Tag: pubmed

J Artif Organs. 2025 Dec 15;29(1):15. doi: 10.1007/s10047-025-01541-8.

ABSTRACT

BACKGROUND: To evaluate the feasibility and safety of anticoagulation-free peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) during lung re-transplantation and to assess its impact on blood transfusion requirements and clinical outcomes.

METHODS: In this single-center retrospective cohort (January 2023-April 2025), we included adults undergoing bilateral re-do lung transplantation on peripheral VA-ECMO with an anticoagulation-avoidance protocol; primary lung transplants were not included. Data on patient demographics, intraoperative transfusion volumes, postoperative complications, and survival were collected. The primary outcomes were intraoperative packed red blood cell transfusion volume and overall survival; secondary outcomes included incidence of primary graft dysfunction, acute kidney injury, and hemorrhagic and thromboembolic events. Continuous variables are reported as medians with interquartile ranges, and survival was estimated using the Kaplan-Meier method.

RESULTS: Seven patients (median age, 42 years; range, 30-56 years) underwent re-transplantation for chronic lung allograft dysfunction. The median intraoperative transfusion requirement was 560 ml (interquartile range 280-1050 ml). One patient developed primary graft dysfunction of grade 3and two developed stage 3 acute kidney injury requiring renal replacement therapy. Two developed deep venous thrombosis nonrelated to ECMO cannulation; no pulmonary embolism occurred. At a median follow-up of 469 days, all patients survived without evidence of recurrence of chronic lung allograft dysfunction.

CONCLUSIONS: Full anticoagulation-free peripheral VA-ECMO during lung re-transplantation is feasible and safe, with acceptable complication rates and potential reduction in transfusion requirements. Larger, multicenter studies are warranted to confirm these findings.

PMID:41396406 | DOI:10.1007/s10047-025-01541-8

Mol Biotechnol. 2025 Dec 15. doi: 10.1007/s12033-025-01520-7. Online ahead of print.

ABSTRACT

Bacterial cellulose (BC) is one of the biodegradable materials that is produced by BC-producing bacteria and is widely used in various industries. In previous studies, we isolated high-yield BC-producing Komagataeibacter diospyri MI 2 and analyzed its genomes. In this study, we aimed to improve the BC production ability of K. diospyri MI 2 by UV light and to investigate BC-regulating genes by comparative genomics. Of the 17 surviving colonies after UV irradiation, most produced significantly more BC higher than the wild type, while K. diospyri mutants B, G, and O had the highest BC yield. The properties of BC were analyzed by SEM and X-ray diffraction. The results showed that the BC produced by the K. diospyri mutants was denser than that of the wild type but did not significantly change crystallinity. The whole-genome sequencing and comparative genomics were performed to explore the genes involved in the improvement of BC in the K. diospyri mutants. The result showed that the descriptive statistics of the assembled genomes of the K. diospyri mutants were similar to that of the wild type. When comparing their genomes, we found that genes, including galE, aes, and bfr, which were likely involved in BC biosynthesis, disappeared in the K. diospyri mutants. In addition, variant analysis was performed, and SNPs and InDels located on the CDS of genes, including the response regulator, efflux transporter outer membrane subunit, chloride channel protein, and ribonuclease E, could be potential biomarkers for higher BC production. Our study provided the K. diospyri mutants by UV mutagenesis and explored the set of genes possibly involved in BC production.

PMID:41396403 | DOI:10.1007/s12033-025-01520-7

Phys Eng Sci Med. 2025 Dec 15. doi: 10.1007/s13246-025-01686-z. Online ahead of print.

ABSTRACT

INTRODUCTION: Deep learning (DL)-based auto-segmentation has rapidly become the state-of-the-art in radiotherapy planning, significantly reducing contouring time while achieving geometric accuracy comparable to expert-derived contours [1-3]. While AI contouring on CTp is now widely established, its application to cone-beam CT (CBCT) is less well explored, despite CBCT’s critical role in daily image guidance for prostate radiotherapy. Current adaptive workflows rely on manual contouring or deformable image registration (DIR), both of which are resource-intensive and subject to limitations in accuracy and consistency. Recent advances in AI-based CBCT segmentation have shown promise in reducing manual workload, improving contour consistency, and supporting adaptive radiotherapy (ART) workflows [4]. To assess the clinical implications of these developments, this study retrospectively analyzed CBCT images from 20 prostate cancer patients, comparing AI- and DIR-generated contours to evaluate systematic differences and their potential impact on dosimetry and ART decision-making.

