METHODS: Patients with MASLD were prospectively enrolled into the Global NAFLD/MASLD Registry. Clinical and HRQL (per CLDQ-MASH and WPAI:SHP questionnaires) data were analyzed according to the presence of significant pruritus, significant fatigue, and sleep disorders.
RESULTS: A total of 8034 patients with MASLD from 39 countries (age 54±12 years, 46% male, 50% type 2 diabetes, 39% advanced fibrosis) were included. At baseline, 25% reported significant pruritus, 35% significant fatigue, and 34% sleep disorders, and 10% had all 3 symptoms. Patients with fatigue, pruritus, or sleep disorder were more likely to be female, have higher BMI, more metabolic comorbidities, and greater psychiatric burden. At 1-year follow-up, over half of the patients with baseline symptoms continued to experience them, and 14% to 18% developed de novo symptoms. Multivariate analyses showed that significant pruritus and sleep disorders each independently predicted fatigue [OR=9.51 (8.0-11.3)] when both conditions were present. Pruritus was a strong predictor of sleep disorders [OR=2.90 (2.6-3.3)]. All 3 conditions, especially fatigue, were independently associated with significantly impaired HRQL and work productivity loss.
CONCLUSION: Clinically significant fatigue, pruritus, and sleep disorders are common in MASLD, having a negative impact on HRQL and a substantial economic burden.
METHODS: This cross-sectional study was conducted from May to September 2024. A total of 306 midwives who had witnessed traumatic childbirth events were recruited from four hospitals in Shiyan, China. VPTG, empathy, core beliefs, and search for meaning were measured using validated questionnaires. A theory-informed structural equation model with bias-corrected bootstrap analysis was used to examine the hypothesized direct and indirect associations.
RESULTS: Greater empathy, greater re-examination of core beliefs, and a more active search for meaning were each correlated with greater VPTG (P
MATERIALS AND METHODS: A custom microfluidic platform was developed to generate a linear WSS gradient from 16 to 130 Pa. Microchannels were patterned with reverse cones and hemispheres in small (1-3 µm) and large (3-9 µm) sizes using two-photon polymerization and nanoimprinting. Human blood was perfused through the microchannels, and platelet deposition was quantified over time as the area coverage ratio (Aₚₗₜ/Aₜₒₜ) and area under the curve (AUC). Platelet detachment events were counted as an indicator of thrombus stability, and computational simulations supported the interpretation of local shear conditions.
RESULTS: Consistent trends emerged, although no statistical differences were observed relative to flat controls. Aₚₗₜ/Aₜₒₜ increased with WSS for all surfaces. At 16 Pa, small and large cones reduced platelet adhesion by approximately 84 and 98%, respectively, compared to flat controls. At 49 Pa, the reduction was about 95% for small cones and 80% for large cones. Conical geometries also promoted platelet washout at higher WSS. Small hemispherical features showed more than 50% lower platelet adhesion than flat surfaces for WSS > 16 Pa, with limited thrombus growth.
CONCLUSION: Conical micropatterns may be most effective at limiting platelet adhesion at lower WSS, while small hemispheres may perform better at higher WSS. These trends suggest a surface-shear interaction that warrants further investigation for LVAD surface optimization.
BACKGROUND: Atrasentan, a highly selective endothelin-A receptor antagonist, is approved for proteinuria reduction in adults with IgA nephropathy. Renin-angiotensin system inhibitors (RASi) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) are guideline recommended, yet the additional benefit of atrasentan has not been rigorously determined.
METHODS: We performed a randomized, double-blind, placebo-controlled crossover study of atrasentan in adults with IgA nephropathy, eGFR ≥30 ml/min per 1.73 m 2 , and urinary protein >0.5 g/d while on maximal, stable RASi and SGLT2i. Participants were randomized 1:1 to either sequence AB or sequence BA (0.75 mg atrasentan [A] once daily during period 1 and matching placebo [B] during period 2, or vice versa), with a 12-week washout period in between. The primary end point was the change in urinary protein-to-creatinine ratio (UPCR) to week 12. The secondary end point was the change in UPCR to week 24. Safety end points included the type, incidence, severity, seriousness, and relatedness of adverse events (AEs).
