Tag: nevin manimala

Sci Rep. 2025 Dec 31. doi: 10.1038/s41598-025-33124-1. Online ahead of print.

ABSTRACT

The impact of Dexmedetomidine (Dex) use on the prognosis of patients with ventilator-associated pneumonia (VAP) remains a subject worthy of further investigation. This study seeks to evaluate the association between Dex administration and prognosis in critically ill patients with VAP. We conducted a retrospective cohort study using the MIMIC-IV database, including adults (≥ 18 years) with VAP and ICU stays ≥ 24 h. Patients were divided into the DEX group and the non-DEX group based on Dex administration. The primary endpoint was in-hospital mortality, and the secondary endpoint was 90-day survival rate. We used multivariable logistic regression and propensity score matching (PSM) to adjust for baseline imbalances. Kaplan-Meier analysis assessed survival differences. Stratified analyses evaluated temporal trends (2008-2022), dosage (mcg/kg/h), and infusion duration (hours) to further validate the robustness of the results. This research included a total of 1766 VAP patients (DEX: n = 905; non-DEX: n = 861), Dex was associated with reduced in-hospital mortality (unadjusted OR 0.55, 95% CI 0.44-0.69; adjusted OR 0.62, 95% CI 0.47-0.83).The survival curve was calculated based on Kaplan-Meier analysis, which indicated that the DEX group exhibited a relatively longer survival time, and this difference was highly statistically significant (p < 0.001).It is worth mentioning that the mortality reduction remained robust across all sensitivity analyses, including PSM, temporal stratification, and dose-duration subgroups. Dex is associated with significantly lower in-hospital mortality in VAP patients.

PMID:41476257 | DOI:10.1038/s41598-025-33124-1

Eur J Med Res. 2025 Dec 31. doi: 10.1186/s40001-025-03783-x. Online ahead of print.

ABSTRACT

OBJECTIVE: Insulin resistance (IR) plays a critical role in shaping long-term outcomes in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Recent findings suggest that biological sex may influence the onset and progression of MASLD, yet it remains unclear whether sex modifies the link between IR and mortality in those with MASLD and advanced liver fibrosis.

METHODS: We analyzed data from 14,081 MASLD patients (7327 men and 6754 women) drawn from the 2001-2018 cycles of the National Health and Nutrition Examination Survey (NHANES). Participants were categorized based on sex-specific deciles of the Metabolic Score for Insulin Resistance (METS-IR). Kaplan-Meier survival analysis and Cox proportional hazards models were used to assess the association between METS-IR and all-cause mortality. Restricted cubic spline (RCS) modeling explored potential non-linear relationships.

RESULTS: Marked sex-related disparities were identified in clinical and metabolic characteristics. Elevated METS-IR significantly predicted increased all-cause mortality in females with MASLD (log-rank p < 0.001), whereas this trend was not evident in males (p = 0.54). Multivariable Cox models showed that higher METS-IR independently correlated with mortality in women with MASLD and advanced fibrosis, but not in their male counterparts.

CONCLUSION: The prognostic significance of METS-IR differs by sex in MASLD. Elevated METS-IR independently increases long-term mortality risk in females, supporting the need for sex-specific risk evaluation in managing metabolic liver disease.

PMID:41476240 | DOI:10.1186/s40001-025-03783-x

Antimicrob Resist Infect Control. 2026 Jan 1. doi: 10.1186/s13756-025-01688-2. Online ahead of print.

ABSTRACT

BACKGROUND: Antimicrobial resistance refers to the ability of microorganisms to become resistant to antibiotics, fungicides, and other antimicrobial agents, which are essential for treating illnesses in humans, land and water-based animals, and plants. This issue is quickly emerging as a major danger to health, economic stability, and livelihoods. One notable driver of these resistant microorganisms is the misuse of antimicrobial medications.

OBJECTIVE: To assess the practices and perspectives on antimicrobial drug misuse in Wolaita Zone, 2024.

METHODS: This study employed a community-based cross-sectional mixed-methods design. The study data were collected from 423 community residents for the quantitative phase and 15 participants for the qualitative phase, data collection for the quantitative component was collected using structured interview-administered questionnaires, and the qualitative component involved in-depth interviews with purposively selected participants, guided by a structured interview. Quantitative data management involved the use of EpiData V4.6 and the Statistical Package for the Social Sciences for data entry and analysis, respectively. The qualitative data underwent thematic analysis utilizing OpenCode software, a qualitative data analysis tool.

