Category: Nevin Manimala

Neurology. 2026 Aug 11;107(3):e218282. doi: 10.1212/WNL.0000000000218282. Epub 2026 Jul 16.

ABSTRACT

BACKGROUND AND OBJECTIVES: Endovascular thrombectomy (EVT) improves outcome in acute ischemic stroke (AIS) due to large vessel occlusion, yet the optimal anesthetic strategy remains controversial. Previous meta-analyses using frequentist methods reported no significant differences between general anesthesia (GA) and non-GA techniques; however, a recently published trial reported a high posterior probability of functional benefit with GA. We aimed to update the existing systematic review and to re-examine the cumulative randomized evidence using Bayesian statistical methods.

METHODS: We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. PubMed/MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were searched from inception to January 3, 2026, for randomized controlled trials (RCTs) comparing GA with non-GA strategies during EVT in adults with AIS. Primary outcomes were functional independence (modified Rankin Scale [mRS] 0-2) at 90 days, successful reperfusion (thrombolysis in cerebral ischemia 2b-3), and 90-day mortality. Bayesian random-effects meta-analyses with weakly informative priors were performed. Results are reported as odds ratio (OR) or mean difference (MD) with 95% credible intervals (CrIs). A posterior probability of superiority exceeding 80% was considered substantial evidence of benefit. Meta-regression and sensitivity analyses were conducted.

RESULTS: Ten RCTs (n = 1,601; mean age 70.0 years; 46.6% female) were included. For functional independence, GA was associated with a 94.2% posterior probability of superiority (OR 1.24, 95% CrI 0.94-1.66). GA was associated with higher successful reperfusion rates (OR 1.73, 95% CrI 1.23-2.43; P (superiority) > 99%). No substantial differences were observed for 90-day mortality (OR 0.92, 95% CrI 0.67-1.27; P [superiority] 69%), excellent functional outcome (mRS 0-1; OR 1.06, 95% CrI 0.80-1.41; P [superiority] 67%), or symptomatic intracranial hemorrhage (OR 0.93, 95% CrI 0.56-1.52; P [superiority] 62%). GA was associated with increased intraoperative hypotension (OR 4.28, 95% CrI 2.35-7.86; P [superiority] 0.01%) and increased pneumonia risk (OR 1.60, 95% CrI 0.95-2.81; P [superiority] 3%).

DISCUSSION: This meta-analysis using a Bayesian approach provides evidence that GA during EVT for AIS is associated with improved functional outcomes, challenging previous conclusions of equivalence. These findings should be interpreted considering open-label designs and heterogeneous non-GA comparators. They suggest that GA may be preferred but confirmatory evidence is needed.

PMID:42462185 | DOI:10.1212/WNL.0000000000218282

Am J Biol Anthropol. 2026 Jul;190(3):e70321. doi: 10.1002/ajpa.70321.

ABSTRACT

OBJECTIVES: Root surface morphology has been used to examine functional signals related to diet and taxonomic affinities in primates with varying degrees of success. The aim of this study is to determine if the use of the functionally significant root cervix can enhance our understanding of these relationships in catarrhines.

MATERIALS AND METHODS: Two-dimensional (2D) semilandmark points were collected using cross sections taken from the cervix of all three mandibular molar positions in a sample of extant catarrhines (n = 68). Multivariate regression was used to examine the influence of size on Procrustes aligned data. Standard and phylogenetic principal component analyses were performed for each molar position. Phylogenetic generalized least squares (PGLS) were used to correct for nonindependence.

RESULTS: Allometric effects were statistically significant (p < 0.05) but weak for each position (M₁ = 0.096, M₂ = 0.064, M₃ = 0.062). Phylogenetic signal, multivariate K, was significant for each molar but less than expected under Brownian motion (K_mult < 1). PGLS removed all functional signal related to dietary ecology at M₁ for phylogenetically aligned PCA (PACA) and phylogenetic PCA (pPCA) components. These signals were diminished but not eliminated at M₂ (PACA) and M₃ (pPCA).

CONCLUSIONS: The influence of size on the morphology of the root cervix is limited and does not impact functional signals related to either phylogeny or diet. Observed morphological variation of the root cervix is driven in part by both phylogeny and diet. However, these variables share a strong relationship, and more work is needed to disentangle the two.

