Tag: nevin manimala

Immunol Res. 2025 Sep 16;73(1):130. doi: 10.1007/s12026-025-09682-x.

ABSTRACT

Efficient utilization of healthcare resources, including laboratory testing, is crucial for environmental sustainability and cost-effectiveness. The diagnosis of APS requires the presence of at least one clinical event (either an objectively confirmed thrombotic event and/or pregnancy complication) and detection of one or more aPL (lupus anticoagulant [LA], IgG/IgM anticardiolipin [aCL], and/or IgG/IgM anti-β2 glycoprotein-1 [aβ2GPI]). However, inappropriate requests for aPL tests contribute to unnecessary healthcare expenses and environmental impact. This study evaluates the appropriateness of aPL testing in a clinical setting. A retrospective analysis was conducted on 642 patients attending the San Giovanni Di Dio Hospital, Florence (11/2023-02/2024). Diagnostic suspicion underlying aPL test requests were classified as appropriate, inappropriate, or unevaluable using a scoring system based on clinical recommendations. Appropriateness assessment was performed independently by two researchers and reconciled with a third expert. Patient demographics, test results, and the specialty of the physicians ordering aPL were recorded and analyzed. Of the 642 queries, 36% were deemed appropriate, 42% inappropriate, and 22% unevaluable. Family physicians accounted for 53% of all test requests but exhibited the highest rate of inappropriate requests (44%). Rheumatologists, internal medicine physicians, and gynecologists demonstrated better adherence to recommendations (with 34%, 30%, and 18% of inappropriate requests, respectively). Only 4.9% of patients underwent comprehensive aPL testing per international standards (Sidney criteria). Among the 115 aPL-positive cases, multiple antibody positivity was more common in appropriate test requests. Inappropriate requests often stemmed from conditions without established links to APS, such as alopecia, hypercholesterolemia, and dysmenorrhea. A considerable proportion of aPL testing in routine practice lacks clinical justification, reflecting variability in guideline adherence across specialties. Inappropriate testing increases healthcare costs, specialist referrals, and environmental burdens. Improved education, adherence to diagnostic recommendations, and sustainable practices are critical to optimizing APS testing and resource utilization.

PMID:40958002 | DOI:10.1007/s12026-025-09682-x

J Math Biol. 2025 Sep 16;91(4):42. doi: 10.1007/s00285-025-02284-z.

ABSTRACT

In this paper, we investigate a two-species Lotka-Volterra competition patch model in a Y-shaped river network, where the two species are assumed to be identical except for their random and directed movements. We show that competitive exclusion can occur under certain conditions, i.e., one of the semi-trivial equilibria is globally asymptotically stable. Specifically, if the random dispersal rates of the two species are equal, the species with a smaller drift rate will drive the other species to extinction, which suggests that smaller drift rates are favored.

PMID:40958001 | DOI:10.1007/s00285-025-02284-z

Pediatr Res. 2025 Sep 16. doi: 10.1038/s41390-025-04386-2. Online ahead of print.

ABSTRACT

BACKGROUND: Preterm infants are often fed donor human milk (DHM) when the mother’s own milk is insufficient or not available. Holder or Retort pasteurization is used to inactivate potential pathogens in DHM. The effects of DHM pasteurization methods on the infant gut microbiome are unknown.

METHODS: To compare the gut microbiome and clinical outcomes between preterm infants fed Holder- versus Retort-pasteurized DHM, we performed weekly collections of stool samples from infants born <34 weeks’ gestation and/or <1500 g birth weight. We analyzed stool samples from 150 patients exclusively fed DHM [Retort (n = 80), Holder (n = 54)] or exclusively fed mother’s own milk (n = 16). Whole-metagenome sequencing was performed to assess microbiome composition, diversity, and functional enrichment.

RESULTS: Compared to infants fed Retort-pasteurized DHM, infants fed Holder-pasteurized DHM showed higher alpha-diversity (Chao-1 p = 0.007) and a higher abundance of beneficial anaerobes, such as Bacteroides thetaiotaomicron, Clostridium spp., and Bifidobacterium spp. Functional enrichment analysis revealed significant differences in carbohydrate metabolism, transport systems, and regulatory pathways between feeding groups. There were no statistically significant differences in short-term clinical outcomes, such as necrotizing enterocolitis, length of hospitalization or death.

CONCLUSION: Differences in pasteurization methods for DHM resulted in measurable gut microbiome changes in preterm infants.

