Nevin Manimala

Circ Arrhythm Electrophysiol. 2025 Aug 28:e013793. doi: 10.1161/CIRCEP.125.013793. Online ahead of print.

ABSTRACT

BACKGROUND: Identification of fast ventricular tachycardia (FVT; cycle length <320 ms) isthmuses is often hindered by hemodynamic instability during sustained FVT and by rate-dependent (functional) scar properties. Comparing ultra-high-density voltage heterogeneity maps (0.1-1.5 mV) of the scar area during sinus rhythm (SR) and FVT may delineate the rate-dependent components of the FVT isthmus (FVTI) and improve substrate identification during SR.

METHODS: Thirty Large White swine with anterior myocardial infarction underwent cardiac magnetic resonance imaging for signal intensity mapping, followed by electrophysiological studies at 4 and 16 weeks post-infarction. FVTIs were defined as corridors of high-frequency electrograms spanning electric diastole and completing reentrant circuits in activation maps. Voltage heterogeneity mapping during FVT and SR was performed to identify voltage channels and delineate functional substrate. Statistical comparisons were performed using the Student t test, with data presented as mean±SD.

RESULTS: Sixty ventricular tachycardias were induced, including 27 monomorphic episodes with a cycle length ≤ 320 ms. Of these, 25 exhibited reentrant activation with identifiable FVTI. All FVTIs were housed within channels identified in voltage heterogeneity maps during FVT and signal intensity maps; 22 of 25 (88%) colocalized with a channel visible in SR voltage maps. Comparing FVT and SR voltage maps revealed that (1) dense scar area (<0.1 mV) was larger in FVT than in SR maps (1.5±0.3 versus 0.1±0.2 cm², P<0.001), (2) voltage channels sustaining FVTI in FVT were longer than in SR (18.7±7.1 versus 14.6±6.1 mm, P=0.047), and (3) while all channels in FVT maps were bordered by dense scar (<0.1 mV), only 4 in SR exhibited this feature, indicating a functional substrate in 84% of FVTIs.

CONCLUSIONS: FVTIs are located within channels identified in voltage heterogeneity maps during SR and FVT. These channels colocalize with heterogeneous tissue channels in signal intensity maps. Comparative analysis of SR and FVT voltage maps enables delineation of functional borders.

PMID:40874305 | DOI:10.1161/CIRCEP.125.013793

J Sports Sci. 2025 Aug 28:1-3. doi: 10.1080/02640414.2025.2541479. Online ahead of print.

NO ABSTRACT

PMID:40874293 | DOI:10.1080/02640414.2025.2541479

J Evid Based Soc Work (2019). 2025 Aug 28:1-14. doi: 10.1080/26408066.2025.2553840. Online ahead of print.

ABSTRACT

PURPOSE: This study investigates the relationships between living with sports (sport-oriented lifestyle), impulsivity, and attitudes toward working life among social welfare professionals in Türkiye, with a specific focus on the mediating role of impulsivity.

MATERIALS AND METHODS: A cross-sectional quantitative research design was employed, collecting data from 1,534 participants aged 18 and older via an online survey. The majority of the sample consisted of women (67.2%), with a mean age of 28.96 years. Data analysis was conducted using IBM SPSS for preliminary statistics and IBM AMOS for confirmatory factor analysis and structural equation modeling (SEM).

RESULTS: Living with sports was negatively associated with impulsivity (β = -0.072, p < .05) and positively associated with attitudes toward working life (β = 0.064, p < .05). Impulsivity was negatively related to attitudes toward working life (β = -0.185, p < .001) and significantly mediated the relationship between living with sports and work attitudes (β = 0.013, p < .05). The model accounted for 5.5% of the variance in impulsivity and 4.4% in attitudes toward working life.

DISCUSSION: The study results suggest that a lifestyle enriched by regular sports participation can reduce impulsive tendencies and support the development of more positive work attitudes among social welfare professionals.

CONCLUSION: This study provides novel empirical evidence on the triadic relationship between sport-oriented lifestyle, impulsivity, and work attitudes. It highlights the importance of integrating sport-based activities into organizational strategies to support emotional regulation, well-being, and sustainable professional engagement in social services.

