Category: Nevin Manimala

J Magn Reson Imaging. 2026 May 23. doi: 10.1002/jmri.70350. Online ahead of print.

ABSTRACT

BACKGROUND: Motion can degrade image quality during Ultrashort Time-to-Echo (UTE) pulmonary MRI and is particularly prevalent in patients with lung disease. Comprehensive assessment of the impact of motion compensation techniques on image quality and clinical interpretation is needed.

PURPOSE/HYPOTHESIS: To compare the impact of retrospective motion compensation schemes on image quality and clinical interpretation of pulmonary UTE MRI in idiopathic pulmonary fibrosis (IPF).

STUDY TYPE: Prospective.

POPULATION: 21 (male = 18; mean age, 69.9 ± 8.1 years) participants with suspected IPF.

FIELD STRENGTH/SEQUENCE: 1.5 T/3 T, 3D center-out radial (gradient-echo) UTE sequence with 2× radial oversampling, while free-breathing.

ASSESSMENT: Images were reconstructed to 1.25 mm isotropic resolution using five retrospective schemes: no gating, hard-gating, soft-gating, motion-resolved (XD-GRASP), and an iterative approach (iMoCo). Signal-to-noise ratios (SNR) were estimated within the lung parenchyma, airways, aorta, muscles, and liver. Contrast-to-noise ratios (CNR) were estimated using the mean airway signal as reference. Image sharpness was estimated using the maximum derivative of a line profile across the diaphragm and a wavelet-based autofocus measure. Three radiologists evaluated image quality, motion artifacts on a 5-point Likert scale, and diagnostic classification of usual interstitial pneumonia (UIP).

STATISTICAL TESTS: The Kruskal-Wallis non-parametric test was used for qualitative reader scores and one-way ANOVA for the quantitative metrics, with p < 0.05 as the threshold for significance.

RESULTS: CNR was highest using the iMoCo reconstructions (lung parenchyma: 1.64 ± 1.41 vs. 0.88 ± 0.81 via XD-GRASP). Image sharpness was significantly improved using compressed sensing (CS)-based techniques (XD-GRASP and iMoCo), compared to the other methods, using both diaphragm profile (CS: 6.28 ± 3.70 vs. non-CS: 3.73 ± 2.06) and wavelet metrics (CS: 2.33 ± 0.42 vs. non-CS: 2.05 ± 0.35). CS methods also demonstrated greatest image quality based on reader scores.

CONCLUSION: Motion compensation using compressed sensing methods can improve image quality and clinical utility of UTE-MRI in the identification and diagnostic classification of typical parenchymal fibrotic patterns.

EVIDENCE LEVEL: Level 2-Prospective study, with a reference standard determined during the course of the study (CT imaging).

TECHNICAL EFFICACY: Stage 1.

PMID:42175722 | DOI:10.1002/jmri.70350

Emerg Microbes Infect. 2026 May 23:2678657. doi: 10.1080/22221751.2026.2678657. Online ahead of print.

ABSTRACT

AbstractPulmonary infections caused by nontuberculous mycobacteria (NTM), particularly Mycobacterium avium complex (MAC), are increasingly recognized as an important clinical entity, yet distinguishing active pulmonary disease from asymptomatic colonization remains challenging because current diagnosis relies on composite criteria. In this study, we aimed to identify blood transcriptomic signatures that discriminate MAC pulmonary disease (MAC-PD) from pulmonary colonization (MAC-PC) and to evaluate their potential as candidate biomarkers. MAC-positive patients from two medical centers in Taiwan were enrolled as training and external validation cohorts, and peripheral blood transcriptomes were profiled. Candidate genes were identified using least absolute shrinkage and selection operator regression and recursive feature elimination across multiple random seeds, followed by filtering based on statistical robustness and biological relevance. Machine-learning models were then trained and externally validated. Among 120 patients (training cohort: 46 MAC-PD and 28 MAC-PC; validation cohort: 25 MAC-PD and 21 MAC-PC), seven enriched gene ontology terms were prioritized. Three models demonstrated robust performance in the validation cohort, with areas under the receiver operating characteristic curve of 0.78, 0.78, and 0.75, and accuracies of 0.76, 0.74, and 0.74, respectively. These models shared a five-gene core signature consisting of IGKV1D-39, IGKV6-21, OVCH1, PLAU, and DMD, highlighting convergent biological signals related to immune responses and tissue remodeling. Overall, blood transcriptomic profiling shows promise in differentiating MAC-PD from MAC-PC in our cohorts, and the identified five-gene core signature represents a biologically coherent, minimally invasive candidate biomarker panel warranting further prospective validation.