RESULTS: In this study, the quantitative data found that 67.1% of participants misused antimicrobial drugs. The factors significantly associated with the misuse of antimicrobial drugs included educational status [AOR: 1.91 (95% CI: 0.93-2.11)], drug cost [AOR: 3.22 (95% CI: 1.18-5.3)], knowledge regarding the use of antimicrobial drugs [AOR: 2.23 (95% CI: 1.66-4.01)], and adherence to stewardship guidelines [AOR: 3.37 (95% CI: 2.44-9.24)]. Additionally, the qualitative study identified four key themes from the data analysis namely, factors related to drug providers, patient-driven factors, sociocultural influences, and limitations in regulatory and policy frameworks.

CONCLUSION: The study reveals a troubling rate of antimicrobial drug misuse among the population. The finding underscores the urgent need to address the gaps and barriers that impede proper use of antimicrobial drugs. It is recommended that government and non-government health sectors, along with relevant stakeholders, implement educational initiatives and health campaigns to combat this problem.

PMID:41476239 | DOI:10.1186/s13756-025-01688-2

Eur J Med Res. 2025 Dec 31. doi: 10.1186/s40001-025-03726-6. Online ahead of print.

ABSTRACT

OBJECTIVES: The study aimed to investigate a non-invasive biomarker for predicting coronary heart disease by analyzing fecal sulfatide levels.

METHODS: A retrospective study was conducted on 593 patients with coronary heart disease, divided into acute myocardial infarction (AMI), unstable angina pectoris (UAP), and stable angina pectoris groups (SAP), and a control group of 200 healthy adults. General information was collected for analysis, and fecal sulfatide levels were compared among groups. Binary logistic regression analysis assessed the correlation between fecal sulfatide levels and coronary heart disease. Statistical analyses were performed to evaluate the risk factors, and predictive value was assessed using receiver operating characteristic (ROC) curves.

RESULTS: Statistically significant differences were observed in the characteristics of age, complete blood cell count, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol between the group of patients with coronary heart disease and the control group (P < 0.05). Noteworthy, fecal sulfatide levels were notably higher in coronary heart disease groups. Furthermore, fecal sulfatide levels in AMI group significantly exceeded those in SAP and UAP groups (P < 0.05). Multivariate logistic regression analysis identified fecal sulfatide as an independent risk factor for coronary heart disease, with an area under the ROC curve of 0.893 (95% CI 0.869, 0.921), indicating strong predictive value.

CONCLUSIONS: Fecal sulfatide may serve as a novel, non-invasive biomarker for early coronary heart disease prediction and risk stratification. However, the retrospective and single-center design of this study limits the generalizability of the results, and future large-scale, multi-center prospective studies are needed to validate these findings.

PMID:41476236 | DOI:10.1186/s40001-025-03726-6

Eur J Med Res. 2025 Dec 31. doi: 10.1186/s40001-025-03603-2. Online ahead of print.

ABSTRACT

OBJECTIVE: This study investigated clinical methodologies for estimating ingested pesticide volume and evaluated their accuracy in acute oral poisonings.

METHODS: The evaluation of poison ingestion was divided into accurate evaluation, empirical evaluation, and simulated ingestion evaluation. Statistical analysis was conducted using the data of 60 cases of acute oral paraquat poisonings (PQP) in our hospital from the aspect of empirical evaluation, simulated ingestion evaluation, blood toxicant test, and prognosis. Moreover, the measurements of oral capacity and simulated dose were compared in the general population based on sex, age, height, weight, and season.

RESULTS: A significant difference was observed between the amount based on empirical evaluation and that based on simulated ingestion evaluation (P < 0.05). In simulated ingestion evaluation, the amount in males was significantly higher than that in females, and the amount in males was correlated with blood toxicant concentration and prognosis. No statistical difference in oral capacity was observed in the general population based on age, season, and body weight (P > 0.05). Both the maximum and normal mouthfuls in males were statistically different from those in females (P < 0.05, P < 0.05). A statistical difference in oral capacity (maximum mouthful and normal mouthful) was observed among various height groups (P < 0.01, P < 0.05), indicating that the higher the height, the larger the oral capacity.

CONCLUSIONS: Only 7.69% of the cases were allowed for an accurate dose evaluation. The ingested poison dose based on empirical and simulated ingestion evaluation were correlated with blood toxicant concentrations and prognosis in patients with PQP. Factors, such as sex and height, should be considered by physicians in empirical evaluation. It is still a great clinical challenge to accurately evaluate the ingested dose of liquid pesticides.

