Tag: nevin manimala

Medicine (Baltimore). 2025 May 16;104(20):e42522. doi: 10.1097/MD.0000000000042522.

ABSTRACT

May measurement month (MMM) is a global blood pressure (BP) screening campaign that aims to emphasize the importance of BP measurement and identify those who require intervention/follow-up for elevated BP. The objective of this regional analysis in Newfoundland and Labrador (NL), Canada, was to examine the proportion of individuals screened with elevated BP, including those with and without a history of hypertension (HTN). This cross-sectional study was completed in accordance with the global MMM protocol. All consenting adults ≥18 years old were eligible to take part. Data collection took place in 28 community pharmacies across the province of NL. Descriptive statistics were analyzed and associations between elevated BP and covariates of interest were determined using logistic regression. A total of 384 participants took part in this study, with a mean age of 54.4 years (standard deviation 18.2); 66.1% (n = 254) of participants were female and 41.4% (n = 159) had known HTN. A complete set of 3 BP readings were recorded for a total of 375 participants and therefore, these participants were included in the analysis. Elevated BP was observed in 21.9% (n = 82) of participants, including 13.5% of those who had no history of HTN (i.e., 30 of 222). Known HTN and diabetes were statistically significant predictors of elevated BP in the multivariate regression model. Regional implementation of the MMM campaign in NL helped to identify a relatively large proportion of individuals with elevated BP, including those with no history of HTN. Targeted measures are needed to achieve BP targets among individuals with hypertension and diabetes in the province.

PMID:40388740 | DOI:10.1097/MD.0000000000042522

Medicine (Baltimore). 2025 May 16;104(20):e42423. doi: 10.1097/MD.0000000000042423.

ABSTRACT

Post-traumatic stress disorder (PTSD) and Attention deficit and hyperactivity disorder (ADHD) are common mental illnesses. Observational studies have indicated that these conditions often co-occur with gastrointestinal diseases. However, the causal relationship between PTSD and ADHD with gastrointestinal diseases remain unclear. We conducted Mendelian randomization (MR) analysis to investigate these associations. We selected genetic instrument data with genome-wide significance levels for PTSD and ADHD from the psychiatric genomics consortium open genome-wide association study platform. Summary statistics for the 24 gastrointestinal diseases were obtained from the FinnGen study. We used the “TwoSampleMR” package in R to perform a 2-sample MR analysis and conducted sensitivity analysis of the results. We found that genetic susceptibility to PTSD was associated with 1 gastrointestinal disease, specifically pancreatic cancer (P = .003; odds ratios [OR] = 1.295; 95% CI, 1.094-1.531). Genetic susceptibility to ADHD was associated with 4 gastrointestinal diseases: gastroesophageal reflux (P = .014; OR = 1.100; 95% CI, 1.020-1.186), gastric ulcer (P = .004; OR = 1.208; 95% CI, 1.061-1.376), duodenal ulcer (P = .020; OR = 1.206; 95% CI, 1.029-1.413), and chronic gastritis (P = .021; OR = 1.122; 95% CI, 1.018-1.237). This study provides MR evidence supporting causal relationship between PTSD and ADHD with specific gastrointestinal diseases.

PMID:40388735 | DOI:10.1097/MD.0000000000042423

Medicine (Baltimore). 2025 May 16;104(20):e42484. doi: 10.1097/MD.0000000000042484.

ABSTRACT

Previous studies have confirmed that hyperthyroidism is one of the common causes of secondary osteoporosis and can aggravate the disease severity in patients with osteoporosis. This study is mainly based on the Taiwan National Health Insurance Database and through big data analysis shows that combining traditional Chinese medicine (TCM) treatment can help the health of patients with hyperthyroidism and osteoporosis. There were 4980 patients who received TCM treatment and 19,920 controls who did not receive TCM treatment selected from Taiwan National Health Insurance Database in a 4:1 ratio of gender, age, and index year. Cox proportional hazards analyzes were performed to compare fracture, inpatient, and all-cause mortality over an average follow-up period of 15 years. A total of 4745/5823/3487 enrolled subjects (19.06%/23.39%/14.00%) suffered fractures/hospitalization/all-cause death which TCM group was 452/987/511 (15.10%/19.82%/10.26%); control group was 3993/4836/2976 (20.05%/24.28%/14.94%). Cox proportional hazards regression analysis showed that subjects in the TCM group had lower fractures, hospital mortality, and all-cause mortality (adjusted HR = 0.563; 95% confidence intervals [CI] = 0.392-0.680, P < .001; adjusted HR = 0.614; 95% CI = 0.474-0.714, P < .001; adjusted HR = 0.691; 95% CI = 0.569-0.792, P < .001). Kaplan-Meier analysis showed that the cumulative risk of fracture, hospitalization and death were lower in TCM group with significant differences (all log-rank P < .001). The analysis of this study shows that patients with hyperthyroidism and osteoporosis even with comorbidity of atrial fibrillation, atrial flutter, or heart failure combined with TCM treatment are associated with a lower risk of fractures, hospitalization, or all-cause death, providing clinicians with a treatment option.

