Category: Nevin Manimala

PeerJ. 2026 Apr 10;14:e21025. doi: 10.7717/peerj.21025. eCollection 2026.

ABSTRACT

BACKGROUND: High-Intensity Focused Ultrasound (HIFU) is an emerging non-invasive therapy for breast fibroadenoma. However, its efficacy across different breast glandular types, which may influence acoustic energy deposition, remains underexplored.

OBJECTIVE: This study sought to investigate the treatment efficacy of ultrasound (US)-guided HIFU for breast fibroadenoma with respect to different breast gland types.

METHODS: A retrospective analysis was conducted on 201 patients (314 lesions) with biopsy-confirmed breast fibroadenomas treated between January 2024 and November 2024. Patients were stratified into four groups based on the American College of Radiology (ACR) breast composition classification: fatty group (<25% glandular tissue), loose group (25-50%), mixed group (51-75%), and dense group (>75%). All patients underwent ultrasound-guided HIFU ablation using the JC-200 system (Chongqing Haifu Medical Technology Co., Ltd., China). The baseline characteristics of patients, lesion features of fibroadenomas, relevant parameters during HIFU treatment, follow-up duration, and tumor volume reduction rate (VRR) were recorded and comparatively analyzed. Statistical analyses included One-Way Analysis of Variance (ANOVA) with least significant difference (LSD)-t tests for pairwise comparisons.

RESULTS: The average surgical power in the loose group (142.8 ± 38.5 W) was significantly higher than that in the fatty group (128.7 ± 23.3 W), mixed group (128.8 ± 36.6 W), and dense group (121.4 ± 39.5 W), with statistically significant differences (P < 0.05). The post-HIFU treatment average VRRs for the fatty, loose, mixed, and dense groups were 72.9 ± 16%, 61.6 ± 24%, 55 ± 22%, and 49 ± 32%, respectively. LSD-t test analysis revealed statistically significant differences between pairwise comparisons, including fatty vs. loose, fatty vs. mixed, fatty vs. dense, and loose vs. dense groups (P < 0.05).

CONCLUSION: HIFU is a safe and effective treatment for fibroadenomas across different breast gland types. The significantly superior VRR in fatty-type breasts underscores the critical role of preoperative breast gland typing in predicting HIFU outcomes. These findings advocate for the integration of breast density assessment into clinical decision-making to optimize individualized HIFU treatment planning for benign breast tumors.

PMID:41983234 | PMC:PMC13075401 | DOI:10.7717/peerj.21025

PeerJ. 2026 Apr 10;14:e21091. doi: 10.7717/peerj.21091. eCollection 2026.

ABSTRACT

BACKGROUND: Unstable core training (UCT), widely used in various sports to enhance trunk muscle strength and sprint performance, results in significantly greater gains in both outcomes compared to traditional core training (TCT). The study aimed to examine the impact of UCT performed on unstable surfaces (Both Side Up (BOSU) balls, Swiss balls and Wobble boards) versus TCT performed on stable surfaces (floor and bench) on trunk muscle strength and sprint performance among flatwater sprint kayakers.

METHOD: A randomized controlled trial was conducted, recruiting 60 eligible kayakers aged 14-19 years from the Ganzhou training base, China. Participants were randomly assigned to the UTC group and the TCT group. Both groups completed an 8-week core training program consisting of 1-hour sessions, 3 times/week. The difference is that the core training exercises of the UTC group were performed on unstable surfaces, while the TCT group was performed on stable surfaces. Trunk stability strength was assessed using the abdomen, back, and side bridge tests, while trunk dynamic strength was measured using the 1-minute sit-up, 1-minute back extension, and 1-minute trunk rotation tests. Sprint performance was evaluated using the 200 m single flatwater sprint time test. Statistical analyses were conducted via Multivariate Analysis of Variance (MANOVA), with the significance level set at p < 0.05.

