Tag: pubmed

Diabetol Metab Syndr. 2025 Nov 6;17(1):419. doi: 10.1186/s13098-025-01970-8.

ABSTRACT

BACKGROUND: The AI-CVD initiative aims to maximize the value of coronary artery calcium (CAC) scans for cardiometabolic risk prediction by extracting opportunistic screening information. We investigated whether artificial intelligence (AI)-derived measures from CAC scans are associated with new-onset Type 2 diabetes mellitus (T2DM) in adults without obesity or hyperglycemia.

METHODS: Baseline CAC scans and up to 23 years of follow-up data were analyzed for participants without obesity (body mass index < 30 kg/m²) and hyperglycemia (fasting plasma glucose < 100 mg/dL) from the Multi-Ethnic Study of Atherosclerosis (MESA). AI-derived measures included liver attenuation index (LAI), subcutaneous fat index (SFI), total visceral fat index (TVFI), epicardial fat index (EFI), skeletal muscle index, and skeletal muscle mean density. Cox regression models compared highest vs. lowest quartiles of each AI-derived metric for T2DM risk. Multivariable models assessed adjusted predictive value using Wald chi-squared statistics. Subgroup analyses stratified participants by demographic and clinical factors.

RESULTS: During a median follow-up of 19.7 years among 2,993 participants (baseline mean age 61.9 ± 10.5 years, 53% women), 257 participants (8.6%) developed T2DM. Key predictors included LAI (HR: 3.13, 95% CI: 2.15-4.55), SFI (HR: 2.85, 95% CI: 1.93-4.21), TVFI (HR: 2.49, 95% CI: 1.72-3.60), and EFI (HR: 1.59, 95% CI: 1.09-2.32). LAI remained the most robust predictor after adjusting for all metrics (Wald χ² = 38.24). Subgroup analyses confirmed LAI’s consistent predictive performance.

CONCLUSION: AI-derived adiposity measures from CAC scans-especially liver fat-can identify adults without obesity or hyperglycemia at elevated risk for developing T2DM. These findings underscore the potential of AI-enabled opportunistic screening during CAC imaging to support early T2DM risk stratification in individuals not captured by current clinical guidelines.

PMID:41199381 | DOI:10.1186/s13098-025-01970-8

Trials. 2025 Nov 6;26(1):473. doi: 10.1186/s13063-025-09209-7.

ABSTRACT

BACKGROUND: According to the WHO, more than 50% of patients do not take their medications as prescribed. Nonadherence is caused by several variables, including social and economic factors, issues with the healthcare team and system, problems related to specific diseases, characteristics of those diseases, and their treatments.

OBJECTIVE: To study the effectiveness of the PARTICIPATE intervention at the community level regarding medication adherence among adults with diabetes and/or hypertension in rural India.

STUDY DESIGN: This is a multicentre cluster randomised trial implemented across 4 blocks (64 villages) of 4 districts in East, West, North, and South India, covering 2880 randomly selected participants. A nested economic evaluation will measure the effectiveness of community-based participatory research (CBPR). The intervention will be delivered by peer educators identified from the community for a duration of 12 months, with the first 6 months followed by monthly sessions for the next 6 months. The control group will continue to receive all aspects of standard care offered by healthcare providers (public or private).

METHODS: The measure of drug adherence for hypertension and/or diabetes, as determined by the self-reported Morisky Medication Adherence Scale (MMAS-8) at baseline, midterm, and end, is the study’s outcome variable. The independent variables, namely socio-economic status, number of antihypertensive and/or antidiabetic drugs, their duration, self-perceived health status, systolic and diastolic blood pressure, and/or HbA1c, will be controlled for during the analysis. Secondary outcomes include improvement in health literacy using the All Aspects of Health Literacy Scale (AAHS), clinical outcomes, quality of life using the EURO-QoL (EQ-5D), cost-effectiveness, and return on investment (ROI). Process evaluations will be conducted with a sub-sample of participants to examine engagement in various intervention components. The fidelity of intervention will be monitored using the Normalisation Process Theory framework.

