Tag: pubmed

ESC Heart Fail. 2025 Aug 11. doi: 10.1002/ehf2.15390. Online ahead of print.

ABSTRACT

BACKGROUND: Nutritional status is a critical determinant of clinical outcomes in patients with chronic heart failure (CHF), potentially contributing to adverse prognosis and suboptimal therapeutic response. Despite growing interest, the interplay between malnutrition and frailty syndrome (FS) in the CHF population remains inadequately elucidated.

AIMS: The study aims to evaluate the association between malnutrition risk and the presence of FS in individuals hospitalized with CHF.

METHODS: A total of 200 patients (mean age: 72.28 years) hospitalized due to CHF were enrolled. Data collection included retrospective analysis of medical records and application of validated instruments: the Mini Nutritional Assessment (MNA) for nutritional evaluation and the Fried phenotype criteria for frailty assessment.

RESULTS: Based on MNA, 63.5% of participants demonstrated normal nutritional status, 35.0% were at risk of malnutrition and 1.5% were malnourished (mean MNA score: 24.25). According to the Fried phenotype, 35% were classified as pre-frail and 65% as frail (mean frailty score: 2.67). A statistically significant association was identified between MNA score and frailty status (P < 0.05), with the highest prevalence of frailty observed in malnourished individuals (P = 0.002). No significant correlations were found between frailty and anthropometric parameters such as calf circumference (P = 0.17), arm circumference (P = 0.687) or body mass index (BMI) (P = 0.643).

CONCLUSIONS: These findings highlight the clinical importance of routine, comprehensive nutritional screening in patients with CHF. Early identification and management of malnutrition may play a pivotal role in mitigating frailty and enhancing clinical outcomes in this high-risk population.

PMID:40785522 | DOI:10.1002/ehf2.15390

Nanoscale Horiz. 2025 Aug 11. doi: 10.1039/d5nh00021a. Online ahead of print.

ABSTRACT

The effects of quantum confinement on the energy-related properties of nanoscale materials and structures are critical for understanding their electronic, optical, and thermal behaviors. This study investigates these effects through a finite-size statistical mechanics framework, integrating theoretical analysis with experimental validation. By examining key material systems, this work provides insights into the mechanisms governing energy-related behaviors at the nanoscale, with implications for advanced applications in energy storage, conversion, and photonics.

PMID:40785520 | DOI:10.1039/d5nh00021a

J Glob Health. 2025 Aug 11;15:04232. doi: 10.7189/jogh.15.04232.

ABSTRACT

BACKGROUND: Interventions using mobile phones, otherwise known as mHealth interventions, are increasingly being used in low- and middle-income countries to remind families about scheduled child immunisations. Despite this, few studies examined impact on zero-dose children – those who failed to receive a single dose of a routine vaccine. As disparities in mobile phone ownership may limit the effectiveness of mHealth interventions, we assessed associations between mobile phone ownership, gender, wealth, residence, and zero-dose and modelled their potential impact for reaching unvaccinated children.

METHODS: We analysed 70 nationally representative surveys with data on immunisations and mobile phone ownership by households and mothers, and correlated ownership with household wealth and place of residence. We performed analyses at the individual child level and pooled across all countries weighted by national populations. We modelled the mHealth interventions’ potential impact on zero-dose prevalence by estimating how many unvaccinated children are reachable via mobile phones.

RESULTS: The surveys included 163 527 children aged 12-23 months, with 13.4% being zero-dose. Among them, 34% of mothers and 73% of households had a mobile phone, compared to 60% and 89% for vaccinated children. Mobile phone ownership by mothers ranged from 32% in the poorest to 86% in the wealthiest quintile. A hypothetical 100% effective intervention using household mobile phones would reduce zero-dose prevalence from 13% to 4%, while one using similar effectiveness assumptions for mothers’ phones would reduce national prevalence to 10%. Interventions with effectiveness ranging from 10% to 50% would lead to smaller impact levels. The largest impact is expected in countries like Guinea and Cote d’Ivoire, where both zero-dose prevalence and mobile phone ownership are high.

CONCLUSIONS: The potential impact of mHealth interventions for reaching zero-dose children may be limited by mobile phone ownership among mothers and families, particularly among the poor, where we find the greatest number of unvaccinated children.

PMID:40785513 | DOI:10.7189/jogh.15.04232

Cancer Sci. 2025 Aug 11. doi: 10.1111/cas.70170. Online ahead of print.