PMID:42460573 | DOI:10.1002/ajpa.70321

Curr Cardiol Rev. 2026 Jul 10. doi: 10.2174/011573403X461776260628210313. Online ahead of print.

ABSTRACT

INTRODUCTION: The association between the gut microbiota and aortic dissection(AD) progression remains to be fully characterized, and current evidence regarding the influence of cortisol on this relationship remains inconclusive. The aim of this study was to determine whether cortisol levels contribute to this association.

METHODS: A two-sample Mendelian Randomization (MR) approach was implemented, incorporating gut microbiota summary statistics derived from a large-scale genome-wide association meta-analysis (n=18,340) performed by the MiBioGen consortium. Additionally, summary-level data on aortic dissection were obtained from the FinnGen Consortium R10 release, which included 967 cases and 381,977 controls. To investigate causal relationships, the study implemented inverse-variance weighting, a weighted model, a weighted median, MR-Egger, and MRPRESSO. Mediated MR analyses were performed on bacteria identified as causally associated with aortic dissection, along with intermediate metabolites derived from 1,400 blood metabolites, and the metabolites that mediated the relationship between them were identified. The study employed Cochran’s Q test to examine heterogeneity in the genetic instruments.

RESULTS: Seven gut microbiota species with elevated abundance potentially exerts a protective or negative effect on aortic dissection. In particular, the Ruminococcus gnavus group may have a deleterious effect on aortic dissection via changes in cortisol levels.

CONCLUSION: This study offers novel insights into the involvement of gut microbiota in the prevention of aortic dissection and the complex relationship between them. Additionally, it underscores the significance of randomized controlled trials in determining the association linking gut microbiota with aortic dissection risks.

PMID:42460537 | DOI:10.2174/011573403X461776260628210313

Recent Adv Inflamm Allergy Drug Discov. 2026 Jul 10. doi: 10.2174/0127722708469832260704203619. Online ahead of print.

ABSTRACT

INTRODUCTION: Dyslipidemia (DLP) is an increase in lipid accumulation; as a result, hypertriglyceridemia causes body inflammation. One risk factor for inflammation is the development of dry eye disease (DED). This study aims to investigate the correlation between the erythrocyte sedimentation rate and C-reactive protein ratio (ESR/CRP ratio) and lipid profile biomarkers as indicators for dyslipidemia in dry eye disease patients.

METHODS: The study was designed based on a case-control study of n=200 patients with dyslipidemia in the King Abdulaziz Medical Center (KAMC) – Jeddah hospital community, who were randomly selected. The patient data were collected for two groups: the control group, dyslipidemia only (DLP; n= 144), and the study group, dyslipidemia with dry eye disease (DLPDED; n= 56). All patients’ demographic and laboratory findings data were retrospectively extracted from the hospital records using the BestCare platform; then, the PRISM software analyzed the statistical data (GraphPad Inc., San Diego, CA, USA). A significance level of p <0.05 was adopted for validation.

RESULTS: This study found that females were more common in DLP-DED patients than DLP patients. Moreover, DLP-DED patients have triglyceride values higher than DLP patients, with a statistically significant difference (p < 0.0001). Compared the correlation of ESR/CRP ratio between groups, only DLP-DED patients showed a positive correlation between ESR/CRP ratio and total cholesterol and between ESR/CRP ratio and low-density lipoprotein (LDL) in the DLP-DED group with statistically significant differences p = 0.0223 and p = 0.0393, respectively.

DISCUSSION: The positive correlation between the ESR/CRP ratio and LDL and cholesterol levels in DLP-DED patients supported a previously published study on DED patients versus non- DED.

CONCLUSION: Given the significant correlations between the ESR/CRP ratio and lipid profile, examining the ESR/CRP ratio is recommended as routine screening of dyslipidemia patients with ocular surface diseases such as dry eye disease to provide clinically beneficial diagnosis and treatment approaches and prevent future eye complications in DLP patients.

PMID:42460530 | DOI:10.2174/0127722708469832260704203619

Curr Neuropharmacol. 2026 Jul 10. doi: 10.2174/011570159X468669260626223524. Online ahead of print.

ABSTRACT

BACKGROUND: Genetic evidence implicates the contribution of the gut-brain axis to neurodegenerative diseases (NDDs). Alterations in gut microbiota and inflammation are key pathophysiological contributors. Elucidating the genetic basis and the role of cytokines can provide insights into mechanisms linking gut microbial composition to neurodegeneration.

