Tag: nevin manimala

BJS Open. 2025 Sep 8;9(5):zraf101. doi: 10.1093/bjsopen/zraf101.

ABSTRACT

BACKGROUND: Intraoperative autotransfusion remains underutilized in high-risk haemorrhagic oncological procedures, particularly in liver transplantation for hepatocellular carcinoma. This is because of the theoretical risk of tumour cell reinfusion and dissemination, potentially leading to reduced recurrence-free survival. The aim of this study was to evaluate the impact of intraoperative autotransfusion on recurrence-free survival during liver transplantation for hepatocellular carcinoma.

METHODS: This was a retrospective study of patients receiving liver transplantation for hepatocellular carcinoma with or without intraoperative autotransfusion between 1 January 2011 and 1 January 2020 at five French hospitals, of which one used autotransfusion and four did not. Propensity score matching was used to match the cohorts with and without autotransfusion. The primary endpoint was 5-year recurrence-free survival.

RESULTS: Some 113 patients in the study cohort (autotransfusion) were compared with 441 patients in the control cohort. The median volume of autotransfused blood was 1500 ml. Median follow-up was 84.6 months. There was no significant difference in 5-year recurrence-free survival between the cohorts (69.7% in control cohort versus 66.3% in study cohort; P = 0.241). After matching patients based on oncological criteria, the difference remained non-significant, with a 5-year recurrence-free survival rate of 67.1% in the study cohort and 77.6% in the control cohort (P = 0.174).

CONCLUSION: The use of autotransfusion during liver transplantation for hepatocellular carcinoma was not associated with recurrence-free survival.

PMID:40924885 | DOI:10.1093/bjsopen/zraf101

Menopause. 2025 Sep 9. doi: 10.1097/GME.0000000000002661. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate depression in postmenopausal women and to explore the relationship between age at menopause, hormone therapy, and depression, while also identifying potential mediators that may explain these associations.

METHODS: This cross-sectional study analyzed data from National Health and Nutrition Examination Survey (NHANES) (2005-2020) for women older than 60 years who completed the Patient Health Questionnaire 9 (PHQ-9) depression questionnaire (n=7,027). Exposures included age at menopause and self-reported hormone therapy; the outcome was depression severity (PHQ-9 ≥10). Covariates included sociodemographics, body mass index, medical conditions, and biomarkers (C-reactive protein, homeostatic model assessment of insulin resistance). Survey-weighted logistic regression, Bayesian modeling, and causal mediation analysis were used. Missing data were handled with multiple imputation and inverse probability weighting. Analyses were conducted with R software, with P<0.05 considered significant.

RESULTS: In this NHANES sample of postmenopausal women older than 60 years, earlier age at menopause was associated with depression (P<0.0001). Hormone therapy did not show a significant association with depression (OR=0.58, 95% CI: 0.23-1.4), while higher education levels were protective (college degree: OR=0.89, 95% CI: 0.85-0.92, P<0.001). C-reactive protein and homeostatic model assessment of insulin resistance partially accounts for the statistical association between menopause and depression (P<0.0001).

CONCLUSION: Age at menopause is inversely associated with depression in women older than 60 years. This relationship is statistically accounted for by the role of inflammation and insulin resistance. Self-reported hormone therapy is not associated with depression in postmenopausal women.

PMID:40924884 | DOI:10.1097/GME.0000000000002661

Menopause. 2025 Sep 9. doi: 10.1097/GME.0000000000002638. Online ahead of print.

ABSTRACT

OBJECTIVE: Our study aimed to compare premenopausal and postmenopausal women in terms of choroidal thickness and choroidal vascularity index.

METHODS: This cross-sectional study included 96 eyes of 96 participants, comprising 48 premenopausal and 48 postmenopausal women. Enhanced depth image optical coherence tomography (EDI-OCT) was used to visualize the choroid. Choroidal thickness measurements were performed at three points, including the subfoveal region (subfoveal choroidal thickness [SFCT]), 1500 μm nasal to the fovea (nasal choroidal thickness [NCT]), and 1500 μm temporal to the fovea (temporal choroidal thickness [TCT]) from EDI-OCT images. The choroidal vascularity index (CVI), total choroidal area (TCA), luminal area (LA), and stromal area (SA) were measured in the subfoveal 3000 μm area by the binarization technique via ImageJ software. Measurements of premenopausal and postmenopausal women were compared after adjusting for age.