ABSTRACT

Although mTOR signaling plays a key role in acute myeloid leukemia (AML), mTOR inhibitors have shown limited efficacy against AML in clinical trials. In this study, we found that the anti-leukemic effect of mTOR inhibition was mediated in part through the TP53 pathway. mTOR inhibition by rapamycin and TP53 activation by DS-5272 collaboratively induced the downregulation of MYC and MCL1 partly through miR-34a, thereby inducing cell cycle arrest and apoptosis in AML cells. Joint non-negative matrix factorization (JNMF) and statistical regression analysis using public AML databases revealed that monocytic AMLs with distinctive gene expression profiles were highly sensitive to mTOR inhibition, leading to the generation of an 11-gene score (Rapa-11) to predict the rapamycin sensitivity of each monocytic AML. Consistent with our in silico prediction, mouse AML cells expressing MLL-AF9, the monocytic AML with a low Rapa-11 score, were highly sensitive to rapamycin, whereas those expressing RUNX1-ETO or SETBP1/ASXL1 mutations were not. Co-treatment with rapamycin and DS-5272 had a dramatic in vivo effect on MLL-AF9-driven AML, curing 85% of the leukemic mice. Thus, machine learning-based predictive approaches identified monocytic AML with wild-type TP53 and low Rapa-11 score as a rapamycin-sensitive AML subtype and an ideal target for mTOR/p53 co-targeting therapy.

PMID:40785506 | DOI:10.1111/cas.70170

Technol Cancer Res Treat. 2025 Jan-Dec;24:15330338251365334. doi: 10.1177/15330338251365334. Epub 2025 Aug 11.

ABSTRACT

IntroductionSCINTIX^® therapy, a form of biology-guided radiotherapy using real-time positron emission tomography (PET) imaging on the RefleXion^® X1 platform, recently received FDA clearance for FDG-guided treatment of lung and bone tumors. This study evaluates the feasibility and dosimetric quality of Biology-Guided Radiotherapy (BgRT) plans for FDG-avid lesions in anatomical sites beyond current indications using processed diagnostic PET (dPET) images.MethodsEleven previously treated FDG-avid lesions in ten patients (sites: liver, head and neck, pancreas, kidney, pelvic/abdominal nodes) were retrospectively analyzed. dPET images were processed to emulate RefleXion X1 PET characteristics. BgRT plans were generated using a non-clinical version of the RefleXion treatment planning system, delivering stereotactic body radiation therapy-level doses (48Gy/3fx for liver, 40Gy/5fx for other sites). Plan deliverability was evaluated based on normalized target signal (NTS >2.7) and activity concentration (AC > 5 kBq/ml). Plans were categorized based on the presence of dose-limiting organs at risk (OAR) constraints. Dosimetric parameters were assessed according to institutional standards. Statistical analyses examined relationships between dPET standardized uptake value (SUV), PET-derived parameters, planning target volume (PTV) characteristics, and plan complexity.ResultsBgRT plans were successfully generated for all lesions. All met the NTS threshold (mean = 9.3); 72.7% met the AC goal (mean = 12.1 kBq/ml). Among cases with dPET SUV > 6, 87.5% met AC criterion, supporting this threshold as a reasonable selection criterion. Plans without dose-limiting OARs (n = 6) achieved higher PTV coverage (V100%=94.4%, conformity index (CI) = 1.08) compared to plans with OAR constraints (n = 5, V100%=78.0%, CI = 1.4). All plans were deemed clinically acceptable despite observed heterogeneity within target regions. MLC modulation intensity correlated strongly with target volume (r = 0.907) and superior-inferior extent (r = 0.896) rather than OAR proximity.ConclusionBgRT planning using processed dPET is feasible for non-lung/bone FDG-avid lesions. SUV > 6 may serve as a reasonable threshold, though feasibility is affected by tumor location, FDG background, and nearby critical structures. Findings support clinical potential of SCINTIX expansion into new anatomical sites.

PMID:40785471 | DOI:10.1177/15330338251365334

Small. 2025 Aug 11:e05452. doi: 10.1002/smll.202505452. Online ahead of print.

ABSTRACT

Scanning tunneling microscopy (STM) studies have shown that protein wires based on the consensus tetratricopetide repeat (CTPR) conduct with an electrical resistance proportional to length of the protein, consistent with long-range hopping transport along the long axis of the protein. However, the attempts to measure similar currents across proteins mounted in fixed-gap devices have not been successful. Here, the study reports conducting atomic force microscopy studies of CTPR8 and CTPR4, ≈8 and 4 nm in length, finding that substantial contact force (>50 nN) is required to observe conduction in CTPR8. Scrape-tests indicate that the probe penetrates the film by ≈1 nm at this force. Importantly, electrical contacts that resemble the STM data are rare-approximately 1% of all contacts. STM reports only successful contacts, so it does not predict statistically how the proteins will behave in a fixed junction.

