Tag: pubmed

Eur J Neurosci. 2025 Dec;62(12):e70370. doi: 10.1111/ejn.70370.

ABSTRACT

The autonomic nervous system (ANS) plays a crucial role in maintaining homeostasis, and its dysfunction is linked to numerous clinical conditions, including chronic pain. Neuromodulatory interventions such as transcutaneous auricular vagus nerve stimulation (taVNS), transcutaneous cervical magnetic stimulation (tCMS), and intermittent theta burst stimulation (iTBS) have been investigated for their potential to modulate autonomic responses and pain perception. However, the efficacy and safety of these techniques remain unclear. This study aimed to evaluate the feasibility and safety of a single session of neuromodulatory stimulation in modulating autonomic function and pain processing in healthy individuals. A double-blind, randomized, crossover clinical trial was conducted with 22 healthy participants, each undergoing four intervention sessions (taVNS, tCMS, iTBS, and Sham-taVNS) in randomized order, with a washout period of at least 36 h between sessions. Heart rate variability (HRV) and conditioned pain modulation (CPM) were assessed pre- and post-intervention using a Polar H10 cardiac sensor and a digital pressure algometer. Adverse effects were recorded immediately after each session. No statistically significant differences were observed in HRV or CPM outcomes across active stimulation conditions when compared to Sham. Among the techniques evaluated, tCMS presented the most favorable safety profile, with fewer reported adverse effects relative to iTBS and taVNS. The absence of significant modulation effects suggests that a single session may be insufficient to induce detectable changes in autonomic or pain processing. However, the tolerability and safety of tCMS indicate its potential for future research involving repeated sessions and clinical populations.

PMID:41454683 | DOI:10.1111/ejn.70370

Pediatr Int. 2026 Jan-Dec;68(1):e70300. doi: 10.1111/ped.70300.

ABSTRACT

BACKGROUND: Patients discharged from the intensive care unit (ICU) often experience high morbidity rates. The aim of the present study was to estimate the incidence of functional capacity impairment in pediatric patients who were discharged from the ICU in a middle-income country and to identify associated factors, considering the socioeconomic context.

METHODS: This was a multicenter cohort study of 357 patients aged <18 years admitted to three ICUs in the interior cities of São Paulo State. The Functional Status Scale was used to assess the patients at admission, ICU discharge, and hospital discharge. New morbidity was defined as a change in any domain of the scale equal to or greater than two, or a change in the total score equal to or greater than three. A multiple logistic regression model was used to identify independent associations with new morbidity.

RESULTS: New morbidity occurred in 14.6% and 12.3% of patients at ICU and hospital discharge, respectively, compared with those at admission. The feeding (p < 0.001) and respiratory (p = 0.036) functional domains were the most affected at ICU discharge. The risk factors associated with new morbidity at hospital discharge were heart disease, older age, longer ICU stay, and higher PELOD2 severity score.

CONCLUSIONS: To reduce the risk of new functional morbidity, healthcare teams should be attentive to the critically ill pediatric population, particularly those who are older and have chronic clinical conditions, especially heart disease.

PMID:41454658 | DOI:10.1111/ped.70300

Aliment Pharmacol Ther. 2025 Dec 27. doi: 10.1111/apt.70511. Online ahead of print.

ABSTRACT

BACKGROUND: Patient-reported barriers to care can delay treatment and increase mortality. Addressing these barriers can improve clinical outcomes and reduce disparities, underscoring the importance to understand their prevalence in patients with cirrhosis.

METHODS: We invited adults with cirrhosis at four US health systems (two tertiary care referral centres, one safety-net health system, and one Veterans Affairs medical center) to complete a survey assessing barriers to care. Questions for barriers to care were adapted from prior surveys as available. Responses were summarised using descriptive statistics, and Chi-square analysis was used to examine differences by study site and race/ethnicity.

RESULTS: Of 5197 patients contacted by telephone, 1332 (25.6%) completed the survey and were eligible for analyses. The most frequent barriers to care included time to travel to clinic (22.7%), long wait times for appointments (21.6%), and difficulty scheduling visits (19.2%). Conversely, few patients reported competing demands or difficulty finding time for liver appointments, difficulty discussing concerns with their physicians, or lack of physician engagement with concerns. Several barriers to care significantly differed by study site but were generally consistent across racial and ethnic subgroups.

CONCLUSION: Patients with cirrhosis report frequent barriers to medical care including limited access to clinic appointments, although barriers vary by healthcare system. Barriers to care serve as intervention targets to improve outcomes for patients with cirrhosis.