RESULTS: The comparison of axial length, spherical equivalent, and body mass index values revealed no significant differences (P>0.05 for all). SCFT, NCT, TCT, LA, and TCA values were statistically significantly lower after adjusting for age in the postmenopausal group compared with the premenopausal group (P=0.002, 0.020, 0.004, 0.020, 0.043) respectively. There was no statistically significant difference in SA and CVI values (P>0.05 for all).

CONCLUSION: The decreased choroidal thickness in postmenopausal women likely resulted from the reduction in the vascular component of the choroid, while the stromal component remained unchanged. Further prospective long-term studies are needed to evaluate women before and during menopause to investigate the relationship between choroidal vascular structure and the risk of ischemic vascular diseases.

PMID:40924883 | DOI:10.1097/GME.0000000000002638

Brain. 2025 Sep 9:awaf317. doi: 10.1093/brain/awaf317. Online ahead of print.

ABSTRACT

The lateral prefrontal cortex (LPFC) serves as a critical hub for higher-order cognitive and executive functions in the human brain, coordinating brain networks whose disruption has been implicated in many neurological and psychiatric disorders. While transcranial brain stimulation treatments often target the LPFC, our current understanding of connectivity profiles guiding these interventions based on electrophysiology remains limited. Here, we present a high-resolution probabilistic map of bidirectional effective connectivity between the LPFC and widespread cortical and subcortical regions. This map is derived from intracranial evoked potential analysis of 48,797 intracranial direct electrical stimulation runs across 759 implantations in 724 patients with refractory epilepsy (368 male, 354 female, two unspecified; mean age 24±13.5 years). We mapped probabilistic connectivity between brain parcels with adaptive resolution – higher resolution in the LPFC in the hemisphere of interest and lower elsewhere – maintaining statistical power while achieving 95% average confidence interval of ∼0.03 for connectivity probability estimates. In addition, the significance threshold (p-value) for probabilistic connectivity was obtained from surrogate distributions. Overall, we observed remarkable symmetry between afferent and efferent connectivity patterns of the LPFC, with a slight preference for efferent connections (mean slope = 0.92±0.09, mean R² = 0.93±0.025). For example, connections between the inferior frontal gyrus (IFG) and anterior cingulate showed notable directional asymmetry. The IFG strongly projected to most brain networks compared to other LPFC regions, with the strongest connectivity to the ventral attention network (0.26±0.01 compared to values between 0.15 and 0.21 in other LPFC regions). Posterior DLPFC demonstrated stronger connectivity to brain networks compared to anterior DLPFC regions (eg. 0.21±0.01 vs 0.15±0.01 for connectivity to ventral attention network), with the exception of the limbic cortex. All LPFC subregions strongly projected to the fronto-parietal (greater than 0.17) and ventral attention (greater than 0.15) networks, with moderate connections to the default network (between 0.1 and 0.15, with the maximum corresponding to superior DLPFC). Finally, latency analysis suggested that the left LPFC’s influence on ipsilateral emotion-related regions is primarily polysynaptic, with particularly strong pathways from IFG to amygdala (0.16±0.02) and hippocampus (0.12±0.01). Taken together, these comprehensive connectivity maps provide a new detailed electrophysiological foundation for understanding the functional anatomy of LPFC and guiding targeted brain stimulation protocols.

PMID:40924875 | DOI:10.1093/brain/awaf317

Menopause. 2025 Sep 9. doi: 10.1097/GME.0000000000002639. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to examine the relationship between vaginal aging and sexual quality of life in postmenopausal women.

METHODS: A descriptive, cross-sectional study was conducted with 210 postmenopausal women aged 45 to 59 years. Data were collected using a Personal Information Form, the Daily Effects of Vaginal Aging Scale, and the Sexual Quality of Life Scale. Descriptive statistics, Pearson correlation analysis, and multiple regression analysis were used to analyze the data.

RESULTS: A statistically significant negative correlation was found between vaginal aging and sexual quality of life (r=-0.533, P<0.001). A one-unit increase in vaginal aging was associated with a 0.506-unit decrease in sexual quality of life score (B=-0.506, P<0.001).

CONCLUSIONS: Vaginal aging was significantly associated with lower sexual quality of life in postmenopausal women. These findings suggest that addressing vaginal aging may contribute to enhancing sexual well-being in this population.

