Tag: nevin manimala

Eur J Vasc Endovasc Surg. 2025 Sep 26:S1078-5884(25)00939-6. doi: 10.1016/j.ejvs.2025.09.052. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate national level differences in in hospital outcomes among patients with autoimmune rheumatic diseases (AIRDs) undergoing endovascular interventions for lower extremity arterial disease (LEAD).

METHODS: This was a retrospective, observational cohort study using a large nationwide administrative database. Adult patients diagnosed with LEAD who underwent percutaneous endovascular interventions were analysed using the 2012 – 2020 Nationwide Inpatient Sample. Patients were stratified into four groups: systemic lupus erythematosus (SLE); rheumatoid arthritis (RA); systemic sclerosis (SSc); and a reference group without these conditions. Multivariable logistic regression was used to assess associations between AIRDs and in hospital mortality, discharge to a long term care facility (LTCF), prolonged hospital length of stay (LoS), and in hospital complications RESULTS: Among 71 436 weighted patients, 1 739 (2.4%) had an AIRD (SLE, 0.4%; RA, 1.8%; SSc, 0.2%). Compared with the reference group, patients with RA had a statistically significantly higher risk of discharge to an LTCF (adjusted odds ratio [aOR] 1.41), prolonged LoS (aOR 1.39), and any in hospital complication (aOR 1.33), including sepsis, infections, and below knee amputation. Patients with SSc exhibited higher odds of pneumonia (aOR 2.02), respiratory failure (aOR 1.77), and minor amputations (aOR 2.89). No statistically significant differences were observed in mortality or total hospital costs among groups. Patients with SLE had outcomes comparable with those of the general population.

CONCLUSION: Although in hospital mortality rates were similar across all groups, patients with RA were at a significantly higher risk of infectious complications and major amputation during hospitalisation following endovascular intervention for LEAD. These findings underscore the need for proactive peri-operative planning and multidisciplinary care strategies tailored to the unique risks and needs of this patient population.

PMID:41016682 | DOI:10.1016/j.ejvs.2025.09.052

Respir Med. 2025 Sep 26:108386. doi: 10.1016/j.rmed.2025.108386. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to determine the effect of preoperative use of different respiratory exercise devices on postoperative outcomes in elderly lung lobectomy patients.

METHODS: This study was retrospectively conducted between 03.12.2024 and 5.02.2025 in the Thoracic Surgery Clinic of a university with 82 patients using 41 Triflow and 41 Acapella. The information obtained from the online files of the patients was entered into the SPSS program using the Patient Introduction Form and Patient Follow-up Form. Descriptive analyses, independent sample t-tests, Mann-Whitney U tests, and chi-square tests were used to evaluate the data.

RESULTS: In the study, the postoperative hospitalization time of the acapella group was higher than that of the triflow group, and this difference was statistically significant (p: 0.042). In addition, the saturation value on the 3rd postoperative day (p:0.023) was significantly higher in the triflow group than in the acapella group. On postoperative days 4 and 7, the pain score (p:0.012) was significantly lower in the Triflow group than in the Acapella group.

CONCLUSION: In the study, it was determined that the hospitalization period was shorter, the saturation value was higher on the 3rd postoperative day, and the pain score was lower on the 4th and 7th postoperative days in the Triflow group compared to the Acapella group as a respiratory exercise device in elderly patients with lung lobectomy.

PMID:41016641 | DOI:10.1016/j.rmed.2025.108386

Urologia. 2025 Sep 28:3915603251376393. doi: 10.1177/03915603251376393. Online ahead of print.

ABSTRACT

OBJECTIVE: This study investigates the diagnostic potential of nicotinamide N-methyltransferase (NNMT) and NM23A as biomarkers for renal cell carcinoma (RCC), focusing on their ability to facilitate early detection and improve diagnostic precision.