PMID:40874284 | DOI:10.1080/26408066.2025.2553840

Recenti Prog Med. 2025 Sep;116(9):513-521. doi: 10.1701/4556.45575.

ABSTRACT

BACKGROUND: The global increase in caesarean section (CS) rates raises concerns about maternal and neonatal outcomes. Italy, with one of the highest CS rates in Europe, especially in the Calabria Region, faces challenges in reducing this trend. The Calabria Region has joined the “Easy-Net” Network Program (NET-2016-02364191) for the evaluation of audit & feedback (A&F) interventions to reduce CS rate. This study aims to analyze past trends, describe maternity unit (MU) characteristics, and provide a baseline assessment of CS rates using the Robson’s Ten Group Classification System (TGCS).

METHODS: This population-based cross-sectional study analyses CS rates using data from National and Regional Birth Registers, categorizing women with the Robson’s TGCS.

RESULTS: From 2017 to 2020, 54,041 births were registered in the Calabria Region. The results reveal a fluctuating CS rate (36.2%-38.1%) with variations from different Robson groups. Group 5 (previous CS) consistently increased, impacting overall rates, while Group 1 (nulliparous, cephalic, spontaneous labor) decreased. The groups 2b (6.8%-4.8%) and 4b (2.5%-1.8%), which represent respectively nulliparous and multiparous women with pre-labour CS, showed high rates despite their reduction over the years. In 2020, variations in CS rates across 11 MUs highlighted complexities, emphasizing the need for localized interventions.

CONCLUSIONS: The study highlights the critical issue of high CS rates in the Calabria Region. It is advisable to monitor and reduce unnecessary CSs through evidence-based interventions, taking advantage of the Robson classification and an A&F strategy. These findings guide future efforts to enhance CS appropriateness and improve maternal and child health outcomes.

PMID:40874272 | DOI:10.1701/4556.45575

Research (Wash D C). 2025 Aug 26;8:0852. doi: 10.34133/research.0852. eCollection 2025.

ABSTRACT

Abrupt shifts, referred to as critical transitions, are frequently observed in complex biological systems, characterized by marked qualitative changes occurring from one stable state to another through a pre-transitional/critical state. Pinpointing such critical states, along with the signaling molecules, can provide valuable insights into the fundamental mechanisms of intricate biological processes. However, the identification and early warning of the critical state remains a challenge, particularly in model-free cases with high-dimensional single-cell data, where traditional statistical methods often prove inadequate due to the inherent sparsity, noise, and heterogeneity of the data. In this study, we propose a novel quantitative method, cell-specific causal network entropy (CCNE), to infer the specific causal network for each cell and quantify dynamic causal changes, thereby enabling the identification of critical states in complex biological processes at the single-cell level. We validated the accuracy and effectiveness of the proposed approach through numerical simulations and 5 distinct real-world single-cell datasets. Compared to existing methods for detecting critical states, the proposed CCNE exhibits enhanced effectiveness in identifying critical transition signals. Moreover, CCNE score is a computational tool for distinguishing temporal changes in cellular heterogeneity and demonstrates satisfactory performance in clustering cells over time. In addition, the reliability of CCNE is further emphasized through the functional enrichment and pathway analysis of signaling molecules.

PMID:40874247 | PMC:PMC12379065 | DOI:10.34133/research.0852

Front Surg. 2025 Aug 12;12:1613915. doi: 10.3389/fsurg.2025.1613915. eCollection 2025.

ABSTRACT

BACKGROUND AND OBJECTIVES: Objectively studying patient outcomes following surgery has been an important aspect of evidence-based medicine. The current gold-standard-patient reported outcomes measures-provides valuable information but have subjective biases. Smartphones, which passively collect data on physical activity such as daily steps, may provide objective and valuable insight into patient recovery and functional status. This study aims to provide a methodological guide for data collection and analysis of smartphone accelerometer data to assess clinical outcomes following surgery.

