Tag: nevin manimala

Front Cardiovasc Med. 2025 Jul 17;12:1563068. doi: 10.3389/fcvm.2025.1563068. eCollection 2025.

ABSTRACT

BACKGROUND: Galectin-3 is a well-established biomarker on the predictor of cardiovascular events in patients with heart failure. Its pathophysiologic association with inflammation, cell proliferation, and fibrogenesis may implicate serum galectin-3 as a predictor of clinical outcomes in coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). The aim of this study was to examine the prognostic value of the galectin-3 level in patients with CAD who underwent PCI with DES.

METHODS: A total of 939 patients undergoing successful PCI with DES were consecutively enrolled between January 2007 and December 2009. The serum galectin-3 level was measured, classified into two groups according to the median galectin-3 level (9.52 ng/ml, interquartile range 7.31-12.81), and compared with the composite of all-cause mortality, non-fatal myocardial infarction (MI), and stroke.

RESULTS: The median follow-up duration was 997 days (interquartile range 766-1,264 days). The high galectin-3 group had a significantly higher incidence of all-cause mortality, cardiac mortality, and composite of all-cause mortality, non-fatal MI, and stroke. High galectin-3 was a significant independent predictor of the composite of all-cause mortality, non-fatal MI, and stroke (adjusted hazard ratio 1.670, 95% confidence interval 1.014-2.751, p = 0.044). The addition of the serum galectin-3 level to the conventional clinical risk model improves the model discrimination (C-statistic = 0.694-0.786, p for difference < 0.01), reclassification [continuous net classification improvement (0.297, p < 0.01) and integrated discrimination improvement (0.064, p < 0.01)].

CONCLUSION: Our data suggest that serum galectin-3 is an independent predictor of cardiovascular events in patients undergoing PCI with DES.

PMID:40747494 | PMC:PMC12310497 | DOI:10.3389/fcvm.2025.1563068

Am Stat. 2025 Jul 3;79(3):371-382. doi: 10.1080/00031305.2025.2505514. eCollection 2025.

ABSTRACT

In this tutorial we present the use of R package mgcv to implement Distributed Lag Non-Linear Models (DLNMs) in a flexible way. Interpretation of smoothing splines as random quantities enables approximate Bayesian inference, which in turn allows uncertainty quantification and comprehensive model checking. We illustrate various modeling situations using open-access epidemiological data in conjunction with simulation experiments. We demonstrate the inclusion of temporal structures and the use of mixture distributions to allow for extreme outliers. Moreover, we demonstrate interactions of the temporal lagged structures with other covariates with different lagged periods for different covariates. Spatial structures are also demonstrated, including smooth spatial variability and Markov random fields, in addition to hierarchical formulations to allow for non-structured dependency. Posterior predictive simulation is used to ensure models verify well against the data.

PMID:40747491 | PMC:PMC12312768 | DOI:10.1080/00031305.2025.2505514

Bladder (San Franc). 2025 May 5;12(2):e21200043. doi: 10.14440/bladder.2024.0063. eCollection 2025.

ABSTRACT

BACKGROUND: Urethral stricture is characterized by long-term scarring and narrowing of the urethral canal caused by acute trauma, inflammation, or medical procedures, such as urethral instrumentation or surgery. Despite the widespread use of both buccal and lingual mucosal grafts (LMG) in urethroplasty, few prospective studies have directly compared their surgical outcomes and donor site morbidity. This study aims to fill that gap.

OBJECTIVE: This study compares the use of buccal and LMG in managing anterior urethral stricture with surgical outcomes and donor site morbidity evaluations.

METHODS: This case-control comparative study was conducted at Ain Shams University Hospital. Patients who attended the urology outpatient clinic, presenting with lower urinary tract symptoms secondary to stricture anterior urethra and underwent surgical management by urethroplasty with a dorsal onlay technique, were selected as cases.

RESULTS: No statistically significant differences were observed between the studied groups regarding age, smoking status, comorbidities, related urinary conditions, or the presence of a urinary catheter. In addition, the groups had no significant differences concerning stricture characteristics, graft details, or operation specifics. Similarly, general and urethral outcomes showed no statistically significant variation between the groups. Problems with drinking, soft food consumption, solid food consumption, dysgeusia, and speaking were significantly less frequent in the buccal mucosal graft (BMG) group than in the LMG group. In contrast, oral tightness was significantly more frequent in the BMG group than in the LMG group.

CONCLUSION: The study concluded that buccal and LMG effectively repair anterior urethral stricture, showing similar success rates. However, LMG patients experience earlier oral complications, while BMG patients face more long-term oral tightness, making graft choice dependent on patient-specific tolerances.

