Category: Nevin Manimala

Psychol Med. 2026 Apr 27;56:e113. doi: 10.1017/S0033291726103614.

ABSTRACT

BACKGROUND: Insomnia is commonly seen in opioid use disorder (OUD) patients receiving methadone maintenance treatment (MMT) and might be related to high heroin relapse risk. This study aims to identify potential mediation pathways among peripheral cytokines, neuroimaging characteristics, and insomnia in MMT patients, and explore diagnostic markers and therapeutic targets for MMT-related insomnia.

METHODS: A total of 121 OUD individuals (OUDs) and 109 healthy controls were recruited, including MMT individuals (MMT group, N = 53), short-term abstinent (median: 30 days) heroin users at baseline (OUD1, N = 68), and around 10-month follow-up (OUD2, N = 61) without MMT, healthy controls-cohort 1 (HC1, N = 53, age/gender/education match MMT), and healthy controls-cohort 2 (HC2, N = 56, age/gender match OUD1). Multimodal datasets, including cerebral diffusion tensor imaging (DTI), peripheral hematologic indicators, and neuropsychological assessments, were collected from the MMT group and HC1. Within the MMT group, we revealed relationships among cytokines, DTI metrics, and neuropsychological assessments via partial correlation and mediation analyses. Mendelian randomization (MR) analyses between OUD and white matter (WM)-related imaging-derived phenotypes were used to further confirm Tract-Based Spatial Statistics (TBSS) results. Besides, the results of TBSS among OUD1, OUD2, and HC2 hypothetically served as baseline WM alteration before MMT.

RESULTS: Through comparisons among OUD1, OUD2, and HC2, WM aberrances could return to normal after 10-month abstinence, and we used the results as baseline alterations before MMT. MMT patients exhibited a broad imbalance in peripheral immune cells and cytokines, as well as presented insomnia, anxiety, and depression symptoms. After Bonferroni correction, mean diffusivity and radial diffusivity in extensive WM regions were higher in MMT patients than those of HC1. Ultimately, through multimodal correlation analysis, the ‘Interferon-γ (IFN-γ)-WM aberrance-insomnia’ axis was discovered in the MMT group.

CONCLUSIONS: Together, these results primarily link cytokines and WM injury for OUDs with MMT to insomnia, implicating pharmacological IFN-γ target as a latent strategy to improve the insomnia of MMT patients.

PMID:42037510 | DOI:10.1017/S0033291726103614

J Orthop Res. 2026 Apr;44(5):e70208. doi: 10.1002/jor.70208.

ABSTRACT

Anterior cruciate ligament (ACL) injury and subsequent changes in the magnitude and distribution of contact stress about the articular surfaces of the knee are associated with post-traumatic osteoarthritis. Soon after ACL injury, changes in tibial articular cartilage thickness occur that can be explained, in part, by abnormal positioning of the tibia relative to the femur. However, little is known about the effects of ACL injury on the positions of the menisci. The purpose of this case-control study was to determine the effect of ACL injury on posterior horn meniscus centroid (PHMC) position relative to the tibia in males and females. ACL-injured and matched control subjects with normal knees underwent bilateral magnetic resonance imaging soon after the index injury and prior to ACL reconstruction. The PHMC position was defined in three dimensions at the point of maximal tibial articular cartilage concavity in the lateral and medial compartments of the knee. In control subjects, there were no significant differences in PHMC position between knees in the lateral and medial compartments. In ACL-injured knees, there were significant posterior-directed changes in PHMC position in both compartments for males and females when compared to their contralateral normal knees. These changes in PHMC position may alter the distribution of articular cartilage contact stress and explain a portion of the changes in knee biomechanics and cartilage thickness that occur following ACL injury. In addition, these findings suggest that the menisci should not be used as landmarks to establish regions of interest when measuring cartilage thickness and matrix components.

PMID:42037506 | DOI:10.1002/jor.70208

Eur J Neurol. 2026 May;33(5):e70568. doi: 10.1111/ene.70568.

ABSTRACT

BACKGROUND: Cognitive impairment is common in multiple sclerosis (MS), yet the application of diagnostic frameworks of Neurocognitive Disorders (NCDs) is limited. Additionally, the integration of multimodal data for predicting cognitive outcomes using artificial intelligence (AI) remains underexplored. This study aimed to characterize NCDs in MS and predict cognitive worsening using an explainable deep learning model trained on MRI and clinical data.

