Category: Nevin Manimala

Can J Anaesth. 2026 Jun 2. doi: 10.1007/s12630-026-03124-4. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study was to investigate the ex vivo effects of various intravenous anesthetic drugs on the contractility of gravid human myometrium. We hypothesized that these drugs would cause a concentration-dependent decrease in spontaneous uterine contractility and oxytocin coadministration would modify their contractile response.

METHODS: We conducted an ex vivo laboratory study with individual myometrial strips obtained from patients undergoing elective Cesarean delivery. We subjected the myometrial strips to concentration-response testing in organ bath chambers with intravenous agents-propofol, etomidate, and ketamine, with or without oxytocin-in a pattern of 0.5 log molar increase from 10^-7 M to 10^-4 M. The control group received oxytocin alone without any study drug. We recorded contractility parameters, and the primary outcome was the motility index (amplitude × frequency).

RESULTS: The motility index with each study drug decreased with increasing concentrations. The overall motility index (estimated mean difference [95% confidence interval]) with etomidate (-6% [-77 to -13]; n = 29; P = 0.007) and ketamine (-66% [-82 to -35]; n = 29; P < 0.001) was significantly lower than that of the oxytocin control group, while the difference between propofol and oxytocin was not statistically significant (-38% [-70 to 29]; n = 25; P = 0.47). The addition of oxytocin reversed contractility decreases induced by all anesthetic drugs, with no significant differences observed between the study drug + oxytocin and oxytocin control groups. Nevertheless, when compared with a study drug alone, the addition of oxytocin significantly increased the strength of contraction (area under the curve) of etomidate (207% [30 to 624]; n = 27; P = 0.002) and ketamine (234% [95 to 471]; n = 27; P < 0.001) but not of propofol.

CONCLUSIONS: All the studied intravenous anesthetic drugs produced a concentration-dependent decrease in uterine contractility; nevertheless, the addition of oxytocin reversed this effect and increased contractility. Coadministration with oxytocin of etomidate and ketamine, but not propofol, resulted in a significant increase in myometrial contractility.

PMID:42231013 | DOI:10.1007/s12630-026-03124-4

J Robot Surg. 2026 Jun 3;20(1):575. doi: 10.1007/s11701-026-03537-9.

ABSTRACT

Robotic-assisted hysterectomy is widely performed, yet device-related malfunctions and their impact on patient safety remain incompletely characterized. This study evaluates device-specific malfunctions and associated patient harm across Da Vinci system generations using the FDA MAUDE database. A retrospective descriptive analysis of adverse event reports submitted to the MAUDE database from system approval dates through March 19, 2026, was conducted. Reports involving robotic-assisted hysterectomy using Da Vinci Si, Xi, SP, and 5 systems were included. Device and patient problems were summarized using frequencies and percentages. Co-occurrence network analysis identified commonly associated device problems. A major limitation of the MAUDE database is the lack of data on the total number of surgeries. Each system, including Xi, SP, and Si, had different deployment periods and operational volumes. Direct comparisons of malfunction numbers and rates between systems lack statistical validity. Such comparisons should be avoided or, if possible, adjusted using the number of operational units and the time they have been on the market. Among 11,190 retrieved reports, 1,278 involved hysterectomy. After excluding 28 reports with “Insufficient Information,” 1,250 reports were analyzed. The Xi system (n = 370 device problems) most frequently reported “Visual Prompts will not Clear” (29.2%), with hemorrhage (20.5%) as the leading patient problem; no deaths were reported in the revised Xi dataset. The SP system (n = 12 device problems) most frequently reported “Visual Prompts will not Clear” (33.3%), with unspecified tissue injury (37.5%) as the leading patient problem. The Si system (n = 71 device problems) most frequently reported “Device Displays Incorrect Message” (32.4%), with strong co-occurrence between incorrect messaging and unexpected device behavior (weight = 11); bowel perforation and fistula each accounted for 16.7% of patient problems, and one death (8.3%) was documented. The Da Vinci 5 system (n = 2 reports) reported a pressure problem with no associated patient adverse events. Because the MAUDE database does not provide the total number of hysterectomies performed with each system, the number of active systems per year, or system-specific procedure volumes, raw malfunction frequencies cannot be used to compare failure rates across the Xi, SP, Si, or 5 platforms. Accordingly, the following results are presented as descriptive summaries only, without cross-system rate comparisons. Device malfunctions in robotic hysterectomy vary by Da Vinci model, predominantly involve software-interface issues such as persistent visual prompts and incorrect messaging, and are associated with serious patient harm including hemorrhage, bowel perforation, fistula, and death. The absence of mortality in the revised Xi dataset and the limited data from the Da Vinci 5 system highlight the need for continued postmarket surveillance. These findings underscore the importance of improved system design, standardized reporting, and enhanced adverse event documentation to better characterize device-related risks in robotic-assisted hysterectomy.

