Tag: nevin manimala

Eur Heart J Open. 2026 Feb 18;6(2):oeag020. doi: 10.1093/ehjopen/oeag020. eCollection 2026 Mar.

ABSTRACT

AIMS: We compared the effects of ‘ablate and pace’ to pharmacological therapy on mortality and left ventricular ejection fraction (LVEF) in patients with atrial fibrillation (AF), with or without heart failure (HF).

METHODS AND RESULTS: Articles were identified by searching PubMed, Central, and Embase until 30 June 2024. Inclusion criteria encompassed observational and randomized controlled trials (RCTs) comparing ‘ablate and pace’ with pharmacological therapy and investigating outcomes of mortality and LVEF in patients with AF. An exclusion criterion was lack of a parallel study design. The primary outcomes were all-cause mortality and the mean difference (MD) in LVEF. Endpoints were assessed through meta-analyses computing relative risks (RRs) and MDs. The clinical diagnosis of HF was used to distinguish between patients with and without HF. Initially, 3837 studies were identified, of which 24 (n = 4292 patients) fulfilled the inclusion criteria, including 17 (n = 3261 patients) that focused on HF. Follow-up time varied from 3 to 96 months. Only in HF patients, ‘ablate and pace’ reduced mortality significantly with a risk reduction of 36% [RR, 0.64; 95% confidence interval (CI), 0.49-0.85; P < 0.01; n = 10] as compared with pharmacological therapy. Except for two studies, cardiac resynchronization therapy (CRT) was the chosen pace mode. The mortality reduction was independent of study design: RCTs (RR, 0.41; 95% CI, 0.18-0.94; P = 0.04; n = 2) and observational studies (RR, 0.70; 95% CI, 0.55-0.90; P = 0.01; n = 8). ‘Ablate and pace’ and pharmacological therapy were similar for the LVEF outcome (MD, 1.1; 95% CI, -1.6-3.8; P = 0.39; n = 16), which was independent of both HF and study designs (results not shown).

CONCLUSION: ‘Ablate and CRT’ reduced mortality in HF patients as compared with pharmacological therapy, which was supported by statistical associations in observational studies. A single RCT corroborated the finding.

PMID:41835811 | PMC:PMC12988461 | DOI:10.1093/ehjopen/oeag020

Front Cell Dev Biol. 2026 Feb 26;13:1695908. doi: 10.3389/fcell.2025.1695908. eCollection 2025.

ABSTRACT

BACKGROUND: To investigate the effect of platelet-rich-fibrin (PRF) on the healing of seawater-impregnated wounds in rabbits and to explore the mechanism.

MATERIAL AND METHODS: Twenty-four New Zealand White rabbits were used. Two full-thickness skin wound models were created on each rabbit’s back and immersed in seawater. According to a random number table, one wound on each rabbit was assigned to the PRF group (treated with PRF gel) and the contralateral wound served as the control (untreated). Wound healing rate, histomorphology, bacteriology, and neovascularization (via CD34 immunohistochemistry) were assessed on days 1, 4, 7, and 14 post-operation. Statistical analysis was performed using ANOVA with paired samples t-test and Bonferroni correction.

RESULTS: Wounds in the control group exhibited significant erythema, edema, and inflammatory exudate, with a healing rate of only 53.5% ± 3.2% by day 14. In contrast, PRF-treated wounds showed minimal signs of infection, reduced inflammation, and were almost completely healed (92.9% ± 0.9%) by day 14. The wound healing rate was significantly higher in the PRF group at all time points (P < 0.01). Bacteriological analysis identified BacAutologous PRF significantly promotes the healing of seawater-immersed wounds in rabbits. The mechanism is likely multifactorial, involving the promotion of angiogenesis, reduction of inflammation, and potential inhibition of bacterial growth. PRF represents a promising therapeutic option for the management of seawater immersion wounds. d formation of new capillaries and fibroblasts. Immunohistochemistry confirmed a significantly higher density of CD34⁺ neovessels in the PRF group at days 4, 7, and 14 (P < 0.05).

