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The effect of low dose caffeine powder supplementation on serve speed, spike speed, and speed-endurance in elite sitting volleyball players: a randomized double-blind crossover study

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

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Impact of recurrence of hepatic cystic echinococcosis on postoperative outcomes in an endemic region of Chile: a retrospective cohort study

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

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Trichomonas vaginalis adhesion protein 65 facilitates human papillomavirus entry via SPCS1-mediated upregulation of CD151 and HSPG2 in keratinocyte lineage

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

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Effectiveness and safety of prolonged prone positioning in adult patients with acute respiratory distress syndrome (ARDS): a systematic review and meta-analysis

Crit Care. 2025 Nov 6;29(1):475. doi: 10.1186/s13054-025-05712-0.

ABSTRACT

BACKGROUND: Prolonged prone positioning (PPP) for ≥ 24 h may enhance outcomes in moderate to severe acute respiratory distress syndrome (ARDS), but may also increase risks such as pressure injuries and complications. Despite clinical rationale, high-quality evidence for PPP’s safety and efficacy remains scarce.

METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) and observational studies. Trials that compared two distinct treatment groups in adult patients with ARDS were included: prone position < 24 h (standard) and ≥ 24 h (prolonged). Databases searched included MEDLINE, CENTRAL, ClinicalTrials.gov, ISRCTN, ICTRP and the Cochrane Covid-19 Study Register (last search: 3 July 2025). Risk of bias was assessed using ROB-2 for RCTs, and the ROBINS-I V2 tool for non-randomised intervention studies (NRSI). The primary outcome was mortality. Secondary outcomes included improvement of oxygenation and adverse events. Outcomes (Risk ratios and hazard ratios) were calculated using a random-effect model with 95% confidence intervals (CI). The quality of evidence was evaluated using the GRADE assessment.

RESULTS: Of 19,986 records, 9 (n = 1,045) were included in the qualitative and quantitative analysis. Four studies, including two small RCTs (n = 112) and two NRSIs (n = 581), had a low to moderate risk of bias. Most studies included patients with COVID-19 ARDS. Meta-analysis showed no significant effect on 90-day mortality (n = 641, HR 0.72; 95% CI 0.41-1.25). No heterogeneity was detected among studies (I² = 0%), but the confidence interval for I² was wide (95% CI: 0-89%), suggesting the possibility that substantial heterogeneity may exist. Similarly, no significant differences were found for secondary outcomes.

DISCUSSION: Current evidence does not support the use of PPP outside of clinical studies. Pooled data from small trials and NRSIs reveal no significant effect of PPP on mortality, oxygenation, or safety outcomes. The evidence is of low to very low certainty, limited by inconsistency and imprecision. The wide confidence intervals indicate low statistical power, therefore both harm and benefit remain plausible on the basis of the available evidence. Well-powered RCTs are needed to clarify the potential benefits and risks of PPP in ARDS.

PMID:41199320 | DOI:10.1186/s13054-025-05712-0

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Clinical outcomes over 12 years: a comparative analysis of oocyte cryopreservation from controlled ovarian stimulation and in vitro maturation retrieved from ovarian tissue

J Ovarian Res. 2025 Nov 6;18(1):241. doi: 10.1186/s13048-025-01847-4.

ABSTRACT

BACKGROUND: Fertility preservation is crucial for females facing gonadotoxic treatments. Controlled ovarian stimulation (COS) followed by oocyte cryopreservation is a well-established method, while ovarian tissue-derived oocyte in vitro maturation (OTO-IVM) is an emerging technique that can be used when COS is contraindicated or time is limited. However, OTO-IVM faces challenges such as low oocyte maturation rates and limited follow-up data. This study aimed to compare the clinical outcomes of COS oocyte cryopreservation and OTO-IVM, with a focus on the impact of transportation methods and the use of gonadotropin (Gn) before oophorectomy on OTO-IVM outcomes.

METHODS: This retrospective study analyzed data from 472 patients who underwent fertility preservation procedures at the Reproductive Medicine Research Center, The Sixth Affiliated Hospital, Sun Yat-sen University, from July 2012 to July 2024. Patients diagnosed with cancer or requiring gonadotoxic treatments were included. The study compared oocyte maturation, fertilization, and embryo transfer outcomes between COS and OTO-IVM groups. Statistical analyses were performed using Student’s t-test for continuous data and Chi-squared or Fisher’s exact test for categorical data, with significance defined as P < 0.05.

RESULTS: COS group resulted in a significantly higher oocyte maturation rate (86.11%) compared to OTO-IVM group (39.43%). Direct oocyte transport yielded a higher rate of denuded oocytes compared to ovarian tissue transport. The use of Gn before oophorectomy in OTO-IVM significantly improved the IVM maturation rate (51.90% vs. 38.00%, P < 0.001).

