Tag: pubmed

JRSM Cardiovasc Dis. 2025 May 30;14:20480040251344344. doi: 10.1177/20480040251344344. eCollection 2025 Jan-Dec.

ABSTRACT

BACKGROUND: Branch pulmonary artery flow patterns in the Fontan circulation manifest oscillations reflecting venous pressure changes. The clinical importance of variation in branch pulmonary artery flow patterns and the relationship with the single ventricle performance is not understood. We describe insights gained from simultaneous hemodynamic and phase contrast magnetic resonance using interventional CMR (iCMR) in these patients.

METHOD: Twenty-seven patients with Fontan circulation referred for iCMR were studied using phase-contrast velocity mapping. The isovolumetric relaxation period (IVRT) was assessed using standard or velocity-encoded cine imaging of the atrioventricular valve (AVV) and aortic valve. We qualitatively assessed branch pulmonary artery flows considering four patterns: IVRT flow reversal, IVRT flow reaching baseline, and normal – phasic flow or continuous flow. We further collected comprehensive left and right heart iCMR hemodynamic and flow data, including pressures, aortopulmonary collateral (APC) burden, and degree of AVV regurgitation.

RESULTS: Most patients underwent extracardiac Fontan palliation and did not have significant APC burden. Cardiac cycle analysis demonstrated that flow reversal and flow reaching baseline correlated with IVRT (v-wave timing on SVC pressure). Further analysis showed statistically significant difference in pulmonary capillary wedge pressure (PCWp) v-wave (P = .008) among the described groups. Notably, patients with IVRT flow reversal pattern had higher PCWp v-wave and most had severe AVV regurgitation.

CONCLUSION: Branch pulmonary artery IVRT flow reversal and IVRT baseline patterns in patients with Fontan circulation may represent indirect signs of single ventricle poor performance and severe AVV regurgitation.

PMID:40454231 | PMC:PMC12125515 | DOI:10.1177/20480040251344344

J Asthma Allergy. 2025 May 28;18:827-834. doi: 10.2147/JAA.S513358. eCollection 2025.

ABSTRACT

OBJECTIVE: To assess the efficacy and safety of the combination of N-acetylcysteine and acebrophylline (Combination named Abiways), in patients with moderate to severe COPD and Asthma.

MATERIALS AND METHODS: In this non-randomized, interventional, prospective, single-arm, post-marketing surveillance study, participants were administered Abiways as an add-on therapy for 90 days. The primary endpoint was Quality of Life, evaluated using the COPD Assessment Test (CAT) and Asthma Control Test (ACT) questionnaires. Secondary endpoints included mean FEV1 and FVC changes. Adverse events were recorded throughout the study.

RESULTS: 97 (of 102 subjects enrolled) completed the study (76 COPD and 21 Asthma patients, respectively; mean age 57.9 ± 8.1 years; 33 females, 64 males). Overall, FEV1 improved significantly from 1.287L to 1.484L (p < 0.001) with similar statistical improvements in COPD (1.237 L to 1.414 L; p = 001) and asthma (1.477 L to 1.747 L; p = 0.004) subpopulations. COPD patients showed statistically significant improvements in CAT scores (17.2 ± 1.0 to 10.6 ± 0.9, p = 0.0001); however, such significance was not observed in the ACT scores for asthma patients. FVC remained unchanged in all subgroups. No severe adverse events were reported.

CONCLUSION: The combination of N-acetylcysteine and acebrophylline improves QoL in moderate to severe COPD patients and FEV1 in both COPD and asthma patients with a favorable safety and tolerability profile. The combination appears safe and effective for managing obstructive airway disease.

PMID:40454226 | PMC:PMC12126983 | DOI:10.2147/JAA.S513358

Front Aging Neurosci. 2025 May 16;17:1595336. doi: 10.3389/fnagi.2025.1595336. eCollection 2025.

ABSTRACT

BACKGROUND: The patient’s somatic health status plays an important role in the factors predisposing to the development of depression. Any disease, especially a chronic one, often associated with pain, may contribute to the development of depression. The aim of the study was to assess the impact of functional capacity on the occurrence of depression among elderly cancer patients.

METHODS: The work used the diagnostic survey method and survey technique research tool consisted of standardized questionnaires: the Nurses’ Observation Scale for Geriatric Patients (NOSGER), the Barthel scale, and the Geriatric Depression Scale (GDS). The authors conducted the study among 110 older adults patients with hospitalized at the Lublin Region Oncology Center in 2022.

