Nevin Manimala

Pituitary. 2026 Jul 27;29(4):133. doi: 10.1007/s11102-026-01725-2.

ABSTRACT

PURPOSE: Biochemical remission after transsphenoidal resection for acromegaly remains challenging, and early prognostication is limited. This study applies statistical and predictive modeling approaches to identify perioperative predictors of remission.

METHODS: We retrospectively analyzed 86 patients with acromegaly who underwent endoscopic endonasal transsphenoidal resection of GH-secreting primary pituitary adenomas between January 2018 and January 2025. Preoperative demographic, biochemical, radiologic, and histopathologic variables were evaluated. Patients were randomly split into training and test sets. Missing data were addressed using median and KNN imputation. Five machine learning models (GBM, RF, GLMNET, KNN, and Nnet) were trained using exhaustive feature subset selection and evaluated using AUROC and accuracy.

RESULTS: Of 86 patients, 62 (72.1%) achieved biochemical remission. Remission was associated with older age (p = 0.016), round tumor shape (p < 0.0001), gross total resection (p < 0.0001), lower Knosp grade (p < 0.0001), and dense CAM 5.2 staining (p = 0.037). The best-performing model was RF using four features (gender, tumor shape, extent of resection, CAM 5.2), achieving an accuracy of 0.8235 and AUROC of 0.8542 on the test set.

CONCLUSION: Predictive modeling may help estimate biochemical remission after surgery for acromegaly. This exploratory perioperative framework may support postoperative risk stratification and patient counseling while complementing standard endocrine follow-up. Further external validation in larger cohorts is warranted.

PMID:42509491 | DOI:10.1007/s11102-026-01725-2

Neurocrit Care. 2026 Jul 27. doi: 10.1007/s12028-026-02609-w. Online ahead of print.

ABSTRACT

INTRODUCTION: White matter hyperintensities (WMH) are key radiographic biomarkers of cerebral small vessel disease (CSVD) and have been associated with worse outcomes after stroke. Since CSVD may involve blood-brain barrier disruption, we hypothesized that worse outcomes in those with WMH may be mediated through more severe cerebral edema and hemorrhagic transformation (HT).

METHODS: In this retrospective multicenter cohort study, we studied patients from four multinational stroke cohorts who presented within 12 h of anterior circulation large vessel occlusion (LVO) stroke and received at least one follow-up computed tomography (CT) between 12 and 48 h. WMH were rated on baseline CTs using a Fazekas-derived system, with a subset also assessed with Fazekas grading on magnetic resonance imaging (MRI). Automated image analysis measured cerebrospinal fluid displacement (ΔCSF) and lesional-to-contralateral hemispheric CSF volumes (CSF-ratio) as quantitative edema biomarkers. We analyzed the association between WMH presence and edema severity, hemorrhagic transformation, and poor functional outcome (mRS 3-6), adjusting for key covariates, overall and in the subgroup undergoing thrombectomy and those with successful reperfusion.

RESULTS: Of 1290 patients with LVO, 782 were eligible for analysis. Of these, 19% had WMH on CT. Patients with WMH were older, more often female, and had a history of hypertension and higher presenting systolic blood pressure and glucose levels. WMH presence was associated with worse functional outcome, adjusting for age and additional covariates [OR 1.84 (1.06-3.22), p = 0.04] but lower risk of any HT [OR 0.48 (0.25-0.88), p = 0.03]. However, WMH presence by CT or MRI was not associated with edema (ΔCSF, CSF ratio, or midline shift) in the whole population or thrombectomy/reperfusion subgroups. Reperfusion was associated with less edema and improved recovery.

CONCLUSIONS: Presence of CT-graded WMH was associated with worse outcome after LVO stroke, independent of age and other factors. However, this risk appears not to be mediated through greater risk of HT or cerebral edema formation.

PMID:42509480 | DOI:10.1007/s12028-026-02609-w

Arch Osteoporos. 2026 Jul 27;21(1):106. doi: 10.1007/s11657-026-01740-7.

ABSTRACT

We evaluated whether adding a genetic risk score derived from forearm fracture improves fracture prediction beyond standard clinical tools. Incorporation of GPS resulted in a small increase in time-dependent AUC, with improvement in NRI. Decision curve analysis suggested potential clinical benefit across certain threshold ranges.

