Category: Nevin Manimala

Inhal Toxicol. 2026 Jun 26:1-15. doi: 10.1080/08958378.2026.2689661. Online ahead of print.

ABSTRACT

OBJECTIVE: Some of the varieties of talc were reported to contain a small fraction of elongate particles, including tremolite. The biological effects of tremolite were demonstrated in literature as dependent on the habit of particles (asbestiform vs. non-asbestiform). The objective of this paper is to utilize advanced methodologies of risk evaluation to determine if risk of mesothelioma could be elevated in persons utilizing talcum powder.

METHODS: Monte Carlo simulation was used to calculate potency factors, cumulative exposure, and mesothelioma risk for a hypothetical scenario.

RESULTS: Excess risk of mesothelioma for the person would be estimated as 0.22 cases per 1,000,000 per lifetime, with 5th percentile of 0.003 and 95th percentile of 0.873. Upper bound of excess mesothelioma risk is lower than the U.S. EPA benchmark for the general population and also comprises only about 1.4% of the mesothelioma baseline level in unexposed people. The morphological habit of tremolite particles reported in talc was typical for non-asbestiform variety.

CONCLUSIONS: Quantitative risk assessment can be used to evaluate possible health outcomes of airborne exposure to talcum powder.

PMID:42363609 | DOI:10.1080/08958378.2026.2689661

J Ultrasound Med. 2026 Jun 26. doi: 10.1002/jum.70344. Online ahead of print.

ABSTRACT

OBJECTIVES: To establish gestational age-specific reference ranges for the intraplacental vascular index measured using microvascularity-flow ultrasound software (VI^MV) and to evaluate its variation by placental location, parity, and pregnancy outcome.

METHODS: This prospective study enrolled 354 singleton pregnancies, of which 243 (68.64%) uncomplicated cases were used to construct reference ranges. A residual bootstrap method with 500 iterations was applied to square-root-transformed VI^MV values, followed by back-transformation to derive the 5th, 50th, and 95th percentiles with 95% confidence intervals. Group differences were assessed using quantile regression, and associations with Doppler parameters were examined.

RESULTS: VI^MV increased significantly with advancing gestational age (linear coefficient 1.88, p = .007), following a curvilinear pattern with mild late-gestation downturn (quadratic coefficient – 0.036, p = .011). Posterior placentas showed slightly higher early values, although this difference was not significant; from 31 weeks onward, anterior placentas demonstrated significantly higher VI^MV (mean difference + 15.4, p = .010 at 31-35 weeks; +11.6, p = .003 at 36-40 weeks). Multiparous women showed a modestly higher fitted trajectory and a similar non-significant trend toward higher birthweight, but parity was not independently associated with VI^MV. Pregnancies complicated by maternal disease, hypertensive disorders, or small-for-gestational-age neonates exhibited lower trajectories than uncomplicated pregnancies, although these differences were not statistically significant. VI^MV was inversely associated with uterine and umbilical artery pulsatility indices and positively associated with umbilical vein time-averaged mean velocity.

CONCLUSIONS: Gestational age-specific VI^MV reference ranges were established. VI^MV may provide an adjunctive quantitative marker for assessing placental vascular adaptation and identifying pregnancies with altered placental perfusion.

PMID:42363588 | DOI:10.1002/jum.70344

Med Sci Monit. 2026 Jun 27;32:e951747. doi: 10.12659/MSM.951747.

ABSTRACT

BACKGROUND Chat Generative Pre-Trained Transformer (ChatGPT) is an advanced artificial intelligence (AI) tool that has become increasingly integrated into daily life. In Saudi Arabia, government initiatives actively encourage the adoption of AI technologies, yet information on public perceptions of this technology remains insufficient. This study assessed public awareness, attitudes, beliefs, and perceptions about ChatGPT in Saudi Arabia. MATERIAL AND METHODS A cross-sectional survey was conducted among individuals living Saudi Arabia, from July to September 2025. Data were collected via an online questionnaire consisting of 25 items collecting information on demographic characteristics, their perceptions, awareness, and use of ChatGPT, and their attitudes and perceived obstacles regarding ChatGPT. Descriptive statistics were used for data analyzing using SPSS version 26. RESULTS Of participants 1069, 56.7% were female and 76.5% held a university degree. While 48.7% were somewhat familiar with ChatGPT, over half (54.6%) of them reported positive attitudes toward ChatGPT. Perceived benefits included productivity and educational enhancement, but concerns centered on overdependence (61.3%), incorrect information (55.7%), job loss (54.2%), and biased content (53.5%). Key obstacles were lack of credibility (76%) and confidentiality concerns (68.5%). The findings indicate that gender (P=0.001), age (P=0.001), and educational attainment (P=0.001) are important factors influencing familiarity and comfort with ChatGPT in daily life. CONCLUSIONS The Saudi public demonstrates a balanced perspective toward ChatGPT, recognizing its potential to enhance productivity and education while expressing valid concerns about trust and accuracy. Targeted awareness and policy measures are needed to build confidence and responsible adoption.