PMID:41476215 | DOI:10.1186/s40001-025-03603-2

Trop Med Health. 2025 Dec 31;53(1):198. doi: 10.1186/s41182-025-00893-4.

ABSTRACT

INTRODUCTION: Hepatitis B virus (HBV) infection remains a significant global health threat, with over 296 million individuals living with chronic HBV and more than 820,000 annual deaths due to related complications. Healthcare workers (HCWs) are at heightened risk due to occupational exposure, especially in sub-Saharan Africa, where HBV prevalence and health system limitations compound their vulnerability. Despite the availability of an effective vaccine, adherence to the three-dose HBV vaccination schedule among HCWs in Nigeria remains suboptimal. This study seeks to explore the psychosocial and digital factors influencing non-adherence to the HBV vaccination schedule among HCWs in Nigeria, with the aim of informing more targeted and effective interventions.

METHODOLOGY: A cross-sectional survey was conducted among 530 healthcare workers at FMC Keffi to assess Hepatitis B vaccine uptake and its determinants. Data were collected using a structured, pre-validated questionnaire covering vaccination status, knowledge, attitudes, barriers, and digital access. Statistical analyses included descriptive statistics, Chi-square tests, binary logistic regression, mediation (PROCESS Model 4), and moderation analyses. These methods evaluated the direct and indirect effects of knowledge, attitudes, occupational exposure, and digital intervention beliefs on vaccine adherence, with gender assessed as a moderating variable.

RESULTS AND DISCUSSION: Among 530 healthcare workers at FMC Keffi, only 19.4% were fully vaccinated against Hepatitis B, while 72.6% had received at least two doses. Mediation analysis showed that knowledge had no significant direct or indirect effect on vaccine uptake (p = 0.21), whereas attitude was a strong predictor (B = – 9.85, p < 0.001). Occupational exposure significantly influenced adherence (χ2 = 33.00, p < 0.001), as none of the unexposed were fully vaccinated. Gender moderated the attitude-uptake link, with females showing stronger associations. Digital access remained low, limiting the effectiveness of digital intervention strategies.

CONCLUSION: This study concludes that HBV vaccine adherence among healthcare workers is influenced more by attitudinal factors, occupational exposure, and gender dynamics than by knowledge alone. Digital intervention strategies remain underutilized due to limited access. To improve vaccine uptake, health systems must adopt multifaceted approaches that prioritize behavioral insights, gender sensitivity, and equitable access to digital health resources.

PMID:41476203 | DOI:10.1186/s41182-025-00893-4

Virol J. 2025 Dec 31. doi: 10.1186/s12985-025-03054-5. Online ahead of print.

ABSTRACT

BACKGROUND: Long COVID presents significant health challenges, especially for patients with type 2 diabetes. Emerging evidence suggests that sodium-glucose cotransporter-2 (SGLT2) inhibitors may provide protective effects against COVID-19 complications, but their role in reducing long COVID risk remains unclear.

METHODS: Utilizing the TriNetX platform, a retrospective cohort study was conducted among adults with type 2 diabetes diagnosed with COVID-19 between January 1, 2020, and June 30, 2024. Propensity score matching balanced demographic, clinical, and comorbidity profiles between SGLT2 inhibitor users and non-users. Cox proportional hazards regression assessed the risk of long COVID, defined by a spectrum of post-COVID-19 conditions.

RESULTS: Among 5,162 matched pairs, SGLT2 inhibitor use was associated with a significantly lower risk of long COVID (HR = 0.85, 95% CI: 0.79-0.91). In the category of long-COVID symptoms such as abdominal symptoms, anxiety/depression, pain, headache, and cognitive symptoms, there were lower risks observed in the SGLT2 inhibitor group. Subgroup analyses showed consistent risk reduction across different age groups and sexes.

CONCLUSIONS: SGLT2 inhibitor use in patients with type 2 diabetes was linked to a reduced risk of long COVID. These findings suggest potential therapeutic benefits beyond glycemic control and highlight the need for further investigation into SGLT2 inhibitors as part of post-COVID-19 management strategies.

PMID:41476195 | DOI:10.1186/s12985-025-03054-5

Sci Rep. 2025 Dec 31. doi: 10.1038/s41598-025-33598-z. Online ahead of print.

