Category: Nevin Manimala

Front Nutr. 2026 Jun 17;13:1865377. doi: 10.3389/fnut.2026.1865377. eCollection 2026.

ABSTRACT

BACKGROUND: The bladder health rehabilitation process depends on dietary choices and drinking patterns, which determine diet quality and hydration levels. Previous studies have suggested that dietary patterns and hydration levels affect urodynamic measurements, yet research on how combined dietary and fluid intake affects bladder rehabilitation outcomes remains limited.

OBJECTIVE: The study aims to assess the effects of dietary quality and fluid intake on urodynamic outcomes, symptom reduction, and functional recovery in patients undergoing a structured bladder rehabilitation program.

METHODOLOGY: The study tracked 2,400 bladder rehabilitation patients in a retrospective cohort study, which divided participants into three dietary quality groups (low, moderate, and high) and three fluid intake groups (low, moderate, and high). The study collected data on baseline demographics and clinical characteristics, as well as nutritional intake and urodynamic parameters. Post-rehabilitation outcomes included bladder capacity, detrusor pressure, compliance, urinary frequency, urgency, incontinence, nocturia, and quality-of-life (QoL) measures. The study analyzed nutrient-specific associations, diet-fluid interactions, and adherence rates. The researchers used multivariate regression analysis to determine which factors predicted functional improvement.

RESULTS: The post-rehabilitation study showed major urodynamic and symptomatic advancements, which included increased bladder capacity of 34 mL (p < 0.001) and decreased detrusor pressure of 3.4 mmHg (p = 0.002) and reduced urinary frequency of 1.3 episodes per day (p < 0.001) and improved quality of life by 5.8 points (p < 0.001). The study found that high diet quality, combined with moderate-to-high fluid intake, led to greater functional improvement, with both factors statistically significant (β = +0.21, p = 0.004; β = +0.18, p = 0.009). The combined high-diet and moderate-fluid groups achieved the best results, with improved bladder compliance, reduced urgency, and higher clinical success rates. The nutrient-specific analysis showed that fiber, potassium, and protein intake were positively associated with improvements in capacity and flow, whereas sodium and evening fluid timing were negatively associated.

CONCLUSION: The bladder rehabilitation process requires both dietary quality and fluid intake, as these factors determine functional improvement. The study found that optimizing nutrition, hydration, and compliance with behavioral interventions led to better urodynamic results, improved symptom management, and enhanced quality of life. The findings demonstrate that individual lifestyle-change methods are essential components of bladder rehabilitation programs.

PMID:42389697 | PMC:PMC13318740 | DOI:10.3389/fnut.2026.1865377

Front Vet Sci. 2026 Jun 17;13:1816115. doi: 10.3389/fvets.2026.1816115. eCollection 2026.

ABSTRACT

Artificial intelligence (AI), especially generative AI and large language models, is increasingly influencing higher education and health professions training. However, there is still limited empirical evidence about what veterinary students know about AI, how they use it, and how they perceive it. The aim of this study was to evaluate self-perceived AI-related knowledge, use, and attitudes among veterinary students in Spain and Portugal, and to analyze the influence of institutional context, prior AI training, and digital engagement. A cross-sectional survey was conducted during the 2023-2024 academic year with 340 undergraduate and postgraduate veterinary students from public and private institutions in Spain and Portugal. The questionnaire included sociodemographic questions and nine Likert-scale items assessing self-perceived AI knowledge, use, and attitudes. Composite scores were calculated and transformed using the Percentage of Maximum Possible (POMP) method (0-100 scale). Internal consistency of the instrument was high (ω = 0.842; α = 0.835). Data was analyzed using MANOVA, one-way ANOVA, independent samples t-tests, and Pearson correlation analyses. Significant differences were observed between institutions in self-perceived AI knowledge, use, and attitudes. Students who had received prior AI training showed higher self-perceived knowledge and use scores (p < 0.001) and more positive attitudes toward AI (p < 0.001). Although formal AI training was limited in many institutions, students with any type of prior exposure-self-directed, university-based, or external-reported greater engagement and felt more prepared to use AI tools. Daily social media use showed a small but statistically significant positive correlation with self-perceived AI knowledge and use (r = 0.115, p = 0.034) and with positive attitudes (r = 0.157, p = 0.004). Categorized analyses showed a gradual increase in AI-related outcomes with higher levels of digital engagement. Veterinary students in the Iberian Peninsula are already using AI, mainly through informal learning pathways, while structured institutional integration remains uneven. Structured exposure to AI is consistently associated with higher self-perceived knowledge, greater use, and more positive attitudes. These results suggest that deliberate curricular integration and guided AI literacy initiatives are important to prepare future veterinarians for responsible and effective use of AI technologies.