PMID:40388732 | DOI:10.1097/MD.0000000000042484

Medicine (Baltimore). 2025 May 16;104(20):e42508. doi: 10.1097/MD.0000000000042508.

ABSTRACT

Chronic kidney disease is a progressive condition, and serum creatinine (CR) levels are closely associated with the glomerular filtration rate, serving as a key indicator of renal function and disease progression. This study aimed to develop a smartphone-based colorimetric analysis system for the efficient and rapid quantification of serum CR and validate its performance to determine whether the method meets clinical testing standards. The CR standard solution was analyzed using a smartphone, and the R, G, and B values were plotted against the concentration. The precision, accuracy, detection limit, linear range, and clinically reportable range of the smartphone detection system were evaluated according to the National Committee for Clinical Laboratory Standards guidelines. Subsequently, 65 serum samples from healthy individuals and 26 serum samples from nephropathy patients were collected and tested using the smartphone system and an automated biochemical analyzer, respectively, to further validate the feasibility of the method. Among all the color channels, the G value showed the strongest correlation with CR concentration, and therefore was used to establish the standard curve. The validation of the assay system demonstrated that its precision and accuracy met clinical standards. The limit of blank, limit of detection, and limit of quantification were 29.95 μmol/L, 32.39 μmol/L, and 36.61 μmol/L, respectively. The linear range was 36.75 to 200.46 μmol/L, whereas the clinical reporting range spanned from 36.61 to 801.84 μmol/L. Furthermore, the results obtained from the 2 methods were statistically analyzed, revealing a strong correlation between the 2 sets of data. Smartphone-based serum CR testing meets clinical standards, and its portability and efficiency position it as a valuable tool for screening and monitoring chronic kidney disease.

PMID:40388728 | DOI:10.1097/MD.0000000000042508

Bioinformatics. 2025 May 19:btaf273. doi: 10.1093/bioinformatics/btaf273. Online ahead of print.

ABSTRACT

MOTIVATION: Genomic data sharing beacon protocol, developed by the Global Alliance for Genomics and Health (GA4GH), offers a privacy-preserving mechanism for querying genomic datasets while restricting direct data access. Despite their design, beacons remain vulnerable to privacy attacks. This study introduces a novel privacy vulnerability of the protocol: One can reconstruct large portions of the genomes of all beacon participants by only using the summary statistics reported by the protocol.

RESULTS: We introduce a novel optimization-based algorithm that leverages beacon responses and single nucleotide polymorphism (SNP) correlations for reconstruction. By optimizing for the SNP correlations and allele frequencies, the proposed approach achieves genome reconstruction with a substantially higher F1-score (70%) compared to baseline methods (45%) on beacons generated using individuals from the HapMap and OpenSNP datasets. We show that reconstructed genomes can be used by downstream applications such as in membership inference attacks against other beacons. Our findings reveal that beacons releasing allele frequencies substantially increases the reconstruction risk, underscoring the need for enhanced privacy-preserving mechanisms to protect genomic data.

AVAILABILITY AND IMPLEMENTATION: Our implementation is available at https://github.com/ASAP-Bilkent/Beacon-Reconstruction-Attack.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:40388204 | DOI:10.1093/bioinformatics/btaf273

Clin Transl Sci. 2025 May;18(5):e70222. doi: 10.1111/cts.70222.

ABSTRACT

Rational prescribing in geriatrics represents an important ethical as well as socio-economic issue. The aim of this project was to analyze the drug-related problems (DRPs) among the Czech nursing home residents and increase public awareness of further possible employment of clinical pharmacists in social care. The project was designed as a multicenter observational study. A total of 16 nursing homes and 800 participants with an average age of 84.6 ± 7.3 years were included in the study. Of them, a DRP was noted in 93.3% of people. The total amount of DRPs identified was 2215, which means an average of 2.8 ± 1.6 DRPs per patient. The most common DRPs identified were ‘overtreatment’ (19.5%), ‘undertreatment’ (12.8%), inappropriate dose (10.6%), recommendations for laboratory monitoring (10.4%) and adverse effects (10.3%). Of different drug classes, BZDs (OR 16.6, 95% CI 1.0-270.2), PPIs (OR 2.5, 95% CI 1.1-5.6) and NSAIDs (OR 4.4, 95% CI 1.1-18.3) were identified to be most commonly associated with DRPs. The risk of DRP identification clearly increased with the number of drugs used, with seven drugs demonstrated as the best cut-off for predicting DRP identification (AUC 0.842, sensitivity 0.602; specificity 0.796). ‘SENIOR’ project has confirmed a high rate of excessive polypharmacy among nursing home residents in the Czech republic resulting in high risk of potential and manifested DRPs. The project emphasized the role of clinical pharmacists in optimizing safety and effectiveness of treatment among older nursing home residents.