METHODS: Twenty prostate radiotherapy patients were retrospectively selected, treated with either 42.7 Gy in 7 fractions or 60 Gy in 20 fractions, and imaged on Halcyon linear accelerators using Hypersight CBCT ([Formula: see text]). AI-generated contours were produced with Limbus AI v1.8.0, while deformable image registration (DIR) contours were propagated from planning CTs in Velocity v4.2. Contour accuracy was assessed by two senior medical officers using a four-point Likert scale across 140 CBCTs. Prostate, bladder, and rectum were analyzed using Dice Similarity Coefficient (DSC), Hausdorff Distance (HD), mean surface distance (MSD), center-of-mass (COM) displacement, and volumetric change relative to the planning CT. Dosimetric evaluation included [Formula: see text], [Formula: see text], [Formula: see text], and clinically defined organ-at-risk metrics to assess potential implications for adaptive radiotherapy. Statistical significance was tested using paired Student’s t-tests and Wilcoxon signed-rank tests with a threshold of [Formula: see text].

RESULTS: AI-generated contours achieved acceptable clinical accuracy in >80% of cases, with fewer severe or medium errors compared to DIR-derived contours, which required minimal changes of 49%. Quantitative analysis demonstrated broadly comparable Dice Similarity Coefficients (DSC), Hausdorff Distance (HD), and mean surface distance (MSD) across prostate, bladder, and rectum. Organ variation on CBCT revealed larger mean centre of mass shifts and volume differences for AI, particularly in bladder contours, whereas DIR showed smaller systematic deviations. Dosimetric comparisons highlighted that prostate dose metrics were significantly different between methods, while bladder differences were mostly non-significant except at high-dose volumes, and rectum analysis revealed consistent statistically significant variations. Overall, although both methods captured daily anatomical changes, suggesting complementary strengths depending on adaptive radiotherapy application.

CONCLUSION: AI-generated contours for prostate radiotherapy on CBCT images demonstrate high geometric accuracy and clinical usability, requiring minimal expert correction, while DIR contours, although generally usable, show greater variability, particularly for organs subject to large anatomical changes such as the bladder and rectum. Despite similar geometric comparisons, statistically significant dosimetric differences highlight the importance of careful expert verification, especially for sensitive structures like the rectum. These findings support the integration of AI-based contouring into adaptive radiotherapy workflows to streamline clinical processes, reduce workload, and maintain treatment accuracy, while emphasizing that automated contours, whether AI- or DIR-derived, should always undergo expert review to ensure safe and effective patient care.

PMID:41396387 | DOI:10.1007/s13246-025-01686-z

Ann Ist Super Sanita. 2025 Oct-Dec;61(4):277-284. doi: 10.4415/ANN_25_04_06.

ABSTRACT

BACKGROUND: Accurate estimation of vaccine effectiveness (VE) in real-world settings is essential for guiding immunization strategies, especially in older populations. However, observational studies are prone to bias due to confounding factors, and the choice of statistical method can significantly influence VE estimates.

MATERIALS AND METHODS: We compared the performance of a multivariable Cox proportional hazards model with seven propensity score (PS)-based models to estimate the relative vaccine effectiveness (rVE) of the bivalent Original/Omicron BA.4-5 mRNA vaccine as a second or third booster, compared to a first mRNA booster received ≥120 days earlier. Data from 11,879,461 individuals aged ≥60 in Italy (April-June 2023) were analyzed.

RESULTS: All models produced consistent rVE estimates, with values ranging from 16.4% to 22.1%. Over time, booster effectiveness declined, with the reference model showing a drop in rVE from 45.6% (15-60 days) to 14.3% (181-265 days). PS-based methods improved covariate balance but did not outperform the Cox model in terms of precision or interpretability.

CONCLUSIONS: In large, relatively balanced datasets, traditional multivariable models remain a robust and reliable choice for estimating VE. While PS-based methods offer theoretical advantages, their practical benefit may be limited when confounding is well controlled.

PMID:41392961 | DOI:10.4415/ANN_25_04_06

Folia Parasitol. 2025 Nov 28;72:2025.031. doi: 10.14411/fp.2025.031.

