The inflammatory biomarker, soluble urokinase plasminogen activator receptor (suPAR), has emerged as a promising prognostic biomarker in cardiovascular diseases. However, little is known about suPAR levels in patients admitted with acute heart failure (AHF). This study investigates the prevalence and prognostic value of elevated suPAR in patients hospitalized with AHF. This cohort study included patients presenting with cardiopulmonary symptoms at the Medical Emergency Department of University Hospital Amager-Hvidovre, Denmark, between March 10, 2020, and March 31, 2022. SuPAR was measured upon admission, with the median time from admission to measurement of two hours (IQR 3.9 - 6.9). A cardiologist adjudicated whether the patients had AHF. Patients were stratified according to validated cut-off values of suPAR <6ng/ml and≥6ng/ml. Kaplan-Meier survival analysis and Cox regression were used to assess the association between suPAR levels and one-year mortality. A total of 386 (3.8%) AHF patients, from a total population of 10,027, were included. The mean suPAR value was significantly higher among AHF patients compared to non-AHF patients: 6.2ng/ml (standard deviation [SD]=4.8ng/ml) vs 4.4ng/ml (SD=2.9ng/ml), p<0.001. A suPAR level≥6ng/ml was significantly associated with mortality, log-rank-p-value <0.0001. Furthermore, Cox regression analysis demonstrated that elevated suPAR levels were independently associated with increased risk of mortality with a hazard ratio (HR): 1.06 (95% CI: 1.03-1.1, p<0.001) after adjusting for potential confounders. SuPAR levels measured at hospital admission in AHF patients correlate significantly with one-year mortality and outperform C-reactive protein, supporting their potential role in early prognostication to identify high-risk patients.

An external blank matrix-free fluorescence sensing platform based on the oxidase-like activity of CuFe2O4 magnetic particles for detecting casein phosphopeptide.

Smartphone-integrated molecularly imprinted sensor with convolutional neural networks for on-site detection of Norfloxacin.

Long-wavelength emissive N-doped carbon dots as a fluorescent probe for sensitive detection of pyrophosphate and cellular imaging.

Blood-based biomarkers offer a widely available, scalable, and noninvasive method to study neurodegeneration. However, the association between blood-based biomarkers of neurodegeneration and long-term risk of mortality, as well as dementia-specific mortality in a racially diverse cohort, remains understudied. The goal of this study was to determine whether baseline biomarkers of neurodegeneration are associated with long-term risk of all-cause and dementia-specific mortality in a biracial cohort. The REasons for Geographic and Racial Differences in Stroke cohort study enrolled 30,239 Black and White participants across the continental United States from 2003 to 2007, with ongoing follow-up. Plasma neurofilament light chain (NfL), total tau, glial fibrillary acidic protein (GFAP), and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) were measured in baseline plasma from a random sample of participants. All-cause mortality, dementia-specific mortality, cardiovascular-specific mortality, and other causes of death were adjudicated and classified using medical records, the Social Security Death Index, and the National Death Index. Cause-specific Cox regression models accounting for competing risks were used to calculate hazard ratios (HRs) of outcomes for each biomarker separately. A total of 917 participants had a mean baseline age of 67.4 years (SD 12.1), 49.4% were female, and 48.6% self-identified as Black. With a mean follow-up of 11.1 (SD 5.7) years, 51.0% (477/935) of participants died and 9.2% experienced dementia-specific mortality (86/935). No associations were observed for total tau. In fully adjusted models for other biomarkers, HRs of all-cause mortality per standard deviation increments were 1.93 (95% CI 1.48-2.52) for GFAP, 1.90 (95% CI 1.55-2.32) for NfL, and 1.23 (95% CI 1.09-1.37) for UCH-L1. Furthermore, GFAP (HR 5.66, 95% CI 2.91-11.00) and NfL (HR 2.72, 95% CI 1.57-4.71) were associated with dementia-specific mortality in fully adjusted models. GFAP (HR 2.06, 95% CI 1.22-3.49) and NfL (HR 2.16, 95% CI 1.66-2.81) were also associated with cardiovascular-specific mortality in fully adjusted models. Plasma biomarkers of neurodegeneration, particularly GFAP and NfL, were associated with increased risk of all-cause, dementia-specific, and cardiovascular-specific mortality in a biracial cohort. These associations should be considered when assessing links between these biomarkers and other outcomes, as well as when used in clinical practice.

Colorimetric and fluorometric dual-response system for rapid analysis of gentamicin in real samples.