DISCUSSION: To the best of our knowledge, this is the first multi-centre cluster randomised controlled trial in India to assess the effectiveness of the CBPR approach for improving medication adherence among diabetics and hypertensive patients. The results of this study will contribute to the evidence base for scaling up peer-educator models for diabetes and hypertension management in India and similar low- and middle-income countries.

TRIAL REGISTRATION: The registration number for this trial is CTRI/2024/01/061939.

PMID:41199367 | DOI:10.1186/s13063-025-09209-7

Malar J. 2025 Nov 6;24(1):381. doi: 10.1186/s12936-025-05626-w.

ABSTRACT

BACKGROUND: Thrombocytopenia is a common haematological abnormality in malaria patients, increasing the risk of mortality in both children and adults with Plasmodium falciparum and Plasmodium vivax infections. In Rwanda, data on the prevalence and associated factors of severe thrombocytopenia in malaria patients are limited. This study aimed to determine the prevalence and factors associated with severe thrombocytopenia among hospitalized patients with malaria attending Kigeme District Hospital, Southern Province, Rwanda.

METHODS: A cross-sectional study was conducted from December 2023 to November 2024 among malaria patients at Kigeme District Hospital, Rwanda. Using simple random sampling, 124 patients were selected while ensuring confidentiality throughout data collection, analysis, and reporting. Data were gathered via a structured form in Kobo Toolbox and later processed in Microsoft Excel. Information on demographic, clinical characteristic and laboratory investigations considered were those collected during the time of patients admission to the hospital. Binary logistic regression was employed to assess associations, with variables showing a p-value < 0.05 in bivariate analysis included in the multivariable model. Adjusted odds ratios (AOR) with 95% confidence intervals were computed, and statistical significance was set at p-value < 0.05.

RESULTS: The study has shown that severe thrombocytopenia was 27.4% among patients with malaria. Factors associated with severe thrombocytopenia among patients with malaria were age group less or equal to 5 years old (AOR = 5.17, 95%CI 1.674-16.259, p = 0.004), type infecting Plasmodium species (AOR = 3.4, 95%CI 2.41-8.3, p = 0.04) positive C-Reactive Protein (AOR = 3.45, 95%CI 2.23-3.56, P = 0.045), jaundice (AOR = 2.875, 95% CI 1.36-26.5, p = 0.045), epistaxis (AOR = 1.84, 95% CI 1.73-2.43, p = 0.042), high serum urea (AOR = 1.73, 95% CI 1.23-1.83, p = 0.001). On the other hand, patients with coma status (cerebral malaria) (AOR = 0.189, 95% CI 0.137-0.985, p = 0.028, Delay to seek medical care (AOR = 0.393, 95% CI 0.043-1.125, p = 0.082) were less likely associated with severe thrombocytopenia.

CONCLUSION: This cross-sectional study found a 27.4% prevalence of severe thrombocytopenia in malaria patients. Key associated factors included less or equal to 5 years old, positive C-reactive protein, type of Plasmodium infecting species, jaundice, epistaxis, and high serum urea levels, while cerebral malaria linked to a lower likelihood of thrombocytopenia. This highlight the need for early identification severe thrombocytopenia among severe malaria patients who are at high likelihood suffering severe thrombocytopenia. Further longitudinal studies are recommended to better understand the predictive value of these factors and their role in guiding clinical management.

PMID:41199350 | DOI:10.1186/s12936-025-05626-w

Malar J. 2025 Nov 6;24(1):377. doi: 10.1186/s12936-025-05624-y.

ABSTRACT

BACKGROUND: Climate change can influence malaria incidence directly and indirectly, impacting vector and parasite dynamics, along with socioeconomic factors influencing malaria risk. In Zimbabwe there is a paucity of research linking climate change, environmental factors, and malaria incidence, hindering coordinated efforts for malaria elimination. Accordingly, the aim of the study was to explore the link between climate change, environmental factors, and malaria incidences, from 2010 to 2022, in Chiredzi district, Zimbabwe.