PMID:42231012 | DOI:10.1007/s11701-026-03537-9

Int J Obes (Lond). 2026 Jun 2. doi: 10.1038/s41366-026-02109-z. Online ahead of print.

ABSTRACT

BACKGROUND: Polybrominated diphenyl ethers (PBDEs) are persistent organic pollutants, with the primary exposure pathway for the general population being the consumption of contaminated food. Human exposure to PBDEs is suspected to increase the risk of obesity.

OBJECTIVES: This study aims to investigate the association between intake of PBDEs and the risk of obesity/overweight or weight gain in the French Etude Epidémiologique auprès des femmes de l’Education Nationale (E3N) cohort.

METHODS: This study included 66 467 women with a mean age of 52.47 years over a 20-years follow-up. Cox proportional hazard regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between PBDEs intake and risk of obesity, overweight and gain more than 10 kg.

RESULTS: Higher PBDEs intakes were related to increased risk of overweight (HR (1-SD increment) = 1.07 (1.05-1.09), HR (Q4 vs. Q1) = 1.13 (1.07-1.19), P-trend <0.001) and weight gain (HR (1-SD increment) = 1.12 (1.09-1.14), HR (Q4vsQ1) = 1.28 (1.21-1.37), P-trend <0.001). A non-linear association (P-non-linearity = 0.0014, P-overall <0.001) between the intake of PBDEs and obesity risk (HR (Q4 vs. Q1) = 1.25 (1.15-1.37), P-trend <0.001) was identified. The associations remained consistent when adjusting in addition separately for total fat, polyunsaturated fatty acids (PUFA), n-3 PUFA, the main food sources of PBDEs intake as well as when running stratified analyses based on the follow-up duration.

CONCLUSIONS: This study identified a positive association between intake of PBDEs and the risk of overweight, obesity and weight gain. Further efforts are needed to reduce PBDEs contamination in food and lower exposure levels in the general population.

PMID:42230986 | DOI:10.1038/s41366-026-02109-z

Sci Rep. 2026 Jun 2;16(1):16980. doi: 10.1038/s41598-026-56238-6.

NO ABSTRACT

PMID:42230952 | DOI:10.1038/s41598-026-56238-6

Sci Rep. 2026 Jun 2. doi: 10.1038/s41598-026-55998-5. Online ahead of print.

ABSTRACT

This study aimed to assess diagnostic values of kinetic parameters in ultrafast dynamic contrast magnetic resonance imaging. The diagnostic performance of ultrafast kinetic parameters (time to enhancement [TTE], maximum slope [MS], time to peak, peak enhancement [PE], and wash-in slope [WIS]), and their correlations with the immunohistopathological findings of breast cancer were evaluated for 101 histologically proven breast lesions. We found that the areas under the curves of five ultrafast kinetic parameters in masses (0.69-0.81) and for MS, PE, and WIS in non-mass enhancement (NME) (0.91-0.94) were comparable to those of Breast Imaging Reporting and Data System (BI-RADS) categorizations (mass: 0.85, NME: 0.83) without statistically significant differences. Values of ultrafast kinetic parameters differed significantly according to invasiveness (invasive vs. non-invasive: TTE, p = 0.029; MS, p = 0.040; PE, p = 0.032; and WIS, p = 0.009), immunohistopathological findings (high vs. low Ki-67: TTE, p = 0.020; MS, p = 0.004; PE, p = 0.003; and WIS, p < 0.001), hormone receptor (negative vs. positive: MS, p = 0.033; and WIS, p = 0.042), and triple-negative status (triple-negative vs. non-triple-negative: MS, p = 0.028; and WIS, p = 0.011) in breast cancer. In conclusion, ultrafast kinetic parameters demonstrate diagnostic performance comparable to that of BI-RADS categories for both mass and NME and may be associated with the immunohistopathological findings of breast cancer.

