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Nevin Manimala Statistics

Fecal sulfatide as a non-invasive biomarker for predicting coronary heart disease

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

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Comparative analysis of ingestion assessment methods in paraquat-poisoned patients

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

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Psychosocial and digital predictors of Hepatitis B vaccination uptake in healthcare workers: insights from a Nigerian tertiary hospital

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

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SGLT2 inhibitors prevent long-COVID-associated cognitive and pain symptoms in type 2 diabetes patients

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

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Clinical outcomes of intra-articular corticosteroid injection vs. multimodal physiotherapy in patients with frozen shoulder in short term: a randomized clinical trial

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

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Generating crossmodal gene expression from cancer histopathology improves multimodal AI predictions

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

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Phosphoproteomics of aged insulin-resistant bone identifies P70S6K phosphorylation of AFF4 as a gene-specific transcriptional regulator

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

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Tropical-leaning Atlantic Oscillation favors more typhoons toward Asian high-latitude cities

Nat Commun. 2025 Dec 31. doi: 10.1038/s41467-025-67946-4. Online ahead of print.

ABSTRACT

Poleward migration of Northwest Pacific typhoons brings severe impacts on East Asian high-latitude cities, yet early typhoon climate prediction remains a long-standing scientific challenge. Here we reveal a seemingly-familiar-yet-strange climate oscillation phenomenon, which we name Tropical-leaning Atlantic Oscillation (TAO). Statistical results show that springtime TAO can explain 56% of the variance in a dominant dipole mode of typhoon track variations during July-September of 1979-2023, suggesting that it possesses a robust predictive skill of peak-season typhoon tracks four months in advance. Specifically, springtime TAO is characterized by a sea-level pressure seesaw between the tropical North Atlantic and the Hudson Bay-Davis Strait, relating to the meridional shift of North America-Atlantic subtropical jet stream. It generates cross-seasonal North Atlantic-and-Pacific surface seawater temperature anomalies, thereby triggering Northwest Pacific cyclonic steering flows that tempt (obstruct) typhoons toward East Asian high-latitude (low-latitude) cities during July-September. Climate models project an increasing frequency of positive TAO events. This may potentially contribute to a poleward migration of typhoon activity toward East Asian high-latitude cities as climate warms, yet uncertainty remains due to model biases in simulating tropical surface seawater temperature patterns. Our results highlight an overlooked impact of an emerging internal climatic oscillation on the enhancing typhoon risks toward high-latitudes.

PMID:41476152 | DOI:10.1038/s41467-025-67946-4

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Pluripotent epigenetic regulator OBP-801 attenuates fibrosis and maintains lower intraocular pressure in a rabbit PRESERFLO MicroShunt surgery model

Sci Rep. 2025 Dec 31. doi: 10.1038/s41598-025-34244-4. Online ahead of print.

ABSTRACT

The inhibition of fibrosis in filtering blebs is indispensable for lowering intraocular pressure (IOP) after PRESERFLO MicroShunt surgery (PMS). We previously reported the anti-fibrotic effect of OBP-801 (OBP) on a filtering bleb in a rabbit glaucoma filtration surgery model using a 22-gauge cannula. In this study, we investigated the effect of OBP after PMS in rabbit eyes for the development of a new practically applicable anti-fibrotic treatment. This study involved 19 Japanese white rabbits that underwent PMS in the right eye, with those eyes divided into 3 groups: (1) intraoperative subconjunctival injection of 0.02% mitomycin-C (MMC) (n = 6), (2) postoperative instillation of 100 nM OBP eye drops (n = 7), or (3) a balanced salt solution (BSS) control (n = 6). Bleb morphology and IOP were monitored for 12 weeks postoperative, with the bleb tissues then undergoing evaluation of fibrosis and Western blot analysis. A lower postoperative IOP was maintained in the OBP-group eyes, and at 12 weeks postoperative, the IOP was significantly lower in that group than in the BSS and MMC groups (p < 0.01). OBP-treated eyes showed no adverse effects and reduced levels of alpha-smooth muscle actin and collagen deposition, thus suggesting that OBP is a promising candidate for improving surgical outcomes post PMS.

PMID:41476143 | DOI:10.1038/s41598-025-34244-4

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Increased Emergency Department Utilization After Revision Compared With Primary Lumbar Fusion

Clin Spine Surg. 2025 Dec 30. doi: 10.1097/BSD.0000000000001928. Online ahead of print.

ABSTRACT

STUDY DESIGN: A retrospective cohort study.

OBJECTIVE: To describe the incidence, timing, and reason for ED visits following primary versus revision lumbar fusion.

SUMMARY OF BACKGROUND DATA: Emergency department (ED) presentation and misutilization place a substantial financial strain on patients and the health care system. ED visits following lumbar fusion are common and may be an overlooked target for reducing cost.

METHODS: A retrospective cohort study of patients undergoing 1-3 level primary versus revision lumbar fusion was performed. Outcomes included the incidence and characteristics (inpatient admission, discharge home, or reoperation) of ED visits at 2 weeks, 30 days, and 90 days postoperatively. Logistic regression analysis was performed to identify independent predictors of postoperative ED visits.

RESULTS: A total of 2360 patients were included (1852 primary and 508 revision). Rate of 90-day ED visits was higher in the revision group (10.2%) compared with the primary group (6.86%, P=0.014). However, breakdown by 15-day intervals revealed this was only significant between 14 and 30 days postoperatively (1.30% vs. 3.35% for revisions, P=0.004). Reasons for ED visits were similar, with both groups presenting most commonly for pain complaints. Primary patients presenting to the ED were more likely to require admission (48.0% vs. 26.9%; P=0.015). Logistic regression demonstrated that revision surgery (OR: 2.67, P<0.001), Cut-to-close time (OR: 1.003, P=0.028) and LOS (OR: 1.11, P=0.023) independently predicted postoperative ED visits.

CONCLUSION: Revision lumbar fusion was an independent predictor of visiting the ED, especially from 14 to 30 days postoperatively, but the absolute increase in risk was mild at 3.4%. Cut-to-close time was also statistically predictive, although with an effect size that is not clinically significant. However, visits to the ED after revision surgery were less likely to require readmission compared with visits after primary lumbar surgery. These findings may suggest that patients undergoing lumbar fusion should be appropriately counseled regarding postoperative pain expectations and appropriate acute care utilization, especially in the revision setting.

PMID:41474544 | DOI:10.1097/BSD.0000000000001928