RESULTS: We recruited 54 participants with mean age 48 years (SD 12), 43% female, mean (SD) eGFR 63 (22) ml/min per 1.73 m 2 , and median UPCR 1.0 g/g (Q1-Q3, 0.7-1.4). Treatment with atrasentan versus placebo resulted in a difference in geometric mean percentage change in UPCR at week 12 of -25.3% (95% confidence interval, -36.8 to -11.7; P < 0.001). The treatment difference in UPCR between atrasentan versus placebo during treatment period 2 at week 24 was -26.4% (95% confidence interval, -45.8 to -0.0). There was one unrelated serious adverse event. Fluid retention events were uncommon, and none required hospitalization. There were no study drug discontinuations due to treatment-related adverse events and no deaths.
CONCLUSIONS: Atrasentan provided a clinically meaningful reduction in proteinuria in adults with IgA nephropathy and proteinuria ≥0.5 g/d treated with RASi and SGLT2i therapy. Atrasentan was well tolerated, and no new safety signals emerged.
CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: NCT05834738 .
METHODS: This was an analysis of an international, prospective, non-interventional registry on the management of Helicobacter pylori infection by European gastroenterologists (European Registry on Helicobacter pylori Management [Hp-EuReg]). Patients receiving empirical bismuth-containing quadruple therapies in any treatment line and registered from 2013 to 2024 were included. Effectiveness was assessed using a modified intention-to-treat (mITT) analysis.
RESULTS: A total of 10,767 first-line records were analyzed. The clarithromycin-amoxicillin-bismuth (CAB) scheme was >90% effective with standard doses of amoxicillin and clarithromycin (2000 mg/d and 1000 mg/d), regardless of bismuth dose. The bismuth-metronidazole-tetracycline (BMTc) regimen achieved >90% effectiveness with tetracycline ≥1500 mg/d, metronidazole 1500 mg/d, and bismuth ≥480 mg/d. The amoxicillin-metronidazole-bismuth (AMB) regimen reported ≈90% mITT with amoxicillin 2000 mg/d, metronidazole ≥1000 mg/d, and bismuth 480 mg/d. The clarithromycin-metronidazole-bismuth (CMB) showed ≥90% mITT with metronidazole ≥800 mg/d, without improvement from increasing bismuth dose. In the amoxicillin-levofloxacin-bismuth (ALB) regimen, mITT was >90%, with no benefit from increasing levofloxacin >500 mg/d. A total of 2952 second- to sixth-line treatments were analyzed, all showing mITT <90% (ALB, 83%; BMTc, 79%; CAB, 88%; MDB, 63%; AMB, 88%), with no significant differences with different bismuth doses.
CONCLUSIONS: Increasing antibiotic or bismuth doses above the standard did not improve effectiveness of H pylori treatment. Adherence, treatment length, and proton pump inhibitor co-therapy may be more impactful than escalation of antibiotics/bismuth doses.
CLINICALTRIALS: gov, Number: NCT02328131.
METHODS: A total of 100 students were randomly selected as participants, and data were collected using a structured questionnaire. The instrument comprised three sections, including demographic information, menstrual patterns and the Premenstrual Symptoms Screening Tool (PSST). Classification of PMS and PMDD was based on the Diagnostic and Statistical Manual IV (DSM-IV) criteria embedded within the PSST.
RESULTS: Findings revealed that seven respondents met the criteria for PMDD, while 46 and 47 respondents were categorized as experiencing no/mild PMS and moderate to severe PMS, respectively. Students diagnosed with PMDD reported higher levels of menstrual pain and more frequent premenstrual symptoms compared to those with no/mild or moderate to severe PMS. These symptoms were found to interfere with daily activities and social interactions, underscoring the psychosocial burden of menstrual health challenges. Furthermore, PMS symptoms are known to persist across the reproductive lifespan and may continue during the menopausal transition.
CONCLUSIONS: Given these implications, raising awareness of PMS and PMDD is essential to safeguard the overall well-being of women, particularly in educational settings where menstrual health challenges can disrupt academic engagement and psychosocial development.
