Tag: nevin manimala

Folia Med Cracov. 2025 Sep 30;65(3):85-100. doi: 10.24425/fmc.2025.156686.

ABSTRACT

INTRODUCTION: Population aging is associated with increased problems of physical and functional fitness in geriatric patients. Fitness constitutes a key element of independence and quality of life in elderly individuals. The proprioceptive neuromuscular facilitation (PNF) method is widely used in orthopedic and neurological rehabilitation; however, there is a lack of research on its comprehensive application in elderly patients in hospital settings.

OBJECTIVE: To assess the impact of the PNF concept on independence in elderly individuals and to compare the effectiveness of the PNF method with general rehabilitation (GR) during a maximum 10-day hospital treatment.

MATERIAL AND METHODS: The study included 80 randomly selected patients over 64 years of age hospitalized in the Department of Internal Medicine and Geriatrics. Patients were randomly divided into two 40-person groups: GR and PNF. Functional fitness assessment was conducted at the beginning of rehabilitation and after a maximum of 10 days of therapy or on the day of discharge. The following were used: ADL assessment, IADL, Up & Go test, SPPB test, balance assessment, gait speed measurement, 5-times sit-to-stand test, and NRS scale.

RESULTS: Patients rehabilitated according to the PNF concept achieved statistically significantly greater improvement in functional and physical fitness compared to the GR group.

CONCLUSIONS: The PNF method in elderly individuals allows for more effective achievement of the main goal of rehabilitation, which is reaching maximum patient independence.

PMID:41404686 | DOI:10.24425/fmc.2025.156686

Folia Med Cracov. 2025 Sep 30;65(3):71-83. doi: 10.24425/fmc.2025.156685.

ABSTRACT

BACKGROUND: Core stability allows to control and properly perform movements of all body. Optimal core stability level depends on deep muscles capacity and neuromuscular control. Poor core stability is a risk factor for injury, especially during physical activity.

OBJECTIVE: The purpose of this study was to examine the differences in core stability between sport and recreational horse riders and people, who don’t do any sports. We hypothesized that horse riders demonstrate better core stability performance.

METHODS: 75 people aged 15-30 (20 recreational horse riders, 20 sport horse riders and 35 non-horse riders) was examined in 4 core stability tests. Individuals were assigned to each group based on authors questionnaire. Differences between groups were assessed by analysis of variance (ANOVA).

RESULTS: The study showed that sport horse riders have the best core stability. Recreational riders, who trained for shorter periods of time obtained much lower results in each test. The non-horse rider group demonstrated the worst results. There was no statistically significant relationship between the frequency of equestrian training and tests results.

CONCLUSIONS: Horse riding increases core stability and has a positive effect on all its parameters. The longer the equestrian training, the better core stability.

PMID:41404685 | DOI:10.24425/fmc.2025.156685

bioRxiv [Preprint]. 2025 Nov 26:2025.11.23.690024. doi: 10.1101/2025.11.23.690024.

ABSTRACT

To characterize key transcription factors (TFs) whose differential DNA binding can be altered by genetic variants associated with risk for renal cell carcinoma (RCC), we conducted a series of mixed model-based analyses integrating 449 TF ChIP-seq profiles across 9 kidney-related cell lines and summary statistics from a multi-ancestry genome-wide association study of RCC. We identified 96 unique TFs for which presence of SNPs in a neighborhood of TF ChIP-seq peaks are significantly associated (p-value <1×10-4) with their effect on RCC, including EPAS1, ARNT, PAX8 and PBRM1, previously implicated in RCC pathogenesis. Most TFs overlapped active promoters/enhancers in RCC tumors but remained significant after adjusting for tumor chromatin accessibility. Further, we found the co-occupancy of 220 pairs of RCC-related TFs to be associated with RCC risk (FDR<5%) beyond effects of individual TFs, highlighting synergistic regulation between pairs of TFs. To further investigate distal (trans) regulation of TF-binding disruption at RCC associated loci on the proteome, we used a set-based regression to aggregate the trans-effects of multiple loci overlapping with TF binding sites. Across 2,732 proteins profiled in UKB-PPP, identified 169 trans-associated (p-value<1.6×10-7) proteins, nominating specific targets for each TF. For example, we identified TLR3 and ZP3 to be associated with EPAS1, ARNT, and PBRM1, indicating these proteins are likely affected by RCC-related variants disrupting binding sites of the corresponding TFs. These results characterize the landscape of RCC-related TFs and implicate TF-mediated proteomic mechanisms in RCC pathogenesis, nominating testable targets for laboratory studies.