RESULTS: When assessing patients using the NOSGER scale, the average result for the entire group was 45.98 ± 12.58 points. The examined people functioned best in terms of memory – average of 5.99 ± 1.32 points. The worst functioning was in the instrumental activities of everyday life – average 9.16 ± 3.61 points. In the assessment of the functional status using the Barthel scale, 54.54% of the respondents were classified as light. Based on the assessment of patients using the GDS scale, it was found that as many as 66.36% of the respondents did not experience symptoms of depression. The regression model showed that the NOSGER scale was a statistically significant variable explaining the geriatric depression scale score in the study group (p < 0.001).

CONCLUSION: Most respondents were fully functional. The surveyed seniors suffering from cancer had the greatest difficulties in the areas of moods and emotions as well as instrumental activities of everyday life. The occurrence of depression symptoms was found in over 30.00% of respondents. It is advisable to use research tools that take into account a wider range of aspects when assessing the impact of functional capacity on the possibility of depression among geriatric patients with cancer.

PMID:40454204 | PMC:PMC12122436 | DOI:10.3389/fnagi.2025.1595336

J Travel Res. 2025 Jul;64(6):1449-1463. doi: 10.1177/00472875241253009. Epub 2024 May 31.

ABSTRACT

Practical measures to entice tourists to behave in environmentally sustainable ways are urgently needed. The effectiveness of such measures is typically tested in survey experiments. This study demonstrates that this approach can be misleading. We test two messages aimed at reducing buffet food waste. One builds on established theories of human behavior (theory of planned behavior, value-belief-norm theory); it assumes that changing beliefs by providing information triggers behavior change. The second message builds on hedonic psychology; it attempts to change behavior through humor, presenting the pro-environmental behavior as enjoyable. In the survey experiment, the belief-based message significantly increases intentions to reduce plate waste; but both messages fail to change behavior in a real hotel. These insights have methodological and practical implications: the effectiveness of new practical measures developed to trigger specific tourist behaviors must be tested in the field before reliable managerial recommendations can be derived.

PMID:40454195 | PMC:PMC12121902 | DOI:10.1177/00472875241253009

J Diabetes Metab Disord. 2025 May 30;24(1):131. doi: 10.1007/s40200-025-01605-9. eCollection 2025 Jun.

ABSTRACT

OBJECTIVES: Trimethylamine N-oxide (TMAO) is related to the pathogenesis of Metabolic dysfunction-associated fatty liver disease (NAFLD). However, the molecular mechanism of how TMAO causes MAFLD development is still unclear. The present study attempted to investigate whether TMAO contributes to MAFLD development through HULC in a cellular model of MAFLD.

METHODS: HepG2 cells were cultured and induced in a fatty liver cell model. HULC knockdown was induced using the CRISPR/Cas13 system. Fatty liver cells were exposed to TMAO concentrations (75µM and 300µM) before and after HULC knockdown. RT-qPCR was used to evaluate the expression of the target genes. Apoptosis was assessed using Annexin V-FITC and PI staining. Statistical analyses included ANOVA and post-hoc tests.

RESULTS: TMAO upregulated the expression of HULC, followed by P38MAPK overexpression (P value < 0.05). Upon HULC knockdown, TMAO could not change P3MAPK expression and its downstream targets, including TNFα, IL-6, and PNPPLA3 in fatty liver cells. Additionally, TMAO significantly induced apoptosis in the fatty acid cellular model (P value < 0.05).

CONCLUSION: In conclusion, the results of this study provide evidence of the TMAO/HULC/P38MAPK axis involvement in the pathogenesis of MAFLD by increasing the expression of genes involved in inflammation and fibrosis. Our data suggests that TMAO reduction could be a therapeutic target in MAFLD through gut microbiome modulation.

PMID:40454183 | PMC:PMC12125414 | DOI:10.1007/s40200-025-01605-9

Stat Biosci. 2025;17(2):528-554. doi: 10.1007/s12561-024-09429-6. Epub 2024 May 9.

ABSTRACT

Nearly 15% (37 million) of adults in the United States (US) have chronic kidney disease (CKD). The longitudinal decline of kidney function is intricately related to the development of cardiovascular disease (CVD) and eventual “terminal” event (kidney failure and mortality) in patients with CKD. Understanding the mechanism and risk factors underlying the three key outcome processes, (1) CKD progression, (2) CVD, and (3) subsequent terminal event in the CKD patient population remains incomplete. Thus, in this work, we develop a novel trivariate joint model to study the risk factors associated with the interdependent outcomes of kidney function (as measured by longitudinal estimated glomerular filtration rate), recurrent cardiovascular events, and the terminal event. Efficient estimation and inference is proposed within a Bayesian framework using Markov Chain Monte Carlo and Bayesian P-splines for hazard functions. The proposed Bayesian framework is directly generalizable beyond trivariate outcome processes to accommodate other potential modeling of complex multi-disease processes. The method is applied to study the aforementioned trivariate processes using data from the Chronic Renal Insufficiency Cohort Study, an ongoing prospective cohort study, established by the National Institute of Diabetes and Digestive and Kidney Diseases to address the rising epidemic of CKD in the US.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12561-024-09429-6.

