Tag: nevin manimala

Int J Clin Pharm. 2025 Apr 15. doi: 10.1007/s11096-025-01908-0. Online ahead of print.

ABSTRACT

BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce major cardiovascular events among individuals with heart failure regardless the ejection fraction. The effect of SGLT2 inhibitors on health-related quality of life (HRQoL) and physical capacity are still unclear.

AIM: To investigate the effects of SGLT2 inhibitors on HRQoL and physical capacity in patients with heart failure.

METHOD: We systematically searched PubMed, Embase, and Cochrane Central databases for randomized controlled trials (RCTs) comparing SGLT2 inhibitors to placebo in this population. The outcomes analyzed were mean changes in Kansas City Cardiomyopathy Questionnaire (KCCQ) score and its domains: total symptoms score (TSS), physical limitations score (PLS), clinical summary score (CSS) and overall summary score (OSS), as well as the six-minute walk test (6MWT) and peak oxygen uptake (peak VO₂).

RESULTS: Eighteen RCTs with 23,848 participants were included. There was a statistical significant improvement in KCCQ TSS (MD: 3.33; 95% CI 1.84 to 4.81; p < 0.001) in HFrEF, HFpEF and non-diabetic subgroups. Consistent findings were found in KCCQ PLS, KCCQ CSS, and KCCQ OSS. The distance covered in the 6MWT was significant higher (MD: 12.8; 95% CI 1.06 to 24.54; p = 0.03) and peak VO₂ was increased (MD: 1.06; 95% CI 0.57 to 1.55; p < 0.001).

CONCLUSION: SGLT2 inhibitors improve HRQoL and functional capacity in patients with HF regardless the ejection fraction and co-diagnosis of diabetes.

PMID:40232664 | DOI:10.1007/s11096-025-01908-0

Spine (Phila Pa 1976). 2025 Apr 15. doi: 10.1097/BRS.0000000000005361. Online ahead of print.

ABSTRACT

STUDY DESIGN: A retrospective registry-based study.

OBJECTIVE: To elucidate the nationwide epidemiology, treatment patterns, and prognosis of primary malignant spine tumors (PMST) using the Japanese Orthopaedic Association’s Bone and Soft Tissue Tumor (BSTT) Registry.

SUMMARY OF BACKGROUND DATA: PMSTs are rare, comprising a small proportion of primary malignant bone tumors. The surrounding anatomical structures make complete resection challenging, leading to poor prognoses. Studies using the Surveillance, Epidemiology, and End Results database have provided valuable epidemiological insights; however, limitations in the granularity and diversity of histological subtypes persist, leaving detailed knowledge of PMSTs insufficiently clarified.

METHODS: We analyzed 288 PMST cases from the BSTT Registry (2006-2019), evaluating patient demographics, tumor characteristics, treatment details, and prognostic outcomes. Kaplan-Meier methods estimated disease-specific survival (DSS), and Cox proportional hazards models identified prognostic factors.

RESULTS: PMSTs accounted for 3.3% of primary malignant bone tumors. Common histological subtypes included osteosarcoma (21.9%), chondrosarcoma (16.3%), chordoma (13.9%), and undifferentiated pleomorphic sarcoma (13.9%). Surgery was performed in 46.2% of cases, with intralesional margins in 54.1%. Chemotherapy and radiotherapy were administered in 42.0% and 54.9% of cases, respectively. The 5-year DSS was 47.5%. Adjusted analysis revealed favorable prognoses for chondrosarcoma (hazard ratio [HR]: 0.23, 95% confidence interval [CI]: 0.06-0.87, P=0.031), chordoma (HR: 0.27, 95% CI: 0.09-0.84, P=0.024), and Ewing sarcoma (HR: 0.42, 95% CI: 0.18-0.98, P=0.044) compared to osteosarcoma. Adults (40-64 years) had better outcomes than the elderly (≥65 years; HR: 0.43, 95% CI: 0.24-0.76, P=0.015). Advanced TNM stage (IVA + IVB) was an adverse prognostic factor (HR: 7.60, 95% CI: 1.85-31.18, P=0.005).

CONCLUSIONS: PMSTs are rare and present diverse histological subtypes with poor prognoses. This study emphasizes the need for further investigations to optimize PMST management and improve prognoses.

LEVEL OF EVIDENCE: 2b.

PMID:40231408 | DOI:10.1097/BRS.0000000000005361

Soft Matter. 2025 Apr 15. doi: 10.1039/d4sm01470g. Online ahead of print.