Introduction: Ischaemic Heart Disease (IHD) and other cardiovascular conditions remain the foremost contributors to global illness and death, with India bearing a considerable share of this burden. Although progress has been made in treatment through medical and surgical approaches, inadequate patient awareness, limited self-care practices, and poor adherence to lifestyle changes continue to affect outcomes and Quality of Life (QoL). Nurse-led interventions, focusing on patient education, counselling, and ongoing support, have emerged as a potential strategy to address these challenges. Aim: To assess the impact of a nurse-led transitional care model on health outcomes (selected bio-physiological parameters) and QoL among individuals with IHD. Materials and Methods: A two-phase design was adopted. Phase I employed a mixed-methods exploratory approach at Dhiraj Hospital, Vadodara, Gujarat, India and Railway Hospital, Lucknow, India. The study period for Phase I was 7 weeks, including (quantitative data collection for 4 weeks and qualitative data collection for consecutive 3 weeks). Based on these findings, a structured video-assisted nurse-led intervention was developed. In Phase II, an experimental study was carried out involving 90 post-operative IHD patients, who were randomly allocated to intervention and control groups. The intervention group received structured counselling, video-assisted education, and weekly telephone follow-ups for 12 weeks, while the control group continued with routine care. Outcomes were assessed using the McNew Heart Disease Health-Related Quality of Life Questionnaire and clinical parameters such as Blood Pressure (BP), Body Mass Index (BMI), and lipid profile, as shown by the results of the mean, standard deviation, and Unpaired t-test results. Results: In Phase I, a total of 46 patients were included, and the mean age of participants was 55.36±7.00 and 56.2±6.34 among the control and intervention groups. The majority of the population (n=17) highlighted major gaps in patients’ understanding of lifestyle adjustments, medication adherence, recognition of danger signs, and follow-up practices. In Phase II, after 12 weeks of intervention, patients in the experimental group showed significant improvements in clinical variables life including systolic BP (p-value=0.001), diastolic BP (p-value=0.016), and BMI (p-value=0.004). Lipid profile changes were not statistically significant, as evident from the mean, standard deviation, and the Unpaired t-test results. Quality of life showed marked improvement in physical, social, and global domains (p-value &lt;0.001), though the emotional domain did not show significant change. Overall, 64.4% of participants in the intervention group reported good QoL compared to only 13.3% in the control group. Conclusion: The nurse-led intervention effectively improved QoL and clinical outcomes in IHD patients, highlighting the value of structured education, video learning, and follow-up, with larger multicentric studies needed to validate these findings.

Predicting dementia risk: Discrimination accuracy of the NCGG-FAT.

Overhead throwing sports, such as softball, impose significant biomechanical demands on the shoulder and elbow, yet chronic musculoskeletal adaptations in female softball players remain underexplored. This study aimed to investigate whether repetitive overhead throwing in collegiate female softball players leads to increased thickness of the supraspinatus, infraspinatus, and ulnar collateral ligament (UCL) in the throwing arm compared to the non-throwing arm. A cross-sectional study was conducted with 19 female collegiate softball players from an NCAA Division I team, excluding pitchers. Ultrasound imaging was used to measure the thickness of the supraspinatus, infraspinatus, and UCL with participants seated with arms relaxed for supraspinatus and infraspinatus imaging, and with the elbow flexed at 90° for UCL imaging. Paired t-tests were used to compare tissue thickness between arms. Mean thicknesses were similar across arms (supraspinatus: 1.93 (standard deviation [SD]=0.31) cm vs. 1.95 (SD=0.29) cm; infraspinatus: 2.26 (SD=0.35) cm vs. 2.18 (SD=0.34) cm; UCL: 0.58 (SD=0.05) cm vs. 0.56 (SD=0.06) cm). Paired t-tests revealed no significant differences between the throwing and non-throwing arms for supraspinatus thickness (P=0.401), infraspinatus thickness (P=0.236), or UCL thickness (P=0.171). We observed no between-arm differences in resting thickness of the supraspinatus, infraspinatus, or UCL; these data do not provide evidence for hypertrophic adaptation in these tissues among collegiate female softball players. This suggests that throwing may not provide sufficient stimulus to drive significant structural adaptation in these tissues. These findings highlight the need to explore additional adaptive mechanisms and position-specific demands to inform injury-prevention strategies better.

Rethinking U-Net architecture in medical imaging: Advancing the efficient and interpretable UKAN-CBAM framework for colorectal polyp segmentation.

Predictors of Contrast Extravasation in the Emergency Department: A Case-Control Multi-Center Retrospective Study.

Vice Chairs of Education in Departments of Surgery: Responsibilities, Value, and Future Directions.