PMID:42230942 | DOI:10.1038/s41598-026-55998-5

Sci Rep. 2026 Jun 2. doi: 10.1038/s41598-026-55651-1. Online ahead of print.

ABSTRACT

Financial fraud detection requires screening massive transaction networks where evolving topologies, extreme label sparsity, and asymmetric misclassification costs make traditional classification paradigms ineffective. We propose ST-CGNN, a spatio-temporal contrastive graph neural network that frames operational screening as a multi-task learning problem in which a shared encoder is supervised by a contrastive regularizer and an evidential triage head. Concretely, ST-CGNN combines a continuous-time heterogeneous encoder with a hard-negative contrastive regularizer and an evidential output head, so that structural representations and uncertainty-aware prioritization are trained from a common backbone with summed losses rather than as a sequential, modular pipeline. Evaluated under strict chronological constraints on large-scale public and controlled benchmarks, ST-CGNN consistently outperforms state-of-the-art GNNs and post-hoc calibration methods. Specifically, on the DGraph-Fin benchmark, the proposed evidential triage score improves Precision@100 to 0.884 and achieves a calibrated ECE of 0.034. On Elliptic, the difference between ST-CGNN and the best competitor (MTP-GAT) lies within seed variance and is not statistically distinguishable; gains concentrate on benchmarks where heterogeneity and bursty timing dominate. Paired bootstrap tests and selective-prediction analysis confirm that this shared-encoder design significantly enhances the reliability of fixed-budget analyst reviews, providing a robust foundation for high-stakes risk management in dynamic transaction environments.

PMID:42230938 | DOI:10.1038/s41598-026-55651-1

Sci Rep. 2026 Jun 2. doi: 10.1038/s41598-026-55468-y. Online ahead of print.

ABSTRACT

During the last decades, the production of bioplastics has emerged as a promising alternative to mitigate the environmental impact generated by the accumulation of unmanaged plastic waste on natural ecosystems. Biodegradable bioplastics are expected to be less persistent than conventional oil-based polymers; however, the conditions under which biodegradation tests are conducted may lead to discrepancies between laboratory results and the real environmental conditions. For freshwater ecosystems, previous studies have highlighted important gaps, such as the variability caused by the inoculum. To assess if the use of commercial lyophilized bacteria as inoculum reduces the test variability, the biodegradation of three microplastics (MPs) with distinct polymer origins, poly-3-hydroxybutyrate-co-3-hydroxyvalerate (PHBV), polylactic acid (PLA), and polypropylene (PP), was studied in closed respirometers. Subsequently, following the reduction of the variability, the impact of the incubation temperature was evaluated at 10, 20 and 30 °C. Finally, the potential differences in the biodegradation process caused using different inocula were assessed with three different inoculum sources: the commercial freeze-dried bacteria, an activated sludge and digestate from biowaste. The results showed that freeze-dried bacteria could be used as an alternative inoculum to reduce inter-laboratory differences in the standardized test. Although no statistical differences were observed for PHB under identical incubation conditions with the freeze-dried inoculum, the results showed that the biodegradation of PHBV is highly influenced by temperature with higher values obtained at 35 °C than at 20 °C and 10 °C. Finally, the diversity and relative abundance of the inocula may significantly influence biodegradation outcomes, highlighting the inoculum source as a critical factor contributing to variability in this type of assay.

PMID:42230919 | DOI:10.1038/s41598-026-55468-y

Sci Rep. 2026 Jun 2. doi: 10.1038/s41598-026-54091-1. Online ahead of print.