METHODS: Two-hundred twenty-four MS patients and 115 healthy controls (HC) underwent 3.0 T MRI and clinical assessment at baseline. MS patients also completed neuropsychological testing, including estimation of z-cognitive reserve, at baseline and after a median follow-up of 3.4 (interquartile range = [2.0; 6.1]) years. MS patients were classified as Mild or Major NCD according to the Diagnostic and Statistical Manual of Mental Disorders criteria at baseline, and as “stable” or “worsened” based on cognitive changes at follow-up. A deep learning model was trained on baseline T1-weighted MRI, demographic, clinical, and brain volumetric data to predict cognitive decline, with explainability methods used to interpret the model’s decisions.

RESULTS: At baseline, 4% of patients had Mild and 11% Major NCD. At follow-up, 12% showed cognitive decline. The deep learning model predicted follow-up cognitive status with 90% accuracy. Explainability models identified the most relevant predictors, in order of importance: cortical gray matter volume, age, thalamic and hippocampal volumes, T2 lesion volume, and z-cognitive reserve.

CONCLUSIONS: The proposed multimodal AI approach demonstrated robust performance and highlighted relevant brain regions associated with cognitive worsening, underscoring its potential for personalized cognitive assessment and monitoring in MS.

PMID:42037489 | DOI:10.1111/ene.70568

Psychol Med. 2026 Apr 27;56:e115. doi: 10.1017/S0033291726103985.

ABSTRACT

Parental severe mental illnesses (SMIs), including schizophrenia, bipolar disorder, and major depressive disorder (MDD), can impact children’s well-being, yet existing meta-analyses are limited in scope and methodology and do not comprehensively assess cognitive and academic performance in offspring across SMIs. This meta-analysis aimed to synthesize the existing evidence on the association between parental SMIs and offspring cognitive and academic performance. MEDLINE, EMBASE, PsycINFO, and CINAHL were searched from their inception to December 2025. We included studies assessing associations between parental SMIs and offspring cognitive/academic performance at any age, including attention, memory, language, executive function, processing speed, IQ, social cognition, and academic performance. Standardized mean differences (SMDs) between offspring of parents with SMIs and controls were calculated. Differences in cognitive performance between affected offspring and controls were pooled using random-effects meta-analyses, with robust variance estimation. The meta-analysis included 109 studies (1,586,339 participants). Parental schizophrenia was strongly associated with several cognitive domains, including general cognition (SMD = -1.07, 95% CI: -1.92, -0.22), language (-0.70; -1.20, -0.20), and IQ (-0.53; -0.72, -0.34). Parental bipolar disorder was associated with general cognition (SMD = -0.45, 95% CI = -0.79, -0.12), memory (-0.40; -0.60, -0.19), executive function (-0.34; -0.51, -0.16), IQ (-0.32; -0.48, -0.17), and language (-0.18, 95% CI -0.34, -0.02). Parental MDD showed weaker but statistically significant associations with executive function, general cognition, and language development. Children of parents with SMIs, particularly schizophrenia or bipolar disorder, are at increased risk of cognitive difficulties. Population-level early intervention strategies targeting these families may improve offspring’s cognitive performance.

PMID:42037487 | DOI:10.1017/S0033291726103985

Glob Chang Biol. 2026 Apr;32(4):e70868. doi: 10.1111/gcb.70868.

ABSTRACT

Detecting changes in forest soil carbon stocks is critical for compiling national carbon budgets, yet remains challenging due to high spatial variability and relatively small temporal changes. Here, we use data from Canada’s National Forest Inventory (NFI), which includes repeated measurements of organic and mineral soil horizons across 532 plots. We quantified within- and between-plot variability in soil carbon properties, assessed minimum detectable differences (MDD), and explored design improvements through simulations. Spatial variation in soil carbon stocks was substantial: coefficients of variation were ~40% for mineral and ~70% for organic horizons, with within-plot comparable to between-plot variability. Consequently, MDDs were also high, at ~4.1 and 4.6 Mg ha^-1 10 year^-1 for the surface mineral and organic horizons, respectively. This implies that only large, widespread changes would be detectable with the current data. Simulations showed that increasing the number of remeasurement plots to ~700 with four subsamples per plot could reduce MDD to be on par with the current estimate of soil carbon change. Grouping plots by ecozone provided inconsistent benefits at the national level because of ecozones with high spatial heterogeneity. The data also had patterns consistent with the statistical phenomenon of regression to the mean, which implies that any change in carbon stock may be a statistical artifact. Indeed, soil carbon stocks appeared to grow by 2.3 Mg C ha^-1 10 year^-1 during the first remeasurement interval, while a small number of second remeasurement interval data showed a completely unrelated pattern supporting the inference that this first interval change was a statistical artifact. Overall, our analysis of the NFI data suggests that its design characteristics of sampling multiple microplots per main plot and collecting longitudinal data per microplot are critical to providing robust estimates of soil carbon stock changes that can be used in national greenhouse gas inventories.

PMID:42037479 | DOI:10.1111/gcb.70868

J Pediatr Orthop B. 2026 Apr 28. doi: 10.1097/BPB.0000000000001351. Online ahead of print.

