Category: Nevin Manimala

J Surg Oncol. 2026 Mar 30. doi: 10.1002/jso.70245. Online ahead of print.

ABSTRACT

BACKGROUND: There is debate regarding the optimal management of small-bowel neuroendocrine tumours (SBNETs), particularly concerning upfront resection in various clinical presentations. While symptom phenotypes are known to influence survival, their impact on technical surgical quality, especially in the emergency setting, remains poorly defined. This study evaluates whether symptom phenotype compromises the delivery of guideline-concordant surgical care.

METHODS: A retrospective analysis of 108 consecutive SBNET resections (2000-2023) at a specialized tertiary centre was performed. Patients were stratified into four phenotypes: obstructive/perforation (n = 54), carcinoid syndrome (22), asymptomatic/incidental (22), and other symptoms (9). Operative metrics, including lymph-node harvest (LNY) and margin status (R0/R1), were compared alongside overall survival (OS).

RESULTS: Symptom phenotype was a predictor of operative urgency and approach. Obstructive cases required emergency surgery in 50% of instances compared to ≤ 11% in all other groups (p < 0.001). Synchronous liver metastases were most prevalent in the carcinoid syndrome phenotype (50%) and lowest in the asymptomatic group (5%) (p = 0.002). Despite these disparities in presentation and urgency, technical quality markers were uniform across all groups: median LNY ranged from 10 to 13 (p = 0.426), R1/R2 margin rates were statistically similar (p = 0.290), and median length of stay was 8 days for all cohorts (p = 0.311). Multivariable analysis identified the asymptomatic phenotype as independently protective for OS (HR 0.42, p = 0.032), while liver metastasis was the strongest adverse prognostic factor (HR 3.25, p < 0.001).

CONCLUSIONS: Symptom phenotype dictates operative urgency and reflects disease burden but does not compromise the technical standards of surgery in a specialized unit. These findings suggest that high-quality, guideline-concordant lymphadenectomy is achievable even in emergency obstructive presentations, and correspondingly, access to specialized surgical oncology expertise may be sought even in obstructed patients to ensure technical quality is maintained.

PMID:41913096 | DOI:10.1002/jso.70245

J Magn Reson Imaging. 2026 Mar 30. doi: 10.1002/jmri.70318. Online ahead of print.

ABSTRACT

BACKGROUND: The neurostructural underpinnings of premenstrual dysphoric disorder (PMDD), particularly integrated white matter and network alteration, remain unclear.

PURPOSE: To identify a core structural network in PMDD by integrating multiple diffusion tensor imaging (DTI)-derived metrics and to develop a predictive model.

STUDY TYPE: Prospective case-control study.

SUBJECTS: Forty-two PMDD patients (age: 23.86 ± 1.32 years), diagnosed according to the American Psychiatric Association DSM-5, and 42 healthy controls (age: 23.79 ± 1.72 years).

FIELD STRENGTH/SEQUENCE: 3.0 T, T1-weighted three-dimensional gradient-echo and echo planar imaging DTI sequences.

ASSESSMENT: Microstructural and connectivity features were extracted from DTI using tract-based spatial statistics (TBSS), network-based statistics (NBS), and graph theory analyses. A combined predictive model was constructed by integrating the most stable features from the three single-modality models via least absolute shrinkage and selection operator (LASSO) regression.

STATISTICAL TESTS: Group comparisons were performed using two-sample t-tests or Mann-Whitney U tests, with false discovery rate correction. Features were selected using LASSO and integrated to construct a combined model. Model performance was evaluated by the area under the receiver operating characteristic curve (AUC) using leave-one-out cross-validation. p < 0.05 was considered significant.

RESULTS: PMDD patients exhibited widespread microstructural and connectivity alterations, including elevated axial diffusivity in the right posterior limb of the internal capsule, enhanced edge connectivity, and altered network topology. The combined model achieved significantly superior predictive performance (AUC = 0.855) compared with the TBSS-based model (AUC = 0.699) and the network-based model (AUC = 0.727), and a higher AUC than the graph-based model (AUC = 0.790). Key predictive features included two enhanced edges originating from the left inferior frontal gyrus and reduced degree centrality of the left inferior occipital gyrus and sulcus.

DATA CONCLUSION: Our DTI-based predictive model showed alterations in brain connections and network properties in the left inferior frontal and inferior occipital regions of PMDD patients.

TECHNICAL EFFICACY: Stage 2.

PMID:41913094 | DOI:10.1002/jmri.70318

Hum Brain Mapp. 2026 Apr 1;47(5):e70491. doi: 10.1002/hbm.70491.