PMID:42175713 | DOI:10.1080/22221751.2026.2678657

Biomed Res Int. 2026;2026(1):e8893135. doi: 10.1155/bmri/8893135.

ABSTRACT

BACKGROUND: Medication safety is an important public health challenge, especially in pediatrics. Medication errors (MEs) are often underreported in pediatrics and can lead to adverse outcomes such as frequent readmissions, increased total healthcare costs, prolonged hospitalization, and related morbidity and mortality. Thus, this study is aimed at assessing the magnitude and determinants of MEs among pediatric hospitalized patients at comprehensive specialized hospitals in Northwest Ethiopia.

METHODS: A multicenter prospective observational study involving pediatric hospitalized patients was conducted over 4 months, utilizing systematic random sampling for participant selection. Three clinical pharmacists, after a day of training, collected data under the supervision of an MSc health professional, with support from pediatricians in each hospital for reviewing MEs and adjusting treatment plans. Pediatric patients were followed prospectively during their hospital stay from admission to discharge. Data collection occurred via the Kobo Toolbox platform and was analyzed with STATA Version 17.0. Both bivariate and multivariable logistic regression analyses identified factors related to MEs, with statistical significance set at a p value < 0.05.

RESULTS: Among 358 pediatric hospitalized patients, 53.63% experienced at least one ME, totaling 254 identified errors. The prescribing stage accounted for the highest percentage of errors (40.16%), followed by the administration stage (32.68%). The predominant types of MEs were dose errors (30.31%), frequency errors (14.96%), and omission errors (14.17%). Multivariable logistic regression analysis revealed that polypharmacy (≥ 5 medications) (AOR = 2.005, 95% CI: 1.269-3.168), male sex (AOR = 1.707, 95% CI: 1.097-2.656), and prolonged hospital stay (AOR = 1.673, 95% CI: 1.076-2.602) were significantly associated with the occurrence of MEs.

CONCLUSION: This study found that MEs were prevalent in pediatric hospitalized patients. Polypharmacy, male patients, and the length of hospital stay were independent predictors of MEs. To reduce MEs, computer-based prescribing practice and clinical pharmacy services should be routine practices in the study settings.

PMID:42175692 | DOI:10.1155/bmri/8893135

J Am Acad Orthop Surg Glob Res Rev. 2026 May 19;10(5). doi: 10.5435/JAAOSGlobal-D-25-00449. eCollection 2026 May 1.

ABSTRACT

OBJECTIVE: Fiberglass long leg casting is often used to treat specific lower extremity fracture patterns in children. However, cylindrical casting limits swelling, increasing risk of compartment syndrome. To account for edema, casts are frequently univalved, but it remains unclear whether univalve location affects skin surface pressures (SSPs) in long leg casts. We hypothesized that a lateral univalve would decrease anterior SSP, whereas univalve location would not affect posterior SSP in long leg casts.

METHODS: A 100-mL saline bag attached to a pressure transducer was placed along the anterior or posterior compartment of a volunteer underneath 20 and 26 long leg casts, respectively. The casts were randomly assigned to receive either lateral or medial univalve. The bag was insufflated with water to 100 mm Hg, and change in SSP was recorded with univalve (stage I), univalve with 3-mm spacer (stage II), univalve with 6-mm spacer (stage III), and bivalve (stage IV). Statistical analysis was done to detect an SSP difference of 10 mm Hg.

RESULTS: In the anterior and posterior compartments, no notable differences were found in SSP change within any stage between lateral and medial univalve. Comparing stage I and stage IV, a notable SSP change was found across all anterior and posterior compartment groups (P < 0.001, 95% confidence).

CONCLUSION: No notable difference was found in anterior or posterior SSP in long leg casts with either medial or lateral univalve. Our data support a “dealer’s choice” that the practitioner may select either medial or lateral univalve to reduce anterior and posterior SSP.

PMID:42175675 | DOI:10.5435/JAAOSGlobal-D-25-00449

J Inherit Metab Dis. 2026 May;49(3):e70202. doi: 10.1002/jimd.70202.

