Tag: nevin manimala

J Clin Rheumatol. 2025 May 29. doi: 10.1097/RHU.0000000000002245. Online ahead of print.

ABSTRACT

OBJECTIVES: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) offers quantitative insights into synovitis by evaluating vascular changes. However, its potential to predict progressive bone destruction in rheumatoid arthritis (RA) remains unclear. This study aimed to identify DCE-MRI parameters that predict joint deformity progression and establish their clinical relevance.

METHODS: This prospective cohort study included 24 RA patients undergoing DCE-MRI at baseline and after treatment initiation. Radiographic progression was assessed using the modified total Sharp score 1 year after the second DCE-MRI. Histogram analysis of the enhanced synovium was performed using a mathematical model to derive parameters, including β (washout rate) and signal enhancement ratio (SER). The differences in mathematical parameters between the groups were statistically evaluated using the Mann-Whitney U test.

RESULTS: Clinical factors, including 28-joint disease activity score (DAS28)-erythrocyte sedimentation rate and visual analog scale scores, were elevated in the progression group (p = 0.001 and p = 0.02, respectively). Patients with progressive bone destruction exhibited significantly higher posttreatment β and SER values (p = 0.023 and p = 0.03, respectively), reflecting delayed-phase curve patterns associated with angiogenesis and increased vascular permeability. No significant differences in the volume of enhanced synovium or Rheumatoid Arthritis Magnetic Resonance Imaging Score synovitis scores were observed. There was no difference between the groups in the change in clinical parameters.

CONCLUSION: Posttreatment β and SER values derived from DCE-MRI may serve as predictive markers of future bone destruction in RA. These findings highlight the potential of DCE-MRI in guiding therapeutic decisions. Future studies with larger cohorts and automated analysis methods are warranted to validate these results and enhance clinical feasibility.

PMID:40442895 | DOI:10.1097/RHU.0000000000002245

Asia Pac J Clin Oncol. 2025 May 29. doi: 10.1111/ajco.14191. Online ahead of print.

ABSTRACT

BACKGROUND: Bladder cancer is a prevalent malignant tumor of the urinary system, primarily affecting middle-aged and elderly populations.

OBJECTIVE: To delineate the pathogenic significance of IGFL2 dysregulation and assess its clinical utility as a theranostic biomarker.

METHODS: Data were retrieved from the TCGA database, whereas complementary datasets were acquired via the Gene Expression Profiling Interactive Analysis (GEPIA), the Human Protein Atlas (THPA), and cBioPortal databases. IGFL2 emerged as a prominently dysregulated gene and was screened by differential expression analysis. Kaplan-Meier survival curves and Cox regression model were used to analyze its relationship with patient survival. The degree of immune cell infiltration and its correlation with IGFL2 were evaluated, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analyses were performed. All statistical analyses were performed using R software, and p < 0.05 was set as significant.

RESULTS: IGFL2 expression was significantly upregulated in bladder cancer (p < 0.05), with a diagnostic AUC of 0.828 (95% CI: 0.761-0.896), and was correlated with pathological TNM staging, histological grading, and overall survival (OS) outcomes. Patients with high expression of IGFL2 were associated with poorer OS and disease-specific survival (DSS) (p < 0.05). High expression of IGFL2 was an independent prognostic risk factor (HR = 3.049, 95% CI: 1.592-5.840, p < 0.001). IGFL2 may be involved in signaling pathways such as PI3K-Akt and MAPK. IGFL2 expression was positively correlated with the infiltration levels of macrophages, Th1 cells, and NK cells (p < 0.05).

CONCLUSION: IGFL2 is highly expressed in bladder cancer and may be associated with a poor prognosis. IGFL2 may become a potential biomarker and an important therapeutic target for bladder cancer patients.

PMID:40442870 | DOI:10.1111/ajco.14191

J Health Popul Nutr. 2025 May 29;44(1):180. doi: 10.1186/s41043-025-00941-z.