CONCLUSION: Autologous PRF significantly promotes the healing of seawater-immersed wounds in rabbits. The mechanism is likely multifactorial, involving the promotion of angiogenesis, reduction of inflammation, and potential inhibition of bacterial growth. PRF represents a promising therapeutic option for the management of seawater immersion wounds.

PMID:41835809 | PMC:PMC12979441 | DOI:10.3389/fcell.2025.1695908

Ann Transl Med. 2026 Feb 28;14(1):1. doi: 10.21037/atm-25-141. Epub 2026 Feb 25.

ABSTRACT

BACKGROUND: Tobacco plays a complex role in patients with inflammatory bowel disease (IBD). Its impact on inpatient outcomes of IBD needs additional study. We aimed to assess the impact of smoking on clinical outcomes in hospitalized patients with IBD.

METHODS: We conducted a retrospective cohort study using data from the National Inpatient Sample (NIS) spanning from 2016 to 2019. Patients with UC and CD were identified utilizing ICD-10 codes. Patients were stratified according to the smoking status in two groups. A propensity score matching was utilized to balance comorbidities between study groups. Study outcomes included rates of steroid use, surgeries, gastrointestinal (GI) bleeding, perianal abscess, and overall mortality. All outcomes were assessed during the index hospitalization. Statistical analysis was performed using Stata 17 software. Results were reported as adjusted odds ratios (aORs) with 95% confidence intervals (CIs).

RESULTS: A total of 413,208 patients were included in our study, 180,558 patients had UC, and 232,650 patients had CD. After propensity score matching, we had a total of 151,106 patients: 39,616 patients had UC, with a total of 19,808 in each group. The CD patients were 111,490, with a total of 55,745 patients in each group. For UC patients, smokers had lower odds of steroid use (aOR =0.69, 95% CI: 0.61-0.79, P=0.001), and all-cause mortality (aOR =0.54, 95% CI: 0.32-0.96, P=0.03). For CD patients, smokers had higher odds of steroid use (aOR =1.13, 95% CI: 1.03-1.25, P=0.009), perianal abscess (aOR =1.12, 95% CI: 1.10-1.36, P=0.02), and all-cause mortality (aOR =1.51, 95% CI: 1.27-1.84, P=0.04). All other outcomes were not significant between the study cohorts.

CONCLUSIONS: Tobacco use in hospitalized patients with UC was associated with lower steroid use, while in patients with CD, it correlated with higher steroid use and increased odds of perianal abscesses. These findings highlight the complex impact of tobacco use on IBD outcomes.

PMID:41835800 | PMC:PMC12981989 | DOI:10.21037/atm-25-141

Ann Transl Med. 2026 Feb 28;14(1):5. doi: 10.21037/atm-25-122. Epub 2026 Feb 25.

ABSTRACT

BACKGROUND: Preeclampsia (PE), a multisystem and complex disorder diagnosed when maternal hypertension manifests after 20 weeks of gestation with proteinuria, is one of the direct causes of maternal morbidity and mortality, in addition to bleeding and infection. Despite its critical impact, effective preventive dietary interventions are scarce. Oxidative stress and microvascular damage are central to PE pathophysiology. Extra virgin olive oil (EVOO), particularly early harvested EVOO (EVOOEH), is rich in antioxidant compounds and may mitigate these issues.

METHODS: This randomized, single-masked (investigator and data analysis) interventional pilot study protocol will enroll 156 high-risk pregnant women (8 to 16 weeks of gestation) at Barzilai University Medical Center. Participants will be allocated to two parallel arms: the EVOOEH arm (n=78), receiving 42 mL/day (three tablespoons) of EVOOEH in addition to general Ministry of Health (MOH) dietary recommendations for 4 weeks; and the Control arm (n=78), receiving MOH dietary recommendations only. Low-dose aspirin prophylaxis will be co-administered, if indicated. Adherence will be monitored via phone calls and assessment of maternal whole blood and plasma hydroxytyrosol (HT) at recruitment and approximately four weeks post-intervention initiation. Primary outcomes are incidence of gestational diabetes mellitus (GDM), PE, Cesarean section, preterm birth, and small for gestational age (SGA) newborns. Secondary outcomes include post-intervention maternal 1-hour glucose challenge test (GCT) and serum ratio of soluble fms-like tyrosine kinase 1 to placental growth factor (sFlt-1/PlGF), as well as maternal blood pressure, gestational age at delivery, and newborn percentile. Blood samples will be analyzed for serum 25-hydroxyvitamin D [25(OH)D], sFlt-1/PlGF ratio and HT. Statistical analysis will include use of JMP Pro software, with compared by chi-squared or Fisher’s exact tests for categorical variables and Student’s t-tests or Wilcoxon rank-sum tests for continuous variables when appropriate. Multivariate analyses will be performed for significant variables.