METHODS: A prospective observational study was conducted over 24 months, enrolling patients with RCC, benign renal tumors, and healthy controls. Biomarker levels were measured using enzyme-linked immunosorbent assays (ELISA). Diagnostic performance was evaluated through statistical analyses, including ROC curve analysis and Mann-Whitney U tests. Additionally, machine learning models such as Random Forest and Gradient Boosting were employed to identify key predictors of RCC.

RESULTS: NNMT and NM23A demonstrated significant diagnostic accuracy, with area under the curve (AUC) values of 0.933 and 0.915, respectively. Both biomarkers showed substantial differences across RCC, benign, and control groups (p < 0.001). Machine learning analyses highlighted NNMT as the most influential predictor for RCC diagnosis, further supporting its clinical relevance.

CONCLUSIONS: NNMT and NM23A emerge as promising non-invasive biomarkers for RCC, offering substantial diagnostic accuracy and reducing reliance on invasive procedures. Their integration into clinical workflows, supported by advanced machine learning methodologies, could transform RCC diagnostics. Further research with diverse populations is recommended to validate these findings and expand their clinical applicability.

PMID:41015874 | DOI:10.1177/03915603251376393

Clin Chem Lab Med. 2025 Sep 29. doi: 10.1515/cclm-2025-0581. Online ahead of print.

ABSTRACT

OBJECTIVES: Regulatory guidelines recommend non-parametric Passing-Bablok regression for evaluating the agreement between two measurement methods in laboratory settings. However, concluding for the agreement if the 95 % CI of the slope and of the intercept include 1 and 0, respectively is incorrect since the agreement assessment must focus on a null hypothesis of not equivalence and an alternative hypothesis of equivalence.

METHODS: We exhaustively simulated appropriate structural models with several values of slope, intercept and measurement error by keeping equal variances and means of the two methods. We calculated the slope and intercept bias of four regressions: non-parametric Passing-Bablok, Theil, Ordinary Least Squares and Deming. In addition, we calculated the percentages of the agreement according to the not shareable Passing-Bablok suggestion. Furthermore, we calculated the percentages of the 95 % CI of the slope and of the intercept included within sensible equivalence thresholds for assessing the agreement.

RESULTS: Passing-Bablok procedure gives unbiased estimates, a little more and less biased than those from Deming’s regression. The percentages of rejecting the hypothesis of no-agreement, according to the wrong Passing-Bablok’s approach are correctly near to 0.05 Type I error under the agreement and also for 0.990≤slopes≤1.005. However, they are too low for slopes >1.05 and <0.950.

CONCLUSIONS: The Passing-Bablok 95 % CIs are too wide for being included in sensible agreement thresholds according to a population equivalence model and, finally, this approach cannot be considered under the best agreement model of the individual equivalence.

PMID:41015873 | DOI:10.1515/cclm-2025-0581

Korean J Radiol. 2025 Oct;26(10):924-937. doi: 10.3348/kjr.2025.0440.

ABSTRACT

OBJECTIVE: To evaluate and compare scan times, measurement accuracy, and image quality (IQ) of free-breathing (FB) and breath-hold (BH) deep learning (DL) cine MRI sequences versus standard cine MRI, with a specific focus on patients with arrhythmia and dyspnea.

MATERIALS AND METHODS: Seventy participants were prospectively enrolled, including 24 with arrhythmia, 17 with dyspnea, and 29 with normal sinus rhythm and eupnea (mean age, 49 ± 17 years). Each patient underwent three cine MRI acquisitions (standard cine, BHDL, and FBDL) on a 3T scanner. Quantitative assessments of biventricular function, left ventricular mass, and myocardial strain were independently performed by three radiologists, blinded to image acquisition techniques. IQ was evaluated by the same readers using both a five-point Likert scale and objective metrics.

