Tag: nevin manimala

Cancer Med. 2025 May;14(10):e70968. doi: 10.1002/cam4.70968.

ABSTRACT

INTRODUCTION: An upward trend in the incidence of thymic epithelial tumors (TETs) has been reported over the past few decades, but because of its rarity, little is currently known about its epidemiological trends. This study examined temporal trends in the incidence and mortality of TETs in the US and explored these trends in population subgroups while investigating important factors that influence their prognosis.

METHODS: A retrospective, population-based study was conducted using nationally representative data from the Surveillance, Epidemiology, and End Results program, and 4979 patients diagnosed with TETs from 2000 to 2020 were evaluated. Associated population data were used to determine age-adjusted incidence and mortality, and 5-year TET-specific mortality (SM). Trends were assessed for the entire cohort, as well as for particular subgroups, including thymoma and thymic carcinoma.

RESULTS: From 2000 to 2020, the overall incidence and mortality of TETs were 2.769 and 1.203 per million person-years, respectively. Both the age-adjusted incidence and mortality of TETs increased over the study period, with increases occurring across almost all ethnic groups, histological subtypes, and stages. Multivariate analysis revealed that age, World Health Organization histological type (B1, B2, and B3 thymoma and thymic carcinoma), Masaoka-Koga stage (IIB and III/IV), maximum tumor diameter (5-10 and > 10 cm), surgery, and chemotherapy were independently associated with TET-SM.

CONCLUSIONS: The incidence and mortality of TETs have steadily increased over time, and these trends might be related to the widespread use of computed tomography for lung cancer screening and the increasing number of TETs found incidentally. The study also identified several important factors independently associated with TET-SM, suggesting that early diagnosis and surgical intervention are critical to achieving good prognoses.

PMID:40371577 | DOI:10.1002/cam4.70968

Brain Connect. 2025 May 15. doi: 10.1089/brain.2024.0084. Online ahead of print.

ABSTRACT

Objectives: Neurofeedback (NF) based on brain-computer interface (BCI) is an important direction in adjunctive interventions for post-traumatic stress disorder (PTSD). However, existing research lacks comprehensive methodologies and experimental designs. There are concerns in the field regarding the effectiveness and mechanistic interpretability of NF, prompting this study to conduct a systematic analysis of primary NF techniques and research outcomes in PTSD modulation. The study aims to explore reasons behind these concerns and propose directions for addressing them. Methods: A search conducted in the Web of Science database up to December 1, 2023, yielded 111 English articles, of which 80 were excluded based on predetermined criteria irrelevant to this study. The remaining 31 original studies were included in the literature review. A checklist was developed to assess the robustness and credibility of these 31 studies. Subsequently, these original studies were classified into electroencephalogram-based NF (EEG-NF) and functional magnetic resonance imaging-based NF (fMRI-NF) based on BCI type. Data regarding target brain regions, target signals, modulation protocols, control group types, assessment methods, data processing strategies, and reported outcomes were extracted and synthesized. Consensus theories from existing research and directions for future improvements in related studies were distilled. Results: Analysis of all included studies revealed that the average sample size of PTSD patients in EEG and fMRI NF studies was 17.4 (SD 7.13) and 14.6 (SD 6.37), respectively. Due to sample and neurofeedback training protocol constraints, 93% of EEG-NF studies and 87.5% of fMRI-NF studies used traditional statistical methods, with minimal utilization of basic machine learning (ML) methods and no studies utilizing deep learning (DL) methods. Apart from approximately 25% of fMRI NF studies supporting exploratory psychoregulatory strategies, the remaining EEG and fMRI studies lacked explicit NF modulation guidance. Only 13% of studies evaluated NF effectiveness methods involving signal classification, decoding during the NF process, and lacking in process monitoring and assessment means. Conclusion: In summary, NF holds promise as an adjunctive intervention technique for PTSD, potentially aiding in symptom alleviation for PTSD patients. However, improvements are necessary in the process evaluation mechanisms for PTSD-NF, clarity in NF modulation guidance, and development of ML/DL methods suitable for PTSD-NF with small sample sizes. To address these challenges, it is crucial to adopt more rigorous methodologies for monitoring NF, and future research should focus on the integration of advanced data analysis techniques to enhance the effectiveness and precision of PTSD-NF interventions. Impact Statement The implications of this study are to address the limited application of Neurofeedback training (NFT) in post-traumatic stress disorder (PTSD) research, where a significant portion of the approaches, foundational research, and conclusions lack consensus. There is a notable absence of retrospective statistical analyses on NFT interventions for PTSD. This study provides a comprehensive statistical analysis and discussion of existing research, offering valuable insights for future studies. The findings hold significance for researchers, clinicians, and practitioners in the field, providing a foundation for informed, evidence-based interventions for PTSD treatment.

