Category: Nevin Manimala

Sci Rep. 2025 Dec 30. doi: 10.1038/s41598-025-34095-z. Online ahead of print.

ABSTRACT

Crayfish play an important role in freshwater ecosystems, and sex classification is crucial for analyzing their demographic structures. This study performed binary classification using traditional machine learning and deep learning models on tabular and image datasets with an imbalanced class distribution. For tabular classification, features related to crayfish weight and size were used. Missing values were handled using different methods to create various datasets. Kolmogorov-Arnold networks demonstrated the best performance across all metrics, achieving accuracy rates between 95 and 100%. Image data were generated by combining at least five images of each crayfish. Autoencoders were employed to extract meaningful features. In experiments conducted on these extracted features, support vector machines achieved 84% accuracy, and multilayer perceptrons achieved 82% accuracy, outperforming other models. To enhance performance, a novel architecture based on stacked autoencoders was proposed. While some models experienced performance declines, Kolmogorov-Arnold networks showed an average improvement of 3.5% across all metrics, maintaining the highest accuracy. To statistically evaluate performance differences, McNemar’s and Wilcoxon tests were applied. The results confirmed significant differences between Kolmogorov-Arnold networks, support vector machines, multilayer perceptrons, and naive Bayes. In conclusion, this study highlights the effectiveness of deep learning and machine learning models in crayfish sex classification and provides a significant example of hybrid artificial intelligence models incorporating autoencoders.

PMID:41469793 | DOI:10.1038/s41598-025-34095-z

Br J Clin Pharmacol. 2025 Dec 30. doi: 10.1002/bcp.70433. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Mineralocorticoid receptor antagonists (MRAs) effects on glucose metabolism and diabetes risk are inconsistently reported. We conducted a meta-analysis to evaluate the association between MRA use and glycaemic profile change as well as the risk of diabetes occurrence and progression.

METHODS: Eligible studies enrolling adult patients receiving spironolactone, eplerenone or finerenone for any clinical indication were included. The primary outcomes were new-onset diabetes mellitus and change in HbA1c (%) levels. A secondary outcome was alterations in glucose levels.

RESULTS: This meta-analysis of 20 studies evaluated the effects of MRAs on glycaemic parameters. Spironolactone significantly reduced endpoint HbA1c (%) compared to placebo (mean difference -0.27%, 95% CI: -0.38 to -0.15; P < 0.00001; I² = 31%) and in change-from-baseline fasting glucose (-0.24 mmol/L, 95% CI: -0.27 to -0.21; P < 0.00001; I² = 0%) over 4-24 weeks. Similarly, change-from-baseline HbA1c (%) was significantly lowered (-0.19%, 95% CI: -0.29 to -0.08; P = 0.0004; I² = 33%). In a head-to-head comparison, spironolactone and eplerenone showed no significant difference in HbA1c (%) change (-0.03%, 95% CI: -0.50 to 0.43; P = 0.89; I² = 88%). In the FINEARTS-HF trial, finerenone significantly reduced the risk of developing new-onset diabetes by 24%. Lastly, finerenone was associated with slightly lower rates of insulin initiation (8.1% vs. 9.0%) and escalation in glucose-lowering medication classes (32.1% vs. 34.0%) compared to placebo.

CONCLUSIONS: Spironolactone use is associated with modest but statistically significant improvements in HbA1c and glucose levels compared to placebo, suggesting a potential glycaemic benefit.

PMID:41469771 | DOI:10.1002/bcp.70433

J Ultrasound Med. 2025 Dec 30. doi: 10.1002/jum.70151. Online ahead of print.

ABSTRACT

BACKGROUND: Gestational diabetes mellitus (GDM) is a common complication observed during pregnancy, with its global prevalence increasing in recent years. GDM has been linked to adverse myocardial remodeling in the fetus and impaired fetal cardiac function. This study seeks to evaluate the impact of GDM on fetal global cardiac function using dual-gate Doppler ultrasound (DD) technology, and to investigate the potential benefits and advantages of DD technology in assessing fetal cardiac function.

METHODS: A cohort consisting of 56 pregnant women diagnosed with gestational diabetes mellitus between 24 and 28 weeks of gestation (GDM group) was selected, alongside a control group of 55 pregnant women with normal glucose levels at the same gestational age. Both the conventional pulsed combined method and the dual-gate (DD) method were utilized to evaluate the ultrasound parameters of fetal global cardiac function in both groups. These parameters included isovolumic contraction time (ICT), isovolumic relaxation time (IRT), and ejection time (ET), from which the Tei index was subsequently calculated.