PMID:40388195 | DOI:10.1111/cts.70222

Reproduction. 2025 May 1:REP-25-0087. doi: 10.1530/REP-25-0087. Online ahead of print.

ABSTRACT

Superovulation is widely used to maximise oocyte/embryo yield in animal models. However, it has been implicated in disrupting normal follicular development, potentially affecting perifollicular angiogenesis. This study investigated the impact of superovulation on ovarian perifollicular neoangiogenesis using Light Sheet Fluorescence Microscopy (LSFM), and by quantitatively profiling the three-dimensional (3D) perifollicular capillary bed in murine antral follicles. Dioestrus CD1 mice received 2.5, 5.0, or 7.5 IU pregnant mare serum gonadotrophin (PMSG) intraperitoneally, and ovaries were collected 24 and 48 hours later, with those from normal cycling females (dioestrus, proestrus, oestrus) as controls. Ovaries were fixed and labelled with fluorescently tagged Wheat Germ Agglutinin lectin and CD34 to visualise the oocyte zona pellucida and thecal vasculature, respectively. Optically cleared samples were imaged using LSFM, and 3D volume rendering, vessel segmentation, and image analysis were performed using Arivis Vision 4D and Fiji. Quantitative metrics including vessel volume, length, branching, density, spatial arrangement and oocyte characteristics were profiled. Statistical analysis was based on Kruskal-Wallis tests. PMSG-induced superovulation showed dose-dependent effects on perifollicular vasculature, causing premature (24h) neoangiogenesis at 7.5 IU and reduced final (48h) vessel density at 2.5 IU compared to naturally cycling animals. Whereas the former may be a compensatory mechanism for reduced blood flow to individual follicles, the latter suggests an insufficient response to ovarian stimulation. By contrast, intrafollicular metrics were largely unaffected. This study provides the first comprehensive quantitative 3D analysis of thecal vasculature and oocytes in murine ovaries and highlights its potential applications in other areas of reproductive biology.

PMID:40388193 | DOI:10.1530/REP-25-0087

JAMA Intern Med. 2025 May 19. doi: 10.1001/jamainternmed.2025.1189. Online ahead of print.

ABSTRACT

IMPORTANCE: Type 2 diabetes (T2D) is a risk factor for cognitive impairment. Whether the choice of the second-line glucose-lowering treatment added to metformin or glycemic control affects cognitive performance in T2D of relatively short duration (<10 years) is not known.

OBJECTIVE: To compare the relative effect of 4 classes of glucose-lowering medications that were randomly added to metformin on cognitive performance and to examine the association of longitudinal glycemic levels with cognitive performance.

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial (the GRADE study) was conducted at 36 clinical centers in the US and included 3721 participants with T2D with baseline and follow-up cognitive performance data. GRADE was implemented 2013 to 2021, and data for this study were analyzed from February 2024 to February 2025.

INTERVENTIONS: For the primary objective, the exposure was randomization of metformin-treated participants to receive long-acting insulin (insulin glargine U-100), sulfonylurea (glimepiride), glucagon-like peptide-1 receptor agonist (liraglutide), or dipeptidyl peptidase-4 inhibitor (sitagliptin). The secondary objective assessed time-weighted hemoglobin A1c levels over the follow-up period.

MAIN OUTCOMES AND MEASURES: The primary cognitive outcome was the Digit Symbol Substitution Test score; the secondary cognitive outcomes were the immediate and delayed recall in the Spanish English Verbal Learning Test and letter and category fluency test scores.

RESULTS: At baseline, the mean (SD) duration of T2D was 4.3 (2.7) years, and the mean (SD) age was 57.1 (9.8) years. Most participants were male (2320 [62.3%]; 1401 female individuals [37.7%]) and non-Hispanic (3015 [81.6%]; 681 Hispanic individuals [18.4%]); 712 (19.1%) were Black and 2452 (65.9%) were White; 777 (20.9%) were recruited from Veterans Affairs medical centers. There were no statistically significant differences between treatment groups in the cognitive outcomes at follow-up. However, a 1-unit increase in time-weighted hemoglobin A1c levels was associated with modestly lower Digit Symbol Substitution Test scores (-0.94 points; 95% CI, -1.30 to -0.57), Spanish English Verbal Learning Test scores (immediate recall, -0.27 points; 95% CI, -0.49 to -0.06), and category fluency test scores (animal fluency, -0.28 points; 95% CI, -0.47 to -0.09) over the mean (SD) of 4.1 (0.1) years of follow-up. Severe hypoglycemia requiring assistance was uncommon in all 4 groups (34 participants [0.9%]).