PMID:40747465 | PMC:PMC12308122 | DOI:10.14440/bladder.2024.0063

Bladder (San Franc). 2025 Mar 27;12(2):e21200040. doi: 10.14440/bladder.2024.0073. eCollection 2025.

ABSTRACT

BACKGROUND: Urodynamic study (UDS) is essential for assessing lower urinary tract function, but quality control methods remain limited. Statistical process control (SPC), a tool originally developed in manufacturing, has shown promise in healthcare for improving quality and reducing variability.

OBJECTIVE: This study explored the application of SPC to analyze the typical value ranges (TVR) of urodynamic measurements.

METHODS: A total of 84 urodynamic traces that met all inclusion criteria were included for analysis. We recorded the TVR for initial intravesical pressure (P_ves), initial abdominal pressure (P_abd), and initial detrusor pressure (P_det) from each enrolled UDS trace. These data were then compared with the standard TVR. In addition, we used the X-bar and S control charts of SPC for process performance analysis.

RESULTS: The study included 20 females and 64 males, with an average age of 58.02 ± 16.09 years. Of the participants, 32 were diagnosed with neurogenic bladder dysfunction, and 52 were diagnosed with non-neurogenic bladder dysfunction. The average TVR for initial P_ves was 34.81 ± 10.78 cmH₂O, P_abd 30.92 ± 11.14 cmH₂O, and P_det 4.20 ± 3.73 cmH₂O. We further analyzed the data using scatter plots. In the X-bar control chart, the control limit (CL) was 22.48, the upper CL (UCL) was 32.04, and the lower CL (LCL) was 12.92. In the S control chart, the CL was 15.78, the UCL was 22.57, and the LCL was 8.9. Two cases exceeded the UCL in the X-bar control chart, and one case exceeded the UCL in the S control chart.

CONCLUSION: The clinical value of SPC in the quality review of UDS has been confirmed in previous studies. In this study, we preliminarily verified the use of SPC for continuous variable data, such as the TVR of UDS parameters. The results of this study need to be further validated in a larger sample size, multi-center, and prospective study.

PMID:40747462 | PMC:PMC12308115 | DOI:10.14440/bladder.2024.0073

Front Health Serv. 2025 Jul 17;5:1604809. doi: 10.3389/frhs.2025.1604809. eCollection 2025.

ABSTRACT

BACKGROUND: International guidelines recommend multidisciplinary intervention programs for addressing childhood obesity. In Western Australia, community-based healthy lifestyle programs for children and young people are insufficient for demand, especially for those over-represented in obesity statistics relating to prevalence. This protocol outlines the implementation and evaluation of an adapted, evidenced, community-based program in Perth, Western Australia.

METHODS: This study follows a multiple-methods hybrid type II design, testing acceptability and feasibility of program scale-out and program participant outcomes. Study (1) Develop the adapted healthy lifestyle program with key partners and Aboriginal and Torres Strait Islander advisors for scale-out. Apply implementation strategies for program realisation. Identify critical elements and outcomes to demonstrate program success with key partners (∼30 workshop participants and ∼80 qualitative proforma respondents). Identify cultural and place-based considerations for program acceptability with Aboriginal and Torres Strait Islander Elders/advisors (∼30 workshop participants). Study (2) Assess acceptability, appropriateness, feasibility, and local clinical outcomes of adapted healthy lifestyle program pilot. Evaluate the program with children and young people aged 4-16 years with obesity or overweight and weight-related comorbidities, seeking healthy lifestyle change. The program will include weight-related assessments at baseline, 6, and 12 months with weekly sessions for 6 months (estimated n = 245 over 22 months, accounting for 30% drop-out). Explore program experience via focus groups with children, young people, and caregivers: ∼8-12 weeks post commencement (∼50 program participants and caregivers), ∼6 months post commencement (∼50 program completers and caregivers), and evaluation survey (e.g., declined/dropped out/completed). Engage with key partners to determine program feasibility for scale-up (∼30 workshop participants and ∼80 qualitative proforma respondents). Mixed model regression will be used to assess within-subject change in outcomes over time. Child health utility instruments will be used for cost-utility analysis. Study (3) Assess program scalability post-pilot. If determined feasible and acceptable, the program will be packaged to assist practitioners and policymakers with scale-up via exploration of currently available packages and key staff interviews. The overarching Replicating Effective Programs framework outlines the implementation stages, and the tools and strategies being applied are presented. Qualitative data will be analysed using Framework Analysis, incorporating the Consolidated Framework for Implementation Research and the Expert Recommendations for Implementing Change.