PMID:42389691 | PMC:PMC13318702 | DOI:10.3389/fvets.2026.1816115

Front Vet Sci. 2026 Jun 17;13:1816404. doi: 10.3389/fvets.2026.1816404. eCollection 2026.

ABSTRACT

Effective immunosuppression in large animal models is essential for successful preclinical assessment of cell-based therapies in the allo- or xeno-transplantation setting. Pigs, due to their physiological and immunological similarity to humans, are widely used in translational research. However, direct, longitudinal comparisons of immunosuppressive strategies in swine are scarce, limiting the development of safe and reliable protocols. To address this gap, we performed a head-to-head comparison of two immunosuppressive regimens in pigs (n = 8; 4 animals per group) to identify a protocol that achieves robust immune modulation with minimal systemic toxicity. Protocol I consisted of an intravenous induction with mycophenolate mofetil (MMF) and methylprednisolone, followed by oral MMF and tacrolimus. Protocol II included intravenous abatacept and methylprednisolone, two booster doses of abatacept, and daily oral cyclosporine A. Both regimens were administered for 6 weeks, followed by a four-week recovery period. Statistical analyses included normality testing (Shapiro-Wilk), multiple t-tests or Mann-Whitney tests with false discovery rate correction for between-group comparisons, and two-way repeated measures ANOVA or mixed-effects models for longitudinal analysis. Both protocols induced lymphopenia without systemic toxicity but exhibited distinct immunological profiles. Protocol I promoted rapid and reversible lymphocyte suppression, whereas Protocol II induced a slower onset with sustained inhibitory signaling. Phenotypic analysis revealed dynamic shifts within lymphocyte populations, including a decline in the CD4/CD8 ratio that did not reach statistical significance. CD21⁺ lymphocytes were differentially affected: Protocol I maintained higher levels after an initial transient decrease, while Protocol II showed a progressive reduction with significant differences at multiple time points. These findings highlight that co-stimulation blockade combined with calcineurin inhibition enforces deeper functional suppression, whereas MMF/tacrolimus-based therapy allows partial recovery of immune compartments. This direct comparative analysis provides a critical framework for designing targeted immunosuppressive strategies for translational models.

PMID:42389690 | PMC:PMC13318597 | DOI:10.3389/fvets.2026.1816404

Proc Mach Learn Res. 2025 Dec;297:136-151.

ABSTRACT

Clinical decisions often require balancing conflicting priorities rather than simply selecting a single “correct” answer. We present an evaluation framework that probes the value judgments embedded in large language models (LLMs) by testing how they assess quality of glycemic control from continuous glucose monitoring (CGM) data. Using synthetic type 1 diabetes profiles, we asked five commercial LLMs to perform pairwise comparisons of CGM summary statistics and derived a percentile ranking for each profile. We then quantified alignment with two reference metrics: time in range (TIR) and the expert-derived Glycemia Risk Index (GRI), which was developed with clinician input regarding preferences across glycemic ranges. Across three insulin therapy modalities, newer models showed stronger correlation with GRI than older models, suggesting a generational shift toward expert consensus. However, a perturbation analysis revealed instances of disagreement around the weighting of mild hypoglycemia and mild hyperglycemia relative to the GRI. These results demonstrate that high average agreement with clinical metrics can mask clinically meaningful misalignments in how LLMs prioritize risks. Our proposed framework reveals how LLM outputs reflect competing priorities in clinical contexts.