CONCLUSIONS AND RELEVANCE: The results of this randomized clinical trial suggest that choice of second-line glucose-lowering medication class added to metformin is not associated with change in cognitive performance in persons with early T2D. Worse glycemic control is associated with modestly worse cognitive performance.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01794143.

PMID:40388190 | DOI:10.1001/jamainternmed.2025.1189

JAMA Neurol. 2025 May 19. doi: 10.1001/jamaneurol.2025.1317. Online ahead of print.

ABSTRACT

IMPORTANCE: Cluster headache, characterized by bouts of excruciating pain attacks, detrimentally affects health and quality of life. Eptinezumab is an anticalcitonin gene-related peptide monoclonal antibody approved for migraine prevention.

OBJECTIVE: To evaluate the efficacy and safety of eptinezumab in the preventive treatment of episodic cluster headache.

DESIGN, SETTING, AND PARTICIPANTS: This double-blind, placebo-controlled, randomized (1:1) clinical trial (Eptinezumab in Participants With Episodic Cluster Headache [ALLEVIATE]) was conducted between December 2020 and October 2023. Results are from the initial 4-week randomized phase. The study took place at 64 sites across Europe, the US, and Japan. Included were adults (aged 18-75 years) with a history of episodic cluster headache for 1 or more years (with bouts lasting ≥6 weeks when untreated) and previous acute and preventive medication use.

INTERVENTIONS: Eptinezumab, 400 mg, or placebo (intravenous infusion).

MAIN OUTCOMES AND MEASURES: The primary end point was the change from baseline in the number of weekly attacks in weeks 1 to 2. Safety was assessed using treatment-emergent adverse events.

RESULTS: Of 628 total participants screened, 320 entered the second screening period, and 231 met eligibility criteria. Of the 231 participants randomized (eptinezumab, n = 118; placebo, n = 113), 215 (93%) completed the placebo-controlled period. The participant mean (SD) age was 44 (11) years, and 178 of 229 were male (78%). At baseline, the mean (SD) weekly attacks were 15.2 (8.1) in the eptinezumab group and 15.7 (8.3) in the placebo group. There was no statistically significant difference between eptinezumab and placebo in the change from baseline in the number of weekly attacks over weeks 1 to 2 (least-squares mean [SE], -4.0 [0.93] vs -4.6 [0.89]; between-group difference, 0.7; 95% CI, -1.3 to 2.6; P = .50). More eptinezumab-treated participants achieved 50% or greater response vs placebo over week 2 (50.9% [54 of 106] vs 37.3% [41 of 110]; odds ratio [OR], 1.77; 95% CI, 1.03-3.07; P =.04), week 3 (62.5% [65 of 104] vs 43.8% [49 of 112]; OR, 2.26; 95% CI, 1.30-3.97; P =.004), and week 4 (66.7% [68 of 102] vs 50.5% [54 of 107]; OR, 2.14; 95% CI, 1.21-3.83; P =.009). Eptinezumab showed numerically larger improvements than placebo for 75% or greater response, average daily pain scores, and across other patient-reported outcomes. Treatment-emergent adverse events occurred in 25.0% of patients (28 of 112) receiving eptinezumab and 26.5% of patients (31 of 117) receiving placebo.

CONCLUSIONS AND RELEVANCE: Among adults with episodic cluster headache, eptinezumab did not significantly reduce the number of attacks vs placebo, although it was associated with numerically higher responder rates and improvements in average daily pain and patient-reported outcomes. Eptinezumab was generally well tolerated.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04688775.

PMID:40388178 | DOI:10.1001/jamaneurol.2025.1317

Dev Psychol. 2025 May 19. doi: 10.1037/dev0001966. Online ahead of print.

ABSTRACT

Memory-derived predictions help us to anticipate incoming sensory evidence. A mismatch between prediction and evidence leads to a prediction error (PE). Previous research suggested that PEs enhance memory of the surprising events. Here, we systematically investigated the effect of PE on episodic memory in children (10-12 years old), younger adults (18-30 years old), and older adults (66-70 years old). Participants learned visual object pairs over 2 days. On Day 3, new objects were shown among the pairs, either after the first item of a pair (violation items), that is, instead of the second item, or between pairs (nonviolation items), that is, when no specific predictions were possible. Our results did not reveal a significant boosting effect of PE on memory in any of the age groups. In contrast, in children, violations resulted in lower memory specificity compared with nonviolations. Older adults showed lower memory specificity than the other age groups across violations and nonviolations. We conclude that the beneficial effect of PE on episodic memory may be less consistent than theoretically postulated and may not always be observed in experimental settings involving statistical learning and item-specific violations, and that children’s memory specificity may even suffer from PE. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40388174 | DOI:10.1037/dev0001966