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Nevin Manimala Statistics

Immune Imbalance and Dynamic Characteristics of T Helper 17, Regulatory T, and Regulatory B Cells in Children With Persistent Immune Thrombocytopenia

Pediatr Blood Cancer. 2025 Dec 17:e70067. doi: 10.1002/1545-5017.70067. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to explore the dynamic alterations of T helper 17 (Th17) cells, regulatory T (Treg) cells and regulatory B (Breg) cells in children with persistent immune thrombocytopenia (ITP).

METHODS: A prospective cohort study was conducted involving 34 children with persistent ITP and 30 age- and sex-matched healthy controls. Peripheral blood samples were collected at baseline and 3 months post-treatment. T helper 17 and Treg cells were quantified as percentages of CD3⁺CD4⁺ T lymphocytes, and Breg cells as a percentage of CD19⁺ B lymphocytes using BD FACSDx Flex flow cytometry. All patients received standard first-line treatment with intravenous immunoglobulin and prednisone, and response was evaluated after 3 months.

RESULTS: At baseline, children diagnosed with ITP exhibited a pronounced imbalance in immune cell subsets compared with age- and sex-matched healthy controls. Specifically, Th17 cell levels and the Th17/Treg ratio were significantly elevated (7.81% ± 3.13% vs. 3.30% ± 1.51% and 1.23 ± 0.72 vs. 0.44 ± 0.23, respectively; both p < 0.001), indicating a proinflammatory immune profile. In contrast, the frequencies of immunosuppressive Treg and Breg cells were notably decreased (6.80% ± 1.75% vs. 8.03% ± 1.14%, p = 0.026; 3.10% ± 2.00% vs. 6.61% ± 1.69%, p < 0.001). After 3 months of standardised treatment, no statistically significant changes were observed in the levels of these immune cell subsets or the Th17/Treg ratio compared with pre-treatment values. Clinically, 73.5% achieved a complete response, 20.6% achieved a partial response, and 5.9% showed no response.

CONCLUSION: Both Th17/Treg cell imbalance and Breg cell deficiency contribute to the pathogenesis of persistent ITP in children. Concurrent monitoring of these immune subsets may aid in immunophenotyping, and their potential role as biomarkers for treatment outcomes warrants further investigation.

PMID:41404740 | DOI:10.1002/1545-5017.70067

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Nevin Manimala Statistics

Clinical Correlates of Anxiety and Depression After Diagnosis of a Pediatric Brain Tumor

Pediatr Blood Cancer. 2025 Dec 17:e70065. doi: 10.1002/1545-5017.70065. Online ahead of print.

ABSTRACT

BACKGROUND: The prevalence and clinical correlates of symptoms of anxiety and depression in pediatric patients with brain tumors are not well described. We aimed to identify clinical characteristics that are correlated with elevated symptoms of anxiety and depression following initial diagnosis.

PROCEDURE: Pediatric patients diagnosed with a brain tumor at Texas Children’s Hospital from 2012 to 2019 were enrolled. Using the parent-proxy report form of the BASC-2, patients were assessed for symptoms of anxiety and depression within 6 months of diagnosis. Correspondence analysis was applied to determine the correlation values (r) for anxiety and depression; r ≥ 0.71 was considered statistically significant as it explained at least 50% of the shared variance.

RESULTS: All patients (n = 149, mean age = 9 years [range 3-18], 56% male) underwent a tumor-directed surgery or biopsy. Overall, 24% (n = 35) of patients had elevated symptoms of anxiety, and 15% (n = 22) had elevated symptoms of depression. There was a strong correlation between elevated anxiety symptoms and surgical resection alone (r = 0.96), surgery plus chemotherapy (r = 0.86), and infratentorial tumors (r = 1.00). Elevated depression symptoms correlated with a diagnosis of low-grade glioma (r = 1.00), infratentorial tumors (r = 0.76), and low global intellectual functioning (r = 0.81).

CONCLUSIONS: Treatment type, tumor histology, tumor location, and global intellectual functioning are significantly associated with anxiety and depression symptoms in children with brain tumors close to the time of diagnosis. These findings may inform the provision of screening and supportive services to these high-risk groups.

PMID:41404737 | DOI:10.1002/1545-5017.70065

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Gender Inequality in Nutritional Status among Indian Children: A Systematic Review and Meta-Analysis

Ecol Food Nutr. 2025 Dec 17:1-22. doi: 10.1080/03670244.2025.2602593. Online ahead of print.

