operating characteristic (ROC) analysis with DeLong’s test was used to determine the optimal quantitative parameter for discriminating pCR from non-pCR. Associations between pCR and changes in calcification, vascularity, and background parenchymal enhancement (BPE) were evaluated using Pearson’s χ² and Fisher’s exact tests.

RESULTS: CBBCT showed excellent agreement with MRI (κ = 0.809) and good pathological concordance (κ = 0.618; MRI κ = 0.700). The area under the curve (AUC) for distinguishing responders from non-responders was 0.950 for CBBCT and 0.905 for MRI. For pCR assessment, the AUC values were 0.643 and 0.786, respectively. Targeted therapy (odds ratio [OR] = 0.059, p = 0.013) and linear/segmental calcifications (OR = 0.127, p = 0.042) were independent factors affecting CBBCT accuracy. The enhanced degree change (ΔE) on CBBCT demonstrated strong predictive performance for pCR (AUC = 0.941) with high computational efficiency. Significant associations with pCR were observed for reductions in calcification extent (p = 0.021), adjacent vascular sign (AVS) grade (p = 0.004), and BPE levels (p = 0.001).

CONCLUSION: CBBCT demonstrates high accuracy in assessing NAT response, with excellent agreement to MRI. ΔE is recommended as an optimal quantitative parameter for predicting pCR, supported by dynamic changes in calcification extent, AVS, and BPE grade as valuable markers, positioning CBBCT as a comprehensive tool for breast cancer management.

CLINICAL RELEVANCE STATEMENT: CBBCT enables a comprehensive and efficient tool for monitoring NAT response, showing excellent concordance with MRI, and its multidimensional features are also valuable for predicting pCR.

PMID:41194290 | DOI:10.1186/s13058-025-02145-z

Diabetol Metab Syndr. 2025 Nov 5;17(1):415. doi: 10.1186/s13098-025-01936-w.

ABSTRACT

BACKGROUND: This study aimed to investigate whether recent physical activity (PA), assessed in a real-world outpatient setting, is associated with a lower prevalence of cardiovascular autonomic neuropathy (CAN) in individuals with type 1 diabetes.

METHODS: Sixty-six patients with type 1 diabetes were tested for CAN using cardiovascular reflex tests. PA level was assessed using the International Physical Activity Questionnaire (IPAQ) and patients were classified into low, moderate, or high PA groups.

RESULTS: PA was low in 13 (19.7%), moderate in 19 (28.8%) and high in 34 (51.5%) patients. Fisher’s exact test conducted to examine the relationship between PA groups and diabetic CAN categories revealed a statistically significant difference (p < 0.001) being absent in 67.7% and early in 29.4% of the patients belonging to the high PA group. In addition, engagement in at least 600 MET minutes per week was independently associated with a lower probability of having CAN (OR = 0.131, 95% CI: 0.017-0.986, p = 0.048).

CONCLUSIONS: Higher levels of self-reported physical activity are associated with a reduced likelihood of CAN in patients with type 1 diabetes. These findings support the importance of promoting regular PA as part of routine diabetes care.

PMID:41194278 | DOI:10.1186/s13098-025-01936-w

BMC Psychol. 2025 Nov 6;13(1):1198. doi: 10.1186/s40359-025-03523-0.

ABSTRACT

BACKGROUND: This study examined how mood (positive or negative) and presentation format (picture or text) influence idea generation during online brainstorming. Creativity was assessed by the number of unique ideas (fluency, defined as the total number of non-redundant ideas) generated, with participants brainstorming ways to improve parks. The research drew on the dual pathway-to-creativity model, emphasizing flexibility and persistence as key factors in creativity.

METHOD: The participants were randomly assigned to one of four conditions: two mood types (positive or negative) and two presentation formats (picture or text). Creativity was measured by counting unique, nonrepetitive ideas and evaluating flexibility (number of unique categories of ideas). Persistence was also analyzed, calculated as the ratio of unique ideas to unique categories. Statistical tests were used to examine the main and interaction effects of mood, presentation format, and persistence on idea generation.