ABSTRACT

BACKGROUND: Life’s Essential 8 (LE8) for assessing cardiovascular health (CVH) has been demonstrated to be inversely associated with osteoporosis (OP). This study aims to create a machine learning (ML) model to assess the clinical association value of lifestyle and behavioral factors, assessed by LE8, on OP risk in the United States.

METHODS: This cross-sectional analysis utilized data from the National Health and Nutrition Examination Survey (NHANES), encompassing participants aged ≧ 50 with comprehensive LE8 and OP information. Initially, the study compared the characteristics of participants with OP against those with normal bone health. Linear and nonlinear associations of LE8 and OP were analyzed by multifactor logistic regression and restricted cubic spline (RCS). Subsequently, LE8 features were integrated into six distinct ML models for OP analysis. Evaluate model performance using relevant metrics and curves. The best-performing model was further analyzed using SHapley Additive exPlanations (SHAP) to rank and clarify the positives and negatives of the contribution of individual LE8 components.

RESULTS: Among 3,902 participants, 364 (9.33%) were identified as having OP. Conventional regression showed that health behaviors (HB) and health factors (HF) in LE8 were negatively and positively correlated with OP, respectively, and that total LE8 was nonlinearly associated with OP. Through comparison of the Area Under the Curve (AUC), Accuracy, F1-Score, Precision, Recall, Specificity, Receiver Operating Characteristic (ROC), Decision Curve Analysis (DCA), and Calibration Curve Analysis (CCA), the optimal performance achieved by the Light Gradient Boosting Machine (LightGBM) model incorporating the 20 features. SHAP analysis revealed that the contributions of LE8 components were ranked as follows: Body Mass Index (BMI) > sleep health > blood glucose > nicotine exposure > blood lipids > blood pressure > Healthy Eating Index-2015 (HEI-2015) > physical activity. Where sleep health, blood lipids, and HEI-2015 were the main negative contributors to OP, BMI was the main positive contributor.

CONCLUSIONS: The integration of LE8 with a LightGBM model offers a promising strategy for analysing OP in the American population, underscoring the potential of ML approaches in enhancing clinical assessments.

PMID:40442859 | DOI:10.1186/s41043-025-00941-z

Stem Cell Res Ther. 2025 May 30;16(1):268. doi: 10.1186/s13287-025-04404-4.

ABSTRACT

BACKGROUND: This study evaluated the effectiveness of intrathecal autologous bone marrow mononuclear cell (BMMNC) therapy combined with education compared with education alone for the treatment of autism spectrum disorder (ASD).

METHODS: Fifty-four children with ASD, aged three to seven years, were randomly assigned to two groups. Fifty patients completed the study (25 patients per group). The cell therapy (CT) group received two BMMNC infusions six months apart along with an educational intervention, while the control group received education only. Efficacy outcomes were assessed at baseline, two, six, and 12 months, based on: (1) changes in ASD severity evaluated through the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the Childhood Autism Rating Scale (CARS), and the Clinical Global Impression-Severity (CGI-S) scale scores and (2) improvements in social interaction, adaptive behavior, and daily living skills measured by the Vineland Adaptive Behavior Scales (VABS-II) and Clinical Global Impression-Improvement (CGI-I) scale scores.

RESULTS: At 12 months, the CT group presented a 48.0% reduction in individuals classified at the most severe DSM-5 level compared with 8.0% in the control group (p = 0.004). The CARS scores were significantly lower in the CT group (-5.9 points) than in the control group (-1.5 points) (p < 0.0001). Similarly, the CT group exhibited greater improvement in CGI-S scores (-1.5 points) than did the control group (-0.1 points) (p < 0.0001). The VABS-II scores increased by 8.5 points in the CT group versus 1.4 points in the control group (p < 0.0001). Finally, the CGI-I scores improved from 2.8 to 2.0 in the CT group but worsened from 3.0 to 3.5 in the control group (p < 0.0001).