PMID:40371570 | DOI:10.1089/brain.2024.0084

Health Econ Policy Law. 2025 May 15:1-16. doi: 10.1017/S1744133125000052. Online ahead of print.

ABSTRACT

We examine the impact of decentralisation on COVID-19 mortality and various health outcomes. Specifically, we investigate whether decentralised health systems, which facilitated greater regional participation and information sharing, were more effective in saving lives. Our analysis makes three contributions. First, we draw on evidence from several European countries to assess whether the decentralisation of health systems influenced COVID-19 mortality rates. Second, we explore the regional disparities in one of the most decentralised health systems, Spain, to untangle some of the determinants shaping health outcomes. Third, we estimate the regional loss of Quality Adjusted Life Years (QALYs) due to COVID-19 mortality, broken down by the wave of the pandemic. Our findings suggest that coordinated decentralisation played a critical role in saving lives throughout the COVID-19 pandemic.

PMID:40371549 | DOI:10.1017/S1744133125000052

Clin Exp Rheumatol. 2025 May 8. doi: 10.55563/clinexprheumatol/5kr6kk. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the survival of the first biological disease-modifying anti-rheumatic drug (bDMARD) in a Greek rheumatoid arthritis (RA) cohort and determine factors influencing drug retention rates.

METHODS: Patients from the Pathophysiology Clinic of LAIKON University Hospital who received their first bDMARD were stratified into anti-tumour necrosis factor (anti-TNF) and non-anti-TNF groups, and whether an event occurred. An event was defined as discontinuation due to inefficacy or adverse event (AE), including severe infections. Drug survival curves were calculated using the Kaplan-Meier method. Analysis was performed using t-tests, chi-square tests, and Cox proportional hazards in STATA, with a 5% significance level.

RESULTS: We included 724 patients, mostly females (79%), with a median age of 48.6 ±15.7 years at diagnosis. More than half were positive for RF and/or ACPA, with a baseline DAS28-ESR of 4.9 ±1.5. The most used anti-TNFs were etanercept (n=261), infliximab (n=177), adalimumab (n=148), while rituximab (RTX, n=40) was the most used non-anti-TNF. RTX recipients experienced one-half of the events compared to those in the anti-TNF group (IRR 0.52, 95%CI: 0.27 to 0.92). After 276 months, 223 patients discontinued treatment due to inefficacy and 187 due to AEs. Most withdrawals (73.3%) occurred within the first 50 months regardless of cause. RTX was found to be protective against treatment failure, while both RF and ACPA positivity were identified as potential risk factors for discontinuation due to either failure or AE.

CONCLUSIONS: Only 26.7% of patients remained on first bDMARD after 50 months, with those receiving RTX less likely to discontinue for any reason. RF and/or ACPA positivity could be potential risk factors for discontinuation due to AEs or inefficacy.

PMID:40371548 | DOI:10.55563/clinexprheumatol/5kr6kk

Clin Exp Rheumatol. 2025 May 7. doi: 10.55563/clinexprheumatol/jmtag4. Online ahead of print.

ABSTRACT

OBJECTIVES: We aimed to analyse the strategies of physicians regarding corticosteroid use in syndrome of undifferentiated recurrent fever (SURF) and examine the published data on this topic.

METHODS: The JIR-CliPS questionnaire which addresses physicians’ practices about on demand corticosteroid use in SURF was distributed via e-mail to potential respondents. We systematically reviewed the MEDLINE and Scopus databases and extracted the data about on demand corticosteroid use in SURF.

RESULTS: One hundred thirty-seven physicians (F/M=2.5; 66.4% paediatric rheumatologists) from 45 countries responded to the survey. Around 70% of physicians prescribe corticosteroids for SURF flares. Most physicians (81.9%) do not use corticosteroids in SURF patients routinely, and this practice is more common among less experienced physicians (p<0.001). Prednisolone at a dose of 1 mg/kg (54.4%) was the most commonly preferred corticosteroid. The most common definition of response to corticosteroids was “response within 12 hours” (51.6%). Most respondents (59.5%) consider changing treatment if corticosteroids cause a decrease in quality of life. We found 10 articles in the literature describing 239 SURF patients treated with on demand corticosteroids. The most frequently preferred corticosteroid was prednisolone (63.8%). The response to corticosteroids was 70.8% and an increase in attack frequency was observed in almost 40% of patients.