RESULTS: Both the UTC and TCT groups demonstrated significant improvements from pre- to post-intervention across all dependent variables. However, the analysis of between-group effects revealed statistically significant greater improvements in the UTC group compared with the TCT group at post-test. These differences included These differences included trunk stability strength in terms of abdomen (p < 0.001, η ² = 0.228), back (p < 0.001, η ² = 0.285), left side (p < 0.001, η ² = 0.280), and right side (p < 0.001, η ² = 0.291); trunk dynamic strength in terms of flexion (p < 0.001, η ² = 0.243), extension (p < 0.001, η ² = 0.212), left rotation (p < 0.001, η ² = 0.182), and right rotation (p < 0.001, η ² = 0.303); as well as sprint performance in terms of 200m single flatwater sprint time (p < 0.001, η ² = 0.739).

CONCLUSION: The findings suggest that UTC may lead to greater improvements in trunk muscle strength and sprint performance compared with TCT over an 8-week intervention among young male Chinese kayakers. However, given methodological limitations (field-based strength tests and manual timing), results should be interpreted cautiously and require confirmation with more precise measurement methods in future research.

PMID:41983232 | PMC:PMC13075397 | DOI:10.7717/peerj.21091

Health Psychol Behav Med. 2026 Apr 10;14(1):2656029. doi: 10.1080/21642850.2026.2656029. eCollection 2026.

ABSTRACT

BACKGROUND: Healthcare students face intense emotional and academic stress, leading to anxiety and poor mental health. Body-Mind Axial Awareness (BMAA)-a movement-based, body-centered practice-integrates bodily awareness and interoceptive attention to promote mind-body regulation and mental health.

METHODS: A pretest-posttest controlled design was used with 38 students in the BMAA group and 27 in the control group. Group differences arising from non-random enrollment were statistically adjusted using analysis of covariance (ANCOVA), and within-group changes were examined using paired t-tests and repeated-measures multivariate analysis of variance (MANOVA). Participants completed eight weeks of BMAA training involving weekly two-hour sessions and daily home practice. Assessments before and after intervention included four domains of psychological functioning, measured using validated instruments: body awareness (Body Awareness Ability Inventory; Multidimensional Assessment of Interoceptive Awareness), mindfulness (Mindful Attention Awareness Scale), positive embodiment (Experience of Embodiment Scale), and mental health (Adult Mental Health Scale; Toronto Alexithymia Scale-20; State-Trait Anxiety Inventory-Trait; Satisfaction with Life Scale).

RESULTS: After controlling for baseline differences, the BMAA group showed greater gains than the control group in body awareness, mindfulness, positive embodiment, and mental health. Within-group analyses further indicated that BMAA participants demonstrated significant pre-post improvements across most body awareness and mindfulness subscales (except Not-Distracting and Not-Worrying), as well as across embodiment dimensions (except Resisting Objectification), along with enhanced emotional awareness and expression, reduced anxiety, and higher life satisfaction (p < .05 for relevant comparisons). Despite the absence of random assignment and modest group-size imbalance, ANCOVA and within-group findings demonstrated consistent effects.

CONCLUSION: The findings demonstrate that BMAA training enhances multiple facets of body-mind functioning, including bodily awareness, mindfulness, positive embodiment, and mental health. As healthcare students encounter cognitive and emotional demands, BMAA may offer a feasible embodied approach for strengthening psychological resilience and adaptive stress management during professional training.

PMID:41983227 | PMC:PMC13072697 | DOI:10.1080/21642850.2026.2656029

Hepatobiliary Surg Nutr. 2026 Apr 1;15(2):36. doi: 10.21037/hbsn-24-433. Epub 2025 Jan 3.

ABSTRACT

BACKGROUND: Gallbladder cancer (GBC) is the most common malignancy of the biliary tract and ranks as the fifth most prevalent cancer of the digestive system. Despite surgical resection, the prognosis for GBC remains dismal, marked by high recurrence rates and poor overall survival (OS). This meta-analysis investigates the impact of adjuvant therapies-including chemotherapy (CT), radiotherapy (RT), and chemoradiotherapy (CRT)-on the prognosis of resectable GBC, aiming to elucidate their clinical benefits.

METHODS: A thorough search of PubMed, Embase, and Web of Science databases was conducted up to April 2024. Studies assessing the effects of adjuvant therapies on OS and disease-free survival (DFS) in patients with resectable GBC were included. Statistical analyses were performed using STATA 17.0 software, with random-effect models employed to address heterogeneity.

