Category: Nevin Manimala

Gen Thorac Cardiovasc Surg. 2026 May 18. doi: 10.1007/s11748-026-02312-9. Online ahead of print.

ABSTRACT

OBJECTIVE: Gastrointestinal complications and acute pancreatitis after cardiac surgery are relatively rare; however, they may sometimes progress to serious conditions and can be challenging to manage. We aimed to investigate the association between lower-body circulatory arrest (LCA) time under mild-to-moderate hypothermia with antegrade selective cerebral perfusion (ASCP) and postoperative visceral complications in patients undergoing thoracic aortic surgery.

METHODS: We retrospectively analyzed 221 patients who underwent thoracic aortic surgery for degenerative aneurysms involving the ascending aorta and aortic arch with LCA under mild-to-moderate hypothermia between 2015 and 2025. The associations between LCA time and postoperative complications, including gastrointestinal complications and pancreatitis, were evaluated using logistic regression analyses.

RESULTS: Prolonged LCA time was significantly associated with an increased incidence of postoperative gastrointestinal (P = 0.006) and lung complications (P = 0.02) in logistic regression models adjusted for minimal temperature. A similar trend was observed for AKI without statistical significance (P = 0.08). In contrast, acute pancreatitis was not associated with LCA time. Within the studied temperature range, minimal temperature was not significantly associated with visceral complications.

CONCLUSIONS: Prolonged LCA time under mild-to-moderate hypothermia using ASCP was significantly associated with increased postoperative gastrointestinal and lung complications, whereas pancreatitis was not associated. The duration of lower-body ischemia may be an important determinant of visceral organ injury within the studied temperature range.

PMID:42151699 | DOI:10.1007/s11748-026-02312-9

Methods Mol Biol. 2026;3000:47-60. doi: 10.1007/978-1-0716-5174-2_3.

ABSTRACT

This chapter has the aim to propose a theoretical framework for describing the qualitative changes in the deformation behavior of isolated human breast cancer cells under varying gravitational conditions. We describe interdisciplinary principles of statistical thermodynamics and nonlinear dynamics of eukaryotic cells. The framework aims to capture how microgravity-induced alterations in cytoskeletal organization lead to distinct mechanobiological phenotypes.

PMID:42151673 | DOI:10.1007/978-1-0716-5174-2_3

Discov Oncol. 2026 May 18. doi: 10.1007/s12672-026-05150-6. Online ahead of print.

ABSTRACT

BACKGROUND: The non-invasive detection of cancer via exhaled breath condensate (EBC) represents a promising frontier in oncology. This study explores the metabolic profiles of EBC to identify biomarkers for the early detection of thyroid cancer (TC) and breast cancer (BC), and to investigate potential metabolic interrelationships between them.

METHODS: We conducted gas chromatography-mass spectrometry (GC-MS) analysis of EBC samples from 74 individuals, including 65 cancer patients (TC and BC) and 9 non-cancer controls. Comparative statistical analyses and machine learning were employed to identify discriminant metabolites.

RESULTS: 305 metabolites were identified in total. Comparative analysis revealed 16 differential metabolites in cancer patients versus controls, with 14 specific to TC and 7 to BC. Notably, five metabolites were common to both cancers: 1,2-Bis(trimethylsilyl)benzene, 1,4-Phthalazinedione,2,3-dihydro-6-nitro-, Eicosane, Methyltris (trimethylsiloxy) silane, and Octadecane, highlighting metabolites that were commonly altered in both cancer types. ROC analysis demonstrated strong diagnostic potential: 1,2-Bis(trimethylsilyl)benzene effectively discriminated cancer from controls (AUC = 0.822) and identified TC (AUC = 0.866), while 1,4-Phthalazinedione,2,3-dihydro-6-nitro- detected BC (AUC = 0.783). Combinations of metabolites yielded AUCs > 0.7 for both cancers. However, limited discriminatory power was observed between TC and BC (maximum AUC = 0.663), indicating significant metabolic similarity. Furthermore, specific metabolite abundances correlated with conventional serum biomarkers, thyroid hormone levels, and lymphatic metastasis.

CONCLUSION: Our findings establish EBC metabolomics as a powerful, non-invasive tool for early cancer detection and monitoring. The identification of shared metabolic alterations between TC and BC suggests common metabolic features that warrant further investigation and paves the way for developing breath-based diagnostic assays.

