Category: Nevin Manimala

Platelets. 2026 Dec;37(1):2607714. doi: 10.1080/09537104.2025.2607714. Epub 2026 Jan 15.

ABSTRACT

While platelets for transfusion are traditionally stored at room temperature (20-24°C), cryopreservation at -80°C is attractive, as it facilitates an extension of the shelf-life from 7 days to several years. Cryopreserved platelets display enhanced procoagulant capacity, which may distort the balance between clot formation and resolution. Platelets were frozen at -80°C using DMSO and thawed and resuspended in fresh plasma before testing. Fresh components (day 1) were tested in parallel. The supernatant of thawed platelets contained a higher concentration of fibrinogen, plasminogen, TAFI, FXIII, PAI-1, and tPA, compared to fresh platelets. However, this was primarily due to the addition of fresh plasma at the time of platelet thawing, with the exception of PAI-1. Thawed platelets displayed a higher surface abundance of PAI-1 and FXIII, compared to fresh platelets. The clots formed by thawed platelets underwent retraction; although this was affected by time and platelet concentration. tPA-induced fibrinolysis, measured by thromboelastography (TEG), was not statistically different between fresh and thawed platelets. Although differences in the abundance of fibrinolytic mediators were observed in thawed platelets, compared to room temperature platelets, clot resolution properties were conserved. This work provides a more complete understanding of the overall hemostatic capacity of cryopreserved platelets.

PMID:41537377 | DOI:10.1080/09537104.2025.2607714

Int J Surg. 2026 Jan 13. doi: 10.1097/JS9.0000000000004788. Online ahead of print.

ABSTRACT

OBJECTIVE: To discuss the anatomy of the optic strut (OS) and its implications for the diagnosis and treatment of vision loss caused by OS mucocele.

METHODS: We collected and analyzed 5 cases of OS mucocele with vision loss treated from 2013 to 2023, and reviewed literatures on nasal mucoceles and orbital apex anatomy. By comparing reported cases, we summarized the OS anatomical characteristics and their effects on patient symptoms. Concurrently, a comprehensive narrative literature review was conducted using PubMed, Embase, and Web of Science databases to identify studies on optic neuropathy caused by mucoceles in the OS and adjacent structures (anterior clinoid process, sphenoid sinus, ethmoid sinus). Relevant data were extracted for descriptive statistical analysis.

RESULTS: All patients were followed up for 6 months postoperatively. One patient showed no significant vision improvement, while the other four had vision recovery: 0.5→1.2, 0.6→1.0, 0.7→1.0, and 1.0→1.2 (typical case). For the narrative literature review, 15 studies encompassing 48 cases were included, with 19 cases analyzed in detail. All 19 cases presented with vision loss (100%), accompanied by headache (68.4%) and afferent pupillary defect (APD, 47.4%) in partial cases. Lesions were confined to the anterior clinoid process in 4 cases and involved the sphenoid sinus in the rest, showing expansile features on CT and high T2 signal on MRI. Endoscopic endonasal surgery was adopted in 63.2% of cases; timely intervention achieved complete visual recovery in 52.6% of patients, whereas delayed treatment frequently led to optic atrophy.

CONCLUSIONS: The OS is a bony structure separating the superior orbital fissure, optic canal, and internal carotid artery. OS mucocele-induced pressure elevation and inflammation can damage the optic nerve and cause vision loss. Prompt surgical resection and optic nerve decompression are critical for preserving visual function in patients with space-occupying lesions around the optic canal.

PMID:41537376 | DOI:10.1097/JS9.0000000000004788

J Hosp Med. 2026 Jan 15. doi: 10.1002/jhm.70241. Online ahead of print.

ABSTRACT

BACKGROUND: Medical training often omits systematic approaches to prognostication and goals of care (GOC) communication, leading to end-of-life (EOL) hospital care misaligned with patients’ values, lower clinician self-efficacy, and greater clinician distress.

OBJECTIVE: This communication training intervention aimed to improve clinician knowledge and self-efficacy and to reduce distress in conducting GOC discussions.

METHODS: We developed and implemented GOComm, a 4-h serious illness communication training program across eight campuses of a large health system. Utilizing a train-the-trainer model, facilitators taught GOComm to inpatient clinicians, primarily hospitalists, intensivists, physician assistants (PAs), and trainees. Topics included prognosticating, conveying serious news, managing emotions, creating values-informed medical recommendations, and discussing hospice. Simulations included a clinician and simulated patient (SP) role play and a family meeting, in which a clinical dyad encountered an SP dyad. Mixed methods evaluation included pre- and postsurveys.