METHODS: A transdisciplinary approach was applied, combining quantitative weather data from weather stations, malaria incidence data and insights from focus group discussions which were used to glean people’s perceptions and knowledge of climate change and malaria in Chiredzi District. Participatory mapping showing hot spots of malaria incidence were also utilized. Statistical analysis in MATLAB was used to analyse the weather and malaria data and a P-value of 0.0479 was obtained which is deemed as statistically significant. ATLAS.ti was used to qualitatively analyse data from the focus group discussions.

RESULTS: Key results from the study show evidence of climate change in Chiredzi district manifesting through an increase in rainfall, increase in temperature, change in seasons and extreme weather patterns. Furthermore, there is a positive relationship between changes in climate and an increase in malaria incidence. However, in some years the relation is negative, and this can be attributed to other factors. Similarly, malaria incidence is also related to other socioeconomic and environmental factors such as poverty and migration which are further exacerbated by climate change. Malaria incidence is also attributed to other environmental and socio-economic factors.

CONCLUSIONS: Further studies with extended datasets that span a longer period need to be carried out. Likewise forecasting malaria incidence based on current climate, environmental and socio-economic conditions is crucial for advocating transformative malaria prevention programs, emphasizing the importance of inclusive partnership and adaptation to a changing climate. New malaria prevention programs that consider the impact of a changing climate on malaria, local environmental and socio-economic factors are urgently needed.

PMID:41199346 | DOI:10.1186/s12936-025-05624-y

BMC Psychol. 2025 Nov 6;13(1):1231. doi: 10.1186/s40359-025-02951-2.

ABSTRACT

BACKGROUND: Emotional intelligence is a person’s ability, capacity and ability to understand, use, understand, manage, anticipate, manage and direct the emotions of oneself or others. Students with high levels of emotional intelligence express themselves better, are more resistant to stress in their lives, and are individuals who can direct their emotions. Leaders with strong emotional intelligence will create synergy for all employees. Therefore, emotional intelligence and stress management skills are important issues in the field of leadership and organizational behavior. At the same time, emotional intelligence and stress management skills interact with hormones. This study aims to examine the emotional intelligence levels and hormone (apelin, cortisol) and cerebral (Brain-derived neurotrophic factor (BDNF)) response of 4th-year students of the faculty of health sciences at the university, who are potential managers of the future in terms of some variables.

METHODS: The research was conducted using the cross-sectional data method with 167 university students aged 18-24 who were reported to be clinically healthy in Türkiye. Apelin, cortisol hormone and BDNF levels in the participants’ saliva samples were analyzed using the ELISA technique. The relationship between emotional intelligence level and total scores from the stress coping scale and salivary apelin, cortisol and BDNF levels were evaluated.

RESULTS: In the study, it was determined that the average level of apelin hormone in saliva was “2.36 ± 0.076)” ng/mL in girls and “2.57 ± 0.071” ng/mL in boys. In girls, the BDNF level was “3.19 ± 0.97” and the cortisol level was “2.04 ± 0.72”. BDNF level in boys is “3.41 ± 0.94”and cortisol level is “1.92 ± 0.59”. There is a significant difference between the participants’ allowances (income levels) and the average levels of salivary apelin hormone, BDNF and emotional intelligence scale (p < 0.01). A positive, strong and statistically significant relationship was found between the participants’ emotional intelligence level and stress management skills and apelin and BDNF levels, and a negative, strong and statistically significant relationship was found between salivary cortisol levels (p˂0.01).

CONCLUSIONS: High emotional intelligence and stress management skills are an important element of strategic importance for a successful management and professional success process in individuals who will work in fields that need people such as health, marketing, law, consultancy, medicine, teaching and the service sector. Our study determined that as university students’ emotional intelligence levels strengthened, the participants’ stress management skills, salivary apelin, and BDNF levels increased, and cortisol hormone levels decreased. As a result, monitoring and examining apelin, BDNF, cortisol hormones can be useful parameters in evaluating the interaction between individuals’ emotional intelligence level and stress management skills and hormone response.

