Category: Nevin Manimala

Trials. 2026 Mar 3. doi: 10.1186/s13063-026-09577-8. Online ahead of print.

ABSTRACT

BACKGROUND: Current intraoperative margin assessment techniques lack the accuracy needed for clinical practice. Indocyanine green fluorescence imaging (ICG-FI) offers a useful technique for detection of tumoral tissue, including breast cancer (BC). There is a great inconsistency in the literature regarding the use of ICG for BC fluorescence imaging mainly concerning ICG dosing and the timing of administration. This study aims to determine the dose and timing of intravenous (IV) ICG administration that provides the optimal diagnostic accuracy for ICG-FI margin assessment during breast-conserving surgery (BCS).

METHODS: This study (BREASTIFLU-1) is a phase II cross-sectional diagnostic accuracy study. It is a five-arm, single-center, prospective, randomized, observational-interventional, open-label study that will include patients with histologically proven early-stage (cT1-T2, cN0-N1) BC who are planned to undergo BCS. Two preoperative timeframes will be used for the administration of five different IV ICG doses in single-dose patient arms. In the intraoperative arms, patients will receive 0.125 mg/kg or 0.25 mg/kg ICG administered IV at induction anesthesia. In the preoperative arms, patients will receive 0.5 mg/kg, 1 mg/kg, or 2 mg/kg ICG administered 24 h before surgery. The primary endpoint is accuracy of the ICG-FI technique for the detection of positive surgical margins. Secondary endpoints include the following: comparison of ICG-FI technique accuracy at different doses and timings, characterization of breast tumor fluorescence, and evaluation of fluorescence intensity of axillary lymph nodes. The trial aims to include 227 patients. Participant recruitment is expected to be complete at the beginning of 2026, and results for the primary outcome are expected to be available in 2026.

DISCUSSION: BREASTIFLU-1 is the first initiative to compare an intraoperative dose of ICG to preoperative ICG administration and is aligned with efforts to standardize the ICG-FI technique. Determining the best dose and timing for IV ICG injection is a crucial step toward using ICG-FI in practice. ICG-FI may provide a relatively easy and quick method to use for reducing the rate of positive margins after BCS.

TRIAL REGISTRATION: This trial was registered on February 15, 2023 at Clinical Trials Information System EU2023-504024-26-00 and on September 10, 2023 at ClinicalTrials.gov NCT06227338.

PMID:41772708 | DOI:10.1186/s13063-026-09577-8

J Cheminform. 2026 Mar 2. doi: 10.1186/s13321-026-01174-w. Online ahead of print.

ABSTRACT

Data curation is a fundamental yet often underappreciated aspect of cheminformatics and computational drug discovery. Large public and proprietary databases now provide vast amounts of chemical structure, physicochemical, absorption, distribution, metabolism, excretion, and toxicity (ADMET), and bioactivity data. However, these resources contain structural inconsistencies, annotation errors, and heterogeneous experimental conditions that can limit model performance and reproducibility. This narrative review summarizes why and how data should be curated before use in cheminformatics workflows. We frame chemical data curation around two complementary pillars: structural curation and curation of experimental conditions. On the structural side, we review existing standardization and quantitative structure-activity relationship (QSAR)-ready workflows, including handling of salts and mixtures, parent-child policies, aromatization, tautomer handling, stereochemistry validation, and duplicate detection with conflict resolution. On the experimental side, we synthesize evidence that assay protocols, measurement methods, and reporting practices introduce substantial uncertainty and bias in physicochemical and ADMET endpoints as well as bioactivity data, and we outline practical strategies for assembling condition-aware datasets from the literature and public databases. Across case studies, we highlight how curated structure-condition pairs yield more accurate, robust, and reproducible models than raw, unfiltered collections. Rather than introducing a new predictive method or performing a formal statistical meta-analysis, we provide a structured narrative synthesis of current best practices, tools, and decision points for data curation in cheminformatics. This review offers practical, evidence-based guidance on the structural and experimental-condition curation required to build reliable cheminformatics models.Scientific Contribution: This article does not introduce a new algorithm but provides a practice-oriented, structured synthesis of data curation in cheminformatics. We (i) formulate a two-pillar framework that treats structural curation and experimental-condition curation as equally important components of cheminformatics workflows; (ii) consolidate scattered best practices into concrete workflows, checklists, and decision maps for building “QSAR-ready” and condition-aware datasets; and (iii) integrate endpoint-specific case studies showing that rigorous curation materially improves predictive performance and reproducibility. We also identify open challenges and research directions for scaling and automating curation, including the use of workflow technologies and large language models, and for establishing community standards for condition metadata.

