Tag: nevin manimala

J Gen Intern Med. 2025 Jul 2. doi: 10.1007/s11606-025-09701-5. Online ahead of print.

ABSTRACT

BACKGROUND: Transgender and gender diverse (trans) populations are at elevated risk for atherosclerotic cardiovascular disease (ASCVD).

OBJECTIVE: Measure the association of gender identity and gender-affirming hormone therapy (GAHT) with ASCVD outcomes.

DESIGN: Cohort study.

PARTICIPANTS: Over 1 million veterans receiving care in the Veterans Health Administration.

MAIN MEASURES: Gender identity was identified via a validated natural language processing (NLP) algorithm. Incident ASCVD (acute myocardial infarction, ischemic stroke, or revascularization after the baseline date) was identified via International Classification of Diseases diagnosis codes among veterans without prevalent ASCVD. We calculated sample statistics stratified by gender identity and used Cox proportional hazard regression to assess associations of gender identity and GAHT with incident ASCVD.

KEY RESULTS: Among 1,105,082 veterans, 42,149 were classified as trans (8013 transfeminine, 7127 transmasculine, and 27,009 uncategorized trans) while 918,843 were cisgender men and 144,090 were cisgender women. During a median follow-up of 9.39 years, 92,910 veterans had incident ASCVD (2806 among trans veterans). Adjusting for age, race, Hispanic ethnicity, and sexual orientation, trans veterans had 1.52 [1.45, 1.59] and 0.92 [0.89, 0.96] times the hazard of ASCVD compared to cisgender women and cisgender men, respectively. Compared to trans veterans not receiving GAHT, GAHT among trans veterans assigned female at birth was significantly associated a reduced hazard of ASCVD (0.89 [0.80, 0.98]); GAHT was not associated with ASCVD among trans veterans assigned male at birth (0.99 [0.89, 1.09]).

LIMITATIONS: With NLP, there is potential for selection bias as clinicians may preferentially document the gender identity for trans more than cisgender veterans.

CONCLUSIONS: This is one of the first studies to examine the association of both gender identity and GAHT with incident ASCVD in veterans. Future research must comprehensively evaluate ASCVD outcomes and the effects of gender-affirming care (including hormone therapy) in trans populations.

PMID:40601199 | DOI:10.1007/s11606-025-09701-5

Environ Sci Pollut Res Int. 2025 Jul 2. doi: 10.1007/s11356-025-36657-0. Online ahead of print.

ABSTRACT

In this study, different statistical methodologies were combined to assess the relationship between PM₁₀ concentrations and meteorological variables (temperature, relative humidity, wind direction and speed, and atmospheric pressure) and their associations with other pollutants (CO, NO₂, NO, and O₃) recorded during the period 2021-2024 at Mendoza City, Argentina. The results indicate that increased humidity and temperature might reduce PM₁₀ levels by enhancing particle dispersion and deposition. Positive correlations between PM₁₀, NO, and NO₂ suggest a shared origin, likely from vehicle emissions. To further analyze PM₁₀ behavior, prediction models were developed to categorize PM₁₀ levels as “good” (≤ 45 μg/m³) or “bad” (>45 μg/m³) based on a air quality guidelines from WHO. The performance of the random forest (RF) and logistic regression (LR) algorithms were evaluated and compared. Additionally, the influence of atmospheric variables and pollutant concentrations was also assessed to determine their impact on PM₁₀ predictions. RF model demonstrated the highest predictive performance for PM₁₀ level. Results indicate that NOx (NO₂ and NO) significantly contribute to PM₁₀ formation, likely due to shared anthropogenic sources. Temperature, humidity, and wind speed also impact PM₁₀ predictions, though to a lesser extent than pollutant concentrations. The inclusion of these variables highlights the role in the dispersion and transformation of air pollutants. Implementing such models could provide policymakers with real-time data to enhance pollution control and public health protection.

PMID:40601188 | DOI:10.1007/s11356-025-36657-0

Rheumatol Ther. 2025 Jul 2. doi: 10.1007/s40744-025-00780-8. Online ahead of print.

ABSTRACT

INTRODUCTION: The prevalence of knee osteoarthritis (OA) is rising worldwide, leading to disability and a reduced quality of life, particularly in elderly patients. While there are several treatment options, there is little consensus in the scientific community over which methods are most effective. Viscosupplementation with hyaluronic acid (HA) has been found to reduce pain in patients with knee OA over a period of up to 6 months, with little to no side effects. The aim of this prospective open-label, uncontrolled, observational, single-site study was to assess the efficacy and safety of a single hybrid HA injection over a period of 6 months in subpopulations of patients with low to severe symptomatic knee OA in everyday clinical practice.

