Tag: nevin manimala

BMC Cardiovasc Disord. 2024 Nov 15;24(1):648. doi: 10.1186/s12872-024-04291-2.

ABSTRACT

BACKGROUND: Anemia represents a commonly reported comorbidity in patients diagnosed with heart failure (HF), related with a higher risk of unfavorable outcomes such as recurrent hospitalizations and mortality. There is a lack of evidence in Latin America regarding this topic. Our aim was to evaluate the prognostic value of the diagnosis of anemia in patients from the Colombian Heart Failure Registry (RECOLFACA).

METHODS: RECOLFACA registry included adult ambulatory patients with HF in 60 medical centers in Colombia during 2017-2019. Baseline characteristics of patients diagnosed with anemia and those without anemia were compared. The main outcome was all-cause mortality. A Cox proportional hazards regression model was used to evaluate the factors linked to the main outcome in patients with anemia. A statistically significant p-value was < 0.05.

RESULTS: From the 2528 patients included in RECOLFACA, 2409 had at least one available hemoglobin value, and 726 (30.1%) corresponded to a diagnosis of anemia. Patients with anemia were significantly older, and had a higher prevalence of comorbidities, especially hypertension, type 2 diabetes, and chronic kidney disease (CKD). Patients without anemia had significantly lower mortality rate of 0.30 per 1000 person-years (95% CI 0.26-0.35), compared to patients diagnosed with anemia who had a mortality rate of 0.42 per 1000 person-years (95% CI 0.26-0.98) (p < 0.001). Lastly, the multivariate model results showed that the presence of an anemia diagnosis was associated with a significantly greater risk of mortality (HR 1.48; 95% CI 1.06, 2.05, p < 0.001).

CONCLUSIONS: Anemia represents a highly prevalent comorbidity in patients with HF in Colombia and is also related with higher mortality in ambulatory patients during follow-up period. Our results highlight the relevance of anemia in the pathophysiology of HF. Nevertheless, due to its observational nature, out study results must be validated and further explored in future studies to elucidate the potential underlying mechanisms of this association.

PMID:39548365 | DOI:10.1186/s12872-024-04291-2

BMC Cardiovasc Disord. 2024 Nov 16;24(1):652. doi: 10.1186/s12872-024-04317-9.

ABSTRACT

BACKGROUND: Cardiovascular disease (CVD) is a major global health concern with increasing incident cases and deaths. Homocysteine (Hcy) has been investigated for its potential association with CVD, researchers have debated the extent to which Hcy should be considered a risk factor for cardiovascular diseases, as only 50% of CVD can be explained by classical risk factors.

METHODS: We conducted a prospective cohort study using NHANES 1999-2006 data, analyzing 1,739 US patients aged at least 30 with CVD. Cox proportional hazards regression and restricted cubic splines were used to examine the relationship between Hcy levels and mortality, adjusting for covariates.

RESULT: A total of 1,739 participants with cardiovascular disease (CVD) were enrolled, with a median follow-up period of 126 months. Among them, 1,194 participants died, including 501 deaths due to cardiovascular causes. After adjusting for covariates, the hazard ratios (HR) and 95% confidence intervals (CI) for CVD mortality at different levels of homocysteine (Hcy) (T1 (< 9.3), T2 (9.3-12.5), T3 (> 12.5)) were 1.26 (0.92, 1.73) (T2), and 1.69 (1.14, 2.51) (T3) (P for trend = 0.0086). The HR and 95% CI for all-cause mortality at different levels of Hcy were 1.22 (1.05, 1.42) (T2) and 1.64 (1.29, 2.09) (T3) (P for trend < 0.0001). Elevated Hcy levels were associated with increased risks of all-cause mortality and CVD deaths, even at levels below the conventional threshold. The nonlinear relationship was observed, with inflection points at 14.5 µmol/L for all-cause mortality and 14.6 µmol/L for CVD mortality. Subgroup analyses revealed interactions with age, serum vitamin B12, and smoking.

CONCLUSION: Our study supports the notion that elevated Hcy levels are associated with higher all-cause and CVD mortality risks in CVD participants. The impact of Hcy on health outcomes can be observed at lower concentrations than previously thought.

PMID:39548360 | DOI:10.1186/s12872-024-04317-9

J Dent Educ. 2024 Nov 15. doi: 10.1002/jdd.13785. Online ahead of print.

