Nevin Manimala

Eur Radiol. 2026 Jun 11. doi: 10.1007/s00330-026-12629-x. Online ahead of print.

ABSTRACT

OBJECTIVES: To establish evidence-based consensus statements on imaging of scaphoid fractures.

MATERIALS AND METHODS: Nineteen hand surgeons formulated a preliminary list of eleven questions on imaging of scaphoid fractures. Based on this preliminary list, radiologists crafted statements considering literature and their clinical experience, then refined them through an iterative Delphi process to revise the questions and statements. A maximum of three Delphi rounds was scheduled until group consensus was achieved for an individual statement, whichever arose first. Twenty-eight radiologists drafted the statements and acted as Delphi panellists. Panellists rated their level of agreement with each statement on an 11-point numeric rating scale, the score ‘0’ indicated complete disagreement and the score ’10’ indicated complete agreement, respectively. Group consensus was specified as a score of ‘8’ or higher for ≥ 23/28 panellists.

RESULTS: Eight of eleven questions and statements achieved group consensus in the first Delphi round. The remaining three questions and statements achieved group consensus in the second Delphi round, indicating more controversial topics. It was agreed that radiographs are the initial imaging technique of choice for suspected scaphoid fractures. MRI or CT are advocated for suspected radiographically occult scaphoid fractures. CT is the method of choice for assessment of osseous consolidation. Contrast-enhanced MRI is the preferred imaging modality for assessing vascularisation of scaphoid nonunion. CT is the most valuable technique in the postoperative evaluation of scaphoid fractures.

CONCLUSION: Delphi-based consensus statements suggest imaging pathways to diagnose scaphoid fractures, assess osseous fracture consolidation and evaluate pre- and postoperative fractures.

KEY POINTS: Question How can an international and interdisciplinary team of hand surgeons and musculoskeletal radiologists develop practical consensus statements on imaging of scaphoid fractures? Findings All eleven statements achieved group consensus among experts using the Delphi technique for consensus-building. Imaging pathways were suggested to diagnose and assess scaphoid fractures. Clinical relevance statement International, interdisciplinary and evidence-based consensus statements on imaging of scaphoid fractures were achieved using the Delphi technique. The focus of the statements was to diagnose scaphoid fractures, assess osseous fracture consolidation and evaluate pre- and postoperative fractures.

PMID:42277387 | DOI:10.1007/s00330-026-12629-x

Atten Percept Psychophys. 2026 Jun 11;88(5):147. doi: 10.3758/s13414-026-03293-w.

ABSTRACT

We investigated the impact of flanker size and horizontal flanker eccentricity in the reading version of the flankers task. Critical targets and the corresponding flankers were words that could either be the same or different. Target size did not change, and flankers could either be the same size as targets or larger. Flankers could be located close to targets (normal spacing – close flankers) or separated from targets by seven spaces (distant flankers). Results revealed significant effects of flanker relatedness (same word as the target or a different word) that interacted with both flanker size and flanker eccentricity in the analysis of response times. The three-way interaction was not significant. The only significant effect in the analysis of error rates was that of flanker relatedness. We replicated prior findings showing that increasing flanker eccentricity diminishes the effect of flanker relatedness, and we further demonstrated that increasing flanker size increases the magnitude of flanker effects. Crucially, an increase in flanker size was not found to compensate for the negative impact of an increase in flanker eccentricity on effects of flanker relatedness. These results suggest that eccentricity is one key visual factor influencing the spatial integration of orthographic information, and that the impact of eccentricity overrides the impact of flanker size. This provides support for the hypothesized scale-invariant gaze-centered processing of letter identities during the initial phase of orthographic processing.

PMID:42277380 | DOI:10.3758/s13414-026-03293-w

Neurol Sci. 2026 Jun 12;47(7):564. doi: 10.1007/s10072-026-09136-8.

ABSTRACT

BACKGROUND: Gait impairments in Parkinson’s disease (PD) worsen under cognitive load and often persist despite medication. Combining treadmill training with gamified virtual reality environments (GVRE) and transcranial direct current stimulation (tDCS) may address both motor and cognitive contributors. This study evaluated the effects and experiences of a cognitive-motor gait training program integrating GVRE and tDCS.