METHODS: Fifty patients who met the inclusion criteria participated in the study. A single intra-articular ultrasound-guided injection of hybrid HA (Sinovial®) was administered. Patients submitted Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaires at 28, 42, 84, and 168 days post-treatment.

RESULTS: VAS scores measured at rest and when walking indicate an improvement during follow-up, particularly at 28 and 42 days, compared to baseline. Similarly, the most notable improvement of the WOMAC score was observed within the first 42 days after injection. While decrease in pain and joint function improvement were not as pronounced at the end of follow-up, they were still statistically better than at baseline. Overall patient satisfaction was high.

CONCLUSION: Treatment with a single injection of hybrid HA was demonstrated to be safe and effective in patients with varying degrees of knee OA. Patients with medial knee OA responded better to treatment than patients with patellofemoral OA, which provides information on which types of patients are best suited to this intervention.

TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT06652893. Retrospectively registered October 10, 2024.

PMID:40601162 | DOI:10.1007/s40744-025-00780-8

Clin Oral Investig. 2025 Jul 2;29(7):370. doi: 10.1007/s00784-025-06445-8.

ABSTRACT

OBJECTIVES: The consumption of energy drinks with high sugar and acid content is common among adolescents and may contribute to the development of white spot lesions (WSL) during orthodontic treatment. This study aimed to assess the incidence and localization of WSL in adolescents with high energy drink consumption treated with completely customized lingual appliances (CCLAs).

MATERIALS AND METHODS: Eligible for inclusion in this retrospective cohort study were adolescents (< 18 years) who underwent orthodontic treatment with CCLAs, consumed ≥ 2 energy drinks daily, and developed ≥ 1 new labial WSL on a non-bonded surface. High-resolution intraoral photographs before (T0) and after (T1) treatment were evaluated for the presence of WSL (yes/no) on maxillary and mandibular incisors and canines. Differences in WSL rates between labial and lingual surfaces were analyzed using paired t-tests (α = 0.05).

RESULTS: A total of 38 patients (mean age 15.2 ± 1.4 years; 11 females, 27 males) with 912 tooth surfaces were included. At T0, 70 (15.4%) labial surfaces and 5 (1.1%) lingual surfaces showed WSL. At T1, WSL increased to 243 (51.4%) labial surfaces and 45 (9.9%) lingual surfaces. Although the appliance was bonded only to the lingual surface, the incidence of WSL per patient was four times higher on the non-bonded labial surfaces: 4.3 ± 2.1 (36.0%) labial versus 1.1 ± 1.9 (8.8%) lingual. This difference was statistically significant (p < 0.001).

CONCLUSIONS: Orthodontic treatment with CCLAs in adolescents with frequent energy drink consumption was associated with significantly fewer WSL on bonded lingual surfaces compared to non-bonded labial surfaces.

CLINICAL RELEVANCE: Lingual orthodontic appliances are beneficial in patients at high-risk for WSL.

PMID:40601131 | DOI:10.1007/s00784-025-06445-8

Curr Diab Rep. 2025 Jul 2;25(1):40. doi: 10.1007/s11892-025-01598-y.

ABSTRACT

PURPOSE OF REVIEW: Lower extremity amputations (LEAs) are among the most severe complications of diabetes, with approximately 1.5 million procedures performed globally each year. This review explores the impact of social and structural determinants of health on amputation rates in diabetic patients, highlighting disparities driven by systemic factors.

RECENT FINDINGS: Structural determinants such as healthcare policies and economic systems intersect with social factors, including access to care, racial disparities, and socioeconomic status, influencing amputation risk. Black patients with diabetes face up to a fourfold increased risk of major amputation compared to non-Hispanic white patients. Lower socioeconomic status is also strongly linked to higher amputation rates. Geographic and environmental factors, like food deserts and limited access to specialized care, further exacerbate these disparities. Emerging prevention strategies, such as telemedicine and mobile health units, demonstrate promise in improving access to care. Addressing disparities in LEAs requires comprehensive policy changes and targeted interventions. Future directions include leveraging artificial intelligence and precision medicine alongside community-based programs to reduce amputation rates in high-risk diabetic populations.

PMID:40601126 | DOI:10.1007/s11892-025-01598-y

Neurosurg Rev. 2025 Jul 2;48(1):540. doi: 10.1007/s10143-025-03684-x.

