Tag: nevin manimala

Adipocyte. 2025 Dec;14(1):2499500. doi: 10.1080/21623945.2025.2499500. Epub 2025 May 23.

ABSTRACT

Inflammatory changes in perivascular adipose tissue are associated with atherosclerotic lesions in the adjacent artery and can also be used as a marker in patient workup. While adipocyte size is known to be closely related to adipose tissue dysfunction and inflammation, it has not been widely studied in perivascular adipose tissue obtained from healthy human subjects without clinical atherosclerosis. In this cross-sectional study, we addressed this issue by measuring adipocyte size and defining its relationship to cardiovascular risk factors in a healthy cohort of living kidney donors. The presence of cardiovascular risk factors was established by a standardized questionnaire, clinical measurements and body composition analyses. Adipocyte size was measured in the perivascular depot. The proportions of various macrophage subtypes were determined by flow cytometry. To confirm the results, the proportion of CD68 + macrophages was additionally assessed by immunohistochemistry. A correlation and principal component analyses were performed to explore associations. Adipocyte size in perivascular adipose tissue correlated with markers of lipid metabolism, inflammation, and glucose metabolism. Further, the positive correlation with the pro-inflammatory subpopulation of macrophages suggests a strong local effect of perivascular adipose tissue. Perivascular adipocyte size was associated with cardiovascular risk factors and markers of inflammation in a healthy cohort of living kidney donors. This further supports the local role of adipose tissue dysfunction and inflammation in early atherosclerosis development and detection.

PMID:40406925 | DOI:10.1080/21623945.2025.2499500

JAMA Neurol. 2025 May 23. doi: 10.1001/jamaneurol.2025.1522. Online ahead of print.

ABSTRACT

IMPORTANCE: Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure.

OBJECTIVE: To estimate the worldwide burden of SAH.

DESIGN, SETTING, AND PARTICIPANTS: Based on the repeated cross-sectional Global Burden of Disease (GBD) 2021 study, the global burden of SAH in 1990 to 2021 was estimated. Moreover, the SAH burden was compared with other diseases, and its associations with 14 individual risk factors were investigated with available data in the GBD 2021 study. The GBD study included the burden estimates of nontraumatic SAH among all ages in 204 countries and territories between 1990 and 2021.

EXPOSURES: SAH and 14 modifiable risk factors.

MAIN OUTCOMES AND MEASURES: Absolute numbers and age-standardized rates with 95% uncertainty intervals (UIs) of SAH incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) as well as risk factor-specific population attributable fractions (PAFs).

RESULTS: In 2021, the global age-standardized SAH incidence was 8.3 (95% UI, 7.3-9.5), prevalence was 92.2 (95% UI, 84.1-100.6), mortality was 4.2 (95% UI, 3.7-4.8), and DALY rate was 125.2 (95% UI, 110.5-142.6) per 100 000 people. The highest burden estimates were found in Latin America, the Caribbean, Oceania, and high-income Asia Pacific. Although the absolute number of SAH cases increased, especially in regions with a low sociodemographic index, all age-standardized burden rates decreased between 1990 and 2021: the incidence by 28.8% (95% UI, 25.7%-31.6%), prevalence by 16.1% (95% UI, 14.8%-17.7%), mortality by 56.1% (95% UI, 40.7%-64.3%), and DALY rate by 54.6% (95% UI, 42.8%-61.9%). Of 300 diseases, SAH ranked as the 36th most common cause of death and 59th most common cause of DALY in the world. Of all worldwide SAH-related DALYs, 71.6% (95% UI, 63.8%-78.6%) were associated with the 14 modeled risk factors of which high systolic blood pressure (population attributable fraction [PAF] = 51.6%; 95% UI, 38.0%-62.6%) and smoking (PAF = 14.4%; 95% UI, 12.4%-16.5%) had the highest attribution.