PMID:42389650 | PMC:PMC13322355

JSES Rev Rep Tech. 2026 Jun 3;6(3):100791. doi: 10.1016/j.xrrt.2026.100791. eCollection 2026 Aug.

ABSTRACT

BACKGROUND: Rotator cuff (RC) tear size is known to influence post-operative outcomes and recovery following arthroscopic rotator cuff repair (ARCR). However, the trajectory of recovery has not been fully explored. This study aims to evaluate patient-reported outcomes pre-operatively, 6 months (6ms) and 2 years (2ys) after ARCR, stratified according to tear size.

METHODS: A retrospective cohort study evaluated outcomes of 136 patients who underwent ARCR. RC tear size was categorized into small (<1 cm), medium (1-3 cm), and large (3-5 cm) groups. Outcome measures included range of movement forward flexion and range of movement abduction, visual analog scale (involved shoulder), Constant score, University of California, Los Angeles score and Oxford Shoulder Score. Paired t-tests were conducted within each tear-size group, comparing pre-operative with 6m outcomes and 6m with 2y outcomes. Between-group differences in change scores were examined using one-way analysis of variance, and multivariate regression analysis was performed to identify independent predictors of outcome. Effect size analysis using Cohen d was performed to complement primary statistical findings, given the underpowered cohort sizes.

RESULTS: All groups displayed significant improvement in all measured outcomes from baseline to 6 months (P < .05). Small and medium tears demonstrated continued significant improvements in several outcomes from 6 months to 2 years (Constant score +7.6 and +7.4, respectively, P < .05; Oxford Shoulder Score +4.3 and 0.017, respectively, P < .05) while large tears did not (P > .05). Between-group analysis of variance demonstrated no significant difference in the degree of change scores for both time intervals (P > .05). Multivariate regression analysis concluded that tear size is not an independent predictor of 2-year outcomes (P > .05). Effect size analysis revealed predominantly moderate-to-large early effect sizes across all groups.

CONCLUSION: ARCR are associated with substantial early improvement across all tear sizes at 6 months, with diminishing returns thereafter. Although larger tear sizes have lower post-operative readings, the equally low pre-operative baseline readings result in similar net numerical improvements across all groups.

PMID:42389647 | PMC:PMC13321195 | DOI:10.1016/j.xrrt.2026.100791

JSES Rev Rep Tech. 2026 May 15;6(3):100778. doi: 10.1016/j.xrrt.2026.100778. eCollection 2026 Aug.

ABSTRACT

BACKGROUND: The aim of this study was to evaluate clinical outcomes in patients with mild-to-moderate concentric glenohumeral osteoarthritis (GHOA) treated with arthroscopic surgery according to the Comprehensive Arthroscopic Management (CAM) procedure combined with intra-articular injection of autologous microfragmented adipose tissue (mFAT) (Lipogems). Since there was no CAM-only control group, the study does not assess the independent contribution of mFAT.

METHODS: In this retrospective study, 19 patients (mean age 52 years; 17 males, 2 females) with Samilson-Prieto grade 1-3 GHOA were included. All patients underwent arthroscopic CAM surgery followed by intra-articular injection of autologous mFAT. Primary outcomes were assessed using the visual analog scale for pain and the American Shoulder and Elbow Surgeons score at baseline (T⁰) and at 1 (T¹), 3 (T³), 6 (T⁶), 12 (T¹²), and 24 months (T²⁴) post-operatively.

