Tag: nevin manimala

Infect Agent Cancer. 2025 May 20;20(1):30. doi: 10.1186/s13027-025-00661-3.

ABSTRACT

PURPOSE: To explore the failure patterns, outcomes, and treatment response of differentiated non-keratinizing nasopharyngeal carcinoma (DNKC) and to further investigate the role of plasma Epstein-Barr virus (EBV)-DNA in follow-up monitoring, prognostic prediction, and assessment of treatment efficacy in DNKC.

METHODS: We retrospectively collected data from patients diagnosed with DNKC from January 2015 to February 2022. The life-table method, Kaplan-Meier survival, and Cox proportional hazards analysis were used for statistical analyses.

RESULTS: A total of 102 patients were included. Of the 77 patients with available EBV-DNA levels, 61 patients (79.2%) had EBV-DNA detectable before treatment. Twenty-seven patients (26.5%) experienced disease recurrence, and 88.9% (24/27) relapsed in the first three years. There were 20 patients who experienced disease recurrence and had pre-treatment EBV-DNA status records. At the time of disease progression, 4 patients initially had undetectable EBV-DNA remained undetectable. Among the 16 patients with initially detectable EBV-DNA, 15 (93.8%) had detectable EBV-DNA. Nodal stage and EBV-DNA levels before treatment were found to be independent prognostic factors for distant metastasis-free survival (DMFS) and disease-free survival (DFS). Those with residual EBV-DNA after induction chemotherapy had significantly inferior DMFS (P = 0.003), DFS (P = 0.006), and overall survival (OS) (P = 0.006) than those without residual EBV-DNA after IC. Those with residual EBV-DNA after radiotherapy had significantly inferior local recurrence-free survival (P = 0.003), DMFS (P < 0.001), DFS (P < 0.001), OS (P < 0.006) than those without residual EBV-DNA after radiotherapy.

CONCLUSION: Our study highlights the aggressive nature of DNKC, characterized by early recurrence. EBV-DNA levels may serve as a biomarker to monitor treatment response, prognostic prediction, and recurrence surveillance.

PMID:40394615 | DOI:10.1186/s13027-025-00661-3

Reprod Health. 2025 May 20;22(1):86. doi: 10.1186/s12978-025-02016-y.

ABSTRACT

BACKGROUND: Polycystic ovary syndrome (PCOS) is a chronic, multifaceted condition influenced by epigenetic and environmental factors that is responsible for a significant proportion of anovulatory infertility cases. Here, we analyzed the global, regional, and national burdens of PCOS from 1990 to 2021 using data from the Global Burden of Disease 2021 (GBD 2021).

METHODS: Incidence, prevalence, and Disability-Adjusted Life Years (DALYs) data relevant to PCOS from 204 countries and 21 territories from 1990 to 2021 were obtained from the GBD 2021 study. Here, we considered age-standardized rates (per 100,000 individuals) with 95% uncertainty intervals (95% UIs) obtained from the aforementioned research and presented trends based on age and Socio-demographic Index (SDI) parameters.

RESULTS: In 2021, the global age-standardized incidence and prevalence rates of PCOS were 30.7 per 100,000 and 867.7 per 100,000, respectively, representing an increase of 26.77% and 28.21% since 1990. Additionally, age-standardized disability-adjusted life years stood at 7.6 per 100,000 globally in 2021, marking a 27.58% increase from 1990. Age-standardized prevalence of PCOS varied across countries, ranging from 93.1 to 3978.9 cases per 100,000 women, with Italy (3978.9), Japan (3104.7), and New Zealand (2789.7) having the highest rates. Notably, PCOS prevalence was noted to peak globally among females 15-19 years of age. Regions with a high SDI exhibited the highest age-standardized incidence (70.2), prevalence (1720.7), and DALY (15.2) rates of PCOS. Furthermore, a nonlinear correlation between PCOS burden and SDI was noted, with prevalence rates peaking around an SDI of approximately 0.9.