RESULTS: The ICT, IRT, and Tei index of the left heart in the GDM group were significantly elevated compared to the control group (P < .05). Although ET in the GDM group, as assessed by the combined method, demonstrated a decreasing trend, this difference did not achieve statistical significance (P > .05). Conversely, the ET determined by the DD method in the GDM group was significantly reduced compared to the control group (P < .05). Right ventricular Tei index measurements showed poor consistency, with intraobserver ICCs of 0.56 for the separated measurement and 0.58 for the DD method, and interobserver ICCs of 0.50 and 0.53. As a result, right ventricular Tei indices were excluded from the final analysis.

CONCLUSION: Pregnant women with GDM will cause an increase in the Tei index of the fetal left global cardiac function, indicating that the intrauterine hyperglycemic environment can cause damage to the global fetal cardiac function. The global fetal cardiac function was impaired in both the well-controlled and poorly controlled GDM groups, suggesting that early detection of GDM and the fetal cardiac dysfunction caused by GDM are necessary. The measurement of the Tei index of the left heart in the fetus using dual-gate Doppler technology can help detect the fetal cardiac dysfunction caused by GDM at an early stage, while the application of dual-gate Doppler technology in the overall cardiac function of the right heart still faces significant challenges.

PMID:41469769 | DOI:10.1002/jum.70151

Sci Rep. 2025 Dec 30. doi: 10.1038/s41598-025-33990-9. Online ahead of print.

ABSTRACT

Kovar alloy is widely used in electronics, aerospace, and precision applications due to its thermal expansion compatibility with ceramics and glass, yet its difficult machinability demands optimized WEDM parameters for improved performance. To address this challenge, the present study aims to evaluate the influence of key WEDM factors and identify optimal machining conditions for Kovar. Experiments were conducted using a Taguchi L₂₇ orthogonal array considering servo voltage, pulse on-time, pulse off-time, and wire feed rate as machining parameters, and their effects on cutting speed, machining time, and surface roughness were systematically analyzed. A hybrid multi-criteria decision making approach combining AHP-based weighting with VIKOR compromise ranking was employed alongside the R-method for comparative validation. Results show that the parameter set Ton: 121 µs, Toff: 49 µs, SV: 20 V, and WF: 4 m/min. achieved the best overall machining performance. Importantly, both the AHP-VIKOR method and the R-method identified the same optimal settings, demonstrating strong agreement and confirming the robustness of the hybrid optimization framework. The study highlights the scientific contribution of integrating statistical ranking with structured multi-criteria analysis to enhance decision quality in multi-response WEDM optimization for Kovar alloy.

PMID:41469759 | DOI:10.1038/s41598-025-33990-9

BMC Psychol. 2025 Dec 30. doi: 10.1186/s40359-025-03919-y. Online ahead of print.

ABSTRACT

BACKGROUND: Attitudes towards aging are multidimensional. It is often affected by the individual’s social and cultural background. Valid and reliable tools across diverse cultures are important to assess the attitudes towards aging among older adults.

METHODS: The Sinhala version of the Attitudes to Aging Questionnaire (AAQ) was cross-culturally validated following standard procedures. A validation study was conducted with a sample of 185 Sinhala-speaking older adults residing in residential care facility homes in the Colombo district. The Sinhala version of the AAQ was interviewer-administered along with the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Floor and ceiling effects were assessed for each AAQ subscale, considering effects present if ≥ 15% of participants achieved the lowest or highest possible score. Psychometric properties (Internal consistency reliability, convergent validity, known-group validity, and construct validity) were assessed by descriptive and inferential statistics using SPSS version 26. Statistical significance was set as 0.05.

RESULTS: The mean age of the sample was 72.3 ± 6.1 years. The majority (56.8%) of the participants were females. No significant floor or ceiling effects were observed for any subscale of AAQ. Internal consistency reliability, measured by Cronbach’s alpha for psychosocial loss, psychological growth, and physical change subscales was 0.81, 0.77, and 0.74, respectively. Significant correlations were shown in Pearson’s correlation between all the AAQ subscales and WHOQOL-BREF domains, indicating the convergent validity. Known-group validity showed that married individuals and individuals diagnosed with chronic disease scored significantly higher mean on all three subscales of AAQ. The exploratory factor analysis extracted three factors with 57.77% cumulative variance with exceptions from the original version. Twenty-two items loaded to any of the factors except items 21and 23.