ABSTRACT

In this systematic review and meta-analysis, we examined how gender inequality influences undernutrition among Indian children across varying social structures. Studies on rural and urban patrilineal and matrilineal communities reporting the prevalence of undernutrition in children were included, following PRISMA 2020 guidelines. We conducted three random-effects meta-analyses to estimate the relative risk (RR) of undernutrition, with boys as the control and girls as the intervention group. In total, 58 articles (73,910 children) were analyzed and classified into three categories, i.e., urban tribal and non-tribal (n = 11), rural non-tribal (n = 13), and rural tribal (n = 34). We found that gender disparity in undernutrition is locale- and population-specific, with girls from rural tribal communities experiencing a higher risk (RR 1.062) than their rural non-tribal and urban counterparts.

PMID:41404703 | DOI:10.1080/03670244.2025.2602593

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Nevin Manimala Statistics

Examining Stroke Symptom Messages Implemented Globally: A Need for Contextually Relevant Stroke Symptom Messaging

J Nurs Scholarsh. 2025 Dec 17:e70059. doi: 10.1111/jnu.70059. Online ahead of print.

ABSTRACT

BACKGROUND: Stroke is a global health concern. A timely response to a stroke can help reduce morbidity and mortality. However, barriers to timely response include poor recognition of stroke symptoms. Stroke symptom messages are designed to increase stroke recognition and encourage individuals to seek urgent medical assistance. The Face, Arm, Speech, Time (FAST) and Balance, Eyes, Face, Arm, Speech, Time (BE FAST) are commonly used stroke symptom messages shown to improve stroke symptom recognition and response. However, cultural factors and language differences may limit the effectiveness of stroke symptom messages and their acceptability in different countries and contexts. There has not been a comprehensive examination of the stroke symptom messages used worldwide and how these messages have been adapted in various settings.

AIMS: We explored what stroke response messages are being used globally, and the contextual factors that influence the adoption of a stroke response mnemonic in different settings.

METHODS: A 14-item survey was disseminated by the World Stroke Organization to its networks. The survey contained open- and closed-ended questions and allowed uploading relevant stroke symptom campaign materials. The survey was analyzed using descriptive statistics and a content analysis.

RESULTS: All except one survey respondent used a stroke symptom message. Fifteen respondents (27%) reported they did not translate their stroke awareness messaging. Of these 15 respondents, they used the English versions of FAST (n = 8), BE FAST (n = 4), and both FAST and BE FAST (n = 3). Forty respondents (71%) reported that they/their organization used an acronym to raise public awareness of the signs/symptoms of stroke that was different from FAST or BE FAST (English), many of which were direct or indirect translations or influenced by FAST and BE FAST. Survey responses shared insights and recommendations related to the content, tailoring and dissemination of stroke symptom messages.

CONCLUSIONS: Study findings highlight the global use of stroke symptom messages and their contextual adaptations to fit diverse settings and contexts. The challenges in applying universal or commonly used stroke symptom messages to different contexts were highlighted.

CLINICAL RELEVANCE: Nurses could have a key role in raising awareness of stroke symptoms and the development of locally adapted stroke symptom messages.

PMID:41404701 | DOI:10.1111/jnu.70059

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Selected factors burdening the caregiver of a chronically ill person on the example of multiple sclerosis

Folia Med Cracov. 2025 Sep 30;65(3):141-160. doi: 10.24425/fmc.2025.156690.

ABSTRACT

INTRODUCTION: The burden on caregivers of chronically ill patients is a subject of concern for many specialists. The course of multiple sclerosis and the associated change in the patient’s functional ability, as well as the resources available to the caregiver, are related to the burden felt by the caregiver. It is extremely important in relation to the care provided to assess the factors that may determine the burden on caregivers. The aim of this study was to identify selected determinants of burden on caregivers of multiple sclerosis patients.

MATERIAL AND METHODS: A diagnostic survey was conducted among 107 caregivers of multiple sclerosis patients using the CBS Caregiver Burden Scale, Guy’s Neurological Disability Scale (GNDS), Berlin Social Support Scale (BSSS), Antonovsky’s SOC-29 Life Orientation Questionnaire, and the author’s own questionnaire. The collected survey data were entered into a Microsoft Excel spreadsheet and then analyzed using Statistica 13 software. The level of statistical significance was adopted as α = 0.05.

RESULTS: The burden on caregivers was high in all subscales. Life orientation and social support were associated with the burden on caregivers. Low life orientation, decreasing perceived available support and currently provided support, as well as a shortage of currently received support and increased search for support resulted in a higher overall burden among caregivers. In addition, deteriorating functioning of patients exacerbated the caregivers’ feelings of social isolation, disappointment, and emotional involvement.

CONCLUSIONS: Caregivers experienced burdens in various dimensions related to the functional ability of patients and their own resources, such as social support and life orientation.

PMID:41404690 | DOI:10.24425/fmc.2025.156690

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Application of PNF (proprioceptive neuromuscular facilitation) concept in hospitalized elderly patients in the context of independence improvement

Folia Med Cracov. 2025 Sep 30;65(3):85-100. doi: 10.24425/fmc.2025.156686.

