Tag: nevin manimala

Clin Transl Allergy. 2025 Jun;15(6):e70064. doi: 10.1002/clt2.70064.

ABSTRACT

OBJECTIVES: The evidence regarding the efficacy of probiotics in improving allergic rhinitis (AR) remains inconsistent. This study aimed to evaluate the potential effects of Bifidobacterium animalis subsp. lactis A6 (A6) on perennial AR.

METHODS: A randomized, double-blind, placebo-controlled trial was conducted involving 70 adults with perennial AR receiving either probiotic (A6, 5 × 10¹⁰ CFU/sachet per day) or placebo intervention for 8 weeks. Nasal symptoms and quality of life (QoL) were recorded using total nasal symptom scores (TNSS) and the rhinitis quality of life questionnaire (RQLQ). Blood eosinophil count, total immunoglobulin E (IgE), allergen-specific IgE, and immunological parameters were also assessed.

RESULTS: After 8 weeks of intervention, the probiotic group showed a statistically significant greater reduction in TNSS total score compared with the placebo group [-3.11 (3.53) vs. -1.29 (3.34), p = 0.029, Cohen’s d = 0.68]. Similar results were noted for serum total IgE and interleukin-13 (IL-13). Comparable findings were seen for RQLQ score only at week 4 but not at week 8.

CONCLUSIONS: In conclusion, A6 could statistically significantly alleviate rhinitis symptoms and improve QoL in adults with perennial AR. The effect size, as measured by Cohen’s d, suggests that A6 may provide clinically meaningful benefits for AR patients to a certain degree.

CLINICAL TRIAL REGISTRATION: Chictr.org.cn Identifier no. ChiCTR2200064158.

PMID:40506807 | DOI:10.1002/clt2.70064

Asia Pac J Clin Oncol. 2025 Jun 12:e14201. doi: 10.1111/ajco.14201. Online ahead of print.

ABSTRACT

AIM: Cervical cancer is caused by persistent infection with the human papillomavirus. This study aimed to investigate whether the changes in serum inflammatory markers between baseline and posttreatment can predict survival in cervical cancer undergoing definitive chemoradiotherapy (CCRT).

METHODS: Eighty-one Stage IB-IVA cervical cancer patients treated with definitive CCRT, with serum inflammatory markers obtained at diagnosis and after completion of pre-planned therapy, were included. The percent changes of post-/pretreatment levels × 100% were calculated for neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic inflammation response index (SIRI), and systemic immune-inflammation index (SII). The cutoffs were obtained with the maximal chi-square statistics.

RESULTS: At a median follow-up of 28 months, the 2-year overall survival (OS) was 75.4%. The 2-year OS for patients with low versus high percent change was as follows: post-/pre-NLR (87.7% vs. 67.8%), post-/pre-MLR (75.9% vs. 71.1%), post-/pre-SIRI (76.5% vs. 61.7%), and post-/pre-SII (91.7% vs. 67.2%) (all p < 0.05). The hazard ratios (HR) in multivariate analysis were as follows: post-/pre-NLR (5.53, 95% confidence interval [CI]: 1.65-18.52), post-/pre-MLR (3.39, 95% CI: 1.39-8.26), post-/pre-SIRI (5.11, 95% CI: 1.92-13.57), and post-/pre-SII (6.57, 95% CI: 1.77-24.36) (all p < 0.05).

CONCLUSION: This study demonstrates the impact of the dynamics of serum inflammatory markers on survival. It has been consistently demonstrated across the markers. To adopt these markers for personalized treatment decisions, a better understanding of their relation with the actual tumor microenvironment is warranted.

PMID:40506804 | DOI:10.1111/ajco.14201

Arthritis Rheumatol. 2025 Jun 12. doi: 10.1002/art.43272. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the efficacy of abatacept to placebo for the treatment of relapsing, non-severe granulomatosis with polyangiitis (GPA).