PMID:41772705 | DOI:10.1186/s13321-026-01174-w

Radiat Oncol. 2026 Mar 2. doi: 10.1186/s13014-026-02811-2. Online ahead of print.

ABSTRACT

OBJECTIVE: To minimize the radiation injury for white matter (WM) pathways during brain arteriovenous malformation (bAVM) stereotactic radiosurgery (SRS), the WM tractography is integrated into treatment planning to identify WM pathways and restrict receiving dose. Manual segmentation of eloquent bAVM adjacent to WM pathways is time-consuming and prone to substantial inter-practitioner variability due to intricate entanglement within eloquent brain areas. The objective of this study is to develop and evaluate a deep learning (DL) system for the segmentation of eloquent bAVM in a clinical setting.

METHODS: A total of 191 eloquent bAVM patients who underwent WM tractography and 3D time-of-flight magnetic resonance angiography (TOF-MRA) images were enrolled. 153 patients were used to construct a two-stage DL bAVM segmentation ensemble (TBASE) consisting of 2D detection and 3D segmentation models to segment the bAVM, the other 38 to test performance. Comparative experiments with ResNet and U-Net were conducted to validate the effectiveness of the proposed network. A randomized multi-reader evaluation was then conducted to assess the impact of TBASE assistance for bAVM segmentation using ten algorithm-unseen cases. Six medical professionals contoured the same series of cases in both assisted and unassisted modes, with a 6-week memory washout period between each session. The aided and unaided Dice Similarity Coefficients (DSC), Hausdorff Distance (HD), along with contouring times were compared.

RESULTS: The mean values and standard deviations for DSC and HD of TBASE are 0.87 ± 0.03 and 3.51 ± 0.26, respectively, while Res-Net and U-Net results are 0.75 ± 0.12 and 4.14 ± 0.99, 0.77 ± 0.09 and 3.94 ± 0.82, respectively. The average volume difference across all patients in test dataset is 0.25 ± 1.39 cc, with no statistically significant variation observed. With TBASE assistance, the mean DSC of readers improved from 0.76 ± 0.07 to 0.86 ± 0.05 (P < 0.001), with corresponding values of mean HD reducing from 4.31 ± 0.68 to 3.35 ± 0.17 (P < 0.001) and a mean time saving of 52.15% ± 13.85% per patient. Less-experienced readers achieved greater improvements in contouring accuracy compared to specialists (DSC increase: 0.15 ± 0.11 vs. 0.06 ± 0.09; P < 0.001), while demonstrating similar reductions in contouring time as specialists (50.68% ± 14.62% vs. 55.1% ± 11.98%; P = 0.217).

CONCLUSIONS: The reliable eloquent bAVM automated-segmentation method has been validated in clinical workflow. The TBASE assistance improved the accuracy and efficiency of the eloquent bAVM manual delineation while considering WM pathway protection.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:41772699 | DOI:10.1186/s13014-026-02811-2

Arch Public Health. 2026 Mar 3. doi: 10.1186/s13690-026-01873-8. Online ahead of print.

ABSTRACT

BACKGROUND: Long-term spatio-temporal analyses of influenza in coastal mega-cities remain limited. This study explores influenza dynamics in Tianjin, China (2010-2023) to inform prevention strategies.

METHODS: The data was based on case data from Tianjin (2010-2023) and the Tianjin Statistical Yearbook. Temporal trends, spatial auto-correlation (global and local Moran’s I), and spatio-temporal clusters (scan statistics) were assessed.

RESULTS: From 2010 to 2023, Tianjin reported a cumulative total of 195,426 influenza cases. The eastern region displayed the top three prevalence indices among the sixteen districts. Spatial auto-correlation analyses indicated that the evolution of influenza incidence rates in Tianjin follows a pattern of being “high along the eastern coast”. The analysis of spatio-temporal scanning identified the most significant cluster in eastern Tianjin, occurring from December 2017 to May 2019. This cluster covered four districts with a relative risk (RR) of 7.73 and log likelihood ratio (LLR) of 6597.49 (P < 0.001). Additionally, a similar cluster emerged in the eastern region of Tianjin from December 2019 to December 2023, covering three districts (RR: 27.41; LLR: 74011.43; P < 0.001).

CONCLUSIONS: Mega-city influenza prevention prioritizes high-economic-activity zones. Coastal mega-cities target influenza spread in old-new economic transition areas.

PMID:41772678 | DOI:10.1186/s13690-026-01873-8

Malar J. 2026 Mar 2. doi: 10.1186/s12936-026-05831-1. Online ahead of print.