PMID:41404623 | PMC:PMC12703995 | DOI:10.1101/2025.11.23.690024

Front Med (Lausanne). 2025 Dec 1;12:1665389. doi: 10.3389/fmed.2025.1665389. eCollection 2025.

ABSTRACT

OBJECTIVE: To investigate the effects of different endocrine therapies (tamoxifen, aromatase inhibitors, selective estrogen receptor modulators) on bone mineral density (BMD) and fracture risk in postmenopausal breast cancer patients.

METHODS: A systematic search was conducted in PubMed, Medline, Web of Science, Cochrane Library, and EMBASE databases to identify randomized controlled trials (RCTs). The quality of RCTs was assessed using the Cochrane Risk of Bias Tool, Meta-analysis was performed using RevMan 5.3 software, with primary outcome measures including changes in BMD and fracture risk.

RESULTS: A total of five studies involving 20,531 patients were included. Meta-analysis results showed: Osteoporosis incidence: Pooled analysis of two studies yielded pooled odds ratio OR of 0.35 (95% CI: 0.04, 3.00), indicating a slight but non-significant advantage in reducing fracture risk in the experimental group compared to the control group (Z = 0.96, P = 0.34). This finding is based on only two studies, so there is uncertainty associated with it. Heterogeneity was low (I² = 97%). fracture risk: The pooled OR from four studies was 1.40 (95% CI: 1.25, 1.57), demonstrating a statistically significant increase in fracture risk in the experimental group (Z = 5.92, P < 0.001) with low heterogeneity (I ² = 29%).

CONCLUSION: The conclusions of this analysis were constrained by the limited number of available studies. Different endocrine therapies might exert varying effects on bone health. Aromatase inhibitors significantly reduce BMD and increase fracture risk, whereas selective estrogen receptor modulators might have a protective effect on bone. These relationships need confirmation in larger studies. Clinicians should consider bone health among other factors when selecting endocrine therapy.

PMID:41404579 | PMC:PMC12702863 | DOI:10.3389/fmed.2025.1665389

Front Med (Lausanne). 2025 Dec 1;12:1638127. doi: 10.3389/fmed.2025.1638127. eCollection 2025.

ABSTRACT

INTRODUCTION: Sirāgranthi results from vitiated vāta in sirās, leading to granthi due to Vātaprakopaka nidānas. Ācārya Vagbhata recommends sirāvyadha for treating sirāgranthi. The role of inflammation in vascular diseases is explored, with a focus on Interleukin-6 as a key biomarker. The absence of studies on sirāvyadha’s impact on inflammatory biomarkers, particularly Interleukin-6, underscores the study’s relevance, aiming to observe changes in inflammatory response in varicose veins post-sirāvyadha within a 15-day period.

OBJECTIVE: To observe changes in IL-6 values before and after sirāvyadha within a 15-day period in individuals with varicose veins. Materials and Methods: After excluding deep vein thrombosis (DVT) through lower limb color doppler, five subjects who satisfied the inclusion criteria were selected. Assessments included BT, CT, Hb screening, and parameters like AVVQ, pain, edema, tortuosity, skin pigmentation, and itching. Sirāvyadha was performed over the tortuous vein with an 18G needle, and sample was collected from drained blood for IL-6 testing. After a 15-day follow-up, Sirāvyadha was repeated, and assessment of all parameters were done.

RESULTS: Statistically significant differences (p<0.05) were observed after treatment in Interleukin-6, AVVQ, pain, edema, tortuosity, and skin pigmentation. However, itching showed no statistically significant difference after treatment (p > 0.05).

CONCLUSION: In all 5 cases, a reduction in the rate of IL-6 was observed. Remarkably, three patients with initially high values showed a statistically significant reduction (p < 0.05) after sirāvyadha treatment, indicating a reduction in inflammation. Clinical and statistical significance (p < 0.05) were also observed in subjective parameters such as pain, edema, tortuosity, and skin pigmentation. Although itching decreased in patients, it did not reach statistical significance, possibly due to some patients not experiencing itching before the procedure. The study demonstrates that sirāvyadha effectively reduces the inflammatory response and subjective symptoms of varicose veins. Furthermore, the improvement in the quality of life after sirāvyadha was highly significant (p < 0.05). Overall, the study supports sirāvyadha’s efficacy in reducing inflammatory biomarker IL-6 and subjective symptoms in varicose veins.