PMID:40785470 | DOI:10.1002/smll.202505452

Curr Med Res Opin. 2025 Aug 11:1-22. doi: 10.1080/03007995.2025.2544596. Online ahead of print.

ABSTRACT

OBJECTIVE: To estimate preferences of adolescents and caregivers of children with food allergies (FA) for food allergy for attributes for treatments intended to prevent exposure-induced severe reactions and to examine how these vary by clinical and demographic factors.

METHODS: A discrete choice experiment (DCE) was conducted between May and June 2024 among US-resident individuals, aged 13-17 years or caregivers of a child with FA aged ≤12 years, self-reporting physician-diagnosed FA. The survey comprised treatment-attribute focused DCE choice sets; the Intolerance of Uncertainty─12 Scale (IUS-12); the Food Allergy Independent Measure (FAIM); and clinical/demographic questions. Conditional logistic regression analyses were conducted overall and among subgroups and presented as odds ratios (ORs) with 95% confidence intervals (CIs). Relative importance of attributes was also calculated.

RESULTS: Participants were adolescents (n = 73, mean age 15.9 years) and caregivers (n = 228, mean age 37.1 years). Overall, treatment attributes associated with statistically significant odds for preferring a treatment included a 95% relative reduction in moderate-to-severe allergic reaction risk vs no reduction (p < 0.001); oral administration over subcutaneous (p < 0.001); administration in a home vs clinical setting (p < 0.05); less frequent vs daily administration (every two weeks: p < 0.001; every four weeks: p < 0.001). Respondents were disinclined to prefer treatment attributes when risk of gastrointestinal symptoms (p < 0.001) or anaphylaxis (p < 0.001) increased. Efficacy (75% decrease in relative risk of a moderate-to-severe allergic reaction) was the top ranked attribute (OR = 1.61 (1.49, 1.75).

CONCLUSION: Overall, respondents indicated significant preferences for more efficacious, safer, and convenient (oral, at-home, and less frequent) treatments. Treatment efficacy was the most highly ranked treatment feature.

PMID:40785461 | DOI:10.1080/03007995.2025.2544596

Womens Health (Lond). 2025 Jan-Dec;21:17455057251358011. doi: 10.1177/17455057251358011. Epub 2025 Aug 11.

ABSTRACT

BACKGROUND: Severe mental illness influences uptake of contraceptive services through a number of factors in developing countries including Uganda. The paucity of data on contraceptive use among females with severe mental illness in sub-Saharan Africa including Uganda impairs the provision of guidelines for proper interventions.

OBJECTIVES: This study aimed to determine the magnitude and factors associated with contraceptive use among females with severe mental illness attending the mental health outpatient’s clinic at Gulu Regional Referral Hospital.

DESIGN: This study used a cross-sectional design.

METHODS: This study purposely screened 377 women with severe mental illness who attended Gulu hospital between March and June 2023 for contraceptive use using a semi-structured questionnaire with questions specific to the different contraceptive methods used such as condom use, injectable use, and others. Descriptive and inferential analyses were performed to determine prevalence and factors associated with contraceptive use.

RESULTS: Out of a total of 377 participants, 331 of them ever used at least one contraceptive method after being diagnosed with severe mental illness, that is the prevalence of 87.7%. Not attending school (Adjusted Odds ratio (AOR): 0.08; 95% CI: 0.01-0.46; p = 0.005), being treated for bipolar affective disorder (AOR: 0.03; 95% CI: 0.01-0.54; p = 0.017), taking both antipsychotic and mood stabilizer (AOR: 13.84; 95% CI: 2.42-234.25; p = 0.007), ever being pregnant after being diagnosed with severe mental illness (AOR: 19.21; 95% CI: 3.40-108.34; p = 0.001), desire to have children (AOR: 9.91; 95% CI: 2.28-43.12; p = 0.002), and being aware of contraceptive use (AOR: 0.01; 95% CI: 0.01-0.29; p = 0.006) were more likely to use contraception.

CONCLUSION: Our results revealed that nearly nine-tenth women with severe mental illness use contraceptives which is associated with not attending school, being treated for bipolar affective disorder, taking both antipsychotic and mood stabilizer, ever being pregnant, desire to have children, and being aware of contraceptive use. The contraceptive facilities should be included directly in the mental health delivery for easy access, hence maximum use by women with severe mental illness.