METHODS: In this mixed-methods RCT, 23 participants with mild-to-moderate PD were randomized to: (1) treadmill (n = 8), (2) treadmill+GVRE (n = 8), or (3) treadmill+GVRE+tDCS (n = 7). Participants completed 12 sessions over six weeks. Primary outcomes included spatiotemporal gait parameters and executive function under single- and dual-task conditions. Secondary outcomes included balance, motor severity, fear of falling and quality of life. Interviews explored perceived effects and motivational factors.

RESULTS: The intervention was safe and well tolerated, with high attendance (92%). No statistically or clinically meaningful changes were observed in gait speed. Balance improved across groups (MiniBESTest + 1.48 points; p = 0.0003). A timepoint-specific improvement in cadence during motor dual-task walking was observed in the treadmill+GVRE+tDCS group compared with treadmill. Interviews revealed increased walking confidence and adoption of mobility strategies in complex walking situations.

CONCLUSIONS: This preliminary mixed-methods RCT supports the feasibility and acceptability of combining treadmill training with GVRE and tDCS in people with mild-to-moderate PD. While the intervention did not yield clinically meaningful improvements in gait speed, exploratory outcomes offered insight into participant experiences. Reported gains in confidence, self-monitoring, and walking strategies provide useful context. Findings should be interpreted cautiously. Larger, adequately powered, sham-controlled trials are needed to determine efficacy.

PMID:42277373 | DOI:10.1007/s10072-026-09136-8

Cell Mol Neurobiol. 2026 Jun 11. doi: 10.1007/s10571-026-01765-z. Online ahead of print.

ABSTRACT

T-lymphokine-activated killer-cell-originated protein kinase (TOPK), was widely overexpressed in various malignant tumors, and played critical roles in their growth, differentiation and metastasis. However, its levels and potential clinical significance in acute ischemic stroke (AIS) was unknown. We detected the plasma TOPK protein level and mRNA level of neutrophilic TOPK in AIS patients using ELISA and RT-PCR, and analyzed their association with functional outcomes statistically. Among 330 patients with AIS, plasma TOPK concentrations differed significantly between patients present with excellent outcomes or not at 3 months. Plasma TOPK ≥ 69.95 pg/mL independently predicted excellent functional outcomes. In the subgroup of patients received rt-PA treatment, patients with TOPK ≥ 69.95 pg/ml also predicted excellent functional outcomes. Addition of plasma TOPK to clinical predictors for excellent outcomes post AIS as well as outcomes after rt-PA treatment improved their reclassification and discrimination. Although TOPK mRNA levels were significantly elevated in the neutrophils of AIS patients, no significant predictive value was observed for excellent outcomes. Conclusively, higher plasma TOPK levels (especially TOPK ≥ 69.95 pg/ml) might emerge as a prognostic indicator for the 3-month excellent functional outcomes post AIS and possessed predictive value in identifying patients with 3-month excellent functional outcomes after rt-PA treatment.

PMID:42277369 | DOI:10.1007/s10571-026-01765-z

Atten Percept Psychophys. 2026 Jun 11;88(5):146. doi: 10.3758/s13414-026-03286-9.

ABSTRACT

Recent work has shown that people are sensitive to coarse differences in network topology, including network features like “holes,” “crosses,” and “T-junctions.” Even children as young as 4 years old will readily distinguish between items that differ slightly in their network topology. But how robust is this sensitivity? Here, we evaluate whether people are not only sensitive to differences in the presence or absence of certain topological features, but also to their exact spatial arrangement. In a first experiment, we show that people distinguish figures which possess all the same topological features as other figures in a set if the features differ in spatial arrangement. In a second experiment, we show that people also match figures based on exact spatial arrangement. Finally, we show that memory encodes the correct relational structure of the figures: People are more likely to falsely indicate having seen an item if it shared the precise arrangement of topological features of other items they had seen (compared to a closely matched item which had the same features arranged in a different way). Combined, these results bolster the theory that people intuitively appreciate the precise spatial arrangement of topological features.

PMID:42277366 | DOI:10.3758/s13414-026-03286-9

Eur J Clin Nutr. 2026 Jun 11. doi: 10.1038/s41430-026-01773-8. Online ahead of print.

