Nevin Manimala

Emergencias. 2024 Dec;36(6):425-437. doi: 10.55633/s3me/105.2024.

ABSTRACT

OBJECTIVE: To describe the characteristics of patients diagnosed with acute heart failure (AHF) in emergency departments (EDs) who develop cardiogenic shock (CS) not associated with ST-segment elevation acute coronary syndrome (STACS).

METHODS: Information for patients diagnosed with AHF in 23 Spanish EDs and registered between 2009 and 2019 were included for analysis if the patients developed symptoms consistent with CS. We described baseline clinical characteristics related to cardiac decompensation and CS, as well as 30-day mortality.

RESULTS: A total of 15 920 cases of AHF were diagnosed; 179 of the patients developed CS (prevalence, 1.1%; 95% CI, 0.2%-3.2%). The median age was 82 years, and 53% were women. The most common causes of SC were valve disease and coronary disease. Prior episodes of AHF had occurred in 76%. More than 40% presented with severely deteriorated baseline functional and respiratory status. Treatment for CS was started in the ED in 75%, CS was refractory in 22%, and palliative measures were taken in 13%. Patients who developed CS had lower mean arterial pressure and worse New York Heart Association classifications at baseline, valve disease, and non-STACS. They had been transferred in an advanced life support ambulance, had severe hyponatremia, and less often had lower extremity edema than patients who did not develop CS. Thirty-day mortality was 38.5% (95% CI, 31.3%-45.7%); 21 of these patients died in the ED (12% of those with CS). Mortality was related to age 80 years or older (adjusted [aHR], 1.977; 95% CI, 1.169-3.343), hypertension (aHR, 2.123; 95% CI, 1.035-4.352), anemia (aHR, 2.262; 95% CI, 1.029-4.970), signs of low cardiac output (aHR, 1.877; 95% CI, 1.150-3.062), and a glomerularfiltration rate less than 30 mL/min/1.73 m2 (aHR, 1.758; 95% CI, 1.051-2.939).

CONCLUSIONS: CS occurring outside a context of STACS is uncommon in ED patients with AHF and is related to poorer functional class. More of these patients have valve disease, hyponatremia, and non-STACS as a precipitant. Nearly 40% die in hospital. Almost a third die in the ED.

PMID:39807548 | DOI:10.55633/s3me/105.2024

J Chem Theory Comput. 2025 Jan 14;21(1):79-87. doi: 10.1021/acs.jctc.4c01249. Epub 2024 Dec 30.

ABSTRACT

Self-diffusion coefficients, D*, are routinely estimated from molecular dynamics simulations by fitting a linear model to the observed mean squared displacements (MSDs) of mobile species. MSDs derived from simulations exhibit statistical noise that causes uncertainty in the resulting estimate of D*. An optimal scheme for estimating D* minimizes this uncertainty, i.e., it will have high statistical efficiency, and also gives an accurate estimate of the uncertainty itself. We present a scheme for estimating D* from a single simulation trajectory with a high statistical efficiency and accurately estimating the uncertainty in the predicted value. The statistical distribution of MSDs observable from a given simulation is modeled as a multivariate normal distribution using an analytical covariance matrix for an equivalent system of freely diffusing particles, which we parametrize from the available simulation data. We use Bayesian regression to sample the distribution of linear models that are compatible with this multivariate normal distribution to obtain a statistically efficient estimate of D* and an accurate estimate of the associated statistical uncertainty.

PMID:39807535 | DOI:10.1021/acs.jctc.4c01249

Heliyon. 2024 Dec 12;11(1):e41210. doi: 10.1016/j.heliyon.2024.e41210. eCollection 2025 Jan 15.

ABSTRACT

Physical properties were studied in commercial plantation of balsa established in Costa Rica. Among other variables studied, physical properties varied mainly for tree age, spacing, stand density, diameter, and height of trees, which we named dasometric conditions. The aim of this study was (i) to determine the variation of specific gravity (SG), air-dry density (AD), green density (GD), and green moisture content (GMC), (ii) to know the site effect and dasometric conditions on these properties, and (iii) to establish the relationship between the four physical properties. The results showed that: SG from 0.08 to 0.21, AD from 90 to 250 kg/m³, GD varied 203-274 kg/m³, and GMC from 38.8 to 137.1 %. Tree age affected statistically all physical properties, it was positively correlated with SG, AD, and GD, but negatively correlated with GMC. Diameter breast height and total height were weakly correlated with SG and AD, respectively. Commercial height and stand density were highly correlated with SG and AD, besides stand density was positively correlated with GMC. AD was positively correlated with SG and GD but negatively correlated with GMC. According to the results, balsa tree plantations exhibited significant variation in physical properties (SG, AD, GD, and GMC) in trees aged between 30 and 40 months and this variation was primarily attributed to the site-specific growth conditions, mainly temperature and precipitation. These wood properties can be selected by site and growing conditions.