ABSTRACT

Cerebral vasospasm (CVS) is a severe complication associated with significant morbidity and in-hospital mortality. While well characterized in aSAH, its occurrence following AVM-related hemorrhage remains less understood. To address this gap, a meta-analysis adhering to PRISMA guidelines was conducted, with two independent authors searching PubMed, Scopus, and Web of Science from inception to July 2024, seeking studies on CVS risk factors following AVM-related hemorrhage. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Dichotomous variables were pooled into an overriding odds ratio (OR) with a 95% confidence interval (CI), while continuous variables were analyzed using the mean difference (MD) with a 95% CI, both using a random-effects model. Out of 2360 screened articles, 4 studies met the inclusion criteria, totaling 7483 AVM-related hemorrhage patients, 958 of whom developed CVS. All studies were rated high quality, according to NOS. A total of 10 extractable demographic, behavioral, clinical, and radiographic variables reported in the literature were assessed. The following CVS risk factors were statistically significant: younger age (MD = -4.99; 95% CI [-9.40 to -0.57]; p = 0.03), female sex (OR = 1.72; 95% CI [1.50-1.98]; p < 0.00001), and intraventricular hemorrhage (OR = 1.24; 95% CI [1.04-1.48]; p = 0.02). Subarachnoid hemorrhage was close to significance (OR = 1.17; 95% CI [1.00-1.36]; p = 0.05). This is the first systematic review and meta-analysis to identify risk factors for CVS in the context of AVM-related hemorrhage. The presented findings may aid clinicians in recognizing high-risk individuals. Further research is warranted to develop a reliable risk scoring system that can predict AVM-associated CVS in clinical settings and to further explore the differences between CVS following aSAH and AVM-related hemorrhage.

PMID:40601117 | DOI:10.1007/s10143-025-03684-x

J Med Entomol. 2025 Jul 2:tjaf084. doi: 10.1093/jme/tjaf084. Online ahead of print.

ABSTRACT

Larviciding is an important part of effective integrated mosquito management. However, growing resistance to chemical- and bacterial-based insecticides requires biocontrol agents with novel modes of action. Entomopathogenic fungi are good candidates for larval control due to their capability to infect mosquito larvae and their production of larvicidal compounds. In this study, we isolated a strain of Trichoderma atroviride from Aedes albopictus larvae collected in Manhattan, KS, USA. We used a laboratory-based microcosm assay to expose L3 Ae. albopictus larvae to T. atroviride conidia and culture supernatant treatments. Larvae were monitored daily for survival and development to pupae and adults. In addition, adult survival was monitored for 10 d postpupation, and wing lengths were measured to assess mosquito size. Our results revealed that T. atroviride culture supernatant was a potent larvicide toward Ae. albopictus. However, conidia by themselves were not larvicidal, indicating the major mode of killing was through toxicity exerted by the culture supernatant. We further show that larval exposure to T. atroviride supernatant delayed larval development to pupae. Sex-specific adult survival was not affected by larval exposure to T. atroviride. However, wing length of male and female mosquitoes were reduced, indicating a reduction in adult mosquito body size as compared to the control. Taken together, this study identifies the culture supernatant from a novel strain of T. atroviride as a potent larvicide of Ae. albopictus, potentially expanding the toolbox for biological control of mosquitoes.

PMID:40600310 | DOI:10.1093/jme/tjaf084

J Neurotrauma. 2025 Jul 2. doi: 10.1089/neu.2025.0126. Online ahead of print.

ABSTRACT

Targeted manipulation of dietary omega-3 and omega-6 fatty acids has previously been shown to decrease nontraumatic headaches in controlled trials. This study assessed the effects of a diet high in omega-3 fatty acids and low in omega-6 linoleic acid (H3L6 diet) on headache frequency and severity, headache impact, and plasma nociceptive mediators in a persistent post-traumatic headache (pPTH) population. One hundred and twenty-two participants with pPTH were randomized 1:1 to 12 weeks of either the H3L6 (n = 62) or a control (n = 60) diet. A priori primary end-points were the plasma levels of the antinociceptive docosahexaenoic acid (DHA) derivative 17-hydroxy-DHA and the Headache Impact Test (HIT-6) score. Secondary end-points included headache days/month and average daily headache pain intensity (0-10 scale). Statistical analyses followed intention-to-treat principles and were adjusted for baseline values. Relative to the control group, the H3L6 group significantly reduced headache days/month (-2.1, 95% confidence interval [CI]: -3.5 to -0.8, p = 0.002) and average headache intensity (-0.9, 95% CI: -1.2 to -0.5, p < 0.001) and increased circulating 17-hydroxy-DHA (nanograms/milliliter; difference 0.07, 95% CI: 0.02-0.11, p = 0.003), although it did not significantly improve HIT-6 scores (-1.6, 95% CI: -4.0 to 0.8, p = 0.18). In conclusion, the H3L6 diet reduced headache pain and increased antinociceptive mediators, supporting its potential as an adjunct nonpharmacological pPTH therapy.