IMPACT: It is known that the preterm infant gut microbiota is different in infants fed pasteurized donor milk compared to mother’s own milk. However, the impact of different pasteurization methods for donor milk on the infant gut microbiome is unknown. We show that the type of pasteurization of donor human milk influences the gut microbiome and its function in preterm infants. In contrast to feeding Retort-pasteurized donor human milk, feeding Holder-pasteurized donor human milk generates an infant gut microbiome similar to feeding mother’s own milk.

PMID:40957978 | DOI:10.1038/s41390-025-04386-2

Surg Endosc. 2025 Sep 16. doi: 10.1007/s00464-025-12207-0. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity has become a global comorbidity with increasing prevalence over the last decade. It is associated with an elevated risk for the development of ventral hernias. Bariatric surgery aims to address obesity through surgical intervention, which has become increasingly safe over time. However, a comparative meta-analysis with a double-arm evaluation of concomitant ventral hernia repair (VHR) and weight loss surgery is not yet available in the literature. Hence, we performed a systematic review and meta-analysis of simultaneous VHR and bariatric surgery.

MATERIAL AND METHODS: Cochrane, Embase, Scopus, Scielo, and PubMed were systematically searched for studies comparing concomitant bariatric surgery and VHR with bariatric surgery alone or staged repair. Outcomes assessed for comparative meta-analysis were surgical site infection (SSI), dehiscence, readmission and reoperation, deep venous thrombosis (DVT) and pulmonary embolism (PE), overall mortality, operative time, and length of hospital stay (LOS). SSI was also analyzed separately as a superficial or deep infection. We also performed a single-arm meta-analysis of incarceration within the staged repair groups with a bariatric surgery as the first procedure and a single-arm meta-analysis of recurrence following concomitant bariatric surgery and VHR. Statistical analysis was performed with R Studio.

RESULTS: 805 studies were screened and 26 were thoroughly reviewed. Six studies were included, comprising a total of 131,323 patients, of whom 3002 (2.3%) underwent simultaneous bariatric and VHR procedures. Simultaneous repair was associated with an increase of 39.4 min (95% CI 26.17 to 52.63; p < 0.01) in the operative time. We found an increased readmission rate for the concomitant procedures (OR 1.48; 95% CI 1.1 to 1.99; p < 0.01), but no differences were found in reoperation rates (OR 2.97; 95% CI 1.0 to 8.84; p = 0.05). Concomitant procedures were also associated with higher DVT (OR 2.54; 95% CI 1.36 to 4.72; p < 0.01) and PE rates compared to separated procedures (OR 3.08; 95% CI 1.57 to 6.05; p < 0.01). No differences were found in overall SSI (OR 1.1; 95% CI 0.59 to 2.12; p = 0.74) and superficial (OR 0.94; 95% CI 0.48 to 1.84; p = 0.86) or deep (OR 7.02; 95% CI 0.36 to 136.1; p = 0.2) SSI. No statistically significant differences were found in dehiscence rates between the groups (OR 0.2; 95% CI 0.01 to 4.16; p = 0.3). Concomitant procedures were associated with an increase of 0.35 days in LOS (95% CI 0.1 to 0.59; p = 0.004) and with increased mortality odds (OR 3.99; 95% CI 1.92 to 8.3; p < 0.01). The proportional meta-analysis found an incarceration rate of 22.95 (95% CI 10.9 to 42) for the patients who delayed the VHR and a recurrence rate of 7.61 per 100 patients (95% CI 1.6 to 29.6) for the patients who underwent concomitant surgery.

CONCLUSION: Our systematic review and meta-analysis found an increase in DVT, PE, readmission, operative time, LOS, and mortality for concomitant procedures. Incarceration rates of 22.95 were found for delayed VHR. Further research is needed to analyze individual bariatric surgery and VHR techniques and draw a more precise conclusion on this subject.

PMID:40957972 | DOI:10.1007/s00464-025-12207-0

Neurol Sci. 2025 Sep 17. doi: 10.1007/s10072-025-08462-7. Online ahead of print.

ABSTRACT

OBJECTIVE: Migraine is a primary headache disorder characterised by attacks of headache that are usually unilateral and throbbing in nature, may be accompanied by neurological symptoms, and, due to its complex pathophysiology, can affect not only the central nervous system but also structures such as the retinal vascular system. In recent years, retinal imaging techniques have emerged as a promising method for studying neuro-ophthalmological diseases. In this study, we aimed to predict migraine by evaluating the measurements made from retinal images obtained with Optical Coherence Tomography (OCT).