ABSTRACT

PURPOSE: To compare the educational outcomes of remote instruction (RI) in impression-taking using smart glasses with those of face-to-face instruction (FI) and paper-based self-learning (SL) and analyze the educational effects, aiming to develop a remote clinical training strategy.

METHODS: Participants were recruited from among the dental residents who were trained in the first-year clinical program at the university hospital in 2023. The participants were divided into three groups as the original skill level was equal, and the groups were assigned RI, FI, printed guidance, and SL. All the participants took impressions of the jaw models attached to the mannequin using alginate impression material. Next, assigned instructions were provided. Then again, the trainees took impressions of the jaw models. The pre- and postinstruction impressions of each participant were evaluated, and the change in the impression score was statistically analyzed.

RESULTS: The pre- and postinstruction scores of the trainees in the RI and FI groups showed a significant increase (p < 0.05), whereas no significant difference was observed in the score changes in the SL group. In the intergroup comparisons, the score changes of the RI and FI groups were greater than those of the SL group, although no significant difference was found between the score changes of the RI and FI groups (p < 0.05).

CONCLUSION: RI in impression-taking using smart glasses has a greater educational effectiveness than paper-based SL. It has also been suggested that RI can have educational efficacy similar to FI.

PMID:39548350 | DOI:10.1002/jdd.13785

Sci Rep. 2024 Nov 15;14(1):28176. doi: 10.1038/s41598-024-79999-4.

ABSTRACT

Low fertility is not conducive to healthy population development. The total fertility rate (TFR) is influenced by the education expansion (measured by the proportion of non-student women, NSP), marriage delay (measured by the proportion of married women, MP), and marital fertility rate (MFR). This study decomposes the TFR change into the changes in NSP, MP, and MFR using China’s census and 1% population sample survey data. During 1990-2020, the changes in NSP, MP, and MFR contributed – 22%, – 90%, and 12%, respectively, to the changes in TFR. The continuous decline in NSP reduced the TFR, and the intensity continued to increase over time. As the primary negative driving force, the rapid decline in MP also consistently reduced the TFR. The marital fertility rate had a downward effect on the TFR before 2000 and an upward effect after 2000. The effects of NSP, MP, and MFR on the TFR varied with the birth order, age and region (among cities, towns, and villages). In summary, China’s TFR has considerably changed in combination with changes in NSP, MP, and MFR. Without effective measures, China’s TFR may further decline into the lowest-low fertility trap.

PMID:39548321 | DOI:10.1038/s41598-024-79999-4

Sci Rep. 2024 Nov 15;14(1):28178. doi: 10.1038/s41598-024-79921-y.

ABSTRACT

Colorectal cancer in Brazil is among the main public health concern. The burden of disease can be related to unhealthy lifestyle behavior and inequality in access to health services. The aim of this study was to identify the main factors associated with colorectal cancer mortality in Brazil. This is an ecological study that had the Brazilian Federal Units as the primary units of analysis. Colorectal cancer mortality data (ICD C18-C21) were obtained from Brazilian national mortality system to the year 2020. Prevalence of overweight, food consumption (fiber, whole grains and red meat), physical inactivity, smoke, alcohol consumption, the median of household income, years of study, rates of cancer treatment units and oncologist by Brazilian Federal Units were considered as factor associated to the colorectal cancer mortality. Quasipoisson Generalized Linear Models were used to associate CRC mortality and variables related to dietary intake, risk behavior, and access to health services. In 2020, there were 21,501 deaths by colorectal cancer (51% among women). Prevalence of overweight (men: IRR 1.03; CI: 1.01-1.04; women IRR 1.05; CI 1.02-1.08) and the density of oncologist (men: IRR 1.02; CI: 1.01-1.03; women IRR 1.02; CI 1.01-1.03) were the main factors associated with colorectal cancer mortality. Sociodemographic and food consumption characteristics were not statistically associated with CRC. Prevalence of overweight was the strongest factor associated with mortality from colorectal cancer in Brazil in 2020. Therefore, current public policies to reduce overweight and obesity should be prioritized and strengthened in Brazil.

PMID:39548314 | DOI:10.1038/s41598-024-79921-y

Sci Rep. 2024 Nov 15;14(1):28230. doi: 10.1038/s41598-024-79727-y.