CONCLUSION: Our findings highlight the growing global impact of PCOS and underscore the need for concerted efforts to attenuate the increasing global prevalence of this condition. Significantly divergent PCOS disease burdens were observed across different age groups and SDI regions, with high SDI regions bearing heavier burdens. The increased disease burden among younger age groups and regional disparities underscore urgency for targeted intervention and formulation of policies to effectively address this public health issue.

PMID:40394609 | DOI:10.1186/s12978-025-02016-y

J Orthop Surg Res. 2025 May 20;20(1):492. doi: 10.1186/s13018-025-05892-z.

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) is rising globally, with patellar management impacting outcomes. Resurfacing reduces pain and revision rates but poses complications, while non-resurfacing lowers costs but risks persistent pain. This study updates previous meta-analyses by comparing the functional and economic outcomes of both approaches.

METHODS: This systematic review and meta-analysis followed PRISMA guidelines. Studies comparing patellar resurfacing and non-resurfacing in TKA with functional outcomes in adults were included. Five databases were searched until February 6, 2024. Two authors independently extracted data and assessed risk of bias. Any disagreements were resolved by a third author. Statistical analysis used a random-effects model, reporting mean differences (MD) and odds ratios (OR) with 95% CI. Sensitivity and subgroup analyses were performed to assess heterogeneity and reliability.

RESULTS: A total of 49 studies (34 RCTs, 15 observational) were included from 963 screened records. Analysis of 22 studies found no significant difference in Knee Society Score (KSS) function between resurfacing and non-resurfacing (MD 2.03; 95% CI 0.58-3.48; p = 0.59, I² = 53%). Resurfacing significantly reduced anterior knee pain (OR 0.61; 95% CI 0.42-0.87; p = 0.007, I² = 70%). However, no significant differences were observed in pain scale, range of motion (ROM), or Oxford Knee Score. Three studies assessed economic outcomes using Incremental Net Benefit (INB) and Incremental Cost-Effectiveness Ratio (ICER) showed no significant cost-effectiveness.

CONCLUSIONS: Patellar resurfacing in TKA significantly reduces anterior knee pain but shows no advantage in KSS function, pain scale, Oxford Knee Score, ROM, or cost-effectiveness. Surgical decisions should be individualized to optimize patient outcomes.

PMID:40394607 | DOI:10.1186/s13018-025-05892-z

Chiropr Man Therap. 2025 May 20;33(1):19. doi: 10.1186/s12998-025-00581-4.

ABSTRACT

BACKGROUND: Previous surveys of physicians revealed diverse attitudes towards chiropractic. One of several strategies proposed by leaders in chiropractic to support the advancement of the profession in North America is to increase opportunities for interprofessional collaboration. One area where chiropractic has achieved some degree of integration in Canada is in the field of sports medicine. A result of the increased integration of chiropractic in the field of sports medicine has been more opportunity for interprofessional collaboration, development of interprofessional relationships and increased exposure to chiropractic. The attitudes of Canadian sport and exercise medicine physicians (CSPs) towards chiropractic are unknown. The purpose of this study is to determine the attitudes and their contributing factors of CSPs toward chiropractic and its use for treatment of athletes and/or Canadians who are participating in sports or exercise (ACSE).

METHODS: An invitation to complete the survey was included in a newsletter emailed to active physician members of CASEM (Canadian Academy of Sports and Exercise Medicine) in March and April 2023 and attendees of their symposium. The survey included the Chiropractic Attitude Questionnaire (CAQ), which allowed respondents to indicate their attitudes towards chiropractic care for ACSE using a 5-point Likert scale. The responses to the CAQ were the primary outcome measure. Descriptive statistics, including mean, median, standard deviation, maximum, minimum and range, regression analysis, t-tests, and ANOVAs were used to analyse the data.

RESULTS: Seventy CSPs completed the survey (response rate: 11%). The summed CAQ scores ranged from 0 to 68 with a mean of 39.03 and a standard deviation of 15.30. CSPs who worked with a chiropractor in a multidisciplinary setting hold a more positive opinion of chiropractic. An independent samples t-test indicated that there was a significant difference between CAQ scores for those with experience of working with a chiropractor (M = 42.03, SD = 14.99) and those without (M = 29.41, SD = 13.10); t(58) = 3.27, p < 0.05.