Ultrasonography is the recommended first-line investigation for the diagnosis of pediatric nephrolithiasis. Despite higher sensitivity and specificity for this condition, computed tomography is reserved for more complex cases due to its radiation exposure. Despite increasing stone prevalence in the pediatric population, there is a lack of low-dose computed tomography pediatric urolithiasis protocols and descriptions of low-dose protocols are sparse. Herein we report the development and implementation of a low-dose protocol to reduce radiation exposure to this vulnerable population. A novel low-dose computed tomography protocol was designed through multidisciplinary collaboration, literature review, and phantom trials. Patients undergoing computed tomography for urolithiasis assessment were evaluated using the novel low-dose protocol and were compared to a retrospective cohort. Radiation reduction was characterized using descriptive statistics and comparative analysis. Mean (± standard deviation) age for the low-dose group was 12.6 ± 4.2 years (n = 26) compared to 12.4 ± 3.7 years for the standard-dose group (n = 15). The low-dose protocol reduced radiation dose when compared to the standard-dose group by 55.5 % (≥45 kg) (p = 0.02) and 27.8 % (<45 kg) (p = 0.03). The low-dose protocol visualized stones seen on ultrasound with 100 % accuracy (n = 6), and in 61.5 % (n = 16/26) of patients. There was no difference in stone sizes between groups. Reduced-dose computed tomography protocols are effective for assessing urolithiasis while reducing radiation exposure. Implementation of reduced-dose computed tomography protocols in cases of suspected urolithiasis is advised to limit radiation exposure while maintaining diagnostic imaging detail.

Chronic pancreatitis (CP) complications in adults are successfully managed with endoscopic retrograde cholangiopancreatography (ERCP). Data are limited on the success of ERCP in children with CP. We reviewed our experience to ascertain the success, safety, and effectiveness of ERCP for relieving pain and its effect on exocrine and endocrine insufficiency. Retrospective analysis of a prospectively kept database of children (≤18 y) with CP who underwent therapeutic ERCP between 2010 and 2020 was reviewed. Clinical details, laboratory and radiologic investigations, procedural details, and follow-up data were retrieved from manual and electronic records. Categorical and numerical data were expressed as proportion and mean ± SD. Sixty-five children (60% males), age 12.8 ± 2.9years, were included. The most common etiology was idiopathic (n = 45, 69%). Technical, endoscopic, and clinical success rates were 95.3%, 92.3%, and 85.6%, respectively. Only 4 patients (6.1%) had major complications. Over a median follow-up of 24 months, therapeutic ERCP resulted in significant pain relief, with nonprogression of exocrine and endocrine insufficiency. Recurrence of symptoms was noted in 10%, which were managed successfully with repeat ERCP. Therapeutic ERCP is a safe and effective therapy for the management of CP in children, with significant improvement in pain, and could influence stabilization of exocrine and endocrine functions.

Introduction: Hypertensive emergencies represent lifethreatening conditions characterised by acute elevations in blood pressure with evidence of target organ damage. They remain a significant contributor to cardiovascular, neurological, and renal morbidity and mortality, often leading to hospitalisation. Early detection of end-organ involvement is therefore crucial to prevent irreversible damage and improve clinical outcomes. Aim: To study the association between patients presenting with hypertensive emergency in the Medical Intensive Care Unit (MICU) and target end-organ damage across different genders and age groups. Materials and Methods: The present cross-sectional study was conducted among adult patients aged 18-80 years presenting with blood pressure ≥180/120 mmHg at R. D. Gardi Medical College and Charitable Hospital, Ujjain, Madhya Pradesh, India, over a period of six months, from June 2024 to November 2024. Demographic data, medical history, and other clinical information, including Electrocardiography (ECG), Two Dimensional (2D) echocardiography, chest X-ray, funduscopic examination, ultrasonography of the abdomen, and neuroimaging studies, were collected. Data were analysed using SPSS software (Statistical Package for the Social Sciences (SPSS) Inc., Chicago, IL), version 29.0.10, with a p-value &lt;0.05 considered statistically significant. Results: Among the 96 patients, 58 (60%) were male and 38 (40%) were female. The mean {±Standard Deviation (SD)} age was 58.66±12.62 years (range: 18-80 years). A past history of hypertension was present in 58 (60.4%) patients, with a mean duration of 6.51±4.34 years (range: 1-20 years). The most common forms of acute target organ damage were Cerebrovascular Accident (CVA) with retinopathy in 24 patients (25%), followed by Myocardial Infarction (MI) with retinopathy in 15 (15.6%), retinopathy alone in 13 (13.5%), retinopathy with pulmonary oedema and acute heart failure in 11 (11.5%), and MI alone in 10 patients (10.4%). Conclusion: Hypertensive emergencies were more frequent among middle-aged and elderly males, most of whom had a prior history of hypertension. CVAs and retinopathy were the leading complications, followed by MI either alone or in combination with retinopathy. Strengthening early detection and ensuring strict blood pressure control are essential to reduce the burden of target organ damage in these patients.