ABSTRACT

INTRODUCTION: Population aging is associated with increased problems of physical and functional fitness in geriatric patients. Fitness constitutes a key element of independence and quality of life in elderly individuals. The proprioceptive neuromuscular facilitation (PNF) method is widely used in orthopedic and neurological rehabilitation; however, there is a lack of research on its comprehensive application in elderly patients in hospital settings.

OBJECTIVE: To assess the impact of the PNF concept on independence in elderly individuals and to compare the effectiveness of the PNF method with general rehabilitation (GR) during a maximum 10-day hospital treatment.

MATERIAL AND METHODS: The study included 80 randomly selected patients over 64 years of age hospitalized in the Department of Internal Medicine and Geriatrics. Patients were randomly divided into two 40-person groups: GR and PNF. Functional fitness assessment was conducted at the beginning of rehabilitation and after a maximum of 10 days of therapy or on the day of discharge. The following were used: ADL assessment, IADL, Up & Go test, SPPB test, balance assessment, gait speed measurement, 5-times sit-to-stand test, and NRS scale.

RESULTS: Patients rehabilitated according to the PNF concept achieved statistically significantly greater improvement in functional and physical fitness compared to the GR group.

CONCLUSIONS: The PNF method in elderly individuals allows for more effective achievement of the main goal of rehabilitation, which is reaching maximum patient independence.

PMID:41404686 | DOI:10.24425/fmc.2025.156686

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Assessment of core stability in equestrian riders

Folia Med Cracov. 2025 Sep 30;65(3):71-83. doi: 10.24425/fmc.2025.156685.

ABSTRACT

BACKGROUND: Core stability allows to control and properly perform movements of all body. Optimal core stability level depends on deep muscles capacity and neuromuscular control. Poor core stability is a risk factor for injury, especially during physical activity.

OBJECTIVE: The purpose of this study was to examine the differences in core stability between sport and recreational horse riders and people, who don’t do any sports. We hypothesized that horse riders demonstrate better core stability performance.

METHODS: 75 people aged 15-30 (20 recreational horse riders, 20 sport horse riders and 35 non-horse riders) was examined in 4 core stability tests. Individuals were assigned to each group based on authors questionnaire. Differences between groups were assessed by analysis of variance (ANOVA).

RESULTS: The study showed that sport horse riders have the best core stability. Recreational riders, who trained for shorter periods of time obtained much lower results in each test. The non-horse rider group demonstrated the worst results. There was no statistically significant relationship between the frequency of equestrian training and tests results.

CONCLUSIONS: Horse riding increases core stability and has a positive effect on all its parameters. The longer the equestrian training, the better core stability.

PMID:41404685 | DOI:10.24425/fmc.2025.156685

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Nevin Manimala Statistics

Integrative multi-omic analysis identifies key transcription factors and target proteins in renal cell carcinoma and its subtypes

bioRxiv [Preprint]. 2025 Nov 26:2025.11.23.690024. doi: 10.1101/2025.11.23.690024.

ABSTRACT

To characterize key transcription factors (TFs) whose differential DNA binding can be altered by genetic variants associated with risk for renal cell carcinoma (RCC), we conducted a series of mixed model-based analyses integrating 449 TF ChIP-seq profiles across 9 kidney-related cell lines and summary statistics from a multi-ancestry genome-wide association study of RCC. We identified 96 unique TFs for which presence of SNPs in a neighborhood of TF ChIP-seq peaks are significantly associated (p-value <1×10-4) with their effect on RCC, including EPAS1, ARNT, PAX8 and PBRM1, previously implicated in RCC pathogenesis. Most TFs overlapped active promoters/enhancers in RCC tumors but remained significant after adjusting for tumor chromatin accessibility. Further, we found the co-occupancy of 220 pairs of RCC-related TFs to be associated with RCC risk (FDR<5%) beyond effects of individual TFs, highlighting synergistic regulation between pairs of TFs. To further investigate distal (trans) regulation of TF-binding disruption at RCC associated loci on the proteome, we used a set-based regression to aggregate the trans-effects of multiple loci overlapping with TF binding sites. Across 2,732 proteins profiled in UKB-PPP, identified 169 trans-associated (p-value<1.6×10-7) proteins, nominating specific targets for each TF. For example, we identified TLR3 and ZP3 to be associated with EPAS1, ARNT, and PBRM1, indicating these proteins are likely affected by RCC-related variants disrupting binding sites of the corresponding TFs. These results characterize the landscape of RCC-related TFs and implicate TF-mediated proteomic mechanisms in RCC pathogenesis, nominating testable targets for laboratory studies.