RESULTS: Both BHDL and FBDL significantly reduced total examination times compared to standard cine (BHDL: 58 ± 5 s; FBDL: 88 ± 12 s; standard cine: 208 ± 12 s; adjusted P < 0.001). Quantitative measurements from BHDL and FBDL showed no statistically significant differences compared to standard cine and showed strong correlations (correlation coefficients > 0.85) with standard cine. BHDL consistently demonstrated narrower 95% limits of agreement (LOA) than FBDL across all parameters. For BHDL, the 95% LOA for left and right ventricular ejection fractions were -3.5% to 3.9% and -3.4% to 4.0%, respectively; for FBDL, they were -4.6% to 5.8% and -7.8% to 9.3%, respectively. In patients with arrhythmia, BHDL achieved significantly higher IQ Likert scores (4.44 ± 0.56) than both standard cine (4.00 ± 0.99; adjusted P = 0.043) and FBDL (3.94 ± 0.56; adjusted P = 0.030). In patients with dyspnea, FBDL received the highest IQ scores (4.24 ± 0.47), outperforming standard cine (3.41 ± 0.97; adjusted P = 0.028) and BHDL (3.68 ± 0.56; adjusted P = 0.028).

CONCLUSION: Both FBDL and BHDL significantly reduced scan times compared to standard cine without compromising quantitative measurement accuracy. BHDL offered superior measurement accuracy and shorter scan time than FBDL. Furthermore, BHDL demonstrated robust suitability for patients with arrhythmia by minimizing arrhythmia-related artifacts, whereas FBDL was more effective in patients with dyspnea by mitigating respiratory motion artifacts.

PMID:41015857 | DOI:10.3348/kjr.2025.0440

Eur J Emerg Med. 2025 Sep 29. doi: 10.1097/MEJ.0000000000001272. Online ahead of print.

ABSTRACT

BACKGROUND AND IMPORTANCE: Emergency medicine professionals face persistent challenges, including excessive workloads, shift work, and emotional stress. Job satisfaction is essential for workforce sustainability, quality of care, and retention; however, international research remains limited.

OBJECTIVES: To evaluate self-reported job satisfaction among emergency medicine professionals globally – including prehospital providers – and explore how individual and institutional factors influence it.

DESIGN: International cross-sectional study using a structured, anonymous online survey.

SETTINGS AND PARTICIPANTS: The survey was disseminated via international emergency medicine organizations (European Society for Emergency Medicine, International Federation for Emergency Medicine, South Asian Federation of Emergency Medicine, African Federation for Emergency Medicine, among others) over 3 weeks in April 2025. Eligible respondents included physicians, nurses, and paramedics working in prehospital and in-hospital emergency medicine settings.

OUTCOME MEASURES AND ANALYSIS: The primary outcome was the satisfaction score (range: 9-36), based on the nine-domain Lausanne scale. Overall job satisfaction was assessed separately using a single-item Likert scale (0-9). Descriptive and inferential statistics explored associations with demographic and organizational variables.

MAIN RESULTS: A total of 1112 professionals from 79 countries participated (56% female and 85.8% physicians). The mean satisfaction score was 25.37 (SD = 4.36), with a median overall satisfaction estimation of 6.77 (interquartile range = 2). High scores were reported for organisational commitment, co-worker support, and professional fulfilment. The lowest scores concerned career opportunities and work organization. Lower satisfaction was reported in high-volume emergency departments (>100 000 visits/year) and among mid-career professionals (5-20 years of experience). Intention to remain in the current role was significantly associated with higher satisfaction (P < 0.001).

CONCLUSION: The Emergency Medicine Day 2025 Survey provides one of the largest international assessments of job satisfaction in emergency medicine to date. Despite moderate-to-high satisfaction overall, challenges persist regarding career development and workload – particularly in high-pressure settings. These findings support the implementation of targeted interventions to enhance leadership, support mid-career staff, and foster resilient, well-functioning teams.

PMID:41015821 | DOI:10.1097/MEJ.0000000000001272

OTJR (Thorofare N J). 2025 Sep 27:15394492251367249. doi: 10.1177/15394492251367249. Online ahead of print.