PMID:39807519 | PMC:PMC11728954 | DOI:10.1016/j.heliyon.2024.e41210

Heliyon. 2024 Dec 9;11(1):e40982. doi: 10.1016/j.heliyon.2024.e40982. eCollection 2025 Jan 15.

ABSTRACT

BACKGROUND: Transvenous pacemakers (TVP) and leadless pacemakers (LP) are two reliable permanent modalities for the treatment of heart rhythm disorders. Several observational studies explored the safety and efficacy of the two devices. The aim of this meta-analysis study is to present a comparative analysis of the safety of leadless versus transvenous pacemakers.

METHODS: The study protocol was registered in PROSPERO registry (CRD42024520647). A comprehensive and systematic search was conducted across PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov, spanning from inception until just before the final analysis. SPSS was used for statistical analysis. Relative risks (RR) and odds ratio (OR) were used to evaluate the outcomes with a 95 % confidence interval (CI).

RESULTS: Nineteen studies met the inclusion criteria and were analyzed, in which the overall effect estimate showed increased risk of major complications in the TVP group (LogOR = -0.27, 95 % CI: [-0.63, 0.10]) compared to the LP group. Among the nineteen studies, seven studies showed that TVP significantly increase the risk of reintervention (LogOR = -0.73, 95 % CI: [-1.15, -0.31]) and thirteen studies showed a higher risk of mortality among patients receiving TVP (Cohen’s d = -0.11, 95 % CI: [-0.22, 0.01]) compared to those receiving LP. Conversely, a higher risk of pericardial effusion or tamponade and thromboembolic events was among patients receiving LP with (LogOR = 1.01, 95 % CI: [0.55, 1.46]) and (LogOR = 0.45, 95 % CI: [-0.33, 1.23]) respectively.

CONCLUSION: This study showed that leadless pacemakers tend to be safer compared to transvenous pacemakers, with reduced risks of major complications, reintervention, generator malfunction, device or lead dislodgement, pneumothorax and hemothorax, infections rates, and mortality. However, higher odds of cardiac perforation and tamponade and thromboembolic events were observed among patients receiving LP. The lack of both randomized clinical trials and long term follow up studies limits our assessment and emphasizes the need for ongoing investigation to understand the extended complications associated with these devices amidst advancing technology.

PMID:39807515 | PMC:PMC11728922 | DOI:10.1016/j.heliyon.2024.e40982

Heliyon. 2024 Dec 12;11(1):e41147. doi: 10.1016/j.heliyon.2024.e41147. eCollection 2025 Jan 15.

ABSTRACT

Sleep stages classification one of the essential factors concerning sleep disorder diagnoses, which can contribute to many functional disease treatments or prevent the primary cognitive risks in daily activities. In this study, A novel method of mapping EEG signals to music is proposed to classify sleep stages. A total of 4.752 selected 1-min sleep records extracted from the capsleep database are applied as the statistical population for this assessment. In this process, first, the tempo and scale parameters are extracted from the signal according to the rules of music, and next by applying them and changing the dominant frequency of the pre-processed single-channel EEG signal, a sequence of musical notes is produced. A total of 19 features are extracted from the sequence of notes and fed into feature reduction algorithms; the selected features are applied to a two-stage classification structure: 1) the classification of 5 classes (merging S1 and REM-S2-S3-S4-W) is made with an accuracy of 89.5 % (Cap sleep database), 85.9 % (Sleep-EDF database), 86.5 % (Sleep-EDF expanded database), and 2) the classification of 2 classes (S1 vs. REM) is made with an accuracy of 90.1 % (Cap sleep database),88.9 % (Sleep-EDF database), 90.1 % (Sleep-EDF expanded database). The overall percentage of correct classification for 6 sleep stages are 88.13 %, 84.3 % and 86.1 % for those databases, respectively. The other objective of this study is to present a new single-channel EEG sonification method, The classification accuracy obtained is higher or comparable to contemporary methods. This shows the efficiency of our proposed method.