DISCUSSION: This pilot study will provide crucial insights into the potential of EVOOEH as a dietary intervention for reducing PE risk in high-risk pregnancies, addressing a significant gap in current preventive strategies. This protocol study findings can inform larger-scale trials and contribute to evidence-based nutritional recommendations for PE prevention.

TRIAL REGISTRATION: This study was registered on ClinicalTrials.gov (NCT06759545).

PMID:41835790 | PMC:PMC12981995 | DOI:10.21037/atm-25-122

J Mach Learn Res. 2025;26:167.

ABSTRACT

Dynamic treatment regimes or policies are a sequence of decision functions over multiple stages that are tailored to individual features. One important class of treatment policies in practice, namely multi-stage stationary treatment policies, prescribes treatment assignment probabilities using the same decision function across stages, where the decision is based on the same set of features consisting of time-evolving variables (e.g., routinely collected disease biomarkers). Although there has been extensive literature on constructing valid inference for the value function associated with dynamic treatment policies, little work has focused on the policies themselves, especially in the presence of high-dimensional features. We aim to fill the gap in this work. Specifically, we first obtain the multi-stage stationary treatment policy by minimizing the negative augmented inverse probability weighted estimator of the value function to increase asymptotic efficiency. An L ₁ penalty is applied on the policy parameters to select important features. We then construct one-step improvements of the policy parameter estimators for valid inference. Theoretically, we show that the improved estimators are asymptotically normal, even if nuisance parameters are estimated at a slow convergence rate and the dimension of the features increases with the sample size. Our numerical studies demonstrate that the proposed method estimates a sparse policy with a near-optimal value function and conducts valid inference for the policy parameters.

PMID:41835788 | PMC:PMC12987690

Cureus. 2026 Feb 11;18(2):e103403. doi: 10.7759/cureus.103403. eCollection 2026 Feb.

ABSTRACT

OBJECTIVE: This pilot study investigated the dosimetric impact of artificial intelligence (AI)-generated seminal vesicle (SV) autocontouring (AC) compared with manual contouring (MC) in high-risk prostate cancer volumetric-modulated arc therapy planning.

METHODS: We retrospectively analyzed treatment plans for 15 patients with high-risk prostate cancer who received 76 Gy in 38 fractions in intensity-modulated radiation therapy. Three plans were created for each patient: MC, AC with slice-adjustment to a clinical standard (2 cm from the prostate base), and unadjusted AC. Subsequently, three groups were made for each contouring method: the adjusted AC group, the unadjusted AC group, and the MC group, each including 15 plans. Primary endpoints were dose coverage of the planning target volume (PTV) and clinical target volume (CTV), evaluated by Dmax, Dmin, Dmean, D95, D98, D99, and V95%. Statistical analysis was performed using Dunnett’s test, and multiple comparisons were made by selecting the MC as the control group.

RESULTS: CTV Dmean showed a tendency to be lower in the unadjusted AC group compared with the MC group, but did not reach statistical significance (difference: -58.7 cGy, 95% confidence interval (CI): -123.0 to 5.5 cGy, p = 0.077, Hedges’ g = 0.78). PTV Dmean also showed a decreasing tendency in the unadjusted AC group, but similarly did not reach statistical significance (difference: -92.8 cGy, 95% CI: -193.6 to 8.0 cGy, p = 0.075, g = 0.67). In the adjusted AC group, there was a slight tendency for a decrease in CTV Dmean, but this did not reach statistical significance (difference: -41.3 cGy, p = 0.254, g = 0.63). Effect size assessment revealed a moderate effect in both the unadjusted and the adjusted AC groups. No statistically significant differences were observed among the three groups in any dose volume histogram parameters.