ABSTRACT

Quantitative imaging biomarkers (QIBs) are objective measures derived from quantitative imaging that can differentiate pathological changes from healthy biological processes. Diffusion MRI parameters derived from Diffusion Tensor Imaging (DTI) and Neurite Orientation Dispersion and Density Imaging (NODDI) could serve as potential QIBs for studying both healthy neurodevelopment and various neurological conditions. However, quantitative neuroimaging studies often require large datasets collected across multiple scanners, which introduces variability. To ensure the reliability of multi-centre studies, the inter-centre reproducibility of DTI and NODDI parameters must be thoroughly assessed before data collection begins. Discrepancies between results reported by previous studies can be explained by other sources of variability. The inter-scanner reproducibility of diffusion parameters needs to be determined when the other sources of variability, such as differences in acquisition parameters, processing and ROI segmentation are controlled for. We assess the reproducibility of DTI and NODDI parameters in clinically relevant white matter (WM) tracts across three scanners of the same model, ensuring consistency in the acquisition scheme and pre-processing pipelines. WM tract regions of interest (ROIs) are automatically segmented to standardise the analysis. Additionally, we investigate ROI and signal-to-noise ratio differences to better understand the sources of variability in diffusion parameters. According to the Koo and Li classification system, our results demonstrate excellent reproducibility for fractional anisotropy and mean diffusivity across scanners of the same model (ICC ≥ 0.964) when using identical acquisition schemes, pre-processing pipelines and automated ROI segmentation. NODDI orientation dispersion index and neurite density index exhibit a similar level of reproducibility (ICC ≥ 0.942 and ICC ≥ 0.911, respectively), while free water fraction (FWF) has ICC ≥ 0.862. However, statistically significant variability was observed in the FWF, specifically within the left inferior fronto-occipital fasciculus (CoV 9.43%) and optic radiation (CoV 9.95%), even when scanning the same cohort across sites. If there is an error in the signal fraction in one compartment in the NODDI model, the signal fractions from other compartments may likely be misestimated. The reproducibility and variability of diffusion parameters reported in this study provide guidance for future QIB research involving datasets derived from multiple scanners. These findings can help determine whether observed changes in diffusion parameters reflect meaningful biological differences or are highly influenced by measurement variability.

PMID:41913049 | DOI:10.1002/hbm.70491

J Anim Sci. 2026 Mar 30:skag106. doi: 10.1093/jas/skag106. Online ahead of print.

ABSTRACT

Improving nutrient utilization in nutrient-restricted diets is an important strategy to reduce feed costs and maintain productivity in broiler production. Dietary emulsifiers are commonly used to improve lipid digestion and overall nutrient utilization in poultry diets. The objective of this study was to investigate the effects of a combination of lysophospholipids, synthetic emulsifier and monoglycerides (LEX) in energy- and amino acid-deficient broiler diets on growth performance, carcass traits, nutrient digestibility, and intestinal morphology from day 11 to 35. A total of 168 ten-day-old Ross 308 male broiler chicks were randomly assigned to one of three dietary treatments in a completely randomized design, with seven replicates and eight birds per cage. The dietary treatments were as follows: i) a positive control diet (PC) containing standard metabolizable energy and amino acid levels; ii) a negative control diet (NC) with 100 kcal/kg less metabolizable energy and 4.0% reduction in essential amino acids (lysine, methionine + cysteine, and threonine); iii) NC diet supplemented with 250 g/ton of LEX. Statistical analyses were conducted using the general linear model (GLM) procedure for one-way analysis of variance (ANOVA), with significance declared at P < 0.05. Broilers fed the LEX-supplemented NC diet exhibited improved (P < 0.001) growth performance, including body weight at day 35 (1737.14 to 1903.46 g), average daily gain (day 11-35; 58.49 to 64.95 g/day), and feed conversion ratio (1.60 to 1.41 g/g), compared to those fed the NC diet alone. Apparent digestibility of crude protein and crude fat in both the jejunum and ileum was higher (P < 0.001) in birds receiving the LEX-supplemented NC diet than in those on the NC diet. In addition, LEX improved intestinal morphology, evidenced by increased villus height (920.87 to 1086.84 µm), crypt depth (126.74 to 161.28 µm) on day 35 (P < 0.05). However, there were no significant differences (P > 0.05) in carcass yield parameters, including breast and leg muscle weights and abdominal fat content, among the dietary treatments. In conclusion, supplementation of 250 g/ton of LEX to a broiler diet deficient in energy and amino acids effectively improved growth performance and nutrient utilization by enhancing protein and fat digestibility and promoting intestinal development. These findings suggest that a combination product based on lysophospholipids, synthetic emulsifier, and monoglycerides can serve as a practical and effective nutritional strategy to optimize production efficiency under nutrient-restricted feeding conditions in commercial broiler production.

PMID:41913048 | DOI:10.1093/jas/skag106

Clin Rheumatol. 2026 Mar 30. doi: 10.1007/s10067-026-08083-1. Online ahead of print.