CONCLUSIONS: Intrathecal BMMNC combined with an educational intervention improved disease severity and adaptability more than education alone in children with ASD.

TRIAL REGISTRATION: clinicaltrials.gov, NCT05307536. Date registered 12 February 2022. http://clinicaltrials.gov/study/NCT05307536 .

PMID:40442857 | DOI:10.1186/s13287-025-04404-4

Arch Public Health. 2025 May 29;83(1):139. doi: 10.1186/s13690-025-01626-z.

ABSTRACT

BACKGROUND: Dementia represents one of the greatest global health challenges. Women have a greater lifetime risk of developing dementia compared to men. Both pharmacological and non-pharmacological interventions aimed at slowing cognitive decline show promising results. However, most studies do not examine whether there are sex and gender differences in access to treatment, quality of care or treatment effectiveness.

OBJECTIVES: To summarise evidence on sex and gender differences in access to treatment, management, and treatment effectiveness for people with dementia.

METHODS: This scoping review followed PRISMA guidelines and was conducted in PubMed/MEDLINE, EMBASE, Google Scholar, and ClinicalTrials.Gov databases in November 2023 and updated in January 2024. Systematic reviews and observational studies were included to explore sex and gender differences in access or management of dementia. Systematic reviews and clinical trials were included to investigate sex and gender differences in treatment effectiveness.

RESULTS: We included 16 studies in our review. Sex and gender differences were observed in the prescription and receipt of anti-dementia medications, as well as access to primary care, with variations by settings. Mixed results were found concerning polypharmacy and inappropriate medications, with women being prescribed antipsychotic and other psychotropic medications for longer periods compared to men. Studies of the impact of exercise on cognitive decline yielded mixed results, though limited disaggregated data by sex indicated a more pronounced impact in women than in men. Cognitive stimulation therapy interventions showed greater cognitive improvements for women. Clinical trials assessing the effectiveness of disease-modifying therapies (DMTs) suggest that women may be less responsive to DMTs than men.

CONCLUSIONS: There are important differences between men and women living with dementia in access to diagnosis, treatments, quality of care and effectiveness of treatments. Such differences can significantly impact health outcomes. Sex and gender inequalities should be considered when planning and implementing healthcare, social care, and associated strategies in dementia. To provide conclusive evidence, it is essential for clinical trials to have sufficient statistical power and report outcomes disaggregated by sex.

PMID:40442851 | DOI:10.1186/s13690-025-01626-z

BMC Res Notes. 2025 May 29;18(1):240. doi: 10.1186/s13104-025-07293-1.

ABSTRACT

OBJECTIVE: Even though the growing prevalence of Parkinson’s disease (PD) is inclusive of ethnic and racial minority groups, these populations remain underrepresented in PD clinical research. This community-based study seeks to add to the limited knowledge on barriers and facilitators to underrepresented group (URG) enrollment in PD trials by assessing minority community members’ PD and research knowledge, trust in medical researchers, and likelihood to participate in research based on various study design factors.

RESULTS: Of the 97 total workshop participants, 80 completed demographic information, with the majority female (71%) and from minority racial groups — African American/Black (37.5%) and East/Southeast Asian (45%). Levels of trust in medical researchers were generally high and improved post-workshop. Most respondents were likely to participate in trials requiring DNA or cognitive testing, and unlikely if requiring intravenous infusion or lumbar puncture. Facilitators to trial participation included offering transportation and financial incentives, while longer study visits and study duration were barriers.

PMID:40442830 | DOI:10.1186/s13104-025-07293-1

Diabetol Metab Syndr. 2025 May 30;17(1):181. doi: 10.1186/s13098-025-01732-6.

ABSTRACT

BACKGROUND: The association between newly developed insulin resistance (IR) indices and all-cause mortality in elderly patients with diabetes has not been investigated.

