Tag: nevin manimala

Front Res Metr Anal. 2025 Sep 22;10:1553928. doi: 10.3389/frma.2025.1553928. eCollection 2025.

ABSTRACT

INTRODUCTION: In a global landscape characterized by intense competition and stringent funding criteria, researchers face the dual challenges of limited resources and high demand for innovation-a challenge that Brazil is no exception to. This study aimed to explore the perceptions, barriers, and challenges faced by researchers during the project submission process for approval by funding agencies, with a focus on schools within the Federal Network of Professional, Scientific, and Technological Education Institutions.

METHODS: A quantitative cross-sectional approach was used to examine the characteristics of researchers at a Brazilian institution in 2023. The sample comprised eighty three researchers who completed an online questionnaire containing eighty three questions on demographic characteristics, factors associated with project submission and approval, and reasons for non-submission or non-approval. The data were analyzed using descriptive statistics, including the Kolmogorov-Smirnov, Pearson’s chi-square, and Mann-Whitney U-tests, followed by post hoc analysis and Yates’ correction. Logistic regression was applied using the backward elimination method, and significant parameters (p < 0.20) free from multicollinearity were selected.

RESULTS: This study revealed that most researchers were men (61.4%) with doctoral degrees (91.6%), highlighted the critical role of proposal clarity and relevance in the project evaluation process. Gender (p = 0.011) and academic level (p = 0.025) were significant factors influencing project submission rates, with Brazilian National Council for Scientific and Technological Development (CNPq) fellows and researchers involved in graduate programs submitting more projects. The participants identified “search for funding” and “desire to expand research impact” as their primary motivations while citing “complex funding calls” and “funding limitations” as major barriers. Additionally, age and the number of children were found to affect project approval (p ≤ 0.018), with “proposal clarity” and “researchers’ experience” having been critical factors for submission approval (p ≤ 0.03).

CONCLUSION: The study results highlighted a gender disparity, with lower participation among women, and identified key factors influencing project submission, including the search for funding, curriculum development, and structural challenges. Additionally, the findings suggest the adoption of gender-sensitive and early-career grant criteria, targeted support for underrepresented researchers, and flexible mechanisms for those with caregiving responsibilities. These findings underscore the importance of public policies and institutional strategies in promoting equitable and inclusive funding opportunities.

PMID:41059466 | PMC:PMC12497820 | DOI:10.3389/frma.2025.1553928

Front Bioeng Biotechnol. 2025 Sep 22;13:1651500. doi: 10.3389/fbioe.2025.1651500. eCollection 2025.

ABSTRACT

BACKGROUND: chronic kidney disease (CKD) remains a global health challenge with limitations in current diagnostic methods, including the invasiveness of biopsies and variability of estimated glomerular filtration rate (eGFR). This study aimed to develop a noninvasive diagnostic model integrating ultrasound viscoelasticity parameters to address these gaps.

METHODS: A prospective cohort of 228 participants underwent standardized renal ultrasound with viscoelastic imaging (Mindray Resona A20) to assess viscoelastic parameters and structural metrics. Key predictors were selected through LASSO regression, and a logistic regression diagnostic model was constructed. Model performance was comprehensively evaluated by analyzing discriminative ability (AUC, sensitivity/specificity), calibration (Brier score, calibration curves), and clinical utility (nomogram development, risk stratification and stage-specific decision curve analysis). Multiclass analysis was implemented to evaluate stage-specific performance (Class 1: normal; Class 2: G1-3; Class 3: G4-5) using one-vs-rest ROC methodology. All statistical analyses incorporated 1000 bootstrap iterations for robust variance estimation.

RESULTS: The diagnostic model demonstrated superior accuracy with an AUC of 0.932 (95% CI 0.908-0.956) in validation sets. Pathological analysis revealed that viscosity values were significantly elevated in CKD patients compared to controls (1.99 vs. 1.64 Pa·s, P < 0.001), while elasticity and shear wave velocity showed increases of 12.7%-13.2% and 5.3% respectively (P < 0.001). For clinical implementation, the model incorporated a visual nomogram that converted scores ranging from 0 to 160 points into CKD probability estimates between 0.1 and 0.9, with an optimal cutoff value of 0.383 providing balanced sensitivity of 88.4% and specificity of 87.8%. Decision curve analysis confirmed clinical utility across probability thresholds of 20%-80%, with peak net benefit at 40% threshold probability. Multiclass analysis revealed stage-dependent performance: Class 3 showed the highest discrimination (AUC = 0.918), followed by Class 1 (AUC = 0.884) and Class 2 (AUC = 0.774), with significant inter-stage differences (DeLong’s test P < 0.001).