CONCLUSION: The Sinhala version of the AAQ has sound psychometric characteristics and it is a culturally appropriate and reliable measure to assess attitudes towards aging among Sinhala-speaking older adults.

PMID:41469751 | DOI:10.1186/s40359-025-03919-y

Int Endod J. 2025 Dec 30. doi: 10.1111/iej.70089. Online ahead of print.

ABSTRACT

AIM: To investigate how the application of dual heat treatment during the manufacturing process influences the mechanical performance (flexibility, cyclic fatigue resistance, torsional strength, bending, buckling and cutting efficiency) of rotary nickel-titanium endodontic instruments.

METHODOLOGY: Rainbow One (n = 58) and Rainbow Ultra (n = 58) instruments (size 25/0.06, 25 mm length) were evaluated. Geometric analysis was performed using optical 3D scanning and SEM to assess cutting edges, tip design and surface features. Metallurgical characterisation included EDS for elemental composition and DSC for phase transformation temperatures, with segments obtained from the tip, middle and coronal blade regions. Mechanical testing comprised cyclic fatigue, torsional strength (torque to failure, maximum angle of rotation), bending resistance, buckling strength and cutting efficiency. Standardised testing protocols were applied, including ASTM and ISO guidelines for mechanical assessments. Statistical analyses were conducted using Shapiro-Wilk and Levene tests to assess assumptions, followed by independent Student’s t-tests, with significance set at 5%.

RESULTS: Both instruments shared equivalent geometries, with deviations below 100 μm, and similar tip designs and surface characteristics. EDS confirmed near-equiatomic NiTi composition for both systems. DSC revealed R-phase crystallographic structure at room temperature for both instruments; however, Rainbow Ultra exhibited higher phase transformation temperatures (Rs 35°C vs. 25°C; Rf 45°C vs. 31°C; As 30°C vs. 24°C; Af 50°C vs. 38°C) and a double austenitic transformation peak, compared with a single peak for Rainbow One. Mechanically, Rainbow Ultra demonstrated greater cyclic fatigue resistance (95.5° ± 7 vs. 79.1 ± 6 s), higher maximum rotation angle (485° ± 49° vs. 402° ± 50°), and improved cutting efficiency (p < 0.05). Rainbow One exhibited higher torque to failure (1.8° ± 0.2 vs. 1.4° ± 0.1 N·cm), greater bending load (369 ± 34 vs. 336 ± 14 gf), and higher buckling resistance (339 ± 32 vs. 273 ± 24 gf), indicating stiffer behaviour.

CONCLUSIONS: The application of dual heat treatment during manufacturing significantly influenced the mechanical performance of the tested rotary NiTi instruments. Rainbow Ultra, subjected to sequential heat treatments, exhibited higher flexibility, cyclic fatigue resistance and cutting efficiency, whereas Rainbow One demonstrated greater torsional strength and buckling resistance.

PMID:41469750 | DOI:10.1111/iej.70089

Syst Rev. 2025 Dec 30. doi: 10.1186/s13643-025-03042-4. Online ahead of print.

ABSTRACT

BACKGROUND: Phosphodiesterase type-5 inhibitors (PDE5is) are used for the treatment of erectile dysfunction (ED) and have potential cardioprotective effects. The impacts of PDE5is on cardiovascular parameters, which may be associated with the occurrence and progression of subclinical cardiovascular diseases, remain uncertain. In this study, we evaluated the effects of PDE5is on vascular parameters.

METHODS: Randomized controlled trials (RCTs) that compared the effects of PDE5is and placebo on vascular parameters and were published from 1998 to 2022 were identified from PubMed, Scopus and Web of Science. Mean differences (MDs) with 95% confidence intervals (CIs) were pooled. A sensitivity analysis was conducted to confirm the robustness of the pooled results. The keywords that were searched in the databases are as follows: ((systolic blood pressure) OR (SBP) OR (diastolic blood pressure) OR (DBP) OR (mean arterial pressure) OR (MAP) OR (Pulse Wave Velocity) OR (PWV) OR (intima-media thickness) OR (cIMT) OR (augmentation Index) OR (AI) OR (FMD) OR (flow-mediated dilation) OR (reactive hyperemia index) OR (RHI) OR (Endothelial microparticles) OR (EMP) OR (EPCs) OR (Endothelial Progenitor Cells) OR (PSV) OR (peak systolic velocity)) AND ((PDE5 Inhibitors) OR (PDE5i) OR (Sildenafil) OR (Vardenafil) OR (Tadalafil) OR (Lodenafil) OR (Udenafil) OR (Avanafil)).

