Tag: nevin manimala

Circ Heart Fail. 2025 Apr 24:e012446. doi: 10.1161/CIRCHEARTFAILURE.124.012446. Online ahead of print.

ABSTRACT

BACKGROUND: Peripheral microvascular dysfunction is a hallmark feature of both heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF) pathophysiology, due partly to impairments in nitric oxide signaling secondary to tetrahydrobiopterin (BH₄) deficiency and oxidative stress.

METHODS: Using a randomized, double-blind, placebo-controlled crossover design, this study examined the impact of enteral BH₄ (10 mg/kg), an antioxidant cocktail (AOx), and coadministration of these 2 agents (BH₄+AOx) on microvascular function in patients with HFrEF (n=14, 64±10 years) and HFpEF (n=19, 74±9 years). Passive limb movement was utilized to assess locomotor muscle microvascular function, and biomarkers of inflammation and oxidative damage were measured.

RESULTS: Compared with placebo, the peak change in leg blood flow was not statistically different after AOx administration (HFrEF, P=0.60; HFpEF, P=0.61), but improved following BH₄ (P=0.033) and BH₄+AOx (P=0.019) in both HFrEF (placebo: 234±31; BH₄: 357±45; BH₄+AOx: 355±49 mL/min) and HFpEF (placebo: 269±33; BH₄: 367±47; BH₄+AOx: 394±65 mL/min). The total hyperemic response to passive limb movement (leg blood flow area under the curve) was not statistically different across treatments in patients with HFrEF (P=0.29), but increased following BH₄ (P=0.016) and BH₄+AOx (P=0.040) in the HFpEF group. CRP (C-reactive protein) was lower following BH₄ (P=0.007) and BH₄+AOx (P=0.007) in HFpEF (placebo: 4268±547; BH₄: 2721±391; BH₄+AOx: 2779±376 ng/mL), but was not statistically different in HFrEF (P=0.39).

CONCLUSIONS: Together, these results provide new evidence for the efficacy of acute BH₄ administration to improve some aspects of locomotor muscle microvascular function in patients with HFrEF and HFpEF, with no apparent benefit of AOx administration, alone or in combination with BH₄, in either group. These findings lend further conceptual support for the nitric oxide pathway as a modifiable target in the treatment of heart failure.

PMID:40270242 | DOI:10.1161/CIRCHEARTFAILURE.124.012446

Haematologica. 2025 Apr 24. doi: 10.3324/haematol.2024.287206. Online ahead of print.

ABSTRACT

Prophylactic and pre-emptive donor lymphocyte infusion (pro/preDLI) is used to prevent haematological relapse of AML and MDS after allogeneic stem cell transplantation. For lack of prospective trials, outcome reports, risk factor analyses and published recommendations for DLI administration had to rely on registry studies, frequently limited by inconsistent reporting and missing data. Therefore, we performed an extensive chart review on recipients of pro/preDLI in two German centers to investigate the clinical applicability of current guidelines in a well-defined cohort. Beyond, as outcome after pro/preDLI is unsatisfactorily described by conventional parameters, we constructed a model for treatment success, defined as leukaemia-free survival (LFS) without intensive immunosuppressive treatment for Graft-versus-Host-Disease (GvHD). Eighty-three patients had received proDLI (n=36), preDLI for incomplete chimerism (preDLIIC, n=27) or for persisting minimal residual disease/molecular relapse (preDLI-MRD, n=20). According to current guidelines concerning initial T cell doses and timing of DLI, 42% of patients had received DLI as recommended (standard-intensity), whereas 30%/28% had received DLI in lower/higher cell doses and/or at a later/earlier time point (low-/highintensity). Two-year rates of overall survival (OS), LFS, relapse incidence and non-relapse mortality within the entire cohort were 80%/67%/27%/8%. One-year rates of high-grade acute/chronic GvHD were 34%/27% among all patients and 53%/33% after high-intensity DLI. One-year treatment success rate were 72%/69% after low-/standard intensity, in contrast to 34% after high-intensity DLI. Apart from advanced disease at alloSCT, high-intensity DLI was the major risk factor for lower OS (HR=6.12), LFS (HR=5.43), higher aGvHD (HR=2.51), and lower treatment success (HR=0.41), supporting adherence to current recommendations.