METHODS: In this multicenter trial, eligible patients with relapsing, non-severe GPA were randomized to receive abatacept 125 mg subcutaneously once a week or placebo, both together with prednisone 30 mg/day (or equivalent), tapered and discontinued at week 12. Patients already taking methotrexate, azathioprine, mycophenolate, or leflunomide continued this medication at a stable dose. Patients achieving remission remained on their randomized assignment until relapse, early termination, or the common close date 12 months after enrollment of the last patient. Those who had a non-severe relapse, non-severe worsening, or were not in remission by month 6 had the option to receive open-label abatacept. The primary endpoint was the rate of treatment failure, defined as relapse, disease worsening, or failure to achieve a BVAS/WG=0 or 1 by 6 months.

RESULTS: Sixty-five patients were randomized, 34 received abatacept and 31 placebo. No statistical difference in the treatment failure rate was found between those who received abatacept compared to placebo (p= 0.853). Treatment with abatacept did not demonstrate any statistical difference from placebo in key secondary endpoints, including time to full remission (BVAS/WG=0), duration of glucocorticoid-free remission, relapse severity, prevention of damage, or patient-reported quality-of life outcomes. There was no difference in the frequency or severity of adverse events between treatment arms, including infection.

CONCLUSIONS: In patients with relapsing, non-severe GPA abatacept did not reduce the risk of relapse, severe worsening, or failure to achieve remission.

PMID:40506793 | DOI:10.1002/art.43272

Infect Dis Poverty. 2025 Jun 12;14(1):47. doi: 10.1186/s40249-025-01316-6.

ABSTRACT

BACKGROUND: Echinococcosis remains highly endemic in some nomadic communities on the Qinghai-Tibet Plateau, China, where alveolar echinococcosis (AE) and cystic echinococcosis (CE) exhibit notably high prevalence rates of 3.64% and 2.37%, respectively. Recent settlement expansion in the region has raised concerns, as smaller, remote settlements often lacked waste disposal and sewage systems, potentially facilitating echinococcosis transmission. The aim of this study is to investigate how settlement characteristics influence echinococcosis transmission.

FINDINGS: The study was conducted from 2022-2024 in nomadic communities of Shiqu County in China. The overall prevalence rate of echinococcosis in 51 settlements was found to be 2.34% (321/13,701; 95% CI: 2.10-2.61), which included a prevalence rate of 1.62% (222/13,701; 95% CI: 1.42-1.85) for AE and a prevalence rate of 0.72% (99/13,701; 95% CI: 0.59-0.88) for CE. The prevalence rate of AE was significantly (χ² = 49.57, P < 0.01) higher than that of CE. Settlements with a smaller population size (Z = -4.27, P < 0.01), a greater distance to the township center (Z = 2.66, P < 0.01) and a higher density of owned dogs (Z = 5.90, P < 0.01) were associated with higher prevalence rates of CE. These associations were also observed for AE prevalence, except for the density of owned dogs.

CONCLUSIONS: This study indicates that the transmission of AE was more active than that of CE in the nomadic communities. Smaller, remote settlements had higher prevalence rates for both CE and AE. The density of owned dogs was a significant risk factor for CE prevalence but not for AE prevalence. Targeted interventions are needed in these high-risk settlements. Future research should investigate how settlement characteristics interact with hygiene practices, the infection status of intermediate and definitive hosts, and their population dynamics to better understand combined effects on echinococcosis prevalence.

PMID:40506786 | DOI:10.1186/s40249-025-01316-6

BioData Min. 2025 Jun 12;18(1):40. doi: 10.1186/s13040-025-00455-8.