RESULTS: The participants exposed to pictures generated more unique ideas than those exposed to text, highlighting the presentation format’s impact on creativity. The positive mood participants outperformed the negative mood participants by generating more unique ideas and exhibiting greater flexibility, as measured by the number of distinct categories of ideas. Persistence played a moderating role, with high persistence in a positive mood condition leading to more unique ideas than medium or low persistence. However, there was no significant difference in idea generation between medium- and low-persistence participants in either mood condition.

CONCLUSIONS: These findings are consistent with a possible mediating role of flexibility in the relationship between mood and creativity, as proposed by the dual pathway to creativity model. Exploratory analyses suggest that persistence may play a potential moderating role, with high persistence amplifying the effects of a positive mood on creativity. Future research should explore more visually engaging stimuli for online brainstorming and investigate the interplay of additional variables. The role of persistence as a mediator or moderator warrants further exploration.

PMID:41194275 | DOI:10.1186/s40359-025-03523-0

J Health Popul Nutr. 2025 Nov 5;44(1):391. doi: 10.1186/s41043-025-01111-x.

ABSTRACT

INTRODUCTION: The non-HDL-C/HDL-C ratio (NHHR) serves as a lipid biomarker indicating the balance of pro-atherogenic and anti-atherogenic lipoproteins in the bloodstream. However, research exploring the effects of NHHR on sarcopenia remains limited. Consequently, this investigation aims to examine the potential correlation between NHHR and sarcopenia.

METHODS: This nationwide study used data from the National Health and Nutrition Examination Survey (NHANES) collected between 2011 and 2018. We looked into the correlation of serum NHHR levels with the risk of sarcopenia through multivariable logistic regression. Furthermore, subgroup and sensitivity analyses were carried out to assess the robustness of the findings, and restricted cubic splines were utilized to investigate potential nonlinearities.

RESULTS: The study encompassed 5,491 participants, of whom 367 (6.68%) were diagnosed with sarcopenia. Elevated NHHR was found to have a significant positive correlation with the incidence of sarcopenia in the fully adjusted model (OR = 1.13, 95% CI: 1.06-1.21, P < 0.001). The occurrence of sarcopenia was 2.11 times higher in participants in the highest NHHR quartile than in the lowest quartile (95% CI: 1.13-3.92, P = 0.023). RCS analysis further demonstrated a nonlinear association of NHHR with sarcopenia (P for nonlinear < 0.001). Extensive subgroup and sensitivity analysis produced consistent outcomes, supported the validity of our findings.

CONCLUSION: Studies indicate that NHHR is linked to an elevated risk of sarcopenia among Americans. In an aging society, NHHR might be a useful biomarker for managing and forecasting sarcopenia.

PMID:41194274 | DOI:10.1186/s41043-025-01111-x

Pilot Feasibility Stud. 2025 Nov 5;11(1):134. doi: 10.1186/s40814-025-01693-7.

ABSTRACT

BACKGROUND: Older Chinese adults in the UK are more likely to be physically inactive and face unique cultural and socioeconomic barriers to physical activity (PA) compared with the general population, yet they lack tailored interventions. Using findings from an evidence review and qualitative interviews, and guided by the Behaviour Change Wheel framework, we developed a culturally appropriate PA promotion package to enhance the capability, opportunity, and motivation of older Chinese adults in the UK to engage in PA.

AIM: This study aims to assess the feasibility and acceptability of conducting a randomised controlled trial (RCT) of culturally appropriate PA promotion strategies among older Chinese adults in the UK.

METHODS/DESIGN: This is a two-arm pragmatic feasibility RCT. Community-dwelling individuals who self-identify as Chinese, reside in the UK, are aged 60 years and older, and do not meet the World Health Organization (WHO) PA recommendations (i.e. < 150 min moderate PA or balance/strength exercise < 2 times per week) will be recruited. Participants will be randomised to receive either the culturally appropriate PA promotion strategy package or the WHO PA recommendation leaflet. Outcome data will be collected at baseline, 12 weeks, and 18 weeks post-randomisation. Primary outcomes will include feasibility measures (e.g. recruitment, compliance, adherence, and follow-up rates), intervention acceptability (qualitative interviews), and both subjective PA levels (PA Scale for the Elderly) and objective PA levels (Realalt 3DTriSport 3D Pedometer). Secondary outcomes will include the Brief COM-B (Capability, Opportunity, Motivation-Behaviour) questionnaire, physical function assessments (Short Physical Performance Battery, SPPB), and quality of life (Control, Autonomy, Self-realisation, and Pleasure-12,CASP-12). The feasibility of the study will be evaluated based on the pre-specified progression criteria.

