Category: Nevin Manimala

J Med Internet Res. 2026 Aug 31;28:e92181. doi: 10.2196/92181.

ABSTRACT

BACKGROUND: Radiology departments frequently manage large, heterogeneous worklists using first-in, first-out (FIFO) reporting workflows. This approach does not account for clinical urgency and may contribute to prolonged reporting delays, particularly in high-volume settings. AI systems are increasingly being integrated into radiology workflows, not only for image analysis but also as tools for worklist prioritization and report generation. However, real-world evidence of their operational impact remains limited.

OBJECTIVE: This study aimed to evaluate the impact of an AI-triaged reading worklist combined with AI-assisted report generation on radiologist workflow efficiency, measured by report generation time (RGT) and overall turnaround time (TAT) for chest radiographs in a real-world hospital setting.

METHODS: We conducted a single-center prospective paired study using a single-sequence crossover design. Eight board-certified radiologists interpreted chest radiographs during 2 reporting sessions: an unaided session using standard FIFO worklists and an AI-assisted session using an AI-triaged worklist with integrated report generation tools, separated by a 4-week washout period. Chest radiographs acquired between November 2023 and January 2024 were included. RGT was defined as the time from opening a study to report finalization, and TAT was defined as the time from the start of a reporting session to report finalization. Statistical comparisons were performed using nonparametric tests.

RESULTS: A total of 1054 chest radiographs were included. Median RGT decreased from 2 (IQR 1-4) minutes in the unaided session to 0.53 (IQR 0.22-1.12) minutes in the AI-assisted session (P<.001), representing a 73.3% reduction. The largest reduction was observed in radiographs categorized as normal, with median RGT decreasing from 2 (IQR 1-3) minutes to 0.2 (IQR 0.13-0.35) minutes (a 90% reduction). Mean TAT decreased from 876.21 (SD 1014.20; 95% CI 816.06-940.55) minutes to 82.25 (SD 83.38; 95% CI 76.98-87.27) minutes with AI assistance, corresponding to a 90.6% reduction. Significant reductions in TAT were observed across all urgency categories, including critical studies (all P<.001).

CONCLUSIONS: In a real-world clinical setting, the use of AI-triaged worklists and AI-assisted report generation was associated with substantial reductions in RGT and overall TAT for chest radiographs. These findings suggest that AI, when deployed as workflow infrastructure rather than a diagnostic replacement, may meaningfully improve radiology operational efficiency and reporting timeliness.

PMID:42673581 | DOI:10.2196/92181

Endocrinol Diabetes Metab. 2026 Sep;9(5):e70267. doi: 10.1002/edm2.70267.

ABSTRACT

AIMS: The role of endogenous oestrogen exposure (EEE) in type 2 diabetes (T2D) remains understudied despite its potential importance. This study aimed to assess T2D incidence in women with different endogenous oestrogen durations.

MATERIALS AND METHODS: At the initiation of the study, 6273 post-menarche women above 20 years were included. After applying the exclusion criteria, 3,411 women remained (2,754 premenopausal and 657 menopausal). Each woman’s EEE was determined, and they were monitored for the incidence of T2D. Based on the EEE duration, hazard ratios (HRs) and 95% confidence intervals (CI) for the T2D event were reported using Cox proportional hazards regression models.

RESULTS: The mean age and menarcheal age (standard deviation) of participants were 39.3(12.5) and 13.5(1.5) years, respectively. Finally, 30.9% (1053) of the women developed diabetes (819 (29.7%) premenopausal and 234 (35.6%) menopausal). The age and BMI-adjusted model’s findings indicated that, overall, the EEE z-score was inversely associated with T2D incidence in postmenarcheal women [HR 0.91, 95% CI 0.85-0.97], meaning that the risk of T2D decreased by 9% for every 1-SD increase in the EEE z-score. Furthermore, after full adjustment for potential confounders, the association remained statistically significant (HR = 0.90, 95% CI: 0.84-0.96).

CONCLUSIONS: The findings suggest that longer EEE duration may reduce the risk of T2D, emphasising the importance of reproductive history in health assessments.

