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A 2D Microfluidic Paper-Based Analytical Device for Diagnosis of Canine Visceral Leishmaniasis via Mass Spectrometry-Based Immunoassay

Anal Chem. 2025 Mar 24. doi: 10.1021/acs.analchem.4c05962. Online ahead of print.

ABSTRACT

This work presents the first indirect immunoassay performed on a paper-based microfluidic platform for the diagnosis of canine visceral leishmaniasis (CVL). The IgG antibody biomarker, which signifies the presence of this infectious disease, was captured with a recombinant K39 antigen and detected with secondary antibodies that were conjugated with cleavable ionic probes. The use of ionic probes enabled direct analysis of the assay results through an on-chip paper spray mass spectrometry (MS) technology. This MS-based immunoassay was developed to allow for early detection of CVL in asymptomatic dogs. The sensitivity required for such a diagnostic method was demonstrated through internal standard calibration in which sample dilution as low as 1/4000 was achieved. Aside from high sensitivity, the ionic probes are stable, which allowed the paper device to be stored at room temperature and under ambient conditions for 30 days without affecting the diagnostic outcome. Our method was used to analyze 20 clinical canine serum samples, where we detected a 2 orders of magnitude higher signal for CVL-positive samples compared to negative samples. MS signal derived from the 10 CVL-positive serum clinical samples showed a strong correlation with antibody titers determined by immunofluorescence assay. This correlation was confirmed through Pearson’s statistical analysis. Overall, the high sensitivity and positive results from stability tests observed for our platform are expected to enable large-scale CVL screening in asymptomatic dogs in remote areas, especially when combined with portable mass spectrometers.

PMID:40128119 | DOI:10.1021/acs.analchem.4c05962

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Comparative analysis of demographic, clinical, biochemical, and predictors of mortality in COVID-19 and NON-COVID-19 ARDS patients: A retrospective cohort study

Medicine (Baltimore). 2025 Mar 21;104(12):e41851. doi: 10.1097/MD.0000000000041851.

ABSTRACT

The COVID-19 pandemic has brought a significant increase in the incidence of acute respiratory distress syndrome (ARDS). This retrospective study aims to compare the differences in demographic, clinical, and biochemical variables and predictive factors in 2 situations of ARDS cause (COVID-19 vs NON-COVID-19) in patients admitted to the intensive care unit. The Mann-Whitney rank-sum test was performed for quantitative variables, and Fisher exact test for qualitative variables. 115 patients with ARDS were enrolled (53 patients with COVID-19 ARDS and 62 NON-COVID-19 ARDS). The COVID-19 ARDS group consisted of 33 male patients (66.2%), whereas the NON-COVID-19 ARDS group had 25 male patients (40.3%) (P = .0248). The median and interquartile age difference of the COVID-19 ARDS group was 64.0 [52.0-69.5], and non-COVID-19 ARDS was 49.0 [34.0-63.0] (P = .0011). Body mass index, simplified acute physiology score, sequential organ failure assessment, and intensive care unit length of stay, with P-values of .0061, .0002, .0003, and <.0001, respectively (COVID-19 vs NON-COVID-19 ARDS). Diabetes, arterial hypertension, venous thrombosis, and chronic obstructive pulmonary disease had values of <.0001, .0234, .0358, and .0001, respectively. On the other hand, the NON-COVID-19 ARDS group had a greater need for dialysis (P = .0109). The stepwise logistic regression showed that relevant clinical, and demographic characteristics associated with ARDS due to COVID-19, such as male gender, diabetes, chronic obstructive pulmonary disease, and body mass index, were independent prognostic factors of severity in patients with COVID-19 ARDS, compared to NON-COVID-19 ARDS. The overall mortality rate was 62.9% for COVID-19 ARDS and 77.4% for the non-COVID-19 ARDS group (P = .2950). Ventilatory parameters of COVID-19 ARDS and NON-COVID-19 ARDS were similar.

