Tag: nevin manimala

J Psychosom Obstet Gynaecol. 2026 Dec 31;47(1):2610384. doi: 10.1080/0167482X.2025.2610384. Epub 2025 Dec 31.

ABSTRACT

PURPOSE: This systematic review synthesizes evidence on depressive symptoms and access to mental health care following miscarriage. It examines differences between women in general care settings and those with recurrent pregnancy loss to explore differential psychological vulnerability and care gaps.

METHODS: A search of four databases (inception-June 2025) followed PRISMA guidelines. Studies reporting depressive symptoms or barriers and facilitators to care were included. Given methodological heterogeneity, findings were synthesized narratively using a SWiM framework, stratifying populations by miscarriage history and assessing quality with risk-of-bias tools.

RESULTS: Of 1,140 records, 46 were included. Depressive symptoms were common, though prevalence varied by timing, tools, and characteristics. Evidence suggests a possible graded association between recurrent loss and symptoms, although this was inconsistent and often attenuated in acute assessments. Key correlates included childlessness, prior psychiatric history, repeated loss, and low social support. Barriers included insensitive communication, lack of follow-up, and financial constraints. Facilitators included empathetic interactions, clear information, and supportive networks.

CONCLUSIONS: Miscarriage is frequently associated with significant distress, yet evidence certainty varies regarding recurrence and intervention effectiveness. Findings highlight a persistent gap between women’s mental health needs and healthcare responses.

PMID:41474415 | DOI:10.1080/0167482X.2025.2610384

Anatol J Cardiol. 2025 Dec 31. doi: 10.14744/AnatolJCardiol.2025.5862. Online ahead of print.

ABSTRACT

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of global morbidity and mortality, underscoring the need for improved early detection strategies for preclinical atherosclerosis. This study evaluated comprehensive multimodal cardiovascular risk predictors-clinical, biochemical, and vascular imaging parameters-in dyslipidemic adults without established ASCVD.

METHODS: A total of 847 adults underwent standardized clinical assessment, laboratory profiling, and duplex-based vascular imaging, including carotid intima-media thickness (IMT), plaque assessment, flow-mediated dilation (FMD), and ankle-brachial index. Statistical analyses included multivariate logistic regression, receiver operating characteristic (ROC) curve analysis, model calibration metrics, and correlation matrices using Pearson or Spearman tests as appropriate. High-density lipoprotein cholesterol (HDL-C) exhibited a strong inverse correlation with AIP (r = -0.57, P < .001).

RESULTS: Triglycerides (TG) demonstrated a strong positive correlation with the atherogenic index of plasma (AIP) (r = 0.80, P < .001). Moderate correlations were observed between age and left ventricular mass index (r = 0.31, P < .001), age and fibrinogen (r = 0.32, P < .001), HbA1c and TG (r = 0.26, P < .001), and HbA1c and AIP (r = 0.30, P < .001). ASCVD and atherosclerosis total score positivity were independently associated with age, HbA1c, IMT, and FMD in multivariable analyses, while model discrimination remained robust (area under the curve values reported).

CONCLUSION: Multimodal integration of clinical, biochemical, and vascular imaging markers provides meaningful refinement of cardiovascular risk stratification and may enhance early detection of preclinical ASCVD.

PMID:41474414 | DOI:10.14744/AnatolJCardiol.2025.5862

CNS Neurosci Ther. 2026 Jan;32(1):e70729. doi: 10.1002/cns.70729.

ABSTRACT

OBJECTIVE: The mechanical thrombectomy (MT) strategy obviously differs for acute middle cerebral artery occlusion (MCAO) stroke caused by embolism or atherosclerosis. Our study aimed to develop and validate a simple and universally applicable score for predicting etiology [embolism or intracranial arteriosclerosis (ICAS)] before MT in patients with acute MCAO stroke.

METHODS: Between November 2019 and September 2022, we retrospectively enrolled eligible patients in our hospital as the training cohort. Additionally, consecutive patients between July 2023 and April 2024 were recruited as the validation cohort. Multivariate logistic regression analysis was used to identify the independent factors associated with etiology in the training group. Each factor was then point assigned based on β-coefficient, and a risk scoring system was developed. The scoring system was validated through the validation cohort. The C-statistic, Brier score, and Hosmer-Lemeshow test were used to assess model discrimination and calibration.