RESULTS: Three hundred and ninety-three clinicians participated: 322 provided demographics, with a mean of 5.57 years in practice; 71.7% were women, 50% were White, and 29.5% were Asian. Of 315 listing roles: 41% were physicians, 41% were PAs. Two hundred and forty-two completed both pre- and postsurveys. Clinicians had statistically significant gains in GOC knowledge, self-efficacy, and distress tolerance. GOComm had high clinician acceptability: 96.2% indicated they would recommend GOComm to a colleague, and 83.2% credited it with changing how they will manage patients.

CONCLUSIONS: GOComm is an effective train-the-trainer curriculum for hospital-based clinicians to gain knowledge and confidence in empathic communication skills. Clinician distress tolerance can be mitigated by enhancing skills training and social support through team simulations.

PMID:41537361 | DOI:10.1002/jhm.70241

Afr J Reprod Health. 2026 Jan 14;30(1):37-43. doi: 10.29063/ajrh2026/v30i1.5.

ABSTRACT

Infertility affects 15% of couples worldwide, with male factors contributing to over half of the cases. Varicocele, present in 35% of men with primary infertility, impairs sperm quality. This study evaluates the effect of electroacupuncture (EA) on improving sperm motility and morphology in varicocele patients. A single-blind, randomized controlled trial was conducted with 14 participants divided into an EA group (n=7) and a control group (n=7). The intervention group received EA in combination with a herbal regimen and Tribulus Terrestris, while the control group received only the herbal regimen and Tribulus Terrestris without EA. Men aged 20-35 with ultrasound-confirmed varicocele and abnormal spermiograms were included. Statistical analysis used the paired t-test, Wilcoxon, and Mann-Whitney tests. The EA group showed significant improvements in sperm morphology (P=0.029) and motility (P=0.026) compared to the control group. These findings suggest that EA significantly enhances sperm quality in varicocele patients and may serve as an effective complementary treatment for male infertility.

PMID:41537313 | DOI:10.29063/ajrh2026/v30i1.5

Brief Bioinform. 2026 Jan 7;27(1):bbaf730. doi: 10.1093/bib/bbaf730.

ABSTRACT

Causal mediation analysis investigates whether the effect of an exposure on an outcome operates through intermediate variables known as mediators. Although progress has been made in high-dimensional mediation analysis, current methods do not reliably control the false discovery rate (FDR) in finite samples, especially when mediators are moderately to highly correlated or follow non-Gaussian distributions. These challenges frequently arise in DNA methylation studies. We introduce CoxMDS, a multiple data splitting method that uses Cox proportional hazards models to identify putative causal mediators for survival outcomes. CoxMDS ensures finite-sample FDR control even in the presence of correlated or non-Gaussian mediators. Through simulations, CoxMDS is shown to maintain FDR control and achieve higher statistical power compared with existing approaches. In applications to DNA methylation data with survival outcomes, CoxMDS identified eight CpG sites in The Cancer Genome Atlas that are consistent with the hypothesis that DNA methylation may mediate the effect of smoking on lung cancer survival, and two CpG sites in the Alzheimer’s Disease Neuroimaging Initiative that are consistent with the hypothesis that DNA methylation may mediate the effect of smoking on time to Alzheimer’s disease conversion.

PMID:41537308 | DOI:10.1093/bib/bbaf730

Pol Przegl Chir. 2025 Nov 13;97(6):33-47. doi: 10.5604/01.3001.0055.4390.

ABSTRACT

<b>Introduction:</b> Pancreatic cancer is still an unresolved, significant diagnostic and clinical problem. An ideal tumor marker with a high sensitivity, organ specificity, and prognostic value that correlates with tumor stages and eliminates the imperfection of preoperative serum carbohydrate antigen 19-9 (CA 19-9) concentration is still being sought.<b>Aim:</b> This study aimed to conduct a comparative analysis expression of genes <i>KRAS, DPM1, ACRV1</i>, and <i>MBD3L2</i> in the saliva of patients with pancreatic cancer (PC) and a control group (CG).<b>Material and methods:</b> The study was performed on a group of 55 patients. Group 1 consisted of 44 patients with PC, group 2 (CG) consisted of 11 individuals who were recruited among patients operated on for non-inflammatory cholelithiasis. Group 1 was divided into 2 subgroups group 1a, 19 patients with resectable pancreatic tumors, and group 1b, 25 patients with unresectable pancreatic tumors. The saliva samples were taken from patients twice, before surgery and 10 days after surgery, and the expression of genes <i>KRAS, DPM1, ACRV1</i>, and <i>MBD3L2</i> in the saliva was evaluated. Gene expression at the transcriptional level was analyzed by assessing the number of mRNA copies using the reverse transcriptase reaction and polymerase chain reaction (RT-PCR).<b>Results:</b> The revealed expression of genetic cancer biomarkers (CB) (<i>KRAS, DPM1, ACRV1, MBD3L2</i>) in saliva was statistically significantly higher in the PC group in comparison to CG. There was a statistically significant decrease in the <i>KRAS</i> gene expression and a statistically significant increase in the <i>MBD3L2</i> expression in patients in subgroup 1a, 10 days after resection procedures. The revealed serum concentration of CA 19-9 was significantly higher in subgroup 1b in comparison to subgroup 1a. Although higher gene expression of <i>KRAS, DPM1</i>, and <i>MBD3L2 </i>was observed in subgroup 1b, no statistical significance was obtained. A statistically significant correlation between <i>DPM1</i> expression and serum CA 19-9 level in the PC group was observed. There were statistically significant differences in <i>KRAS </i>and <i>DPM1</i> expression depending on the tumor stage in the TNM/UICC classification regarding to T and N category. A significant difference in <i>MBD3L2</i> expression was observed in N category. A statistically significant increase in the expression of <i>KRAS, DPM1</i>, and <i>MBD3L2 </i>was observed in the case of neoplastic infiltration of blood vessels, and a significant increase in the expression of <i>KRAS</i> and <i>MBD3L2 <i/>in the case of neoplastic infiltration of nerve fibers.<b>Conclusions:</b> Presented findings suggest the usefulness of the salivary transcriptome profiles in distinguishing patients with PC from healthy controls but its usefulness in the differential diagnosis between resectable and unresectable PC is limited. However, more studies on a large population are needed to support our result.