ABSTRACT

Engaging community collaborators in research is crucial for enhancing health care outcomes, especially for cerebral palsy (CP). However, effective multi-collaborator involvement poses challenges. This study used an occupation-based approach to engage community collaborators in developing a CP Task Force to initiate patient-centered comparative clinical effectiveness research and evaluated member perspectives on roles and experiences. A repeated cross-sectional design was employed, with 18 CP Task Force members completing 39 surveys. Engagement activities focused on social participation, leisure, play, education, and work. Surveys assessed team culture, trust, and role satisfaction. Descriptive statistics analyzed survey data, while thematic analysis summarized qualitative responses. Participants reported high satisfaction and engagement. Key themes included inclusivity, effective communication, accessibility, and expanded engagement. Occupation-based engagement can enhance collaboration, build rapport, and create a shared sense of purpose among multi-collaborators when establishing a CP Task Force to support patient-centered comparative clinical effectiveness research.

PMID:41015817 | DOI:10.1177/15394492251367249

J Tradit Chin Med. 2025 Oct;45(5):1135-1143. doi: 10.19852/j.cnki.jtcm.20241231.001.

ABSTRACT

OBJECTIVE: To explore the clinical observation of white eye distribution characteristics of hyperlipidemic patients based on artificial intelligence digital eye diagnosis technology.

METHODS: One hundred and fifty subjects were examined in the outpatient and inpatient departments of Guang’anmen Hospital of the China Academy of Traditional Chinese Medicine from 01 February 2022 to 01 February 2023, including 80 cases in the hyperlipidemic patient (HLP) group and 70 cases in the normal lipid level patient (NC) group. The two groups were collected and extracted by the artificial intelligence visual diagnostic instrument and analyzed by the MyEyeD-10 white eye shadowless imaging health intelligence analysis system. Finally, SPSS 26.0 (Version X; IBM Corp., Armonk, NY, USA) was used for statistical processing.

RESULTS: Significant differences were noted in the scores of “spot” and “foggy” features between the two groups. Between groups, the “spot” feature score of the white eye morphology in the HLP group (11.07 ± 3.22) was higher than that in the NC group (7.50 ± 4.11) (P <0.01). Moreover, the “foggy” feature score of the eye morphology in the HLP group (8.37 ± 2.25) was higher than that in the NC group (P <0.01), higher than that of the NC group (5.72 ± 1.21) (P <0.05). There were significant differences in the “A” (stomach), “B”, “O” (spleen), and “M” (liver) eye-contact region scores between the two groups, and the “B”, “O” (spleen) and “M” (liver) eye-contact region scores were significantly different. The scores of the white eye channel region in the HLP group were significantly higher than those in the control group, with the “A”, “B”, and “O” regions (P <0.01), “M” region (P <0.01), “A”, “B”, “O”, and “M” region (P <0.01). “M” zone (P <0.05). The scores of “dull red” and “yellow” features were significantly different, and the scores of “dull red” and “yellow” colors of the white eye choroid in the HLP group were significantly higher than those in the HLP group. The scores of “dull red” and “yellow” were significantly higher in the HLP group than in the NC group (P <0.01).

CONCLUSION: The morphological features of the white eye ocular image, the white eye chakra’s color, and the bulbar conjunctiva’s vascular zoning are closely related to hyperlipidemia. Importantly, these provide a reference for the objectivity and precision of the identification of Chinese medicine by looking at the eyes.

PMID:41015812 | DOI:10.19852/j.cnki.jtcm.20241231.001

J Tradit Chin Med. 2025 Oct;45(5):1127-1134. doi: 10.19852/j.cnki.jtcm.2025.05.018.

