Tag: nevin manimala

Eur Radiol. 2025 Jul 1. doi: 10.1007/s00330-025-11648-4. Online ahead of print.

ABSTRACT

Early detection of lung cancer through low-dose CT lung cancer screening in a high-risk population has proven to reduce lung cancer-specific mortality. Nodule management plays a pivotal role in early detection and further diagnostic approaches. The European Society of Thoracic Imaging (ESTI) has established a nodule management recommendation to improve the handling of pulmonary nodules detected during screening. For solid nodules, the primary method for assessing the likelihood of malignancy is to monitor nodule growth using volumetry software. For subsolid nodules, the aggressiveness is determined by measuring the solid part. The ESTI-recommendation enhances existing protocols but puts a stronger focus on lesion aggressiveness. The main goals are to minimise the overall number of follow-up examinations while preventing the risk of a major stage shift and reducing the risk of overtreatment. KEY POINTS: Question Assessment of nodule growth and management according to guidelines is essential in lung cancer screening. Findings Assessment of nodule aggressiveness defines follow-up in lung cancer screening. Clinical relevance The ESTI nodule management recommendation aims to reduce follow-up examinations while preventing major stage shift and overtreatment.

PMID:40593170 | DOI:10.1007/s00330-025-11648-4

Eur Radiol. 2025 Jul 1. doi: 10.1007/s00330-025-11647-5. Online ahead of print.

ABSTRACT

The European Society of Thoracic Imaging (ESTI) nodule management recommendation for lung cancer screening with low-dose CT builds on existing nodule management guidelines but puts a stronger focus on lesion aggressiveness and measurement error. Key objectives included finding a compromise between the overall number of follow-up examinations, avoiding a major stage shift, and reducing the risk for overtreatment. Nodule management categories at baseline are chosen depending on the size of a solid nodule or the solid component of a subsolid or cystic nodule, with suspicious morphology upgrading risk to the next higher category. Higher risk categories mandate shorter follow-up times or diagnostic workup. Volume is the preferred size measure, with diameter measurements as a fallback if segmentation for volumetry is inaccurate at visual control. Nodule aggressiveness at follow-up is estimated from growth rate, calculated as volume doubling time (VDT), or yearly diameter change. Calculation of growth rate, however, is strongly affected by measurement variability, with large error margins for short follow-up and slower growing lesions. Growth thresholds were therefore set so that rapidly growing lesions can be identified while still small, while unnecessary workups for benign or slow-growing lesions could be kept low. New lesions that are retrospectively visible on earlier scans are managed according to their growth rate. New nodules not visible on earlier scans are followed after 3 months if they have a volume of ≥ 30 mm³. KEY POINTS: Question This work strives to reduce follow-up examinations while preventing major stage shift and overtreatment. It provides nodule management based on estimated nodule aggressiveness. Findings Calculation of the growth rate of pulmonary nodules is strongly affected by measurement variability, with large error margins for short follow-up and slower growing lesions. Clinical relevance Growth thresholds that trigger management are adjusted to the follow-up time so that rapidly growing lesions can be identified while still being small while unnecessary workups for benign or slow-growing lesions can be reduced.

PMID:40593169 | DOI:10.1007/s00330-025-11647-5

Eur Radiol. 2025 Jul 1. doi: 10.1007/s00330-025-11787-8. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the diagnostic performance of preoperative contrast-enhanced cone-beam breast CT (CE-CBBCT) and identify significant predictors of nipple-areolar complex (NAC) involvement in early-stage breast cancer patients.

MATERIALS AND METHODS: This retrospective study included 641 breast cancer cases from 631 patients at Sun Yat-sen University Cancer Center (2019.3-2021.3). From these, 182 cases were selected after one-by-one matching with the NAC involvement group using the propensity score matching method. Two radiologists independently assessed CE-CBBCT imaging factors in 182 cases. Diagnostic performance indices were analyzed, and predictors of NAC involvement in breast cancer were identified using logistic regression analyses.

RESULTS: The 182 matched cases were females with a median age of 50 (interquartile range, 44-55; range, 25-81 years). Interobserver agreement regarding CBBCT prediction by two radiologists was relatively substantial (κ = 0.730). The accuracy of radiologists in predicting NAC involvement in CE-CBBCT was 83.52% (152/182), with a sensitivity of 96.70% (88/91), specificity of 70.33% (64/91), negative predictive value of 95.52% (64/67), and positive predictive value (PPV) of 76.52% (88/115). On CE-CBBCT, asymmetric NAC enhancement (odds ratio, 5.279; p = 0.001) and TNE (tumor-nipple enhancement) within 2 cm of the NAC (odds ratio, 4.184; p = 0.02) were significant predictors of NAC involvement. When asymmetric NAC enhancement and TNE extending to the NAC were present, the PPV was 82.35% (56/68).