PMID:40924870 | DOI:10.1097/GME.0000000000002639

Clin Transplant. 2025 Sep;39(9):e70315. doi: 10.1111/ctr.70315.

ABSTRACT

BACKGROUND: In the United States, a severe organ shortage precipitates an extensive transplant waitlist. Living donor kidneys are functionally superior to those from deceased donors and offer an alternative to close the supply-demand gap.

METHODS: A retrospective review of 2147 patients who self-referred to begin the living kidney donation workup process at our center between June 1, 2012, and October 1, 2023 was conducted with subsequent statistical analysis of gathered data. National Kidney Registry (NKR) affiliation began February 1, 2018, and the pre- and post-NKR periods were compared.

RESULTS: The pre-NKR period saw 894 total referrals (42%) compared to 1253 post-NKR (58%). Post-NKR donors increased to 89 from 47 pre-NKR with similar times between stages except for a significantly shorter referral-to-lab review post-NKR (47.0 vs. 56.5 days, p < 0.01). A notable decrease in referrals from Indigenous Peoples was observed (121 [14%] to 93 [7%], p < 0.01) yet donations increased (2 [4%] to 7 [8%], p = 0.042). Donors originating from South Dakota increased (26-54, p = 0.59) post-NKR, and significantly more patients pursued nondirected referral (25 [3%] vs. 173 [14%], p < 0.01) with similar proportions following through with donation. Reasons for dropout during the process were similar between the periods, yet quantitative distributions differed.

CONCLUSION: NKR affiliation coincided with encouraging results, in many cases similar to broad national trends, attesting to improved connectivity and impact on focal population groups.

PMID:40924854 | DOI:10.1111/ctr.70315

Clin Transl Gastroenterol. 2025 Sep 10. doi: 10.14309/ctg.0000000000000919. Online ahead of print.

ABSTRACT

BACKGROUND: Severe acute pancreatitis (SAP) is a life-threatening condition requiring early risk stratification. While the Bedside Index for Severity in Acute Pancreatitis (BISAP) is widely used, its reliance on complex parameters limits its applicability in resource-constrained settings. This study introduces a decision tree model based on Classification and Regression Tree (CART) analysis, utilizing Neutrophil-to-Lymphocyte Ratio (NLR) and C-reactive Protein (CRP), as a simpler alternative for early SAP prediction.

METHODS: In a prospective cohort of 340 patients at National Hospital, Vietnam (November 2022-September 2023), NLR, CRP, and BISAP scores were assessed upon admission. CART analysis was used to develop a decision tree, and model performance was compared with BISAP using receiver operating characteristic (ROC) curves, decision curve analysis (DCA).

RESULTS: The CART model identified NLR ≥11.4 and CRP ≥173.3 mg/L as optimal thresholds for SAP prediction. The model achieved an area under the curve (AUC) 0.866 in the validation cohort, statistically comparable to BISAP (AUC = 0.900, p = 0.286). The model demonstrated high sensitivity (90.9%), specificity (84.5%), and accuracy (86.25%), confirming its robustness. DCA highlighted similar clinical benefits with BISAP, but the CART-based model offered greater simplicity, making it ideal for resource-limited settings.

CONCLUSION: The CART-derived decision tree using NLR and CRP provides an accessible and reliable tool for early SAP prediction. With performance comparable to BISAP but requiring fewer resources, this model supports rapid, evidence-based decision-making in clinical practice.

PMID:40924813 | DOI:10.14309/ctg.0000000000000919

PLoS One. 2025 Sep 9;20(9):e0331243. doi: 10.1371/journal.pone.0331243. eCollection 2025.

ABSTRACT

This research explores the dynamical properties and solutions of actin filaments, which serve as electrical conduits for ion transport along their lengths. Utilizing the Lie symmetry approach, we identify symmetry reductions that simplify the governing equation by lowering its dimensionality. This process leads to the formulation of a second-order differential equation, which, upon applying a Galilean transformation, is further converted into a system of first-order differential equations. Additionally, we investigate the bifurcation structure and sensitivity of the proposed dynamical system. When subjected to an external force, the system exhibits quasi-periodic behavior, which is detected using chaos analysis tools. Sensitivity analysis is also performed on the unperturbed system under varying initial conditions. Moreover, we establish the conservation laws associated with the equation and conduct a stability analysis of the model. Employing the tanh method, we derive exact solutions and visualize them through 3D and 2D graphical representations to gain deeper insights. These findings offer new perspectives on the studied equation and significantly contribute to the understanding of nonlinear wave dynamics.