ABSTRACT

An open challenge in soft matter science is the ability to create hydrogels that are soft but also have high fracture energy. A possible solution to this stiffness-toughness conflict has arisen through a class of material known as hybrid double-network hydrogels, which combine two polymeric networks with diametrically opposed chain stiffness and with both covalent and physical crosslinking. The vast parameter space inherent to such a system means it is difficult to identify the precise compositional parameters that lead to both high toughness and low stiffness. In this work, we address this challenge through a design of experiments (DoE) framework used to establish the statistical relationship between factors and mechanical properties of a hybrid double-network hydrogel. The crosslinking density of the networks is noted to play a prominent role in determining the stiffness of the hydrogel, while the network characteristics of the ductile network determine the toughness of the hydrogel. We also report that contrary to observations in current literature, it is possible to toughen the hydrogel without stiffening it. Therefore, the present experimentation and optimization exercise provides a hands-on guide for the use of DoE to determine the conditions for optimised mechanical properties of thin hybrid double-network hydrogels for various applications.

PMID:40231401 | DOI:10.1039/d4sm01470g

J Pediatr Orthop. 2025 Apr 15. doi: 10.1097/BPO.0000000000002980. Online ahead of print.

ABSTRACT

BACKGROUND: Achondroplasia (ACH) is the most common skeletal dysplasia and is characterized by a short-limbed short stature, sagittal spinal malalignment, and genu varum. Vosoritide promotes longitudinal bone growth in children with ACH; however, its effects on various disease-specific complications, other than short stature, are unknown. This study aimed to investigate the therapeutic effects of vosoritide on spinal and lower limb malalignment in children with ACH.

METHODS: This single-center, open-label, prospective study included patients with ACH aged younger than or equal to 15 years who received vosoritide treatment and had a minimum follow-up period of 1 year. To evaluate alignment after vosoritide treatment, radiologic parameters were measured from sagittal radiographs of the spine and anteroposterior radiographs of the bilateral lower limbs before the administration of vosoritide and 12 months after treatment. Paired t tests were used to compare parameters before and after vosoritide treatment.

RESULTS: Seventeen patients (mean age, 7.6±2.7 y) were included. After 1-year treatment of vosoritide, the mean height increased by 5.4±1.3 cm. Changes in spinal alignment after 1 year of vosoritide treatment were 1.5 degrees for cervical lordosis, -1.3 degrees for thoracic kyphosis, -2.8 degrees for thoracolumbar kyphosis, -5.2 degrees for lumbar lordosis (LL), -2.2 degrees for pelvic tilt, -2.6 degrees for pelvic incidence, -0.4 degrees for sacral slope, and 2.6 mm for C7 sagittal vertical axis. Alignment changes in the lower limbs were -3.4 degrees for mechanical axis angle (MAA), 1.7 degrees for mechanical lateral proximal femoral angle (mLPFA), -2.8 degrees for mechanical lateral distal femoral angle (mLDFA), -0.2 degrees for medial proximal tibial angle, and -0.5 degrees for lateral distal tibial angle. The LL, MAA, mLPFA, and mLDFA levels showed statistically significant changes towards the normal range after treatment.

CONCLUSIONS: One-year treatment of vosoritide decreased the exaggerated LL and improved genu varum deformity in children with ACH. Vosoritide therapy may not only increase longitudinal bone growth but also improve spinal and lower limb malalignment in children with ACH.

LEVEL OF EVIDENCE: Level II: prospective comparative study.

PMID:40231376 | DOI:10.1097/BPO.0000000000002980

J Dig Dis. 2025 Apr 15. doi: 10.1111/1751-2980.13338. Online ahead of print.

ABSTRACT

OBJECTIVES: In this study, we aimed to evaluate the effectiveness of a novel endoscopic purse-string suture auxiliary instrument compared with traditional methods for closure of a full-thickness defect of the stomach in an ex vivo model.

METHODS: Twelve perforation sites (10-20 mm in diameter) were created in the ex vivo porcine stomach models. Two physicians (A and B had performed endoscopic surgery for 6 and 3 years) performed suturing using both the experimental and traditional (control) instruments. Operation time, success rate, and number of attempts for successful suture required were recorded.