PMID:42151663 | DOI:10.1007/s12672-026-05150-6

Environ Monit Assess. 2026 May 19;198(6):607. doi: 10.1007/s10661-026-15457-0.

ABSTRACT

The COVID-19 pandemic provided a unique opportunity to evaluate the impact of reduced anthropogenic activities on air quality. This study assesses variations in atmospheric concentrations of carbon monoxide (CO), nitrogen dioxide (NO₂), and sulphur dioxide (SO₂) across selected regions of South India during three phases: pre-COVID (2019), during lockdown (2020), and post-COVID (2021). Satellite observations from Sentinel-5P and NASA Giovanni datasets were used to analyse spatial and temporal trends. The results indicate a clear reduction in pollutant concentrations during the lockdown period, particularly for NO₂, followed by a noticeable rebound as restrictions were relaxed. These trends highlight the strong influence of transportation, industrial activity, and energy consumption on regional air quality. Although variations exist between datasets due to differences in retrieval approaches and resolution, the overall patterns consistently demonstrate improved air quality during reduced human activity. The findings emphasise the potential for achieving significant air quality improvements through effective emission control strategies. This study provides insights for sustainable urban planning and air pollution management, underscoring the need for long-term policies that balance economic development with environmental protection.

PMID:42151662 | DOI:10.1007/s10661-026-15457-0

Behav Res Methods. 2026 May 18;58(6):168. doi: 10.3758/s13428-026-03029-6.

ABSTRACT

With the advent of wearable recorders, scientists are increasingly turning to automated methods of analysis of audio and video data in order to measure children’s experience, behavior, and outcomes, with a sizable literature employing long-form audio-recordings to study language acquisition. While numerous articles report on the accuracy and reliability of the most popular automated classifiers, less has been written on the downstream effects of classification errors on measurements and statistical inferences (e.g., the estimate of correlations and effect sizes in regressions). This paper’s main contributions are drawing attention to downstream effects of confusion errors, and providing an approach to measure and potentially recover from these errors. Specifically, we use a Bayesian approach to study the effects of algorithmic errors on key scientific questions, including the effect of siblings on children’s language experience and the association between children’s production and their input. By fitting a joint model of speech behavior and algorithm behavior on real and simulated data, we show that classification errors can significantly distort estimates for both the most commonly used Language ENvironment Analysis (LENA™), and a slightly more accurate open-source alternative (the Voice Type Classifier from the ACLEW system). We further show that a Bayesian calibration approach for recovering unbiased estimates of effect sizes can be effective and insightful, but does not provide a foolproof solution.

PMID:42151656 | DOI:10.3758/s13428-026-03029-6

Spine Deform. 2026 May 18. doi: 10.1007/s43390-026-01414-x. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study is to examine the factors that contribute to the occurrence of hidden blood loss (HBL) in individuals with ankylosing spondylitis (AS) who undergo posterior correction surgery.

METHODS: From October 2019 to September 2023, 186 patients with AS who were scheduled to have a posterior orthopedic correction surgery were included in our study. The patient’s demographics, bone mineral density (BMD), operative time, hospital stay, intraoperative blood loss, blood transfusion volume, type of corrective osteotomies, the number of pedicle screws and fusion segments, drainage volume, correction angle of kyphosis and laboratory examinations, including preoperative hematocrit (HCT) and platelets (PLT_pre), and preoperative fibrinogen (Fib_pre), were collected retrospectively. The total blood loss (TBL) and HBL were calculated using the Gross equation. The statistical analysis was conducted utilizing SPSS 22.0. Pearson or Spearman correlation analyses were utilized to assess the potential risk factors associated with HBL. To identify the factors that affect HBL, multiple linear regression was utilized.

RESULTS: We reviewed 186 consecutive patients in our study. Potential risk factors of HBL included BMI (P = 0.050), BMD (P = 0.013), operative time (P = 0.002), the number of fusion segments (P = 0.001), the number of pedicle screws (P = 0.033), type of osteotomy (P < 0.001), correction angle (P = 0.005), and PLT_pre (P = 0.079). Multiple linear regression analysis showed that BMD (P = 0.032), type of osteotomy (P = 0.019), and PLT_pre (P = 0.034) were identified as risk factors for HBL.