CONCLUSION: This study establishes a novel “function-structure” integrated diagnostic paradigm for CKD, combining the accuracy of ultrasound parameters with unique structural insights. The model’s noninvasive nature and stability under physiological variability make it particularly valuable for early detection and longitudinal monitoring.

PMID:41059457 | PMC:PMC12498016 | DOI:10.3389/fbioe.2025.1651500

Front Cardiovasc Med. 2025 Sep 22;12:1600189. doi: 10.3389/fcvm.2025.1600189. eCollection 2025.

ABSTRACT

OBJECTIVE: This study aims to investigate the effect of Yiqi Huoxue Tongluo decoction (YHTD) in combination with conventional medicine therapy on restenosis rates and clinical efficacy in patients with coronary heart disease undergoing percutaneous coronary intervention.

METHODS: A total of 80 patients with coronary artery disease who underwent PCI between August 2019 and February 2021 were selected, and the patients were assigned to either the control group (n = 40) or the observation group (n = 40) according to a randomized numerical table. The control group received conventional medicine treatment, while the observation group took YHTD alongside conventional medicine treatment. Coronary angiography was performed after 6 months of treatment to compare the changes in coronary restenosis, TCM syndrome scores, Seattle Angina Questionnaire (SAQ) scores, cardiac function indexes, and related serum biomarkers between the two groups.

RESULTS: After treatment, the TCM syndrome scores of patients in both groups were lower than those before treatment, and the post-treatment TCM syndrome scores of the observation group were significantly lower than those of the control group. Similarly, the SAQ scores of patients in both groups were significantly higher than those before treatment, and the SAQ scores of the observation group were significantly higher than those of the control group. After treatment, both groups showed significant reductions in the LVEDD and LVESD compared with those before treatment, and the LVEDD and LVESD values of the observation group were significantly lower than those of the control group. Similarly, the LVEF and SV of patients in both groups increased compared with those before treatment; however, the LVEF and SV values of the observation group were significantly higher than those of the control group, and the difference was statistically significant. After treatment, hs-CRP, Hcy, and sST2 were significantly reduced in both groups, and the levels of hs-CRP, Hcy, and sST2 in the observation group were significantly lower than those in the control group.

CONCLUSION: YHTD combined with conventional medicine therapy can significantly reduce the rate of coronary restenosis in post-PCI patients, improve the TCM symptoms, alleviate angina symptoms, enhance cardiac function indexes, and effectively regulate serum biomarker levels, which offers a better choice for the treatment of post-PCI coronary artery disease.

PMID:41059441 | PMC:PMC12498481 | DOI:10.3389/fcvm.2025.1600189

North Clin Istanb. 2025 Aug 26;12(4):461-467. doi: 10.14744/nci.2025.48902. eCollection 2025.

ABSTRACT

OBJECTIVE: Ado-trastuzumab emtansine (T-DM1) is a key treatment for HER2-positive metastatic breast cancer (HER2+ MBC), yet the influence of progression sites and therapy lines on outcomes remains unclear.To assess the relationship between progression sites and the line of T-DM1 therapy with survival outcomes in HER2+ MBC.

METHODS: We retrospectively analyzed 123 patients with HER2+ MBC treated with T-DM1. Data on metastatic progression sites (brain, liver, bone, lung, lymph nodes), line of T-DM1 therapy (2^nd-line vs ≥3^rd-line), and death status were examined. Due to limited survival time data, mortality was used as the primary outcome. Death rates were compared across subgroups using descriptive statistics.

RESULTS: Brain and lung progression were associated with the highest mortality rates (76.7% and 73.1%, respectively). Liver and bone progression also showed elevated death rates (70.0% and 64.3%). Notably, more patients who used T-DM1 as the second-line therapy had a higher mortality rate at 66.7% compared to those treated with it in the third line or after (45.1%).

