Category: Nevin Manimala

J Foot Ankle Res. 2025 Mar;18(1):e70026. doi: 10.1002/jfa2.70026.

ABSTRACT

BACKGROUND: Transmetatarsal amputation (TMA) is a commonly performed procedure for gangrene in the setting of diabetes or peripheral vascular disease. The purpose of this study is to investigate the incidence of and risk factors for reoperation and perioperative complications after TMA in patients undergoing surgery for primarily infectious/diabetic wounds versus peripheral vascular disease.

METHODS: Patients undergoing TMA between January 1, 2015 and December 31, 2020 were identified using the American College of Surgeons National Surgical Quality Improvement Program database. The indication for surgery was reported using the International Classification of Disease 9/10 codes. Patients were categorized into two groups: patients undergoing surgery for primarily infectious/diabetic wounds versus peripheral vascular disease. The incidence of 30-day mortality, readmission, reoperation, nonhome discharge, and various medical and surgical complications was reported. Outcome measures were compared between the diabetic and peripheral vascular disease groups. Logistic regression was used to identify independent risk factors for each outcome measure of interest.

RESULTS: 3392 patients were included in the final cohort. There was a 30-day mortality rate of 2.9%, reoperation rate of 13.8%, readmission rate of 16.8%, surgical complication rate of 22.2%, and medical complication rate of 15.8%. Patients undergoing surgery for a vascular indication had a higher rate of mortality, reoperation, hospital readmission, nonhome discharge, and various medical complications (p < 0.05). Patients undergoing surgery for infectious/diabetic wounds had a higher rate of deep surgical site infection and systemic sepsis (p < 0.05). A vascular surgical indication was independently associated with reoperation and overall medical complications (p < 0.05). Various factors, including age, body mass index, medical comorbidities, and the presence of preoperative sepsis were associated with poor outcomes.

CONCLUSION: Significant rates of mortality, reoperation, and hospital readmission were reported after TMA. The presence of peripheral vascular disease was independently associated with reoperation and medical complications. Patients undergoing TMA, particularly for peripheral vascular disease, should be counseled about perioperative risks and indicated for surgery carefully.

PMID:39924627 | DOI:10.1002/jfa2.70026

Sci Rep. 2025 Feb 10;15(1):4858. doi: 10.1038/s41598-025-89250-3.

ABSTRACT

Concrete frameworks require strong structural integrity to ensure their durability and performance. However, they are disposed to develop cracks, which can compromise their overall quality. This research presents an innovative crack diagnosis algorithm for concrete structures that utilizes an optimized Deep Neural Network (DNN) called the Ridgelet Neural Network (RNN). The RNN model was then adjusted with a new advanced version of the Human Evolutionary Optimization (AHEO) algorithm that is introduced in this study. The AHEO as a new method combines human intelligence and evolutionary principles to optimize the RNN model. To train the model, an image dataset has been used, consisting of labeled images categorized as either “cracks” or “no-cracks”. The AHEO algorithm has been employed to refine the network’s weights, adjust the output layer for binary classification, and enhance the dataset through stochastic rotational augmentation. The effectiveness of the RNN/AHEO model was evaluated using various metrics and compared to existing methods. The model’s performance is evaluated by metrics such as accuracy, precision, recall, and F1-score, and is compared to existing methods including CNN, CrackUnet, R-CNN, DCNN, and U-Net, achieving an accuracy of 99.665% and an F1-score of 99.035%. The results demonstrated that the RNN/AHEO model outperformed other approaches in detecting concrete cracks. This innovative solution provides a robust method for maintaining the structural integrity of concrete frameworks.

PMID:39924615 | DOI:10.1038/s41598-025-89250-3

Int Ophthalmol. 2025 Feb 10;45(1):68. doi: 10.1007/s10792-025-03440-6.

ABSTRACT

OBJECTIVE: The objective of this study is to assess the therapeutic efficacy of low-temperature plasma ablation (LTP) combined with drug treatment in the treatment of fungal keratitis (FK) caused by various pathogens, thereby establishing a clinical foundation for the use of LTP in treating FK.