RESULTS: Significant improvements in both visual analog scale and American Shoulder and Elbow Surgeons scores were observed at 1 month and maintained up to 24 months (P < .05). Patients aged ≤50 years or with grade 1-2 GHOA tended to experience greater clinical improvements. The observed improvements in pain and function exceeded published thresholds for the Minimal Clinically Important Difference and fell below the Patient Acceptable Symptom State, indicating that changes were not only statistically significant but also clinically meaningful. No major adverse events occurred, and no patients required conversion to shoulder arthroplasty. The combination of CAM and mFAT was safe and feasible, providing sustained pain relief and functional improvement over a 2-year follow-up.

CONCLUSION: The CAM procedure combined with intra-articular mFAT injection represents a safe and minimally invasive approach associated with durable improvements in pain and shoulder function in patients with mild-to-moderate GHOA. However, the study design does not allow conclusions regarding the specific contribution of mFAT beyond the CAM procedure alone. Further controlled studies are needed to clarify potential additive benefits.

PMID:42389646 | PMC:PMC13320478 | DOI:10.1016/j.xrrt.2026.100778

Geriatr Gerontol Int. 2026 Jul;26(7):e70634. doi: 10.1111/ggi.70634.

NO ABSTRACT

PMID:42387272 | DOI:10.1111/ggi.70634

Am J Cardiovasc Drugs. 2026 Jul 1. doi: 10.1007/s40256-026-00809-5. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) who survive myocardial infarction (MI) remain at high risk for recurrent cardiovascular events and heart failure (HF). Although glucagon-like peptide-1 receptor agonist (GLP-1 RA) reduces cardiovascular events in stable atherosclerotic disease, its impact among patients with established MI has not been comprehensively synthesized.

OBJECTIVES: To evaluate the association between GLP-1 RA use and cardiovascular outcomes in patients with T2DM across MI-defined cohorts.

METHODS: We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using random-effects models. Heterogeneity was evaluated using the I² statistic, and 95% prediction intervals (PIs) were calculated to estimate the expected range of true effects in future clinical settings. Outcomes included all-cause mortality, cardiovascular death, study-defined major adverse cardiovascular events (MACE), MI, stroke, and HF or hospitalization for HF. A sensitivity analysis using the Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment was performed to account for the small number of included studies and substantial heterogeneity. Statistical analysis was performed using R software version 4.5.0.

RESULTS: Seven studies, including 37,393 patients with T2DM from MI-defined populations (9556 receiving GLP-1 RA), were analyzed. GLP-1 RA use was associated with lower all-cause mortality (HR, 0.67; 95% CI, 0.49-0.90; I² = 87.3%; PI, 0.27-1.63; P = 0.0085), reduced study-defined MACE (HR, 0.69; 95% CI, 0.56-0.84; I² = 55.6%; PI, 0.44-1.06; P = 0.0002), and fewer HF events or hospitalizations for HF (HR, 0.78; 95% CI, 0.62-0.98; I² = 77.6%; PI, 0.42-1.45; P = 0.0306). No significant associations were observed for cardiovascular death (HR, 0.85; 95% CI, 0.67-1.06; I² = 0%; PI, 0.42-1.69; P = 0.15), recurrent MI (HR, 0.82; 95% CI, 0.62-1.09; I² = 63%; PI, 0.41-1.63; P = 0.1753), or stroke (HR, 0.91; 95% CI, 0.68-1.22; I² = 61.2%; PI, 0.40-2.05; P = 0.5237). In the sensitivity analysis using the HKSJ adjustment, statistical significance was lost for all endpoints, including all-cause mortality (P = 0.05), study-defined MACE (P = 0.13), and HF or hospitalization for HF (P = 0.06).

CONCLUSIONS: In patients with T2DM across MI-defined populations, GLP-1 RA use showed signals toward lower all-cause mortality, study-defined MACE, and HF-related events; however, these findings remain exploratory because of substantial heterogeneity, wide PIs, and attenuation of statistical significance under HKSJ adjustment.

REGISTRATION: PROSPERO identifier no. CRD420251270326.

PMID:42387250 | DOI:10.1007/s40256-026-00809-5

Behav Res Methods. 2026 Jul 1;58(8):216. doi: 10.3758/s13428-026-03073-2.