RESULTS: Sixty-three studies involving 3242 subjects were included. Overall, PDE5is decreased systolic blood pressure (MD: -2.80 mmHg, 95% CI: -4.24, -1.37, P < 0.001), diastolic blood pressure (MD: -1.80 mmHg, 95% CI: -2.37, -1.22, P < 0.001), carotid intima‒media thickness (MD: -0.01 mm, 95% CI: -0.02, -0.01, P < 0.001), and pulse wave velocity (MD: -0.75 cm/s, 95% CI: -1.01, -0.49, P < 0.001). In addition, PDE5is increased the peak systolic velocity (MD: 3.70 cm/s, 95% CI: 3.52, 3.88, P < 0.001), flow-mediated dilation (MD: 2.47%, 95% CI: 1.24, 3.71, P < 0.001), concentration of endothelial progenitor cells (MD: 475.29 cells/mL, 95% CI: 51.38, 899.20, P = 0.03), and concentration of endothelial microparticles (MD: 4.86%, 95% CI: 0.65, 9.07, P = 0.02). However, the effects of PDE5is on the augmentation index, brachial artery diameter and reactive hyperemia index were not statistically significant.

CONCLUSION: Compared with the placebo, PDE5is improved vascular parameters, indicating the potential of PDE5is for treating subclinical cardiovascular diseases. Further research is needed to confirm the role of the improvement on vascular parameters by PDE5isin preventing and treating cardiovascular diseases.

SYSTEMATIC REVIEW REGISTRATION: The present study protocol was reviewed and approved by PROSPERO. The title is “Associations between PDE5is and vascular parameters: A systematic review and meta-analysis” (https://www.crd.york.ac.uk/PROSPERO/) (Reg. No. CRD42023387924).

PMID:41469737 | DOI:10.1186/s13643-025-03042-4

BMC Sports Sci Med Rehabil. 2025 Dec 30;17(1):387. doi: 10.1186/s13102-025-01433-7.

ABSTRACT

BACKGROUND: Physical inactivity is a key risk factor for metabolic disorders. High-intensity interval training (HIIT) has been recognized for its metabolic benefits, but its acute effects on adiponectin isoforms remain unclear. This study examines the impact of a single HIIT session on circulating adiponectin (high-molecular weight; HMW, medium-molecular-weight; MMW, and low-molecular weight; LMW) isoforms and metabolic outcomes in insufficiently active young adults.

METHODS: A quasi-experimental study was conducted with 21 physically inactive adults (11 women, 10 men, mean age 22.7 ± 1.5 years). Participants performed a HIIT session consisting of six bouts at 80% heart rate reserve (HRR). Pre- and post-exercise blood samples were ana-lyzed for adiponectin isoforms via Western blotting, and metabolic markers were assessed. Statistical analyses included Wilcoxon tests.

RESULTS: MMW adiponectin significantly increased (~ 19%; effect size [95%CI]: 0.49 [-0.02-1.00] p < 0.05), while LMW and HMW adiponectin remained unchanged. The HMW/MMW ratio decreased (-16%; effect size [95%CI]: -0.49 [-0.99-0.00] p < 0.05). Additionally, non-HDL cholesterol (effect size [95%CI]: 0.464 [-0.03-0.958]) and lactate levels (effect size [95%CI]: 1.164 [0.568-1.759]) increased post-exercise (both p < 0.05).

CONCLUSIONS: A single HIIT session acutely increases MMW adiponectin in insufficiently active young adults. Further research is needed to determine the long-term metabolic implications of repeated HIIT sessions on adiponectin isoform dynamics.

TRIAL REGISTRATION: retrospectively registered in ClinicalTrials.gov (NCT07146867) on August 21st, 2025.

PMID:41469733 | DOI:10.1186/s13102-025-01433-7

Isr J Health Policy Res. 2025 Dec 31;14(1):81. doi: 10.1186/s13584-025-00744-x.