ABSTRACT

BACKGROUND: Malaria continues to pose a serious public health challenge in Zamfara State, Nigeria, disproportionately affecting women and children due to socio-economic barriers. This study aimed to develop a Composite Gender-Sensitive Malaria Vulnerability Index (CGMVI) to identify areas of heightened malaria vulnerability and support informed targeted interventions.

METHODS: Malaria incidence and mortality data from the Malaria Atlas Project, and population data from WorldPop, were integrated with indicators of Insecticide-Treated Net (ITN) access and usage, maternal education, and household wealth. A Pentagonal Fuzzy Analytic Hierarchy Process was used to compute the CGMVI, while Getis-Ord Gi* hotspot analysis identified spatial patterns of vulnerability across Zamfara State.

RESULTS: The CGMVI revealed a west-to-east gradient of malaria vulnerability across Zamfara State, with hotspots in Gummi (3.86) and Bukkuyum (3.62), characterized by low ITN usage (82-85%), high maternal education deficits (89-91%), and household poverty (85-90%). Moderate vulnerability was observed in central Local Government Areas (LGAs) such as Anka and Bungudu, while northern and eastern LGAs, including Shinkafi, Zurmi, and Tsafe, exhibited low vulnerability with higher ITN coverage (≈92%) and better socio-economic profiles. Hotspot analysis using Getis-Ord Gi* confirmed statistically significant clustering in western LGAs (z-scores 2.11-4.89 at 99% confidence), while coldspots in the north and east had z-scores from – 1.69 to – 3.39. These patterns reflect intersections of socio-economic barriers, ITN access, and maternal education, highlighting areas where women and children face elevated malaria risk.

CONCLUSION: The study offers a spatial framework for understanding how epidemiological, socio-economic, and gender-related factors shape malaria vulnerability in Zamfara State. By identifying areas where women and children may face elevated risk, the findings can inform gender-sensitive ITN distribution, community malaria literacy initiatives, and socio-economic support strategies. The CGMVI provides a tool to guide evidence-informed planning and better integrate gender considerations into malaria control efforts in the state.

PMID:41772643 | DOI:10.1186/s12936-026-05831-1

J Neuroinflammation. 2026 Mar 2. doi: 10.1186/s12974-026-03713-6. Online ahead of print.

NO ABSTRACT

PMID:41772634 | DOI:10.1186/s12974-026-03713-6

Harm Reduct J. 2026 Mar 2. doi: 10.1186/s12954-026-01414-0. Online ahead of print.

NO ABSTRACT

PMID:41772631 | DOI:10.1186/s12954-026-01414-0

AIDS Res Ther. 2026 Mar 2. doi: 10.1186/s12981-026-00869-2. Online ahead of print.

ABSTRACT

BACKGROUND: As a chronic disease, effective HIV self-management is crucial for men who have sex with men (MSM) living with HIV. Psychosocial factors, including perceived stress and self-regulatory fatigue, have been shown to negatively impact self-management behaviors. However, research on the relationships among perceived stress, self-regulatory fatigue, and self-management behaviors remains limited. This study aimed to explore the mediating effect of self-regulatory fatigue in the relationship between perceived stress and self-management behaviors among MSM living with HIV in China.

METHODS: From December 2024 to March 2025, cross-sectional data were collected from 328 MSM living with HIV at an HIV-designated hospital in Jiangsu Province using convenience sampling. Data were collected using the Perceived Stress Scale, Self-Regulatory Fatigue Scale, and HIV Self-Management Scale. Descriptive statistics, univariate analysis, and Pearson correlation analysis were performed in this study. The mediating effect of self-regulatory fatigue in the relationship between perceived stress and self-management behaviors was assessed using Model 4 of the PROCESS macro for SPSS.

RESULTS: Among 328 MSM living with HIV, the average score of perceived stress was 30.67 ± 7.87, the average self-regulatory fatigue score was 43.99 ± 8.76, and the average HIV self-management score was 36.65 ± 7.88. Perceived stress was positively related to self-regulatory fatigue (r = 0.544, p<0.05), whereas self-management behaviors were proven to be negatively associated with perceived stress (r = -0.486, p<0.05) and self-regulatory fatigue (r = -0.504, p<0.05). Self-regulatory fatigue partially mediated the association between perceived stress and self-management behaviors, accounting for 34.39% of the total effect.