CONCLUSIONS: On demand corticosteroid use is not uncommon in the acute management of SURF attacks. However, most physicians do not use corticosteroids routinely and there is no consensus regarding the definition of response to treatment and when to change treatment neither in our survey results nor in the literature.

PMID:40371538 | DOI:10.55563/clinexprheumatol/jmtag4

Ying Yong Sheng Tai Xue Bao. 2025 Apr;36(4):1118-1126. doi: 10.13287/j.1001-9332.202504.025.

ABSTRACT

The unique climatic conditions of Qinghai are highly suitable for the growth of goji berry (Lycium barbarum), with superior yield and quality to other production areas. Screening areas with similar conditions can guide the scientific cultivation of high-yield and high-quality goji berry, thereby increasing income. Based on the climatic characteristics of Qinghai production area, we utilized the optimized MaxEnt model and ArcGIS to identify the key meteorological factors affecting the distribution of suitable habitats and to predict suitable distribution areas under different climate scenarios. The results showed that the optimized feature combination was linear and quadratic, and the regularization multiplier was 0.5, with both the area under the receiver operating characteristic curve of the subject and true skill statistic values being greater than 0.90, indicating highly accurate and reliable prediction. The key meteorological factors affecting the distribution of high-yield and high-quality goji berry were mean diurnal temperature range (suitable range was 12.94-19.08 ℃) and maximum temperature of warmest month (19.01-28.32 ℃). Under current climatic conditions, the area of suitable habitat for high-yield and high-quality goji berry in China was 42.69×10⁴ km², primarily distributed in the Qaidam Basin of Qinghai, the northwest and the foothills of the Qilian Mountains of Gansu, the foothills of Kunlun Mountains and Altai Mountains in Xinjiang, and the central-western part of Xizang. In the future climate scenarios (2050s and 2070s), the area of suitable habitat for high-yield and high-quality goji berry was larger than the current ones, showing an eastward expansion trend. The area of suitable habitats reached its maximum under the SSP585 (59.26×10⁴ km²) and SSP370 scenarios (58.51×10⁴ km²), respectively. Temperature was the key meteorological factor influencing the distribution of high-yield and high-quality goji berry. Climate warming would cause the expansion of suitable habitat eastward, benefiting its cultivation.

PMID:40371513 | DOI:10.13287/j.1001-9332.202504.025

Anal Methods. 2025 May 15. doi: 10.1039/d5ay00457h. Online ahead of print.

ABSTRACT

A simple, rapid and sensitive spectrofluorimetric method was developed and validated for the determination of brexpiprazole in bulk, pharmaceutical formulations and spiked human plasma. The method is based on the fluorescence quenching of erythrosine B upon its reaction with brexpiprazole in Toerell-Stenhagen buffer solution (pH 3.2). A Box-Behnken design was employed to optimize the factors influencing the method’s performance considering factors such as buffer pH, buffer and reagent volumes and reaction time. The fluorescence intensity was measured at 554 nm after excitation at 530 nm. The method exhibited a linear response over the concentration range of 0.2-2 μg mL^-1. The limit of detection and limit of quantitation were found to be 0.0515 and 0.1561 μg mL^-1, respectively. The method was validated according to ICH guidelines, demonstrating good accuracy, precision and robustness. The proposed method was successfully applied to determine brexpiprazole in commercial tablets and spiked human plasma samples with excellent recoveries. The results obtained were statistically compared with those of a reference method showing no significant difference. This cost-effective and efficient method offers a valuable tool for routine quality control analysis of brexpiprazole in pharmaceutical formulations and biological samples.

PMID:40371454 | DOI:10.1039/d5ay00457h

Wilderness Environ Med. 2025 May 15:10806032251337476. doi: 10.1177/10806032251337476. Online ahead of print.