METHODS: Patient health metrics-namely daily steps, distance travelled, and flights climbed-were extracted from patient smartphones using easy-to-download applications. These applications upload the data that smartphone accelerometers passively collect daily to a HIPAA compliant encrypted server while de-identifying the patient’s personal health information. Patients were consented in multiple settings-synchronously during clinical visits or asynchronously over the phone-and could be enrolled during the initial pre-operative visit or well after the surgery. With the patient data acquired, the peri-operative window of selection is determined based on the needs to the study. The timeseries data is then statistically normalized to account for individual baselines and smoothened over a 14-day moving average to minimize noise. Mathematical analysis can be harnessed to study quantifiable recovery and decline periods, which provide continuous and nuanced insight into patient’s health throughout their spine disease and treatment course. Additionally, integrating clinical variables permits computational machine models capable of predicting patient trajectories and guiding clinical decisioning.

CONCLUSION: Smartphones offer a new metric for studying patient well-being and outcomes after surgery. The research with them is in its nascent stages but further studies can potentially revolutionize our understanding of spinal disease.

PMID:40874243 | PMC:PMC12378811 | DOI:10.3389/fsurg.2025.1613915

Bioinform Adv. 2025 Aug 9;5(1):vbaf189. doi: 10.1093/bioadv/vbaf189. eCollection 2025.

ABSTRACT

MOTIVATION: The growing availability of single-cell RNA sequencing (scRNA-seq) data highlights the necessity for robust integration methods to uncover both shared and unique cellular features across samples. These datasets often exhibit technical variations and biological differences, complicating integrative analyses. While numerous integration methods have been proposed, many fail to account for individual-level covariates or are limited to discrete variables.

RESULTS: To address these limitations, we propose scINSIGHT2, a generalized linear latent variable model that accommodates both continuous covariates, such as age, and discrete factors, such as disease conditions. Through both simulation studies and real-data applications, we demonstrate that scINSIGHT2 accurately harmonizes scRNA-seq datasets, whether from single or multiple sources. These results highlight scINSIGHT2’s utility in capturing meaningful biological insights from scRNA-seq data while accounting for individual-level variation.

AVAILABILITY AND IMPLEMENTATION: The scINSIGHT2 method has been implemented as a R package, which is available at https://github.com/yudimu/scINSIGHT2/.

PMID:40874236 | PMC:PMC12380451 | DOI:10.1093/bioadv/vbaf189

Clin Epidemiol. 2025 Aug 22;17:693-705. doi: 10.2147/CLEP.S521309. eCollection 2025.

ABSTRACT

BACKGROUND: In the presence of competing risks, when the baseline risk is unclear, if only the sub-distribution hazard ratio (SHR) is reported in the results, which is related to the cumulative incidence function, the survival disparity of events of interest between groups cannot be clarified. In contrast, the difference in restricted mean time lost (RMTLd), which is the difference in the areas under the cumulative incidence between two groups, can well compensate for the deficiencies of SHR and explain the effects on a time scale, facilitating clinical interpretation and communication.

METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was used to collect information on female patients with locally advanced breast cancer diagnosed between 2010 and 2015. The prognostic factors of breast cancer death were evaluated considering competing risk. Univariable and multivariable analyses were conducted to get SHR and RMTLd.

RESULTS: SHR can indicate the direction of prognostic factors, while RMTLd can quantify prognostic effects and provide time-scale interpretation. For instance, in adjuvant radiotherapy, the SHR showed a protective effect, which can be quantified as an average increase of 4.15 months in survival time.

DISCUSSION: In the presence of competing risks, the combined use of absolute measure RMTLd can more intuitively explain the prognostic effect, which is convenient for clinical practice and communication.

PMID:40874217 | PMC:PMC12380099 | DOI:10.2147/CLEP.S521309

SAGE Open Med. 2025 Aug 25;13:20503121251345598. doi: 10.1177/20503121251345598. eCollection 2025.