CONCLUSION: This study demonstrated that self-regulatory fatigue partially mediated the relationship between perceived stress and self-management behaviors and underscored the importance of designing targeted interventions aimed at reducing perceived stress and self-regulatory fatigue to improve self-management behaviors among MSM living with HIV in China. Multidimensional strategies, achieved through collaborative efforts among patients, healthcare providers, government, and community, should incorporate personalized mental care and stress management, available social support, trained peer navigation, and consistent health education.

PMID:41772624 | DOI:10.1186/s12981-026-00869-2

J Transl Med. 2026 Mar 2. doi: 10.1186/s12967-026-07925-5. Online ahead of print.

ABSTRACT

OBJECTIVE: In the present meta-analysis, we aimed to explore the efficacy and safety of immunosuppressants and immunomodulators for the treatment of juvenile myasthenia gravis (JMG).

METHODS: We conducted a systematic search for studies published between January 1st, 2000 and July 28th, 2025, in PubMed, Embase, Web of Science, and the Cochrane Library. Statistical analyses were performed using Stata (version 16.0). Cochran’s Q test and the I² statistic were used to assess the heterogeneity among the included studies. If significant heterogeneity existed (I² ≥50% or P < 0.05), the random effects model was used; otherwise, the fixed effects model was used to calculate the pooled results.

RESULTS: A total of 3029 articles were retrieved. This meta-analysis included 9 cohort and case-control studies, 11 case series, 3 single-arm studies, and 1 randomized controlled trial, focusing on tacrolimus, glucocorticoids, monoclonal antibodies, and intravenous immunoglobulin. Regarding tacrolimus, 9 studies involving 310 patients assessed the efficacy of tacrolimus for treating JMG. The results showed a significant reduction in both the Quantitative Myasthenia Gravis (QMG) and Myasthenia Gravis Activities of Daily Living (MG-ADL) scores. Moreover, tacrolimus treatment allowed for a reduction in steroid dosage, with a response rate of 0.862 (95% CI: 0.716-0.967). For monoclonal antibodies, 6 studies with 67 patients analyzed the efficacy for JMG. The response rate of monoclonal antibodies was 0.993 (95% CI: 0.935-1.000). Descriptive analyses were conducted for glucocorticoids and IVIG. Besides, 5 studies with 348 patients assessed the efficacy of glucocorticoids for JMG. Included studies showed that the efficacy rate of glucocorticoid monotherapy for isolated ocular myasthenia gravis (OMG) was higher than that for patients with both OMG and generalized myasthenia gravis (GMG). Finally, regarding the use of IVIG, 4 studies reported efficacy for JMG. These investigations reported a response rate ranging from 47.06% to 94.3% for IVIG therapy.

CONCLUSIONS: In summary, this was the first comprehensive meta-analysis of immunosuppressants and immunomodulators in JMG. However, most included studies were single-center retrospective observational studies. Future prospective multicenter studies are needed to further investigate the efficacy and safety of immunosuppressants and immunomodulators in JMG.

PMID:41772612 | DOI:10.1186/s12967-026-07925-5

Harm Reduct J. 2026 Mar 2. doi: 10.1186/s12954-026-01427-9. Online ahead of print.

ABSTRACT

BACKGROUND: Appropriate treatments for nonopioid substance use are currently unavailable. Venlafaxine may reduce withdrawal from nonopioid substances, but the effects have not been evaluated. We aimed to investigate the association between venlafaxine use and the risk of withdrawal from nonopioid substances.

METHODS: We linked Taiwan’s National Health Insurance Research Database and the Taiwan Illicit Drug Issue Database from January 2012 to December 2019. We used a case-case-time-control study involving a case-crossover analysis and a control-crossover analysis consisting of future cases. The outcomes were withdrawal from substances and all-cause mortality. For each individual, venlafaxine use during the hazard period (day – 8 to – 67 before the outcome) was compared with that during the 60-day reference period (between days – 248 and – 307). Conditional logistic regression was used to determine odds ratios with 95% confidence intervals to evaluate the associations between outcome events and the use of venlafaxine.

RESULTS: The participants’ average age on the index date was 39.5 years (standard deviation 8.7), with 84.1% men and 88.3% having low income. Venlafaxine was significantly associated with a lower risk of withdrawal from substances (odds ratio 0.35, 95% confidence interval 0.13 to 0.96). However, we found no association between the recent use of venlafaxine and all-cause mortality (1.08, 0.55 to 2.14). The point estimates were similar in a series of sensitivity analyses, though not all analyses statistical significance.

CONCLUSIONS: This study provides strong ground for clinicians to consider the use of venlafaxine to reduce patient experiencing withdrawal symptoms from substances.

PMID:41772603 | DOI:10.1186/s12954-026-01427-9