CONCLUSION: Progression to brain and lung during T-DM1 treatment correlates with higher mortality. Early-line use of T-DM1 may be linked with worse outcomes, possibly due to more aggressive disease biology. The obtained data could inform the decision-making process when treating patients with HER2+ MBC and predict their prognosis.

PMID:41059432 | PMC:PMC12497911 | DOI:10.14744/nci.2025.48902

North Clin Istanb. 2025 Aug 8;12(4):490-495. doi: 10.14744/nci.2024.42890. eCollection 2025.

ABSTRACT

OBJECTIVE: The aim of this study is to radiologically compare area and volume changes in the costoclavicular region with the unaffected side in patients treated nonoperatively after unilateral midshaft clavicle fracture and to evaluate functional outcomes.

METHODS: This study included 16 patients (14 males, 2 females) with midshaft clavicle fractures who were admitted between 2017-2018 and union was achieved with conservative methods. Magnetic resonance imaging (MRI) of the shoulder including the costoclavicular region was performed after union. Area and volume calculations of the fractured and unaffected costoclavicular region of the patients were performed on the standard MR sections under the guidance of a specialist radiologist. The Short Version of Disabilities of the Arm, Shoulder and Hand (QDASH) score was used for functional assessment. Range of motion was measured on the affected and unaffected sides at the last follow-up visit.

RESULTS: The mean age of the patients was 30.4±20.8 years (5-69) and the mean follow-up was 8.3±1.3 (6-10) months. The mean shortening was 14.3 mm±8.2 (3-29). The area measurements of the costoclavicular region were divided into 3 levels in axillary section: acromioclavicular joint, mid 1/3 of the clavicle, and sternoclavicular joint level. The median area measurements were 1115 (364-3675) mm², 1495 (365-4199) mm², and 1201 (197-3812) mm² on the unaffected side and 895.5 (351-3670) mm², 1098.5 (340-3191) mm², and 1037.5 (166-3237) mm² on the fractured side, respectively (p=0.905, p=0.491, p=0.888). In volume measurements, the median volumes of the unaffected side and the fractured side were 34.3 (10.7-69.7) mm³ and 28.9 (8.1-60.9) mm³, respectively (p=0.268). No significant difference was found in the statistical analysis of area and volume measurements. At the end of the follow-up period, the QDASH score and functional outcome of the patients were good.

CONCLUSION: Conservative treatment of midshaft clavicle fractures did not result in significant area and volume changes in the costoclavicular region. The inability to clinically demonstrate the theoretical expectation of decreased area and volume on the fractured site suggests that other biomechanical factors are involved in the healing process of the human body.

PMID:41059429 | PMC:PMC12497898 | DOI:10.14744/nci.2024.42890

North Clin Istanb. 2025 Aug 19;12(4):387-395. doi: 10.14744/nci.2025.43788. eCollection 2025.

ABSTRACT

OBJECTIVE: Laparoscopic techniques have emerged as the preferred approach over traditional open surgery for the treatment of adrenal gland disorders. Right laparoscopic adrenalectomy (RLA) typically requires liver retraction for exposure, and various retractors can be used for this purpose. While studies have been conducted on liver injury during liver retraction in upper abdominal surgeries, no research has specifically addressed liver damage during laparoscopic adrenalectomy (LA). This study aims to evaluate the impact of two retractors used for liver retraction during RLA on liver function test results (LFTs) and their clinical significance.

METHODS: This retrospective study included 87 LA patients who underwent surgery for adrenal gland pathology at our institution between 01/01/2010 and 04/30/2024. The patients were divided into two groups: RLA (n=42) and left LA (LLA) (n=45). The RLA patients were further categorized into two subgroups based on the retractor used: 5-blade retractor (FB) (n=22) and full ring retractor (GF) (n=20). Clinicopathological findings, operative outcomes, and laboratory test results were compared across groups.

RESULTS: Postoperative levels of aspartate aminotransferase (AST), alanine aminotransferase, and alkaline phosphatase were significantly higher in the RLA groups (FB and GF) compared to the LLA group (p<0.001, p<0.001, p=0.001, respectively). Although no statistically significant difference was observed between groups, the median length of stay (LOS) was slightly shorter in the FB group (2 (2-3), p=0.058). There were no significant differences between FB and GF groups in terms of operation time, LFTs, complications, or mortality. Correlation analysis showed a statistically significant positive correlation between postoperative AST levels and lesion size (rho=0.31, p=0.045). Additionally, patients with functional adrenal pathologies had a significantly longer hospital stay compared to those with nonfunctional pathologies (2 (2-2.25) vs. 3 (2-3.5), p<0.001).