DISCUSSION: Implementation outcomes will be determined by evaluating acceptability, appropriateness, and feasibility of scale for this healthy lifestyle program. Utilising implementation science, partnership-building, and place-based and cultural considerations, this research will inform potential scale-up of equity-focused healthy lifestyle programs.

PMID:40747434 | PMC:PMC12310583 | DOI:10.3389/frhs.2025.1604809

J Environ Health Sci Eng. 2025 Jul 30;23(2):25. doi: 10.1007/s40201-025-00948-y. eCollection 2025 Dec.

ABSTRACT

Climate change is a global issue that presents significant challenges for countries worldwide, including Iran. Researchers need up-to-date information on climate change within their own country, including statistics on its severity, efforts to address it, and the impacts on the environment, temperatures, extreme weather events, water resources, agriculture, biodiversity, migration, air quality, and human health. This review provides an overview of these topics in the context of Iran, discussing challenges, sustainable practices, renewable energy, government responses, and international collaborations to mitigate climate change effects. It aims to offer a comprehensive perspective on the current and potential future implications of climate change in Iran. Climate change in Iran has resulted in higher temperatures, droughts, and wildfires, impacting agriculture and exacerbating water scarcity. Extreme weather events such as floods and storms are causing damage to infrastructure. Climate change poses a significant threat to global health, with direct consequences including severe storms, heat stress, and deteriorating air quality. Despite this uncertainty, it is imperative to adapt to the adverse effects of climate change. Rising global temperatures are contributing to more frequent and severe extreme weather events, resulting in widespread damage and loss of life. Iran’s efforts to address climate change include investing in renewable energy, and implementing sustainable practices. Collaboration between the government and local communities is crucial for mitigating the effects of climate change through effective policies and initiatives. Iran aims to reduce greenhouse gas emissions and promote sustainability through investments in renewable energy and energy efficiency initiatives.

PMID:40747432 | PMC:PMC12307847 | DOI:10.1007/s40201-025-00948-y

bioRxiv [Preprint]. 2025 Jul 19:2025.07.17.665375. doi: 10.1101/2025.07.17.665375.

ABSTRACT

Machine learning has generated millions of high-quality predicted protein structures, creating a need for computationally efficient structure search algorithms and robust estimates of statistical significance at this scale. We show that unrelated proteins have a universal tendency towards convergent evolution of secondary and tertiary motifs, causing an excess of high-scoring false positive alignments. To address this excess, and to accommodate recent innovations in search algorithm design, we describe a novel method for estimating statistical significance. We implement our approach in Reseek, showing that its E -values are accurate, scale successfully with database size, and are robust against the (generally unknown) diversity of folds in the database. We investigate popular structure search and alignment algorithms, finding that previous methods routinely overestimate significance by up to six orders of magnitude.

PMID:40747427 | PMC:PMC12312179 | DOI:10.1101/2025.07.17.665375

Stoch Environ Res Risk Assess. 2025;39(8):3605-3617. doi: 10.1007/s00477-025-03032-x. Epub 2025 Jun 24.

ABSTRACT

Urbanization affects atmospheric boundary layer dynamics by altering cloud formation and precipitation patterns through the urban heat island (UHI) effect, perturbed wind flows, and urban aerosols, that overall contribute to the urban rainfall effect (URE). This study analyzes an ensemble of numerical simulations with the Weather Research and Forecasting (WRF) model and its version with coupled chemistry and aerosols (WRF-Chem) through a Functional ANalysis Of VAriance (FANOVA) approach to isolate the urban signature from the regional climatology and to investigate the relative contributions of various mechanisms and drivers to the URE. Different metropolitan areas across the United States are analyzed and their urban land cover and anthropogenic emissions are replaced with dominant land-use categories such as grasslands or croplands and biogenic only emissions, as in neighboring regions. Our findings indicate a significant role of the urban land cover in impacting surface temperature and turbulent kinetic energy over the city, and precipitation patterns, both within and downwind of the urban environment. Moreover, simulations of a deep convection event suggest that the aerosols impact dominates the sign and spatial extent of the changes in the simulated precipitation compared to the UHI effect, leading to a significant precipitation enhancement within the urban borders and suppression in downwind regions.

PMID:40747414 | PMC:PMC12307560 | DOI:10.1007/s00477-025-03032-x

J Clin Exp Hepatol. 2025 Nov-Dec;15(6):102633. doi: 10.1016/j.jceh.2025.102633. Epub 2025 Jul 7.