PMID:39807512 | PMC:PMC11728888 | DOI:10.1016/j.heliyon.2024.e41147

Heliyon. 2024 Dec 13;11(1):e41000. doi: 10.1016/j.heliyon.2024.e41000. eCollection 2025 Jan 15.

ABSTRACT

A green methodology for the synthesis of carbon quantum dots (CQDs) from coffee husk without the use of any toxic solvents is proposed in this work. Sonochemical exfoliation of biochar, obtained from the thermal carbonization of coffee husk (from a certified coffee seeds) at low temperature in an air-restricted atmosphere, is described as an alternative procedure for the sustainable production of CQDs. The synthesized CQDs exhibited blue fluorescence with a strong maximum emission band at 410 nm when excited at a maximum absorption wavelength of 330 nm. The obtained CQDs were evaluated by various physicochemical methods. According to the results, TEM investigation indicates the average size of CQDs is 8.27 ± 1.57 nm with a quasi-spherical morphology. The aim of this study is to optimize the synthesis parameters and compare them with common preparation strategies. This paper reports the main requirements for reproducible and scalable production of CQDs solution, such as the mass of the precursors for each process, for the first time. The conversion and yield percentages on a dry basis, mass of CQDs powder agglomerates, and the specific time duration for each individual step are provided to compensate for the variability of the raw material and facilitate statistical comparison of the methodology. A TEM micrographs analysis for CQDs reconstitution process was conducted, which can be considered a potential mechanism for CQDs agglomeration process.

PMID:39807508 | PMC:PMC11728949 | DOI:10.1016/j.heliyon.2024.e41000

Heliyon. 2024 Dec 12;11(1):e41161. doi: 10.1016/j.heliyon.2024.e41161. eCollection 2025 Jan 15.

ABSTRACT

This research aims to monitor the hydrological drought trends within the geographical confines of Ethiopia, Sudan, and Egypt in the Blue Nile River Basin. Historical drought circumstances in the basin were analyzed through the utilization of the stream flow drought index (SDI). The long-term historical drought trend was investigated via the application of the Mann – Kendall Sen (MK) test. Streamflow data were collected at the border (GERD) (Ethiopia) and Khartoum and Dongola (Sudan) spanning the period from 1900 to 2001. Four distinct temporal scales were examined, including monthly (SDI1), seasonal (SDI3), bi-annual (SDI6), and annual (SDI12) frequency. Notably, SDI1, SDI3, and SDI6 exhibited a higher frequency of drought occurrences, whereas SDI12 demonstrated lower frequencies, accompanied by the longest duration of drought in all gauged stations. For the preceding 102-year period, two extreme drought events were identified across all stations: 1912/1913 and 1913/1914 in the Border and Dongola stations, and 1912/1913 and 1986/1987 in the Khartoum station. Moreover, the SDI12 results revealed that severe drought events manifested three, six, and four times, in the Border, Khartoum, and Dongola stations, respectively. Furthermore, an investigation of historical extreme and severe drought patterns led to the conclusion that extreme hydrological drought does not pose an imminent threat to downstream nations, including Egypt and Sudan. However, the trend analysis revealed that an increasing drought trend was observed in the Autumn season across all stations, while a positive trend characteristic of a wet condition was observed in the remaining seasons. Annual trend analysis did not show any statistically significant findings. Nevertheless, the study highlighted the imperative role of soil and water conservation measures in upstream countries, such as the Ethiopian highlands, in mitigating the prolonged effects of meteorological drought which gradually propagates into severe hydrological drought. Consequently, downstream nations must engage in cooperative efforts with upstream countries to address this issue collectively, rather than bestowing sole responsibility on the latter.

PMID:39807500 | PMC:PMC11728863 | DOI:10.1016/j.heliyon.2024.e41161

Heliyon. 2024 Dec 18;11(1):e41312. doi: 10.1016/j.heliyon.2024.e41312. eCollection 2025 Jan 15.