PMID:42363582 | DOI:10.12659/MSM.951747

Medicine (Baltimore). 2026 Jun 26;105(26):e49266. doi: 10.1097/MD.0000000000049266.

ABSTRACT

The triglyceride-glucose-Chinese visceral adiposity index (TyG_CVAI) has been validated as an effective predictor of early stroke. However, its predictive efficacy across different glycemic metabolic states remains unexplored. This study utilized data from the China Health and Retirement Longitudinal Study, including 7744 stroke-free participants. Participants were categorized into 3 glycemic groups: diabetes mellitus (DM), prediabetes mellitus (Pre-DM), and normal glucose regulation (NGR). K-means clustering further divided participants into 2 clusters based on TyG_CVAI fluctuations: Cluster 1 (lower TyG_CVAI) and Cluster 2 (higher TyG_CVAI). The primary outcome was the first stroke occurrence. Statistical analyses included Kaplan-Meier survival curves, Cox proportional hazards models, restricted cubic spline analysis, and receiver operating characteristic curve analysis to assess associations between baseline TyG_CVAI and stroke risk. Over 9 years (2011-2020), 540 participants (7.0%) experienced a first stroke. Participants in Cluster 2 (higher TyG_CVAI) exhibited a significantly elevated stroke risk compared to Cluster 1. Kaplan-Meier analysis revealed significant differences in stroke incidence between clusters among Pre-DM, NGR, and the overall population (P < .001), but not in the DM group (P = .071). Cox regression models, adjusted for confounders, confirmed a significant positive correlation between TyG_CVAI and stroke risk in the overall population, Pre-DM, and NGR groups. The hazard ratios and 95% confidence intervals for Cluster 2 versus Cluster 1 were 1.40 (1.15-1.71), 1.42 (1.07-1.88), and 1.68 (1.19-2.36), respectively. In contrast, no significant association was observed in the DM group (P > .1). Restricted cubic spline analysis further supported that higher TyG_CVAI levels correlated with increased stroke risk. Elevated baseline TyG_CVAI is significantly associated with stroke risk in middle-aged and older adults. However, its predictive capacity is attenuated in individuals with diabetes compared to those with normal glycemic metabolism. These findings underscore the importance of considering glycemic status when evaluating TyG_CVAI as a stroke predictor.

PMID:42363562 | DOI:10.1097/MD.0000000000049266

Medicine (Baltimore). 2026 Jun 26;105(26):e49516. doi: 10.1097/MD.0000000000049516.

ABSTRACT

Breast cancer (BC) has the highest cancer incidence and mortality in women worldwide, and the relationship between serum enzymes and BC has been inconsistent in previous observational studies. In this paper, 2-sample Mendelian randomization (MR) is used to clarify the causal relationship between them. The serum enzymes in 216,026 study subjects from Finnish heritage subjects as the exposure data. The BC included 212,402 study subjects in United Kingdom Biobank as the result data. We performed univariable MR with 5 MR methods inverse variance weighted, MR-Egger regression, weighted median, simple mode, and weighted mode and multivariable MR to estimate the effect of serum enzymes independent of BC. Finally, we performed a series of sensitivity analyses as validation of primary MR results. The single nucleotide polymorphisms screened in this study were mostly strong effect instrumental variables. A total of 5 forest plot model results indicate that abnormal serum enzyme levels have a significant causal relationship with BC. MR analysis of different models of abnormal serum enzyme levels gave consistent direction estimates, and their slopes were relatively consistent. Serum enzyme indicators did not consider heterogeneity in the MR results of BC (Cochran Q P value > .05, I 2 < 50%). MR-Egger’s results show that there is no effect of pleiotropy(P ≥ .05, intercepts were close to 0). Sensitivity analysis showed that no significant change in the estimated effect value of abnormal serum enzyme levels was found, indicating the stability of the results. inverse variance weighted model results indicate that BC has no causal effect on abnormal serum enzyme levels (P value > .05). The results of multivariate MR showed that serum enzyme indicators still have a significant direct effect on BC. Our findings suggest that a significant statistical causal association between abnormal serum enzyme levels and the risk of BC. Abnormal serum enzyme levels have important clinical implications and might be used as BC risk.