ABSTRACT

BACKGROUND/AIMS: Sorafenib, lenvatinib, and atezolizumab combined with bevacizumab (Atezo/Bev) are approved first-line treatments for unresectable hepatocellular carcinoma (uHCC). However, direct comparisons among these therapies remain limited. This study aims to compare the efficacy and safety of Atezo/Bev versus tyrosine-kinase inhibitors (TKIs) as first-line therapies for uHCC.

METHODS: Two independent authors conducted a literature search using electronic databases (Google Scholar, Medline, and PubMed) and manual reference list reviews up to June 2024. We included studies reporting on overall survival (OS), progression free survival (PFS) or safety data comparing Atezo/Bev versus TKI (sorafenib or lenvatinib) in patients with uHCC, irrespective of study design. Data extraction and statistical analysis were performed using RevMan 5.4.

RESULTS: We included a total of 12 studies (Ten retrospective cohort studies, one prospective study, one randomized controlled trial) involving 9952 patients (3560 received Atezo/Bev combination therapy and 6392 received TKI). Atezo/Bev significantly improved OS and PFS compared to lenvatinib (HR: 0.79, 95% CI: 0.71-0.89, P = 0.0001 for OS; HR: 0.76, 95% CI: 0.64-0.90, P = 0.002 for PFS). Atezo/Bev also improved OS in viral patients (HR: 0.72, 95% CI: 0.60-0.86, P = 0.0004), while lenvatinib improved OS (HR: 1.36, 95% CI: 1.13-1.65, P = 0.001) and PFS (HR: 1.46, 95% CI: 1.04-2.05, P = 0.03) in nonviral patients. Atezo/Bev had fewer grade ≥3 adverse events than lenvatinib (OR: 0.43, 95% CI: 0.36-0.51, P = 0.03). Atezo/Bev also demonstrated superior OS and PFS compared to sorafenib (HR: 0.68, 95% CI: 0.57-0.81, P < 0.00001 for OS; HR: 0.67, 95% CI: 0.57-0.77, P < 0.00001 for PFS).

CONCLUSIONS: Atezo/Bev demonstrates better survival outcomes and safety profile compared to TKI. However, for patients with HCC of nonviral etiology, lenvatinib may be a more suitable alternative.

PMID:40747369 | PMC:PMC12309488 | DOI:10.1016/j.jceh.2025.102633

EClinicalMedicine. 2025 Jul 24;86:103381. doi: 10.1016/j.eclinm.2025.103381. eCollection 2025 Aug.

ABSTRACT

BACKGROUND: Atorvastatin and rosuvastatin are the most widely used statins in patients with ischemic stroke or transient ischemic attack (TIA). However, evidence on their effectiveness and safety during actual use is scarce. This study aims to compare the effectiveness and safety of initiating atorvastatin versus rosuvastatin among patients with ischemic stroke or TIA.

METHODS: This observational study was based on the Third China National Stroke Registry (CNSR-III), which recruited consecutive adult patients with ischemic stroke or TIA within 7 days from the onset of symptoms to enrollment from August 2015 to March 2018. This study identified 3322 adults aged ≥18 years who had a pre-stroke modified Rankin Scale (mRS) score of 0 and initiated atorvastatin or rosuvastatin on the day of onset. The primary outcome was the ideal outcome, as defined by a mRS score of 0, at 3 months. The secondary outcomes included the ideal outcome at discharge, at 6 months, and at 12 months, along with 12-month stroke recurrence, all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events.

FINDINGS: A total of 3322 eligible patients were identified, with 2605 initiating atorvastatin and 717 initiating rosuvastatin. The proportion of patients achieving an ideal outcome, as defined by a modified Rankin Scale of 0, was 44.63% in rosuvastatin initiators, significantly higher than 41.46% in atorvastatin initiators, with a relative rate of 1.12 (95% confidence interval 1.03, 1.22). Also, a greater percentage of rosuvastatin initiators attained the ideal outcome at discharge and at 6 months, compared with atorvastatin initiators. Regarding other secondary outcomes, no statistically significant difference was observed.

INTERPRETATION: Compared with atorvastatin, rosuvastatin was associated with a potentially higher proportion of patients attaining a mRS score of 0 among patients with ischemic stroke or TIA who initiate atorvastatin or rosuvastatin, which was not yet sufficient to guide clinical practice. Further research is needed to validate these findings.

FUNDING: This work was supported by National Key Research and Development Program of China (2022YFC2502400, 2022YFC2502404), Beijing Natural Science Foundation Haidian original innovation joint fund (L222123), and Youth Innovation Fund of Beijing Neurosurgical Institute (2025 Reform and Development-Youth 15).

PMID:40747367 | PMC:PMC12311946 | DOI:10.1016/j.eclinm.2025.103381