ABSTRACT

While opioid medications are commonly used to manage postoperative pain in patients undergoing posterior spinal fusion (PSF) for adolescent idiopathic scoliosis, their use is associated with negative short and long-term effects. There is a paucity of data evaluating the feasibility and efficacy of opioid-free pain regimens in this population. The purpose of this study was to compare a multimodal opioid-free with a traditional opioid-containing protocol in pediatric patients undergoing instrumented PSF for idiopathic scoliosis. We hypothesized that the opioid-free pain management pathway would result in equivalent length of stay (LOS) and fewer opioids prescribed at discharge compared with an opioid-containing pathway. This was a prospective case-control study comparing opioid-free versus opioid-containing pathways. Eligible participants included patients aged 10-20 years at time of surgery with idiopathic scoliosis who underwent primary instrumented PSF by a single, fellowship-trained pediatric orthopedic surgeon during a 2-year period. Total opioid use was recorded. Statistical analysis included Wilcoxon, Chi-square, and Fisher’s exact tests for group comparisons. Patients in the opioid-free group had a greater number of levels fused (P = 0.036), had a similar inpatient LOS postoperatively (P = 0.917), and required fewer opioid prescriptions at discharge [10/36 patients (27.8%) vs. 55/56 patients (98.2%), respectively; P < 0.0001]. A comprehensive, multimodal, opioid-free pain management pathway following instrumented PSF for idiopathic scoliosis results in equivalent LOS and fewer opioids prescribed at discharge compared with an opioid-containing pathway. Establishing patient/family expectations beforehand is crucial to the successful engagement and implementation of this opioid-free protocol.

PMID:42037458 | DOI:10.1097/BPB.0000000000001351

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2026 May;40(5):477-481. doi: 10.13201/j.issn.2096-7993.2026.05.012.

ABSTRACT

Objective:To compare the effects of remote interactive voice therapy versus traditional in-person therapy on treatment adherence and clinical outcomes in patients with voice disorders. Methods:A retrospective historical control study was conducted, categorizing patients into three groups based on distinct periods of COVID-19 prevention policies: the 2019 traditional therapy group（n=82）, the 2021 traditional therapy group（n=43）, and the 2022 remote therapy group（n=54）. Adherence differences were analyzed by geographic subgroup（Guangzhou vs. non-Guangzhou）, and improvements in Voice Handicap Index（VHI）, jitter, and shimmer were compared pre-and post-treatment. Results:Adherence: The overall〓adherence rate in the 2022 remote therapy group（38.89%） was higher than in the 2019（31.71%） and 2021（23.26%） traditional groups, although the difference was not statistically significant（P>0.05）. Notably, non-Guangzhou patients exhibited significantly higher adherence with remote therapy（2022: 45.45%） compared to traditional therapy（2019: 5.00%; 2021: 0）（P<0.01 for both comparisons）. Efficacy: Among patients with good adherence, all three groups showed significant improvements in VHI, jitter, and shimmer（all P<0.01）. Further analysis revealed no statistically significant differences in the magnitude of improvement between the 2022 remote group and the 2019/2021 traditional groups（all P>0.05）, indicating comparable therapeutic efficacy. Conclusion:Remote interactive voice therapy significantly enhances adherence among non-local patients, with equivalent efficacy to traditional in-person therapy. This approach provides an effective solution to overcome spatial and temporal barriers in voice rehabilitation, and holds important practical significance for optimizing voice disorder management strategies and improvinghealthcare service accessibility.

PMID:42037438 | DOI:10.13201/j.issn.2096-7993.2026.05.012

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2026 May;40(5):473-476. doi: 10.13201/j.issn.2096-7993.2026.05.011.

ABSTRACT

Objective:To investigate the expression of HPV 6/11 in NIP tissues and evaluate the adjuvant therapeutic effect of interferon-α gel on HPV-positive NIP patients. Methods:Forty-two newly diagnosed Nasal Inverted Papilloma（NIP） patients were included, and the expression of HPV6/11 in tissues was detected using fluorescence in situ hybridization with specific probes. Twenty-two HPV-positive patients were randomly divided into an interferon treatment group（n=11） and a control group（n=11）. Both groups underwent endoscopic tumor resection, with the treatment group receiving local application of interferon-α gel during and after surgery. Postoperative recovery was assessed using the DIP endoscopic scoring system at 3, 6, and 12 months. Results:The positive expression rate of HPV6/11 in NIP tissues was 52.38%（22/42）, which was significantly higher than that in the nasal polyp control group（8.33%, 1/12）（P<0.05）. Among HPV-positive NIP patients, there were no statistically significant differences were observed in DIP scores between the interferon treatment group and the control group at 3, 6, and 12 months postoperatively（P>0.05）. Conclusion:HPV6/11 shows high expression in NIP tissues, but the use of interferon-α gel did not improve postoperative recovery in HPV-positive patients.