ABSTRACT

This research explores the design of an infrared (IR) photodetector using mercury cadmium telluride (Hg_1-xCd_xTe). It proposes two- and three-dimensional homojunction models based on p⁺-Hg_0.7783Cd_0.2217Te/n^–-Hg_0.7783Cd_0.2217Te, focusing on applications in the long-wavelength infrared range. The photodetector’s performance is analyzed using Silvaco ATLAS TCAD software and compared with analytical calculations based on drift-diffusion, tunneling, and Chu’s approximation techniques. Optimized for operation at 10.6 μm wavelength under liquid nitrogen temperature, the proposed photodetector demonstrates promising optoelectronic characteristics including the dark current density of 0.20 mA/cm², photocurrent density of 4.98 A/cm², and photocurrent density-to-dark current density ratio of 2.46 × 10⁴, a 3-dB cut-off frequency of 104 GHz, a rise time of 0.8 ps, quantum efficiency of 58.30 %, peak photocurrent responsivity of 4.98 A/W, specific detectivity of 3.96 × 10¹¹ cmHz^1/2/W, and noise equivalent power of 2.52 × 10^-16 W/Hz^1/2 indicating its potential for low-noise, high-frequency and fast-switching applications. The study also incorporates machine learning regression models to validate simulation results and provide a predictive framework for performance optimization, evaluating these models using various statistical metrics. This comprehensive approach demonstrates the synergy between advanced materials science and computational techniques in developing next-generation optoelectronic devices. By combining theoretical modeling, simulation, and machine learning, the research highlights the potential to accelerate progress in IR detection technology and enhance device performance and efficiency. This multidisciplinary methodology could serve as a model for future studies in optoelectronics, illustrating how advanced materials and computational methods can be utilized to enhance device capabilities.

PMID:39548271 | DOI:10.1038/s41598-024-79727-y

J Perinatol. 2024 Nov 15. doi: 10.1038/s41372-024-02161-5. Online ahead of print.

ABSTRACT

OBJECTIVES: Characterize the relationship between infant outcomes and prenatal homelessness, food insecurity and unemployment.

STUDY DESIGN: California live births between 22- and 44-weeks’ gestation comprised 6,089,327 pregnancies (2007-2020). Data were collected from linked Vital Statistics and hospital discharge records. Prenatal homelessness, food insecurity, and unemployment were classified as health-related social needs (HRSN) using International Classification of Disease codes in delivery records. Risk ratios for preterm birth, low birthweight, small for gestational age, neonatal intensive care unit admission, emergency department admission, rehospitalization, and death were estimated using log-linear Poisson regression adjusted for birthing person race, payer, and education.

RESULTS: 65.7 per 100,000 births had HRSN. These infants had a higher risk of preterm birth (aRR 2.7), low birthweight (aRR 2.7), SGA (aRR 1.5), NICU admission (aRR 3.5), and death (aRR 3.0).

CONCLUSIONS: HRSN increase the risk of infant morbidity and mortality but remain underreported in administrative records, making definitive conclusions difficult.

PMID:39548269 | DOI:10.1038/s41372-024-02161-5

Sci Rep. 2024 Nov 15;14(1):28185. doi: 10.1038/s41598-024-79571-0.

ABSTRACT

Acute hydrocephalus is a severe complication that may occur early after an intracerebral hemorrhage (ICH). However, clinical factors predicting the occurrence of acute hydrocephalus have rarely been studied. This study aimed to establish a nomogram model to predict early acute hydrocephalus after ICH. We retrospectively analyzed the data of 930 patients with ICH who were treated at our hospital between January 2017 and May 2024. Least absolute shrinkage and selection operator (LASSO) regression analysis was used to screen for risk factors for acute hydrocephalus, and stepwise logistic regression analysis was used to construct the prediction model, which was visualized using a nomogram. Data were randomly divided into training (n = 652) and test (n = 278) sets at a 7:3 ratio. A total of 930 patients were included, of whom 123 (13.2%) developed acute hydrocephalus within 6 h of being diagnosed with ICH. Univariate analysis revealed that 11 indicators were associated with acute hydrocephalus. In the training set, LASSO and stepwise logistic regression analyses identified four independent risk factors that were used to establish a prediction model. These were the modified Graeb score, age, infratentorial hemorrhage > 15 mL, and thalamic hemorrhage > 15 mL. A graphical nomogram was then developed. The area under the receiver operating characteristic (ROC) curve was 0.974 (95% confidence interval 0.961-0.987). In the Hosmer-Lemeshow test, the p-value was 0.887. The mean absolute error of the calibration plot was 0.012. The decision curve analysis (DCA) validated the fitness and clinical application value of this nomogram. Internal validation showed the test set was in good accordance with the training set. The nomogram prediction model showed good accuracy and could be used to predict the risk of early acute hydrocephalus after ICH, thereby aiding neurologist in making rapid clinical decisions.