PMID:40128087 | DOI:10.1097/MD.0000000000041851

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CYP2B6 genetic variation in cyclophosphamide metabolism and hemorrhagic cystitis in Fanconi anemia patients undergoing allogeneic hematopoietic cell transplantation: A descriptive genetic association study

Medicine (Baltimore). 2025 Mar 21;104(12):e41937. doi: 10.1097/MD.0000000000041937.

ABSTRACT

Fanconi anemia (FA) is an inherited disorder characterized by congenital malformations, bone marrow failure, and malignancies. Hematopoietic cell transplant (HCT) is the only proven cure for the hematological complications. FA patients have increased chromosomal instability and aberrant deoxyribonucleic acid repair and thus can only tolerate low doses of chemotherapy or radiation as part of conditioning prior to HCT. Yet, they are still prone to severe regimen related toxicities including hemorrhagic cystitis (HC) from cyclophosphamide (CY). As CYP2B6 is a primary enzyme responsible for the catalyzation of the prodrug form of CY, understanding the association between CYP2B6 genetic variants and HC in FA patients may predict which patients will be more susceptible to developing HC. A descriptive genetic association study was performed to identify genetic variants associated with HC in patients with FA who underwent HCT between 1999 and 2017. All patients received a CY-based preparative regimen and had pretransplant recipient deoxyribonucleic acid available for genomic analysis. Forty FA pediatric patients were eligible for this analysis. They had received HCT from matched sibling donors (n = 6) or alternative donors (n = 34) for marrow failure (n = 38) or myelodysplastic syndrome (n = 2). The incidence of HC was 32.5% which occurred at a median of 32 days (range 20-180) after HCT. 9 patients had a concomitant viral infection (BK virus, n = 8 both adenovirus and BK virus, n = 1). No genetic variants were significantly associated with HC. The top variants were rs2279343 (g.23060A > G), and rs2279344 (g.23280G > A) in the CYP2B6 gene. The incidence of HC among FA patients with the rs2279343 variant was 42% (CI 22%-62%) compared to 20% (CI 0%-40%) among those without the variant (P = .19). The incidence of HC among patients with the variant in rs2279344 was 40% (CI 22%-58%) compared to 10% (CI 0%-28%) among those without (P = .11). No variants in our analysis were statistically associated with HC. The data suggest that CYP2B6 variants may increase the risk for HC in FA patients who received a CY based preparative therapy but these risk variants must be further evaluated in a larger population.

PMID:40128086 | DOI:10.1097/MD.0000000000041937

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Comparison of vitamin B levels in febrile children with and without febrile seizures: A prospective single-center study

Medicine (Baltimore). 2025 Mar 21;104(12):e41891. doi: 10.1097/MD.0000000000041891.

ABSTRACT

Febrile seizures (FS) are among the most common neurological disorders in childhood, and their pathogenesis may be influenced by multiple factors. As scientific research progresses, the significant role of B vitamins in the nervous system has become progressively clearer. In this study, children clinically diagnosed with FS were selected as the experimental group, and febrile children without a history of convulsions or a family history of seizures were selected as the control group to investigate the potential correlation between FS and whole-blood B vitamin levels. The concentrations of B vitamins in whole blood were measured using liquid chromatography-mass spectrometry, and statistical analyses were conducted using SPSS 25.0, followed by significance testing. The levels of vitamins B1, B2, B5, B6, B7, and B12 in the experimental group were significantly higher than those in the control group, particularly vitamins B5 and B7 (P < .05). Additionally, statistically significant differences were observed between sodium and calcium ion levels. These results suggest that febrile convulsions are the complex outcome of multiple factors, including known ion channel defects. Vitamin B may play a role in febrile convulsions and warrants further investigation.

PMID:40128085 | DOI:10.1097/MD.0000000000041891

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Time trends in disability-adjusted life years for cataracts attributable to indoor air pollution across 17 low- and middle-income countries

Medicine (Baltimore). 2025 Mar 21;104(12):e41914. doi: 10.1097/MD.0000000000041914.