ABSTRACT

OBJECTIVE: Hyperuricemia (HUA) is a prevalent metabolic disorder linked to substantial morbidity. Oxidative stress is a key pathogenic mechanism, yet the cumulative effect of dietary and lifestyle pro- and anti-oxidants remains unclear. The Oxidative Balance Score (OBS) offers a comprehensive metric of oxidative potential. This study aimed to investigate the association between OBS and HUA in a large, nationally representative US adult population.

METHODS: This cross-sectional study included 29,876 adults aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. The OBS was constructed from 16 dietary and 4 lifestyle components. HUA was defined as serum uric acid ≥ 7.0 mg/dL for men and ≥ 6.0 mg/dL for women. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between OBS quartiles and HUA. Restricted cubic splines (RCS) were employed to model non-linear relationships. Subgroup analyses were conducted by gender, age, and estimated glomerular filtration rate (eGFR).

RESULTS: The overall prevalence of HUA was 20.2%. A significant inverse association was observed between OBS and HUA. After adjusting for multiple confounders, participants in the highest OBS quartile (Q4, most anti-oxidant profile) had a 42% lower odds of HUA compared to those in the lowest quartile (Q1) (OR: 0.58, 95% CI: 0.51-0.66, P-trend < 0.001). This association was more pronounced for lifestyle OBS (OR for Q4 vs. Q1: 0.35, 95% CI: 0.29-0.42) than for dietary OBS (OR for Q4 vs. Q1: 0.70, 95% CI: 0.61-0.81). RCS analysis revealed a significant nonlinear relationship (P-nonlinearity < 0.001), with the protective effect of OBS plateauing at higher scores. The inverse association was consistent across gender and age subgroups but appeared stronger in individuals with normal renal function (eGFR ≥ 90 mL/min/1.73m²).

CONCLUSION: A higher OBS, reflecting a lifestyle and diet rich in antioxidants, is independently and non-linearly associated with a lower prevalence of hyperuricemia. These findings highlight the importance of a holistic approach targeting overall oxidative balance, particularly through modifiable lifestyle factors, for the primary prevention of hyperuricemia. Key Points • A higher Oxidative Balance Score is linked to lower hyperuricemia prevalence. • Lifestyle factors show a stronger protective association than dietary factors. • The relationship is nonlinear, with benefits plateauing at higher scores.

PMID:41913033 | DOI:10.1007/s10067-026-08083-1

Saudi Dent J. 2026 Mar 30;38(4):42. doi: 10.1007/s44445-026-00156-w.

ABSTRACT

BACKGROUND: Light-cured resin cements are widely used for veneer cementation due to their color stability and extended working time. However, polymerization through ceramic materials may be influenced by ceramic composition, thickness, and bonding substrate, potentially affecting bond strength. A quantitative comparison between lithium disilicate and translucent zirconia veneers under light-cured protocols remains limited.

OBJECTIVE: To compare the bond strength of lithium disilicate and translucent zirconia veneers luted with light-cured resin cements and to evaluate the influence of substrate type and veneer thickness.

METHODS: A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. Six in vitro studies (64 specimens) met inclusion criteria. Random-effects models using restricted maximum likelihood estimation with Hartung-Knapp adjustment were applied. Subgroup analyses were performed according to ceramic material and substrate. An exploratory meta-regression assessed the association between veneer thickness and bond strength.

RESULTS: The pooled mean bond strength across all studies was 15.9 MPa. Lithium disilicate veneers demonstrated higher pooled bond strength (25.4 MPa) than translucent zirconia (12.1 MPa). Enamel substrates showed higher bond strength (21.1 MPa) compared with composite cores (11.3 MPa). Considerable heterogeneity was observed (I² = 98.2%). Meta-regression suggested an inverse trend between veneer thickness and bond strength; however, this finding was based on a limited dataset and should be interpreted cautiously.

CONCLUSION: Within the limitations of in vitro evidence, lithium disilicate and enamel bonding were associated with higher bond strength under light-cured cementation. Due to substantial heterogeneity and limited study numbers, these findings should be considered exploratory and not directly extrapolated to clinical performance.

PMID:41913027 | DOI:10.1007/s44445-026-00156-w

Ann Surg Oncol. 2026 Mar 30. doi: 10.1245/s10434-026-19377-8. Online ahead of print.

ABSTRACT

BACKGROUND: There is a significant risk of blood loss and transfusion requirements during surgeries for different cancers, raising perioperative morbidity and mortality. The antifibrinolytic drug tranexamic acid (TXA) has been studied to address this issue, but the results remain conflicting. This systematic review and meta-analysis pools all available evidence regarding the use of this medication in cancer surgeries.