PMID:41404623 | PMC:PMC12703995 | DOI:10.1101/2025.11.23.690024

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Impact of different endocrine therapies on bone mineral density and fracture risk in postmenopausal breast cancer patients: a meta-analysis

Front Med (Lausanne). 2025 Dec 1;12:1665389. doi: 10.3389/fmed.2025.1665389. eCollection 2025.

ABSTRACT

OBJECTIVE: To investigate the effects of different endocrine therapies (tamoxifen, aromatase inhibitors, selective estrogen receptor modulators) on bone mineral density (BMD) and fracture risk in postmenopausal breast cancer patients.

METHODS: A systematic search was conducted in PubMed, Medline, Web of Science, Cochrane Library, and EMBASE databases to identify randomized controlled trials (RCTs). The quality of RCTs was assessed using the Cochrane Risk of Bias Tool, Meta-analysis was performed using RevMan 5.3 software, with primary outcome measures including changes in BMD and fracture risk.

RESULTS: A total of five studies involving 20,531 patients were included. Meta-analysis results showed: Osteoporosis incidence: Pooled analysis of two studies yielded pooled odds ratio OR of 0.35 (95% CI: 0.04, 3.00), indicating a slight but non-significant advantage in reducing fracture risk in the experimental group compared to the control group (Z = 0.96, P = 0.34). This finding is based on only two studies, so there is uncertainty associated with it. Heterogeneity was low (I2 = 97%). fracture risk: The pooled OR from four studies was 1.40 (95% CI: 1.25, 1.57), demonstrating a statistically significant increase in fracture risk in the experimental group (Z = 5.92, P < 0.001) with low heterogeneity (I 2 = 29%).

CONCLUSION: The conclusions of this analysis were constrained by the limited number of available studies. Different endocrine therapies might exert varying effects on bone health. Aromatase inhibitors significantly reduce BMD and increase fracture risk, whereas selective estrogen receptor modulators might have a protective effect on bone. These relationships need confirmation in larger studies. Clinicians should consider bone health among other factors when selecting endocrine therapy.

PMID:41404579 | PMC:PMC12702863 | DOI:10.3389/fmed.2025.1665389

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Estimation of the inflammatory biomarker IL-6 in blood samples from varicose veins after repeated sirāvyadha (venesection/bloodletting)

Front Med (Lausanne). 2025 Dec 1;12:1638127. doi: 10.3389/fmed.2025.1638127. eCollection 2025.

ABSTRACT

INTRODUCTION: Sirāgranthi results from vitiated vāta in sirās, leading to granthi due to Vātaprakopaka nidānas. Ācārya Vagbhata recommends sirāvyadha for treating sirāgranthi. The role of inflammation in vascular diseases is explored, with a focus on Interleukin-6 as a key biomarker. The absence of studies on sirāvyadha’s impact on inflammatory biomarkers, particularly Interleukin-6, underscores the study’s relevance, aiming to observe changes in inflammatory response in varicose veins post-sirāvyadha within a 15-day period.

OBJECTIVE: To observe changes in IL-6 values before and after sirāvyadha within a 15-day period in individuals with varicose veins. Materials and Methods: After excluding deep vein thrombosis (DVT) through lower limb color doppler, five subjects who satisfied the inclusion criteria were selected. Assessments included BT, CT, Hb screening, and parameters like AVVQ, pain, edema, tortuosity, skin pigmentation, and itching. Sirāvyadha was performed over the tortuous vein with an 18G needle, and sample was collected from drained blood for IL-6 testing. After a 15-day follow-up, Sirāvyadha was repeated, and assessment of all parameters were done.

RESULTS: Statistically significant differences (p<0.05) were observed after treatment in Interleukin-6, AVVQ, pain, edema, tortuosity, and skin pigmentation. However, itching showed no statistically significant difference after treatment (p > 0.05).

CONCLUSION: In all 5 cases, a reduction in the rate of IL-6 was observed. Remarkably, three patients with initially high values showed a statistically significant reduction (p < 0.05) after sirāvyadha treatment, indicating a reduction in inflammation. Clinical and statistical significance (p < 0.05) were also observed in subjective parameters such as pain, edema, tortuosity, and skin pigmentation. Although itching decreased in patients, it did not reach statistical significance, possibly due to some patients not experiencing itching before the procedure. The study demonstrates that sirāvyadha effectively reduces the inflammatory response and subjective symptoms of varicose veins. Furthermore, the improvement in the quality of life after sirāvyadha was highly significant (p < 0.05). Overall, the study supports sirāvyadha’s efficacy in reducing inflammatory biomarker IL-6 and subjective symptoms in varicose veins.

PMID:41404578 | PMC:PMC12702841 | DOI:10.3389/fmed.2025.1638127