MATERIALS AND METHODS: In the present study, 70 eyes of migraine patients and 38 eyes of healthy control group were examined. In cases where there was an imbalance between the classes, the data were balanced by applying the SMOTE method, which is widely preferred in studies. In addition to age and gender data, features such as retinal artery and vein diameters and choroidal thickness measurements were used as data. Pearson’s Correlation Coefficient method was applied to calculate the linear relationship between the features.

RESULTS: Classification results were evaluated with Area Under the Curve (AUC), Accuracy (Acc), Kappa statistic (KS), F1-score (F1), and Matthews Correlation Coefficient (MCC) parameters. The most successful result in the classification process between migraine and healthy control was obtained with the LightGBM algorithm with 93.28% AUC, 91.14% Acc, 86.67% F1, 0.74 KS, and 0.76 MCC rates.

CONCLUSION: The presented research can be considered as a preliminary study. The results of the research on the application of machine learning algorithms showed an effective performance in migraine prediction from OCT data. Ensemble-based Boosting model classifiers were more successful than traditional machine learning classifiers.

PMID:40957962 | DOI:10.1007/s10072-025-08462-7

BJC Rep. 2025 Sep 16;3(1):61. doi: 10.1038/s44276-025-00178-7.

ABSTRACT

BACKGROUND: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced renal cell carcinoma (RCC), but their use is associated with immune-related adverse events, including hepatic adverse events (irHAEs).

METHODS: We retrospectively analysed 105 RCC patients treated with ICIs as first-line therapy between 2018 and 2023 at the University Hospital of Essen. Patients were categorized by the development of irHAE, defined per CTCAE grading v5.0. Multivariable logistic regression was used to identify risk factors, while Kaplan-Meier survival analyses evaluated PFS and OS.

RESULTS: Among the cohort, 16.19% (n = 17) developed irHAE, while 8.57% (n = 9) experienced higher-grade events. Combination therapy with tyrosine kinase inhibitors (TKIs) was associated with a higher likelihood of irHAE (OR: 7.69, p = 0.037) compared to ICI-only regimens, with cabozantinib showing a significantly shorter time to onset (35 vs. 84 days; p < 0.001). Patients with a BMI ≥ 25 had a significantly increased risk (p = 0.011). Differences in PFS (18.63 vs. 19.87 months; p = 0.099) and OS (27.80 vs. 23.87 months; p = 0.36) were not statistically significant.

CONCLUSIONS: The combination of ICI with TKI posed higher risks for irHAE in RCC patients. While survival outcomes were unaffected, the results underscore the need for tailored monitoring and management. Prospective studies are warranted to refine therapeutic approaches.

PMID:40957947 | DOI:10.1038/s44276-025-00178-7

Nat Rev Genet. 2025 Oct;26(10):661-662. doi: 10.1038/s41576-025-00885-4.

NO ABSTRACT

PMID:40957943 | DOI:10.1038/s41576-025-00885-4

Nat Commun. 2025 Sep 16;16(1):8296. doi: 10.1038/s41467-025-64015-8.

ABSTRACT

Floods displace an average of 12 million people every year, and are responsible for 54% of all disaster-induced displacements. Displacement risk scales with the vulnerability of exposed populations, but this vulnerability is poorly understood at a global scale. Here we show that measures of human development and rural areas explain more of the variance of displacement vulnerability than income levels measured by gross domestic product. We combine global flood and displacement data to estimate vulnerability, as the ratio of displacement to exposure, for over 300 historical flood events. We find that this vulnerability varies by several orders of magnitude both between and within countries. A random forest regression shows that infant mortality rate and population density are among the most important predictors of displacement vulnerability at national level and within countries, respectively, highlighting the vulnerability of low-income and marginalized populations and of rural communities. Our results indicate that, rather than relying on overall economic development alone, targeted investments are needed to improve living conditions and coping capacities for the most vulnerable groups, particularly outside of large cities, and to prepare for increasing flood hazards due to climate change.

PMID:40957930 | DOI:10.1038/s41467-025-64015-8

J Med Internet Res. 2025 Sep 16;27:e77014. doi: 10.2196/77014.

ABSTRACT

BACKGROUND: Telemedicine is an effective and promising strategy, especially for the initial stages of a home-based therapeutic exercise program.

OBJECTIVE: The objectives of this study were 2-fold: first, to assess whether Tai Chi practice combined with wearable device-based monitoring improves cognitive function in this population, and second, to explore the underlying mechanisms for any improvements observed, including changes in physical activity levels and sleep patterns.