PMID:41454644 | DOI:10.1111/apt.70511

J Magn Reson Imaging. 2025 Dec 27. doi: 10.1002/jmri.70218. Online ahead of print.

ABSTRACT

BACKGROUND: Dysfunction of cerebral perforating arteries is a major contributor to cerebral small vessel disease. Developing a reliable MRI technique for assessing cerebral perforating arteries on widely accessible 3T systems would be advantageous.

PURPOSE: To evaluate the feasibility and reliability of dual-velocity encoding (dual-VENC) PC-MRI at 3T for assessing pulsatility of cerebral perforating arteries.

STUDY TYPE: Prospective.

SUBJECTS: Twelve healthy young adults (2 female, 24.0 ± 3.99 years) and 31 older adults with and without vascular risk factors (21 female, 67.72 ± 8.48 years).

FIELD STRENGTH/SEQUENCE: Dual-VENC 2D PC-MRI at 3T and 7T.

ASSESSMENT: The number of perforators (N_perforator) and pulsatility index (PI) measured using 3T dual-VENC PC-MRI were evaluated through test-retest and comparison against those by 7T dual-VENC PC-MRI on the younger participants. The associations of PI and N_perforator with age, cognition, and vascular risk factors were investigated in the elderly cohort.

STATISTICAL TESTS: Paired t-tests, two-sample t-tests, Bland-Altman analysis, coefficient of variation (CV), Shapiro-Wilk Test, one-way ANOVA, and multivariable regression models. Significance level: 0.05.

RESULTS: 3T dual-VENC PC-MRI provided better reproducibility with CV values of 10% and 14% for PI and N_perforator, respectively, compared to single VENCs (high VENC: 21% and 21%, low VENC: 13% and 14%). 3T dual-VENC PC-MRI showed no significant difference in N_perforator and PI measurements with 7T dual-VENC (p = 0.16, 0.38, respectively). Among the older participants, aging and cognitive impairment were both significantly associated with increased PI but not with N_perforator (p = 0.17 and 0.365); global vascular risk burden, as well as individual vascular risk factors, including pulse pressure and hypercholesterolemia, showed a significant association with PI but not with N_perforator (p = 0.858, 0.345, and 0.476).

DATA CONCLUSION: 3T dual-VENC PC-MRI provides high-fidelity pulsatility assessment of cerebral perforating arteries and may be a useful tool at widely accessible 3T.

LEVEL OF EVIDENCE: Level 2.

TECHNICAL EFFICACY: Stage 2.

PMID:41454626 | DOI:10.1002/jmri.70218

Cancer Med. 2026 Jan;15(1):e71445. doi: 10.1002/cam4.71445.

ABSTRACT

BACKGROUND: Mitochondrial permeability transition (MPT)-driven necrosis, a recently identified form of programmed cell death, significantly influences tumor progression, therapy response, and prognosis. However, research on mitochondrial permeability transition-driven necrosis-related long non-coding ribonucleic acids (MPTDNRlncRNAs) in hepatocellular carcinoma (HCC) remains limited.

METHODS: In the current study, we aimed to construct an MPTDNRlncRNA signature to predict survival and classify patients with HCC. RNA sequencing and clinical data were sourced from the Cancer Genome Atlas database, while MPT-driven necrosis-linked genes were obtained from the Gene Set Enrichment Analysis database. We identified MPTDNRlncRNAs in HCC tumor tissues and deployed the least absolute shrinkage and selection operator-Cox analysis to construct a predictive lncRNA signature. Immune cell infiltration variations were analyzed between high- and low-risk subgroups. The MPTDNRlncRNA signature performance was estimated using statistical methodologies, and bioinformatics methods were utilized to investigate functional and pathway differences across risk groups.

RESULTS: A seven-lncRNA signature specific to HCC was developed, and its predictive accuracy was systematically evaluated using survival analysis, time-dependent receiver operating characteristic curves, and Cox regression analyses. Correlation analysis demonstrated a strong association between the lncRNA signature and immune cell infiltration, several immune checkpoint targets, and its significant prognostic value for patients with HCC. Additionally, LINC02313 was recognized as a hub lncRNA in vitro, demonstrating its role in promoting cell proliferation and tumor metastasis. Finally, we validated the function of LINC02313 using a liver cancer organoid model.

CONCLUSION: The effective construction of an MPT-driven necrosis-related prognostic model highlights its potential to independently predict the prognosis of patients with HCC. These findings not only deepen our understanding of MPT-driven necrosis but also offer novel theoretical foundations for developing more effective treatment strategies. The gene LINC02313 has been identified as a promoter of HCC’s ability to proliferate and invade, underscoring its potential as a therapeutic target for HCC.