BACKGROUND: Previous studies have incorporated estimated bone mineral density (eBMD)-derived polygenic scores into FRAX to improve fracture risk prediction, indirectly capturing genetic susceptibility through bone mineral density. However, the genetic architectures of fracture and BMD only partially overlap, suggesting that fracture-specific genetic risk may provide complementary and more direct biological information. With the availability of recently released forearm fracture GWAS summary statistics, we developed Bayesian genome-wide polygenic scores (GPS) derived from fracture risk and evaluated whether integrating fracture-derived Bayesian GPS into FRAX could enhance clinical fracture risk prediction.

METHODS: We constructed two Bayesian GPS using recently released UK Biobank forearm fracture GWAS summary statistics (GWAS Catalog study ID: GCST90281273) with two Bayesian frameworks: polygenic risk score-continuous shrinkage (PRS-CS) and summary-data-based Bayesian regression with continuous shrinkage and functional annotation integration (SBayesRC). The fracture-derived Bayesian GPS were integrated into FRAX to derive fracture-specific GPS-FRAX models. Model performance was evaluated in 10,135 postmenopausal women from the Women’s Health Initiative (WHI) using time-dependent area under the receiver operating characteristic curve (AUC), Brier score, net reclassification improvement (NRI), calibration analysis, and decision curve analysis (DCA).

RESULTS: Compared with the FRAX-CRF model (time-dependent AUC = 0.683), fracture-derived Bayesian GPS-FRAX models demonstrated modest improvements in discrimination, with time-dependent AUCs of 0.693 for PRS-CS and 0.690 for SBayesRC. Overall reclassification proportions were low (1.58% for SBayesRC and 1.82% for PRS-CS), but NRI was significantly improved, with overall NRI estimates of 2.20% (95% CI, 0.83 to 3.58%) for SBayesRC and 2.72% (95% CI, 1.34 to 4.19%) for PRS-CS. These findings indicate incremental predictive gain beyond clinical FRAX factors despite modest increases in discrimination.

CONCLUSIONS: Incorporation of fracture-derived Bayesian GPS into FRAX resulted in a modest but statistically significant improvement in model discrimination, as reflected by a small increase in AUC. In addition, improvements in NRI and higher estimated net benefit in decision curve analysis suggest incremental clinical utility. However, the overall magnitude of improvement remained limited, indicating that the added predictive value beyond established clinical risk factors is modest. Further evaluation in more diverse populations is warranted.

PMID:42509442 | DOI:10.1007/s11657-026-01740-7

Atherosclerosis. 2026 Jul 25;420:121859. doi: 10.1016/j.atherosclerosis.2026.121859. Online ahead of print.

ABSTRACT

BACKGROUND: Mosaic loss of chromosome Y (mLOY) is the most common acquired somatic mutation in men and has been linked to multiple age-related diseases, including cardiovascular diseases. However, its association with symptomatic peripheral artery disease (PAD) remains poorly understood. We aimed to investigate the relationship between hematopoietic mLOY and incident symptomatic PAD in a large population-based male cohort.

METHODS: We conducted a longitudinal cohort study including 171 698 male participants from the UK Biobank who were free of PAD history. mLOY was assessed using leukocyte-derived genotyping data and modelled separately in three forms: binary (No/Yes), three level (No/Moderate/Substantial), and continuous (per 1-SD increase). Cox proportional-hazards models were used to analyze the association between mLOY and incident symptomatic PAD. Restricted cubic spline models were applied to evaluate nonlinear relationships. We also examined the joint associations and potential interactions between mLOY and genetic susceptibility (PAD polygenic risk score), smoking status, clonal hematopoiesis of indeterminate potential (CHIP), diabetes and estimated glomerular filtration rate (eGFR).

RESULTS: During a median follow-up of 15.3 years, 3785 participants developed symptomatic PAD. In fully adjusted Cox models, each SD increase in mLOY percentage was associated with 5% increased risk of incident symptomatic PAD (HR 1.05, 95% CI 1.02-1.07). Similarly, mLOY defined as ≥10% mLOY was associated with 37% increased risk of symptomatic PAD (HR 1.37, 95% CI 1.18-1.60). No statistically significant interactions were observed between mLOY and PAD genetic susceptibility, smoking status, CHIP status, or eGFR (all P for interaction >0.05). However, a significant interaction was observed between mLOY and diabetes status (P for interaction = 0.013), with a stronger association observed among participants without diabetes.