CONCLUSIONS: COS oocyte cryopreservation remains more effective than OTO-IVM. However, the study highlighted the importance of optimizing transportation methods and using Gn before oophorectomy to improve OTO-IVM outcomes. These findings could guide clinical practice in selecting appropriate fertility preservation strategies. Further research is needed to refine OTO-IVM techniques and enhance their clinical applicability.

PMID:41199301 | DOI:10.1186/s13048-025-01847-4

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Impact of muscle mass on mortality in patients with rheumatoid arthritis: insights from NHANES 1999-2018

Nutr J. 2025 Nov 6;24(1):170. doi: 10.1186/s12937-025-01220-7.

ABSTRACT

BACKGROUND: Muscle loss is linked to multiple adverse outcomes, but its impact on rheumatoid arthritis (RA) prognosis is unclear. This study aimed to examine the association between muscle mass and mortality in RA patients.

METHODS: RA patients from the NHANES database were followed for survival until December 31, 2021. Muscle mass was measured using dual X-ray absorptiometry, low muscle mass was defined as appendicular skeletal muscle mass index (ASMI) < 7.0 kg/m² in men or < 5.5 kg/m² in women. The relationship between ASMI and mortality was analyzed using weighted Cox regression.

RESULTS: The study included 892 participants (weighted mean [SE] age 52.22 [0.59] years, 57.36% female). During a median (SE) follow-up of 11.44 (0.33) years, 291 deaths (32.62%) were recorded, of which 197 (28.23%) were attributed to cardiovascular disease. In fully adjusted models, a 1 kg/m²increase in ASMI was associated with decreased all-cause and cardiovascular mortality risk by 34% (HR = 0.66, 95% CI 0.50-0.86) and 40% (HR = 0.60, 95% CI 0.38-0.93), respectively. When ASMI stratified, RA with low muscle mass had a 1.42-fold higher risk of all-cause mortality (HR = 1.42, 95% CI 1.01-2.00) and a 2.58-fold higher risk of cardiovascular mortality (HR = 2.58, 95% CI 1.18-5.62) than those with normal muscle mass. Restricted cubic spline analysis showed a nonlinear association between ASMI and cardiovascular (Pnonlinear = 0.04) but not for all-cause mortality (Pnonlinear = 0.25).

CONCLUSIONS: Muscle loss in RA patients is linked to higher mortality risk, underscoring the need to recognize its harmful effects.

PMID:41199290 | DOI:10.1186/s12937-025-01220-7

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Integrated in-silico and in-vitro analysis of lncRNA H19/miRNA-675/p53 in OSCC: Structural characterization and molecular docking insights

Diagn Pathol. 2025 Nov 6;20(1):124. doi: 10.1186/s13000-025-01714-2.

ABSTRACT

BACKGROUND: Long non-coding RNAs (lncRNA) H19 has drawn special attention because of its varied role in several malignancies, including OSCC. Therefore, this study was conducted to assess the association between H19-miR675-p53 by in-silico analysis, quantify the expression levels of H19, miRNA-675, and target oncogene p53 in cancerous versus normal individuals, and Correlate the Clinicopathological findings with their expression pattern.

METHODS: The secondary structure of lncRNA H19 was predicted using the RNAfold web server ( http://rna.tbi.univie.ac.at/cgi-bin/RNAWebSuite/RNAfold.cgi ). The FASTA sequence of H19 was retrieved from the NCBI database ( https://www.ncbi.nlm.nih.gov/ ). We performed molecular docking studies to analyze the interaction between miRNA-675 and p53 using the MDockPP ( https://zougrouptoolkit.missouri.edu/MDockPP/ ) web server. Real-time PCR was used to measure the amounts of H19 and miR-675, and Immunohistochemistry was used to analyse the pattern of p53 expression.

RESULT: The study successfully associated miR-675 from the first exon of H19 modulating p53 via in silico analysis. It was found that H19 and miR-675 levels were higher in OSCC patients (3.12 ± 1.16) compared to healthy patients (1.0 ± 0.0), and was statistically significant (p-value < 0.001).

CONCLUSION: The specificity of H19 expression in OSCC compared to normal presents an attractive target for cancer-specific therapies, minimizing the risk of off-target effects.

PMID:41199286 | DOI:10.1186/s13000-025-01714-2

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Supporting orthopaedic surgery residents as parents – there is room to improve!

Am J Surg. 2025 Oct 17;251:116662. doi: 10.1016/j.amjsurg.2025.116662. Online ahead of print.