METHODS: Using aggregated statistics from five large-scale Genome-Wide Association Studies (GWAS) on Alzheimer’s disease, Parkinson’s disease, dementia with Lewy bodies, multiple sclerosis, and amyotrophic lateral sclerosis, bidirectional two-sample Mendelian Randomization (MR) was used to examine the associations. A two-step multivariable Mendelian randomization approach incorporates data from 91 cytokines to explore potential mediators.

RESULTS: The study reveals 18 positive and 17 negative effects between gut microbiota and NDDs, as well as 10 positive and 10 negative effects between cytokines and NDDs. Remarkably, mediation analysis identified a causal pathway, with evidence that plasma neurturin levels partially mediate the association from genus Ruminococcus2 to multiple sclerosis, with a mediation proportion of 19.19% (OR = 1.038, 95% CI = 1.001-1.086, P = 0.044). No pleiotropy or heterogeneity was detected.

DISCUSSION: These MR findings provide compelling evidence for a genetically anchored gutimmune-brain network in NDDs, with cytokines as intermediates. Bidirectional effects highlight disease-specific microbial signatures and inflammatory contexts. The Ruminococcus2-neurturin pathway in multiple sclerosis may offer mechanistic specificity, aligning with neurotrophic and anti-inflammatory signaling pathways.

CONCLUSION: This study emphasizes the importance of gut microbiota alterations in NDDs and explores inflammation’s partial intermediary role. The findings suggest potential targets for personalized neurodegeneration prevention strategies.

PMID:42460525 | DOI:10.2174/011570159X468669260626223524

J Surg Oncol. 2026 Jul 16. doi: 10.1002/jso.70337. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the survival impact of radical hysterectomy versus simple hysterectomy on non-endometrioid endometrial cancer with cervical involvement.

METHODS: We conducted a multicenter retrospective cohort study of 422 women with uterine serous carcinoma or uterine clear cell cancer treated between 2013 and 2020 at four tertiary teaching hospitals. We classified the patients by the type of hysterectomy. Overall survival and disease-free survival were analyzed and compared using the Kaplan-Meier method and the log-rank test. To adjust for the potential confounders, the Cox proportional hazards regression model was employed.

RESULTS: Our cohort included 275 women who underwent radical hysterectomy and 147 women who underwent simple hysterectomy. The baseline characteristics of the two groups did not differ significantly. There was no statistical difference in recurrence between the two groups (23.8% vs. 20.4%, p = 0.456). Compared with a simple hysterectomy, a radical hysterectomy was not associated with improved overall survival (hazard ratio 0.93, 95% confidence interval 0.69-1.26, p = 0.652), and improved disease-free survival (hazard ratio 0.96, 95% confidence interval 0.72-1.26, p = 0.745). After adjusting for potential confounders, the analysis showed that the type of hysterectomy did not affect overall survival (hazard ratio 0.99, p = 0.968) and disease-free survival (hazard ratio 1.01, p = 0.985) in non-endometrioid endometrial cancer with cervical involvement.

CONCLUSION: Radical hysterectomy was not associated with a survival benefit in non-endometrioid endometrial cancer with cervical involvement.

PMID:42460510 | DOI:10.1002/jso.70337

Bioanalysis. 2026 Jul 16:1-8. doi: 10.1080/17576180.2026.2698605. Online ahead of print.

ABSTRACT

BACKGROUND: Cumene is a high-production volume aromatic hydrocarbon recently reclassified as a Category 1B carcinogen, and 2-Phenyl-2-Propanol (2P2P) is its primary urinary metabolite. Highly sensitive analytical methods, required to detect the low-level exposures typical of the non- occupationally exposed general population, are not available for this compound in literature to this day.

RESEARCH DESIGN AND METHODS: This research details the development and validation of a fully automated Gas Chromatography-Mass Spectrometry (GC-MS) method using SPME extraction to quantify 2P2P at ng/L levels.

RESULTS: The study established reference values by analyzing 242 non-exposed workers, yielding a background range of 31.6-652.7 ng/L (5th-95th percentiles). The literature review encompassed global production trends, environmental ubiquity, and human metabolism. Furthermore, the study utilized biomarkers like cotinine and S-Phenyl Mercapturic Acid (SPMA) to statistically evaluate smoking as a potential confounder.