ABSTRACT

Neuronal ceroid lipofuscinosis type 2 (CLN2) disease, a lysosomal storage disorder, causes early childhood psychomotor regression, vision loss, seizures, and rapid progressive gray matter loss. However, the link between neurodegenerative processes induced by lysosomal pathophysiology and the clinical phenotype remains unclear. This study investigated the longitudinal association of gray matter atrophy on MRI with in-depth clinical phenotyping in 27 patients receiving intraventricular enzyme therapy (n_timepoints = 170; biannual clinical assessments and MRIs). Longitudinal changes in cortical thickness and subcortical volumes were modeled via linear mixed effects regression. We used linear regression to correlate 24-week (Δ24) changes in clinical assessments with global cortical thickness and applied multivariate data-driven statistics to model how specific brain regions are associated with clinical domains. Our analysis revealed a significant reduction in the mean cortical thickness over time (β = -0.002, p = 0.021), corresponding to an annual loss of 4.2%, compared to natural history controls with 12.5%, respectively. Regional analysis revealed a widespread pattern of cortical and subcortical gray matter atrophy. Global cortical thickness reductions over 24 weeks (Δ24) were significantly associated with changes in the Hamburg motor and language scale Δ24, Weill Cornell scale Δ24, and Movement Disorder Inventory Δ24. Multivariate statistics identified a significant latent dimension relating regional morphometric abnormalities to worse clinical outcomes, accounting for 82% of the shared variance. Leveraging connectome data, we demonstrated that atrophy was linked to brain network architecture. Given their strong associations with clinical outcomes, MRI-based brain morphometric measures are promising CLN2 disease biomarkers to aid diagnosis, monitor disease progression, and guide therapy.

PMID:42175674 | DOI:10.1002/jimd.70202

J Oral Rehabil. 2026 May 23. doi: 10.1111/joor.70219. Online ahead of print.

ABSTRACT

BACKGROUND: This cross-sectional observational study aimed to assess the relationships between headache (HA), orofacial pain (OFP), sleep bruxism (SB), trauma, emotional control, stress management, and illness acceptance, as measured by scales.

METHODS: Eligible patients underwent overnight videopolysomnography and completed validated questionnaires on pain, trauma, coping strategies, and illness acceptance; all data were analysed using TIBCO Statistica 13.

RESULTS: The results showed a positive correlation between experienced trauma and pain (p = 0.001 for HIT 6, p = 0.002 for MIDAS, p = 0.002 for SF-MPQ), as well as between pain and negative coping strategies such as denial (p = 0.020 for MIDAS, p = 0.038 for SF-MPQ), venting (p = 0.020 for HIT-6, p = 0.009 for MIDAS, p = 0.037 for SF-MPQ), taking psychoactive substances (p = 0.009 for SF-MPQ), behavioural disengagment (p = 0.007for HIT-6, p = 0.039 for SF-MPQ), and self-blame (p = 0.000 for HIT-6, p = 0.001 for MIDAS, p = 0.000 for SF-MPQ). The results also showed a correlation between lower illness acceptance and greater pain complaints (p = 0.000 for GCPS, p = 0.000 for HIT-6, p = 0.000 for MIDAS, p = 0.000 for SF-MPQ). We observed a significant negative relationship between self-blame and the bruxism episode index (BEI) (p = 0.006) and between venting and BEI (p = 0.039).

CONCLUSIONS: Factors such as trauma, the use of negative coping strategies, and low levels of illness acceptance among patients with chronic orofacial pain can be associated with increased pain, which in turn compromises the effectiveness of treatment therapy. Self-blame and emotional venting-showed significant negative correlations with BEI, indicating fewer SB episodes.

TRIAL REGISTRATION: www.

CLINICALTRIALS: gov, “Relationship Between Selected Parameters and Bruxism”, identifier NCT04214561.

PMID:42175672 | DOI:10.1111/joor.70219

Int J Lang Commun Disord. 2026 May-Jun;61(3):e70263. doi: 10.1111/1460-6984.70263.

ABSTRACT

BACKGROUND: Effective support for children’s speech, language, and communication development is essential to prevent long-term negative outcomes. Parental behaviours play a critical role in whether children are referred to and receive speech-language therapy.

AIMS: This study aimed to identify predictors of parents receiving Speech-language Therapy using longitudinal data from Growing Up in New Zealand.

METHOD: Data were drawn from the Growing Up in New Zealand study, which is representative of the national child population. The analysis focused on children with reported speech concerns by age 54 months (N = 771). The primary outcome was whether speech-language therapy had been received for speech concerns by that age.