PMID:42673573 | DOI:10.1002/edm2.70267

Psychol Rep. 2026 Aug 31:332941261484076. doi: 10.1177/00332941261484076. Online ahead of print.

ABSTRACT

Subclinical paranoia and social anxiety frequently co-occur in non-clinical populations, yet the cognitive mechanisms underlying their association remain unclear. This study examined whether social anxiety severity is associated with paranoid tendencies among university students and whether cognitive biases account for this association. University students (N = 123) completed measures of social anxiety (LSAS), delusion-like experience endorsement (PDI), and cognitive biases (DACOBS and CBQp). Bivariate correlations, hierarchical regression, and cross-sectional mediation (indirect-effects) analyses were conducted, with age and sex included as covariates in the regression and mediation models. Results indicated that higher social anxiety was associated with higher levels of paranoid ideation and higher cognitive-bias scores. Regression and mediation models using total DACOBS and CBQp scores further showed that maladaptive cognitive biases were significantly associated with paranoid ideation and statistically accounted for the association between social anxiety and paranoia. The findings support a dimensional account in which maladaptive cognitive biases are linked to both social anxiety and subclinical paranoid thinking in university students.

PMID:42673567 | DOI:10.1177/00332941261484076

J Surg Oncol. 2026 Aug 31. doi: 10.1002/jso.70386. Online ahead of print.

ABSTRACT

OBJECTIVE: This single-center retrospective cohort study aimed to evaluate the efficacy of auricular acupressure combined with heat-sensitive moxibustion in promoting gastrointestinal functional recovery and regulating gastrointestinal hormone levels in patients who underwent laparoscopic colorectal cancer surgery.

METHODS: A total of 68 patients with colorectal cancer who underwent laparoscopic radical resection at Ningde Municipal Hospital affiliated to Ningde Normal University from January to December 2022 were retrospectively enrolled. According to the postoperative intervention measures received, the patients were divided into an intervention group (n = 34, standard postoperative care plus auricular acupressure combined with heat-sensitive moxibustion) and a control group (n = 34, only standard postoperative care). The primary outcome indicators included the time to first flatus, time to recovery of bowel sounds, and time to first defecation after surgery. The secondary outcome indicators included the incidence and severity of postoperative abdominal distension, abdominal distension scores and bowel sound scores at 12, 24, 48 and 72 h after surgery, and the levels of gastrointestinal hormones (gastrin [GAS], motilin [MTL], gastric inhibitory polypeptide [GIP]) detected by radioimmunoassay before surgery and 5 days after surgery. The clinical data of the two groups were collected and statistically analyzed to compare the differences in each outcome indicator.

RESULTS: There were no statistically significant differences in baseline demographic data, clinical characteristics and operative variables between the two groups (p > 0.05), with good comparability. The time to first flatus, time to recovery of bowel sounds and time to first defecation in the intervention group were significantly shorter than those in the control group (all p < 0.05). At 72 h after surgery, the incidence of abdominal distension in the intervention group (67.65%) was significantly lower than that in the control group (88.24%), and the severity of abdominal distension in the intervention group was milder than that in the control group (p < 0.05). The abdominal distension scores and bowel sound scores of the intervention group at 12, 24, 48 and 72 h after surgery were significantly lower than those of the control group (all p < 0.05). There were no significant differences in the levels of GAS, MTL and GIP between the two groups before surgery (p > 0.05). At 5 days after surgery, the levels of the three gastrointestinal hormones in both groups were changed compared with those before surgery, and the levels of GAS, MTL and GIP in the intervention group were significantly higher than those in the control group (all p < 0.05).

CONCLUSION: Auricular acupressure combined with heat-sensitive moxibustion can effectively shorten the recovery time of gastrointestinal function, reduce the incidence and severity of postoperative abdominal distension, and effectively regulate the levels of gastrointestinal hormones in patients after laparoscopic colorectal cancer surgery. It is a safe and effective non-pharmacological adjuvant therapy for postoperative clinical management, and is worthy of clinical promotion and application.