ABSTRACT

The pathogenicity of haemogregarines and their effects on the health status of ectothermic hosts remain largely unexplored. In this study, we examined the impact of Hemolivia mauritanica (Sergent et Sergent, 1904) infection on the differential leukocyte count (DLC) as a measurable indicator of health in tortoise hosts. A total of 206 blood smears were analysed, including 181 from spur-thighed tortoises (Testudo graeca Linnaeus) and 25 from marginated tortoises (Testudo marginata Schoepff). Light microscopy was used to identify infected individuals, determine DLC, and quantify parasitaemia levels. Overall, H. mauritanica was detected in 125 of 181 (69%) T. graeca samples and 21 of 25 (84%) T. marginata samples. To assess whether infection influenced DLC, we statistically compared leukocyte profiles between infected and uninfected individuals. Additionally, we evaluated the effects of other factors, including host species, parasitaemia intensity, sex, age, and the month and year of blood collection. Wilcoxon rank-sum tests revealed that parasitaemia and age had a statistically significant effect on DLC in T. graeca. Further analysis using linear models showed a significant association between parasitaemia and DLC, specifically affecting azurophils in T. graeca and basophils in T. marginata. Nine T. graeca tortoises positive for H. mauritanica were co-infected with haemosporidian parasites of the genus Haemocystidium Castellani et Willey, 1904, specifically three with Haemocystidium anatolicum (Orkun et Güven, 2013) and six with Haemocystidium caucasicum (Krasilnikov, 1965). Although co-infection itself was not statistically significant, a separate analysis of Haemocystidium parasitaemia revealed a significant effect on lymphocyte DLC. Furthermore, the frequent presence of mitotic and polychromatophilous erythrocytes in H. mauritanica-infected tortoises suggests a potential increase in erythrocyte regeneration.

PMID:41392952 | DOI:10.14411/fp.2025.031

Drug Alcohol Rev. 2026 Jan;45(1):e70091. doi: 10.1111/dar.70091.

ABSTRACT

ISSUES: This review aimed to estimate the prevalence of non-medical anabolic-androgenic steroid (AAS) use among same-sex attracted men (SSM).

APPROACH: We conducted a systematic review of peer-reviewed articles in English, focusing on AAS use among SSM. We excluded grey literature and studies that measure AAS use through some form of analysis (e.g., hair or urine). Ten databases were searched. Titles and abstracts for all articles were screened, followed by full-text assessment and data extraction by multiple authors. The pooled overall and subgroup (gym/community-recruited SSM) lifetime and past 12-month prevalence of AAS use among SSM was obtained using a generalised linear random effects model, which was reported when heterogeneity of estimates was not high. Risk of bias was assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool.

KEY FINDINGS: Nine studies met inclusion criteria. All studies were conducted in high-income countries. Overall, the pooled lifetime and past 12-month prevalences of AAS use were 13.9% (95% CI 9.2%-20.5%, 6 studies) and 8.1% (95% CI 3.9%-16.2%, 3 studies), respectively. Among the gym subgroup, the pooled lifetime and past 12-month prevalences were 15.2% (95% CI 11.6%-19.6%, I² = 72.8%, 3 studies) in the gym subgroup and 13.3% (95% CI 9.9%-17.7%, I² = 73.1%, 2 studies). The difference in lifetime prevalence between gym and community-recruited SSM was not statistically significant (p = 0.676).

CONCLUSIONS: The non-medical use of AAS among SSM is higher than general global estimates, with some evidence that use may be higher among gym users.

PMID:41392947 | DOI:10.1111/dar.70091

Ann Noninvasive Electrocardiol. 2026 Jan;31(1):e70139. doi: 10.1111/anec.70139.

ABSTRACT

BACKGROUND: Venous puncture failure during cardiac implantable electronic device (CIED) implantation is a significant procedural challenge, particularly in fasting patients. Pre-procedural intravenous normal saline (NS) infusion may enhance venous filling and improve procedural outcomes, but evidence in this setting is limited.

METHODS: We conducted a retrospective cohort study at Abbas Institute of Medical Sciences, including 2852 patients undergoing CIED implantation. Patients were divided into two groups: those who received intravenous NS infusion prior to the procedure (n = 1130) and those who did not (n = 1722). Baseline demographics, procedural details, and outcomes-including venous puncture failure, arterial puncture, site change, and acute kidney injury (AKI)-were compared.

RESULTS: The NS group demonstrated a significantly lower rate of venous puncture failure (4.6% vs. 8.9%, p < 0.001) and arterial puncture failure (1.6% vs. 2.8%, p = 0.03). AKI occurred less frequently in the NS group, although this difference was not statistically significant (1.8% vs. 2.6%, p = 0.09). Predictors of venous puncture failure included absence of NS infusion (OR 2.1, 95% CI 1.5-3.0), BMI ≥ 30, and CKD. ROC analysis demonstrated good model discrimination (AUC = 0.81).

CONCLUSION: Pre-procedural NS infusion significantly improves venous puncture success in fasting patients undergoing CIED implantation.

PMID:41392938 | DOI:10.1111/anec.70139

J Environ Sci Health A Tox Hazard Subst Environ Eng. 2025 Dec 15:1-12. doi: 10.1080/10934529.2025.2602353. Online ahead of print.