CONCLUSIONS: CSPs attitudes toward chiropractic and its use for treatment of ACSE range from very positive to extremely negative. CSPs who reported to have worked with a chiropractor have more positive attitudes than those that have not.

PMID:40394604 | DOI:10.1186/s12998-025-00581-4

Transfus Apher Sci. 2025 May 15;64(3):104156. doi: 10.1016/j.transci.2025.104156. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the potential of whole blood-derived platelets (WBDP) to mitigate platelet shortages, their underutilization persists globally. This study investigates the perceptions of transfusionists and identifies barriers to the adoption of WBDP within China’s blood supply system for tertiary hospitals.

MATERIALS AND METHODS: A structured questionnaire comprising 16 items was distributed through WeChat to 254 transfusionists working in tertiary hospitals across China. Data regarding demographics, platelet preferences, and operational challenges were analyzed using descriptive statistics for quantitative data and thematic analysis for qualitative responses.

RESULTS: Results indicated a strong preference for AP (95.28 %), primarily attributed to perceived safety (80.99 %), efficacy (75.21 %), and familiarity with its use (76.86 %). In contrast, WBDP adoption was impeded by concerns over transfusion reactions (85.04 %), safety uncertainties (77.20 %), and operational challenges, such as increased workload (74.41 %) and higher labor costs (50.39 %). Despite this, 90.19 % of respondents expressed willingness to use WBDP during AP shortages, primarily due to critical shortages (66.81 %) and institutional mandates (33.19 %). Moreover, the key barriers included the risk of transfusion reactions (85.04 %), uncertainties regarding safety (77.20 %), doubts about efficacy (57.48 %), and increased labor costs (50.39 %).

CONCLUSION: Institutional inertia favoring AP, along with operational costs and workload for transfusionists, limit WBDP utilization. Implementing centralized compatibility testing and subsidy policies could improve contingency preparedness and address operational challenges.

PMID:40393093 | DOI:10.1016/j.transci.2025.104156

Animal. 2025 Apr 17;19(6):101520. doi: 10.1016/j.animal.2025.101520. Online ahead of print.

ABSTRACT

Many studies focus on animal welfare in terms of specific, either behavioural or physiological, indicators or on the impact of a particular management factor. However, an animal’s welfare state results from the individual’s perception of its general environment, which has consequences at both behavioural and physiological levels. Previous research on horses has shown that different riding schools could be characterised by different emotional/cognitive profiles of horses, in relation sometimes with one single management factor. In the present study, we aimed at determining if such facility-specific horse profiles could also be found in terms of welfare, i.e. facility-specific “welfare profiles”, using a multifaceted approach where animals’ welfare state was assessed based on detailed behavioural, health and physiological measurements. A total of 59 horses from three different riding schools, with a very similar global conventional management but differed slightly in terms of turn-out frequency and riding techniques were studied. A principal component analysis and statistical comparisons showed that, despite the close similarity in management between the three sites, the horses’ welfare state was very different and specific to each structure. Thus, this study using behavioural, health and physiological measures, highlights the existence of facility horse welfare profiles and reveals that even apparently minor differences in management practices could have a major impact on the horses’ welfare state. The quality of ridden work, which is often not taken into account in studies on horse welfare, could be a major issue.

PMID:40393084 | DOI:10.1016/j.animal.2025.101520

Genetics. 2025 May 20:iyaf094. doi: 10.1093/genetics/iyaf094. Online ahead of print.