RESULTS: The meta-analysis included 23 studies encompassing 36,214 patients. Adjuvant therapy was significantly associated with improved OS [hazard ratio (HR), 0.72; 95% confidence interval (CI): 0.66-0.78]. Specific types of adjuvant therapy showed distinct benefits: CT (HR, 0.80; 95% CI: 0.72-0.88), RT (HR, 0.76; 95% CI: 0.65-0.88), and CRT (HR, 0.56; 95% CI: 0.47-0.67). Subgroup analysis revealed a greater benefit in high-risk patients, including those with more severe tumor-node-metastasis (TNM) staging, R1 resection, and older age (HR, 0.62; 95% CI: 0.50-0.76).

CONCLUSIONS: Adjuvant therapy significantly improves OS in patients with resectable GBC, with CRT offering the most substantial benefit. These results advocate for the inclusion of adjuvant therapy in treatment regimens, particularly for high-risk patients, and underscore the necessity for ongoing research to refine therapeutic approaches.

PMID:41983195 | PMC:PMC13071675 | DOI:10.21037/hbsn-24-433

Braz J Vet Med. 2026 Apr 13;48:e001826. doi: 10.29374/2527-2179.bjvm001826. eCollection 2026.

ABSTRACT

Stomoxys calcitrans is a hematophagous dipteran known as a “stable fly”, capable of parasitizing several animal species. The use of biological agents is an alternative for controlling S. calcitrans, with entomopathogenic nematodes (EPNs) being both resistant and virulent. The present study aimed to evaluate the effect of infection by EPNs subjected to spraying pressure on S. calcitrans larvae in sugarcane straw and vinasse under environmental conditions. Groups of 20 larvae of the stable fly were placed in plastic containers containing one kilogram of autoclaved soil and 200 g of sugarcane straw each. Subsequently, 200 JIs/larvae were sprayed onto the trays with larvae, and emergence traps were placed on the containers. In the control group, there were no EPNs; only vinasse was used. The experiment had three replicates and was monitored daily for 15 days. It was observed that the EPN Heterorhabditis bacteriophora HP88 showed a mortality rate of 33.3%, which was not statistically different from that of the control group (38.3%). The EPNs H. indica LPP30 and H. baujardi LPP7 caused mortality rates of 81.7% and 73.3%, respectively; both being higher than H. bacteriophora HP88 and the control group, but equal to each other under these conditions. It is concluded that H. indica LPP30 and H. baujardi LPP7 were effective against stable fly larvae under environmental conditions, whereas H. bacteriophora HP88 does not demonstrate similar efficacy.

PMID:41983164 | PMC:PMC13075582 | DOI:10.29374/2527-2179.bjvm001826

Oral Dis. 2026 Apr 14. doi: 10.1111/odi.70315. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the effectiveness of a formulated 5% thyme mouthwash with 0.2% aqueous chlorhexidine solution for improving oral health in ventilator-dependent intensive care unit (ICU) patients.

METHODS: This prospective, triple-blinded, randomized controlled trial (RCT) allocated 46 mechanically ventilated patients to the thyme (n = 23) or 0.2% aqueous chlorhexidine solution (n = 23) groups. Oral health indices, including the Oral Health Assessment Tool (OHAT), were evaluated at baseline and re-evaluated 5 days (Day 5) after the intervention commenced.

RESULTS: Baseline characteristics were comparable. Both mouthwashes significantly improved oral health indicators from baseline (p < 0.001). However, on Day 5, the thyme group showed a statistically greater improvement in key OHAT components compared to the 0.2% aqueous chlorhexidine solution group (e.g., Oral Hygiene score, p = 0.004). Importantly, no adverse reactions or tolerability issues were reported in either group.

CONCLUSION: The 5% thyme mouthwash demonstrated comparable effectiveness to the 0.2% aqueous chlorhexidine solution by Day 5. This positions the thyme-based mouthwash as a viable, well-tolerated alternative to conventional 0.2% aqueous chlorhexidine solution for oral care in invasively ventilated ICU patients.