ABSTRACT

Neuroblastoma is a common pediatric cancer that affects thousands of infants worldwide, especially children under five years of age. Although recovery for patients with neuroblastoma is possible in 80% of cases, only 40% of those with high-risk stage four neuroblastoma survive. Electronic health records of patients with this disease contain valuable data on patients that can be analyzed using computational intelligence and statistical software by biomedical informatics researchers. Unsupervised machine learning methods, in particular, can identify clinically significant subgroups of patients, which can lead to new therapies or medical treatments for future patients belonging to the same subgroups. However, access to these datasets is often restricted, making it difficult to obtain them for independent research projects. In this study, we retrieved three open datasets containing data from patients diagnosed with neuroblastoma: the Genoa dataset and the Shanghai dataset from the Neuroblastoma Electronic Health Records Open Data Repository, and a dataset from the TARGET-NBL renowned program. We analyzed these datasets using several clustering techniques and measured the results with the DBCV (Density-Based Clustering Validation) index. Among these algorithms, DBSCAN (Density-Based Spatial Clustering of Applications with Noise) was the only one that produced meaningful results. We scrutinized the two clusters of patients’ profiles identified by DBSCAN in the three datasets and recognized several relevant clinical variables that clearly partitioned the patients into the two clusters that have clinical meaning in the neuroblastoma literature. Our results can have a significant impact on health informatics, because any computational analyst wishing to cluster small data of patients of a rare disease can choose to use DBSCAN and DBCV rather than utilizing more common methods such as k-Means and Silhouette coefficient.

PMID:40506780 | DOI:10.1186/s13040-025-00455-8

Crit Care. 2025 Jun 13;29(1):237. doi: 10.1186/s13054-025-05384-w.

ABSTRACT

BACKGROUND: The duration of episodes of intracranial hypertension is related to poor outcome, hence the need for prompt diagnosis. Numerous issues can lead to delays in the implementation of invasive intracranial pressure (ICP) monitoring, thereby increasing the dose of intracranial hypertension to which the patient is exposed. The aim of this prospective, observational, multicenter study was to assess the magnitude of this delay, evaluating the time required for initiation of invasive ICP monitoring, from indication (T1) to initiation of the maneuver (T2) when performed by neurosurgeons compared to intensive care physicians.

METHODS: We evaluated the impact of the operator performing the maneuver (neurosurgeon vs. intensivist) on the T2-T1 time interval, where T1 represents the time at which indication for invasive ICP monitoring is declared, and T2 the time at which the maneuver starts, defined as the skin incision. The effect of the operator performing the maneuver was evaluated through a parametric survival model. Both intraparenchymal catheters (IPCs) and external ventricular drains (EVDs) were considered as invasive ICP monitoring devices. Invasive monitoring could be performed in intensive care unit (ICU) or in operating room (OR).

RESULTS: A total of 112 patients were included into the final analysis; 39 IPCs were placed by intensivists within the ICU, and a total of 73 IPCs and EVDs by neurosurgeons both within the ICU and OR settings. The mean difference in T2-T1 time for IPCs placement in the ICU was 69 min (CI 50.1-94.8) in the intensivist group and 145 min (CI 103.4-202.9) in neurosurgeon group. The mean difference between these groups, 76 min, was found to be statistically significant (p-value = 0.0021). In the group treated by neurosurgeons, no statistically significant differences were found in timing between the ICU and the OR.

CONCLUSIONS: Invasive ICP monitoring performed with IPCs in ICU begins earlier when performed by intensivists rather than neurosurgeons. This finding suggests the possibility to obtain a prompt diagnosis of intracranial hypertension when intensivists intervein directly at patient’s bedside. Further studies are needed to confirm these findings and investigate their effect on outcome.

PMID:40506776 | DOI:10.1186/s13054-025-05384-w

Int J Retina Vitreous. 2025 Jun 12;11(1):64. doi: 10.1186/s40942-025-00688-z.

ABSTRACT

BACKGROUND: Retinal vessel geometry characteristic have been studied as one of the signs of microvascular changes in diabetic retinopathy (DR) that necessitates early screening. This study aimed to investigate the differences in retinal vessel tortuosity (VT) and fractal dimension (FD) between patients with and without DR.