PMID:41537300 | DOI:10.5604/01.3001.0055.4390

Pol Przegl Chir. 2025 Aug 11;97(6):57-63. doi: 10.5604/01.3001.0055.2379.

ABSTRACT

<b>Introduction:</b> Caspases play a key role in apoptosis, the disruption of which can lead to the proliferation of abnormal cell clones and tumor growth. Caspases’ role as potential biomarkers has been confirmed in relation to many types of cancer.<b>Aim:</b> In this study, the authors focused on the European population with an average incidence of gastric cancer to investigatethe importance of caspases in gastric cancer.<b>Material and methods:</b> For this purpose, we evaluated the expression of representative caspases – an effector caspase-3 as well as caspase-8 and -9 initiating the apoptosis process, studying the cases of 53 patients who had been operated on in the Department of General Surgery and Surgical Oncology from 2010 to 2014. Also, we selected patients who had not received the neoadjuvant chemotherapy. An attempt was then made to identify correlations between caspase expression and clinical or pathological features of gastric cancers. The expression was evaluated by immunohistochemical reactions using monoclonal antibodies. Statistical analysis was performed, including parametric and nonparametric tests, like Kruskal-Wallis and Spearman's rho.<b>Results:</b> The study did not confirm a significant role of caspases in gastric cancer. We found no correlation with overall survival, tumor location, clinical stage, or its grade of histopathological malignancy as defined by World Health Organization (WHO). The possibility of using the selected caspases as biomarkers was not confirmed.<b>Discussion:</b> Our observations are significantly different from those described in the literature. This may indicate differences in tumour biology in different patient populations.<b>Conclusions:</b> In the study performed by the authors of this paper, no correlation of caspase-3, -8, and -9 IRS score with clinicopathological factors and long-term survival was found to be statistically significant.

PMID:41537294 | DOI:10.5604/01.3001.0055.2379

Pol Przegl Chir. 2025 Oct 15;97(6):25-32. doi: 10.5604/01.3001.0055.3177.

ABSTRACT

<b>Introduction:</b> Iatrogenic pseudoaneurysms are uncommon but increasingly encountered complications due to the rising number of percutaneous interventions. For minor lesions, conservative treatment, such as pressure or observation, is often effective. However, its effectiveness depends on many factors, which do not always allow for avoiding surgical intervention.<b>Aim:</b> The aim of this study is to evaluate the diagnostic and therapeutic strategies for iatrogenic pseudoaneurysms based on a single-center experience, with emphasis on treatment efficacy, safety, and clinical outcomes.<b>Material and methods:</b> From 2021 to 2023, 57 patients underwent surgery for iatrogenic pseudoaneurysms at the Department of General and Vascular Surgery, Clinical Hospital in Poznan. Patients were retrospectively divided into two groups: with (n = 22) or without (n = 35) prior conservative treatment. Groups were compared regarding demographics, primary procedures, diagnostic tests performed, pseudoaneurysm features, vascular access, need for red blood cell transfusion (CRC), and outcomes.<b>Results:</b> No significant differences were found between groups in gender, BMI, smoking, prior endovascular interventions, or anticoagulant use (p > 0.05). Differences were observed in the primary procedures causing pseudoaneurysms (p < 0.05). Conservative treatment was more frequent after coronary angiography, ablation, and thrombolysis. Direct surgery without conservative attempts was associated with procedures like peripheral angioplasty, pacemaker or electrode implantation, TAVI, vascular access placement/removal, and aneurysm embolisation. In both groups, no statistically significant differences were found when comparing the type of diagnostic test performed (p>0.05). No significant differences were noted in pseudoaneurysm size, multicellularity, arteriovenous fistula presence, access type, transfusion needs, or treatment outcomes (p>0.05).<b>Conclusions:</b> Management should be individualized, considering patient history, prior interventions, pharmacotherapy, and imaging. Treatment should balance efficacy and safety, guided by clinical status.