Gold nanobipyramid-based colorimetric sensor for rapid on-site detection of microcystin-LR in drinking water.

Streptococcus pneumoniae (Sp) is the leading bacterial pathogen causing complicated pneumonia, that is, with parapneumonic effusion/pleural empyema (PPE/PE). In 2022, there was a rise in group A Streptococcus (GAS)-complicated pneumonias in children. We reviewed the clinical characteristics of Sp- or GAS-complicated pneumonias admitted to 4 Portuguese tertiary hospitals, in 2018-2023. Of the 128 cases, 107 were by Sp and 21 by GAS, with a rise in PPE/PE in 2023. Pathogens were identified by molecular methods (89.8%) or culture (16.4%) from pleural fluid or blood. The mean age was 3.8 years (standard deviation 2.9) and 52.3% were male. Children with GAS PPE/PE were more likely to have rash (57.1% vs. 3.8%, P < 0.001), pharyngitis (52.4% vs. 19.8%, P = 0.004), septic shock (28.6% vs. 0.9%, p <0.001), higher procalcitonin (PCT) (80 vs. 2.13 ng/mL, P = 0.005), higher rates of admission to the intensive care unit (81.0% vs. 55.1%, P = 0.030) and of invasive mechanical ventilation (38.1% vs. 11.2%, P = 0.005). Fatality rate was similar in both groups (4.8% vs. 0%, P = 0.164). Among cases where genotyping was possible, 4/7 GAS were emm 1 (3/4 M1 UK sublineage, all in 2023) and 64/88 Sp were serotype 3. Sp serotype 3 remains the leading cause of PPE/PE in children in Portugal. The increase in GAS PPE/PE cases in 2023 followed an expansion of the M1 UK sublineage in Portugal. GAS should be considered, especially in children presenting with rash, pharyngitis or higher PCT levels. Adequate antimicrobial and clinical management of GAS PPE/PE could be crucial to improve outcomes.

Purpose in life and depressive symptoms: An individual-participant meta-analysis of >500,000 participants across six world regions.

Identifying the relative contributions of body size across life course to midlife and late-life cognitive function: a Bayesian analysis from the Guangzhou Biobank Cohort Study.

Airway management in patients with odontogenic infections presents a known challenge. The current study aims to identify factors associated with anesthesia ready time (ART) and first-attempt intubation failure (FAIF) in patients with odontogenic infections. In a retrospective cohort study, subjects 14 years and older between January 1, 2012, and December 31, 2019, requiring incision and drainage for odontogenic infections under general anesthesia were included. Predictor variables included age, sex, race, body mass index (BMI), maximum incisal opening (MIO), Mallampati score, size and location of abscesses, airway deviation, intubation method, and route. The primary outcome variable, ART, was measured as the time elapsed between the patient entering the operating room and the anesthesiologist marking "Anesthesia Ready." A secondary outcome variable was FAIF. T tests, analysis of variance (ANOVA), or nonparametric tests were used to compare ART values based on our predictor variables. Logistic regression was used to assess for FAIF. A significance level of P ≤ .05 was used. The sample was composed of 137 intubations in 129 subjects with a mean age of 38.6 (standard deviation [SD] 7.1) years, of which 59 (45.7%) were male. Mean ART was 19.2 (SD 10.4) [95% confidence interval [CI], 17.5-20.9] minutes. Abscess size was not associated with ART. Factors associated with increased ART were severe airway deviation (mean 23.0 [95% CI, 19.4-26.6] minutes, P = .02), involvement of the sublingual (mean 20.5 [95% CI, 18.1-22.8] minutes, P = .02), lateral pharyngeal (mean 21.7 [18.5-24.9] minutes, P = .02), and retropharyngeal (mean 24.7 [18.1-31.3] minutes, P = .02) spaces, total number of spaces involved (r = 0.18, P = .03), choice of flexible scope (FS) intubation (mean 26.8 [95% CI, 22.6-31.0] minutes, P < .01), and nasal route of intubation (mean 24.2 [95% CI, 21.3-27.2 minutes, P < .01)], the last 2 of which maintained significance after Bonferroni correction for multiple comparisons. FS intubation method remained significantly associated with increased ART, regardless of whether oral or nasal route was used ( P < .01). FAIF was encountered 13.3% of the time. For patients with odontogenic infections, the strongest predictor of increased ART is the choice of FS technique. Other factors that may be associated with increased ART are severe airway deviation, number of spaces involved, involvement of the sublingual, lateral pharyngeal, or retropharyngeal spaces, although these other factors lose statistical significance after correction for multiple comparisons.