RESULTS: The training group and validation group finally included 277 patients (154 embolism-MCAO and 123 ICAS-MCAO) and 101 patients (59 embolism-MCAO and 42 ICAS-MCAO), respectively. A scoring system (AHOC score) covering four variables (atrial fibrillation, hyperdense middle cerebral artery sign, stenosis/occlusion in other arteries, and collateral status) was derived to help identify embolism-MCAO or ICAS-MCAO. The AHOC score showed good discrimination and calibration in the training cohort (C-statistic, 0.932 [0.902-0.963]; Brier score, 0.092 [0.070-0.115]; p value of the Hosmer-Lemeshow test, 0.604) and in the validation cohort (C-statistic, 0.933 [0.888-0.978]; Brier score, 0.102 [0.067-0.140]; p value of the Hosmer-Lemeshow test, 0.846). According to the AHOC score, patients with a score of 4-8 were identified as high-risk for the embolism-MCAO category. Conversely, a patient with a score of 0-3 was considered high-risk for the ICAS-MCAO category.

CONCLUSIONS: Our scoring system (AHOC score), consisting of atrial fibrillation, hyperdense middle cerebral artery sign, stenosis/occlusion in other arteries and collateral status, is a valid and applicable model for predicting the etiology in patients with acute MCAO before MT.

PMID:41474412 | DOI:10.1002/cns.70729

J Physiol. 2025 Dec 31. doi: 10.1113/JP290334. Online ahead of print.

NO ABSTRACT

PMID:41474389 | DOI:10.1113/JP290334

J Physiol. 2025 Dec 31. doi: 10.1113/JP289753. Online ahead of print.

ABSTRACT

Spontaneous tendon rupture occurs in a concerning number of individuals with chronic kidney disease (CKD); however almost no data exist regarding CKD-related tendon pathology. Given that tendon ruptures have a significant impact on health and well-being we sought to determine whether tendon mechanics are altered by kidney disease in an established rat model of CKD. Male and female Sprague-Dawley rats (age = 8 weeks) were equally divided into a control group (CON, n = 16) and a group fed a diet containing 0.25% adenine to induce kidney disease (_ADICKD). After 9 weeks, Achilles and tibialis anterior (TA) tendons were excised, and maximum tensile load (MTL), failure stress, modulus and cross-sectional area (CSA) were measured and evaluated by two-way ANOVA (main effects: CKD and sex). CKD was confirmed through elevated creatinine (1.99 vs. 0.61 mg/dl, CKD vs. CON, P < 0.001) and blood urea nitrogen (93.4 vs. 21.4 mg/dl, P < 0.001). Plantar flexor strength was 13% lower in _ADICKD (P = 0.0214), and femur yield force was decreased by 41% in male _ADICKD (P < 0.001). The failure stress of TA tendons was 24% lower in CKD vs. CON (P = 0.0383). There were no statistically significant differences in TA tendon MTL, modulus or CSA. There were no significant main effects for any parameter for the Achilles; however, post hoc testing following a finding of group-by-sex interactions revealed that in females Achilles failure stress was decreased in _ADICKD by 25% (P = 0.0283). To our knowledge this is the first direct evidence that tendon weakness is caused by kidney disease, providing a model for further evaluating mechanisms and interventions. KEY POINTS: Chronic kidney disease is well known to lead to musculoskeletal dysfunction, such as bone and muscle wasting. Numerous case reports suggest that chronic kidney disease may also predispose patients to catastrophic tendon injuries; however, there are no mechanistic studies or animal models addressing this phenomenon – and thus, no treatments. We determined whether a rat model of chronic kidney disease previously used to study muscle and bone dysfunction (0.25% adenine in the diet) would also cause impaired tendon function. Eight weeks of adenine-induced kidney disease caused tibialis anterior tendons to tear at 24% lower stress than in control animals, while also decreasing plantar flexor muscle strength by 13% and femur strength by 41% (males only). This is the first experimental evidence for a direct effect of chronic kidney disease on tendon function, establishing a comprehensive multitissue model for future research.

PMID:41474384 | DOI:10.1113/JP289753

Epilepsia. 2025 Dec 31. doi: 10.1002/epi.70084. Online ahead of print.