PMID:41199340 | DOI:10.1186/s40359-025-02951-2

J Transl Med. 2025 Nov 6;23(1):1237. doi: 10.1186/s12967-025-07296-3.

ABSTRACT

BACKGROUND: This study examined the relationship between maternal preeclampsia (PE) and gut microbiota colonization in preterm infants and analyzed the effects of prenatal Bifidobacterium supplementation.

METHODS: This observational study included 45 preterm infants categorized according to their mothers’ exposure status during pregnancy. Group A (healthy controls, n = 15) included infants born to healthy mothers who received no supplementation; Group B (PE+Bifidobacterium, n = 15) included infants whose mothers had PE and received Bifidobacterium supplementation as part of routine clinical management; and Group C (PE only, n = 15) included infants born to mothers with PE who did not receive Bifidobacterium supplementation. All enrolled infants were followed from birth for subsequent analyses. The initial postnatal fecal samples of the infants were collected and analyzed using 16S rRNA gene sequencing. Microbial diversity within the intestinal microbiota was evaluated using alpha diversity (within-sample) and beta diversity (between-sample) analyses. To identify taxon-specific differences among groups, we performed linear discriminant analysis effect size and differential abundance analysis, with statistical significance set at p < 0.05. The functional potential of the gut microbiota was inferred based on Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways via the PICRUSt2 algorithm.

RESULTS: Alpha diversity analysis revealed significantly greater microbial diversity in the fecal microbiota of preterm infants born to healthy mothers (Group A) than in those delivered by mothers with PE, regardless of prenatal Bifidobacterium exposure. Taxonomic profiling revealed distinct microbial community structures across groups: Group A exhibited significant enrichment of Bacteroides at all taxonomic levels, along with an elevated abundance of Clostridium at the class and order levels. Group B showed a markedly greater relative abundance of Actinobacteria at the phylum level and Rothia at the genus level, whereas Group C was dominated by Proteobacteria (phylum level) and Streptococcus (genus level). All intergroup differences were statistically significant following Benjamini‒Hochberg correction (q < 0.05). A functional analysis of the gut microbiota revealed 53 KEGG pathways with significant overall group differences (p < 0.05), among which 23 pathways were significantly different in at least two groups (q < 0.05). Notably, the activity of the LPS biosynthesis pathway was significantly upregulated in Group C compared with Group A (q = 0.001). Although LPS biosynthesis activity was reduced in Group B relative to Group C (q = 0.018), it remained elevated compared to Group A (q = 0.001), suggesting incomplete mitigation of endotoxin risk. Additionally, glycolytic activity was significantly impaired in Group C relative to Group A (q = 0.003) but was partially restored in Group B compared to Group C (q = 0.022).

CONCLUSIONS: Maternal PE impaired early-life gut microbiota establishment in preterm infants, manifesting in reduced microbial diversity, enrichment of pathogenic Proteobacteria and Streptococcus, and consequent functional dysbiosis characterized by elevated endotoxin biosynthesis potential and compromised energy metabolism. Although prenatal supplementation with Bifidobacterium partially restored the microbial compositional balance, promoting beneficial bacteria, reducing LPS synthesis activity, and partially improving glycolytic function, it failed to fully reverse endotoxin-related risks, indicating the need to develop more effective microbiota-targeted strategies to comprehensively optimize metabolic and immune homeostasis.

PMID:41199330 | DOI:10.1186/s12967-025-07296-3

Arch Public Health. 2025 Nov 6;83(1):265. doi: 10.1186/s13690-025-01758-2.

ABSTRACT

BACKGROUND: High-quality immunization data is critical for making evidence-based decisions, ensuring effective program implementation, and achieving intended outcomes. Conversely, low-quality data hinders program monitoring and evaluation activities. Despite efforts to improve data quality in the health sector, the status of immunization data quality in Ethiopia is not well-known. This national study examined immunization data quality status and its challenges in Ethiopia.