CONCLUSIONS AND RELEVANCE: Although the global age-standardized burden rates of SAH more than halved over the last 3 decades, SAH remained one of the most common cardiovascular and neurological causes of death and disabilities in the world, with increasing absolute case numbers. These findings suggest evidence for the potential health benefits of proactive public health planning and resource allocation toward the prevention of SAH.

PMID:40406922 | DOI:10.1001/jamaneurol.2025.1522

J Int Med Res. 2025 May;53(5):3000605251340304. doi: 10.1177/03000605251340304. Epub 2025 May 23.

ABSTRACT

ObjectiveThis retrospective cohort study aimed to develop and validate a nomogram for predicting in-hospital mortality among patients with community-acquired pneumonia admitted to the intensive care unit.MethodsData of patients meeting the inclusion criteria were extracted from the Medical Information Mart for Intensive Care-IV database, and the patients were randomly allocated into training (n = 3798, 70%) and validation (n = 1629, 30%) cohorts. First-day intensive care unit admission parameters were averaged. Least Absolute Shrinkage and Selection Operator regression and multivariate logistic regression analyses were used to identify mortality risk factors in the training cohort, followed by nomogram construction. Model performance was evaluated based on discrimination (area under the curve), calibration (Hosmer-Lemeshow test and bootstrap resampling), and clinical utility (decision curve analysis). Data from emergency intensive care unit were used to perform external validation of the value of the model.ResultsIn total, 5427 patients were included. Age, red cell distribution width, Sequential Organ Failure Assessment, Acute Physiology Score-III, blood urea nitrogen-to-serum creatinine ratio, anion gap, osmolarity, and sepsis were identified as independent risk factors for hospital mortality. The nomogram demonstrated superior discrimination compared with Sequential Organ Failure Assessment and Acute Physiology Score-III in the validation (area under the curve: 0.772 vs. 0.685-0.724) and training (area under the curve: 0.787 vs. 0.708-0.740; p < 0.05) sets. Calibration and decision curve analyses confirmed robust performance (Hosmer-Lemeshow p = 0.11; net benefit threshold: 20%-80%). In both cohorts, calibration and decision curve analyses showed that the nomogram had good calibration degree, discriminative ability, and clinical benefits. Data from emergency intensive care unit showed that the area under the curve of the model was 0.7864 (95% confidence interval, 0.76-0.81), area under the curve of Sequential Organ Failure Assessment was 0.7217 (95% confidence interval, 0.69-0.75), and area under the curve of Acute Physiology Score-III was 0.7055 (95% confidence interval, 0.68-0.73).ConclusionsThis nomogram provides moderate predictive accuracy for hospital mortality in critically ill patients with community-acquired pneumonia and may aid prognosis assessment.

PMID:40406909 | DOI:10.1177/03000605251340304

Chem Commun (Camb). 2025 May 23. doi: 10.1039/d5cc00856e. Online ahead of print.

ABSTRACT

Herein, we investigate a two-point crosslinked amyloid-β (Aβ) dimer, which forms an intermolecular β-sheet. The atomic force microscopy statistical results indicate that the heights of these dimers are approximately 0.37 nm, providing a baseline for the Aβ peptide sizes and improving our understanding of Aβ oligomers in Alzheimer’s disease.

PMID:40406894 | DOI:10.1039/d5cc00856e

Anal Methods. 2025 May 23. doi: 10.1039/d5ay00426h. Online ahead of print.

ABSTRACT

A bio-chip substrate made from amorphous carbon was successfully developed as an innovative and practical biodetection system. This peptide-microarray biochip was based on a novel principle for protein detection in diagnostics. The carbon material as a substrate carrier offered significant advantages over conventional glass slides with regard to its surface chemistry. The biochip detection system used the measurement of fluorescent intensity changes caused by the interactions between capture molecules (labelled structured peptides arrayed on the substrate) and analytes. Fluorescent intensity changes with and without analytes were dose-dependent and could be visualized as “protein fingerprints”. In this recognition system, interactions are not limited to one-to-one correspondence as in ELISA. Hence, this method can even be applied to analytes containing uncharacterized molecules. Statistical data handling, such as multivariate analyses, enabled discrimination of complex analytes such as body fluids. The present biochip used with an in-house developed detection device could be re-used 10-20 times with the same or different analytes. The captured molecules in this system were immobilized on the chip-surface through stable amide bonds, which allowed washing and even scrub cleaning. This unique material has a potential for dual detection thorough fluorescent intensity changes and mass spectrometric analyses when the chip is used as a sample tray, since this material has high electric conductivity. Thus, this dual detection allows the possibility of discovering marker candidates.