ABSTRACT

Political accountability is essential for maintaining trust and transparency in governance. However, the factors that influence political parties’ accountability remain underexplored in Nepal. This paper examines the factors influencing citizens’ perceptions of political parties’ accountability in Nepal, utilizing data from the National Governance Survey 2017/18 (N = 4191). A four-stage multiple cluster sampling technique was used to randomly select respondents from 43 out of 77 districts in Nepal. Data were collected between December 2017 and March 2018. Results from logistic regression analysis indicate that citizens’ perceptions of political parties’ honesty, transparency, adherence to rules, and corruption control significantly impact political parties’ accountability. While citizen engagement in political discussions was positively associated with political parties’ accountability, this factor did not demonstrate statistical significance. These findings highlight the importance of honesty, transparency, rule of law, and anti-corruption measures in fostering political parties’ accountability. This study contributes to the literature on democratic governance and offers practical insights for authorities seeking to strengthen accountable political institutions in Nepal. The insights of this paper provide a roadmap for political parties to prioritize ethical conduct, proactive information sharing, regulatory compliance, and anti-graft efforts to build public trust and accountability.

PMID:39807491 | PMC:PMC11728868 | DOI:10.1016/j.heliyon.2024.e41312

Health Sci Rep. 2025 Jan 12;8(1):e70257. doi: 10.1002/hsr2.70257. eCollection 2025 Jan.

ABSTRACT

OBJECTIVES: This study aims to investigate the impact of comorbidity with chronic hepatitis B (CHB) on the survival rates and incidence of liver cancer in patients with alcohol-related liver disease (ARLD).

METHODS: Patients with ARLD and those with ARLD co-morbid with CHB were included in this study and designated as the ARLD group and the ARLD + HBV group, respectively. Propensity score matching (PSM) was then employed to compare survival rates and liver cancer development between these two groups.

RESULTS: Among the 404 patients, 254 were in the ARLD group and 150 in the ARLD + HBV group. After propensity score matching, each group comprised 67 patients. Initially, the ARLD + HBV group exhibited lower 5-year survival rates compared to the ARLD group (51.3% vs. 70.1%, p < 0.001). However, PSM mitigated this difference, with survival rates now comparable (61.2% vs. 60.9%, p = 0.390). Notably, the ARLD + HBV group showed a higher incidence of liver-specific mortality after matching (32.6% vs. 6.2%, p = 0.018). Furthermore, although a higher proportion of patients in the ARLD + HBV group developed liver cancer post-matching, the difference was not statistically significant compared to the ARLD group (15.7% vs. 9.8%, p = 0.170).

CONCLUSION: Co-morbidity with CHB in ARLD patients elevates the risk of liver-related mortality.

PMID:39807487 | PMC:PMC11725528 | DOI:10.1002/hsr2.70257

Health Sci Rep. 2025 Jan 13;8(1):e70338. doi: 10.1002/hsr2.70338. eCollection 2025 Jan.

ABSTRACT

BACKGROUND AND AIMS: A catheter-related bloodstream infection (CRBSI) is a life-threatening complication of hemodialysis. It is responsible for significant morbidity and mortality and a costly long hospital stay. Despite its burden, little is known about the factors associated with it and the antibiogram of its responsible causative bacteria. This study aimed to evaluate the determinants of hemodialysis CRBSI and the appropriate antibiogram for the isolated bacterial pathogens among patients attending the KCMC hemodialysis unit.

METHODS: A hospital-based retrospective analytical cross-sectional study involved adult patients with CKD or AKI undergoing hemodialysis at KCMC with tunneled or non-tunneled central venous catheters who attended from January 1, 2021 to December 31, 2022. Data were collected from the hospital’s electronic medical record system. Statistical analysis was performed using SPSS version 27. Multivariate logistic regression was used to determine the factors associated with CRBSI. A p-value of < 0.05 was considered statistically significant.

RESULTS: A total of 286 patients were analyzed. The patients were predominantly males (70.6%), and more than half were above 55 years old (56%), with a mean age of 58 (SD ± 14.8) years. 56.6% developed CRBSI and were predominantly gram-positive (69.7%). Major associated factors were hypoalbuminemia of < 35 g/dL, diabetes mellitus, anemia of hemoglobin < 10 g/dL, and having a femoral central venous catheter. For gram-positive bacteria, the most efficient antibiotic was vancomycin, with an overall average efficacy of 99% for all isolates. For gram-negative bacteria, the most efficient antibiotic was meropenem, with an overall average efficacy of 82.1% for all isolates.

CONCLUSION: Over 50% of patients developed CRBSI and gram-positive bacteria were the major causative bacteria. Associated factors were multifactorial and preventive care would be ideal to reduce the number of CRBSI based on these findings.

PMID:39807485 | PMC:PMC11725762 | DOI:10.1002/hsr2.70338