ABSTRACT

Indoor air pollution (IAP) is a risk factor leading to cataracts. The disease burden of cataracts due to IAP is currently greater in low- and middle-income countries, an in-depth analysis is necessary to track the current time trend of cataracts caused by IAP in low- and middle-income countries. Our data from the global burden of disease 2021 study. In our study, disability-adjusted life years (DALYs) and DALYs rate were used to assess the disease burden of cataracts due to IAP across 17 low- and middle-income countries. The contribution of IAP exposure to the associated burden of cataracts was quantified by using population attribution fractions. Additionally, the estimated annual percentage change was calculated to quantify the long-term trend in the burden of cataracts due to IAP from 1990 to 2021. An age-period-cohort model was used to estimate the effects of age, period, and cohort on time trend of disease burden. In 2021, age-standardized DALY rates (ASDR) values varied widely across the 17 countries. Pakistan had the highest ASDR 122.5 (-35.3 to 247.4). ASDR declined in all 17 countries. For all countries, the age effect increases rapidly after about age 55. South Africa, Brazil, and Mexico have made great progress in the period and cohort effects. The situation of burden for IAP-related cataracts varies across countries, and it is necessary to set targeted public health strategies and interventions.

PMID:40128084 | DOI:10.1097/MD.0000000000041914

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The 100 most cited articles in androgenetic alopecia: A bibliometric analysis

Medicine (Baltimore). 2025 Mar 21;104(12):e41881. doi: 10.1097/MD.0000000000041881.

ABSTRACT

Androgenetic alopecia (AGA) is a condition with a rapidly evolving research landscape. The expanding volume of AGA research necessitates synthesis to identify trends and gaps. Bibliometric analysis can be used to quantify the characteristics of a body of literature, and this technique has not been previously applied to AGA. We aimed to evaluate the bibliometric characteristics of the top 100 most cited AGA articles over the past 50 years. This includes the analysis of contributing authorship, institutional affiliation, journal representation, publication years, citation counts, country productivity, and funding sources, among other characteristics. We used the Web of Science to identify and characterize the 100 most cited AGA publications between 1975 and 2024. A secondary analysis was performed to identify and characterize the top 20 most cited AGA articles from 2020 to 2024. The top 100 articles amassed 24,289 citations. Authors from the United States contributed the most articles (n = 56). The University of Pennsylvania contributed the most articles (n = 11). Dr Elise A Olsen and Dr George Cotsarelis were the most frequent contributors. The Journal of the American Academy of Dermatology published the most number of articles. From 1975 to 2024, most studies primarily discussed pathophysiology (45%) and treatment (35%). However, from 2020 to 2024, 75% of the top articles focused on the treatment options. This bibliometric analysis provides an overview of influential AGA research over the last 50 years, highlighting shifting trends toward treatment optimization and emerging therapies.

PMID:40128083 | DOI:10.1097/MD.0000000000041881

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Impact of FMEA-based nursing intervention combined with early rehabilitation training on the prognosis of mechanically ventilated patients in cardiac intensive care units

Medicine (Baltimore). 2025 Mar 21;104(12):e41735. doi: 10.1097/MD.0000000000041735.

ABSTRACT

This study aimed to assess the effects of failure mode and effect analysis (FMEA)-based nursing intervention combined with early rehabilitation training on the outcomes of mechanically ventilated patients in the cardiac intensive care unit (CICU). A retrospective cohort design included 100 patients who underwent tracheal intubation and mechanical ventilation in the CICU from January 2023 to June 2024. The observation group (n = 50) received FMEA-based nursing intervention alongside early rehabilitation training, while the control group (n = 50) received standard nursing care with early rehabilitation training. Results demonstrated that the observation group had significantly better muscle strength levels, lower incidence of ICU-acquired weakness, fewer tracheal intubation-related complications, shorter durations of mechanical ventilation, and reduced hospital stays compared to the control group (P < .05). Additionally, nursing satisfaction was significantly higher in the observation group (P = .027). In conclusion, the combination of FMEA-based nursing intervention and early rehabilitation training notably improves the prognosis of mechanically ventilated patients in the CICU, minimizes complications, and enhances patient satisfaction with nursing care.

