Category: Nevin Manimala

AMB Express. 2026 Apr 10. doi: 10.1186/s13568-026-02041-5. Online ahead of print.

NO ABSTRACT

PMID:41961440 | DOI:10.1186/s13568-026-02041-5

Int J Cardiovasc Imaging. 2026 Apr 10. doi: 10.1007/s10554-026-03702-z. Online ahead of print.

ABSTRACT

Providing insights into the feasibility of pulmonary function assessment in real-world cardiovascular magnetic resonance (CMR) practice by applying Phase-REsolved FUnctional Lung imaging (PREFUL). We retrospectively analyzed consecutive patients who underwent PREFUL imaging in addition to routine 1.5T CMR between September 2023 and January 2024. PREFUL was acquired in three coronal slices, with a prototype tool used to derive quantitative perfusion and ventilation defect percentages (QDP and VDP, respectively). Cardiac function was assessed from short-axis cine images. Subgroup analyses included patients with primary pulmonary disease and reduced left ventricular ejection fraction (LVEF). Statistical analyses comprised linear regression, correlation analysis, and Kruskal-Wallis test. The final cohort included N = 172 patients (74 females), median age 60 years (IQR 46-71). PREFUL was feasible in all cases (mean scan time 60 s/slice). Multivariable regression with bootstrap-based backward selection showed associations of QDP with LVEF, pulmonary disease, age, and BMI (all p ≤ 0.005), while VDP was associated with pulmonary disease, age, and male sex (all p < 0.001). QDP correlated negatively with LV stroke volume (ρ (Spearman’s rho) – 0.336, p < 0.001) and cardiac output (ρ – 0.360; p < 0.001) and was higher in patients with LVEF < 50% (p < 0.001). Patients with primary pulmonary disease had higher QDP (p = 0.005) and VDP (p = 0.036). No correlations between cardiac function and VDP were detected (all p > 0.05). Application of PREFUL is feasible and fast in CMR routine. While QDP and VDP are affected by pulmonary disease, QDP is additionally associated with markers of cardiac function and was higher in patients with reduced LVEF.

PMID:41961412 | DOI:10.1007/s10554-026-03702-z

Environ Monit Assess. 2026 Apr 10;198(5):436. doi: 10.1007/s10661-026-15174-8.

ABSTRACT

The longstanding reliance on synthetic herbicides for aquatic weed management has imposed a significant chemical legacy on freshwater ecosystems. While effective for short-term control, these compounds often persist in water and sediments, leading to bioaccumulation and long-term ecological shifts. This review critically re-evaluates this dependency, synthesizing evidence of direct and indirect impacts on non-target organisms, including phytoplankton, invertebrates, and fish, often via sublethal physiological and behavioral effects. The rapid degradation of plant biomass can trigger regime shifts, such as algal blooms and oxygen depletion, thereby altering ecosystem structure and function. Furthermore, the challenges of herbicide resistance and the underestimated risks of commercial formulations and chemical mixtures underscore the limitations of a purely chemical approach. We argue for an urgent paradigm shift towards integrated weed management (IWM). This review provides a critical synthesis that repositions herbicides as a targeted, last-resort tool within a broader, ecologically sustainable framework. This framework prioritizes prevention, biological control, and ecological restoration to safeguard aquatic health, moving beyond the entrenched, chemical-centric paradigm. Clinical trial number: not applicable.

PMID:41961347 | DOI:10.1007/s10661-026-15174-8

Environ Monit Assess. 2026 Apr 10;198(5):435. doi: 10.1007/s10661-026-15295-0.

ABSTRACT

Heavy metal pollution in soil has become an environmental challenge attracting global concern. In China, the national standard GB15618-2018 is widely adopted for classifying heavy metal pollution risk in agricultural soils into three levels, including the background, screening, and intervention levels. However, it only specifies risk screening and intervention values for five heavy metals (Hg, Cd, As, Pb, Cr), which make systematic risk classification for other metals unfeasible. To address this limitation, an integrated method combining GB15618-2018 with the geo-accumulation index (I_geo) is proposed. Risk levels are determined preferentially through risk values specified in GB15618-2018, and otherwise by I_geo values (with new thresholds of 1.4 and 3.7). Analysis of 493 soil samples from the Yuanjiang area confirmed I_geo as a valid supplementary tool, enabling unified three-level risk classification for all heavy metals. Application in the Yuanjiang area showed most areas at the background level, with small screening-level patches requiring supervision and rare intervention-level spots requiring control. Source apportionment using multivariate statistical analyses mainly identified three distinct sources: ultramafic rocks (Cr, Ni, Co, Hg, As), Pb-Zn mineralization (Cd, Pb, Zn), and Cu mineralization (Cu and V). Although developed within China’s regulatory framework, the proposed method addresses a challenge common to many countries, namely incomplete regulatory coverage for certain heavy metals, and thus offers a template adaptable to other regions worldwide.