CONCLUSIONS: CE-CBBCT is a safe and non-invasive modality with comparably high accuracy for the preoperative diagnosis of NAC involvement. Asymmetric NAC enhancement and TNE within 2 cm of the NAC performed well in predicting NAC involvement.

KEY POINTS: Question Several imaging modalities have been studied to preoperatively evaluate NAC involvement, but CE-CBBCT’s performance was unknown. Findings CE-CBBCT showed high accuracy in diagnosing NAC involvement. Asymmetric NAC enhancement and tumor-nipple enhancement within 2 cm of the NAC were independent predictors of NAC involvement. Clinical relevance CE-CBBCT can serve as a safe, non-invasive modality to diagnose NAC involvement preoperatively and help to identify candidates for nipple-sparing mastectomy.

PMID:40593168 | DOI:10.1007/s00330-025-11787-8

Sci Rep. 2025 Jul 1;15(1):21656. doi: 10.1038/s41598-025-98985-y.

ABSTRACT

There is no consensus on which diet best for improving male reproductive health and published studies on the effect of diet on sexual function and semen quality are limited. The aim of this study was to investigate the effect of intervention based diet, namely Persian Medicine Diet (PMD) and Mediterranean Diet (MD), on sexual function and semen quality parameters. In this single blind, randomized controlled clinical trial, 159 male patients with oligoasthenospermia aged between 18 and 45 years were enrolled and divided into three groups of 53 people each. The patients were randomly assigned to either PMD or MD intervention and control groups for two months between July 2022 and February 2023 in Shiraz, Iran. To evaluate the outcomes, we used the International Index of Erectile Function (IIEF-15) questionnaires that included five subscales and semen quality parameters. The mean age of the participants was 30.87 ± 6.55. Our analysis showed that total score of IIEF was higher in the PMD intervention (P ≤ 0.001). In addition, the PMD intervention showed a higher average difference in erectile function and intercourse satisfaction subscales, respectively (P ≤ 0.001, P ≤ 0.003). However, MD intervention showed a higher average difference in orgasm function subscale (P = 0.053). Additionally, in semen analysis, the study showed that MD intervention improved statistically. Also, semen count, sperm motility, and morphology difference improved significantly (all P ≤ 0.001). To improve infertility, PMD and MD interventions could positively impact male sexual function and semen quality parameters in infertile mess. Further studies with larger sample sizes and longer durations are needed for conclusive results.

PMID:40593139 | DOI:10.1038/s41598-025-98985-y

Sci Rep. 2025 Jul 1;15(1):21467. doi: 10.1038/s41598-025-06428-5.

ABSTRACT

The optimal timing for initiating anticoagulation following an ischemic stroke remains a debated issue. While several professional societies offer guidelines derived from observational studies and randomized clinical trials in patients with atrial fibrillation, these studies often exclude patients with high-risk embolic sources and hemorrhagic transformation. To address this gap, we conducted a nationwide survey to determine current practice patterns among vascular neurologists. We used the REDCap platform at the University of Chicago to distribute a survey to board-certified vascular neurologists identified through the American Board of Psychiatry and Neurology and the American Academy of Neurology databases. Statistical analyses, including t-tests, chi-squared tests, Mann-Whitney-Wilcoxon tests, and Kruskal-Wallis tests, were performed to evaluate continuous and categorical variables as applicable. Out of 1,556 invited participants, 201 (approximately 13%) responded, with 62% identifying as academic neurologists. Early anticoagulation is defined as within 24 h for ischemic stroke < 1.5 cm, 5 days for one third of MCA territory with hemorrhagic transformation type 1, and 7 days with parenchymal hemorrhage type 2. When compared to atrial fibrillation, vascular neurologists are more likely to initiate early anticoagulation in ischemic stroke with hemorrhagic transformation type 1 when it is caused by LV thrombus (69% vs. 21%, p < 0.001), antiphospholipid syndrome (87% v 21%, p < 0.001), and non-occlusive thrombus (83% vs. 21%, p < 0.001). A similar trend of early anticoagulation was noted in cases of ischemic stroke with parenchymal hemorrhage type 2 caused by LV thrombus (63% vs. 13%, p < 0.001), antiphospholipid syndrome (73% vs. 13%, p < 0.001), and non-occlusive thrombus (71% vs. 13%, p < 0.001) when compared to atrial fibrillation as the underlying cause. This study suggests that vascular neurologists prefer early anticoagulation in high-risk stroke mechanisms as compared to atrial fibrillation.