PMID:41404578 | PMC:PMC12702841 | DOI:10.3389/fmed.2025.1638127

Front Med (Lausanne). 2025 Dec 1;12:1547410. doi: 10.3389/fmed.2025.1547410. eCollection 2025.

ABSTRACT

BACKGROUND: Diabetic nephropathy (DN) is characterized by tubular injury and tubulointerstitial fibrosis, leading to progressive renal dysfunction. While dysregulation of autophagy has been linked to DN pathogenesis, the underlying regulatory mechanisms remain incompletely understood. This study aimed to test the hypothesis that transcription factor 3 (TCF3) serves as a critical upstream regulator of autophagy dysfunction in DN by suppressing Netrin-1 expression, thereby promoting epithelial-mesenchymal transition (EMT) through activation of the PI3K/Akt/mTOR pathway.

METHODS: We established a DN rat model using high-fat diet followed by low-dose streptozotocin injection (25 mg/kg). Thirty-five male Sprague-Dawley rats were divided into five groups (n = 6-7/group, with specific numbers clearly defined for each experimental condition): control, DN, DN + vector, DN + TCF3-shRNA lentivirus, and DN + TCF3-shRNA + 3-methyladenine (3-MA). All key experiments were performed with at least three independent biological replicates. In vitro, HK-2 cells were categorized into four groups: normal glucose (NG, 5.5 mmol/L), high glucose (HG, 30 mmol/L), HG with negative control siRNA (HG + si-NC), and HG with TCF3-targeting siRNA (HG + TCF3-siRNA). Western blotting was utilized to determine the expression levels of autophagy-related proteins, EMT-associated proteins, and PI3K/Akt/mTOR signaling pathway-related proteins. Quantitative real-time polymerase chain reaction (qRT-PCR) was employed to assess the mRNA expression levels of TCF3 and Netrin-1. Additionally, a dual-luciferase reporter gene assay was performed to investigate the interaction between TCF3 and Netrin-1. Statistical analyses were performed using one-way ANOVA followed by Tukey’s post-hoc test, with p < 0.05 considered statistically significant.

RESULTS: We first confirmed that TCF3 expression was significantly elevated in both DN rat kidneys (2.8-fold increase at protein level, p < 0.001) and high glucose-treated HK-2 cells (2.5-fold at protein level, p < 0.001) compared to controls. Both the DN rat model and HG-stimulated HK-2 cells exhibited enhanced EMT markers, with significantly increased α-SMA and vimentin expression (p < 0.001), and decreased E-cadherin levels (p < 0.001). TCF3 knockdown significantly attenuated these EMT changes and increased autophagy markers, as evidenced by decreased P62 levels (p < 0.01) and increased LC3-II/I ratio (p < 0.001) and Beclin-1 expression (p < 0.01). The dual luciferase assay confirmed direct binding of TCF3 to the Netrin-1 promoter, with a 57% ± 4.3% reduction (p < 0.001) in luciferase activity. Mechanistically, TCF3 silencing mitigated HG-induced fibrosis and promoted autophagy by increasing Netrin-1 expression and suppressing the PI3K/Akt/mTOR signaling pathway.

CONCLUSION: Our findings demonstrate that TCF3 functions as a critical negative regulator of autophagy in DN, establishing a novel TCF3-Netrin-1-autophagy regulatory axis. This study provides new mechanistic insights distinct from previous work by demonstrating the direct transcriptional repression of Netrin-1 by TCF3 in renal pathophysiology. The limitation of our study includes the lack of human DN tissue validation and TCF3-specific pharmacological inhibitors. These findings suggest TCF3 as a potential therapeutic target for preventing renal fibrosis in DN through restoration of autophagy function.

PMID:41404576 | PMC:PMC12702734 | DOI:10.3389/fmed.2025.1547410

Front Public Health. 2025 Dec 1;13:1648606. doi: 10.3389/fpubh.2025.1648606. eCollection 2025.

ABSTRACT

BACKGROUND: Fractures are among the most common traumatic injuries in China, with rising incidence driven by population aging, traffic accidents, and sports injuries. They impose a heavy economic burden due to high treatment costs and prolonged rehabilitation. To improve cost efficiency, China launched a nationwide Diagnosis-Related Groups (DRG) payment reform in 2019. While DRG has shown positive effects in controlling costs for chronic diseases, its impact on trauma-related conditions like fractures remains unclear due to clinical complexity and treatment variability. Existing research mostly focuses on epidemiology, lacking economic evaluations under the DRG system. This study aims to assess how DRG reform influences the inpatient cost structure of fracture patients and explore differential effects across comorbidity and fracture types, providing evidence for more refined payment strategies in trauma care.