RESULTS: For physician A, the median suturing time was 56.50 s (interquartile range [IQR] 40.50 s, 134.50 s) and 215.50 s (IQR 63.75 s, 254.75 s) in the experimental and control groups. For physician B, they were 53.00 s (IQR 38.50 s, 87.75 s) and 174.00 s (IQR 104.50 s, 279.25 s), respectively. The differences between experimental and control groups were statistically significant for both physicians A (p = 0.010) and B (p = 0.004). The median number of attempts required for successful suturing in the experimental and control groups was 1 (IQR 1, 2) and 2 (IQR 1, 3) for physician A, and 1 (IQR 1, 1) and 3 (IQR 2, 3) for physician B, which were statistically significant for both physicians (p = 0.026 and 0.006). The overall success rate was significantly higher in the experimental group (100% vs. 75.0%, p = 0.022).

CONCLUSION: This novel purse-string suture auxiliary instrument may assist in single-channel endoscopic suturing operations, improve the suture success rate, reduce the number of operations required, and shorten the operation time.

PMID:40231373 | DOI:10.1111/1751-2980.13338

Int J Speech Lang Pathol. 2025 Apr 15:1-12. doi: 10.1080/17549507.2025.2484314. Online ahead of print.

ABSTRACT

PURPOSE: A public health approach has the potential to address inequities in speech, language, and communication needs and prevent and reduce the impact of these needs in the population. However, little is known about speech-language pathologists’ knowledge, attitudes, and practices regarding a public health approach, including health promotion and prevention. The aim of this study was to investigate the self-rated knowledge, attitudes, and practices of Australian clinicians regarding health promotion and prevention for children’s speech, language, and communication needs.

A cross-sectional online survey of 96 Australian speech-language pathologists was conducted. Inferential statistics were used to investigate associations between clinicians’ self-rated knowledge, training, attitudes, practices, and demographics.

RESULT: The majority of participants had positive attitudes towards health promotion and reported high self-rated knowledge of health promotion. More recently trained speech-language pathologists reported learning about health promotion in their university professional training. Different levels of self-rated knowledge, attitudes, practices, and barriers to practice were associated with workplace type (e.g. private practice, state health department).

Australian speech-language pathologists are supportive of health promotion and prevention for children’s speech, language, and communication needs. Further research into the organisational aspects and educational needs related to health promotion and prevention of these needs are recommended.

PMID:40231357 | DOI:10.1080/17549507.2025.2484314

Histopathology. 2025 Apr 15. doi: 10.1111/his.15456. Online ahead of print.

ABSTRACT

AIMS: Mucosal melanoma of the head and neck (MM-H&N) is an aggressive disease known for its frequent residual tumours/relapses (RT/R) at the surgical site, as well as eventual metastases. Our understanding of the MM-H&N mutational landscape, together with the correlation of specific mutations with clinical-pathological features, is significantly less comprehensive compared to that of cutaneous melanoma. Additionally, the mutational status of consecutive samples collected from single patients has not been investigated, which limits our ability to characterise the prognosis and treatment options for this patient subset.

METHODS AND RESULTS: A total of 53 MM-H&N specimens from 27 patients were analysed using a laboratory-developed multigene next-generation sequencing (NGS) panel. Among these, material from 46 of 53 (86.8%) samples and from 25 of 27 patients (92.6%) was suitable for NGS. The most frequently detected mutations were found in the RAS genes family, specifically KRAS and NRAS (seven of 46, 15.2%), as well as TP53, KIT and BRAF (each in three of 46, 6.5%); 25 of 46 (54.3%) samples exhibited a wild-type (WT) status. A statistically significant association between BRAF/RAS mutations and mucosal lentiginous histology (P = 0.041) was observed. Additionally, four of 11 (36.4%) patients with consecutive specimens, with no pre-/intersurgery systemic therapies administered and all having at least two evaluable NGS results, demonstrated molecular heterogeneity in the analysed samples.

CONCLUSIONS: MM-H&N shows a significant percentage of WT cases and a limited number of targetable mutations, predominantly involving BRAF/RAS mutations, the latter of which are associated with mucosal lentiginous histology. A subset of patients with consecutive samples demonstrates discordant molecular results, indicating that NGS of all samples may be necessary to determine the most appropriate therapeutic approach.

PMID:40231352 | DOI:10.1111/his.15456

Clin Nurs Res. 2025 Apr 15:10547738251329412. doi: 10.1177/10547738251329412. Online ahead of print.