DISCUSSION: This is the first study to assess the feasibility and acceptability of conducting an RCT of a culturally appropriate PA promotion strategy package among older Chinese adults in the UK. The findings from this study will inform improvements in PA promotion strategies and guide the development of a full-scale RCT, with the ultimate goal of creating culturally appropriate, sustainable interventions to improve the health and well-being of older Chinese adults in the UK.

TRIAL REGISTRATION: The study protocol was registered on the Open Science Framework on 19 November 2024 ( https://doi.org/10.17605/OSF.IO/XQHJS ).

PMID:41194268 | DOI:10.1186/s40814-025-01693-7

Adv Rheumatol. 2025 Nov 5;65(1):54. doi: 10.1186/s42358-025-00485-0.

NO ABSTRACT

PMID:41194251 | DOI:10.1186/s42358-025-00485-0

Confl Health. 2025 Nov 5;19(1):80. doi: 10.1186/s13031-025-00720-x.

ABSTRACT

BACKGROUND: The World Health Organization encourages all countries to implement Maternal and Perinatal Death Surveillance and Response (MPDSR), a continuous quality improvement cycle of death identification, reporting, and review to prevent future mortality. However, MPDSR implementation in humanitarian settings requires contextual adaptations for effective implementation. The aim of this study was to understand the landscape of existing health surveillance and information systems that capture maternal and perinatal mortality in crisis-affected areas of Eastern Democratic Republic of the Congo (DRC) to inform future implementation of MPDSR.

METHODS: A mixed-methods study was conducted in North Kivu and South Kivu in Eastern DRC. Within each province, three health zones were targeted. We conducted 109 key informant interviews to identify and understand how existing surveillance and health information systems capture data on maternal and perinatal mortality. Surveys were administered for each identified system (N = 53). Data collection occurred in December 2022 in South Kivu and in June 2023 in North Kivu. Descriptive statistics of survey findings were conducted to compare key characteristics of reporting systems. Thematic content analysis of interview transcripts was conducted and triangulated with survey findings to understand implementation realities by system and health zone type.

RESULTS: Two categories of death reporting systems were identified: health systems (National Health Information System, MPDSR, and their extensions into communities via community health workers) and administrative systems (civil registration and other community-based systems). Commonly reported implementation challenges in all health zones included insufficient human and financial resources, unavailable tools, and complex socio-cultural dynamics which created obstacles in the identification, reporting, and review of deaths. Insecurity within the region often limited system functionality. However, promising practices related to health authority and community engagement were implemented to overcome implementation challenges.

CONCLUSION: Our findings uncover a wealth of implementation experience that is essential to inform the development, implementation, and extension of MPDSR systems tailored for optimal functionality in crisis-affected contexts. Structural system inputs must be addressed alongside socio-cultural dynamics that influence reporting and review of maternal and perinatal deaths. The intervention mechanism in crisis contexts must include a component aimed at strengthening the community networks involved in information gathering.

PMID:41194246 | DOI:10.1186/s13031-025-00720-x

J Ovarian Res. 2025 Nov 5;18(1):240. doi: 10.1186/s13048-025-01818-9.