METHODS: Using data from 12,101 hospitalized fracture patients (ICD-10 codes S22-S92) admitted to a tertiary hospital in Anshan, Liaoning Province between 2018 and 2024, we conducted a structural change analysis to assess shifts in the composition of inpatient costs before and after the introduction of the DRG payment system. An interrupted time series (ITS) model was applied to estimate both the immediate impact and the longitudinal trend changes associated with the DRG reform initiated on July 1, 2019. In addition, gray relational analysis was employed to further examine the relative contribution of different cost categories to overall expenditure.

RESULTS: A total of 12,101 fracture inpatients were included, covering the entire period before and after the DRG reform. Significant changes in the cost structure were observed post-implementation. The median drug cost decreased from 3,416.06 CNY to 2,796.74 CNY (a reduction of 18.1%). Although the proportion of consumables costs slightly increased (median rose from 7,358.12 CNY to 7,465.64 CNY), the growth rate significantly slowed (p < 0.05). Meanwhile, therapeutic costs (median increased from 1,015.38 CNY to 1,200.91 CNY) and the proportion of surgical fees rose, indicating a shift of medical resources toward technical services under DRG. Rehabilitation costs declined in certain fracture types (e.g., femoral fractures, S72), but increased in others (e.g., lower leg fractures, S82), reflecting DRG’s differential effects on treatment stages. Structural variation analysis showed the greatest fluctuation in consumables costs in spinal fracture cases (S32 group, DsV = 2170.42%), while drug costs significantly declined in the S72 group (DsV = -39.78%). Patients with comorbidities experienced more pronounced structural adjustments-for example, the structural variation in the hypertensive group was 15.3% higher than that in the non-comorbidity group (p < 0.01), suggesting stronger cost-control effects of DRG in complex cases. ITS analysis revealed that the DRG reform had a significant impact on costs across various fracture types (p < 0.05). For total costs, S32 fractures exhibited a reversal from a pre-policy increasing trend (β₁ = 1247.93) to a rapid decreasing trend (β₃ = -2467.0). After the DRG implementation, diagnostic costs showed an increasing trend in most fracture types, while decreasing significantly in S32 fractures (β₃ = -227.16); in contrast, S72 fractures demonstrated a notable increase (β₃ = 52.86). Treatment and medication costs generally displayed decreasing trends, with the most pronounced decline observed in medication costs for S32 fractures (β₃ = -355.1). Consumables costs exhibited a divergent pattern, characterized by an anomalous increasing trend in S42 fractures (β₃ = 1578.62). Rehabilitation costs showed a universal decreasing trend, with the most significant control effect seen in S32 fractures (β₃ = -483.58). Gray relational analysis indicated that, before and after DRG implementation, the cost struetures of different fracture types exhibited distinct patterns of change. In S22 and S42 fractures, the correlation coefficients of diagnostic and drug-related costs increased notably, with all categories in S42 rising to 0.89-0.90, reflecting a highly concentrated cost structure. S32 and S82 fractures showed overall stability or slight increases across cost categories. In contrast, S52 and S62 fractures demonstrated a general decline, particularly in therapeutic, consumable, and rehabilitation costs. S72 fractures remained relatively stable, with minimal fluctuations in correlation coefficients. S92 fractures displayed increases across all cost categories with balanced magnitudes, indicating a comprehensive enhancement. Overall, different fracture types exhibited distinct patterns of cost structure adjustment following DRG implementation.

CONCLUSION: The DRG-based payment reform effectively controlled pharmaceutical expenditures while increasing diagnostic costs, leading to fracture-type-specific shifts in treatment structure and highlighting the need for differentiated management strategies. This study provides empirical evidence to support the optimization of DRG payment standards and the advancement of healthcare payment reform.

PMID:41404571 | PMC:PMC12704093 | DOI:10.3389/fpubh.2025.1648606

Front Public Health. 2025 Dec 1;13:1675383. doi: 10.3389/fpubh.2025.1675383. eCollection 2025.

ABSTRACT

OBJECTIVE: To explore the correlation between body mass index (BMI) and cognitive impairment in type 2 diabetes patients through a cross-sectional observational study.