PMID:41454619 | DOI:10.1002/cam4.71445

Cell Biochem Funct. 2026 Jan;44(1):e70158. doi: 10.1002/cbf.70158.

ABSTRACT

Botryosphaeran is an exocellular (1 → 3)(1 → 6)-β-d-glucan that promotes significant metabolic effects in male rats, as antiobesogenic and hypoglycemic effects. This study aimed to investigate its metabolic effects in female Wistar rats subjected to a high-fat high-sucrose diet. Obesity induction resulted in increased body weight, accumulation of adipose tissue, glucose intolerance, insulin resistance, hepatomegaly and high levels of TBARS (oxidative stress marker) in the liver, compared with the controls; all differences were statistically significant (p ˂0.05). Treatment with botryosphaeran (12 mg/kg/day; 15 days) significantly reduced the weight gain (p ˂0.01), the retroperitoneal adipose tissue (-29.7%, p ˂0.05), and corrected glucose intolerance with a 8.32% reduction in the area under the curve (AUC, p ˂0.05), relative to untreated obese rats. Furthermore, botryosphaeran reduced the levels of TBARS (-45.4%, p ˂0.05) in liver, reducing oxidative stress. Additionally, no differences were observed in the liver for protein carbonyls, superoxide dismutase, catalase, glutathione peroxidase, and ascorbic acid. In conclusion, botryosphaeran was observed to promote a significant antiobesogenic effect, promoting an expressive loss in body-weight, reduction of adipose tissue, correction of glucose intolerance and promoting an antioxidant effect in the female rats.

PMID:41454613 | DOI:10.1002/cbf.70158

J Chemother. 2025 Dec 26:1-9. doi: 10.1080/1120009X.2025.2605782. Online ahead of print.

ABSTRACT

Bevacizumab is a monoclonal antibody targeting vascular endothelial growth factor-A (VEGF-A), a key mediator of tumor angiogenesis. Among VEGF-A splice variants, VEGF-A_xxxa has proangiogenic activity, whereas VEGF-A_xxxb exerts anti-angiogenic effects. Recent methodological advances have enabled accurate quantitative assessment of the plasma VEGF-A_xxxa, defined as the proportion of VEGF-A_xxxa relative to total VEGF-A. In this study, we evaluated the predictive potential of the VEGF-A_xxxa ratio for bevacizumab efficacy in patients with non-squamous non-small cell lung cancer treated with carboplatin and paclitaxel with or without bevacizumab. A higher VEGF-A_xxxa ratio (≥0.45) was associated with significantly longer progression-free survival and overall survival in the bevacizumab-treated group, with statistically significant treatment interactions. These results suggest that the plasma VEGF-A_xxxa ratio may serve as a minimally invasive biomarker with potential utility for predicting clinical benefit from bevacizumab.

PMID:41454602 | DOI:10.1080/1120009X.2025.2605782

J Asthma. 2025 Dec 26:1-21. doi: 10.1080/02770903.2025.2610344. Online ahead of print.

ABSTRACT

Effective pediatric asthma management relies on medication adherence, correct inhaler technique, and positive parental illness perception. This study examined the levels, interrelationships, and predictive value of these factors for asthma control among children aged 7-11 years. In this cross-sectional observational study, 62 children with asthma and their caregivers were recruited from community and clinical settings in Alabama, USA. Asthma control was assessed using the Childhood Asthma Control Test (C-ACT), medication adherence via the Medication Adherence Report Scale for Asthma (MARS-A), and parental illness perception via the Asthma Illness Representation Scale (AIRS), including five subscales: Attitudes Toward Medication Use, Treatment Expectations, Facts About Asthma, and Nature of Symptoms/Emotional Aspects. Inhaler technique was evaluated using a pressurized metered-dose inhaler (pMDI) with a spacer via a 9-step checklist. Descriptive statistics summarized outcomes, and correlations and regressions explored relationships. Only 34.77% of participants demonstrated correct inhaler technique. Inhaler technique correlated positively with asthma control (r_s=.25, p=.048), and medication adherence correlated with parental attitudes toward medication (r_s=.46, p<.001). Regression showed that later age at diagnosis predicted poorer asthma control (B=-0.64, p=.008). Ordinal regression indicated that higher caregiver education (high school: B=-5.73, p=.019; college: B=-4.90, p=.027) and perceiving income as exceeding expenses (B=-4.63, p=.045) were associated with better asthma control. Despite favorable control scores, incorrect inhaler use and suboptimal adherence remain challenges. Parental perceptions and sociodemographic factors, particularly education and financial well-being, significantly influence outcomes. Findings underscore the need for family-centered educational strategies to improve pediatric asthma management.