PMID:40270206 | DOI:10.3324/haematol.2024.287206

Work. 2025 Apr 24:10519815251323988. doi: 10.1177/10519815251323988. Online ahead of print.

ABSTRACT

BackgroundToday, researchers try to recognize and improve the weaknesses of complex systems using resilience engineering (RE) principles.ObjectiveThis descriptive-analytical epidemiological study aims to evaluate the resilience performance of the hospital staff based on the principles of RE to enhance personnel performance.MethodA questionnaire containing 27 questions in four areas (anticipation, monitoring, response, and learning) was designed based on Hellangel’s model and field surveys to collect data from nurses and managers of various wards of five hospitals. The face validity and reliability of the questionnaire were confirmed by 16 professors and some individuals from the statistical sample.A hybrid approach utilizing entropy, TOPSIS, and DEA was employed in the Excel environment to process the collected data.ResultsThe results of the entropy method indicated that the responding and monitoring indicators, with values of 0.29 and 0.23, respectively, had the greatest impact on the resilience performance of the studied units. The outcomes of TOPSIS revealed that hospital D possesses the highest level of resilience. According to the DEA method, the first, second, and fifth efficient units were associated with hospital B.ConclusionBy evaluating the cornerstone of resilience, this study’s findings empower nurses and managers to mitigate the impacts of stress, emotional exhaustion, and burnout, fostering work interactions and improving their performance in the face of workplace challenges. The main limitation of the study was the spread of COVID-19, which impeded the training of personnel in the field of RE and its indicators, as well as the distribution, collection, and completion of questionnaires, along with challenging access to personnel.

PMID:40270181 | DOI:10.1177/10519815251323988

Folia Med (Plovdiv). 2025 Mar 21;67(2). doi: 10.3897/folmed.67.e137670.

ABSTRACT

Maxillofacial space infection refers to infections in the potential spaces and fascial planes of the maxillofacial region. The primary objective was identifying predictive variables associated with increased hospital stay in patients with odontogenic maxillofacial space infections.

PMID:40270143 | DOI:10.3897/folmed.67.e137670

Folia Med (Plovdiv). 2025 Mar 21;67(2). doi: 10.3897/folmed.67.e145825.

ABSTRACT

Malignant pleural effusions are a common and debilitating complication of advanced malignancies, affecting approximately one million patients annually. This condition leads to significant morbidity and a decline in quality of life. Accurate diagnosis and effective management are critical yet challenging due to the overlap in biochemical markers between malignant and benign pleural effusions.

PMID:40270142 | DOI:10.3897/folmed.67.e145825

Am J Rhinol Allergy. 2025 Apr 24:19458924251335075. doi: 10.1177/19458924251335075. Online ahead of print.

ABSTRACT

BackgroundPatients with chronic rhinosinusitis (CRS) refractory to medical management often require endoscopic sinus surgery (ESS). Oral corticosteroids (OCSs) are frequently prescribed postoperatively, but the evidence of their efficacy is limited.ObjectiveThe purpose of this study is to evaluate the efficacy of OCS use in patients with CRS following ESS.MethodsA systematic search was performed to identify studies examining the use of OCSs in patients undergoing ESS for CRS. The primary outcomes were sinonasal outcome test (SNOT) and Lund-Kennedy (LK) endoscopic scores. Secondary outcomes were visual analog scale (VAS) scores. Meta-analysis was conducted using a fixed effects model with a heterogeneity test via the I2 statistic.ResultsThe search yielded 1899 articles, and 22 were included in the qualitative analysis, 14 of which were randomized controlled trials with 793 total patients. OCS use differed based on type, dosage, and duration. Studies included in meta-analysis did not show a significant difference in SNOT (Standardized Mean Difference [SMD] -0.03, Confidence Interval [CI] -0.47-0.40, I2 0%), LK (SMD -0.20 CI -0.57-0.17 I2 58%), or VAS (SMD 0.19 CI -0.25-0.63 I2 54%) scores between steroid and non-steroid groups. Two studies that assessed OCSs in the allergic fungal rhinosinusitis (AFRS) subtype of CRS showed significant improvement in outcomes. Two additional studies examined OCS versus itraconazole in AFRS, with both groups showing improvement but neither one with greater significance.ConclusionThis study showed no significant difference in SNOT, LK, or VAS scores in patients with CRS who received OCSs following ESS. Given the limited number of studies in the analysis, further investigations are warranted before making recommendations.