ABSTRACT

We previously found the glycaemic index (GI) of 3 foods to be similar in subjects aged >40 y (mean 49 y) versus <40 y (mean 29 y), but a more recent study reported the GI of 2 foods to be higher in subjects aged >55 y (mean 70 y) vs. <33 y (mean 24 y). Here, we compared the GI or relative glycaemic response (RGR, analogous to GI but using a different reference food) of the younger (age <33 y) vs. the older (age >55 y) subjects who participated in previously published studies that included n ≥ 9 in each group. Study 1, (GI, 3 foods) had n = 19:9 younger:older subjects; Study 2, (GI, 2 foods) n = 14:10; Study 3, (RGR, 1 food), n = 68:16. The GI or RGR of the 6 foods varied from 36 to 88; none differed significantly in younger vs. older and the overall means were equivalent, 63.2 vs. 63.7, respectively. The GI or RGR values for 5 foods from 3 additional studies not meeting the inclusion criteria above were also similar in younger vs. older subjects. Therefore, we found no evidence from n = 11 comparisons that GI values differ in younger vs. older subjects. However, there are insufficient data to determine if GI values are equivalent in older vs. younger subjects, something that requires a different statistical test.

PMID:42277346 | DOI:10.1038/s41430-026-01773-8

Int Dent J. 2026 Jun 11;76(4):109677. doi: 10.1016/j.identj.2026.109677. Online ahead of print.

ABSTRACT

OBJECTIVES: Sal is one of the ten islands of Cape Verde, a lower-middle-income country in Africa. Local reports suggest poor oral health among residents, but no scientific data exists. This study aimed to assess oral health status and oral health-related quality of life (OHRQoL) of Sal’s dentulous inhabitants, identify risk factors associated with oral health, and explore correlations between oral health and OHRQoL in adults.

MATERIALS AND METHODS: A population-based cross-sectional study was conducted among dentulous Sal residents. Final-year dental students from the Academic Centre for Dentistry Amsterdam (ACTA), Faculty of Dentistry in Amsterdam, performed duplicate oral health examinations. Outcomes included caries experience (dmft/DMFT), consequences of untreated caries (pufa/PUFA), and periodontal health (DPSI; in adults only). Data on brushing frequency, toothbrush ownership, toothpaste availability, dental visits, dental insurance, and tobacco use (adults only) were collected. Adults completed the OHIP-14 questionnaire (OHRQoL). Descriptive statistics summarized characteristics; multivariable regressions assessed associations.

RESULTS: A total of 1,371 dentulous residents participated (609 children aged 1-17 years; 762 adults aged 18-89 years). Caries prevalence was 87.5% and pufa/PUFA 52.2%. Mean dmft/DMFT was 3.7 ± 3.2 (children) and 7.5 ± 6.2 (adults). 63.1% had DPSI maximum-scores ≥3+ (periodontal disease). Toothbrush ownership was high (>96%), access to toothpaste (<90%) and dental insurance was limited (children 63%; adults 46%). Dental insurance was associated with lower dmft/DMFT (p = .019) and lower pufa/PUFA (p = .005). Higher DMFT, PUFA, and severe periodontal disease was associated with poorer OHRQoL.

CONCLUSIONS AND CLINICAL RELEVANCE: Oral health among Sal’s residents is poor, with a high disease burden and limited access to care. Improving preventive strategies and access to dental services is important to reduce disease prevalence and enhance quality of life.

PMID:42275744 | DOI:10.1016/j.identj.2026.109677

Blood Cells Mol Dis. 2026 Jun 6;120:103022. doi: 10.1016/j.bcmd.2026.103022. Online ahead of print.

ABSTRACT

BACKGROUND: Polycythemia vera (PV) is a chronic myeloproliferative neoplasm characterized by the clonal proliferation of hematopoietic stem cells, primarily driven by JAK2 mutations. Even though there are established diagnostic and therapeutic standards, there is not a lot of information about the clinical and molecular features of PV in Latin America. Our aim was to characterize the demographic, clinical, hematological, and treatment characteristics of patients with polycythemia vera at a specialized hematology/oncology center in southern Colombia.

METHODS: We conducted a retrospective cohort analysis involving patients aged 18 years and older diagnosed with polycythemia vera at Hemato Oncólogos S.A. and Clínica Imbanaco in Cali, Colombia, from July 2015 to July 2023. We looked at 59 consecutive medical records to get demographic information, JAK2 mutational status, hematologic parameters, initial treatment, relapse reasons, and outcomes. We used descriptive statistics and compared groups using the Chi-square/Fisher’s exact test for categorical variables and the Student’s t-test, ANOVA, or non-parametric alternatives for continuous variables. A p-value under 0.05 was considered statistically significant.