PMID:42363553 | DOI:10.1097/MD.0000000000049516

Medicine (Baltimore). 2026 Jun 26;105(26):e49310. doi: 10.1097/MD.0000000000049310.

ABSTRACT

Coronavirus disease 2019 (COVID-19) was reported to persist long-term in the brain and leave several long-term neurologic sequelae. However, the causal relationship between COVID-19 and brain aging is still unknown. The genome-wide association study (GWAS) data on COVID-19 phenotypes (susceptibility, hospitalization, and severity), involving a total of 5,779,391 participants, were collected from the COVID-19 Host Genetics Initiative. In addition, GWAS data on longitudinal changes in 15 brain structures, assessed via magnetic resonance imaging across the lifespan, were sourced from the ENIGMA Consortium and involved 15,640 participants. Two-sample Mendelian randomization was conducted to infer the causal relationship between COVID-19 and longitudinal brain changes. Multi-trait GWAS meta-analysis, colocalization, and fine-mapping analyses were performed to identify shared genetic etiologies. H3K27me3 ChIP-seq was used to evaluate the regulatory effect of colocalized loci. Two-step Mendelian randomization was applied to explore potential mediating mechanisms across multi-omics layers, including proteomics, metabolomics, and immunomics. Our results showed that COVID-19 hospitalization (β = -262.405, P = .041) and severity (β = -177.676, P = .049) were genetically associated with atrophied volume of total brain during longitudinal change. This suggests that individuals with advanced COVID-19 may be more susceptible to accelerated global brain aging. Caudate was genetically affected by all COVID-19 phenotypes. Seven variants were shared between advanced COVID-19 and global brain aging. rs117169628 was colocalized between advanced COVID-19 and global brain aging, and exerted an inhibitory effect on CDH15 expression, further strengthening the causality. Six metabolites, 1 protein, and 1 immune trait were identified as potential mediators. Our study indicates that advanced COVID-19 might be genetically associated with accelerated brain aging. Brain health should be paid more attention in long COVID-19.

PMID:42363551 | DOI:10.1097/MD.0000000000049310

Medicine (Baltimore). 2026 Jun 26;105(26):e49486. doi: 10.1097/MD.0000000000049486.

ABSTRACT

It has been proved that lipids have an effect on endometriosis, and the plasma atherosclerosis index (AIP), as a new lipid index, has not been proved to be correlative to endometriosis. The National Health and Nutrition Examination Survey from 1999 to 2006 covered 2405 female. AIP (log10 (triglyceride/high-density lipoprotein cholesterol)) was employed to evaluate the danger of hyperlipidemia. Moreover, the connection between AIP and endometriosis can be further studied by using multivariate logistic regression, restricted cubic spline and subgroup analysis. Totally 2405 female were covered, of whom 182 (7.57%) had endometriosis and 2223 (92.43%) did not have endometriosis (named control). The AIP level in the endometriosis group (0.37) was visibly exceed that in the non-endometriosis group (0.26), and the imparity was statistically meaningful(P < .0001), even when sensitivity analysis was performed, the imparity retained the same. Overall, there was a significant active connection between the AIP and endometriosis (per 1-unit increment in the AIP: OR = 2.624; 95% CI 1.479, 4.657). The consequences of subgroup analysis demonstrated that there was no meaningful interaction between AIP and concrete subgroups (all interaction P < .05). Restricted cubic spline analysisprovide evidence of statistically significant linearity between AIP and endometriosis prevalence. AIP is actively connection with endometriosis in US female. Therefore, by using AIP as a new lipid market indicator, we are expected to offer new ideas and insights into the prevention and treatment of endometriosis.” To further confirm our works, we need larger cohort researches to support the consequences of this research.

PMID:42363550 | DOI:10.1097/MD.0000000000049486

Medicine (Baltimore). 2026 Jun 26;105(26):e49477. doi: 10.1097/MD.0000000000049477.