ABSTRACT

Primary liver cancer (PLC) is the third major cause of cancer related death, which seriously affects the survival period and quality of life of patients. However, there is currently no evidence to prove which treatment method is most effective. Traditional Chinese Medicine (TCM) has shown certain advantages in the treatment of PLC, especially in the side effects of Western Medicine. Therefore, we designed a clinical trial protocol for the treatment of PLC using TCM granules. Our purpose is to explore the efficacy and safety of Yangxiao Fukang granule (YXFKG, ) in the treatment of stage III hepatitis B related PLC. A total of 216 patients from three hospitals in Henan Province will be enrolled and randomly divided into a trial group and a control group in a 1∶1 ratio. The trial group will be treated with conventional western medicine plus YXFKG, while the control group will receive conventional western medicine plus a placebo for YXFKG. All patients will receive a daily dose of either YXFKG or a placebo for six months, followed by a six-month follow-up period. The main observation outcome includes 1-year survival rate, while secondary outcomes include conversion rate to remission, objective response rate, progression free survival, overall survival, quality of life score, and TCM clinical symptom score. Blood routine, urine routine, stool routine, electrocardiogram, liver and kidney function, coagulation function test, and D-dimer are safety indicators. Collect data before treatment and during the 3rd, 6th, 9th, and 12th months of treatment, and conduct statistical analysis. This study will preliminarily verify the effectiveness and safety of YXFKG in the treatment of stage III hepatitis B related PLC, which may provide a new choice for clinical treatment of PLC.

PMID:41015811 | DOI:10.19852/j.cnki.jtcm.2025.05.018

J Tradit Chin Med. 2025 Oct;45(5):979-986. doi: 10.19852/j.cnki.jtcm.2025.05.005.

ABSTRACT

OBJECTIVE: To investigate the effect and mechanism of Shaoyao Gancao granule (SGG, ) on the hypothalamic-pituitary-adrenal (HPA) axis and immune imbalance status in stressed alopecia areata (AA) mice, and to provide an objective experimental basis for the clinical application of SGG.

METHODS: Seventy female C57BL/6J mice aged 5-7 weeks were randomly divided into two groups: 10 mice in the blank control group and 60 mice in the mock group. The moulding group received topical imiquimod cream in combination with chronic unpredictable mild stress. On day 10, the moulding group was further divided into six groups: Shaoyao Gancao granule low-dose (SGL), Shaoyao Gancao granule medium-dose (SGM), Shaoyao Gancao granule high-dose (SGH), Antalarmin, and compound glycyrrhizin (CG). On day 24, overall and trichoscopic photographs of mice were taken on day 24 of the experiment; behavioral tests were completed; serum corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and cortisol levels were measured by enzyme-linked immunosorbent assay; and T helper cell (Th)1/Th2 and Th17/Treg cell differentiation in peripheral blood T lymphocyte subpopulations was detected by flow cytometry.

RESULTS: The dorsal skin lesions of mice in all SGG groups showed faster hair growth, less dilated skin capillaries, and scaly conditions compared with those in the model group. In the open field test, compared with those of the model group, the moving distance and number of uprights and entries into the central area of the mice in the SGM and SGH groups significantly increased (P < 0.05), while in the forced swimming test, compared with the model group, the rest time of the mice in the SGL, SGM, and SGH groups significantly decreased (P < 0.05). The enzyme-linked immunosorbent assay results showed that, compared with the model group, the mice in the SGH group had significantly reduced CRH levels (P < 0.05), and the ACTH and cortisol levels in the SGM and SGH groups were significantly reduced (P < 0.05). The flow cytometry results showed that, compared with those in the model group, Th2 levels were significantly higher (P < 0.05), Th17 levels were significantly lower (P < 0.05), the Th1/Th2 ratio was significantly lower (P < 0.05), and the Th17/Treg ratio was significantly lower (P < 0.05) in the SGM and SGH groups. The Th1 and Treg cell ratios were reduced in all SGG groups, but the difference was not statistically significant.

CONCLUSION: SGG may exert therapeutic effects in AA by modulating the HPA axis and regulating immune imbalance.

PMID:41015796 | DOI:10.19852/j.cnki.jtcm.2025.05.005