PMID:41961342 | DOI:10.1007/s10661-026-15295-0

Eur J Pediatr. 2026 Apr 10;185(5):252. doi: 10.1007/s00431-026-06917-3.

ABSTRACT

Alagille syndrome (ALGS) is a rare multisystem disorder most commonly resulting from pathogenic variants in JAG1 and, less frequently, NOTCH2. We evaluated long-term native liver survival (NLS) and overall survival (OS) in a Korean ALGS cohort and compared the genetic characteristics of this cohort with those of the Global ALagille Alliance (GALA) study cohort. We retrospectively reviewed 60 patients with clinically diagnosed ALGS at Seoul National University Hospital. Forty-three patients with genetically confirmed disease were analyzed. Eight patients (18.6%) underwent liver transplantation (median age: 3.9 years), revealing a lower rate than that in the comparator cohort. The estimated NLS percentages at 5, 10, and 18 years were 86.9%, 86.9%, and 76.6%, respectively, exceeding those in previous reports. The corresponding OS rates were 90.2%, 86.9%, and 86.9%, respectively. The following types of JAG1 variants were identified in 41 patients (95.3%): frameshift (34.1%), nonsense (26.8%), missense (24.4%), and splice-site (9.8%) variants and in-frame deletions (4.9%). Compared with the reference group, our cohort exhibited a greater frequency of non-protein-truncating variants (missense variants and in-frame deletions; p = 0.023) and no structural variants (p = 0.043). Two patients (4.7%) carried NOTCH2 nonsense variants. Mortality was significantly higher among patients with frameshift variants compared with patients with non-frameshift variants (4 of 5 deaths; p = 0.035).

CONCLUSION: Compared with the GALA cohort, Korean patients with ALGS exhibited more favorable long-term NLS and a higher proportion of non-protein-truncating JAG1 variants, alongside the absence of structural variants. These findings suggest potential genetic influences and highlight the need for multicenter validation.

WHAT IS KNOWN: • The Global ALagille Alliance (GALA) study reports native liver survival (NLS) rates of 66.8%, 54.4%, and 40.3% at 5, 10, and 18 years, respectively, in patients with Alagille syndrome. • NLS rates are higher among Asians, with unclear genotype-phenotype correlations.

WHAT IS NEW: • Compared to the GALA study cohort, the Korean cohort demonstrates superior NLS rates of 86.9%, 86.9%, and 76.6% at 5, 10, and 18 years and a higher frequency of non-truncating JAG1 variants, along with the absence of structural variants. • Protein-truncating variants are associated with higher initial gamma-glutamyl transferase levels, while frameshift variants are associated with reduced overall survival.

PMID:41961327 | DOI:10.1007/s00431-026-06917-3

Eur J Pediatr. 2026 Apr 10;185(5):250. doi: 10.1007/s00431-026-06914-6.

ABSTRACT

HyperCKemia is a frequent laboratory finding in pediatric practice and may reflect a wide spectrum of conditions, ranging from benign transient states to rare primary neuromuscular disorders. The lack of pediatric-specific diagnostic algorithms complicates risk stratification and clinical decision-making. A retrospective cohort study was conducted, including patients under 18 years of age with hyperCKemia referred to a tertiary reference center between January 2017 and December 2024. Clinical, laboratory, genetic, and histological data were collected. Statistical analyses included univariate testing and logistic regression to identify predictors of primary disease. A total of 119 patients were included (median age 10 years; 76.5% male). Most were symptomatic at presentation (87.4%), and 80.3% met criteria for rhabdomyolysis. A primary disorder was identified in 25.2% of patients, while 52.1% had secondary causes, predominantly viral myositis, and 22.7% remained undiagnosed. Metabolic myopathies accounted for the majority of primary diagnoses (60.0%), followed by muscular dystrophies (23.3%) and inflammatory myopathies (13.3%). Persistent hyperCKemia and male sex emerged as strong independent predictors of primary disease (OR 8.5 and 5.1, respectively). Muscle weakness and exercise intolerance were exclusive to primary disorders. Genetic testing yielded a diagnosis in 26.8% of tested patients, with targeted next-generation sequencing proving particularly valuable.