METHODS: A retrospective study was performed, including 76 patients (76 eyes) with FK diagnosed at the Affiliated Eye Hospital of Nanchang University. The patients were categorized into the Fusarium group, Alternaria group, Aspergillus group, and other genus groups based on positive results from biological cultures. Key clinical parameters, including best-corrected visual acuity (BCVA), maximum ulcer lesion diameter, and healing grades, were assessed and compared at baseline (pre-treatment), on postoperative day 3, and at postoperative week 3.

RESULTS: The study demonstrated that the BCVA (LogMAR) of all patients revealed no significant differences at postoperative day 3 (F = 2.54, p = 0.063) and week 3 (F = 1.86, p = 0.143). Although BCVA improved to varying degrees compared to preoperative levels, the changes were not statistically significant (p > 0.05). After treatment with LTP combined with pharmacotherapy across all four groups, an average of 53 patients (69.74%) achieved grade I healing, with the group effect being nonsignificant (F = 2.85, p = 0.071), while the effect of time post-treatment was significant (F = 67.85, p < 0.001). Additionally, the corneal scar diameter at postoperative week 3 was significantly smaller compared to the preoperative lesion diameter (p < 0.05). Multiple comparisons revealed significant differences in scar diameter among patients with grade I healing at postoperative week 3 (F = 3.48, p = 0.023), with notable differences observed between the Alternaria and Fusarium groups (p = 0.017). The average rate of grade III healing, defined by the occurrence of corneal perforation and/or the need for therapeutic penetrating keratoplasty, was 7.89%.

CONCLUSION: Low-temperature plasma ablation demonstrates effective therapeutic outcomes for FK caused by various pathogens that are unresponsive to pharmacological treatments, with no significant complications.

PMID:39924602 | DOI:10.1007/s10792-025-03440-6

Bull Environ Contam Toxicol. 2025 Feb 9;114(2):31. doi: 10.1007/s00128-025-04012-1.

ABSTRACT

Three beaches on the Eastern Black Sea coast of Türkiye, with different usage purposes and urbanization, were evaluated regarding marine litter densities and categories in four seasons. 3573 marine litter items were collected, classified, and recorded. In an area of 3,000 m², the highest amount of litter was counted in summer with a total of 1473 pieces of litter (Average: 0.491 ± 0.131 items/m²), and the lowest was counted in the spring months with 577 pieces of litter (Average: 0.192 ± 0.026 items/m²). Plastics (79 ± 0.9%) were the most predominant, and litter items mainly consisted of metal (7.2 ± 0.5%) and paper/cardboard (5.6 ± 0.6%.). Beach litter was also associated with fishing activities and tourism. It was observed that litter relatively increased during the fishing season in the region where fishing activities were intense. SIMPER analysis revealed that Çamburnu, located near a fishing port, exhibited a significantly different litter composition, with fishing gear being the most dominant category.

PMID:39924596 | DOI:10.1007/s00128-025-04012-1

Ann Surg Oncol. 2025 Feb 9. doi: 10.1245/s10434-025-16976-9. Online ahead of print.

ABSTRACT

BACKGROUND: Optimal timing for surgery after neoadjuvant chemoradiotherapy (NCRT) remains controversial, necessitating reliable preoperative indicators. This study examines how sarcopenia and surgical timing affect prognosis in patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC).

PATIENTS AND METHODS: This retrospective study analyzed patients with LA-ESCC who underwent NCRT and surgery at three institutions in China from 2014 to 2023. The skeletal muscle area at the third lumbar vertebra was measured to calculate the skeletal muscle index (SMI). Prognostic analysis was performed using Cox proportional hazards models and propensity score matching (PSM), with survival curves generated using the Kaplan-Meier method and statistical significance set at p<0.05.