PMID:40270102 | DOI:10.1177/19458924251335075

Clin Appl Thromb Hemost. 2025 Jan-Dec;31:10760296251322779. doi: 10.1177/10760296251322779. Epub 2025 Apr 24.

ABSTRACT

BackgroundAtrial fibrillation (AF) after acute pulmonary embolism (PE) may lead to a poor prognosis. We conducted this study to explore influencing factors of new-onset AF in patients after acute PE.MethodsPatients with objectively confirmed acute PE at the China-Japan Friendship Hospital from first January 2015 to 31st May 2022 were retrospectively included in the study, and patients with new-onset AF confirmed by electrocardiography were defined as the case group. The control group was obtained from the above PE patients without new-onset AF in age matching. Patients with a history of AF, pulmonary hypertension, acute myocardial infarction, valvular heart disease and hyperthyroidism were excluded. Logistic regression was conducted to identify potential influencing factors for the development of new-onset AF in patients with acute PE. To assess the prediction value of potential variables, receiver operating characteristic curves were plotted.ResultsAmong 853 patients diagnosed with acute PE, 732 patients met the including criteria, and 29 patients with new-onset AF were identified. The median age of all patients was 74 years, with 77.6% being male. No statistically significant differences were observed between the case and control groups regarding demographic characteristics. Patients with new-onset AF had significantly enlarged right atrium, right ventricle and left atrium in echocardiography compared with control group, but no significant differences were observed in the diameter of the left ventricle and the proportion of left ventricular ejection fraction (LVEF) ≤ 40%. Right atrial enlargement (OR, 4.19; 95%CI, 1.24-15.09; P = 0.023), left atrial enlargement (OR, 14.76; 95%CI, 4.79-57.28; P < 0.001) and the simplified pulmonary embolism severity index (sPESI) (OR, 2.04; 95%CI, 1.19-3.67; P = 0.012) were associated with increased risk of new-onset AF.ConclusionsBoth severity of acute PE and enlargement of left and right atrium were associated with an increased risk of new-onset AF in patients with acute PE. In patients with high-risk acute PE, greater vigilance is needed for the occurrence of new-onset AF.

PMID:40270083 | DOI:10.1177/10760296251322779

Sci Rep. 2025 Apr 23;15(1):14063. doi: 10.1038/s41598-025-98134-5.