CONCLUSION: This preliminary study (n = 15) suggests no statistically significant dosimetric differences between AI autocontoured and manually contoured SVs, with dose differences <1% of the prescription. However, given the small sample size, validation in larger cohorts is needed before clinical implementation.

PMID:41835785 | PMC:PMC12983348 | DOI:10.7759/cureus.103403

Actas Urol Esp (Engl Ed). 2026 Mar 13:501966. doi: 10.1016/j.acuroe.2026.501966. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess long-term mortality trends for male genital organ (MGO) cancers in Spain from 1999 to 2023, stratified by age group and tumour type.

METHODS: A retrospective, population-based ecological study was conducted using mortality records from the Spanish National Institute of Statistics. Deaths were classified by ICD-10 codes: penile (C60), prostate (C61), testicular (C62), and other/unspecified (C63). Age-standardised mortality rates (ASMRs) were calculated using the 2013 European Standard Population. Temporal trends were evaluated with Joinpoint regression to estimate annual percentage change (APC) and average annual percentage change (AAPC). Analyses were stratified by early-onset (<50 years) and late-onset (≥50 years) disease.

RESULTS: From 1999 to 2023, 147,917 MGO-related deaths were recorded; prostate cancer comprised approximately 97%, predominantly in men aged ≥50 years. Crude mortality increased slightly over time due to population ageing, whereas prostate cancer ASMR decreased from 49.61 to 27.26 per 100,000 (AAPC – 2.5%; 95% CI – 2.7 to -2.3). A joinpoint in 2016 indicated a slowing decline thereafter (APC – 1.3%). Testicular cancer mortality remained low and stable (AAPC – 0.4%), with a minor reduction in older men but stable or slightly increasing patterns among younger men. Penile cancer mortality showed persistently low and unchanged rates (AAPC – 0.8%). Early-onset prostate and penile cancer mortality was rare and exhibited stable trends.

CONCLUSIONS: MGO cancer mortality in Spain is overwhelmingly driven by prostate cancer, which has declinedC markedly over 25 years but has plateaued since 2016. Mortality from testicular and penile cancers remains low with limited age-specific variability.

PMID:41833724 | DOI:10.1016/j.acuroe.2026.501966

Can J Cardiol. 2026 Mar 13:S0828-282X(26)00256-4. doi: 10.1016/j.cjca.2026.02.054. Online ahead of print.

ABSTRACT

BACKGROUND: The burden of cardiovascular events remains substantial under current care, highlighting the clinical importance of identifying high-risk populations. Sarcopenia, affecting 10%-27% of older adults worldwide, is modifiable but under-recognised in cardiovascular prevention due to unclear risk associations. We aimed to clarify the association between sarcopenia and cardiovascular events risk.

METHODS: PubMed, Embase, and Web of Science were searched for longitudinal studies reporting associations between sarcopenia or its related traits with cardiovascular events risk until January 2024. The primary outcome was a composite of cardiovascular events, encompassing cardiovascular diseases (such as coronary heart disease, heart failure, and stroke) and cardiovascular mortality. Data pooled by random-effects models are presented as risk ratios (RRs) and 95% confidence intervals (CIs).

RESULTS: One hundred longitudinal studies (approximately 2.3 million participants) were included. Sarcopenia was associated with higher risk of cardiovascular events (unadjusted risk ratio [uRR]=1.92, 95% CI 1.59 to 2.32; adjusted risk ratio [aRR]=1.63, 1.30 to 2.04) and cardiovascular diseases (uRR=1.69, 1.39 to 2.04; aRR=1.28, 1.12 to 1.46), whereas the association with cardiovascular mortality was significant only in unadjusted analyses (uRR=2.28, 1.56 to 3.33; aRR=1.61, 0.98 to 2.64). Similar associations with cardiovascular events were observed for low muscle mass (uRR=1.61, 1.32 to 1.97; aRR=1.43, 1.23 to 1.68) and low grip strength (uRR=2.04, 1.72 to 2.44; aRR=1.46, 1.37 to 1.56).