PMID:40600308 | DOI:10.1089/neu.2025.0126

Addiction. 2025 Jul 2. doi: 10.1111/add.70123. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Dispensing of prescription stimulants to adults has risen dramatically over the past decade. Examining trends in nonprescribed use of prescription stimulants can inform public health responses. Most studies in the United States (U.S.) have faced challenges in assessing trends over time due to changes in survey methodologies and variation in populations assessed. We examined data from the Population Assessment of Tobacco and Health (PATH) Study to assess changes in nonprescribed use of prescription stimulants in the U.S. from 2013 to 2022.

DESIGN: The PATH Study is an ongoing longitudinal study of U.S. youth and adults, representative of the civilian noninstitutionalized population. Repeated cross-sectional estimates at each wave were used (8 total waves). Trends from Wave (W) 1 (September 2013-December 2014) to W7 (January 2022-April 2023) were assessed. Full-sample and replicate weights were used; joinpoint analyses and wave-to-wave comparisons were applied to test trends.

SETTING: Civilian noninstitutionalized U.S. youth and adults.

PARTICIPANTS/CASES: Youth aged 12-17 and adults aged 18 + were assessed, with a total of 45 727 participants at wave 1 (Ns vary by wave).

MEASUREMENTS: Past 12-month (P12M) prevalence of nonprescribed use of Ritalin or Adderall was assessed. Nonprescribed use of stimulants was assessed across subgroups according to age (12-17, 18-24, 25-39, ≥40) and sex (male, female).

FINDINGS: While wave-to-wave comparisons showed fluctuations across certain waves, overall, there were no statistically significant changes in P12M prevalence of Ritalin or Adderall nonprescribed use (1.3% at W1 and 1.5% at W7) across the study period. However, statistically significant differences in trends existed across age groups. Among 12-17 year-olds, nonprescribed use prevalence remained stable (1.4% in W1 and 1.5% in W7). Nonprescribed use prevalence also remained stable for 18-24-year-olds from W1 to W3, but then significantly declined (p = 0.016) from W3 (5.3%) to W7 (2.6%). There were no significant changes in nonprescribed use prevalence among 25-39-year-olds (1.7% in W1 and 2.4% in W7) and those aged ≥40 (0.3% in W1 and 0.9% in W7). Across most waves, young adults aged 18-24 had a statistically significantly higher prevalence of nonprescribed use. Neither sex had significant trends in P12M nonprescribed use prevalence.

CONCLUSIONS: Despite an increase in dispensing of prescription stimulant medications in the United States, the prevalence of nonprescribed Ritalin or Adderall use does not appear to have increased, as assessed in the nationally representative Population Assessment of Tobacco and Health (PATH) Study. The prevalence of nonprescribed Ritalin or Adderall use among young adults aged 18-24, the age group with the highest nonprescribed use prevalence, declined 2013 to 2022.

PMID:40600292 | DOI:10.1111/add.70123

Multivariate Behav Res. 2025 Jul 2:1-24. doi: 10.1080/00273171.2025.2496507. Online ahead of print.

ABSTRACT

The social relations model (SRM) is a linear random-effects model applied to examine dyadic round-robin data within social networks. Such data have a unique multilevel structure in that dyads are cross-classified within individuals who may be nested within different social networks. The SRM decomposes perceptual or behavioral measures into multiple components: case-level random effects (in-coming and out-going effects) and dyad-level residuals (relationship effects), the associations among which are often of substantive interest. Multivariate SRM analyses are increasingly common, requiring more sophisticated estimation algorithms. This article evaluates Markov chain Monte Carlo (MCMC) estimation of multivariate-SRM parameters, compares MCMC to maximum-likelihood estimation, and introduces two methods to reduce bias in MCMC point estimates using empirical-Bayes priors. Four simulation studies are presented, two of which reveal dependency of small-group results on priors by manipulating location and precision hyperparameters, respectively. The third simulation study explores the impact of sampling more small groups on prior sensitivity. The fourth simulation study explores how Bayesian model averaging might compensate for underestimated variance due to empirical-Bayes priors. Finally, recommendations for future research are made and extensions of the SRM are discussed.

PMID:40600284 | DOI:10.1080/00273171.2025.2496507