Tag: nevin manimala

J Investig Med. 2025 May 30:10815589251348911. doi: 10.1177/10815589251348911. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to explore the potential causal relationship between frailty and allergic diseases through bidirectional Mendelian randomization (MR) analysis.

METHODS: Single nucleotide polymorphisms (SNPs) were selected as instrumental variables from genome-wide association studies summary data. The inverse variance weighted (IVW) method was used as the main analysis method, and MR-Egger regression and weighted median method were employed to complement the IVW results. Verification of the reliability of results using multiple sensitivity analysis methods.

RESULTS: The results of forward MR analysis revealed a statistically significant positive causal relationship between allergic asthma (AA) and frailty, as well as between atopic dermatitis (AD) and frailty; however, no causal effects were detected between allergic conjunctivitis (AC), allergic rhinitis (AR) and frailty. The results of reverse MR analysis indicated that frailty had a statistically significant positive causal effect with AD and AR, but no causal effect with AA or AC. The sensitivity analysis showed that the MR results were stable, with no heterogeneity and horizontal pleiotropy.

CONCLUSIONS: This study found a bidirectional causal relationship between AD and frailty, a positive causal relationship between AA and frailty, an inverse causal relationship between AR and frailty, and no causal relationship between AC and frailty. In view of this, it may be recommended to promote routine frailty screening among patients with AD and AR to help identify high-risk individuals early. Additionally, appropriate interventions for frailty are crucial to reduce the risk of AA and AD.

PMID:40444436 | DOI:10.1177/10815589251348911

Andrology. 2025 May 30. doi: 10.1111/andr.70070. Online ahead of print.

ABSTRACT

BACKGROUND: Varicocoele is a common cause of male infertility, affecting spermatogenesis through increased testicular temperature, venous stasis, and oxidative stress. Microsurgical subinguinal varicocelectomy improves semen quality, whereas intrauterine insemination is widely used for mild male factor infertility. The comparative efficacy of these treatments in varicocoele patients with mild semen abnormalities remains unclear.

OBJECTIVES: To evaluate the efficacy of microsurgical subinguinal varicocelectomy and intrauterine insemination in improving clinical pregnancy and live birth rates in varicocoele patients with mild semen abnormalities and assess post-operative improvements in semen parameters following microsurgical subinguinal varicocelectomy.

MATERIALS AND METHODS: A retrospective cohort study involving 650 microsurgical subinguinal varicocelectomy patients from five medical centers and 700 intrauterine insemination patients from one center was conducted. Inclusion criteria included varicocoele diagnosed via ultrasonography, mild semen abnormalities (total motile sperm count ≥5 million), and at least one abnormal semen parameter. Primary outcomes were clinical pregnancy and live birth rates. Secondary outcomes included sperm concentration, motility, and total motile sperm count changes post-microsurgical subinguinal varicocelectomy. Statistical analyses included chi-square tests and logistic regression.

RESULTS: Microsurgical subinguinal varicocelectomy patients demonstrated significant improvements in sperm concentration (35.2-43.3 × 10⁶/mL), motility (26%-38%), and total motile sperm count (18.8-34.9 × 10⁶, p < 0.001). Clinical pregnancy and live birth rates were higher in the microsurgical subinguinal varicocelectomy group (35.23% and 31.08%) compared to the intrauterine insemination group (29.57% and 24.00%, p < 0.05). Multivariate analysis revealed that microsurgical subinguinal varicocelectomy significantly increased pregnancy (OR = 1.43, 95% CI: 1.12-1.83, p < 0.05) and live birth rates (OR = 1.56, 95% CI: 1.21-2.02, p < 0.05).

DISCUSSION AND CONCLUSION: Microsurgical subinguinal varicocelectomy significantly enhances semen quality and achieves superior clinical pregnancy and live birth rates compared to intrauterine insemination for varicocoele patients with mild semen abnormalities. These findings suggest that microsurgical subinguinal varicocelectomy is a more effective treatment option, highlighting the importance of individualized treatment strategies and supporting the preferential use of surgical intervention in this specific patient population.

PMID:40444428 | DOI:10.1111/andr.70070

J Investig Med. 2025 May 30:10815589251348912. doi: 10.1177/10815589251348912. Online ahead of print.

ABSTRACT

IntroductionEach year, the National Resident Matching Program (NRMP) releases match outcomes data, highlighting trends, match rates, and competitiveness for each specialty. However, research on the demographics, temporal trends, and disparities among Nephrology applicants remains limited.MethodsThis retrospective study analyzed data from the NRMP for Hospice and Palliative Care fellowships from 2016 to 2024, including applicant demographics and match outcomes. Chi-square tests were used to assess differences and temporal trends were evaluated with Mann-Kendall tests, and statistical significance was set at p<0.05.ResultsAlthough the total number of training programs (p<0.001) and fellowship positions (p<0.001) increased from 2010 to 2024, the percentage of filled positions significantly declined from 94.1% in 2010 to 65.8% in 2024 (p=0.047). Females were less likely to apply for Nephrology compared to other fellowships (p=0.002) and had a lower match rate (p<0.001). White applicants were less likely to apply for Nephrology than other fellowships (p<0.001). US MD graduates had a significantly higher match rate than non-US MD graduates over the study period (p<0.001).ConclusionsDespite the annual increase in Nephrology training positions, declining applicant numbers have reduced fellowship competitiveness. Males, Asians, and non-US IMGs comprised the majority of trainees. Addressing pay, job opportunities, and gender disparities is crucial to sustaining the future Nephrology workforce in the US.

PMID:40444425 | DOI:10.1177/10815589251348912

Lupus. 2025 May 30:9612033251345648. doi: 10.1177/09612033251345648. Online ahead of print.

ABSTRACT

IntroductionSystemic lupus erythematosus (SLE) primarily affects women of reproductive age. In pregnant women, frequent antepartum and intrapartum monitoring is required to improve obstetric outcomes and reduce the risk of flares. This study describes the characteristics of pregnant women with SLE and their obstetric and disease outcomes.MethodsRetrospective descriptive cohort in a hospital in Bogotá, Colombia, from 1/January/2012 to 29/February/2024. The research was approved by the Ethics Committee. Descriptive statistics and univariate analysis by Fisher and Mann-Whitney U test were used.ResultsWe analyzed 29 pregnancies of 28 women with a median age of 28 years, high educational and socioeconomic level, belonging to the social security system, and residing in Bogotá. Most of them had been diagnosed with SLE before pregnancy (median disease duration of 60 months). Twenty percent had poly-autoimmunity. Overall disease activity was mild to moderate. Obstetric outcomes (e.g. preterm delivery) were associated with a moderate to severe SLEPDAI (Systemic Lupus Erythematosus Pregnancy Disease Activity Index) score in the second and third trimester (83%, p = .04), shorter disease duration (24 vs 96 months, p = .027) and proteinuria >1 g (40.91%, p = .03).ConclusionsThis study associates preterm delivery with factors such as proteinuria >1 g, shorter disease duration, and a moderate to severe score in the second trimester of pregnancy. A higher level of evidence is required to establish these associations with the causality of adverse outcomes in the Latin American population.

PMID:40444419 | DOI:10.1177/09612033251345648

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