ABSTRACT

IntroductionAvalanches and tree-wells (TW) are causes of snow immersion death in skiers and snowboarders. TW burials may have different victim physiology profiles and rescue considerations than avalanche-related burials due to snow density, burial position, and compensatory physiologic responses. This study aimed to compare the physiological responses between avalanche and TW burials through a prospective controlled trial of simulated avalanche burial to simulated TW burial.MethodsEleven volunteers participated in two paired 60-min snow burials: Avalanche and TW simulations, controlling for position and snowpack densities. We monitored core temperature, respiratory rate, minute ventilation, end-tidal carbon dioxide, oxygen saturation, partial pressure of inspired carbon dioxide, and heart rate.ResultsThe average cooling rate for the avalanche simulation was -0.017(Δ°C/min) versus -0.012(Δ°C/min) for the TW simulation (p = 0.014*), 1.42 times faster cooling rate than TW burial. SpO2 decreased 10.9 times faster on average in TW burial than in avalanche conditions when normalized by burial time as a rate (avalanche -0.011 vs TW -0.12 (Δ%/min), p = 0.033*). More participants requested early study termination in the TW scenario.DiscussionSimulated TW burial resulted in a statistically significant slower rate of core temperature cooling and earlier hypoxemia. Inverted body position in TW burials may lead to increased physiologic distress and contribute to earlier hypoxia. These findings may have important implications for search and rescue as well as resuscitation efforts for snow burial victims.

PMID:40371442 | DOI:10.1177/10806032251337476

Cent European J Urol. 2025;78(1):85-93. doi: 10.5173/ceju.2024.0197. Epub 2024 Nov 28.

ABSTRACT

INTRODUCTION: Pre-stenting remains a subject of debate, and its influence on FANS assisted ureteroscopy is unclear. The global FANS collaborative group aims to address the influence of pre-stenting on FANS-assisted ureterorenoscopy (URS).

MATERIAL AND METHODS: This prospective multicentre study assesses the outcomes of 394 patients undergoing FANS-assisted ureteroscopy for renal stones. Patients were stratified into a non-pre-stented (group 1, n = 163) and pre-stented group (group 2, n = 231). Data on demographics, stone characteristics, operative parameters, and postoperative 30-day outcomes were analysed. Statistical analyses, including multivariate regression, were performed for stone-free rates (SFR) and complications. SFR was defined by bone window on non-contrast computed tomography (CT).

RESULTS: Pre-stented patients had a higher prevalence of positive urine culture treated with preoperative antibiotics (23.8% vs 12.3%, p = 0.006). Larger stone volumes were noted (1,306 mm³ vs 1,200 mm³, p = 0.027) in group 1. Postoperative complications were minor. Sepsis was not reported in either group. Group 1 had a higher incidence of low-grade Traxer grade 1 ureteric injuries (4.3% vs 0.4%, p = 0.021). FANS resulted in high overall SFRs of 97.5% and 97.0% in groups 1 and group 2. Multivariate analysis showed no statistical difference in SFR between the groups (63.2% vs 53.2%, p = 0.063). Only thulium fibre laser (TFL) and stone volume were significant predictors of residual fragments (RF).

CONCLUSIONS: Pre-stenting for FANS is not mandatory irrespective of stone location and volume. The use of TFL and stone volume significantly influenced SFR, while FANS itself proved highly effective in achieving high SFR.

PMID:40371431 | PMC:PMC12073519 | DOI:10.5173/ceju.2024.0197

Cent European J Urol. 2025;78(1):94-99. doi: 10.5173/ceju.2024.0222. Epub 2025 Feb 28.

ABSTRACT

INTRODUCTION: This review aims to determine whether the use of ureteral stents with extraction strings in adult patients undergoing upper urinary tract endoscopic procedures results in a higher incidence of urinary tract infections (UTIs) compared to stents without strings.

MATERIAL AND METHODS: A systematic literature search was conducted using PubMed, Scopus, and Google Scholar. Studies evaluating differences in UTI rates among adult patients with ureteral stents with or without extraction strings were included. Data on UTI rates, antibiotic prophylaxis protocols, and stent dwell time were extracted.

RESULTS: The review included 11 trials published between 2015 and 2023. One multicenter retrospective study involving 4,392 patients reported a significantly higher UTI rate in patients with extraction strings (2.1% vs 1.1%, p = 0.006). In the remaining 10 studies, including four randomized controlled trials, the differences were not statistically significant. Antibiotic prophylaxis was described in five studies. In two studies, a single perioperative antibiotic dose was administered, with a total UTI rate of 6.8% (28/410). In contrast, three studies using prolonged prophylactic antibiotic regimens reported a total UTI rate of 3.2% (13/403). The impact of stent dwell time on UTI risk could not be determined. The risk of bias was high in 10 studies and moderate in one retrospective study.

CONCLUSIONS: Based on low-quality evidence, the difference in UTI risk between ureteral stents with and without extraction strings appears to be minimal and statistically insignificant. Well-designed studies with standardized methodologies are needed to clarify these findings.

PMID:40371425 | PMC:PMC12073513 | DOI:10.5173/ceju.2024.0222