PMID:41454597 | DOI:10.1080/02770903.2025.2610344

Med Decis Making. 2025 Dec 26:272989X251406639. doi: 10.1177/0272989X251406639. Online ahead of print.

ABSTRACT

BackgroundWhile machine learning (ML) models are increasingly used to predict outcomes in health care, their practical effect on health care operations, such as bed capacity management, remains underexplored. There is a variety of traditionally used evaluation metrics to analyze ML models; however, decision makers in health care settings require a deeper understanding of their implications for resource management. Traditional performance measures often fail to provide this practical insight.MethodsIn this work, we conduct a simulation study to evaluate the impact of ML-driven length-of-stay (LOS) predictions on intensive care unit (ICU) bed capacity management. Two classification models differing in terms of explainability and interpretability, logistic regression (LR) and extreme gradient boosting (XGB), are applied to predict ICU-LOS. We use the HiRID dataset containing high-frequency data of more than 33,000 patients. The predictions of the ML models are integrated into a simulation framework that replicates real-world ICU bed management, allowing for the assessment of the practical implications of using these algorithms in a clinical setting.ResultsThe application of both classification models results in improved capacity control regarding the key performance indicators in the simulation study, with XGB outperforming LR. While LR leads to slight overoccupancy in the ICU, slight underoccupancy can be observed when XGB is applied.ConclusionOur study bridges the gap between predictive accuracy and practical application by emphasizing the importance of evaluating ML models within the context of ICU capacity management. The simulation-based approach offers a more relevant assessment for health care practitioners, providing actionable insights that go beyond classical performance measures and directly address the needs of decision makers in clinical practice.HighlightsWe apply multiple classification models for ICU-LOS prediction using time-series data. This approach enables an update of the initial prediction resulting in the possibility of efficiently managing intensive care capacities.We present a simulation-based approach to evaluate ML algorithms and their impact on bed capacity management in real-world clinical settings.Our work provides in-depth insights into the impact of using ML techniques as decision support systems in the ICU and can lead to increased acceptance in practice.

PMID:41454594 | DOI:10.1177/0272989X251406639

Cancer Med. 2026 Jan;15(1):e71491. doi: 10.1002/cam4.71491.

ABSTRACT

BACKGROUND: Paracentesis temporarily relieves malignant ascites but causes hypoalbuminemia. Cell-free and concentrated ascites reinfusion therapy (CART) reinfuses autologous proteins to prevent hypoalbuminemia and has been increasingly used in Japan. However, CART has not been widely adopted outside of Japan, and its benefit remains unclear. We evaluated the clinical outcomes and healthcare costs of CART compared with paracentesis in metastatic cancer.

METHODS: This retrospective cohort study included hospitalized patients with metastatic solid cancer receiving CART or paracentesis across Japan (April 2016-March 2023). Baseline characteristics were balanced using overlap propensity-score weighting. Primary outcomes were in-hospital mortality, functional disability, and 30-day unplanned readmission. Secondary outcomes were length of stay (LOS), albumin administration or re-drainage rates, and costs. Mortality risk was assessed using a modified Poisson regression. The composite primary outcomes were assessed using a win-ratio approach.

RESULTS: Among 1159 patients (CART: 457, paracentesis: 702) from 51 hospitals, the CART group had lower mortality than the paracentesis group (28.6% vs. 36.7%; risk ratio: 0.78, 95% confidence intervals [95% CI]: 0.64-0.94). The win-ratio analysis also favored the CART group over the paracentesis group (win ratio: 1.34, 95% CI: 1.09-1.64). Additionally, CART was associated with lower mortality and better composite outcomes than paracentesis, particularly among males, patients with serum albumin ≤ 2.5 g/dL, and those with non-gastrointestinal cancer. Despite higher procedural costs, CART was associated with shorter median LOS (14.1 vs. 19.0 days), lower albumin administration (11.6% vs. 17.3%) and re-drainage (32.7% vs. 52.7%) rates, and lower total median costs (4490.9 [interquartile range: 2042.3-7054.5] vs. 5084.1 [interquartile range: 3054.7-8659.7] USD) than paracentesis.

CONCLUSIONS: CART was associated with improved clinical outcomes and healthcare costs over paracentesis among hospitalized patients with metastatic cancer, particularly in males, patients with serum albumin ≤ 2.5 g/dL, and those with non-gastrointestinal cancer. These findings may support clinical decision-making and resource allocation.

PMID:41454579 | DOI:10.1002/cam4.71491