METHODS: Baseline data and all-cause mortality for 1,248 elderly diabetes patients from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2018 were collected. The traditional IR index homeostasis model assessment of insulin resistance (HOMA-IR) and several newly developed indices, including metabolic score for insulin resistance (METS-IR), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), triglyceride glucose index (TyG), triglyceride glucose combined with body mass index (TyG-BMI), estimated glucose disposal rate (eGDR), and visceral adiposity index (VAI), were calculated for the patients. Cox proportional hazards regression and restricted cubic spline (RCS) regression models assessed the relationship between IR indices and all-cause mortality.

RESULTS: In a median follow-up period of 73.3 months, there were 381 recorded deaths. In the total cohort, METS-IR (p < 0.001), TyG-BMI (p < 0.001), and eGDR (p = 0.011) demonstrated a significant association with all-cause mortality as continuous variables. HOMA-IR, METS-IR, TyG-BMI, and eGDR exhibited significant correlations with all-cause mortality in the Cox regression models (p < 0.05) when analyzed as categorical variables. A U-shaped relationship exists between METS-IR, TyG-BMI, eGDR, and all-cause mortality (p-overall < 0.0001, p-nonlinear < 0.05). No significant associations were found between TyG, TG/HDL-C, VAI, and all-cause mortality. Among male patients, TyG-BMI and HOMA-IR exhibited superior prognostic value, whereas in female patients, METS-IR, TyG-BMI, and eGDR showed better performance.

CONCLUSION: HOMA-IR, TyG-BMI, METS-IR, and eGDR were associated with mortality in elderly diabetic patients, with gender differences in their prognostic values.

PMID:40442829 | DOI:10.1186/s13098-025-01732-6

J Health Popul Nutr. 2025 May 29;44(1):174. doi: 10.1186/s41043-025-00898-z.

ABSTRACT

BACKGROUND: Folate level is associated with depression, yet prospective evidence is lacking on the relationship of dietary intake, serum, and red blood cell (RBC) folate levels with mortality risk in patients with depression.

METHODS: Dietary intake, serum, and RBC folate data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018 were included. Depression was diagnosed using the PHQ-9 with a cutoff value of 5. Additionally, all-cause and cause-specific mortality data up to December 31, 2019, were determined from the National Death Index. Weighted multivariable Cox regression and restricted cubic spline (RCS) analysis were used to determine the relationship between folate and outcomes.

RESULTS: A total of 4843 adult patients with depression were included, with a mean age of 45.16 years, and females accounted for 61.59%. Over a mean follow-up of 7.2 years, 544 participants died. Weighted Cox regression showed that, after adjustment, only RBC folate among nine folate indicators significantly predicted all-cause mortality in patients with depression. A per standard deviation (SD) increase in RBC folate increased the all-cause mortality risk by 12% (HR: 1.12, 95% CI: 1.04-1.21, p = 0.003). RCS analysis revealed a U-shaped association of RBC folate with all-cause, CVD, and cancer mortality, with inflection points at 540.5 ng/ml, 575.2 ng/ml, and 624.1 ng/ml, respectively. Further segmented regression showed that an increase in RBC folate reduced only cancer mortality risk to the left of the inflection points. To the right of these points, RBC folate was significantly positively associated with all-cause, CVD, and cancer mortality risks.

HIGHLIGHTS: RBC folate exhibited a U-shaped association with all-cause, cardiovascular-specific, and cancer-specific mortality risks in patients with depression.

CONCLUSION: Dietary and serum folate were not associated with overall mortality rates in patients with depression. However, RBC folate exhibited a U-shaped association with all-cause, cardiovascular-specific, and cancer-specific mortality risks in patients with depression.

PMID:40442828 | DOI:10.1186/s41043-025-00898-z

J Health Popul Nutr. 2025 May 29;44(1):176. doi: 10.1186/s41043-025-00881-8.