PMID:41537292 | DOI:10.5604/01.3001.0055.3177

J Clin Res Pediatr Endocrinol. 2026 Jan 15. doi: 10.4274/jcrpe.galenos.2025.2025-10-4. Online ahead of print.

ABSTRACT

BACKGROUND: Data on the impact of aromatase inhibitor (AI) therapy on final or near-final adult height (FNFH) in males with short stature is limited. This study investigates whether AI therapy improves FNFH in males with advanced or rapidly advancing bone age (ABA) and compromised predicted adult height.

METHODS: Data were collected through retrospective chart review. Descriptive statistics were used to characterize the study cohort. Fisher’s exact test and the Wilcoxon rank-sum test were used to compare outcomes.

RESULTS: Of 72 patients reviewed, 59 (82%) received anastrozole, 11 (15%) received letrozole, and 2 (2.8%) switched from anastrozole to letrozole. Median treatment duration was 25 months (IQR: 18-32). Most common diagnoses included growth hormone deficiency (31%), early puberty and premature adrenarche (18%), idiopathic short stature (15%), overweight/obesity (14%). Growth hormone (GH) was used in 66%. The overall median gain in height (FNFH minus initial predicted height) was 1.2 cm (IQR: -1.9-4.2). Letrozole-treated patients showed a greater median height gain (4.2 cm, IQR: 0.6-13) compared to the anastrozole group (0.8 cm, IQR: -2.6-3.5; p=0.013) and reached a FNFH closer to mid-parental height (MPH) (p=0.031). Longer duration of treatment, therapy at earlier puberty stages, and GH therapy were all significantly associated with greater gain in height (p-values: 0.005, 0.012, and 0.022).

CONCLUSION: Our findings suggest that letrozole is associated with greater gain in height compared to anastrozole in males with ABA. Other factors associated with greater gains are treatment at earlier stages of puberty, longer duration of treatment and concurrent GH therapy.

PMID:41537284 | DOI:10.4274/jcrpe.galenos.2025.2025-10-4

Afr J Reprod Health. 2026 Jan 14;30(1):29-36. doi: 10.29063/ajrh2026/v30i1.4.

ABSTRACT

Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality and a common obstetric complication. Rapid onset and severity can lead to hemorrhagic shock and fatal outcomes if not promptly managed. Major causes include uterine atony, placental abnormalities, birth canal trauma, and coagulation disorders. This study proposes a risk prediction model for PPH based on a Deep Belief Network (DBN), using relevant risk factors as input features. To address limitations from random initialization in the DBN, an improved Particle Swarm Optimization (IPSO) algorithm-featuring adaptive inertia weight and learning factors-was introduced to optimize network parameters. The optimized model, referred to as IDBN, was applied to predict PPH risk levels more accurately and efficiently. The results demonstrate the superior performance of the IDBN method, which achieved the highest accuracy and F1 score among all models evaluated. This approach offers a novel, data-driven method for early PPH risk identification and clinical intervention.

L’hémorragie du post-partum (HPP) demeure la principale cause de mortalité maternelle ainsi qu’une complication obstétricale fréquente. Son apparition rapide et sa gravité peuvent entraîner un choc hémorragique et des issues fatales si elle n’est pas prise en charge rapidement. Les causes majeures incluent l’atonie utérine, les anomalies placentaires, les traumatismes du canal génital et les troubles de la coagulation. Cette étude propose un modèle de prédiction du risque de HPP basé sur un Réseau de Croyance Profond (Deep Belief Network, DBN), utilisant des facteurs de risque pertinents comme variables d’entrée. Afin de pallier les limitations dues à l’initialisation aléatoire dans le DBN, un algorithme amélioré d’optimisation par essaim particulaire (IPSO) – intégrant un poids d’inertie adaptatif et des facteurs d’apprentissage modulables – a été introduit pour optimiser les paramètres du réseau. Le modèle optimisé, nommé IDBN, a été appliqué pour prédire les niveaux de risque de HPP de manière plus précise et efficace. Les résultats démontrent les performances supérieures de la méthode IDBN, qui a obtenu les meilleurs scores en termes de précision et de F1 parmi tous les modèles évalués. Cette approche offre une méthode innovante et fondée sur les données pour l’identification précoce du risque de HPP et pour guider les interventions cliniques.

PMID:41537277 | DOI:10.29063/ajrh2026/v30i1.4