PMID:41981720 | DOI:10.1111/odi.70315

J Magn Reson Imaging. 2026 Apr 14. doi: 10.1002/jmri.70338. Online ahead of print.

ABSTRACT

BACKGROUND: Slab-selective radiofrequency (RF) pulses are commonly required in three-dimensional (3D) turbo spin echo (TSE) in brachial plexus magnetic resonance neurography (MRN). However, their long selective RF pulses lead to violation of Carr-Purcell-Meiboom-Gill conditions, which might increase imaging artifacts.

HYPOTHESIS: That VERSE STIR-TSE would yield comparable motion artifact to conventional STIR-TSE with superior nerve conspicuity and greater subjective appeal.

STUDY TYPE: Prospective, cross-sectional study.

POPULATION: Twenty-four subjects (16 females; mean age: 43.7 years; range: 19-76 years) evaluated for clinical suspicion of brachial plexopathy, undergoing brachial plexus MRI (10 left, 9 right, 5 bilateral, 29 total scans analyzed). Agar phantoms mimicking nerve and muscle were also evaluated.

FIELD STRENGTH/SEQUENCE: 3-Tesla, 3D STIR-TSE with and without VERSE.

ASSESSMENT: Three radiologists, blinded to the sequence type and clinical data, qualitatively evaluated nerve conspicuity, motion, and preferred sequence on a 5-point scale.

STATISTICAL TESTS: Wilcoxon signed-rank tests compared nerve conspicuity (0-4 scale), motion artifact (0-4 scale), and preferred series between the non-VERSE and VERSE pulse sequences. Gwet’s AC2 assessed inter-rater agreement. A p-value < 0.05 was considered statistically significant.

RESULTS: The VERSE STIR-TSE sequence was significantly preferred by all raters. Motion artifact was not significantly different between the sequences (p = 0.11). Conspicuity of the suprascapular nerve was significantly greater with VERSE for both its proximal segments (median: 3, interquartile range: (2, 4), vs. 3 (1, 4)) and distal segments (4 (2, 4) vs. 3 (2, 4)), but conspicuity of the axillary nerve was not significantly different between the sequences (p = 0.27-0.61). Phantom scans confirmed a 74% and 49% increase in signal with VERSE in the muscle and nerve-mimicking phantoms, respectively.

DATA CONCLUSION: STIR-TSE with VERSE provided overall superior image quality for brachial plexus MRN as compared to conventional STIR-TSE.

EVIDENCE LEVEL: 2.

TECHNICAL LEVEL: 1.

PMID:41981719 | DOI:10.1002/jmri.70338

Alzheimers Dement. 2026 Apr;22(4):e71387. doi: 10.1002/alz.71387.

ABSTRACT

INTRODUCTION: We investigated the association between traumatic brain injury (TBI) and incidence of early-onset dementia (EOD) versus late-onset dementia (LOD).

METHODS: We included 501,710 UK Biobank participants (average age 56.5). Over a median 13.6 years of follow-up, 836 developed EOD (before 65) and 8947 developed LOD (after 65). We estimated hazard ratios (HRs) for TBI’s association with EOD and LOD using Cox proportional hazard models with TBI as a time-varying exposure and coefficient.

RESULTS: TBI was associated with higher risk of both EOD (HR: 4.06 [95% confidence interval: 3.13, 5.26]) and LOD (HR: 2.51 [2.31, 2.72]. Among participants included in both EOD and LOD analyses, the effect estimate was higher for EOD (3.41 vs. 2.80), but the difference was not statistically significant. The association of TBI with EOD was stronger in those with more severe TBIs.

DISCUSSION: TBI is associated with an increased risk of EOD, with a higher risk observed in more severe injuries.

HIGHLIGHTS: Traumatic brain injury (TBI) is a significant risk factor for early-onset dementia (EOD). TBI was analyzed as a time-varying exposure and time-varying coefficient. Moderate/severe/penetrating TBIs have a heightened risk of developing EOD. TBI is more strongly associated with an earlier age cut-off for dementia.

PMID:41981712 | DOI:10.1002/alz.71387

Inj Epidemiol. 2026 Apr 14. doi: 10.1186/s40621-026-00673-6. Online ahead of print.