CONCLUSIONS: Hematopoietic mLOY is associated with an increased risk of incident symptomatic PAD in men, independent of traditional cardiovascular risk factors. Assessement of mLOY status may therefore have the potential to improve PAD risk stratification and identify high-risk individuals who would benefit most from early lifestyle modifications and preventive pharamacological treatments.

PMID:42508147 | DOI:10.1016/j.atherosclerosis.2026.121859

Clin Neurol Neurosurg. 2026 Jul 17;270:109579. doi: 10.1016/j.clineuro.2026.109579. Online ahead of print.

ABSTRACT

OBJECTIVES: Spinal metastatic disease incidence has increased due to advances in radiation and chemotherapy that improve survival. Surgical treatment includes separation surgery, for decompression of neural elements from the tumor to allow for post-operative stereotactic radiation versus maximal tumor resection via corpectomy. Data is mixed on whether more invasive corpectomy for tumor resection provides significant benefit over less invasive separation surgery.

METHODS: A retrospective review of 100 consecutive patients was performed, 60 underwent corpectomy and 40 were treated with instrumented separation surgery. Demographics, tumor characteristics, clinical and radiographic data, treatments, and outcomes were analyzed.

RESULTS: Both groups had similar baseline characteristics in terms of age, cancer type, and preoperative function. Postoperatively, both groups had similar functional outcomes while corpectomy was associated with a significant correction (p = 0.02) in kyphosis by 4 ° compared to separation surgery which was neutral (0 °). The median overall survival did not significantly differ between the two groups. Poor neurologic function was associated with shorter survival. Reoperation rate did not statistically differ between the two groups. The separation surgery group had a higher rate of reoperation for tumor progression, but it did not reach significance (p = 0.057).

CONCLUSION: Compared to separation surgery, corpectomy offers similar functional outcomes with improved segmental kyphosis correction, with possible survival benefit. However, this comes at the cost of added surgical complexity, reflected in greater operative time and need for transfusion. In the right candidate, corpectomy may be favored due to improved anterior column reconstruction and reduced oncologic burden.

PMID:42508137 | DOI:10.1016/j.clineuro.2026.109579

Food Chem. 2026 Jul 22;525(Pt 3):150497. doi: 10.1016/j.foodchem.2026.150497. Online ahead of print.

ABSTRACT

Conventional coffee production faces sustainability challenges. Coffee cell cultures (CC) are a promising alternative coffee raw material. This study investigated the composition of CC in comparison to conventional green coffee beans (GB) using untargeted metabolomics and lipidomics approaches. The lipid content (g/100 g) of GB was approximately four times higher than that of CC with triglycerides as the predominant lipid class identified followed by diterpenes. Additionally, differences were observed in the diterpene profiles of CC and GB. CC accumulated more thiamine and choline but lower contents of caffeine, trigonelline, and alpha-tocopherol compared to GB. The detected carbohydrates of statistical significance between CC and GB were mostly monosaccharides. This study provides information on the bioactive metabolites in CC, demonstrates the possibility of tailor-made coffee products from CC, and encourages further optimization of the production process of CC to enable development of sustainable, healthy coffee beverages for the future.

PMID:42508117 | DOI:10.1016/j.foodchem.2026.150497

Nurse Educ Pract. 2026 Jul 16;95:104932. doi: 10.1016/j.nepr.2026.104932. Online ahead of print.

ABSTRACT

AIM: To translate, culturally and linguistically adapt and validate the psychometric properties of the Technological Competency as Caring in Nursing Instrument, for the Portuguese cultural context.

BACKGROUND: The integration of caring practices with technological and informatics knowledge is central to advancing nursing and requires a refined understanding of the interaction between human care and technology-enabled practice. In this context, the importance of an instrument capable of assessing technological competence in nursing care becomes evident. The Technological Competency as Caring in Nursing Instrument (TCCNI-RePract), evaluates this competence across two dimensions: perception and practice.