PMID:40128075 | DOI:10.1097/MD.0000000000041735

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Analysis of the current status and influencing factors of LEDVT in patients with acute hemorrhagic stroke

Medicine (Baltimore). 2025 Mar 21;104(12):e41759. doi: 10.1097/MD.0000000000041759.

ABSTRACT

Lower extremity deep venous thrombosis (LEDVT) is a common complication in patients with acute hemorrhagic stroke, leading to increased risk of pulmonary embolism, disability, and mortality. Despite its importance, LEDVT often goes undetected in clinical practice, and early preventive strategies remain insufficient. This study aimed to explore the incidence of LEDVT in acute hemorrhagic stroke patients, identify key risk factors, and discuss potential preventive measures to reduce its occurrence and improve patient outcomes. A retrospective analysis was conducted on 431 acute hemorrhagic stroke patients admitted to The First Affiliated Hospital of Chengdu Medical College between January 2022 and December 2023. Relevant clinical data, including patient demographics, comorbidities, NIHSS score, and treatment history, were collected. LEDVT was diagnosed using standardized ultrasound criteria. Statistical analyses, including univariate and multivariate logistic regression, were performed using SPSS 17.0 to identify independent risk factors associated with LEDVT. The incidence of LEDVT among the 431 acute hemorrhagic stroke patients was 12.1%, with 52 cases identified. Significant risk factors for LEDVT included advanced age, diabetes, infection, prolonged bed rest, high-dose diuretic use, NIHSS score ≥16, and hyperlipidemia (P < .05). Gender, smoking history, and alcohol consumption were not found to be statistically significant. Multivariate logistic regression revealed that advanced age, diabetes, infection, prolonged bed rest, high-dose diuretic use, NIHSS score ≥16, and hyperlipidemia were independent risk factors for LEDVT. LEDVT in acute hemorrhagic stroke patients is influenced by multiple factors, including comorbidities, severity of neurological impairment, and treatment regimens. Dehydration therapy used for managing brain edema and intracranial pressure was also found to be an independent risk factor. Given the significant impact of LEDVT on patient prognosis, early identification of at-risk patients and the implementation of proactive preventive measures-such as pharmacological treatments and physical interventions-are critical in reducing the occurrence of LEDVT, alleviating patient suffering, and improving long-term outcomes. Future studies should focus on refining preventive strategies and exploring more individualized interventions to further reduce the incidence of LEDVT in these patients.

PMID:40128074 | DOI:10.1097/MD.0000000000041759

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Exploring the benefits of traditional Chinese exercises (Tai Chi and Qigong) on the anxiety and depression of older adults: A systematic review and meta-analysis

Medicine (Baltimore). 2025 Mar 21;104(12):e41908. doi: 10.1097/MD.0000000000041908.

ABSTRACT

BACKGROUND: Research shows that traditional Chinese exercises (TCEs) significantly improve anxiety and depression in older adults. However, studies on the effects of different exercise durations, frequencies, and intensities in this population are limited. This systematic review and meta-analysis evaluate the impact of TCEs on anxiety and depression, and explores the optimal exercise parameters, aiming to provide evidence for nonpharmacological treatment options in clinical practice.

METHODS: As of August 2023, we conducted a literature search through 3 English electronic databases to identify relevant studies. We included studies that met our criteria. During the literature inclusion process, we used Review Manager 5.4 to create flow diagrams, assess the risk of bias, and perform statistical analyses.