CONCLUSION: HBL constitutes a significant proportion of perioperative blood loss in individuals with AS who received posterior correction surgery. BMD, type of osteotomy, and PLT_pre are the most important risk factors which determine HBL. Therefore, surgeons should take into account these factors when considering surgical strategies for AS patients.

LEVEL OF EVIDENCE: Level III.

PMID:42151655 | DOI:10.1007/s43390-026-01414-x

J Robot Surg. 2026 May 19;20(1):511. doi: 10.1007/s11701-026-03479-2.

ABSTRACT

Robotic low anterior resection (R-LAR) has been proposed to overcome technical limitations of laparoscopy in rectal surgery. However, previous meta-analyses have evaluated mixed-age populations, and no meta-analysis has specifically investigated younger patients (aged < 65 years) undergoing low anterior resection. This study aimed to compare operative, short-term postoperative, and oncological outcomes between robotic and laparoscopic low anterior resection in this cohort. A systematic review and meta-analysis were conducted according to PRISMA 2020 and the Cochrane Handbook, with prospective registration in Prospero. PubMed, Scopus, and the Cochrane Library were searched up to January 2026. Comparative studies evaluating R-LAR versus L-LAR in younger rectal cancer cohorts, defined as studies with mean patient age ≤ 65 years, were included. Random-effects models were used to calculate pooled mean differences (MD), odds ratios (OR), and hazard ratios (HR) with 95% confidence intervals (CI). Risk of bias was assessed using ROBINS-I and RoB2, and certainty of evidence using GRADE. A total of 16 studies were included. Compared with laparoscopy, R-LAR was associated with longer operative duration (MD 24.59 min, 95% CI 3.85-45.33, p = 0.02, I² = 96%), lower conversion to open surgery (OR 0.38, 95% CI 0.27-0.53, p < 0.0001, I² = 38%), lower overall complications (OR 0.84, 95% CI 0.73-0.97, p = 0.02, I² = 0%), lower 30-day mortality (OR 0.59, 95% CI 0.45-0.77, p = 0.006, I² = 0%), lower 30-day reoperation (OR 0.77, 95% CI 0.61-0.98, p = 0.04, I² = 0%), higher complete TME rates (OR 3.30, 95% CI 2.14-5.10, p = 0.003, I² = 0%) and shorter hospital stay (MD -0.82, 95% CI -1.50 to -0.13, p = 0.02, I²=97%). Estimated blood loss (p = 0.05) and major complications (p = 0.05) were borderline significant in favor of R-LAR. Anastomotic leakage (p = 0.17), postoperative ileus (p = 0.49), time to first flatus (p = 0.12), time to diet initiation (p = 0.10), CRM positivity (p = 0.56), lymph node yield (p = 0.09), local recurrence (p = 0.67), loop ileostomy (p = 0.56), disease-free survival (p = 0.53), and overall survival (p = 0.73) were comparable. The certainty of evidence ranged from very low to moderate. Functional outcomes were insufficient for pooling. Robotic low anterior resection in younger rectal cancer cohorts may improve several perioperative and technical outcomes without compromising oncological adequacy. Further high-quality studies are required to confirm these findings.

PMID:42151640 | DOI:10.1007/s11701-026-03479-2

J Neurooncol. 2026 May 19;178(1):6. doi: 10.1007/s11060-026-05632-1.

ABSTRACT

BACKGROUND: Despite multimodal therapy, glioblastomas invariably recur. In focal recurrent glioblastoma IDH-wildtype (rGBM), local therapy options include laser interstitial thermal therapy (LITT) and stereotactic radiosurgery (SRS), but their relative utilities are unknown. The goal of this study is to compare the efficacy of these two treatment modalities in a homogeneous rGBM population.

METHODS: We conducted a retrospective study of patients undergoing surgical procedures for rGBM between 2010 and 2025. All patients underwent either LITT or SRS at first recurrence. Survival outcomes were assessed with univariable log-rank tests and multivariate Cox regression models. A propensity-score matching (PSM) was performed to address confounders.

RESULTS: 57 patients were identified; of these, 10 underwent LITT, and 47 underwent SRS. There was no difference in post-recurrence survival (PRS) between groups (11.5 months vs. 13.4 months, p = 0.824). There were no surgical complications in the LITT cohort. In the SRS cohort, there were two symptomatic radiation necrosis cases (0% vs. 4.3%, p = 1.000). Contrast-enhancing tumor volume at recurrence was larger in the LITT cohort (8.49 cm³ vs. 1.91 cm³, p = 0.007). To address this difference, we performed a PSM of two cohorts with 7 patients each. This PSM analysis also revealed no significant difference in survival outcomes.