CONCLUSION: Sarcopenia, defined using heterogeneous criteria, was associated with an increased risk of cardiovascular events later in life. These findings suggest that sarcopenia and related traits may serve as markers of elevated subsequent cardiovascular risk.

PMID:41833723 | DOI:10.1016/j.cjca.2026.02.054

J Subst Use Addict Treat. 2026 Mar 13:209942. doi: 10.1016/j.josat.2026.209942. Online ahead of print.

ABSTRACT

INTRODUCTION: Methadone is an effective medication for the treatment of opioid use disorder, yet barriers to treatment access exist. Community pharmacies are more accessible than opioid treatment programs (OTPs) and are utilized in countries other than the United States to observe methadone dosing and dispense take-home doses. The purpose of this study was to assess North Carolina OTP staff perceptions towards community pharmacy-based methadone dispensing.

METHODS: A cross-sectional online survey was used to assess the perceived acceptability, appropriateness, and feasibility of community pharmacy-based methadone dispensing among OTP staff using validated measures. Survey distribution occurred from April to June 2025. Descriptive statistics were used to identify potential benefits, negative consequences, and barriers to pharmacy-based methadone dispensing.

RESULTS: The response rate was 72.7% (56 of 77). Perceived acceptability, appropriateness, and feasibility of observed dosing and dispensing methadone take-home doses in the community pharmacy were low among OTP staff. Perceived negative consequences of pharmacy-based methadone dispensing were loss of counseling and care coordination provided by the OTP. Lack of community pharmacist training on methadone dispensing and community pharmacist stigma were the greatest perceived barriers to pharmacy-based dispensing. Over 25% of respondents did not think there were any potential benefits to pharmacy-based methadone dispensing.

CONCLUSION: OTP staff in North Carolina are, in general, not supportive of pharmacy-based methadone dispensing. With low perceived appropriateness, acceptability, and feasibility of observed methadone dosing and dispensing methadone take-home doses in the community pharmacy, further work to implement pharmacy-based methadone dispensing may be stifled by OTP resistance. If policy-based efforts to increase methadone access through community pharmacies continue to be pursued, researchers and other key informants should seek to mitigate concerns identified by OTP staff to ensure people with OUD can receive high quality, patient-centered care in the pharmacy setting.

PMID:41833712 | DOI:10.1016/j.josat.2026.209942

Int J Biol Macromol. 2026 Mar 13:151399. doi: 10.1016/j.ijbiomac.2026.151399. Online ahead of print.

ABSTRACT

Pheromone perception is crucial for mating behaviour in insects, and its manipulation can significantly influence the reproductive outcomes. In this study, a total of 156 chemosensory genes were identified from the transcriptome of the heads along with antennae of both male and female Leucinodes orbonalis. These included 35 sequences belonging to odorant-binding proteins (OBPs) including four pheromone binding proteins (PBPs) and three general odorant binding proteins (GOBPs), 73 odorant receptors (ORs), 20 ionotropic receptors (IRs), 25 chemosensory proteins (CSPs), and 3 sensory neuron membrane proteins (SNMPs). Expression analysis revealed male-biased expression of PBP1, PBP2, and PBP3, whereas PBP4 showed predominant expression in females. To investigate the molecular interaction with the pheromone compound, three-dimensional (3D) structures of the four identified PBPs were modelled. Molecular docking followed by 100 ns Molecular Dynamics (MD) simulations with the species-specific sex pheromone revealed that hydrophobic and hydrogen-bond interactions between the ligand and conserved residues play a crucial role in stabilizing PBP-ligand binding. Functional validation using RNA interference demonstrated that silencing of PBPs using dsRNA significantly reduced the pheromone sensitivity, as confirmed by electroantennogram (EAG) recordings performed after dsRNA-induction. Further, silencing of individual PBPs led to the overexpression of others, suggesting compensatory functional adaptation in L. orbonalis. In addition, simultaneous silencing of different combinations of PBP genes followed by behavioral assays using a Y-tube olfactometer showed a marked reduction in pheromone response. These findings highlight the crucial role of PBPs in pheromone-mediated mate recognition and suggest potential target for pest management strategies.

PMID:41833667 | DOI:10.1016/j.ijbiomac.2026.151399