RESULTS: There were 59 patients in all, with a slight male majority (50.8%) and an average age of 70.1 ± 12.3 years; the average age at diagnosis was 60.1 ± 11.3 years. In 61.0% of patients, JAK2 mutations were found, and in 81.4% of patients, the risk was high. The average hemoglobin level upon diagnosis was 17.2 ± 2.9 g/dL, but by the last follow-up, it had dropped to 14.4 ± 2.6 g/dL. The main treatments were acetylsalicylic acid plus hydroxyurea (32.2%) or phlebotomy (28.8%). During the follow-up period (mean 0.9 ± 3.6 years), 37.3% of individuals experienced recurrence, sometimes requiring an increase in treatment to hydroxyurea or ruxolitinib. The overall death rate was 15.3%. No statistically significant differences were seen between patients who survived and those who died concerning baseline hemoglobin, age, JAK2 status, or therapeutic mode.

CONCLUSION: This study provides one of the first extensive characterizations of PV in southern Colombia, confirming internationally recognized clinical features, including advanced age at diagnosis, increased prevalence of cardiovascular comorbidities, and a predominance of high-risk classification. The low rate of finding JAK2 mutations suggests that molecular testing may not be as easy to get as it could be. Even if the treatment followed the guidelines, the risk of recurrence and thrombosis remained, showing that PV is a long-term and worsening condition. These findings highlight the urgent need to expand access to molecular diagnostics, develop tailored risk-adapted medicines, and initiate prospective multicenter studies in Latin America to optimize outcomes and quality of life in PV.

PMID:42275722 | DOI:10.1016/j.bcmd.2026.103022

Food Chem. 2026 Jun 8;522:149991. doi: 10.1016/j.foodchem.2026.149991. Online ahead of print.

ABSTRACT

Brandy flavor is shaped by complex production processes, yet comprehensive multivariate analyses of these stages remain limited. This study employed flavoromics and chemometrics to characterize the influence of grape variety, micro-region, distillation method, and aging protocol on brandy. HS-SPME-GC-MS and sensory data were analyzed using multivariate models (PCA, PLS-DA) and FDR-corrected univariate analyses. Results showed that representative compounds such as geraniol, ethyl heptanoate, and isoamyl lactate discriminated samples of micro-regions, while grape variety, distillation system, and aging regime generated distinct volatile and sensory patterns. Rather than being treated solely as statistical markers, these compounds were interpreted in relation to precursor differences, process-dependent transfer, and time-dependent chemical evolution. In particular, isoamyl lactate showed persistence from base wine to newmake brandy, whereas aging-related changes in esters and lactones reflected reaction equilibria associated with wood contact and toasting intensity. These findings provide a process-oriented framework for understanding how production variables shape brandy aroma.

PMID:42275714 | DOI:10.1016/j.foodchem.2026.149991

Clin Radiol. 2026 Apr 28;99:107371. doi: 10.1016/j.crad.2026.107371. Online ahead of print.

ABSTRACT

AIM: When radiologists encounter an unfamiliar musculoskeletal neoplasm on conventional and advanced MR images, they now have an option to search the internet for MRI image examples. The purpose of this project was to systematically evaluate the quality of images returned by a widely used general search engine.

MATERIALS AND METHODS: Systematic internet searches were conducted for 16 benign and malignant musculoskeletal neoplasms, focusing on T1-weighted (T1W), T2-weighted (T2W), contrast-enhanced, diffusion-weighted (DWI), and out-of-phase MR images. The top five images from each search were evaluated for image quality and clinical relevance using a 5-point scoring key.

RESULTS: General internet engine returned correct sequence among the top five results for 88% of lesions when searched for T1W images, 100% for T2W images, 100% for contrast-enhanced images, 63% for DWI, and 25% for out-of-phase images. Fleiss Kappa statistic demonstrated substantial agreement (Kappa = 0.72) for binary “useful” vs “not useful” image designation, and moderate agreement (Kappa = 0.48) for all five categories.

CONCLUSION: The general internet search engine returned useful results when searching for conventional MRI sequences but performed sub-optimally when searching for advanced MR image examples.

PMID:42275688 | DOI:10.1016/j.crad.2026.107371