METHODS: A quasi-experimental single-arm pre-post pilot study was conducted among Malaysian parent-adolescent dyads. Parents received a six-week structured SRH module delivered via a website, supported by healthcare professionals through digital platforms, and engaged in PACS. Adolescents completed a validated 30-item SRH knowledge questionnaire at baseline and post-intervention.
RESULTS: Fifty adolescents with a mean age of 14.45 (SD=1.50) years completed the study (completion rate: 89.3 %). Median knowledge scores increased significantly from 19.0 (IQR=11.5-26.5) to 23.0 (IQR=17-29) (p<0.001, r=0.62). Significant improvements were observed across several knowledge domains, including contraception misconceptions, oral sex and pregnancy risk, gender identity, digital safety, grooming awareness, and abortion (r=0.28-0.40, p<0.05).
CONCLUSIONS: This pilot study provides preliminary evidence that empowering parents with digitally delivered, structured SRH education and professional support can enhance parent-adolescent communication and improve adolescents' knowledge, particularly in sensitive and under-addressed domains. This family-based approach offers a feasible and scalable complement to school-based SRH education, especially in culturally sensitive and resource-limited settings.
OBJECTIVE: This study explored the molecular mechanisms of Ficus religiosa's alleviation of DOMS using network pharmacology, molecular docking, and molecular dynamics simulation analyses.
MATERIALS AND METHODS: This study used a network pharmacology framework to identify and analyze the phytochemicals from F. religiosa. Databases like IMPPAT 2.0 were used to retrieve potential compounds, while SwissTargetPrediction predicted target proteins. Therapeutic targets were identified using Genecards and OMIM databases. Protein-protein interaction networks were analyzed using STRING and Cytoscape software, while pathway enrichment was conducted using Enrichr. Molecular docking was performed using AutoDockTools (v1.5.7), followed by molecular dynamics simulations using GROMACS to validate target-compound interactions.
RESULTS: Of the 140 phytochemicals, 44 met the drug-likeness and bioavailability criteria and were associated with 39 potential therapeutic targets for DOMS. KEGG enrichment analysis revealed inflammation, oxidative stress, and immune regulation as the primary mechanisms of action. Prostaglandin-endoperoxide synthase 2 (PTGS2) was identified as a critical target. Molecular docking showed that compounds such as α-eudesmol, epi-γ-eudesmol, and α-cadinol exhibited superior binding affinities for PTGS2 compared to ibuprofen. Finally, molecular dynamics simulation demonstrated that α-cadinol exhibited the most stable binding owing to its robust hydrogen bonding, whereas epi-α-cadinol displayed progressive stabilization and efficient accommodation inside the active region of the protein.
CONCLUSION: This study suggests that F. religiosa could be used as a therapeutic agent for the management of DOMS. The key compounds, α-cadinol and epi-α-cadinol, show potential anti-inflammatory and analgesic effects.
METHODS: A 160-mm-diameter PLA head CTDI phantom with five dosimetry holes was fabricated using fused deposition modeling. Its elemental composition, density, effective atomic number, electron density, Hounsfield units (HU), and CT dosimetry parameters were characterized. Measurements were performed on 128-slice Ingenuity Philips and GE Discovery scanners, at 80, 120, and 140 kV. CTDI was measured at two different times and then compared with PMMA.
RESULTS: PLA showed properties close to PMMA, with differences of 5.08% in density, -0.015% in effective atomic number, and -4.46% in electron density. PLA HU values were lower than PMMA, ranging from 22.5 to 45.3 HU on Philips and 25.1-49.1 HU on GE. CTDIvol deviations between PLA and PMMA ranged from -9.00% to -2.82% in November 2025 and from -5.78% to -3.83% in June 2026. These deviations remained within <10%, which was generally considered acceptable for comparative phantom-based CT dosimetry.
CONCLUSION: The PLA CTDI phantom showed good effective atomic number, electron density, and dosimetric agreement with the standard PMMA phantom across two CT systems and two measurement time points.
IMPLICATIONS FOR PRACTICE: 3D-printed PLA CTDI phantom could offer a practical, low-cost complementary tool for comparative CTDI measurement, education, protocol optimization, and quality assurance.