PMID:42673555 | DOI:10.1002/jso.70386

J Craniofac Surg. 2026 Aug 31. doi: 10.1097/SCS.0000000000013356. Online ahead of print.

ABSTRACT

BACKGROUND: Cutaneous neurofibromas (cNF) are common in neurofibromatosis type 1 (NF1) and may require repeated procedural management, yet practical data on cNF-specific surgical burden remain limited. We characterized surgical event burden, anatomic distribution, recurrence patterns, and clinical correlates among NF1 patients undergoing surgery specifically for cNF.

METHODS: We performed a retrospective chart review of patients with NF1 evaluated at a tertiary academic center from 1990 to 2024. Patients were included if they underwent at least one institutionally documented surgical procedure primarily for cNF. Procedures for plexiform neurofibromas or other non-cutaneous NF1 manifestations were excluded. Surgical events, anatomic sites, indications, recurrence, and clinical features were abstracted and analyzed using descriptive statistics, Wilcoxon rank-sum tests, Fisher exact tests, Spearman correlation, and exploratory negative binomial regression.

RESULTS: Thirty-five patients underwent 88 cNF surgical events. Median events per patient were 2.0, and 9 patients were classified as having a high surgical burden. Pain was the most common documented indication. The trunk, arm, scalp, forehead, and cheeks contributed most to cumulative site-specific procedures. Greater proportional head and neck involvement was associated with lower total event burden, suggesting higher-volume disease was driven primarily by broader non-head and neck involvement. Site-specific recurrence was frequent and strongly correlated with total event burden. Chart-documented recurrence was associated with both higher event counts and high-burden status, whereas skeletal involvement, surgical follow-up duration, and age at first surgery were not robust predictors.

CONCLUSIONS: In this cNF-specific NF1 surgical cohort, cumulative operative burden was driven primarily by recurrent procedures across multiple anatomic sites rather than by skeletal phenotype, age at first surgery, or duration of follow-up. These findings suggest that documented recurrence and multisite involvement may help identify patients at risk for repeated surgical intervention. Distinguishing high-volume disease affecting the trunk and extremities from high-impact head and neck disease may improve patient counseling, longitudinal operative planning, and future efforts to reduce cumulative surgical burden in NF1.

PMID:42673529 | DOI:10.1097/SCS.0000000000013356

Genetics. 2026 Aug 31:iyag234. doi: 10.1093/genetics/iyag234. Online ahead of print.

ABSTRACT

Production livestock provide a natural system for studying gene regulation under physiologically demanding conditions shaped by rapid growth, environmental exposure, and immune challenges. Using farm pigs from the PigGTEx resource, we apply quantile regression to reveal context-dependent genetic effects on gene expression across tissues. We identify quantile-specific eQTLs missed by standard linear models that preferentially localize to distal regulatory elements and three-dimensional genome architecture, in contrast to the promoter-proximal bias of canonical eQTLs. Genes with quantile-dependent eQTLs are more intolerant to loss-of-function variants and exhibit distinct patterns of enrichment in GO functional categories, indicating their likely functional significance. Cross-species comparisons reveal substantial overlap between pig and human eGenes across tissues, indicating conservation of regulatory architecture. Notably, many quantile-specific eQTLs influence tail expression states and involve genes relevant to human disease. For example, we identify a cis-eQTL affecting the conserved transcriptional regulator BCL6B in pig blood that modulates enhancer activity and reduces expression at lower quantiles. In contrast, BCL6B is minimally expressed in resting human blood and lacks detectable cis-regulatory variation under baseline conditions, consistent with its reported induction during immune activation. These findings demonstrate that pig eQTL maps can reveal context-dependent regulatory variation at loci that remain silent or weakly variable in human cohorts.

PMID:42673503 | DOI:10.1093/genetics/iyag234

J Craniofac Surg. 2026 Aug 31. doi: 10.1097/SCS.0000000000013308. Online ahead of print.

ABSTRACT

BACKGROUND: Moyamoya disease (MMD) is a chronic progressive cerebrovascular disease characterized by bilateral steno-occlusive changes at the terminal internal carotid arteries. Fragile vascular wall alterations combined with hemodynamic stress may facilitate intracranial aneurysm formation. This study aimed to identify risk factors of intracranial hemorrhage in MMD patients with associated aneurysms.