DESIGN: The study followed a two-phase design consisting of qualitative translation and quantitative psychometric validation phases.

METHODS: This methodological, exploratory, cross-sectional study evaluated the psychometric properties of the TCCNI-RePract in a Portuguese sample (n = 257, non-random). Transcultural adaptation followed established guidelines to assess the instrument’s validity, reliability and sensitivity. Descriptive statistics, Cronbach’s alpha and factor analysis were performed.

RESULTS: The Portuguese version of the TCCNI_RePract instrument consists of two scales: an 18-item Perception dimension and a 21-item Practice dimension, both organized within a three-factor model that explains 54% and 62% of the total variance, respectively. The Perception and Practice dimensions demonstrated high internal consistency, with Cronbach’s alpha values of 0.89 and 0.94.

CONCLUSION: The instrument demonstrates strong psychometric properties to assess technological competence as caring in nursing and can be used as a reliable and effective measure in the Portuguese health system.

PMID:42508113 | DOI:10.1016/j.nepr.2026.104932

Ecotoxicol Environ Saf. 2026 Jul 27;322:120566. doi: 10.1016/j.ecoenv.2026.120566. Online ahead of print.

ABSTRACT

BACKGROUND: Intelligence quotient (IQ) plays a significant role in assessing neurodevelopment. However, the effects of prenatal exposure to bisphenols or air pollution on intelligence quotient in preschool children remain unclear.

METHODS: A total of 231 mother-child pairs were from Guangxi Zhuang Birth Cohort. Single- and multiple-pollution methods were performed to examine the effects of prenatal exposure to bisphenols and air pollutants on IQ in preschool children, including generalized linear models, restricted cubic spline (RCS), principal component analysis (PCA), quantile G-computation (Qgcomp), and Bayesian kernel machine regression (BKMR).

RESULTS: In generalized linear model, prenatal exposure to bisphenol A (BPA) (β=-3.55; 95%CI: -7.04, -0.06) and bisphenol F (BPF) (β=-12.68; 95%CI: -21.31, -4.05) was negatively associated with working memory index (WMI) in preschool children. Similarly, prenatal tetrabromobisphenol A (TBBPA) exposure was associated with lower verbal comprehension index (VCI) (β=-4.23; 95%CI: -7.90, -0.57), FRI (β=-5.59; 95%CI: -9.88, -1.30), WMI (β=-5.40; 95%CI: -9.47, -1.32), processing speed index (PSI) (β=-4.79; 95%CI: -9.25, -0.33), and full-scale IQ (FSIQ) (β=-4.38; 95%CI: -7.92, -0.84). Among air pollution, higher O₃ exposure was correlated with lower VCI (β=-138.44; 95%CI: -198.55, -78.34), visuospatial index (VSI) (β=-64.41; 95%CI: -126.53, -2.29), WMI (β=-93.59; 95%CI: -162.67, -24.50), and FSIQ (β=-114.85; 95%CI: -173.79, -55.92). Furthermore, prenatal exposure to PM_2.5 and PM₁₀ was correlated with decreased VCI (PM_2.5: β=-45.64; 95%CI: -82.77, -8.51 and PM₁₀: -61.85; 95%CI: -107.36, -16.35) and FSIQ (PM_2.5: β=-49.76; 95%CI: -85.57,-13.95 and PM₁₀: β=-60.23; 95%CI: -104.28, -16.19). After gender stratification, the above effects were more significant in boys. In Bayesian kernel machine regression, prenatal exposure to the mixtures of 10 pollutants (5 bisphenols and 5 air pollutants) or 5 air pollution components was associated with less VCI, VSI, WMI, and FSIQ, and an inverted U-shaped association was found between these mixtures and FRI.

CONCLUSIONS: Prenatal exposure to both single and mixed bisphenols and air pollutants may decrease the IQ of preschool children. These adverse effects appear to be more pronounced in boys and exhibit a nonlinear exposure-response relationship. This work offers epidemiological support for public health interventions that reduce co-exposure to multiple pollutants during pregnancy.