ABSTRACT

We performed a 2-step Mendelian randomization (MR) study to investigate the associations of Fms-related tyrosine kinase 3 ligand (FLT3L) and phosphate levels with the risk of hypertrophic cardiomyopathy (HCM). Genetic instruments for 75 circulating inflammatory factors were obtained from the NHGRI-EBI GWAS Catalog, while summary statistics for circulating phosphate and HCM were derived from the UK Biobank and FinnGen, respectively. Univariable MR analysis using the inverse-variance weighted method indicated that genetically predicted higher phosphate levels were associated with an increased risk of HCM (OR = 1.36, P = 4.82 × 10-2). Among the inflammatory markers, FLT3L emerged as a significant candidate and showed inverse associations with phosphate levels (β = -0.05, P = 1.70 × 10-9) and HCM (OR = 0.79, P = 4.10 × 10-2). Bidirectional MR analyses did not support a causal effect of phosphate on FLT3L. Mediation analysis suggested that phosphate levels accounted for an estimated 12.05% of the total effect of FLT3L on HCM. Genetic liability to lower FLT3L levels is associated with a higher risk of HCM, and this relationship may be partially mediated through circulating phosphate levels.

PMID:42363547 | DOI:10.1097/MD.0000000000049477

Medicine (Baltimore). 2026 Jun 26;105(26):e49518. doi: 10.1097/MD.0000000000049518.

ABSTRACT

The routine placement of a double-J (DJ) stent before ureteroscopic lithotripsy (URS) remains controversial. This study aims to compare the stone clearance rates between preoperative DJ stent placement and non-placement and to analyze the risk factors associated with residual stones, providing more clinical evidence for preoperative management. A retrospective analysis was conducted on 163 patients who underwent URS for kidney and ureteral stones between April 2023 and October 2024, among which 135 patients met the inclusion criteria. General clinical and perioperative data were collected. The stone clearance rates were compared between the group with preoperative DJ stent placement and the group without DJ stent placement. Univariate and multivariate logistic regression analyses were used to identify risk factors for residual stones after URS. The overall stone clearance rate in patients undergoing URS was 85.19% (115/135). The stone clearance rate in the non-DJ group was 75.51% (37/49), while it was 90.70% (78/86) in the DJ group, showing a statistically significant difference between the 2 groups (P = .017). Univariate regression analysis found that the preoperative DJ stent placement (P = .021) and surgery duration (P = .047) were risk factors for residual stones after URS. Multivariate regression analysis also identified the preoperative DJ stent placement (P = .019) and surgery duration (P = .039) as independent risk factors for residual stones after URS. Preoperative DJ stent placement resulted in a higher stone clearance rate compared to non-placement during URS. The preoperative DJ stent placement and surgery duration were independent risk factors for residual stones after URS.

PMID:42363538 | DOI:10.1097/MD.0000000000049518

Medicine (Baltimore). 2026 Jun 26;105(26):e49526. doi: 10.1097/MD.0000000000049526.

ABSTRACT

The association between early magnesium sulfate administration and outcomes in sepsis remains incompletely understood, particularly in relation to differences in systemic immune-inflammatory status. In this retrospective cohort study using Medical Information Mart for Intensive Care IV (version 3.1), adult critically ill patients with sepsis were included. Systemic immune-inflammation index (SII) was calculated from platelet, neutrophil, and lymphocyte counts obtained within a peri-intensive care unit window (6 hours before to 24 hours after intensive care unit admission). Early magnesium administration was defined as intravenous magnesium sulfate initiated within the same window. The primary outcome was 30-day all-cause mortality. Propensity score matching was performed to balance baseline characteristics. Associations were examined overall and across SII quartiles using stratified multivariable Cox proportional hazards models, with nonlinear relationships explored using restricted cubic splines. Among 12,087 patients, 6039 received early intravenous magnesium. After propensity score matching, 3396 matched pairs were analyzed. Early magnesium administration was associated with lower 30-day mortality overall (15.8% vs 18.3%, P = .007). In stratified analyses, adjusted hazard ratios were 0.66 (95% confidence interval: 0.51-0.87), 0.65 (0.49-0.85), 0.75 (0.59-0.94), and 0.85 (0.70-1.04) across quartiles 1 to 4. Restricted cubic spline analyses showed descriptive attenuation at higher SII values (P for interaction = .208), without evidence of a statistically definitive interaction. Early magnesium administration was associated with lower 30-day mortality in critically ill patients with sepsis. Although formal interaction testing did not reach statistical significance, adjusted hazard ratios showed a descriptive gradient of attenuation across increasing SII quartiles, directionally consistent across sensitivity analyses. These findings are hypothesis-generating and require prospective validation.

PMID:42363536 | DOI:10.1097/MD.0000000000049526