PMID:40924812 | DOI:10.1371/journal.pone.0331243

Physiol Int. 2025 Sep 9. doi: 10.1556/2060.2025.00640. Online ahead of print.

ABSTRACT

PURPOSE: Contribution of the gastrocnemii muscles to ankle moment is influenced by the knee joint position because they span the knee and the ankle joint as well. However, limited information is available on the effect of knee joint position on soleus activation under dynamic plantarflexion, hence the aim of this study was to investigate if soleus have a compensatory strategy in fascicle behavior or EMG activity during knee flexed plantarflexion in order to reduce the magnitude of the decrement in ankle moment.

EQUIPMENT AND METHODS: Isokinetic dynamometry with EMG and ultrasound measurements was used to estimate medial gastrocnemius and soleus behavior during knee flexed and extended plantarflexions using three angular velocities. Seventeen healthy males were participated in this study.

RESULTS: Flexed knee plantarflexions resulted in lower peak ankle moments at all ankle angular velocities by 18% (P = 0.1062) at 30°∙s-1, 44% (P < 0.001) at 60°∙s-1 and by 18% (P = 0.0001) at 120°∙s-1. Soleus showed significantly higher EMG activity during knee flexed plantarflexion at 30°∙s-1 (P = 0.0094) and 60°∙s-1 (P = 0.0142). The magnitude of mean shortening of the medial gastrocnemius and soleus show statistically significant difference between knee flexed and knee extended plantarflexion at any contraction velocity.

CONCLUSIONS: Soleus may perform a compensatory EMG activity in knee flexed plantarflexions possibly to counteract the reduced contribution of gastrocnemius to ankle moment at low angular velocity contractions.

PMID:40924490 | DOI:10.1556/2060.2025.00640

JAMA Netw Open. 2025 Sep 2;8(9):e2530730. doi: 10.1001/jamanetworkopen.2025.30730.

ABSTRACT

IMPORTANCE: Long COVID (ie, post-COVID-19 condition) is a substantial public health concern, and its association with health-related social needs, such as food insecurity, remains poorly understood. Identifying modifiable risk factors like food insecurity and interventions like food assistance programs is critical for reducing the health burden of long COVID.

OBJECTIVE: To investigate the association of food insecurity with long COVID and to assess the modifying factors of Supplemental Nutrition Assistance Program (SNAP) participation and employment status.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective, cross-sectional survey study used data from the 2022 to 2023 National Health Interview Survey. Respondents aged 18 years and older who reported prior COVID-19 infection and responded to questions on food insecurity and long COVID were included.

EXPOSURE: Food insecurity, categorized as food secure or food insecure.

MAIN OUTCOMES AND MEASURES: The primary outcome was current long COVID, defined as symptoms lasting 3 or more months after initial COVID-19 infection persisting to time of interview. The secondary outcome was long COVID recovery, indicating history of long COVID without current symptoms. Food insecurity was measured using the validated 10-item National Center for Health Statistics food insecurity scale. Odds ratios (ORs) and 95% CIs for the association of food insecurity with long COVID were calculated using simple and multiple logistic regression.

RESULTS: The study enrolled 21 631 participants (1255 female [weighted percentage, 53%]; 5058 aged 65 years or older [weighted percentage, 16%]), including 19 824 with food security and 1807 with food insecurity. In total, 288 respondents with food insecurity (weighted percentage, 15%) reported current long COVID compared with 1547 (weighted percentage, 7%) without food insecurity. Food insecurity was positively associated with current long COVID (adjusted OR, 1.73; 95% CI, 1.39-2.15) and negatively associated with recovery among adults with prior long COVID (adjusted OR, 0.70; 95% CI, 0.54-0.92). SNAP participation (P for interaction = .04) and unemployment (P for interaction = .04) significantly modified these associations.

CONCLUSIONS AND RELEVANCE: In this survey study of US adults with prior COVID-19 infection, food insecurity was associated with greater odds of long COVID and lower odds of recovery, with SNAP participation and unemployment mitigating these associations. These findings suggest that expanding SNAP eligibility, simplifying enrollment processes, and increasing awareness of food assistance programs may reduce the burden of food insecurity and long COVID and further emphasize the importance of addressing health-related social needs in chronic disease prevention and management.

PMID:40924424 | DOI:10.1001/jamanetworkopen.2025.30730