CONCLUSIONS: In pediatric hyperCKemia, persistent CK elevation and male sex are key predictors of underlying primary neuromuscular disease. A phenotype-driven, stepwise diagnostic approach incorporating early genetic testing may improve diagnostic yield and optimize resource utilization.

WHAT IS KNOWN: • HyperCKemia in children is most frequently secondary to benign conditions such as viral myositis, while primary neuromuscular disorders are less common but clinically significant. • Creatine kinase levels lack specificity, and the diagnostic approach increasingly relies on genetic testing.

WHAT IS NEW: • Persistent hyperCKemia and male sex were identified as independent predictors of primary disease. • Most primary disorders occurred in patients with CK over 1000 UI/L, and higher inter-crisis CK levels were associated with an increased likelihood of underlying disease.

PMID:41961319 | DOI:10.1007/s00431-026-06914-6

Abdom Radiol (NY). 2026 Apr 10. doi: 10.1007/s00261-026-05420-5. Online ahead of print.

ABSTRACT

BACKGROUND: Response evaluation of pancreatic ductal adenocarcinoma (PDAC) with routine contrast-enhanced CT (CECT) using RECIST is currently inadequate for identification of patients benefiting from chemotherapy treatment, as the majority of patients show stable disease. This might lead to inappropriate treatment and potentially diminishes patients’ quality of life. Recent developments in CT perfusion (CTP) show its potential as a biomarker to evaluate therapy response in PDAC.

PURPOSE: To investigate quantitative CT Perfusion as a prognostic biomarker during chemotherapy treatment in patients with PDAC.

MATERIALS AND METHODS: This prospective cohort trial included patients between January 2018 and December 2022 with biopsy-proven PDAC of all stages who underwent CT Perfusion before (i.e. baseline) and after three months of chemotherapy treatment. A previously developed AI-assisted CTP analysis method provided automatic segmentations of tumor and pancreas parenchyma. A trilinear non-parametric CTP contrast-enhancement model described the upslope and the peak of the time intensity curve for both tumor and parenchyma. Perfusion features of baseline and follow-up scans were compared to calculate the percentual difference. The primary endpoint was the association between quantitative CTP parameters and overall survival (OS). Secondary endpoints included comparison with RECIST 1.1 and CA 19-9 response criteria for prognostic stratification. Statistical analysis included Kaplan-Meier curves and log-rank test.

RESULTS: A total of 25 patients were included. Treatment response based on RECIST 1.1 criteria showed two cases with progressive and 23 with stable disease. Patients with increased peak enhancement after chemotherapy demonstrated significantly longer survival compared to those with decreased enhancement (p = 0.02). In contrast, CA19-9 response (≥ 30% decrease) did not significantly differentiate survival (758 days vs 371 days, p = 0.27). Furthermore, CTP found more patients with a higher chance of long survival compared to RECIST (60% vs 25% survival in 24 months). In the subgroup with RECIST stable disease CTP still finds patients with a significantly longer survival (p = 0.02). Combined analysis showed that patients with both CTP increase and CA19-9 response had the best median survival at 758 days (IQR: 561-895).

CONCLUSION: Our study demonstrates that quantitative CTP is associated with better identification of long-term survivors than RECIST, based on increased peak enhancement after chemotherapy. Quantitative CTP may serve as a valuable complement to current treatment assessment methods in patients with PDAC.

PMID:41961316 | DOI:10.1007/s00261-026-05420-5

Drug Saf. 2026 Apr 10. doi: 10.1007/s40264-026-01650-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Giant cell arteritis (GCA) is an immune-mediated vasculitis of large and medium arteries, mainly affecting older adults. Prompted by a consumer concern, a few spontaneous reports after coronavirus disease 2019 (COVID-19) vaccination and Australian regulator signal, we investigated a possible association between GCA and vaccination.

METHODS: This study analysed multiple data sources from January 2021 to September 2024. We reviewed spontaneous GCA reports submitted to the statewide vaccine safety service, Surveillance of Adverse Events following Vaccination in the Community (SAEFVIC), and applied self-controlled case series (SCCS) to two large Australian healthcare datasets [general practice (GP) and linked hospital data]. SCCS used a 1-42-day risk window, stratified by vaccine type, age, and sex. Incident GCA cases were identified via keyword matching and diagnostic codes [Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT)/International Classification of Diseases Tenth Revision, Australian Modification (ICD-10-AM)].