ABSTRACT

This study compared the effectiveness of Automated Fiber Quantification (AFQ) and Tract-Based Spatial Statistics (TBSS) in detecting white matter (WM) changes in patients with moderate-to-severe obstructive sleep apnea (OSA), aiming to identify the more suitable method for investigating WM alterations of OSA patients. It also explored the potential neuropathological links between WM changes and anxiety/depression in OSA. Thirty-three untreated patients with moderate-severe OSA and 28 good sleepers without sleep disorders underwent 3.0T MRI scans. TBSS was used to construct WM skeletons and compare diffusion tensor imaging (DTI) metrics between groups. AFQ was then applied to extract 20 major fiber tracts from each subject, with each tract divided into 100 nodes to precisely localize affected areas. TBSS revealed no significant group differences after correction. In contrast, AFQ identified significant changes: decreased fractional anisotropy at nodes 77-78 of the forceps major (positively correlated with anxiety scores); increased mean diffusivity at nodes 23-24 of the right thalamic radiation; and increased axial diffusivity at nodes 54-57 of the right inferior fronto-occipital fasciculus (negatively correlated with anxiety and depression scores), and nodes 66-68 of the right superior longitudinal fasciculus. AFQ is more sensitive than TBSS in detecting focal WM changes in OSA, allowing precise localization of affected fiber nodes. These WM alterations, particularly in the corpus callosum and right inferior fronto-occipital fasciculus, are linked to anxiety and depression, offering insights into the neuropathological mechanisms of anxiety and depression in OSA.

PMID:42230913 | DOI:10.1038/s41598-026-54091-1

Sci Rep. 2026 Jun 1. doi: 10.1038/s41598-026-55442-8. Online ahead of print.

ABSTRACT

In this paper, a distributed event-based control architecture is proposed to improve the security and environmental performance of cyber-physical smart grids. The strategy concurrently responds to coordinated cyberattacks, such as false data injection (FDI) and denial-of-service (DoS), and incorporates carbon emission trading (CET) into the optimization of the energy dispatch. It constructs a novel event-based resilient consensus algorithm (ERCA), which incorporates attack detection and recovery schemes into a distributed decision-making framework. The algorithm employs a trust-node-based correction strategy and reliable acknowledgment signaling to maintain reliable state estimation and coordination under communication interruptions and data falsification. By incorporating carbon-pricing directly into the local cost functions, the framework enables generation units and responsive loads to achieve economically efficient and low-carbon operation without centralized supervision. Convergence of the proposed method is rigorously established under simultaneous FDI and DoS attacks. Simulation studies on an IEEE 41-bus system confirm that the framework maintains power balance, stabilizes electricity prices, ensures consistency in reported emissions, and reduces overall carbon output, even in the presence of stealthy and disruptive cyber intrusions.

PMID:42230878 | DOI:10.1038/s41598-026-55442-8

Sci Rep. 2026 Jun 2. doi: 10.1038/s41598-026-54798-1. Online ahead of print.

ABSTRACT

To date, little is known regarding the treatment effects of different timed-dosing antihypertensive medications among hypertensive patients with albuminuria. We aimed to investigate whether morning or evening dosing of antihypertensive medication differentially affects early changes in albuminuria.We conducted an open-label, single-center, assessor-masked, parallel-group, pilot randomized controlled trial among adult hypertensive patients with albuminuria (urinary albumin‒creatinine ratio [UACR] ≥ 30 mg/g) receiving at least one antihypertensive medication. The participants were assigned (1:1) to receive antihypertensive medications either in the morning (6:00-10:00 AM) or in the evening (6:00-10:00 PM), with a treatment follow-up at 3 months. The primary outcome was the change in the log UACR. The secondary outcomes were changes in blood pressure and kidney function. Post hoc outcomes included clinically meaningful control of outcomes.Among the 60 participants enrolled (mean age, 65.6 years; proportion of females, 51.7%; median UACR, 116.1 mg/g), 58 patients completed the trial. The absolute changes in log UACR over 3 months were – 0.21 (95% CI, -0.40 to -0.03; n = 31) for morning-dosing and – 0.22 (95% CI, -0.46 to 0.01; n = 27) for evening-dosing, with an adjusted difference of -0.01 (95% CI, -0.32 to 0.30; P = 0.955) between the groups. No statistically significant difference was observed for secondary and post hoc outcomes. No safety profile concerns were identified. Among hypertensive patients with albuminuria, chronotherapy, whether administered in the morning or evening, did not affect early treatment outcomes in terms of the UACR, blood pressure, or kidney function. Trial registration: Thai Clinical Trials Registry (TCTR); TCTR20240930002; Registration date: 30/09/2024; retrospectively registered.

PMID:42230872 | DOI:10.1038/s41598-026-54798-1