ABSTRACT

There is debate on the predictive value of multiday seizure cycles versus simple statistical baselines. Multidien seizure cyclicity is a prevalent, patient-specific phenomenon with promise for epilepsy management. We challenge the assertion that cycle tracking is no better than a moving average, which is an inherently retrospective model that lags changes in seizure likelihood. This commentary compared a causal cyclic forecast to a prospectively applied moving average across a large seizure diary cohort (n = 768) and two gold-standard chronic EEG cohorts (n = 24). For the EEG and diary cohorts, cycle tracking demonstrated significantly superior accuracy to the moving average for both hourly and daily forecasts (p < 0.0001), using multiple performance metrics. These results confirm that event-based cyclical models offer more accurate, simulated real-world forecasts. Robust forecasting tools must prioritize the detection and modeling of seizure cycles to move beyond simple baseline performance and provide actionable clinical utility.

PMID:41474376 | DOI:10.1002/epi.70084

FASEB J. 2026 Jan 15;40(1):e71400. doi: 10.1096/fj.202502393R.

ABSTRACT

Gastric cancer (GC) has a high incidence in China. There is a closed-loop structure in circRNAs, which is involved in various cellular biological processes such as tumor development. However, there is a lack of research on the function of circRNAs in GC. In this study, we aimed to explore the potential of circXPO1 as a diagnostic biomarker and the role of circXPO1 in the progression of GC. We screened out circXPO1 through circRNA sequencing. Using exonuclease digestion assay, agarose gel electrophoresis (AGE), Sanger sequencing, and gDNA experiment, we proved that circXPO1 contained a cyclic structure. Quantitative real-time fluorescent Polymerase Chain Reaction (qRT-PCR) was used to detect the expression of circXPO1 in plasma and GC tissues. The receiver operating characteristic curve (ROC curve) was established to evaluate the diagnostic efficacy of circXPO1. The role of circXPO1 was assessed in vitro. The binding sites between circXPO1 and miRNAs were predicted by CircBank, Circinteractome, CircAtlas and miRanda databases. CircXPO1 was up-regulated in 67 GC tissues compared with the adjacent normal tissues (p = 0.0002). It was stable and hard to be degraded, which made it an ideal tumor biomarker. Compared with the patients in the normal control group, the expression level of circXPO1 in plasma was higher in GC patients (p < 0.001) and those with benign lesions (p = 0.0031) with statistically significant differences. CircXPO1 was proved to have satisfactory diagnostic efficacy in distinguishing GC patients from healthy donors (AUC = 0.813, 95% CI: 0.749-0.877). Besides, the diagnostic efficacy, sensitivity, and specificity could achieve 0.853, 78% and 86%, respectively, when circXPO1, CEA and CA199 were used together in diagnosis. In addition, in vitro experiments indicated that circXPO1 knockdown significantly weakened the proliferation, invasion and migration of GC cells. It was also predicted that circXPO1 could serve as a sponge of miR-1248 to regulate the progression of GC.

PMID:41474375 | DOI:10.1096/fj.202502393R

Biomed Eng Online. 2025 Dec 30;24(1):153. doi: 10.1186/s12938-025-01450-0.

ABSTRACT

INTRODUCTION: Dental autotransplantation (DAT) is a surgical procedure used to replace hopeless or missing teeth. The technique entails the purposeful extraction of a desired sound tooth, which is then implanted into another alveolar site of the same oral cavity.

OBJECTIVES: To analyse the survival rates and success rates of DAT in relation to donor teeth with an incomplete root development (open apex) and complete root formation (closed apex). Additionally, it attempts to evaluate the prognostic components of DAT with infection-related (inflammatory) root resorption, ankylosis, and pulpal necrosis complications.

MATERIALS AND METHODS: An electronic search was conducted using EBSCO MEDLINE Web of Science, Scopus and Cochrane databases from January 2014 until November 2024. The selected articles were chosen within the parameters outlined in the Materials and Statistical Methodology section. The addressed PICO question “does the stage of the donor tooth’s root development affect the long-standing prognosis and clinical outcomes of dental autotransplantation?”.

RESULTS: The final 26 articles featured a total of 2837 transplanted teeth: 2192 donor teeth with an open apex and 645 donor teeth with a closed apex. The overall survival rate was 93.8% in the open apex group and 92.6% in the closed apex group. Success rate was 84.0% in the open apex group and 86.7% in the closed apex group. The rate of infection-related root resorption was 6.3% in the open apex group and 5.9% in the closed apex group. The rate of ankylosis was 4.4% in the open apex group and 6.7% in the closed apex group. The rate of pulp necrosis was 6.4% in the open apex group. No factors were identified as influencing the rate of pulp necrosis; however, the duration of follow-up was significantly associated with the rate (p = 0.057). None of the selected articles reported pulp necrosis rate in the closed apex; thus, no meta-analysis was possible.