PMID:40454178 | PMC:PMC12122633 | DOI:10.1007/s12561-024-09429-6

Curr Dev Nutr. 2024 Aug 30;9(Suppl 1):104452. doi: 10.1016/j.cdnut.2024.104452. eCollection 2025 Feb.

ABSTRACT

BACKGROUND: Recall bias or memory error is a known limitation of recall-based dietary assessment methods and can lead to substantial misrepresentation of diets. Pictorial recall aids have been used by various studies to mitigate recall bias, but their effect on quantitative, 4-pass 24-h dietary recall (24HR) results has not yet been measured.

OBJECTIVES: This article examines uptake of pictorial recall aids among caregivers of young children in Kathmandu Valley, Nepal, and Guédiawaye Department, Senegal; describes what foods/beverages are subject to recall bias in these contexts; and assesses the effect of these recall aids on estimated dietary outcomes.

METHODS: We used cross-sectional data from 24HR surveys that provided a recall aid to reduce caregiver recall bias. Young children’s dietary outcomes were calculated from the 24HR data. Logistic regressions were used to compare characteristics and estimated dietary outcomes of children by recall aid uptake. McNemar’s test and paired t-tests were used to compare estimated dietary outcomes in initial 24HR data with revised 24HR data that incorporated omitted items identified by the recall aid.

RESULTS: Pictorial recall aids had relatively high uptake by caregivers in both contexts. Beverages, unhealthy snacks, and fruit were most subject to recall bias. Adding omitted items identified by recall aids resulted in statistically significant changes in most dietary outcomes assessed. Children of caregivers who chose to use the recall aid had significantly different estimated dietary outcomes than children of caregivers who did not use the recall aid.

CONCLUSIONS: The use of pictorial recall aids modifies 24HR results in these 2 contexts. Rigorous research is needed to fully understand the impact of recall aids on 24HR methodology and results, with an aim to improve the accuracy of dietary assessment and ultimately inform evidence-based nutrition programming, policy, and recommendations.

PMID:40454165 | PMC:PMC12125692 | DOI:10.1016/j.cdnut.2024.104452

Trials. 2025 Jun 1;26(1):183. doi: 10.1186/s13063-025-08870-2.

ABSTRACT

BACKGROUND: Intraoperative blood loss (IBL) is the major concern in hepatectomy, which was closely relating to the central venous pressure (CVP). The controlled low central venous pressure (CLCVP) technique is moderately required for minimizing hemorrhage during hepatectomy nowadays. Nevertheless, an excessive reduction in CVP might give rise to the jeopardy of inadequate perfusion of vital organs. Sildenafil, being a first-line pharmaceutical for treating pulmonary hypertension, its mechanism of action lies in diminishing pulmonary vascular resistance (PVR) by dilating pulmonary arteries, and thereby alleviating the afterload of the right ventricle. We initially postulate that administration of sildenafil citrate in combination with intermittent Pringle’s maneuver (IPM) can exert a notable impact in efficaciously reducing intraoperative blood loss (IBL), enhancing the surgical field of vision, and augmenting the safety of the operation.

METHODS: This research constitutes a double-blind, randomized, controlled trial. All patients fulfilling the criteria for open or laparoscopic hepatectomy will be randomly allocated to the sildenafil (S) group and the placebo (C) group via the block randomization approach. All surgeons, anesthesiologists, and outcome assessors will remain oblivious to the patient’s group details. The primary outcome is the intraoperative blood loss (IBL). Secondary outcomes include the classification of the surgical field, the cumulative consumption of nitroglycerine, hemodynamic parameters, blood gas analysis, coagulation function (comprising thromboelastogram (TEG), activated partial thromboplastin time (APTT), and prothrombin time (PT)), intraoperative urine output, adverse events in the recovery room (hypotension, hypoxemia and hematuria), biochemical markers (total bilirubin, total albumin, alanine aminotransferase, aspartate aminotransferase, creatinine, urea nitrogen), complete blood count (Hb, Plt, and Hct), cardiac function (brain natriuretic peptide, creatine kinase isoenzyme, troponin), postoperative hospital stay and indwelling time of drainage tube, and postoperative complications. These parameters will be comprehensively compared and analyzed in-depth through appropriate statistical means.