METHODS: A mixed-method study was conducted on health facilities and all levels of administrative units, including the Ministry of Health, 12 regional health bureaus, 51 zonal health departments, 233 district health offices, 395 health facilities, and 267 health posts from April 15 to July 30, 2023. In-depth interviews were conducted with 74 purposefully selected key informants across these levels. The quality of immunization data was assessed based on accuracy, timeliness, and completeness. Open Data Kit (ODK) was used to collect quantitative data, and STATA statistical software was used for analysis. Qualitative data were analyzed using the thematic analysis approach with ATLAS.ti.

RESULTS: Out of 4062 immunization data elements expected to be reported in the months under review, only 2413 (59.4%) were available. One-third of health facilities had acceptable reporting accuracy, while 27% had inaccurate reports. 41% of health facilities had inadequate documentation for verifications. Complete documentation and accuracy of reporting were better in hospitals than in health centers and health posts, but lower in pastoralist settings and some regions. Report timeliness ranged from 94% in the Oromia region to 37% in Gambella. The main reasons for low immunization data quality were inadequate skilled data management personnel, lack of standard data management and data quality assessment tools, and irregular data quality assessments at health facilities.

CONCLUSIONS: The study identified a significant immunization data quality problem in Ethiopia’s health institutions, with data accuracy, timeliness and completeness rates falling far below the standard. To improve immunization data quality and informed decision-making, it is crucial to strengthen data quality improvement strategies starting from the point of data collection.

PMID:41199326 | DOI:10.1186/s13690-025-01758-2

BMC Sports Sci Med Rehabil. 2025 Nov 6;17(1):320. doi: 10.1186/s13102-025-01408-8.

ABSTRACT

BACKGROUND: Sitting volleyball relies heavily on upper-body strength and anaerobic capacity. Serve, spike, and speed-endurance are decisive skills, yet the ergogenic potential of low-dose caffeine in this Paralympic sport remains unclear.

PURPOSE: To examine the acute effects of low-dose caffeine (3 mg/kg) supplementation on serve speed, spike speed, and speed-endurance in elite sitting volleyball players.

METHODS: Using a randomized, double-blind, crossover design, 13 elite male athletes from the Turkish National Sitting Volleyball Team completed serve speed, spike speed, and speed-endurance tests under caffeine (CAF) and placebo (PLA) conditions.

RESULTS: Caffeine intake produced a moderate improvement in serve speed (p = 0.028, d = 0.460); however, this effect did not remain statistically significant after Bonferroni correction (adjusted p = 0.084). No significant effects were observed for spike speed (p = 0.547, d = 0.166) or speed-endurance performance (p = 0.709, d = 0.111). Perceived exertion during the speed-endurance test was similarly high in both conditions.

CONCLUSIONS: Low-dose caffeine may offer a trend toward improved serve performance, but the effect was not robust after statistical adjustment, and no benefits were observed for spike speed or speed-endurance. These findings highlight that caffeine’s ergogenic effects are context-dependent and shaped by task complexity and sport-specific motor demands. Further research with larger and more diverse samples, genotype-based subgroups, and varied dosing strategies is warranted to clarify caffeine’s role in adaptive sports.

TRIAL REGISTRATION: The randomized controlled trial was retrospectively registered on 21/06/2025 at ClinicalTrials.gov, under the registration number NCT07056231.

PMID:41199325 | DOI:10.1186/s13102-025-01408-8

Trop Med Health. 2025 Nov 6;53(1):153. doi: 10.1186/s41182-025-00832-3.

ABSTRACT

BACKGROUND: Hepatic cystic echinococcosis (HCE) remains a significant public health issue in endemic countries. Although recurrence is a recognized challenge, its independent impact on adverse clinical outcomes such as postoperative complications (POC), mortality, and length of hospital stay (LHS) remains poorly studied in Latin America. This study aimed to assess the risk of POC, mortality, and LHS in patients with recurrence of HCE.