RESULTS: Six cases of GCA were spontaneously reported, four with onset within 42 days postvaccination, all following the adenoviral vectored Vaxzevria® {reporting rate 0.10 [95% confidence interval (CI) 0.03-0.27]}. The proportional reporting ratio signal detection method did not indicate a safety signal. Of 2700 incident cases of GCA identified across primary and hospital care datasets, 293 occurred within 42 days of COVID-19 vaccination. There was no increased risk of GCA following COVID-19 vaccination in either dataset [GP relative incidence (RI): 0.96 (95% CI 0.76, 1.21); hospital RI: 0.79 (95% CI 0.68, 0.91)], including by vaccine type, age, or sex.

CONCLUSIONS: Using three Australian data sources, this study found no increase in GCA presentations within 6 weeks of COVID-19 vaccination. These consumer-stimulated findings support informed decisions, strengthen vaccine safety evidence, and help clinicians counsel patients.

PMID:41961244 | DOI:10.1007/s40264-026-01650-0

Jpn J Ophthalmol. 2026 Apr 10. doi: 10.1007/s10384-026-01340-5. Online ahead of print.

ABSTRACT

PURPOSE: To assess the 6-month efficacy and safety of oxymetazoline hydrochloride ophthalmic solution 0.1% (OMZ 0.1%) versus placebo for acquired blepharoptosis.

STUDY DESIGN: A phase 3, randomized, double-masked, parallel-group, multicenter study conducted in Japan.

METHODS: Patients were randomized 1:1:1 to OMZ 0.1%, once daily (QD) or twice daily (BID), or placebo. Patients received OMZ 0.1% for 6 months. Patients in the placebo group were randomized after 3 months (Treatment Period 1) to OMZ 0.1%, either QD or BID, for the remaining 3 months (Treatment Period 2). The primary efficacy endpoint was the marginal reflex distance-1 (MRD-1) change from baseline to Day 14 (2 hours after the morning drop) with OMZ 0.1% QD or BID versus placebo. Adverse events and adverse drug reactions (ADRs) were recorded.

RESULTS: Overall, baseline MRD-1 (standard deviation) of 336 patients analyzed (n=112 per group) was 1.31 (0.83) mm (Day 0). MRD-1 change from baseline to Day 14 (2 hours after the morning drop) was 1.09 (0.07), 0.93 (0.07), and 0.50 (0.07) mm, with OMZ 0.1% QD, BID, and placebo, respectively. There was a statistically significant difference in the least squares mean (standard error) MRD-1 change versus placebo with OMZ 0.1% QD (0.59 [0.10] mm; 95% CI 0.38, 0.79) and OMZ 0.1% BID (0.43 [0.10] mm; 95% CI 0.23, 0.64) (both p<0.05). All ADRs related to the study drug were mild.

CONCLUSION: Fourteen days of OMZ 0.1% treatment significantly increased MRD-1 versus placebo. There was no loss of effect after 6 months of treatment and no significant safety concerns.

PMID:41961227 | DOI:10.1007/s10384-026-01340-5

Clin Exp Nephrol. 2026 Apr 10. doi: 10.1007/s10157-026-02848-3. Online ahead of print.

ABSTRACT

BACKGROUND: Zinc deficiency is highly prevalent in patients undergoing hemodialysis, and may contribute to cognitive impairment, given its essential role in neurotransmission and neurogenesis. This study aimed to examine the association between serum zinc and cognitive function in this population.

METHODS: This was a cross-sectional study (N = 1207). Cognitive function was assessed by using the Modified Mini-Mental State examination (3MS). The association between serum zinc and 3MS score and its domains were examined by using a linear regression model and ordinal logistic regression model, respectively.

RESULTS: In total patients, 3MS score and serum zins levels were 91 (82-97) points and 68 (61-76) μg/dL, respectively. Serum zinc level was not associated with 3MS score in adjusted model with 16 potential confounders. However, there was a significant interaction between serum zinc and albumin levels (p = 0.019). Therefore, participants were categorized into 2 subgroups by the median serum albumin level (3.7 g/dL) in further analyses. In the lower serum albumin group, the positive association between serum zinc and 3MS was significant after adjustment for 15 potential confounders (p = 0.022). After additional adjustment for both magnesium and phosphate, the association showed a similar positive trend but did not reach statistical significance (p = 0.072). Among the cognitive domains of the 3MS, attention was significantly associated with serum zinc level in participants with lower serum albumin (p = 0.016).

CONCLUSIONS: Lower serum zinc was a novel factor associated with cognitive function, particularly in attention in patients undergoing maintenance hemodialysis with low serum albumin.

PMID:41961222 | DOI:10.1007/s10157-026-02848-3