ABSTRACT

BACKGROUND: Appropriate procurement of blood cultures (BC) is essential for diagnosis of bacteremia and susceptibility testing. This includes (1) adequate preparation of the venipuncture site to minimize contamination; (2) obtaining ≥ two sets with a time interval before starting antibiotics. Although these recommendations are standard since the 1960s, adherence is far less than expected – which may adversely impact on the management of bacteremic patients.

AIMS OF STUDY: This single-center study conducted in Shaare Zedek Medical Center aimed to decrease the proportion of contaminated BCs and to increase the percentage of obtaining two sets of BC/ blood-culture-taking episode.

METHODS: Determination of both markers at baseline, then monthly for one year, then subsequently on a quarterly basis; showing data from all departments in real-time to all department directors; and providing short educative lectures during departmental staff meetings, at baseline and after 1-2 years. These markers were adopted as one of the hospital-wide quality measures.

RESULTS: In the 20-year period 2000-2019 more than 1 million BCs were obtained, of which 70% were from patients ≤ 72 h in hospital. During the 5-year study (2020-2024), the percent of blood-culture-taking episodes from which two culture sets were obtained increased annually by ± 16% from a baseline of 27% (9010/33306) in 2020, to 46% (18462/40191) in 2024 (Incidence Rate Ratios, IRR 1.16 [95%CI 1.13-1.18], p < 0.001). This improvement was observed in almost all departments and was especially profound in the emergency department (ED), starting at a baseline of 19% (1979/10326) and increasing to 53% (5304/9915)(IRR 1.33 [95%CI 1.27-1.39], p < 0.001). During the same period, the annual proportion of false-positive BCs, from which only contaminants were isolated, decreased annually by 18% from 2.4% (1592/65230) in 2020 to 1.3% (895/68991) in 2024 (IRR 0.82 [95%CI 0.77-0.88], p < 0.001). This improvement was observed in all departments: in the emergency department, this rate decreased from 3.3% (676/20529) to 1.56% (272/17459) (IRR 0.79 [95%CI 0.75-0.83], p < 0.001).

CONCLUSION: A simple educational intervention, combined with meticulous data mining and presentation of each department’s results, with comparison of all other departments, led to significant and sustained improvement in measurable markers.

PMID:41469732 | DOI:10.1186/s13584-025-00744-x

Cancer Med. 2026 Jan;15(1):e71490. doi: 10.1002/cam4.71490.

ABSTRACT

BACKGROUND: Patient-derived organoid (PDO) models have emerged as critical tools in pancreatic ductal adenocarcinoma (PDAC) research and are used as surrogates for studying the individual’s tumor biology. Still, PDO-based concepts for direct clinical application remain challenging. In this prospective observational trial (OrgaPanCCC-01), we aim to address clinical feasibility, identify predictive factors for PDO establishment, and assess the prognostic potential of PDO establishment for patient’s survival.

METHODS: Samples for PDO generation were prospectively collected via endoscopy, surgery, and transcutaneous punch biopsy, or from ascites. Patients were followed up for a median time of 14.6 months. We evaluated the clinical feasibility by determining the PDO establishment rate and the time required for establishment. Uni- and multivariate analyses were performed to examine the effect of clinical and sample characteristics on PDO establishment. For the predictive and prognostic potential, PDO establishment was correlated to the patients’ disease-free (DFS), progression-free (PFS) and overall survival (OS).

RESULTS: Between 2021 and 2023, 75 patients were enrolled with radiologically suspected PDAC at the Charité Universitätsmedizin Berlin and at the Waldfriede Krankenhaus Berlin. PDAC was confirmed in 62 patients (83%). PDO establishment was achieved in 58% (n = 36/62) of patients within a median of 28 days, supporting the feasibility of clinical implementation. In the uni- and multivariate analysis, samples from metastatic sites (p = 0.04) and higher CA19-9 levels (p = 0.03) were found to be positively correlated with PDO growth. Patients without PDO growth tended to have longer PFS (p = 0.32), whereas no statistically significant correlation was observed between PDO growth and OS.

CONCLUSION: In this prospective observational trial, we show that PDO generation is feasible at a success rate of 58% within a clinically reasonable time frame of 6 weeks. The efficacy of PDO establishment depended on sample site, with metastatic samples showing higher establishment rates. Higher CA 19-9 levels were positively correlated with PDO growth. Successful PDO establishment did not have a prognostic value for OS. Overall, our findings underline the great potential of PDO-based precision medicine approaches, which should further be evaluated in prospective interventional translational trials.

PMID:41469727 | DOI:10.1002/cam4.71490