CONCLUSION: This method fills a significant technical gap by providing a noninvasive, highly sensitive tool for health surveillance. Establishing empirical background reference values is essential for accurately distinguishing between environmental and occupational exposure. Critically, statistical analysis confirms that cigarette smoking is not a significant confounding factor for urinary 2P2P levels, reinforcing its reliability as a specific biomarker for cumene.

PMID:42460492 | DOI:10.1080/17576180.2026.2698605

J Biopharm Stat. 2026 Jul 16:1-17. doi: 10.1080/10543406.2026.2685280. Online ahead of print.

ABSTRACT

By early 2023, there were over 100 gene, cell and RNA products approved globally (Chancellor et al. 2023). The way in which autologous cell and cell-based gene therapy products are administered can include multiple treatment stages, at times including leukapheresis, optional bridging therapy during manufacturing, conditioning regimen, and one or more doses of product. This brings important considerations in the development of the statistical analysis plan for clinical trials of autologous cell and cell-based gene therapies, including application of the estimand framework for key facets. In this article, we review all of the FDA currently approved autologous cell and cell-based gene therapy products as examples as they apply to general considerations for the statistical analysis plan as well as more in-depth discussion of treatment exposure, safety and efficacy analyses, and other aspects.

PMID:42460470 | DOI:10.1080/10543406.2026.2685280

Acta Odontol Scand. 2026 Jul 16;85:416-424. doi: 10.2340/aos.v85.46468.

ABSTRACT

OBJECTIVE: To analyze the effects of cervical headgear (CHG) timing on costs and orthodontic outcome.

MATERIAL AND METHODS: Sixty-seven participants with Class II malocclusion were randomized into two groups. In the early group (EG, n = 33), CHG treatment began after the eruption of first upper molars. In the later-timed group (LG, n = 34), CHG treatment began nearly 2 years later. Orthodontic outcome was evaluated when CHG ended and at the end of follow-up using the Peer Assessment Rating (PAR) index and Little’s Irregularity Index (LII). Costs were calculated using medical records, estimated chairside times and average personnel and material costs.

RESULTS: The mean total costs including personnel and material costs during the follow-up were higher in the EG (€416) compared with the LG (€364) (p = 0.043). No statistically significant differences between the groups were found in the PAR and in the LII scores at the end of follow-up. The number of visits during CHG treatment was higher in the EG (13.3) compared with the LG (10.4) (p = 0.01).

CONCLUSIONS: Earlier initiation of CHG treatment increased the personnel and material costs, number of appointments, and chairside time. Based on the PAR and in the LII scores, the orthodontic outcome of CHG treatment was equal regardless of the timing of the treatment. If orthodontic treatment during mixed-dentition stage is considered, it would be justified from an economic perspective to favor treatment during late mixed-dentition.

PMID:42460461 | DOI:10.2340/aos.v85.46468

Pain Res Manag. 2026;2026(1):e3699422. doi: 10.1155/prm/3699422.

ABSTRACT

BACKGROUND: Medication-overuse headache (MOH) is a disabling secondary headache arising from frequent acute medication intake in individuals with preexisting primary headache. Behavioral and psychosocial factors may perpetuate medication overuse. As a reduction of acute medication intake is essential for remission, educational and behavioral interventions are commonly used; however, their effectiveness remains uncertain.

OBJECTIVES: To systematically evaluate the effectiveness of educational and behavioral interventions on acute medication use, headache frequency, and headache-related disability in patients with MOH, and to assess short- and longer-term outcomes compared to usual care.

METHODS: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to January 2026 for randomized controlled trials evaluating educational or behavioral interventions in adults with MOH. Outcomes included reduction of acute medication use, headache frequency, and headache-related disability. Random-effects meta-analyses were performed where appropriate.

RESULTS: Six trials (610 participants) were included. Brief educational interventions were associated with clinically meaningful reductions in acute medication use and headache frequency. Multiple-session interventions, compared to minimal intervention, were associated with additional mean reductions in acute medication use of approximately 3 days per month and in headache frequency of 2.6 days per month at 3 months and 0.8 days per month at 12 months; however, between-group differences were not statistically significant. Substantial heterogeneity was observed.

CONCLUSIONS: Brief educational interventions may be considered as a potentially useful component of MOH care. Multisession interventions may offer additional benefit but remain inconclusive because of heterogeneity and limited evidence. Further high-quality trials are needed to define optimal strategies.

PMID:42460454 | DOI:10.1155/prm/3699422