PMID:40593128 | DOI:10.1038/s41598-025-06428-5

Sci Rep. 2025 Jul 1;15(1):22398. doi: 10.1038/s41598-025-07630-1.

ABSTRACT

Sleep staging plays a crucial role in the diagnosis and treatment of sleep disorders. Traditional sleep staging requires manual classification by professional technicians based on the characteristic features of each sleep stage. This process is time-consuming, and the accuracy of staging is heavily influenced by subjective factors. Currently, research on automatic sleep staging models based on deep learning has made significant progress. However, the automatic sleep staging models proposed by researchers seldom distinguish between age groups. With increasing age, changes in sleep architecture occur, and older adults experience a reduction in deep sleep duration. This age-related alteration makes older adults more susceptible to sleep disorders. Consequently, the automatic sleep staging problem for older adults is more challenging and warrants greater attention. This study first established a three-dimensional time‒frequency feature fusion map dataset based on continuous wavelet transform and determined the optimal channel signals from the Sleep-EDF expanded dataset. We subsequently proposed an automatic sleep model tailored for older adults, named RICM-SleepNet. This model employs Inception modules to extract features at multiple scales, uses the CBAM attention mechanism to further identify efficient features at different scales, and finally employs the multiscale connection structure to concatenate features from different stages, enhancing the model’s feature utilization capability. RICM-SleepNet was subject to a performance evaluation on the three-dimensional time‒frequency feature fusion map dataset, yielding a sleep staging accuracy and κ value of 87.66% and 0.8492, respectively. Compared with the baseline models GoogLeNet, MobileNetV2, ShuffleNetV2, DenseNet121, RegNet, and ResNet50, RICM-SleepNet exhibited the highest recognition accuracy. To further validate the superiority of the RICM-SleepNet model, this study compared it with recent research methods that have demonstrated good performance in sleep staging. The results indicate that the proposed RICM-SleepNet model is superior to the other models in terms of performance. The Kruskal‒Willis test yielded a p value of 0.0014, indicating statistical significance. RICM-SleepNet attained the highest mean rank, underscoring its superior performance. In summary, the proposed multichannel automatic sleep staging model, RICM-SleepNet, shows promise in enhancing the accuracy and effectiveness of sleep staging, especially for older adults. Further validation and refinement of the model are warranted for its application in clinical settings and broader use in addressing sleep-related issues in the ageing population.

PMID:40593120 | DOI:10.1038/s41598-025-07630-1

Anal Methods. 2025 Jul 1. doi: 10.1039/d5ay00531k. Online ahead of print.

ABSTRACT

This study employed headspace gas chromatography-ion mobility spectrometry (HS-GC-IMS) technology combined with multivariate statistical analysis methods to analyze the flavor compounds in flue-cured tobacco from five different regions in China: Henan, Hunan, Yunnan, Chongqing, and Fujian. A total of 98 volatile aroma compounds were identified through HS-GC-IMS analysis, including esters, ketones, aldehydes, acids, alcohols, heterocyclic compounds, sulfur-containing compounds, other types of compounds, and 8 uncharacterized compounds. Principal Component Analysis (PCA) and Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA) were utilized to conduct dimensionality reduction and distinguish the samples, effectively recognizing differences in volatile compounds among tobacco leaves from various origins. A Random Forest (RF) classification model was constructed, and its reliability was validated through ROC (Receiver Operating Characteristic) analysis, achieving an AUC (Area Under the Curve) value of 0.980, which demonstrates exceptional predictive performance. PCA revealed distinct separations of tobacco leaf samples from different regions on the PCA score plot, and OPLS-DA analysis further validated these differences and confirmed the model’s validity through permutation testing. Twenty key aroma compounds with VIP > 1.0 were screened by integrating OPLS-DA with the Random Forest classification model. These compounds showed significant differences in content among different samples, suggesting their potential as chemical markers for distinguishing the origin of flue-cured tobacco. This study not only provides a new method for identifying volatile compounds in tobacco but also offers novel insights into the geographical identification of flue-cured tobacco.

PMID:40590198 | DOI:10.1039/d5ay00531k

Ren Fail. 2025 Dec;47(1):2515530. doi: 10.1080/0886022X.2025.2515530. Epub 2025 Jul 1.