METHODS: Data on basic information and cognitive impairment of type 2 diabetes were collected through questionnaires, and the correlation between BMI and cognitive impairment of type 2 diabetes was analyzed using logistic regression model, restricted cubic spline (RCS) model and subgroup analysis. At the same time, the interaction between BMI and exercise, living status and other factors was tested.

RESULTS: A total of 565 valid samples were included in this study and 51.15% had cognitive impairment. The mean BMI score was 24.51 ± 2.16 kg/m². An inverse association between BMI score and cognitive impairment in patients with was observed in all three models. Subsequent regression analysis using RCS confirmed this nonlinear association and found two inflection points at 23.72 kg/m² and 27.77 kg/m². Specifically, cognitive impairment increased with decreasing BMI at BMI scores <23.72 kg/m², was least expressed in the interval 23.72-27.77 kg/m², and increased with increasing BMI scores >27.77 kg/m². In addition, the interaction between BMI and factors such as exercise and lifestyle was examined, and the results showed that the interaction did not reach the statistical significance level.

CONCLUSION: Observations indicate that the U-shaped relationship between cognitive impairment and BMI observed in middle-aged and older adults with type 2 diabetes was more pronounced in those who live alone and are physically inactive. Although the interaction test was not significant, the subgroup analysis suggested that middle-aged and older adults with type 2 diabetes who live alone and are physically inactive may need to manage their BMI more rigorously.

PMID:41404570 | PMC:PMC12702732 | DOI:10.3389/fpubh.2025.1675383

Front Public Health. 2025 Dec 1;13:1670577. doi: 10.3389/fpubh.2025.1670577. eCollection 2025.

ABSTRACT

BACKGROUND: Frailty is a common geriatric syndrome that imposes a heavy disease burden globally. Indoor ventilation is a crucial measure for improving air quality. However, the association between indoor ventilation frequency (IVF) and frailty remains unclear. This study aimed to explore this association among Chinese older adults.

METHODS: We used data from 5,511 older adults in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2018 and an external validation sample of 718 older adults from Chongqing. Logistic regression models and linear regression models were employed to assess the association between IVF and frailty and its seasonal variations. We further conducted subgroup analysis to examine differences across various populations. All statistical analyses were performed using SPSS 25.0 and R 4.3.0.

RESULTS: Compared with low ventilation frequency, intermediate (OR = 0.722, 95% CI: 0.559 ~ 0.933) and high (OR = 0.824, 95% CI: 0.643 ~ 0.995) frequencies were significantly associated with a lower risk of frailty. Seasonal analysis revealed that this inverse association was particularly significant in autumn and winter. Subgroup analysis suggested that this association was more pronounced in subgroups such as females, older adults over 80 years old, and those who use non-clear energy for cooking. External validation data from Chongqing supported these findings.

CONCLUSION: This research demonstrated a significant association between IVF and frailty among Chinese older adults. These findings provide supportive evidence for considering ventilation behavior in public health strategies aimed at promoting healthy aging.

PMID:41404569 | PMC:PMC12704094 | DOI:10.3389/fpubh.2025.1670577

Front Public Health. 2025 Dec 1;13:1631596. doi: 10.3389/fpubh.2025.1631596. eCollection 2025.

ABSTRACT

Acquired Immunodeficiency Syndrome (AIDS), caused by the Human Immunodeficiency Virus (HIV), remains a major public health problem in Brazil. Infection rates vary greatly between regions and states. The North region, in particular, has a higher number of cases, making it a long-lasting challenge, especially in a region with many social and economic challenges. This ecological, descriptive, and analytical study examined AIDS trends across Northern Brazilian states from 2013 to 2023 using data from Brazil’s Notifiable Diseases Information System (SINAN), Mortality Information System (SIM) and national HIV/AIDS epidemiological reports. Our R-based analytical approach incorporated descriptive statistics, Joinpoint regression, linear modeling (calculating trend coefficients, determination coefficients, and p-values with significance at p < 0.05), plus heatmap clustering with dendrograms to evaluate inter-state rate patterns. Spatial variation analysis revealed distinct epidemiological patterns: four states (Amazonas, Amapá, Tocantins, and Rondônia) showed declining detection rates, while Acre experienced a concerning >90% increase despite stable mortality rates. These findings emphasize important groups of cases and identify which states should prioritize public health efforts. This information can assist in more effectively allocating resources to areas with the most cases.

PMID:41404554 | PMC:PMC12702984 | DOI:10.3389/fpubh.2025.1631596