ABSTRACT

Large language models (LLMs) are rapidly being integrated into psychological and behavioral research as research tools, evaluation targets, human simulators, and cognitive models. Yet recent evidence reveals severe measurement unreliability: personality assessments degenerate under factor analysis, moral preferences reverse with punctuation changes, and theory-of-mind accuracy varies widely with trivial rephrasing. These “measurement phantoms”-statistical artifacts masquerading as psychological phenomena-threaten the validity of a growing body of research. Guided by the dual-validity framework that integrates psychometrics with causal inference, this article presents a six-stage workflow that scales validity requirements to research ambition-using LLMs to code text requires basic reliability and accuracy, whereas claims about psychological properties demand comprehensive construct validation. Researchers must (1) explicitly define their research goal and corresponding validity requirements, (2) develop and validate computational instruments through psychometric testing, (3) design experiments that control for computational confounds, (4) execute protocols transparently, (5) analyze data with methods appropriate for nonindependent observations, and (6) report findings within boundaries and use results to refine theory. The workflow is illustrated through an example of model evaluation-“LLM selfhood”-showing how systematic validation can distinguish genuine computational phenomena from measurement artifacts. By establishing validated computational instruments and transparent practices, this workflow provides a path toward building a robust empirical foundation for AI psychology research.

PMID:42387246 | DOI:10.3758/s13428-026-03073-2

World J Pediatr. 2026 Jul 1. doi: 10.1007/s12519-026-01055-0. Online ahead of print.

ABSTRACT

BACKGROUND: Multiple clinical studies have confirmed that combining biologics and/or small molecules (tofacitinib or upadacitinib) exhibits favorable efficacy and manageable safety in adult patients with inflammatory bowel disease (IBD). However, data on the application of this therapy in pediatric IBD are limited and lack systematic integration and analysis. This study aims to evaluate the safety and efficacy of combining biologics and/or small molecules for the treatment of pediatric IBD and provide high-quality evidence-based guidance for pediatric clinical treatment decision making.

METHODS: We systematically searched multiple databases from inception to January 1, 2026 and included all studies that used combination therapy with biologics and/or small molecules in pediatric IBD. We conducted a pooled analysis of clinical remission rate, endoscopic remission rate, adverse event incidence, pediatric ulcerative colitis activity index (PUCAI) scores, pediatric Crohn’s disease activity index (PCDAI) scores, and changes in laboratory parameters.

RESULTS: A total of 12 studies meeting the inclusion criteria were included in the analysis, involving 217 pediatric patients with IBD. All patients had failed treatment with at least one biologic agent or immunomodulator. The primary treatment regimens included anti-tumor necrosis factor (TNF)-α + vedolizumab (accounting for 37.2%) and anti-TNF-α + ustekinumab (accounting for 28.6%). The pooled clinical remission rate was 69% [95% confidence interval (CI) = 52%-84%], the endoscopic remission rate was 51% (95% CI = 18%-83%), and the corticosteroid-free remission rate was 66% (95% CI = 41%-88%). Significant reductions were observed in C-reactive protein, fecal calprotectin, and erythrocyte sedimentation rate, as well as in PCDAI and PUCAI scores. The pooled adverse event rate was 17% (95% CI = 6%-31%), with infection being the most common. Pooled rate of serious adverse events was 11% (95% CI = 4%-20%), with no reported cases of malignancy or fatality. The clinical remission rate for ulcerative colitis was lower than that for Crohn’s disease, and the incidence of adverse events was higher, although these differences were not statistically significant.

CONCLUSIONS: For pediatric patients with IBD that is unresponsive to monotherapy, combining biologics and/or small molecules may represent an effective and relatively safe treatment option, achieving high clinical remission rates and improvements in biological markers. However, high-quality prospective studies are needed to confirm long-term efficacy and safety.

PMID:42387245 | DOI:10.1007/s12519-026-01055-0