ABSTRACT

BACKGROUND: Hypovitaminosis D or vitamin D deficiency is a significant public health issue. Several vitamin D preparations are currently available. However, there is no consensus on the optimal dose and duration of vitamin D supplementation. This study aimed to evaluate the effects of vitamin D supplementation on symptoms and clinical outcomes in adults with insufficient or deficient baseline vitamin D levels.

METHOD: A pre-post two-month intervention with 50,000 IU vitamin D3 supplementation for adults with documented insufficient or deficient baseline vitamin D levels, presented at Jazan University Hospital from August to December 2022.

RESULTS: Of the 204 participants, 65.1% had baseline vitamin D levels < 30 nmol/L. Vitamin D insufficiency is more prevalent among females, older adults, married individuals, and those with low income. However, these differences were not statistically significant (p > 0.5). The symptoms and clinical outcomes were significantly improved after 2 months of vitamin D3 supplementation for the participants who achieved vitamin D levels > 50 nmol/L (p = 0.000). After adjusting for multiple confounders, the significant determinants of symptom improvement and clinical outcomes post-supplementation included education level, income, smoking status, and baseline vitamin D level.

CONCLUSIONS: Hypovitaminosis D or vitamin D deficiency was observed in study participants. The use of a 50,000 IU cholecalciferol (vitamin D3) orally once per week for two months is sufficient to improve the symptoms and clinical outcomes of vitamin D deficiency. However, long-term follow-up could better assess the sustainability of benefits and explore long-term outcomes, such as the risk of deficiency recurrence.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40442818 | DOI:10.1186/s41043-025-00881-8

J Orthop Surg Res. 2025 May 30;20(1):546. doi: 10.1186/s13018-025-05934-6.

ABSTRACT

BACKGROUND: Calcaneal fractures usually arise from high-energy trauma and predominantly impact young individuals. In older adults (aged ≥ 50 years), declining bone density and muscle strength increase fracture risk from low-energy trauma, leading to a bimodal epidemiological distribution. The intricacies of calcaneal fractures in older adults, alongside osteoporosis and soft tissue fragility, complicate surgical intervention. This study aims to analyze age-related differences in calcaneal fracture characteristics using three-dimensional(3D) mapping and assess their impact on medial incision design.

METHOD: A total of 95 patients with closed calcaneal fractures were categorized into two groups: Younger (< 50 years, n = 61) and Older (≥ 50 years, n = 34). The process of 3D fracture mapping was executed utilizing Mimics and 3-matic software, alongside the reconstruction of soft tissue, which encompassed the posterior tibial neurovascular bundle. Differences in fracture distribution and incision parameters (length, α angle, D1, and D2) were statistically analyzed, with p < 0.05 considered statistically significant.

RESULTS: Fracture lines in both groups were predominantly located around the lateral Gissane’s angle and critical weight-bearing areas of the calcaneus. In the Younger Group, fracture lines were long, continuous, and involved fewer fragments, correlating with high-energy trauma. The Older Group showed more comminuted lines, characteristic of osteoporotic fractures. The α angle and D1 distance were significantly smaller in the Older Group (p < 0.05), indicating closer proximity to the medial malleolus. D2 values were also smaller (p < 0.05), with 48.65% intersecting the neurovascular bundle compared to 31.34% in the Younger Group.

CONCLUSION: Age significantly influences medial wall fracture patterns and complexity in calcaneal injuries. A personalized medial incision based on fracture morphology provides better exposure and reduction compared to traditional methods. Although the incision is closer to the neurovascular bundle in older patients, meticulous surgical technique guarantees safety. The integration of a medial incision with sinus-tarsi (ST) approach minimizes the necessity for extensive lateral exposure, thereby diminishing soft tissue complications and improving surgical outcomes for the elderly population.

LEVEL OF EVIDENCE: Level IV, retrospective case series.

PMID:40442805 | DOI:10.1186/s13018-025-05934-6