ABSTRACT

This study aimed to compare the short-term effects of multimodal physiotherapy (MPT) with intra-articular corticosteroid injection (IAI) on pain, disability, effectiveness of treatment, and passive range of motion in patients with frozen shoulder. Randomized Controlled Trial. University Hospital. Patients diagnosed with frozen shoulder with at least 50% passive range of motion (PROM) limitation. Forty-eight patients were allocated into two groups: Group A: MPT and Group B: IAI. After allocation, all patients received a prescription of a comprehensive home exercise pamphlet (HEP) and were instructed to perform them for six weeks. Pain ((visual analogue scale (VAS), shoulder pain and disability index (SPADI)), disability (SPADI), and PROM for abduction, external rotation, and scaption were recorded at the baseline and 6 weeks after randomization. The effectiveness of treatment (global rating scale (GRC)) was recorded 6 weeks after randomization. Pain (VAS) and (SPADI), disability (SPADI), and passive range of motion (PROM) significantly improved after both treatments (p < 001). The effect size of MPT was larger than IAI for all outcomes. Notably, significant positive differences were observed in internal rotation PROM (p = 0.036, effect size (ES) = 0.627) and the disability section of the GRC scale (p = 0.005), indicating that MPT was more effective. However, in VAS, SPADI (total), GRC (pain), external rotation, abduction, and scaption PROM, the difference between the treatment groups was not statistically significant. MPT and IAI are both effective short-term interventions. The stronger effect and specific superior outcomes of MPT are promising, but the limited sample size precludes definitive conclusions regarding superiority. Larger trials are warranted to confirm these findings.

PMID:41476186 | DOI:10.1038/s41598-025-33598-z

Nat Commun. 2025 Dec 31. doi: 10.1038/s41467-025-66961-9. Online ahead of print.

ABSTRACT

Emerging research has highlighted that artificial intelligence-based multimodal fusion of digital pathology and transcriptomic features can improve cancer diagnosis (grading/subtyping) and prognosis (survival risk) prediction. However, such direct fusion is impractical in clinical settings, where histopathology remains the gold standard and transcriptomic tests are rarely requested in public healthcare. We experiment on two publicly available multimodal datasets, The Cancer Genomic Atlas and the Clinical Proteomic Tumor Analysis Consortium, spanning four independent cohorts: glioma-glioblastoma, renal, uterine, and breast, and observe significant performance gains in gradation and risk estimation (p-value < 0.05) when incorporating synthesized transcriptomic data with WSIs. Also, predictions using synthesized features were statistically close to those obtained with real transcriptomic data (p-value > 0.05), consistently across cohorts. Here we show that with our diffusion based crossmodal generative AI model, PathGen, gene expressions synthesized from digital histopathology jointly predict cancer grading and patient survival risk with high accuracy (state-of-the-art performance), certainty (through conformal coverage guarantee) and interpretability (through distributed co-attention maps). PathGen code is available on GitHub at https://github.com/Samiran-Dey/PathGen for open use.

PMID:41476170 | DOI:10.1038/s41467-025-66961-9

Nat Commun. 2025 Dec 31. doi: 10.1038/s41467-025-68106-4. Online ahead of print.

ABSTRACT

Insulin action on the skeleton is essential for bone development and whole-body energy metabolism, however a global view of signaling in this tissue is lacking. Furthermore, whether there are signaling differences that drive the gene-specific activation under insulin-resistant (IR) or ageing conditions is unknown. Here, we perform a phosphoproteomic analysis of insulin signaling in the bones of young, lean, insulin-sensitive versus old, obese, IR mice revealing a rewiring of phosphorylation. We target dysregulated phosphoproteins in a zebrafish functional genomic screen of bone development and mineralization revealing candidates important for skeletal formation. One of these is ALF Transcription Elongation Factor 4 (AFF4), the core scaffold of the Super Elongation Complex and we show that phosphorylation of S831 on AFF4 is an insulin-dependent substrate of P70S6K and attenuated in aged, IR bone. Phosphorylation of S831 is defective in IR osteoblasts and associated with reduced transcriptional elongation at discrete locations in the genome. Mechanistically, we show phosphorylation of S831 increases recruitment of chromatin remodelers, ENL/AF9 to crotonylated histone via the YEATS domain, and promotes gene-specific activation. Our analysis identifies regulators of insulin action on the skeleton, further uncovering a mechanism of IR via locus-specific changes in transcriptional elongation and gene activation.

PMID:41476161 | DOI:10.1038/s41467-025-68106-4