ABSTRACT

Accurate reconstruction of pedigrees from genetic data remains a challenging problem. Many relationship categories (e.g. half-sibships versus avuncular) can be difficult to distinguish without external information. Pedigree inference algorithms are often trained on European-descent families in urban locations. Thus, existing methods tend to perform poorly in endogamous populations for which there may be reticulations within the pedigrees and elevated haplotype sharing. We present a simple, rapid algorithm which initially uses only high-confidence first-degree relationships to seed a machine learning step based on summary statistics of identity-by-descent (IBD) sharing. One of these statistics, our “haplotype score”, is novel and can be used to: (1) distinguish half-sibling pairs from avuncular or grandparent-grandchildren pairs; and (2) assign individuals to ancestor versus descendant generation. We test our approach in a sample of ∼700 individuals from northern Namibia, sampled from an endogamous population called the Himba. Due to a culture of concurrent relationships in the Himba, there is a high proportion of half-sibships. We accurately identify first through fourth-degree relationships and distinguish between various second-degree relationships: half-sibships, avuncular pairs, and grandparent-grandchildren. We further validate our approach in a second African-descent dataset, the Barbados Asthma Genetics Study (BAGS), and a European-descent founder population from Quebec. Accurate reconstruction of relatives facilitates estimation of allele frequencies, tracing allele trajectories, improved phasing, heritability and other population genomic questions.

PMID:40393068 | DOI:10.1093/genetics/iyaf094

JMIR Mhealth Uhealth. 2025 May 20;13:e53586. doi: 10.2196/53586.

ABSTRACT

BACKGROUND: Anticoagulation management is important in preventing complications in patients undergoing cardiac valve replacement. The development of mobile apps offers new opportunities for the management of long-term anticoagulants. However, there is a lack of randomized controlled trials evaluating the effectiveness, safety, cost-effectiveness, and user demand for internet-based anticoagulation management.

OBJECTIVE: This study aimed to evaluate the efficacy, safety, and cost-effectiveness of a 3-month warfarin dose adjustment mobile app Alfalfa compared to offline management in patients postcardiac valve replacement. We also explored the app’s feasibility on user satisfaction and demand.

METHODS: This study was a randomized controlled trial with assessments conducted at baseline and at a 3-month follow-up. Participants were eligible if they had been on warfarin therapy for at least 3 months, received warfarin management either through the Alfalfa app or through pharmacist-led anticoagulation outpatient clinic visits, consented to regular follow-ups, and had not experienced serious bleeding or thrombotic events in the 3 months before warfarin treatment. A P value of ≤.05 was considered statistically significant.

RESULTS: A total of 405 participants were included in the analysis. The time in therapeutic range was significantly higher in the Alfalfa app group than in the offline group (66.46% vs 46.65%, P<.001). Participants in the Alfalfa app group had a higher monitoring frequency (8.14 vs 4.47, P<.001) and a greater percentage of international normalized ratio values within the target range (896/1660, 53.98% vs 346/899, 38.49%; P<.001) than those in the offline group. In addition, the Alfalfa app group exhibited lower rates of subtherapeutic (235/1660, 14.16% vs 152/899, 16.91%; P<.05) and extreme subtherapeutic international normalized ratio values (273/1660, 16.45% vs 186/899, 20.69%; P<.05) than the offline group. However, the incidence of minor bleeding was higher in the Alfalfa app group (12/204, 5.9% vs 3/201, 1.5%; P=.02). In terms of cost-effectiveness, the Alfalfa app group had a significantly lower average cost per test (42.37 vs 78.3, P<.001), average time per test (47.42 vs 90.74, P<.001), and cost-effectiveness ratio (385.9 vs 662.9) than the offline group. A total of 86 participants completed the satisfaction questionnaire, and the vast majority of participants expressed high levels of satisfaction with the Alfalfa App, while also providing further suggestions for improvement.

CONCLUSIONS: The integration of “Internet+Pharmacy Care” using the Alfalfa App can improve the effectiveness of warfarin anticoagulation management in patients following heart valve surgery. The Alfalfa app provides a more efficient, secure, and cost-effective solution to warfarin management than traditional offline methods.

PMID:40393057 | DOI:10.2196/53586

JMIR Form Res. 2025 May 20;9:e72659. doi: 10.2196/72659.