ABSTRACT

Post-COVID-19 condition (PCC) is a serious debilitating condition that develops after the resolution of an acute infection of severe acute respiratory syndrome-associated coronavirus 2. Some commonly reported symptoms include fatigue and cognitive deficits. Multiple lines of evidence have indicated fatigue to be associated with cognitive deficits in the general population. Herein, we perform a secondary analysis of the effects of fatigue on subjective and objective cognition in persons with PCC using a generalized linear model. In this study, fatigue was measured using the Fatigue Severity Scale (FSS) and cognition was measured using the Digit-Symbol Substitution Test (DSST) and the Trails Making Test parts A and B (TMT-A/B). FSS had a statistically significant negative correlation with DSST and TMT-A/B scores. Fatigue serves as a possible target for the development of PCC therapeutics. Fatigue and cognition correlates should be further investigated for underlying neurobiological substrates in persons with PCC.

PMID:40231351 | DOI:10.1177/10547738251329412

Knee Surg Sports Traumatol Arthrosc. 2025 Apr 15. doi: 10.1002/ksa.12679. Online ahead of print.

ABSTRACT

PURPOSE: This study investigates change of direction (COD) performance and biomechanics using wearable technology in athletes with a history of anterior cruciate ligament reconstruction (ACL-R) compared to healthy controls.

METHODS: A within and between subjects’ cross-sectional design was used. The sagittal plane kinematics of the hip, knee, and ankle during 90° side-step cutting were measured with inertial measurement units, while the vertical force was recorded with insoles in the players’ boots. Twenty-six professional soccer players participated (mean age 22.7 ± 3.7 years, height 177.8 ± 5.1 cm, weight 69.4 ± 8.5 kg). Sixteen players were healthy controls, and 10 were in a full-time ACL-R rehabilitation programme, assessed 9 months post-surgery. Mixed model analysis and statistical parametric mapping were used to compare COD completion time, kinetics, and kinematics between limbs (involved vs. uninvolved) and groups (ACL-R vs. controls) during the penultimate and final foot contacts.

RESULTS: No significant differences in COD completion time were found between limbs (p = 0.52, d = 0.22) or groups (p = 0.65, d = 0.51). However, during the penultimate foot contact, the involved limb exhibited greater ankle dorsiflexion compared to the uninvolved and controls from 48% to 100% of stance (p = 0.002, d = 0.94-1.86), with lower vertical force production (p > 0.05, d = 0.81-0.95). During the plant step, lower knee flexion angles were noted compared to the uninvolved limb and controls from 2% to 69% of stance (p = 0.011, d = 1.26-1.31).

CONCLUSION: The findings suggest that soccer players with ACL-R can restore COD completion time at the time to return to sport. However, they used compensatory movement strategies on the involved side to achieve similar performance, and this must be considered from a rehabilitation standpoint.

LEVEL OF EVIDENCE: Level III.

PMID:40231346 | DOI:10.1002/ksa.12679

ScientificWorldJournal. 2025 Apr 7;2025:9993948. doi: 10.1155/tswj/9993948. eCollection 2025.

ABSTRACT

Background: Chronic kidney disease (CKD) is typically associated with anemia, with both implicated in global mortalities and morbidities. Adequate knowledge about these conditions might help individuals to prevent and/or manage them effectively. This study was aimed at assessing the knowledge of CKD and anemia regarding their causes, risk factors, and preventive practices among undergraduate students. Methods: The study was a cross-sectional design conducted from July 2023 to September 2023, involving 267 students pursuing either health-related or nonhealth-related programs. A structured questionnaire was administered to participants to assess their knowledge of CKD and anemia and was analyzed. Results: An overwhelming majority, 208 (77.9%), demonstrated a good level of general knowledge of CKD, whereas an even higher proportion, 215 (80.5%), had a good level of general knowledge of anemia. Also, the bulk of the participants, 222 (83.1%), showed a good level of knowledge of the relationship between CKD and anemia. There was a significant relationship between a student’s faculty and general CKD knowledge (p < 0.001). Participants in health-related faculties and in the third/fourth year significantly had good knowledge of CKD than those in nonhealth-related faculties and in the first/second year of studies. With regards to anemia, individuals aged 20 years and beyond had good knowledge of anemia than teenage students. There was also a significant relationship between a student’s faculty and general knowledge of anemia (p < 0.001), such that participants in health-related faculties were about 99% less likely to have poor knowledge of anemia than those in nonhealth-related faculties [AOR = 0.01 (0.00, 0.007)]. Conclusion: Students with good knowledge of CKD, anemia, and/or their interrelationships were the majority. However, students in health-related faculties significantly had good knowledge of both CKD and anemia than their counterparts in nonhealth-related faculties. Health-related courses that would enlighten students in nonhealth-related faculties should be promoted.

PMID:40231323 | PMC:PMC11996275 | DOI:10.1155/tswj/9993948