ABSTRACT

This study applies total reflection X-ray fluorescence (TXRF) to assess multielement contamination in river sediments from a small urban basin in western Paraná, Brazil. Eleven elements (Al, K, Ca, Ti, Cr, Mn, Fe, Ni, Cu, Zn and Pb) were quantified using an internal standard, and the concentration data were evaluated using Spearman correlation, principal component analysis and hierarchical cluster analysis. Cu, Zn and especially Pb reached concentrations up to 703, 349 and 344 mg kg^-1, with several values exceeding Brazilian guideline thresholds for soils impacted by anthropogenic activities. Multivariate results indicate that Ti, Cr and Fe form a predominantly lithogenic assemblage related to the basalt-derived parent material, whereas Cu and Zn define a distinct anthropogenic group associated with urban, industrial and wastewater inputs; Mn, Ni, Ca and Pb show mixed origin. The combined use of TXRF and multivariate tools thus provides a robust, resource-efficient framework for sediment monitoring, source differentiation and support of pollution control strategies in contaminated aquatic environments.

PMID:41392928 | DOI:10.1080/10934529.2025.2602353

Recent Adv Inflamm Allergy Drug Discov. 2025;19(3):374-379. doi: 10.2174/0127722708319486241202113259.

ABSTRACT

BACKGROUND: It is well known that acute or chronic kidney injury could be due to free radicals and pro-oxidants. This investigation aimed to monitor tacrolimus or cyclosporine blood trough levels and anti-oxidant capacity after kidney transplantation.

METHODS: There was no intervention in the routine management of transplant recipients. The sample size (n=70) included healthy individuals and kidney-transplanted recipients (n=25 on tacrolimus and n=10 on cyclosporine). The study population was matched for age. The attained information was examined by using the Statistical Package (SPSS Inc, Chicago, IL, USA). The significance level was considered as P ≤ 0.05.

RESULTS: In healthy individuals, the mean ± SD for the capacity of antioxidants was 91.9 ± 16.6 (u/ml), which was significantly higher when compared to the mean value of 28.5 ± 22.6 (u/ml) versus 24.7 ± 25.5 (u/ml), kidney recipients with tacrolimus versus cyclosporine (P ≤ 0.04) as immunosuppressive drugs. The mean value of tacrolimus levels was 14.6 ± 6.4 (ng/ml). The correlation between tacrolimus and cyclosporine trough levels and anti-oxidant capacity was 0.19 (P ≤ 0.14). There were no significant differences regarding age in cases and controls (P ≤ 0.42).

CONCLUSION: This study showed that the capacity of anti-oxidants in kidney transplant recipients, those on tacrolimus or cyclosporine, might be lower than in healthy individuals. Subsequent investigations are recommended to delve into the therapeutic consequences of the influence of antioxidant therapies on the clinical outcomes of transplanted recipients.

PMID:41392914 | DOI:10.2174/0127722708319486241202113259

J Reprod Infant Psychol. 2025 Dec 15:1-16. doi: 10.1080/02646838.2025.2599244. Online ahead of print.

ABSTRACT

BACKGROUND: India’s rising dependence on institutional childbirth through Caesarean sections has intensified both the health-related risks and the financial pressures experienced by women and their households. The escalating costs of Caesarean deliveries have become a significant source of out-of-pocket spending, with the burden falling most heavily on low-income families in Kerala.

OBJECTIVE: This study aims to identify the cognitive, emotional, and healthcare related predictors that influence women’s intentions to opt for elective Caesarean delivery. It seeks to understand the underlying factors that shape this preference, using the theory of planned behavior framework, which emphasizes the role of attitudes, subjective norms, and perceived behavioral control in shaping behavioral intentions.

METHODS: Using a cross-sectional design, a structured household survey was conducted among 1,030 married women in Kerala planning future pregnancies. The main outcome measured was their stated intention to opt for a Caesarean delivery in a subsequent birth. Key predictors included unmet health needs, childbirth-related knowledge, depression severity, attitudes, subjective norms, and perceived behavioral control. Binary logistic regression and propensity score matching (STATA 14.0; p < 0.05) were applied to identify statistically significant associations.

RESULTS: Greater childbirth-related knowledge significantly lowered the likelihood of intending to choose a Caesarean delivery (intermediate knowledge: OR = 0.167; good knowledge: OR = 0.297). Depression severity displayed a nonlinear relationship: moderately severe depression reduced the intention to opt for a C-section (OR = 0.140), whereas severe depression substantially increased it (OR = 4.357). The most influential predictor was unmet healthcare need (OR = 27.876), a result further supported by propensity score matching.

CONCLUSION: Women’s intentions to choose elective Caesarean delivery are strongly influenced by their level of knowledge, psychological well-being, and access to healthcare. Strategies that strengthen health literacy, bolster mental health support, and reduce healthcare barriers may help decrease unnecessary C-sections and enhance maternal health outcomes.

PMID:41392907 | DOI:10.1080/02646838.2025.2599244