ABSTRACT

BACKGROUND: Controlling glycated hemoglobin (HbA1c) levels can be challenging for patients with type 2 diabetes mellitus (T2DM). Peer support promotes HbA1c control, and a digital peer-supported app designed for group interactions may enable patients with T2DM to encourage one another to achieve better HbA1c outcomes. However, no studies have investigated the use of digital peer-supported apps to control HbA1c levels in patients with T2DM.

OBJECTIVE: This pilot study aimed to explore the effects of a digital peer-supported app on HbA1c control in patients with T2DM.

METHODS: This prospective single-arm pilot study enrolled patients with T2DM who owned smartphones and visited medical institutions in Japan. During the 3-month intervention, participants used a digital peer-supported app in addition to receiving standard care. This app allowed participants to share activity logs and concerns via a chat function to improve HbA1c levels through mutual engagement and encouragement. The primary outcome was the change in HbA1c levels, measured at health care facilities at baseline and after 3 months. The secondary outcomes were body weight and blood pressure, with the most recent data obtained from hospitals and clinics. Physical activity (≥1 hour/day) was assessed at the same time points using a self-reported questionnaire.

RESULTS: The study included 21 participants with a median age of 56 (IQR 51-61) years, of which 13 (61.9%) were female. After using the digital peer-supported app for 3 months, the participants’ HbA1c levels significantly decreased from 7.1% (SD 0.6%) at baseline to 6.9% (SD 0.1%) (P=.04). Similarly, participants’ body weight decreased from 70.7 (SD 12.7) kg to 69.9 (SD 12.4) kg (P =.004) through app use. Although blood pressure decreased slightly from 128.2 (SD 12.5) mm Hg to 126.0 (SD 12.9) mm Hg, this change was not statistically significant (P=.20). Additionally, the proportion of participants engaged in ≥1 hour of daily physical activity significantly increased from 23.5% (n=4) to 58.5% (n=10) (P=.03).

CONCLUSIONS: In addition to receiving standard clinical care, the use of a digital peer-supported app may significantly lower HbA1c levels in patients with T2DM by promoting healthy behaviors.

PMID:40393047 | DOI:10.2196/72659

PLoS One. 2025 May 20;20(5):e0320466. doi: 10.1371/journal.pone.0320466. eCollection 2025.

ABSTRACT

OBJECTIVE: This study aimed to estimate the accuracy of the underlying Cause of Death (CoD) in the original death certificate, compared with a gold standard certificate based on information from clinical records and relatives, in population deceased in Colombia during 2021.

METHODS: A sample size of 806 deaths across 92 municipalities in Colombia were estimated from the pool of 326,833 original certificates provided by the National Department of Statistics. A two-stage stratified random sample with replacement was employed for selection. Information from medical records of the deceased and, when necessary, interviews with relatives or witnesses were used to determine CoDs on the gold standard certificate. We analyzed and compared the underlying CoD of the original and standard death certificates to estimate the level of accuracy. Measures of concordance, patterns of false positives and negatives, and a kappa value were utilized as metrics to evaluate the death certificates quality.

RESULTS: Information was obtained from 776, representing 96% of the desired sample. The concordance between original and gold standard certificates, categorized according to the ICD-10 chapters, was found in 74%. Higher levels of agreement were observed for “codes for special COVID-19 situations” (kappa = 0.84) and neoplasms (kappa = 0.84). Higher levels of agreement were observed for “codes for special COVID-19 situations” (kappa = 0.84) and neoplasms (kappa = 0.84). Overestimation was identified for “circulatory system diseases” (Chapter IX); “pregnancy, childbirth and puerperium” (Chapter XV); “signs, symptoms, and poorly defined conditions” (Chapter XVIII) and “diseases of the respiratory system” (Chapter X), while underestimation in “diseases of the genitourinary system” (Chapter XIV) among CoD. The most significant variations in the fraction of mortality due to specific CoDs corresponded to “codes for special situations COVID-19”.

CONCLUSIONS: The level of concordance between the original and gold standard death certificates was deemed adequate. However, improvements in the death certification process in Colombia are recommended, emphasizing the enhancement of training programs for health professionals.

PMID:40393038 | DOI:10.1371/journal.pone.0320466