METHODS: This retrospective study analyzed medical records and OCT-A images of DR and No-DR patients. DR severity was graded by a vitreoretinal specialist following the International Clinical Diabetic Retinopathy and Diabetic Macular Edema Severity Scales. Retinal VT and FD were quantified using ImageJ software. Comparison between groups using non-parametric and Generalized Estimating Equations (GEE) statistical analysis combined with cluster bootstrapping.

RESULTS: We analyzed 96 (161 eyes) with the mean age of 52.7 ± 9.9 years. Compared to No-DR, VT was significantly higher in all DR groups (p < 0.05). Mild non proliferative DR (β = +0.0621), Moderate NPDR (β = +0.0412), Severe NPDR (β = +0.0441), and proliferative DR (β = +0.0404). FD of the superficial capillary plexus (SCP) showed no significant difference among the groups and a significantly lower FD of the deep capillary plexus (DCP) compared to the No-DR groups (moderate NPDR (β = -0.0131), severe NPDR ( β = -0.0316) and PDR ( β = -0.0326)).

CONCLUSION: Compared to No-DR group, VT was found significantly higher in DR group, and FD of the DCP found significantly lower in the DR group. These parameters offer unique insights beyond simple vessel loss and complementary information into the geometric complexity and structural alterations of the retinal microvasculature in DR.

PMID:40506774 | DOI:10.1186/s40942-025-00688-z

Mil Med Res. 2025 Jun 13;12(1):30. doi: 10.1186/s40779-025-00613-3.

ABSTRACT

BACKGROUND: More efficacious, noninvasive screening methods are needed for advanced colorectal neoplasia. miR-92a is a reliable and reproducible biomarker for early colorectal cancer detection in stool samples. We compared the diagnostic efficacies of miR-92a, immunochemical fecal occult blood testing (FIT), and their combination (FIT + miR-92a) in a prospective multicenter screening trial.

METHODS: Overall, 16,240 participants aged 30-75 years were enrolled between April 1, 2021, and December 31, 2023. A total of 15,586 participants returned samples available for both FIT and miR-92a tests. All those with positive, and a random selection of those with negative screening tests were recommended to undergo colonoscopy. Follow-ups were performed until participants completed the colonoscopic examination. A total of 1401 screen-positive and 2079 randomly selected screen-negative individuals completed colonoscopies. Primary outcomes included sensitivity, number needed to screen (NNS), Youden index and receiver operating characteristic area under the curve (AUC) for advanced adenomas and colorectal cancer [advanced neoplasia (AN)] for each screening modality in the diagnostic performance analysis.

RESULTS: Colonoscopy was performed in 3480 individuals. The colonoscopy compliance rate was 47.8% for screen-positive individuals. The sensitivity of miR-92a versus FIT for AN was 70.9% versus 54.3% (P < 0.001), NNS was 24.7 versus 32.2 (P = 0.001), Youden index was 47.9% versus 35.0% (P < 0.001), AUC was 0.74 versus 0.67 (P = 0.010). FIT + miR-92a had a sensitivity of 85.4%, an NNS of 20.5, a Youden index of 47.9% and an AUC of 0.74 for AN.

CONCLUSIONS: For AN screening, miR-92a demonstrated better sensitivity, NNS, Youden index and AUC as compared with FIT. Compared with FIT, using miR-92a appears to be more efficient for population-based screening programs. Screening sensitivity for AN can be further enhanced if conditionally used in combination with FIT.

TRIAL REGISTRATION: Chinese Clinical Trial Registration Number: ChiCTR2200065415.

PMID:40506768 | DOI:10.1186/s40779-025-00613-3

J Health Popul Nutr. 2025 Jun 12;44(1):194. doi: 10.1186/s41043-025-00969-1.

ABSTRACT

OBJECTIVE: This study aims to evaluate the effects of vitamin D supplementation on glycemic control, insulin sensitivity, and pregnancy outcomes in patients with gestational diabetes mellitus (GDM) undergoing dietary therapy.