ABSTRACT

BACKGROUND: Pickleball has grown rapidly in popularity in recent years, accompanied by an increasing number of reported injuries among players. Our aim is to determine the epidemiology of pickleball-related injuries at a single academic center and evaluate patient-specific factors such as incidence and type of injury, mechanisms of injury, and treatment outcomes.

METHODS: This is a cross-sectional study at a tertiary academic outpatient orthopedic and physical medicine and rehabilitation clinic. We reviewed 164 cases of patients presenting with pickleball-related injuries from 2019 to 2023 involving the shoulder (n = 23), elbow (n = 8), wrist/hand (n = 30), hip/thigh (n = 9), knee (n = 52), foot/ankle (n = 32), and spine (n = 10). Independent variables included age, gender, and hand dominance. Outcome measures included injury type, laterality, treatment modality, and follow-up duration. Demographic and epidemiologic data were analyzed, and comparisons between injury characteristics were performed using appropriate statistical tests (Fisher’s exact tests and Kruskal-Wallis tests).

RESULTS: The most common pickleball-related injuries included lateral epicondylitis at the elbow (75%), rotator cuff tears at the shoulder (70%), distal radius fractures after a fall at the hand/wrist (60%), Achilles tendon tears at the foot/ankle (50%), radicular pain and spinal stenosis at the spine (50% each), medial meniscus tears at the knee (48%), and hamstring strain or rupture and iliopsoas tendinitis at the hip/thigh (33% each).Rates of injury were similar between male and female players except in the hand/wrist, which was higher among female players (77%). Non-paddle side injuries in the upper extremity occur disproportionally higher in the hand/wrist (52%) when compared to the shoulder (7%) or elbow (17%) (p < 0.01). There was no significant difference in laterality for lower extremity and spine injuries.

CONCLUSIONS: As pickleball has become the fastest growing sport in America, the incidence of pickleball-related injuries has risen dramatically. Characterizing the wide spectrum of musculoskeletal injuries unique to pickleball may inform athletes on injury prevention considerations and allows for targeting modifiable risk factors.

PMID:41981700 | DOI:10.1186/s40621-026-00673-6

Clin Transl Sci. 2026 Apr;19(4):e70541. doi: 10.1111/cts.70541.

ABSTRACT

Fluoroquinolones (FQs) are among the most frequently prescribed antibiotic classes worldwide. Despite their therapeutic versatility in treating bacterial infections, regulatory authorities recognized risks of persistent and potentially irreversible adverse effects, particularly peripheral neuropathy (PN). However, a comprehensive pharmacovigilance assessment of PN-related adverse events (AEs) across all six FDA-approved FQs remains limited. We therefore analyzed adverse event reports (AERs) associated with these six agents from the FDA Adverse Event Reporting System (FAERS) Public Dashboard spanning 2007-2024 Q3, following READUS-PV guidelines. Disproportionality analysis was conducted to identify potential safety signals for PN-related AEs reported with FQ use following deduplication and exclusion of cases involving non-FQ concomitant medications. Positive disproportionality signals were observed for the commonly prescribed FQs (ciprofloxacin, levofloxacin, moxifloxacin, and ofloxacin), with seven distinct PN manifestations generating signals. Notably, we detected PN-related signals for gemifloxacin, a relatively new FQ with limited prior evaluation of neurotoxicity. Univariate logistic regression revealed that women and adults aged 18-64 years were more frequently represented in FQ-associated PN-related AERs, whereas men and patients aged ≥ 65 years were disproportionately represented among cases with fatal outcomes. Combination therapy with multiple FQs generated disproportionality signals exceeding those with FQ monotherapy. These findings underscore the need for increased vigilance when prescribing FQs, particularly for mild infections where risks may outweigh benefits. Strengthened clinical monitoring for early signs of PN is advisable when FQ treatment becomes unavoidable. Further controlled epidemiological studies are needed to validate these signals and define at-risk groups, alongside mechanistic research aimed at supporting the development of neuroprotective strategies.

PMID:41981685 | DOI:10.1111/cts.70541