RESULTS: A total of 415 patients were analyzed, with a median follow-up of 39.1 months. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 59.3% and 53.1%, respectively. Malnutrition and time to surgery (TTS) were independent prognostic factors for both OS and PFS (p < 0.05). Patients with long TTS showed better OS [hazard ratio (HR) = 0.62, p = 0.01] and PFS (HR = 0.68, p = 0.02) compared with those with short TTS. Among patients with sarcopenia, long TTS significantly improved OS (HR = 0.56; p = 0.01) and PFS (HR = 0.62; p = 0.02), while no survival benefit was observed for TTS in patients who were nonsarcopenic (p > 0.05).

CONCLUSIONS: Sarcopenia does not independently impact OS or PFS. Patients with sarcopenia benefit from a longer surgical time interval after NCRT. In addition, preoperative evaluation of muscle quality may aid in optimizing surgical timing to improve outcomes.

PMID:39924590 | DOI:10.1245/s10434-025-16976-9

Sci Rep. 2025 Feb 9;15(1):4844. doi: 10.1038/s41598-025-89287-4.

ABSTRACT

Exercise Self-Efficacy Scale (ESES) is widely used to assess individuals’ exercise self-efficacy through self-reporting. It includes one factor and 18 items that gauge one’s confidence in exercising under various conditions, such as when tired, stressed, or in unfavourable weather. Evidence indicates that differences in the original factor structure and psychometric properties were observed across different populations, including school-age students, university students, and adults. This study examined the factor structure, reliability, convergent validity, and measurement invariance of the Chinese version of the ESES among secondary school students. Data from 856 students (age: M = 13.80, SD = 0.94) were analysed using exploratory and confirmatory factor analyses to identify the best-fitting factor structure. The reliability and convergent validity were tested using the collected data. Configural, metric, and scalar invariances, as well as the likelihood ratio test, were tested for measurement invariance. A 14-item, two-factor structure of the ESES, consistently demonstrated the best fit among secondary school students. The two-factor structure showed strong internal consistency reliability (McDonald’s Omega of 0.921 and 0.843) and satisfactory convergent validity (average variance extracted values of 0.582 and 0.478, composite reliability values of 0.917 and 0.845). Multi-group confirmatory factor analysis (likelihood ratio test, p > 0.01) revealed scalar measurement invariance across sex, ethnic backgrounds, grades, and school locations. These findings suggest that the 14-item, two-factor Chinese version of the ESES is suitable for use with secondary-school students. Future studies could confirm these findings by examining the 14-item, two-factor ESES in diverse samples, considering ethnicity, socioeconomic status, and age range.

PMID:39924573 | DOI:10.1038/s41598-025-89287-4

Sci Rep. 2025 Feb 10;15(1):4848. doi: 10.1038/s41598-025-89482-3.

ABSTRACT

Ensemble learning can effectively mitigate the risk of model overfitting during training. This study aims to evaluate the performance of ensemble learning models in predicting tumor deposits in rectal cancer (RC) and identify the optimal model for preoperative clinical decision-making. A total of 199 RC patients were analyzed, with radiomic features extracted from T2-weighted and apparent diffusion coefficient images and selected through advanced statistical methods. After that, the bagging-ensemble learning model (random forest), boosting-ensemble learning model (XGBoost, AdaBoost, LightGBM, and CatBoost), and voting-ensemble learning model (integrating 5 classifiers) were applied and optimized using grid search with tenfold cross-validation. The area under the receiver operator characteristic curve, calibration curve, t-distributed stochastic neighbor embedding (t-SNE), and decision curve analysis were adopted to evaluate the performance of each model. The voting-ensemble learning model (VELM) performs best in the testing cohort, with an AUC of 0.875 and an accuracy of 0.800. Notably, Calibration plots confirmed VELM’s stability and t-SNE visualization illustrated clear clustering of radiomic features. Decision curve analysis further validated the VELM’s superior net benefit across a range of clinical thresholds, underscoring its potential as a reliable tool for clinical decision-making in RC.

PMID:39924571 | DOI:10.1038/s41598-025-89482-3

Sci Rep. 2025 Feb 10;15(1):4855. doi: 10.1038/s41598-025-89536-6.