METHODS: Between March 2014 and October 2021, a consecutive cohort of 69 patients who were diagnosed with MMD associated with aneurysms was enrolled in this retrospective single-center study. Treatments, including conservation, endovascular intervention, surgical clipping, and revascularization, were conducted in patients based on individual status and clinical experience. Hemorrhage was noticed by annual clinical visit or telephone and confirmed by computed tomography.

RESULTS: This cohort of MMD with IA underwent a median follow-up of 76.2 months. During this period, 17 patients experienced hemorrhage while 52 maintained hemorrhagic-free survival. Logistic regression showed that ipsilateral moyamoya vessels with aneurysms (P=0.018) and low admission GCS (P<0.001) were independent predictors of hemorrhage. Cox regression analysis also confirmed both factors (P=0.003; <0.001) had a statistical association with reduced hemorrhage-free survival. No significant differences between the nonhemorrhagic and hemorrhagic groups were observed in sex, age, previous hemorrhage, or impaired perfusion on computed tomography perfusion between the 2 groups.

CONCLUSIONS: Hemorrhage constituted a clinically significant incident in MMD with aneurysm, characterized by relatively high frequency and catastrophic neurological consequences. Ipsilateral moyamoya vessels harboring aneurysms and low admission GCS were independent factors for hemorrhage following initial intervention. Both factors also correlated with shorter hemorrhage-free survival.

PMID:42673502 | DOI:10.1097/SCS.0000000000013308

Lab Med. 2026 Aug 4;57(5):lmag057. doi: 10.1093/labmed/lmag057.

ABSTRACT

INTRODUCTION: No evidence-based preanalytical guideline exists for EDTA blood storage before hemoglobin H (HbH) inclusion body detection. We evaluated the stability of rapid (30-minute) brilliant cresyl blue staining across α-globin and β-globin genotypes in blood stored at 4 °C.

METHODS: Residual EDTA blood from 322 patients with microcytic hypochromic anemia was stored at 4 °C and tested on days 0, 2, 4, and 7 by 3 blinded medical technologists. Hemoglobin typing and genotyping followed inclusion body counting. Wilcoxon and Mann-Whitney U tests as well as intraclass correlation coefficient(2,1) were applied.

RESULTS: Six α-globin genotype groups were identified, including HbH disease (n = 103), by β-globin genotype background. Non-HbH groups showed no meaningful inclusion bodies, confirming stable specificity. In HbH disease with a normal β-globin gene, 100% qualitative concordance was maintained at day 7, with no statistically significant quantitative change from day 0 (P = .28); the intraclass correlation coefficient(2,1) was 0.858. A transient increase at day 2 (P < .001) may have reflected in vitro HbH autoxidation during cold storage. Hemoglobin H disease co-inheriting HbE showed stable but markedly reduced counts throughout storage; a consistent pattern was observed in isolated cases co-inheriting β-thalassemia.

DISCUSSION: EDTA blood stored at 4 °C maintains qualitative stability for HbH inclusion body detection for up to 7 days; HbE co-inheritance substantially reduces diagnostic sensitivity, with a similar pattern observed in isolated β-thalassemia co-inheritance.

PMID:42673501 | DOI:10.1093/labmed/lmag057

J Craniofac Surg. 2026 Aug 31. doi: 10.1097/SCS.0000000000013334. Online ahead of print.

ABSTRACT

PURPOSE: Temporomandibular disorder (TMD) and sleep-disordered breathing (SDB) tend to be comorbid conditions that negatively impact quality of life, including jaw pain and breathing function. Genome-wide association studies (GWAS) demonstrate that OSA has a causal effect on TMD. Clinical studies support that TMD-related pain and headache symptoms improve after 18 months of OSA treatment. Transverse maxillary hypoplasia (TMH) associated with nasal obstruction may contribute to both airway compromise and altered occlusal loading, predisposing individuals to TMD. Our study aims to identify TMH with nasal obstruction as one mechanism of developing TMD.