RESULTS: Logistic regression showed children had significantly higher odds of receiving speech-language therapy if their mothers experienced low socioeconomic deprivation during pregnancy (OR = 2.31, p < 0.01) and if family doctors were perceived as highly helpful when the child was nine months old (OR = 3.77, p < 0.05). In contrast, children whose mothers identified Māori as their prioritised ethnicity were significantly less likely to receive speech-language therapy than those identifying as European/Pākehā (OR = 0.40, p < 0.001).

CONCLUSION: Findings highlight persistent ethnic and social inequities in access to speech-language therapy in New Zealand. Parental information-seeking may play a role but requires further research. These results support the need for targeted policies and early engagement strategies to ensure equitable receipt of speech-language therapy for children with speech, language, and communication needs.

WHAT THIS PAPER ADDS: What is already known on this subject Less than half of children with speech concerns receive speech-language therapy. Socio-economic and ethnic disparities are known to contribute to this gap. However, the specific factors influencing access to speech-language therapy, and the role of healthcare providers in supporting service uptake, are not well understood. What this study adds to the existing knowledge This study identifies key factors associated with non-receipt of speech-language therapy, including socio-economic deprivation, ethnicity, and perceived helpfulness of support. It underscores the important role of healthcare providers in early identification and in improving access to speech-language therapy services for children in at-risk groups. What are the actual clinical implications of this work? The findings highlight the need for targeted strategies to overcome barriers to speech-language therapy access. Strengthening collaboration between healthcare providers, such as general practitioners and early childhood professionals, may improve early intervention and service uptake among underserved populations.

PMID:42175668 | DOI:10.1111/1460-6984.70263

J Oral Rehabil. 2026 May 23. doi: 10.1111/joor.70218. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to compare the effects of soft tissue mobilization (STM) and joint mobilization (JM) on mandibular mobility, cervical joint position sense (JPS), jaw function and anxiety levels in individuals with rheumatoid arthritis (RA) and temporomandibular disorders (TMD).

METHODS: This randomized controlled study included 57 patients with RA and TMD, who were allocated to three groups: STM group (n = 19), JM group (n = 19) and control group (CG; n = 19). Interventions were applied twice weekly for 6 weeks. Outcome measures included mandibular range of motion (ROM), jaw function assessed using the Jaw Functional Limitation Scale-20 (JFLS-20), cervical JPS using a CROM device, and anxiety levels using the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Statistical significance was set at p < 0.05.

RESULTS: Both intervention groups demonstrated significant improvements in mandibular mobility, jaw function, and anxiety compared to CG (p < 0.05), whereas the CG showed deterioration in mouth opening, protrusion and anxiety over time. In mandibular mobility, both STM and JM showed significant improvements across most parameters, with JM showing a more consistent pattern of improvement. Significant improvements in cervical JPS were observed in the STM group for flexion, extension, and left rotation, and in the JM group for flexion only. No significant differences were found between the intervention groups in jaw function or anxiety outcomes.

CONCLUSION: Soft tissue mobilization enhances cervical proprioception more effectively, whereas joint mobilization provides greater improvements in mandibular mobility. Both manual therapy techniques are effective, non-invasive and clinically applicable options for managing TMD in individuals with RA.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT07171671.

PMID:42175667 | DOI:10.1111/joor.70218

Headache. 2026 May 23. doi: 10.1111/head.70111. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine if there is increased headache burden and disability among women with and without migraine during an in vitro fertilization (IVF) cycle.

BACKGROUND: Migraine and infertility commonly impact women of childbearing age. Estradiol fluctuations influence migraine, yet the impact of exogenous estrogen on migraine during fertility treatments such as IVF is not well characterized. We assessed migraine burden and disability among women with and without a history of migraine during an IVF cycle. Secondary outcomes included psychological symptoms and estradiol levels. We hypothesized that although all women may be at risk of migraine symptoms during an IVF cycle, women with migraine would be more likely to experience greater headache-related disability and associated psychological symptoms during an IVF cycle. Furthermore, we hypothesized that women with migraine would experience an increase in headache-related disability between time point 2 (when estrogen peaks after ovulation trigger) and time point 3 (when estradiol levels reach a nadir). Women without a history of migraine were included to assess the development of de novo migraine during IVF due to shifts in estradiol.