ABSTRACT

Previous studies have shown that athletes recovering from anterior cruciate ligament (ACL) reconstruction experience a decline in motor cortex excitability and injury-related cortical reorganization, potentially leading to ongoing complications and a higher risk of subsequent injuries. Therefore, incorporating an intervention that consistently delivers sensory inputs to the central nervous system and enhances excitability at both spinal and supra-spinal levels, in addition to exercise therapy, may offer greater benefits. The purpose of this study was to explore whether combining whole body vibration (WBV) with exercise therapy enhances motor cortical excitability in athletes undergoing ACL reconstruction more effectively than exercise therapy alone. Additionally, it aimed to assess whether this combination improves quadriceps strength and reduces functional limitations in daily activities. This study is a randomized, single-blinded, controlled trial. Twenty-six participants were assigned to either the WBV plus exercise therapy group (intervention group) or the exercise therapy-only group (control group). Outcome measures, assessed before and after treatment, included motor cortex excitability [active motor threshold (AMT) and motor-evoked potential amplitude of the quadriceps], isometric peak torque of the quadriceps, and daily functional disabilities using the knee outcome survey activities of daily living scale (KOS-ADL scale). The treatment period consisted of 12 sessions (4 weeks, with 3 sessions per week). A two-way mixed ANOVA was conducted to examine the main effects of group, time and their interactions. The results showed that in the intervention group (WBV plus exercise therapy), AMT significantly decreased (F(1, 12) = 11.35, P = 0.006, η² = 0.486), while the control group (exercise therapy only) showed no significant change (F(1, 12) = 0.252, P = 0.625, η² = 0.021). In the intervention group, AMT decreased by 19.47% post-treatment. Both groups showed significant improvements in isometric peak torque and KOS-ADL scores (P < 0.001), with large effect sizes for these parameters. The study concluded that adding WBV to exercise therapy is more effective in increasing motor cortex excitability compared to exercise therapy alone. However, since both groups showed significant improvements in quadriceps peak torque and KOS-ADL scores, it suggests that the addition of WBV did not provide substantial added benefits in enhancing quadriceps strength and improving daily functional abilities. The observed improvements may primarily be attributed to exercise therapy. Nonetheless, it is important to consider the small sample size and low statistical power when interpreting these results.RCT registration: On the Iranian Registry of Clinical Trials (IRCT20220220054078N1).

PMID:40269014 | DOI:10.1038/s41598-025-98134-5

Sci Rep. 2025 Apr 23;15(1):14126. doi: 10.1038/s41598-025-97866-8.

ABSTRACT

In the context of telecommunications, AI enhances network efficiency by predicting and managing traffic. In many decision-making scenarios, decision-makers choose the more flexible structure that can handle all kinds of information. Bipolarity is the only case in which we can discuss the positive and negative aspects of certain scenarios. On one side, AI enhances network efficiency, proactive maintenance, and personalized customer experience but on the other hand, it has also some negative aspects (1) implementing AI infrastructure can be costly (2) Uses of AI in telecommunication may raise data security concerns and user privacy (3) AI can lead to potential issues if system fail or misused. To cover these issues, the idea of an interval-valued bipolar fuzzy soft set (IVBFSS) has been developed that can deal with both positive and negative aspects of AI. Some basic operational laws for IVBPFS numbers are developed. Several fundamental aggregation operators have been introduced like arithmetic average and geometric average aggregation operators, indicating our main contribution. An algorithm is developed to discuss the application perspective of the initiated approaches. We have utilized these developed notions to classify AI-driven techniques in the telecommunications sector to discuss the applicability of the initiated notions. A comparative analysis of the developed approaches shows the advantages and superiority of the introduced work.

PMID:40269011 | DOI:10.1038/s41598-025-97866-8

Sci Rep. 2025 Apr 23;15(1):14137. doi: 10.1038/s41598-025-98112-x.

ABSTRACT

The Gazelle Optimization Algorithm (GOA) is a recently proposed and widely recognized metaheuristic algorithm. However, it suffers from slow convergence, low precision, and a tendency to fall into local optima when addressing practical problems. To address these limitations, we propose a Multi-Strategy Improved Gazelle Optimization Algorithm (MIGOA). Key enhancements include population initialization based on an optimal point set, a tangent flight search strategy, an adaptive step size factor, and novel exploration strategies. These improvements collectively enhance GOA’s exploration capability, convergence speed, and precision, effectively preventing it from becoming trapped in local optima. We evaluated MIGOA using the CEC2017 and CEC2020 benchmark test sets, comparing it with GOA and eight other algorithms. The results, validated by the Wilcoxon rank-sum test and the Friedman mean rank test, demonstrate that MIGOA achieves average rankings of 1.80, 2.03, 2.03, and 2.70 on CEC2017 (Dim = 30/50/100) and CEC2020 (Dim = 20), respectively, outperforming the standard GOA and other high-performance optimizers. Furthermore, the application of MIGOA to three-dimensional unmanned aerial vehicle (UAV) path planning problems and 2 engineering optimization design problems further validates its potential in solving constrained optimization problems. Experimental results consistently indicate that MIGOA exhibits strong scalability and practical applicability.

PMID:40268989 | DOI:10.1038/s41598-025-98112-x