PMID:39548258 | DOI:10.1038/s41598-024-79571-0

Sci Rep. 2024 Nov 15;14(1):28245. doi: 10.1038/s41598-024-79486-w.

ABSTRACT

Acute-on-chronic liver failure (ACLF) is a syndrome characterized by the acute decompensation of chronic liver disease, resulting in organ failure and high short-term mortality. The progression of ACLF is dynamic and reversible in a considerable proportion of patients during hospitalization. Early detection and accurate assessment of ACLF are essential; however, ideal methods for this purpose are still lacking. Therefore, this study aimed to develop a new score for predicting the onset of ACLF in patients with various chronic liver diseases.A total of 6,188 patients with various chronic liver diseases were included in the study. Clinical and laboratory data were collected, and the occurrence of ACLF within 28 days was recorded. The Lasso-Cox regression method was employed to develop prediction models for the onset of ACLF at 7, 14, and 28 days. Among 5,221 patients without ACLF, 477 progressed to ACLF within 28 days. Seven predictors were identified as significantly associated with the occurrence of ACLF at 7, 14, and 28 days. A new scoring system was developed as follows: [NEUT ≥ 7, 10⁹/L; 1 or 0] × 0.49 + [PLT < 100, 10⁹/L; 1 or 0] × 0.44 + [TBIL ≥ 35, µmol/L; 1 or 0] × 0.05 + [HDL-C < 0.5, mmol/L; 1 or 0] × 1.04 – Ln[Hb, g/L] × 0.89 + [BUN > 7, mmol/L; 1 or 0] × 0.51 + Ln[INR] × 0.87 + 3.40. This new score demonstrated superior discrimination, with the C-indexes of 0.958, 0.944, and 0.938 at 7, 14, and 28 days, respectively, outperforming those of four other scores (CLIF-C-ACLF-Ds, MELD, MELD-Na, and CLIF-C-ADs score; all P < 0.001). Additionally, the new score improved in predictive accuracy, time-dependent receiver operating characteristics, probability density function evaluations, and calibration curves, making it highly predictive for the onset of ACLF at all time points. The optimal cut-off value of 9.6 effectively distinguished between high- and low-risk patients for ACLF onset. These findings were further validated in a separate cohort of patients. A new progressive score, based on seven predictors, has been developed to accurately forecast the occurrence of ACLF within 7, 14, and 28 days in patients with various chronic liver diseases. This tool may be utilized to identify high-risk patients, tailor follow-up management, and guide the escalation of care, prognostication, and transplant evaluation.

PMID:39548240 | DOI:10.1038/s41598-024-79486-w

Sci Rep. 2024 Nov 15;14(1):28107. doi: 10.1038/s41598-024-79477-x.

ABSTRACT

In this study, polymer composite nanofibers and thin membranes were synthesized using Carbon Nanotubes (CNTs) and Zinc Oxide (ZnO) as fillers in a Polyvinyl Alcohol (PVA) matrix, aiming to evaluate their electrical and mechanical properties. The composite nanofibers and thin membranes were prepared by incorporating different weight ratios of CNTs and ZnO into the PVA matrix using electrospinning and solution casting techniques, respectively. Solutions were prepared by mixing specific weight ratios of PVA, ZnO, and CNTs, followed by magnetic stirring and ultrasonication for homogenization. Electrospinning was performed at 20 kV with a syringe-to-collector distance of 14.5 cm at flow rate of 2.4 ml/hr. The composites were characterized using FTIR spectroscopy and Scanning Electron Microscopy (SEM). The PVA/5%ZnO/0.5%CNT composite exhibited the highest dielectric constant of 10.3 at high frequencies, while PVA/5%CNT showed the highest capacitance of 31.1 pF at 2 MHz. The maximum AC conductivity of 2.72 × 10^{– 7}S/m was also observed for the PVA/5%ZnO/0.5%CNT composite. Mechanical testing revealed significant improvements in Young’s modulus, stress yield, and load yield, with PVA/5%CNT achieving a Young’s modulus of 387.12 MPa and a stress yield of 6.92 MPa. The addition of ZnO and CNT fillers resulted in enhanced electrical and mechanical properties, making these composites suitable for applications in microelectronic devices and packaging materials.

PMID:39548235 | DOI:10.1038/s41598-024-79477-x