ABSTRACT

Apple scab disease causes significant losses in apple crop production. In the north western Himalayas of India, the indiscriminate use of triazole fungicides to manage apple scab has led to the emergence of triazole-resistant strains of V. inaequalis. To investigate the resistance profile in three Venturia inaequalis populations collected from North, South and Central Kashmir, baseline sensitivity assays were conducted on 30 V. inaequalis isolates unexposed to any fungicides. The mean ED₅₀ value and discriminatory dose of difenoconazole and flusilazole were determined to be 0.584, 0.15 µg ml^-1 and 0.018, 0.02 µg ml^-1 respectively. The assessment at these discriminatory doses revealed a major shift in sensitivity against both fungicides. The sequencing of conserved region-2 of CYP51A1 revealed that the resistant isolates have TTT (Phenylalanine) instead of TAT (Tyrosine) codon at position 133. Moreover, the same mutation was observed in some shifted isolates which confirmed that this mutation is not solely responsible for the development of resistance. From linear mixed-model regression analyses, the fitness parameters of resistant isolates were assessed which revealed that except for oxidative stress at 1 mm H₂O₂ (wherein a decreased micro colony growth linearly increases with resistance), there is no fitness cost associated with the development of resistance against difenoconazole and flusilazole. Meanwhile, the resistance against both fungicides is phenotypically stable. Consequently, it is speculated that these populations are unlikely to regain their sensitivity even in the absence of these frequently used fungicides.

PMID:39924568 | DOI:10.1038/s41598-025-89536-6

Sci Rep. 2025 Feb 10;15(1):4856. doi: 10.1038/s41598-025-88730-w.

ABSTRACT

The pore structure of porous media directly affects its permeability characteristics and fluid flow properties, making the accurate reconstruction of these structures of great significance. In recent years, multi-point statistics (MPS) methods have been widely used in pore structure modeling. Among them, the SNESIM algorithm, as an advanced MPS technique, has been extensively applied in the study of porous media pore structures. This paper aims to investigate the use of the SNESIM algorithm for reconstructing pore structures on 2D core slices with varying porosities, all taken from the same core. It also analyzes the effectiveness, limitations, and applicable conditions of the algorithm. This study utilizes CT scan images to construct digital core technology and applies the SNESIM algorithm to reconstruct pore structures of core slices with different porosities. By analyzing performance parameters such as porosity, pore throat ratio, average grain radius, coordination number, and permeability, the study shows that the reconstructed images(RI) from most samples maintain a trend similar to that of the training images(TI), demonstrating the good applicability and reliability of the SNESIM algorithm in pore structure reconstruction. However, the core slices used in this study were all taken from the same core. Effectively transferring the pore structures from the 2D plane to the 3D pore space and restoring the pore structures to the greatest extent still requires further research. In particular, when dealing with complex pore structures, the accuracy and performance of the SNESIM algorithm need further improvement. Future research will focus on optimizing the algorithm to handle more diverse pore structures and exploring 3D reconstruction methods to more comprehensively describe and analyze the pore characteristics in actual porous media.

PMID:39924565 | DOI:10.1038/s41598-025-88730-w

Sci Rep. 2025 Feb 9;15(1):4819. doi: 10.1038/s41598-025-89065-2.

ABSTRACT

Science holds high prestige in society and understanding public perception of what is considered scientific is essential. The scientificity of a profession is the degree of scientific legitimacy and is determined by the quality of its scientific procedures. Higher levels of scientificity are achieved when scientific results are more objective, impartial, and neutral. In this work, we first estimate the scientificity levels attributed to various professions using a logistic regression model. Then, we explore ways to simultaneously improve their scientific perception by means of multiobjective optimization techniques. To this aim, the statistical results are used to formulate a multiobjective optimization model that maximizes the scientific perception of all the professions considered. The findings provide insights into science policy measures to optimize resource allocation in order to increase the scientific perception of the professions.

PMID:39924535 | DOI:10.1038/s41598-025-89065-2