METHODS: We conducted a retrospective cohort study of patients who underwent surgery for HCE between 1993 and 2019 at two centers in southern Chile. Patients with recurrence (exposed group) were compared to those undergoing primary surgery (non-exposed group). The primary outcome was the presence of POC; secondary outcomes included mortality and LHS. Crude and adjusted relative risks (RR) with 95% confidence intervals were estimated using Poisson regression with robust errors. Linear regression models were applied to assess the effect of recurrence on LHS.

RESULTS: A total of 154 patients with 271 cysts were included. Recurrence was identified in 43 patients (27.9%). POC occurred in 18.2% of the total cohort and were significantly more frequent in the recurrence group (41.9% vs. 9.0%, p < 0.001). Adjusted RR for POC in the presence of recurrence was 5.1 (95% CI 2.7-9.9). Mortality was higher in patients with recurrence (7.0% vs. 2.7%, RR: 2.6; 95% CI 0.5-12.3), though not statistically significant. LHS was 1 day longer in the recurrence group (7.3 ± 4.5 vs. 5.6 ± 3.4; p = 0.02), but this association lost significance in regression models.

CONCLUSIONS: Recurrence of HCE increases the risk of POC. While trends toward higher mortality and prolonged LHS were observed, these did not reach statistical significance. These findings underscore the importance of long-term follow-up and the need to identify prognostic factors for recurrence to optimize outcomes in patients with HCE in endemic regions.

PMID:41199324 | DOI:10.1186/s41182-025-00832-3

Infect Dis Poverty. 2025 Nov 6;14(1):114. doi: 10.1186/s40249-025-01381-x.

ABSTRACT

BACKGROUND: Cervical cancer driven by human papillomavirus (HPV) infection remains a critical global health challenge. Co-infection with Trichomonas vaginalis, a prevalent sexually transmitted protozoan, is strongly associated with increased susceptibility to HPV, yet the molecular basis for this synergy is unclear. Here, we investigated the role of T. vaginalis adhesion protein 65 (TvAP65) in HPV entry, focusing on its interaction with host factors in epithelium.

METHODS: Using in vitro (human adult low calcium high temperature keratinocytes, HaCaT cells) and in vivo (BALB/c athymic nude mice, BALB/cA-nu mice) models, we assessed HPV infection rates and the expression of HPV entry receptors (cluster of differentiation 151, CD151 and heparan sulfate proteoglycan 2, HSPG2) under T. vaginalis exposure. TvAP65 was either knocked down or overexpressed to evaluate its functional impact. A siRNA screen targeting 12 host molecules that interact with TvAP65 identified signal peptidase complex subunit 1 (SPCS1) as a key mediator. Dual knockdown of TvAP65 and SPCS1 or HPV receptors (CD151/HSPG2) was performed to dissect mechanistic hierarchies. Statistical analyses were performed using Student’s t-test for two-group comparisons and analysis of variance (ANOVA) for comparisons involving three or more groups (P < 0.05).

RESULTS: T. vaginalis markedly enhanced HPV entry in epithelial cells by upregulating CD151 and HSPG2 (P < 0.001). TvAP65 knockdown reversed this effect, reducing HPV infection by 21.76 ± 0.12% (P < 0.001) and protein-level expression of the receptors (P < 0.001), while overexpression amplified both. Strikingly, SPCS1 knockdown alone attenuated HPV infection by 33.61 ± 0.40% and abolished T. vaginalis-driven CD151/HSPG2 upregulation. Dual knockdown of TvAP65 and SPCS1 synergistically suppressed HPV entry (54.64 ± 0.39% reduction, P < 0.001), confirming the central role of SPCS1 in TvAP65-mediated receptor activation.

CONCLUSIONS: Our study unveils a previously uncharacterized mechanism by which T. vaginalis exacerbates HPV infection: TvAP65 hijacks SPCS1 to transcriptionally upregulate CD151 and HSPG2, thereby facilitating HPV entry into host cells. This TvAP65-SPCS1-CD151/HSPG2 axis highlights potential therapeutic targets to disrupt the synergy between HPV and T. vaginalis, offering new strategies for cervical cancer prevention.

PMID:41199321 | DOI:10.1186/s40249-025-01381-x