ABSTRACT

The dehydroepiandrosterone (DHEA)-induced mouse model is widely used to study polycystic ovary syndrome (PCOS), yet findings on antral follicle (AF) dynamics remain inconsistent. Among 12 representative studies-classified as mechanistic (n = 1), intervention (n = 7), or mixed-type (n = 4)-half reported increased AF counts, while the others reported reductions. This variability likely stems from methodological differences, including DHEA dosage, solvent, animal age, treatment duration, follicle classification, and estrous cycle control. AMH, a key regulator of folliculogenesis, was reported in only one study, limiting mechanistic interpretation. Our subgroup and forest plot analyses suggest that ethanol solvents, younger animals, and longer treatment durations may increase the likelihood of AF elevation, though none reached statistical significance and these results should be interpreted as exploratory due to small sample sizes and study heterogeneity. We propose standardizing key variables such as AMH measurement, follicle classification, histological sectioning, estrous cycle staging, and DHEA administration protocols. Although the DHEA model recapitulates reproductive hallmarks of PCOS-such as hyperandrogenism and follicular arrest-it incompletely reflects the metabolic and neuroendocrine features of human PCOS, limiting its translational fidelity. These findings highlight the need for greater methodological transparency and standardization to improve the translational value of preclinical PCOS models.

PMID:41194236 | DOI:10.1186/s13048-025-01818-9

Matern Health Neonatol Perinatol. 2025 Nov 6;11(1):37. doi: 10.1186/s40748-025-00233-8.

ABSTRACT

BACKGROUND: There are expert-agreed upon malnutrition indicators for infants, but the meaningfulness of these indicators in hospitalized neonates is unknown.

METHODS: Eighty-four term infants hospitalized in a level IV neonatal intensive care unit had body composition measurements and other anthropometric data extracted from the medical record. Linear regression using maximum likelihood estimation was performed to evaluate the relationship of malnutrition status (assessed at time of body composition assessment) with each body composition metric (body fat percent z-score, fat mass z-score, fat-free mass z-score) and with toddler body mass index (BMI) z-score. Linear regression was also performed to evaluate the relationship between each body composition metric and toddler BMI z-score.

RESULTS: There was a statistically significant negative association between neonatal malnutrition diagnosis with a -0.83 change in fat-free mass z-score (95% CI -1.61 to -0.05, p = 0.04). There was no statistically significant association between body fat percent or fat mass and neonatal malnutrition diagnosis. There was no statistically significant relationship between each infant body composition metric and toddler BMI z-score in unadjusted linear regression models.

CONCLUSIONS: Neonatal malnutrition diagnosis is associated with lower fat-free mass in critically ill infants with a variety of conditions.

PMID:41194224 | DOI:10.1186/s40748-025-00233-8

BMC Med Inform Decis Mak. 2025 Nov 5;25(1):410. doi: 10.1186/s12911-025-03243-w.

ABSTRACT

PURPOSE: This scoping review aims to synthesize research on artificial intelligence (AI) in predicting open-heart surgery outcomes, evaluating AI model performance, and identifying gaps in data quality, algorithmic bias, and clinical applicability to guide future advancements in personalized surgical planning and patient outcomes.

METHODS: Conducted using the PRISMA-ScR guideline, the review involved a systematic search across PubMed, Web of Science, IEEE, and Scopus. Articles were included if they focused on open-heart surgery, utilized AI methods, and were published in English. Exclusion criteria included non-relevance to open-heart surgery, non-original research, and lack of AI techniques. Data extraction included study details, AI methods, and performance metrics. Descriptive statistics were used for analysis.

RESULTS: Of the 64 included studies, 89.06% were retrospective. The most frequently employed algorithm was logistic regression (n = 41), followed by random forest in 38 studies and XGBoost in 32 studies for data analysis. Most studies focused on predicting postoperative outcomes. Mortality, acute kidney injury, and complications were the outcomes that more studies concentrated on. XGBoost, used in 32 studies, exhibited the best performance in 11 of these studies. Deep learning and hybrid models were underutilized. Major limitations included inconsistent model validation, limited prospective data, and lack of diversity in patient populations.

CONCLUSION: AI demonstrates promising predictive capabilities in open-heart surgery, particularly through machine learning models. These models can already assist surgeons in real-world practice by supporting real-time risk stratification and personalized decision-making, such as identifying high-risk patients for targeted interventions. However, methodological limitations hinder clinical translation. Future work should emphasize prospective validation, explainable AI, and equitable data representation to enhance model reliability and applicability in real-world settings.

PMID:41194211 | DOI:10.1186/s12911-025-03243-w