PMID:42037437 | DOI:10.13201/j.issn.2096-7993.2026.05.011

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2026 May;40(5):457-461. doi: 10.13201/j.issn.2096-7993.2026.05.008.

ABSTRACT

Objective:To investigate the preoperative coagulation characteristics and postoperative changes in patients with primary hyperparathyroidism（PHPT）. Methods:A retrospective analysis was conducted on the clinical data of 55 PHPT patients treated at Beijing Chaoyang Hospital, including preoperative and postoperatively（1 week） serum calcium, serum phosphorus, parathyroid hormone（PTH）, 25-hydroxyvitamin D, prothrombin time（PT）, activated partial thromboplastin time（APTT）, fibrinogen（FIB）, thrombin time（TT）, D-dimer（D-Dimer）, and thromboelastography（TEG） parameters such as coagulation index（CI）, reaction time（R）, kinetic time（K）, maximum amplitude（MA）, and lysis at 30 minutes（LY30）. The preoperative coagulation status and the impact of postoperative biochemical changes on coagulation function were analyzed. Results:All 55 patients successfully underwent parathyroid tumor resection, pathological findings were 41 cases of adenoma（74.5%）, 12 cases of atypical tumor（21.8%）, and 2 cases of carcinoma（3.6%）. The median preoperative serum calcium and PTH levels were 2.67 mmol/L and 171.60 pg/mL, respectively. All patients had PT, APTT, FIB, TT, CI, MA, K, and LY30 values within normal ranges, but 11 patients（20.0%） exhibited reduced preoperative R values. Compared to the normal R-value group, the reduced R-value group had shorter APTT, higher D-Dimer, and higher CI values, with statistically significant differences（P<0.05）, suggesting a hypercoagulable state preoperatively. One week postoperatively, the median serum calcium and PTH levels significantly decreased to 2.14 mmol/L and 35.10 pg/mL, respectively（P<0.05）. Except for a slight increase in D-Dimer, PT, APTT, FIB, TT, CI, MA, K, and LY30 values remained stable within normal ranges. The differences in APTT, D-Dimer, and CI values between the reduced R-value group and the normal R-value group were no longer statistically significant（P>0.05）. Conclusion:Some PHPT patients exhibit a hypercoagulable state with reduced R values preoperatively, and surgical resection of parathyroid tumor helps improve coagulation function in these patients.

PMID:42037434 | DOI:10.13201/j.issn.2096-7993.2026.05.008

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2026 May;40(5):427-431. doi: 10.13201/j.issn.2096-7993.2026.05.003.

ABSTRACT

Objective:To investigate the clinical value of thoracoscopic partial parathyroidectomy via the subclavian approach for the treatment of parathyroid adenoma with primary hyperparathyroidism. Methods:A retrospective analysis was conducted on 26 patients with parathyroid adenoma and primary hyperparathyroidism treated between September 2023 and April 2024. Patients were divided into two groups based on surgical approach: the thoracoscopic subclavian approach group and the median anterior cervical open approach group. Multiple indicators, including perioperative parameters, postoperative complications, postoperative pain, and incision cosmetic satisfaction, were compared and analyzed. The clinical efficacy of thoracoscopic partial parathyroidectomy via the subclavian approach was evaluated. Results:All surgeries were completed successfully. There were significant differences between the two groups in terms of operative time and intraoperative blood loss（P=0.001,<0.001）, while there were no statistically significant differences in age, lesion size, preoperative/postoperative serum parathyroid hormone（PTH）, preoperative/postoperative serum calcium, postoperative drainage volume, drainage tube placement time, length of hospital stay, and cost（all P>0.05）. At 24 hours postoperative serum PTH and calcium concentrations were significantly decreased compared to preoperative levels（P=0.012,<0.001; P=0.018,<0.001）. There was no statistically significant difference in the incidence of postoperative complications between the endoscopic and open surgery groups（P>0.05）. At 24 hours postoperatively, the visual analogue scale（VAS） pain scores were comparable between the two groups（P>0.05）. In contrast, cosmetic satisfaction scores were significantly higher in the endoscopic cohort compared to the open surgery group（P=0.003）. Conclusion:Subclavicular approach endoscopic parathyroidectomy is an ideal treatment option compared to the median approach, effectively reducing serum PTH and calcium levels without increasing the risk of postoperative complications, while also satisfying patients’ aesthetic needs. The surgery is safe and feasible, and has high clinical application value.

PMID:42037429 | DOI:10.13201/j.issn.2096-7993.2026.05.003