CONCLUSION: In RLA procedures, the LFT values were higher compared to LLA procedures. The effects of FB and GF retractors on surgical outcomes and LFT values were similar, indicating both retractors can be safely used during RLA surgeries. While no clinical impact was detected, caution is advised regarding potential liver injury during RLA procedures.

PMID:41059426 | PMC:PMC12497914 | DOI:10.14744/nci.2025.43788

North Clin Istanb. 2025 Aug 14;12(4):438-444. doi: 10.14744/nci.2024.19794. eCollection 2025.

ABSTRACT

OBJECTIVE: TFE3 rearranged carcinomas constitute 5% of malignant tumours of the kidney in adults. TFE3 immunohistochemistry plays a crucial role in the diagnosis. TFE3 positivity in the appropriate histological context supports the diagnosis of Xp11 translocation renal cell carcinomas. However, there isn’t any standardized approach to performing and interpreting immunohistochemical staining.

METHODS: A total of 51 renal cell carcinomas are included in the study. In this study, we compared the expression profiles of two different anti-TFE3 antibody clones (MRQ37, Cell Marque, and IHC627, GeneAbTM) on renal cell carcinoma samples that have conflicting morphologies and assessed the overall performance of these clones to identify TFE3 rearranged carcinomas.

RESULTS: There was a statistically significant difference in terms of immunohistochemical staining with TFE3-MRQ37 clone between TFE3 rearranged renal cell carcinomas and other subtypes, while no significant difference was found in staining with TFE3-IHC672. 47% of cases were stained with the TFE3-IHC672 clone and 9.8 % of cases were stained with the TFE3-MRQ37 clone at different staining intensities and proportions.

CONCLUSION: The TFE3-MRQ37 clone is easier to interpret because of the absence of background staining and is more reliable in identifying TFE3 rearranged renal cell carcinomas. However, because of various sensitivity and specificity rates, and immunoreactivity in many subtypes of renal cell carcinomas, there is a need for a standardised approach for TFE3 immunohistochemistry for diagnostic use in TFE3-tRCCs.

PMID:41059424 | PMC:PMC12497915 | DOI:10.14744/nci.2024.19794

North Clin Istanb. 2025 Aug 27;12(4):413-418. doi: 10.14744/nci.2025.24603. eCollection 2025.

ABSTRACT

OBJECTIVE: Biofeedback electromyography (EMG) involves the transmission of pelvic and abdominal muscle activity to the patient via visual and sometimes auditory feedback, with the ultimate goal of learning to contract and relax the pelvic muscles at the appropriate times through real-time analysis and feedback. To determine the optimal number of biofeedback therapy sessions required for a therapeutic response in the treatment functional voiding dysfunction.

METHODS: The retrospective data of 779 patients who underwent biofeedback therapy at a tertiary pediatric hospital between 2017 and 2023 were analyzed. The study included patients referred for urinary symptoms and uroflow/EMG findings who did not respond to standard urotherapy and behavioral therapy and completed at least 8 biofeedback sessions. During treatment, methods such as EMG biofeedback, pelvic muscle training, and keeping symptom diaries were utilized. Statistical analyses were performed using the Mann-Whitney U test and Chi-Square test.

RESULTS: Of the patients, 62.4% were female, 37.6% were male, and the mean age was 9.05±3.05 years. The most common urinary symptoms were daytime urinary incontinence (59.4%) and nocturnal enuresis (54%). The average number of sessions required for a therapeutic response was 6±1.3. Female patients showed an earlier response to treatment compared to males (p<0.01). Younger patients demonstrated faster recovery and better response to therapy (p<0.05). Patients who did not respond to therapy had a higher mean age and required more sessions (p<0.05). The higher mean number of sessions in non-responders compared to responders was found to be statistically significant (p=0.001; p<0.05).