METHODS: The study was a randomized controlled trial in which participants were randomized (1:1:1) to receive usual care, fitness walking, or Tai Chi exercise. All indicators were assessed at baseline and 12-week follow-up. The usual care includes traditional diabetes education. Participants in the fitness walking group performed walking exercises on a treadmill under the supervision of a researcher 3 times a week for 12 weeks. Participants in the Tai Chi group practiced 24-style Simplified Tai Chi through live video streaming under the guidance of professors and professionals. In this 12-week program, participants underwent continuous glucose monitoring (CGM) using Guardian Sensors 3, CGM sensors attached to the upper arm. All participants carried bracelets to record their heart rate, sleep parameters, and steps. The primary outcome was the Montreal Cognitive Assessment (MoCA) at 12 weeks. Secondary outcomes included other cognitive subdomain tests and blood metabolic indices. The MoCA is a tool designed for rapid screening for mild cognitive impairment (MCI) and early dementia, with the core advantage of being more sensitive to early cognitive problems. The MoCA has a total score of 30. Lower scores may indicate the presence of cognitive dysfunction.

RESULTS: After 12 weeks of intervention, the Tai Chi exercise group showed a significant improvement in MoCA scores from baseline (mean difference 23.83, 95% CI 17.79-25.66 vs 21.42, 95% CI 17.11-24.74; P=.03). The fitness walking exercise group showed an improvement in MoCA scores (22.94, 95% CI 18.05-23.98 vs 21.58, 95% CI 17.35-24.12; P.08), but this did not reach statistical significance. Furthermore, there was a statistical difference in the improvement of MoCA scores between the Tai Chi and fitness walking groups (2.65, 95% CI 0.34-4.41 vs 1.44, 95% CI 0.89-2.87; P<.05). The usual care group showed the least change in score at both points (0.23, 95% CI -0.02 to 1.39; P=.83). Compared with the MQ in the fitness walking group (91.93, 95% CI 77.83-97.47) vs 88.62, 95% CI 77.14-95.84; P=.45), Trail Making Test Part B (TMT-B) (220.81, 95% CI 210.03-233.49 vs 223.66, 95% CI 215.04-230.27; P=.33), the Tai Chi group was more effective in improving the MQ (99.23, 95% CI 80.55-107.69 vs 89.23, 95% CI 78.16-96.08; P=.001), TMT-B (207.33, 95% CI 200.26-220.82 vs 225.58, 95% CI 214.12-234.94; P=.001) scores, and there were significant differences between the two groups.

CONCLUSIONS: In summary, this study demonstrated that web-based exercise therapy for patients may enhance the effectiveness of exercise therapy in improving cognitive function among older individuals with type 2 diabetes mellitus. Tai Chi has significant advantages in improving cognitive function and sleep quality, while fitness walking, although also beneficial, is relatively weak in these areas.

PMID:40957073 | DOI:10.2196/77014

Clin Exp Dent Res. 2025 Oct;11(5):e70222. doi: 10.1002/cre2.70222.

ABSTRACT

OBJECTIVES: This in vitro experimental study aimed to evaluate the effects of laboratory contamination of implant abutment screws and connection surfaces on reverse torque values (RTVs), as an indicator of screw preload loss.

MATERIAL AND METHODS: Forty-five Dentis One Q implants and 45 CCM UCLA abutments were randomly assigned into three groups (n = 15 per group). Group 1 (control) involved uncontaminated abutments and screws with no restorations. Group 2 (screw contamination) used new abutments attached with screws contaminated by laboratory materials (porcelain powder, metal debris, and polishing paste). Group 3 (connection contamination) included screw-retained restorations fabricated under contaminated conditions and attached using new screws. All samples were subjected to standardized torque (250 N·cm), thermocycling (1500 cycles between 5°C and 55°C), and subsequent RTV measurement. One-way ANOVA and Tukey’s post hoc tests were used for statistical analysis (α = 0.05).

RESULTS: Mean RTVs (SD) were 218 (0.15) N·cm (control), 181 (0.14) N·cm (screw contamination), and 207 (0.11) N·cm (connection contamination). RTVs in the screw contamination group were significantly lower than both the control (p < 0.001) and connection contamination groups (p < 0.001). The difference between the control and connection contamination groups was not statistically significant (p = 0.08).

CONCLUSIONS: Laboratory contamination of implant components can significantly reduce reverse torque values, particularly in cases of screw contamination, indicating an increased risk of screw loosening. Contamination control during prosthetic procedures is essential to maintaining implant stability.

PMID:40957072 | DOI:10.1002/cre2.70222