PMID:40785454 | DOI:10.1177/17455057251358011

Womens Health (Lond). 2025 Jan-Dec;21:17455057251356806. doi: 10.1177/17455057251356806. Epub 2025 Aug 11.

ABSTRACT

BACKGROUND: Cesarean section delivery is a surgical way to safeguard maternal and neonatal health when medical risk is associated with delivering babies. Its rates have been increasing globally over the past few decades, with a significant rise recorded in low- and middle-income countries, which leads cesarean section to crucial public health concerns due to unnecessary surgical interventions and associated risks for maternal and neonatal.

OBJECTIVES: This study aims to identify the socioeconomic and demographic determinants contributing to the higher likelihood of cesarean section deliveries among Bangladeshi mothers residing in urban areas.

DESIGN: The initial survey employed a cross-sectional design to collect data.

METHODS: This research examined the Bangladesh Demographic and Health Survey (BDHS) dataset to identify the cesarean section among urban mothers. It utilized the chi-square test to measure associations, the Boruta algorithm, and a multivariable logistic regression model with a forest plot.

RESULTS: The study pointed out that urban mothers belonging in richer and richest families (adjusted odds ratio: 2.83, 95% confidence interval: 1.88-4.26 and adjusted odds ratio: 4.79, 95% confidence interval: 3.13-7.34) and higher educational attainment (adjusted odds ratio: 1.89, 95% confidence interval: 1.20-2.99) are significantly correlated with cesarean section. Divisional differences are also robust with the significance of Sylhet (adjusted odds ratio: 0.23, 95% confidence interval: 0.12-0.47) and Chottogram (adjusted odds ratio: 0.50, 95% confidence interval: 0.30-0.83) divisions. Media exposure (adjusted odds ratio: 1.54, 95% confidence interval: 1.27-1.87) and mothers gave birth at the age 20-24 and 25-34 (adjusted odds ratio: 1.67, 95% confidence interval: 1.31-2.14 and adjusted odds ratio: 3.15, 95% confidence interval: 2.03-4.89) are also highly significantly associated with the likelihood of cesarean section. Moreover, mothers working status (adjusted odds ratio: 0.53, 95% confidence interval: 0.43-0.65) and religion (adjusted odds ratio: 2.33, 95% confidence interval: 1.60-3.38) are also correlated with cesarean section.

CONCLUSION: The study reveals socioeconomic and sociodemographic reasons associated with the increase in cesarean section rates among urban mothers in Bangladesh, highlighting the need for targeted interventions to mitigate cesarean section rates and improve maternal and neonatal health.

PMID:40785446 | DOI:10.1177/17455057251356806

Ann Indian Acad Neurol. 2025 Aug 8. doi: 10.4103/aian.aian_225_25. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: The time taken to transport patients for thrombolytic therapy in stroke cases remains alarmingly high, compromising potential positive outcomes. Addressing these delays can enhance prehospital care and improve patient prognoses.

AIM: This study aimed to identify factors causing delays in treating acute stroke patients at a tertiary care hospital in southern India, to inform better practices and expedite care.

METHODS: Caregivers of ischemic stroke patients were interviewed about delays. Patients were divided into two groups: those who arrived within the critical four-and-a-half-hour window (Group A) and those who arrived later (Group B). Data collected included distance from home to hospital, transportation options, and mode of transport. A comparative analysis was performed between patients from stroke-ready facilities versus others, with data analyzed using SPSS software.

RESULTS: The study included 594 patients, with 73.4% arriving outside the recommended window. Women represented one-third of the population overall and 20% in Group A. Younger patients arrived sooner (P < 0.0001). The main reason for delays was a lack of awareness of stroke symptoms (53.2%), followed by initial care sought at non-stroke-ready hospitals (23%). Use of ambulances and vehicle ownership significantly correlated with faster arrivals (P < 0.0001), while distance to the hospital did not significantly affect timeliness. Though most of the variables showed statistical significance between those coming to the hospital within and outside the four-and-a-half hour window with univariate analysis, none of the variables showed a significant association when subjected to logistic regression.

CONCLUSIONS: Delays in stroke treatment are a major concern, linked to factors like age, gender, and transportation issues. No single factor independently predicted early hospital arrival. To improve outcomes, we need strategies that enhance public education, symptom recognition, and transportation-especially for vulnerable groups like women and the elderly.

PMID:40785019 | DOI:10.4103/aian.aian_225_25