CONCLUSION: Biofeedback is an effective and non-invasive treatment method for children with functional voiding dysfunction. Most patients show symptomatic improvement within 1.5-2 months (2-8 sessions – average 6). Male patients may require longer treatment durations, while younger children respond better to therapy. Future studies focusing on factors influencing biofeedback success may contribute to optimizing this treatment.

PMID:41059422 | PMC:PMC12497902 | DOI:10.14744/nci.2025.24603

North Clin Istanb. 2025 Aug 8;12(4):419-424. doi: 10.14744/nci.2024.79577. eCollection 2025.

ABSTRACT

OBJECTIVE: A combination of local anesthetic treatments provides better pain alleviation than periprostatic nerve block (PPNB) alone during a prostate biopsy procedure. The primary objective of this study was to compare Visual Analog Scale (VAS) pain levels during transrectal ultrasound (TRUS)- guided prostate biopsy whilst the use of prilocaine-lidocaine cream, diclofenac suppository, or PPNB only in a prospective, randomized study.

METHODS: This study included 162 patients who had TRUS-guided prostate biopsies performed at the Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Center within a 6 month period, from April to October 2017. Three groups of patients were randomly assigned: group 1 underwent PPNB plus prilocaine-lidocaine cream, group 2 received diclofenac suppository along with PPNB, and group 3 underwent PPNB alone. The VAS was used to measure the degree of pain: VAS 1 was used to record the pain at the time the ultrasound probe was inserted, VAS 2 was used to document the pain during PPNB, and VAS 3 was used to record the pain during needle biopsy. Following the biopsy, any complications or negative consequences were recorded.

RESULTS: Mean age or serum prostate specific antigen (PSA) levels were similar between the three groups. The VAS 1, VAS 2, and VAS 3 pain scores showed statistically significant difference among the three groups (p=0.001). Between groups 1 and 2, there was a statistically significant difference in VAS 1 pain scores (p=0.01). There was no statistically difference in VAS 2 and VAS 3 pain scores between the groups 1 and 2 (p=0.08 and p=0.23, respectively). Patients between the groups 3 and other groups had significantly difference in VAS pain scores (p<0.05).

CONCLUSION: In this study, we highlight that when applied as an adjuvant to PPNB, either 5% prilocaine-lidocaine cream or a 100 mg diclofenac suppository reduced pain levels relative to PPNB alone. When compared to a 100 mg diclofenac suppository, prilocaine-lidocaine cream significantly reduces pain during the insertion and manipulation of the ultrasound probe.

PMID:41059421 | PMC:PMC12497900 | DOI:10.14744/nci.2024.79577

North Clin Istanb. 2025 Aug 8;12(4):468-474. doi: 10.14744/nci.2025.08455. eCollection 2025.

ABSTRACT

OBJECTIVE: Congenital myasthenic syndromes (CMS) represent a group of genetically heterogenous disorders characterized by defective signal transmission at the neuromuscular junction. Although global prevalence of CMS remains uncertain, regional studies have reported varying prevalence rates. This study aimed to define the incidence and prevalence of CMS in Turkiye utilizing data from the national electronic health registry. Additionally, the rate of pyridostigmine prescriptions among patients with CMS was assessed.

METHODS: The study was a retrospective national cohort study, and patients with at least three G70.2 ICD-10 code entries between 1 January 2015 and 22 May 2024 were included. While calculating incidence and prevalence rates official census data from the Turkish Statistical Institute were used.

RESULTS: A total of 406 patients were included in the study, with females comprising 48.8% of the cohort. The mean age at diagnosis was 20.59±21.65 years (median: 12.00, min-max: 0-86). Among the cohort, 58.6% were diagnosed before the age of 18, and 12.3% before the age of one. Pyridostigmine was prescribed at least once to 68.2% of the patients. The annual incidence of CMS ranged from 0.28 to 0.59 per million between 2016 and 2023. In 2023, the incidence and prevalence rates of CMS were calculated as 0.63 and 4.49 per million, respectively.

CONCLUSION: This study represents the first comprehensive nationwide epidemiological analysis of CMS in Turkiye utilizing the national electronic health registry. The study enhances the understanding of the epidemiological landscape of CMS in the country by reporting the current incidence, prevalence, and pyridostigmine prescription rates and underscores the significance of this rare but impactful neuromuscular disorder.

PMID:41059415 | PMC:PMC12497907 | DOI:10.14744/nci.2025.08455