METHODS: This is a retrospective cohort study that included 98 patients diagnosed with GDM according to the IADPSG criteria. Patients were divided into two groups based on vitamin D supplementation: the Vitamin D group (n = 49) and the Control group (n = 49). The Vitamin D group received 400 IU of vitamin D daily until delivery. All patients followed a standardized dietary management plan. The primary outcome was the time to achieve glycemic control. Secondary outcomes included changes in HbA1c, HOMA-IR, LDL-C, hs-CRP, MDA, and pregnancy and neonatal outcomes. Propensity score matching (PSM) was used to adjust for baseline differences, and statistical analyses were performed using SPSS version 28.0.

RESULTS: A total of 98 patients (49 per group) were included after propensity score matching (PSM), with similar baseline characteristics between groups (all P > 0.05), except for higher gestational edema scores in the control group (P = 0.001). The Vitamin D group achieved glycemic control faster than the control group (adjusted HR = 2.30, 95% CI 1.50-3.52, P < 0.001) and required less insulin (β = -0.11 U/kg/day, 95% CI -0.14 to -0.08, P < 0.001). Significant improvements were observed in key metabolic and inflammatory markers, including HbA1c, fasting blood glucose, 2-hour postprandial glucose, HOMA-IR, LDL-C, hs-CRP, MDA, BMI, and gestational edema score (all P < 0.001), with no change in mid-upper arm circumference. The Vitamin D group also had significantly lower risks of pregnancy complications, adverse outcomes, and neonatal issues (P < 0.05), including reduced rates of pregnancy-induced hypertension, fetal distress, and postpartum hemorrhage.

CONCLUSION: Vitamin D supplementation significantly improves glycemic control, enhances insulin sensitivity, and positively impacts pregnancy outcomes in patients with gestational diabetes. Vitamin D supplementation should be considered in the management of GDM.

PMID:40506758 | DOI:10.1186/s41043-025-00969-1

J Cardiothorac Surg. 2025 Jun 12;20(1):261. doi: 10.1186/s13019-025-03482-y.

ABSTRACT

BACKGROUND: The study aimed to investigate the correlation of carotid plaque and peripheral carotid adipose tissue (PCAT) characteristics with coronary computed tomography-derived fractional flow reserve (CT-FFR) values.

METHODS: Data of 136 patients who underwent head and neck computed tomography angiography (CTA) followed by coronary CTA were retrospectively reviewed. Based on their CT-FFR values, they were divided into CT-FFR ≤ 0.8 and CT-FFR > 0.8 groups. The patients’ baseline data, carotid plaque and PCAT characteristics were collected. Univariate analysis and multivariate logistic regression were employed to identify differences between groups.

RESULTS: Univariate analysis indicated a statistical differences in carotid plaque thickness, plaque area, plaque load, the carotid plaque Crouse score, minimum plaque density, and net enhancement value of PCAT of patients (P < 0.05). Based on this, multivariate logistic regression analysis demonstrated that carotid plaque thickness (odds ratio (OR) = 0.553; 95% confidence interval (CI) = 0.360-0.847), the carotid plaque Crouse score (OR = 0.653; 95% CI = 0.514-0.830), and net enhancement value of PCAT (OR = 0.820; 95% CI = 0.730-0.919) were independent predictors of the diagnosis of CT-FFR ≤ 0.8. Furthermore, receiver operating characteristic curve analysis showed that the area under the curve of plaque thickness, the carotid plaque Crouse score, and net enhancement value of PCAT for the diagnosis of CT-FFR ≤ 0.8 were 0.816, 0.843, and 0.836, respectively.

CONCLUSION: Carotid plaque thickness, the carotid plaque Crouse score, and net enhancement value of PCAT are independent related indicators of CT-FFR ≤ 0.8, which can be simultaneously clarified by head and neck CTA alone, as well as the severity of coronary atherosclerosis.

PMID:40506756 | DOI:10.1186/s13019-025-03482-y