PATIENTS AND METHODS: The PubMed, Scopus, Web of Science, and Cochrane CENTRAL databases were used for data retrieval until 29 April 2025. Any randomized controlled trial involving surgical patients with cancer who received TXA as the intervention was included. The main addressed outcomes were perioperative blood loss, transfusion requirements, and complications. Study quality and evidence certainty were appraised with the Cochrane RoB 2.0 tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.

RESULTS: A total of 16 RCTs with 1830 patients were analyzed. TXA markedly reduced total, intraoperative, and postoperative blood loss compared with control. Hemoglobin changes were also smaller in the TXA group. Intraoperative blood component and perioperative red blood cell transfusions were lower with TXA. TXA was also linked to a modest reduction in operative time. No significant differences were observed between the groups for perioperative complications, reoperation rate, in-hospital or 30-day mortality, and length of hospital stay. GRADE assessments for the outcomes were mainly moderate or low, except for two that had very low certainty.

CONCLUSIONS: TXA appears to statistically improve perioperative outcomes in cancer surgeries while maintaining a favorable safety profile.

PMID:41913008 | DOI:10.1245/s10434-026-19377-8

Behav Res Methods. 2026 Mar 30;58(4):100. doi: 10.3758/s13428-026-02990-6.

ABSTRACT

Understanding how people covary in performance across experimental tasks is central to individual-difference psychology. The classic Pearson correlation has two strengths: (1) it is invariant to the scale of measurement, and (2) it is invariant to including additional variables in the analysis. However, it is susceptible to attenuation from measurement noise. Bayesian hierarchical models address this issue by modeling measurement error directly. Resulting estimates, however, depend on prior specifications and are not invariant to scale or variable inclusion. We compare three common priors-inverse Wishart (IW), scaled inverse Wishart (SIW), and LKJ-to assess robustness to prior assumptions in hierarchical settings. Our main tools are visualizing the priors and evaluating their effects on posterior estimates through simulation. When prior settings match ground truth, all priors recover true correlations accurately in low-dimensional settings. When prior variance is misspecified, the IW shows strong bias: low-variance priors inflate correlations, and high-variance priors deflate them. The SIW shows the same pattern but less severely, while the LKJ remains largely unaffected by scale misspecification. When more variables are added, the IW is most stable, whereas the SIW and LKJ show slight shrinkage toward lower correlations. The main drawback of the LKJ is computational speed-models with it can take orders of magnitude longer than those using IW or SIW. Overall, the LKJ provides the most accurate estimates, while the SIW offers a practical compromise for large-scale models where computational speed is crucial.

PMID:41912980 | DOI:10.3758/s13428-026-02990-6

Environ Monit Assess. 2026 Mar 30;198(4):386. doi: 10.1007/s10661-026-15225-0.

ABSTRACT

Urban air pollution is a major challenge for environmental health, especially in tropical cities where complex topography and fossil fuel dependence exacerbate poor air quality. Epiphytes, which rely on atmospheric water and nutrients, are particularly sensitive to airborne contaminants and represent promising biomonitors. This study compares the potential of vascular and non-vascular epiphytes to accumulate airborne pollutants, providing a direct assessment of their biomonitoring performance. We evaluated these epiphytes as biomonitors of urban air pollution in Medellín, Colombia. Six species were studied: three vascular epiphytes (Tillandsia recurvata, Pleopeltis macrocarpa, Rhipsalis baccifera), two bryophytes (Fabronia ciliaris, Kymatocalyx dominicensis), and one lichen (Flavoparmelia caperata). Host tree leaves were included for comparison. The samples were collected from 49 trees across sites representing contrasting pollution levels. We quantified magnetic susceptibility (χ) as a measure of particle accumulation, complemented by scanning electron microscopy (SEM) and inductively coupled plasma optical emission spectroscopy (ICP‒OES). The results revealed marked interspecific differences: vascular epiphytes presented significantly higher χ values than bryophytes, lichens, and host tree leaves did. T. recurvata presented the strongest response, with median χ values up to an order of magnitude greater. Non-vascular species reflected pollution differences only weakly, indicating limited suitability for active monitoring. SEM revealed abundant metal particles and microplastic debris on vascular epiphytes, whereas ICP‒OES confirmed elevated Ba, Cu, and Cr at polluted sites. These results provide the first integrated assessment of epiphyte functional groups for biomonitoring in a tropical city, demonstrating that vascular epiphytes, particularly T. recurvata, are robust, accessible and low-cost biomonitors.

PMID:41912976 | DOI:10.1007/s10661-026-15225-0

Neurol Sci. 2026 Mar 31;47(4):393. doi: 10.1007/s10072-026-08970-0.

NO ABSTRACT

PMID:41912973 | DOI:10.1007/s10072-026-08970-0