DISCUSSION: This trial evaluated the influence of administration of sildenafil citrate combined with IPM on IBL and surgical results during open or laparoscopic hepatectomy, as well as its safety and feasibility. It is expected to provide an innovative management optimization plan for reducing the bleeding in hepatectomy, and to provide empirical support for the potential value of sildenafil citrate or sildenafil-like drugs in improving the safety and quality of perioperative hepatectomy patients.

TRIAL REGISTRATION: This trial was registered on June 25, 2024, in the US Clinical Trials Registry ( https://register.

CLINICALTRIALS: gov ), with the ClinicalTrial.gov Identifier: NCT06237751. The protocol version is V1.0 (20,231,114).

PMID:40450350 | DOI:10.1186/s13063-025-08870-2

Reprod Health. 2025 May 31;22(1):94. doi: 10.1186/s12978-025-02047-5.

ABSTRACT

BACKGROUND: Research training in Sub-Saharan Africa is crucial for strengthening the capacity of healthcare professionals and researchers to address specific sexual and reproductive health (SRH) challenges within their communities. Interventions that enhance research capacity and foster a culture of innovation within existing structures offer a practical and economical strategy capable of addressing national and sub-national SRH needs. This study evaluated an intervention to enhance reproductive health research skills to assess research competence changes among participants.

METHODS: A pre-post intervention design was employed. Pre- and post-program assessments were conducted using the Clinical Research Appraisal Inventory (CRAI)-12 scale to establish baseline and endline levels of research competence. Descriptive statistics, chi-squared and Kruskal Wallis tests were used to analyze data. Our data interpretation is guided by the Social Cognitive Career Theory.

RESULTS: Faculty members and clinicians from Uganda and Rwanda completed the intervention and 84 had complete baseline while 77 had complete endline data. Analyses revealed significant improvements in nearly every item on the CRAI-12 scale after the research training program, including increased Self-Efficacy in Designing and Collecting Data (Factor 1); Reporting, Interpreting and Presenting (Factor 2); Conceptualizing and Collaborating (Factor 3); Setting Expectations for Research Staff (part of Factor 4); Describing the Funding Process (Part of Factor 5); and Protecting Study Participants (Factor 6) (all p = < 0.05). The only items that did not improve significantly were Confidence in Asking Staff to Leave the Project Team when Necessary (part of Factor 4) and Locating the Appropriate Grant Application Forms (part of Factor 5).We proposed a conceptual framework outlining the hypothesized pathways through which training and skill development influence research-related career planning and progression.

CONCLUSIONS: The research training intervention effectively improved participants’ research competence. These findings underscore the importance of structured research training programs in enhancing research skills. Future research should focus on longitudinal assessments to explore sustained changes and the enduring impact of self-efficacy, outcome expectations (anticipations about career-related consequences), and research-related career goals on career planning and skill development.

PMID:40450342 | DOI:10.1186/s12978-025-02047-5

Radiat Oncol. 2025 May 31;20(1):91. doi: 10.1186/s13014-025-02659-y.

ABSTRACT

PURPOSE: Breast cancer patients may use a bolus to increase the dose to skin in radiotherapy after radical mastectomy. The 3D printed bolus (3DPB) specifically customized based on individual conditions offers better conformity. This study aims to provide clinical insights by evaluating the dosimetric benefits and safety of 3DPB in radiotherapy following radical mastectomy for breast cancer.

MATERIALS AND METHODS: The study included breast cancer patients who received post-mastectomy radiotherapy with 3DPB. Researchers retrospectively collected dose data from patients’ radiotherapy plans, including with and without 3DPB, and prospectively observed the acute and late side effects in the cohort of patients undergoing mixed plan radiotherapy. To compare the dosimetric differences between radiotherapy plans with and without 3DPB, such as the dose distribution data of CTV, PTV, and organs at risk, matched sample T-test was used for data conforming to normal distribution, and non-parametric test was used for data not conforming to normal distribution. P < 0.05 was considered statistically significant.

RESULTS: A total of 35 patients were included with a median follow-up time of 16 months. In terms of radiotherapy side-effects, no level 4 acute side-effects occurred. A total of 82.2% of the patients had no obvious side-effects. No late radiotherapy side-effects of level 2 or higher occurred. In terms of dosage, radiotherapy plans with 3DPB showed better conformance (P < 0.001) and dose homogeneity (P < 0.001) than plans without 3DPB. The results indicated that the V95% dose of CTV1, CTV2, P-CTV, P-CTV1, and P-CTV2 was higher in the plans with 3DPB than in those without 3DPB (all P < 0.001).

CONCLUSIONS: The use of 3DPB in breast cancer radiotherapy is effective, achieving higher and more uniform dose distribution and better target conformity compared to without 3DPB. Additionally, it is associated with a low incidence of acute and late side effects.

PMID:40450338 | DOI:10.1186/s13014-025-02659-y