CONCLUSION: Within the limitations of a relatively small sample size, no statistically significant differences in outcomes were observed between LITT and SRS for the treatment of small, focal rGBM. Both modalities remain viable salvage options for small focal rGBM. Larger, multi-institutional studies are warranted.

PMID:42151639 | DOI:10.1007/s11060-026-05632-1

Int J Legal Med. 2026 May 19. doi: 10.1007/s00414-026-03831-z. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: A Likelihood ratio (LR) is a numerical measure of evidential value. Our objective was to use LRs to express the patient-specific evidential values of medical findings that best differentiate abusive versus non-abusive head trauma (AHT). We hypothesized that the evidential values of patients’ AHT-related medical findings would be highly variable.

METHODS: We analyzed existing, uniform, prospective, de-identified data regarding 973 acutely head-injured children < 3 years hospitalized for intensive care across 18 sites between 2011 and 2021; applied two different proxies for AHT and non-AHT ground truth; trained and validated statistical models that differentiate AHT versus non-AHT; and analyzed patient-specific LRs in a log₁₀ (LLR) format that facilitated assessment of evidential values (where LLR values > 0 and < 0 supported hypotheses of AHT and non-AHT, respectively).

RESULTS: The two best performing statistical models revealed evidential (LLR) values for patient-specific, AHT-related medical findings that varied from modest (-1 to + 1) to relatively large (-2.5 to -1 and + 1 to + 3.5), and values that were misleading (AHT patients with LLR values indicative of non-AHT, and vice versa). A few non-AHT patients presented with misleading evidence that was moderately strong, with LLRs approaching + 3.

CONCLUSIONS: Reasonable medical certainty of AHT and non-AHT can be enhanced or limited by the highly variable evidential values of patients’ most discriminating medical findings. Physicians can use available LRs to inform their AHT-related diagnostic reasoning, opinions, and testimony.

PMID:42151630 | DOI:10.1007/s00414-026-03831-z

Aesthetic Plast Surg. 2026 May 18. doi: 10.1007/s00266-026-05871-7. Online ahead of print.

ABSTRACT

BACKGROUND: Atrophic acne scarring presents a significant therapeutic challenge with a profound psychosocial impact, and conventional treatments often yield suboptimal results. Autologous biologics, specifically stromal vascular fraction (SVF) and platelet-rich plasma (PRP), have emerged as promising regenerative strategies to address this issue.

METHODS: This single-center, pilot, randomized, assessor-blinded controlled trial included 60 patients with severe atrophic acne scars. Patients were randomized into four groups: subcision plus SVF (Group 1), subcision plus combined SVF and PRP (Group 2), subcision plus PRP (Group 3), and subcision alone (Group 4, control). Primary endpoints included clinical improvement documented by digital imaging and changes in qualitative grading scales from baseline to 12 months post-procedure. Additionally, flow cytometry was performed to evaluate the cellular composition and mesenchymal stem cell (MSC) marker expression of the SVF preparations.

RESULTS: Group 2 (subcision + SVF + PRP) demonstrated superior clinical efficacy, with 53.3% of patients achieving “Grade 3” (marked) physician satisfaction compared to 0% in the control group (p ≤ 0.001). This group also showed significantly greater improvement in scar size and color (p ≤ 0.001). Mechanistically, flow cytometry confirmed that Group 2 contained significantly higher expression of mesenchymal stem cell markers (CD73+ and CD105+) compared to the SVF alone (p ≤ 0.001). While patient-reported FACE-Q scores consistently favored Group 2, differences in specific QoL sub-domains did not reach statistical significance (p > 0.05), likely due to the pilot sample size.

CONCLUSION: The combination of SVF and PRP, when used as an adjuvant to subcision, represents a promising regenerative strategy for atrophic acne scars, achieving clinical results superior to monotherapies or subcision alone. This enhanced therapeutic effect appears attributable to the enrichment of the mesenchymal stem cell population within the “biostimulated” SVF.

LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:42151612 | DOI:10.1007/s00266-026-05871-7