METHODS: A prospective cohort study of adult women undergoing an IVF cycle at the Weill Cornell Medicine Center for Reproductive Medicine (New York, NY) from 2020 to 2023 completed an initial health questionnaire and follow-up throughout an IVF cycle at three time points. Data collected included a measure of headache disability (Headache-Attributed Lost Time over the past 30 days [HALT-30]); psychological scales (Depression Anxiety and Stress Scale-21 item); and serum estradiol, follicle-stimulating hormone, luteinizing hormone, and progesterone levels.

RESULTS: Seventy-six participants completed all study time points, including 52 with migraine (18 with aura) and 24 controls. At each time point, the migraine group had higher total HALT-30 scores compared to controls. HALT-30 scores were 5.6 (confidence interval: 2.1 to 9.1) higher, on average, in the migraine group compared to the control group after controlling for time and the interaction between the two (p = 0.002). There were no statistically significant differences in HALT-30 scores over time when analyzing the migraine with aura and migraine without aura groups separately. However, in the combined model, with each week that passed, the HALT score increased, on average, by 0.09 in the migraine without aura group (p = 0.011). Despite the migraine group having greater headache-related disability scores at each time point, the level of disability as measured by the HALT-30 did not change over time throughout the IVF cycle. Serum estradiol levels peaked at the second time point in both groups without significant differences between groups. Participants with migraine consistently reported greater psychological distress (stress, anxiety, and depression) than controls across multiple time points. Depression Anxiety and Stress Scale-21 item stress scores decreased, on average, by 4 [interquartile range: -5, 0] points in the control group compared to 0 [interquartile range: -4, 4] points in the migraine group (p = 0.019) between the second and final time points.

CONCLUSION: This prospective cohort study demonstrated that women without migraine history maintained a low level of headache-related disability during IVF. It did demonstrate that women with history of migraine experienced elevated migraine disability during an IVF cycle; however, headache-related disability did not change over time, specifically between time point 2 and time point 3 when there is the largest change (peak-to-nadir) in estradiol levels post-ovulation trigger. This study highlights that the shifts in estradiol during an IVF cycle may not exacerbate headache-related disability beyond baseline in women with migraine. However, participants with migraine reported higher levels of psychological distress at different time points in three domains throughout the study-stress, anxiety, and depression-highlighting the importance of mental health support for women with migraine during an IVF cycle. Overall, this study found that participants maintained a low level of headache-related disability throughout the IVF cycle; however, this study cannot rule out the possibility of transient exacerbations in disability that were not captured by the HALT-30.

PMID:42175659 | DOI:10.1111/head.70111

Pharmacoepidemiol Drug Saf. 2026 Jun;35(6):e70398. doi: 10.1002/pds.70398.

ABSTRACT

BACKGROUND: Direct oral anticoagulants (DOACs) offer advantages over warfarin; however, concerns exist regarding their association with acute interstitial lung diseases (ILDs). This study investigated the risk of acute-onset ILDs associated with DOAC use.

METHODS: We conducted a case-crossover study to assess the risk of hospitalization for acute-onset ILDs following DOAC initiation using the JMDC database, a Japanese administrative claims database. Patients aged ≥ 18 years hospitalized for acute-onset ILDs (April 2011-February 2023) were included. DOAC exposure was defined as ≥ 14 days within predefined 30-day windows: 1-30 days before admission (exposure period) and 60-90 and 120-150 days before admission (reference periods). The primary outcome was hospitalizations for acute-onset ILD, identified using a validated algorithm. Conditional logistic regression estimated odds ratios (ORs). Sensitivity analyses included a bidirectional case-crossover design, a case-crossover analysis with warfarin as an active comparator, weighted case-crossover analysis, and a case-case-time-control design. A descriptive cohort analysis of new DOAC and warfarin users examined ILD frequency and prognosis.

RESULTS: The main case-crossover analysis included 178 patients, showing an association between DOAC use and acute-onset ILDs (adjusted OR, 4.44 [95% CI, 1.58-12.5]). Sensitivity analyses demonstrated a consistent direction of association (adjusted ORs: 3.37-6.85). In descriptive cohort analysis (52 021 DOAC and 12 026 warfarin initiators), ILD incidence was low (0.24% vs. 0.20%), but 90-day mortality was higher in the DOAC group (21% vs. 0%).

CONCLUSIONS: DOAC use was associated with an increased risk of hospitalization for acute-onset ILDs. Clinicians should monitor patients on DOACs for ILD symptoms.

PMID:42175652 | DOI:10.1002/pds.70398