RESULTS: A total of 31 eligible studies involving 2501 participants were included. Compared with the control group, TCEs showed significant improvements in anxiety (standardized mean differences [SMD] = -0.93, 95% confidence interval [CI]: -1.78 to -0.08, P = .03, I2 = 96%) and depression (SMD = -1.14, 95% CI: -1.82 to -0.47, P = .03, I2 = 96%). Subgroup analyses indicated that an intervention duration of 12 to 16 weeks yielded the largest effect size for anxiety (SMD = -1.36, 95% CI: -2.36 to -0.36, P = .008), while the 24-week group showed the largest effect size for depression (SMD = -0.87, 95% CI: -1.43 to -0.30, P = .002). For intervention frequency, a regimen of 3 to 4 times per week produced the largest effect size for anxiety (SMD = -2.34, 95% CI: -4.69 to 0.02, P = .05), whereas a frequency of 5 to 7 times per week demonstrated the largest effect size for depression (SMD = -1.00, 95% CI: -1.83 to -0.17, P = .02). Regarding single-session exercise duration, a group exercising for 40 to 60 minutes showed the largest effect sizes for anxiety (SMD = -1.38, 95% CI: -2.40 to -0.37, P = .007) and depression (SMD = -0.75, 95% CI: -1.07 to -0.42, P < .00001).

CONCLUSION: The results indicate that TCEs significantly alleviate anxiety and depression in older adults, with intervention frequency, intensity, and duration potentially influencing the outcomes. However, heterogeneity across studies was observed, primarily due to differences in intervention types and control group designs. These findings offer valuable guidance for future research directions.

PMID:40128068 | DOI:10.1097/MD.0000000000041908

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Anatomic characteristics of the vertebrobasilar artery: A three-dimensional reconstruction study based on computed tomography angiography

Medicine (Baltimore). 2025 Mar 21;104(12):e41931. doi: 10.1097/MD.0000000000041931.

ABSTRACT

The vertebrobasilar artery (VBA) exhibits substantial inter-individual variation that must be considered in diagnosis and surgical planning. We conducted 3-dimensional reconstruction of the bilateral VBA based on head and neck computed tomography angiography (CTA) to assess bilateral, individual, age-dependent, and sex-dependent differences in anatomical parameters. A retrospective study was performed. Individual 3-dimensional models of the VBA and skull were constructed and morphology evaluated based on head and neck CTA data from 199 adults. According to morphological and anatomical variation, the VBA was divided into 3 types: balanced, L, and S. The diameters and lengths of basilar and bilateral vertebral artery (VA) intracranial segments as well as VBA blending length, and bilateral distances of the vertebral arteries moving up the atlas were measured and statistically compared. The L-type was the most common VBA morphology, and anatomic type distribution differed significantly by age (P < .05). VA diameter was 3.34 ± 0.68 mm on the left side and 3.09 ± 0.71 mm on the right side, while bending length was 5.62 ± 3.35 mm on the left and 4.94 ± 3.41 mm on the right side. Balanced basilar arteries measured 3.41 ± 0.61 mm in diameter, 2.83 ± 0.33 cm in length, and 2.55 ± 2.45 mm in bending length. The L-type basilar artery measured 3.48 ± 0.71 mm in diameter, 3.06 ± 0.44 cm in length, and 2.78 ± 0.37 mm in bending length. Finally, S-type basilar arteries measured 3.84 ± 0.86 mm in diameter, 3.38 ± 0.61 cm in length, and 3.67 ± 4.39 mm in bending length. The distance traveled by the VA across the atlas differed significantly between left and right sides as well as between males and females (P < .05). The vertebrobasilar arteries in the general healthy population were successfully fused and 3-dimensionally reconstructed based on the CTA, and an observational study was conducted on their morphological and anatomical characteristics. Three-dimensional reconstruction of the VBA using CTA is feasible for anatomical research and also has diagnostic value for the variations and anatomical parameters of the VBA.

PMID:40128065 | DOI:10.1097/MD.0000000000041931