PMID:40406893 | DOI:10.1039/d5ay00426h

Euro Surveill. 2025 May;30(20). doi: 10.2807/1560-7917.ES.2025.30.20.2400655.

ABSTRACT

BackgroundBetween 2020 and 2023, ECDC has supported 21 of 30 EU/EEA and six Western Balkan countries by enhancing severe acute respiratory infection (SARI) surveillance to monitor trends, detect unexpected events, evaluate public health interventions, identify risk factors and support vaccine effectiveness studies. Using diverse strategies, countries have implemented SARI surveillance and reported data at national/European levels.AimWe evaluated European-level SARI surveillance and provided recommendations to achieve objectives and improve key attribute performance.MethodsWe analysed 2022/23 surveillance data for completeness. We administered a questionnaire, targeting country-level representatives, to evaluate surveillance attributes (meeting objectives, usefulness, acceptability, timeliness, representativeness) and identify strengths, weaknesses, opportunities and threats.ResultsThirteen countries (13/27) reported data at European level. Data showed good overall completeness but varied across countries and some variables need improvement (vaccination, sequencing). The questionnaire was completed by all 27 countries. Most countries (23/27) reported that the system effectively monitored trends and considered it useful and acceptable (25/27), but only 16 found it timely and 14 representative. Challenges included insufficient case-based data, data linkage issues and insufficient data completeness. Slow/inefficient manual data extraction affected timeliness, while insufficient geographical coverage affected representativeness. Multi-pathogen surveillance was identified as the main strength, heterogeneity of systems the main weakness, improvements of hospital information systems the main opportunity, and lack of sustainable funding the main threat.ConclusionsSARI surveillance was perceived as effective in monitoring trends, useful and acceptable. To achieve additional objectives and enhance timeliness and representativeness, we recommend improving data completeness, digitalisation/automation and geographical coverage.

PMID:40406887 | DOI:10.2807/1560-7917.ES.2025.30.20.2400655

Euro Surveill. 2025 May;30(20). doi: 10.2807/1560-7917.ES.2025.30.20.2400797.

ABSTRACT

BackgroundData on economic costs of respiratory syncytial virus (RSV) infections among children in primary care are scarce, although most RSV-infections are managed in this setting.AimTo estimate outpatient costs for RSV-positive children aged < 5 years.MethodsIn the RSV ComNet prospective cohort, children < 5 years with acute respiratory infection were recruited for RSV testing through primary care physicians in Belgium, Italy, the Netherlands, Spain and the United Kingdom (UK) during RSV seasons 2020/21 (UK only), 2021/22 and 2022/23. Outpatient healthcare utilisation and parental work absence were assessed over 30 days through parental questionnaires. Average costs per RSV episode were calculated from outpatient healthcare sector and societal perspectives, stratified by country and age.ResultsWe included 3,414 children and 1,124 (33%) tested RSV-positive. Physicians completed reports for 878 episodes, with follow-up questionnaire data for 819 (93%). Outpatient costs ranged from EUR 97 (95% CI: 91-104) in the Netherlands to EUR 300 (95% CI: 287-312) in Spain and were higher for infants than children aged 1-5 years. Societal costs ranged from EUR 454 (95% CI: 418-494) in the UK to EUR 994 (95% CI: 938-1,053) in Belgium. For children aged 1-5 years, societal costs were primarily driven by parental work absence. In infants, the main societal cost driver varied by country, but overall outpatient healthcare costs represented a higher proportion of societal costs vs older children.ConclusionRSV infections in children attending primary care result in substantial economic costs per episode, although differences exist across countries. This study provides essential data to inform cost-effectiveness analyses on novel RSV immunisations.