ABSTRACT

INTRODUCTION: Preconception care involves measures to enhance a woman’s physical, psychological, and nutritional health before pregnancy. Despite various observational studies assessing healthcare practitioners’ knowledge of preconception care in East Africa, the overall pooled knowledge level remains unclear, and the studies often report inconsistent associated factors. This systematic review and meta-analysis aimed to determine the aggregated knowledge of preconception care among healthcare providers in East Africa and identify influencing factors.

METHOD: We searched studies using PubMed, Scopus, Embase, and Google Scholar that were published between January 01, 2018 and November 30, 2024. This study used the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The quality of studies was evaluated using the modified Newcastle-Ottawa quality assessment tool. The data were extracted by two authors independently using Microsoft Excel and analyzed by Stata version 17. A random effects model was applied to calculate the pooled level of knowledge and its associated factors. The International Prospective Register of Systematic Review registration number for the review was CRD42024608878.

RESULTS: A total of 12 studies comprising 4892 participants were involved in this meta-analysis. The pooled knowledge of preconception care among healthcare providers was 56% (95% CI: 45%-66%). This study showed that gender (odds ratio (OR) = 1.35), educational level (OR = 3.52), monthly salary (OR), work experience (OR = 1.77), Internet access (OR = 3.41), ever read the preconception care guideline (OR = 2.77), having Smartphone (OR = 1.70), working institution (OR = 2.05), Training on HIV testing and management (OR = 4.28), training on providing alcohol or tobacco cessation service (OR = 1.14), the presence of a library in a working health facility (OR = 1.98), taking training on preconception care education and counseling (OR = 3.44) were significant factors associated with knowledge of preconception care.

CONCLUSION: The findings indicate that healthcare providers in East Africa have limited knowledge of preconception care. Gender, educational level, monthly salary, previous work experience, internet connection, awareness of preconception care policy, smartphone possession, type of work schedule, prior HIV testing, and management training, library access in healthcare facilities, and involvement in preconception care training meetings and counseling sessions are significant factors of the knowledge of preconception care among healthcare providers.

PMID:40874216 | PMC:PMC12378543 | DOI:10.1177/20503121251345598

J Hepatocell Carcinoma. 2025 Aug 22;12:1893-1904. doi: 10.2147/JHC.S536877. eCollection 2025.

ABSTRACT

BACKGROUND: The tumor immune microenvironment (TME) plays a key role in the development of hepatocellular carcinoma (HCC). As the important components of TME, interleukin-2 (IL-2) mediates immune responses by specifically binding to the interleukin-2 receptor (IL-2R). This study aimed to explore the role of IL-2R in HCC development and provided possible clinical implications in HCC prognosis and treatment.

METHODS: The IL-2R genetic data were acquired from publicly available TCGA and CCLE databases. Data processing and analysis, including construction of the prognostic model and evaluation of immune status in HCC, were performed on Xiantao platform by using statistical methods including the Wilcoxon test, Cox regression analysis, correlation analysis. GEPIA2 was used to explore the relationship between IL-2R genes expression and clinical stages, while genetic variations in IL-2R subunits in HCC were determined using cBioPortal. The IL-2Rα co-expression gene analysis was conducted on the LinkedOmics database. Enzyme-linked immunosorbent assay (ELISA), colorimetric method, and flow cytometric method were used to analyze peripheral blood samples from patients with HCC.

RESULTS: A prognostic risk model was established by incorporating IL-2Rα, IL-2Rβ, and IL-2Rγ expression. The infiltration levels of B cell memory, T cell regulatory cells (Tregs), and immune checkpoints (PDCD1, CTLA4, CD274 and TIGIT) were significantly elevated in high-risk group of the risk model. Additionally, sIL-2Rα levels were positively correlated with tumor-specific growth factor (TSGF) and Tregs in the peripheral blood of HCC patients.

CONCLUSION: The prognostic risk model based on IL-2R subunits may play a role in the regulation of immune function within the HCC tumor microenvironment. Besides, IL-2Rα may act as a more important role in HCC development among the three IL-2R subunits. Further research will be needed to verify these initial findings. Overall, these results may provide important insights in clinical prognosis and therapeutic strategies for HCC.

PMID:40874213 | PMC:PMC12379987 | DOI:10.2147/JHC.S536877