METHODS: This retrospective, single-center cohort study included 358 subjects aged 18 years and older presenting with TMJ arthralgia between 2024 and 2025. Exclusion criteria included lack of MRI or CBCT imaging, systemic bone diseases, history of facial trauma, neurological disorders, and prior TMJ or orthognathic surgery. The predictor variable was group (1), no TMD symptoms (n=49), and group (2) MRI-confirmed unilateral anterior disc displacement without reduction (n=23). The primary outcome was naso-maxillary width. Secondary outcomes were maxillary angle at the pyriform rim, nasal floor width, greater palatine foramen width, and the presence of chronic nasal obstruction or prior nasal surgery. Covariates included age, sex, and BMI. Statistical analysis involved descriptive and bivariate analyses, including Fisher’s exact test for categorical variables, and multivariable analyses, with P < 0.05 considered statistically significant.

RESULTS: Twenty-three subjects met the inclusion criteria for unilateral anterior disc displacement without reduction (ADDwoR), with a mean age of 39.6±14 years. The cohort included 2 male subjects and 1 nonbinary subject. Subjects in the ADDwoR group had a narrower naso-maxillary width of 17.4±1.6 mm compared with the control group of 20.9±1.8 mm, and a narrower nasal floor width of 18.6±1.5 mm compared with 21.7±2 mm in the controls. The maxillary angle at the pyriform aperture was 42.4±6.2 degrees compared with 48±7 degrees, while the greater palatine foramen width was narrower (23.5±2 mm vs. 25.8±2.4 mm). Chronic nasal obstruction or prior nasal surgery was more prevalent in the unilateral ADDwoR group (39.1%) than in the control group (10.2%) (OR=5.66, P=0.008). When adjusted for age, sex, and BMI, narrower naso-maxillary width, nasal floor width, maxillary angle, and greater palatine foramen width remained significantly associated with increased odds of ADDwoR (adjusted OR = 0.34).

CONCLUSION: Subjects with unilateral ADDwoR are associated with transverse maxillary hypoplasia and a higher prevalence of chronic nasal obstruction or prior nasal surgery. Transverse maxillary hypoplasia may contribute to occlusal instability and asymmetric TMJ loading, potentially aggravating unilateral ADDwoR. Combined with GWAS findings linking OSA as a causal factor for TMD, these results emphasize the need for more research in support of sleep-disordered breathing screening and intervention in ADDwoR.

PMID:42673486 | DOI:10.1097/SCS.0000000000013334

Proc Natl Acad Sci U S A. 2026 Sep 8;123(36):e2608875123. doi: 10.1073/pnas.2608875123. Epub 2026 Aug 31.

ABSTRACT

The human brain operates through large-scale networks whose subcortical components are critical for consciousness, emotion, and cognition. While cortical network connectivity has been mapped with increasing precision, subcortical network mapping has lagged far behind due to two fundamental barriers: the overlapping and correlated nature of brain networks, which conventional analytic methods cannot disentangle, and the inherently low signal-to-noise ratio of functional imaging data within the subcortex. As a result, no consensus or normative atlas for subcortical functional brain connectivity exists-a critical gap that has impeded both basic neuroscience and the development of targeted neuromodulatory therapies. In this work, we address these barriers using NASCAR, a tensor decomposition method explicitly designed to separate overlapping and correlated networks, applied to resting-state functional MRI data from 1,000 healthy individuals in the Human Connectome Project. This approach enabled us to fractionate four large-scale brain networks into 15 highly reproducible subnetworks spanning both cortical and subcortical structures, revealing their sites of neuroanatomic overlap and defining a normative whole-brain functional atlas grounded in subcortical connectivity. As proof of principle for the translational potential of this framework, we show that individual patterns of subnetworks predict levels of consciousness in patients with severe traumatic brain injury. By establishing a gold-standard, openly accessible reference for subcortical functional brain organization, this work expands the landscape of human brain network mapping and opens avenues for precision targeting in the treatment of a broad spectrum of neurological and psychiatric disorders.

PMID:42673458 | DOI:10.1073/pnas.2608875123