ABSTRACT

OBJECTIVE: To evaluate the effect of rapamycin on DFG (delayed graft function in kidney transplant) recipients through a systematic review and meta-analysis.

METHODS: We searched PubMed, Embase, Cochrane Library, and other databases for studies assessing rapamycin use in kidney transplantation with a focus on DGF. The search was conducted from the time of database construction to December 2024. Literature search and quality evaluation were conducted by two researchers. Data were analyzed using RevMan 5.3, with odds ratio (OR) for dichotomous outcomes and mean differences (MD) for continuous outcomes. The meta-analysis was performed with Q-I²; fixed model for I² < 50%; sensitivity analysis for I² ≥ 50%. p Values < 0.05 were considered statistically significant.

RESULTS: Nine studies (n = 9,219) were included. Rapamycin was associated with an increased risk of DGF (OR = 1.29, 95% CI: 1.04-1.58), with a prolonged DGF duration (MD = 8.86, 95% CI: 3.84-13.89). No significant differences were found in graft survival (OR = 1.40, 95% CI: 0.72-2.73); patient survival (OR = 1.89, 95% CI: 0.84-4.26), or rejection incidence (OR = 1.22, 95% CI: 0.78-1.90).

CONCLUSIONS: Rapamycin significantly increases the risk and duration of DGF after kidney transplantation. However, it does not appear to affect long-term outcomes such as graft survival or rejection rates. These findings suggest that rapamycin should be used cautiously in transplant recipients at risk for DGF, and further studies are needed to optimize immunosuppressive strategies for this population.

PMID:40590196 | DOI:10.1080/0886022X.2025.2515530

Mol Ecol. 2025 Jul 1:e70010. doi: 10.1111/mec.70010. Online ahead of print.

ABSTRACT

Approximately, 40% of earthworm species can reproduce by parthenogenesis. This is the case for the cosmopolitan species, Aporrectodea trapezoides, although sexual forms have been described sporadically. We analyse the genotypes and microbiomes of 30 individuals from four localities where both forms appear in order to understand the evolutionary mechanisms related to parthenogenesis. In all sites, heterozygosity values were approximately 30% higher in parthenogenetic individuals. However, we detected a stronger genomic structuring due to reproduction than to the geographical setting only in the Algerian population, underpinned by 195 loci that were related to gametogenesis, symbiont-like processes, and nitrate reduction. Similarly, statistical differences in the abundance of ZOTUs were only found between the Algerian sexual and parthenogenetic earthworms, with 754 ZOTUs that included the genus Romboutsia, which is involved in the production of nitric oxide, which enhances sperm motility. In summary, significant genomic and microbiome differences were found only between sexual and parthenogenetic lineages in a single locality. We hypothesise that obligate parthenogenesis evolved early, leaving traces at the genomic and microbiome levels in the Algerian parthenogens that were the earliest splitting lineage. Such obligate parthenogenesis was lost secondarily and individuals in the Iberian sites were facultative parthenogens, with the potential to copulate and therefore erase the genomic and microbial traces of obligate parthenogenesis. Our results indicate a hybrid origin of parthenogenesis in A. trapezoides and shed light on the complex interplay between genomic, microbiome, and reproductive mechanisms in A. trapezoides.

PMID:40590190 | DOI:10.1111/mec.70010

Toxicol Mech Methods. 2025 Jul 1:1-28. doi: 10.1080/15376516.2025.2527154. Online ahead of print.

ABSTRACT

Microplastics (MPs) have emerged as a serious global environmental threat due to their resistance to degradation and persistence in ecosystems. Given their potential risks to human health, it is essential to thoroughly investigate the mechanisms of toxicity and associated health consequences. This study examined the toxicological and reproductive effects of varying doses of polyethylene microplastics (PE-MPs) in 120 male and female Sprague Dawley rats. A statistically significant, dose-dependent increase in malondialdehyde levels was observed, along with a reduction in catalase activity. Furthermore, alterations were detected in sexual hormone levels and disruptions were noted in both the Keap1-Nrf2-ARE (antioxidant response element) and p38 MAPK-Nrf2 signaling pathways. PE-MP exposure also produced marked histopathological changes in the testes and ovaries. These findings indicate that reproductive toxicity from PE-MPs is associated with impairments in the Keap1-Nrf2-ARE and p38 MAPK-Nrf2 pathways. The results underscore the importance of limiting microplastic exposure to mitigate potential health hazards and provide new data on the potential mechanisms of toxicity of MPs.

PMID:40590170 | DOI:10.1080/15376516.2025.2527154