ABSTRACT

BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) mandates at least six weeks of paid medical, parental, or caregiver leave for residents and fellows. The primary aim of this study is to determine the proportion of orthopaedic surgery residency programs with parental/adoption leave policies on their website. The absence of this information may dissuade female medical students from pursuing orthopaedic surgery.

METHODS: Websites of all ACGME-accredited allopathic orthopaedic surgery residency program websites reviewed. Data collected included the number of current female residents and parental/adoption leave policies.

RESULTS: Among 183 program websites, 4.4 ​% listed a parental leave policy and 3.3 ​% listed an adoption leave policy. Listing a parental leave policy on the program website was associated with a higher mean proportion of female residents, although this did not reach statistical significance.

DISCUSSION: Despite ACGME policy, very few programs list parental/adoption leave policies on their websites, highlighting an opportunity for improvement.

PMID:41197205 | DOI:10.1016/j.amjsurg.2025.116662

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Adjunctive curcumin nano-micelles reduce overall pruritus intensity in refractory post-burn pruritus: A randomized controlled trial

Burns. 2025 Oct 28;51(9):107761. doi: 10.1016/j.burns.2025.107761. Online ahead of print.

ABSTRACT

Post-burn pruritus (PBP) is a common and refractory condition that can significantly impair quality of life (QoL). Curcumin, a bioactive compound with anti-inflammatory and neuroprotective properties, has been proposed as a therapeutic option for chronic pruritus. This study evaluated the efficacy of a nano-micelle formulation of curcumin in patients with refractory PBP. In this randomized controlled trial, 100 adults with PBP were assigned to receive standard treatment alone or with curcumin nano-micelle capsules (40 mg, twice daily) for 12 weeks. Outcomes included pruritus severity, frequency, distribution, sleep condition, sleep disturbance, total pruritus intensity, and QoL (ItchyQoL), assessed at baseline, week 6, and week 12. Analyses were performed using mixed-effects models with group, time, and group×time as factors. Both groups demonstrated significant within-group improvements in some pruritus domains. However, in the mixed-effects model, curcumin produced a significant between-group reduction in total pruritus intensity (adjusted mean difference -2.83; 95 % CI -5.54 to -0.11; p = 0.041). No significant between-group effects were observed for individual domains. Sleep condition improved with curcumin (adjusted mean difference -0.50; 95 % CI -1.04-0.03) but did not reach statistical significance. QoL improved significantly over time (time effect p = 0.045) in both groups, with a non-significant trend favoring curcumin (adjusted mean difference 2.85; 95 % CI -2.13-7.83). Adjunctive curcumin nano-micelle therapy significantly reduced overall pruritus intensity in patients with refractory PBP. Sleep and QoL outcomes improved in both groups, with trends favoring curcumin. Larger, longer trials with optimized dosing are warranted to confirm these findings.

PMID:41197197 | DOI:10.1016/j.burns.2025.107761

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Coordination index – A method for the assessment of the inter-joint coordination during gait

Gait Posture. 2025 Nov 1;124:110030. doi: 10.1016/j.gaitpost.2025.110030. Online ahead of print.

ABSTRACT

BACKGROUND: The gait analysis is a relatively commonly used tool for evaluating the functional deficits of various groups of patients, regardless of the origin of these deficits, but is especially common in patients with neurological deficits. One of the problems they encounter is disrupted coordination. One of the methods to asses it is cyclogram, or angle-angle plot.

RESEARCH QUESTION: Could cyclogram index, based on cyclograms for lower limbs contribute to understanding of the disrupted coordination in neurological patients?

METHODS: This paper presents the coordination index, which is based on the perimeters of four cyclograms: hip/pelvis, knee/hip and ankle/knee in the sagittal plane and hip/pelvis in the frontal plane. Data extracted from retrospective gait analyses of patients with spastic diplegia cerebral palsy, dystrophy and Guillain-Barre syndrome were used to calculate cyclograms, coordination index and gait indices: Gillette Gait Index (GGI), Gait Deviation Index (GDI) and Gait Profile Score (GPS).

RESULTS: The main finding of this paper is the independence of the new coordination index from commonly used indices: GGI, GDI and GPS. A discriminant analysis, in which the grouping variable was the name of the disease, revealed that cyclogram perimeters and coordination index were statistically significant predictors.

SIGNIFICANCE: Coordination index could be used as additional measure assessing the disrupted coordination in patients.

CONCLUSION: This paper shows the potential usefulness of the proposed method in clinical application, especially in the long-term changes induced by the various treatment methods.

PMID:41197188 | DOI:10.1016/j.gaitpost.2025.110030