CONCLUSION: DAT is a reliable treatment alternative for the replacement of lost teeth. The procedure yields low complication rates of infection-related root resorption, ankylosis, and pulp necrosis, while achieving high rates of survival and success. It can be accomplished with donor teeth that have an open or closed apex.

PMID:41469883 | DOI:10.1186/s12938-025-01450-0

Lipids Health Dis. 2025 Dec 30. doi: 10.1186/s12944-025-02840-y. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the associations between longitudinal body roundness index (BRI) trajectories and the risk of incident diabetes mellitus (DM) using data from the China Health and Retirement Longitudinal Study (CHARLS).

METHODS: Group-based trajectory modeling (GBTM) identified distinct BRI trajectories (Waves 1-3, 2011-2016). Their associations with DM incidence (Wave 4, 2017-2018) were assessed using multivariate Cox models. The predictive performance of a single baseline BRI was compared with body mass index (BMI) and waist circumference (WC) via receiver operating characteristic (ROC) analysis. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) evaluated the incremental value of adding BRI trajectories to a conventional risk model. Subgroup and sensitivity analyses, including a landmark approach, assessed robustness.

RESULTS: Among 4,150 participants, 103 developed DM. Three stable BRI trajectories were identified: low-stable (49.0%), moderate-stable (41.3%), and high-stable (9.7%). Compared with the low-stable group, the high-stable group had a significantly increased DM risk with a fully-adjusted hazard ratio (HR) of 2.63 (95% confidence interval [CI]: 1.41-4.91). A single baseline BRI showed comparable discrimination to BMI and WC (AUC ≈ 0.63). Longitudinal trajectories of BRI, BMI, and WC all identified high-stable subgroups with elevated risk (HRs: BRI = 2.63, BMI = 2.16, WC = 2.31), with overlapping confidence intervals. However, adding BRI trajectories to a conventional model significantly improved risk reclassification (NRI = 10.76%, 95% CI: 2.40-19.47) and discrimination (IDI = 0.27%, 95% CI: 0.03-0.52). Results were consistent across subgroups and sensitivity analyses.

CONCLUSIONS: Sustained high BRI exposure, captured by longitudinal trajectory modeling, is independently associated with increased DM risk. While BRI trajectories were not statistically superior to BMI or WC trajectories, the longitudinal framework itself adds value over single-time-point assessments by more robustly identifying individuals with persistent high adiposity-related risk, highlighting the utility of monitoring long-term body shape stability for early risk stratification.

PMID:41469881 | DOI:10.1186/s12944-025-02840-y

BMC Med Educ. 2025 Dec 30. doi: 10.1186/s12909-025-08529-1. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate whether increases in heart rate-used as an objective surrogate marker of rescuer fatigue-could influence CPR performance during infant chest compressions.

METHODS: This study was a manikin-based simulation study that enrolled PALS-certified pediatric emergency nurses matched by clinical experience and randomly assigned to three groups. All participants performed three 2-min cycles of infant chest compressions on a manikin (Little Baby QCPR). Each group completed a 90-s exercise protocol at different time points to induce varying degrees of heart-rate elevation. The primary outcome was the difference in CPR quality across groups according to heart-rate variation (percentage increase from baseline).

RESULTS: Twenty-seven nurses were enrolled and evenly allocated to Groups A, B, and C (n = 9 each). Heart rate increased immediately after exercise in all groups and gradually declined during subsequent compression cycles, with no significant between-group differences at any time point (baseline 85-100 bpm/cycle, peak 130-150 bpm/cycle). Across all cycles, CPR performance metrics-including total compression count, hand-placement accuracy, mean compression velocity, compression depth, and chest recoil-showed no significant within-group changes for any group. Similarly, no significant between-group differences were observed for any CPR parameter during any cycle. In post-hoc analyses, stratification by the median percentage increase in heart rate (> 67.7% vs. < 67.7%) revealed no statistically significant differences in CPR quality between groups.

CONCLUSION: Within this short, three-cycle simulation, exercise-induced heart-rate elevation was not associated with measurable deterioration in infant CPR quality.

PMID:41469879 | DOI:10.1186/s12909-025-08529-1