PMID:40406885 | DOI:10.2807/1560-7917.ES.2025.30.20.2400797

Health Informatics J. 2025 Apr-Jun;31(2):14604582251345328. doi: 10.1177/14604582251345328. Epub 2025 May 23.

ABSTRACT

Objectives: Advances in technology have improved the lives of Indonesians. For example, the health sector. This is indicated by the emergence of telemedicine to facilitate health services. This study aims to test the effect of individual trust on the intention to use telemedicine applications. Therefore, the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) are used as the basis for answering the questions posed by this research. Methods: Sampling was conducted online and involved 402 respondents who all came from the Indonesian island of Java. Validity, reliability, and hypothesis testing used Structural Equation Modeling (SEM) with Smart-PLS 4 tools. Result: The results show that effort expectancy, performance expectancy, and social influence have a positive influence on individual belief; intention to use is influenced by individual belief and behavioral intentions. The results of the hypothesis testing show that behavioral intention has the greatest influence on intention to use with a t value of 31.315 and a β value of 0.801. Conclusion: The novelty of this study is that it includes individual belief variables that are influenced by variables from UTAUT, namely effort expectancy, performance expectancy, social influence, and facilitating conditions.

PMID:40406860 | DOI:10.1177/14604582251345328

Neuroradiol J. 2025 May 23:19714009251345108. doi: 10.1177/19714009251345108. Online ahead of print.

ABSTRACT

Background and purpose: This study focuses on an objective evaluation of a novel reconstruction algorithm-Deep Learning Image Reconstruction (DLIR)-ability to improve image quality and reduce radiation dose compared to the established standard of Adaptive Statistical Iterative Reconstruction-V (ASIR-V), in unenhanced head computed tomography (CT). Materials and methods: A retrospective analysis of 163 consecutive unenhanced head CTs was conducted. Image quality assessment was computed on the objective parameters of Signal-to-Noise Ratio (SNR) and Contrast-to-Noise Ratio (CNR), derived from 5 regions of interest (ROI). The evaluation of DLIR dose reduction abilities was based on the analysis of the PACS derived parameters of dose length product and computed tomography dose index volume (CTDIvol). Results: Following the application of rigorous criteria, the study comprised 35 patients. Significant image quality improvement was achieved with the implementation of DLIR, as evidenced by up to a 145% and 160% increase in SNR in supra- and infratentorial regions, respectively. CNR measurements further confirmed the superiority of DLIR over ASIR-V, with an increase of 171.5% in the supratentorial region and a 59.3% increase in the infratentorial region. Despite the signal improvement and noise reduction DLIR facilitated radiation dose reduction of up to 44% in CTDIvol. Conclusion: Implementation of DLIR in head CT scans enables significant image quality improvement and dose reduction abilities compared to standard ASIR-V. However, the dose reduction feature was proven insufficient to counteract the lack of gantry angulation in wide-detector scanners.

PMID:40406852 | DOI:10.1177/19714009251345108

Healthc Q. 2025 Jan;27(4):72-77. doi: 10.12927/hcq.2025.27578.

ABSTRACT

This retrospective review evaluates the Ontario Surgical Quality Improvement Network’s patient outcomes and financial returns. Criteria from the Organisation for Economic Co-operation and Development Network are used to examine the program, and risk-adjusted data from the American College of Surgeons National Surgical Quality Improvement Program on four indicators spanning 2016 to 2023 were used to calculate outcomes. With reductions in post-operative complications, readmissions and length of hospital stay, the Ontario healthcare system is saving an estimated $3,000,000 per year, representing a return on investment of 38%. Similar quality improvement networks could be adopted in other jurisdictions to elevate surgical care standards.

PMID:40406844 | DOI:10.12927/hcq.2025.27578