PMID:42508106 | DOI:10.1016/j.ecoenv.2026.120566

Int Orthod. 2026 Jul 27;24(4):101217. doi: 10.1016/j.ortho.2026.101217. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the surface morphology and time-dependent antimicrobial effectiveness of antibiotic-loaded silver and gold nanoparticle coatings, with or without polyethylene glycol, applied to anodized titanium orthodontic mini-implants.

METHODS: Twenty-eight Ti-6Al-4V mini-implants (ARROW) were divided into four groups: Ti-AgNP-PEG-CM (Group A), Ti-AgNP-CM (Group B), Ti-AuNP-PEG-CM (Group C), and Ti-AuNP-CM (Group D). After anodization and SILAR nanoparticle deposition, the surface morphology was examined by HR-SEM and atomic force microscopy (AFM), the chemical composition was analysed by Attenuated Total Reflectance Fourier Transform Infrared Spectroscopy (ATR-FTIR), and crystallographic phase characterisation was performed by X-ray diffraction (XRD). Antibacterial activity against Staphylococcus aureus and Enterococcus faecalis was quantitatively evaluated at 6, 24, 48, and 72hours using a standard colony-forming unit (CFU/mL) assay. A two-way repeated-measures ANOVA with Bonferroni correction was used for statistical analysis.

RESULTS: PEG-containing groups demonstrated lower surface roughness on AFM and more homogeneous surface morphology on SEM. XRD suggest crystalline fcc nanoparticle deposition in respective groups. ATR-FTIR spectra showed characteristic bands attributable to PEG (1070-1110cm^-1) and clindamycin-related functional groups (600-3400cm^-1) across the coated groups. Group C achieved the lowest average colony counts for both S. aureus. Coating over time showed a significant interaction (P<0.001).

CONCLUSIONS: Ti-AuNP-PEG-CM demonstrated the most effective antibacterial performance against both test organisms throughout the 72-hour evaluation period. Although direct drug-release kinetics were not measured in this study, PEG emerged as an important formulation factor across nanoparticle types. These findings support further in vivo evaluation of PEG-based nanocomposite coatings to reduce early peri-implant bacterial colonization.

PMID:42508092 | DOI:10.1016/j.ortho.2026.101217

J Magn Reson Imaging. 2026 Jul 27. doi: 10.1002/jmri.70466. Online ahead of print.

ABSTRACT

BACKGROUND: Erectile dysfunction (ED) and anxiety have a well-documented bidirectional relationship, with anxiety affecting up to 37% of men with ED. While vascular and endocrine mechanisms are well studied, the central nervous system underpinnings linking anxiety to psychogenic ED (pED) remain unclear.

PURPOSE: To delineate the neural circuitry through which anxiety potentiates erectile dysfunction.

STUDY TYPE: Retrospective case-control study.

POPULATION: About 62 male patients (Age: 45.4 ± 12.3) with confirmed pED and 64 age- and education-matched healthy male controls (Age: 46.1 ± 14.7).

FIELD STRENGTH/SEQUENCE: 3.0 T; T2*-weighted gradient-echo echo-planar imaging sequence.

ASSESSMENT: Task-based fMRI was performed using the Hariri picture-matching task with negative and neutral emotional stimuli; state anxiety was measured with the State-Trait Anxiety Inventory (STAI), and erectile dysfunction severity was assessed using the International Index of Erectile Function (IIEF); all assessments were conducted by trained research staff following standardized protocols.

STATISTICAL TESTS: Whole-brain activation analysis, seed-based Granger causality mapping, and serial mediation analysis were conducted, with significance set at p < 0.05 and family-wise error correction for multiple comparisons.

RESULTS: pED patients showed significant hypoactivation in the right amygdala and occipital cortex during negative emotion processing. In the pED group, amygdala activation significantly correlated with state anxiety (r = -0.54) and ED severity (r = -0.53). Medial prefrontal cortex (mPFC) was identified as the primary upstream regulator of amygdala activity. Elevated state anxiety showed both direct and indirect statistical associations on erectile function via the mPFC-amygdala pathway.

CONCLUSION: Dysfunction of the mPFC-amygdala circuit is associated with the relationship between state anxiety and pED. This circuit represents a novel therapeutic target for pED management.

STAGE OF TECHNICAL EFFICACY: Stage 3.

PMID:42508052 | DOI:10.1002/jmri.70466