Nevin Manimala

Cytometry A. 2026 Jul 20. doi: 10.1002/cyto.a.70053. Online ahead of print.

ABSTRACT

Flow cytometers, based on an optical measurement principle, are widely used for cell characterization in a variety of medical applications. Especially in hematology, high counting accuracy is crucial. Therefore, it is essential to develop accurate but also fast coincidence correction methods. We developed a procedure for post-processing the time-dependent signals (pulses) captured by the detectors during the transition of particles or cells through the flow cytometer’s laser beam. These pulses are characterized by their area, maximum intensity, standard deviation, and skewness. By using standard deviation versus area, we are able to detect significantly more coincidences in monodisperse suspensions than by using the common method of area or width versus height. This demonstrates the superior sensitivity and accuracy of our approach for coincidence detection. In polydisperse suspensions and whole blood, we successfully identify and distinguish coincidences between differently sized particles (e.g., 1 and 5 μm) and particles of the same size, as well as between thrombocytes and erythrocytes based on pulse skewness and standard deviation. Unlike the current state-of-the-art method for coincidence correction in cell concentration measurements, which relies on statistical evaluation through dilution series, the developed procedure identifies a specific number of coincidences for individual measurements.

PMID:42473817 | DOI:10.1002/cyto.a.70053

Can Respir J. 2026;2026(1):e2606203. doi: 10.1155/carj/2606203.

ABSTRACT

BACKGROUND: Bronchiolitis obliterans (BO) is a rare chronic pulmonary condition in pediatric patients, characterized by irreversible fibrotic constriction of the small airways. This study aims to analyze the risk factors for BO caused by severe adenovirus pneumonia (SAP) and to develop a nomogram model for personalized prediction.

METHODS: We retrospectively analyzed 251 children with SAP admitted to the Children’s Hospital of Nanjing Medical University between January 2017 and March 2024. Among them, 77 were classified into the BO group and 174 into the non-BO group. A predictive nomogram was developed based on independent risk factors identified through univariate analysis, least absolute shrinkage and selection operator (LASSO) regression, and multivariate logistic regression.

RESULTS: Multivariable analysis identified the following independent risk factors for BO: wheezing (odds ratio [OR] = 4.78; 95% confidence interval [CI], (2.00∼11.40); p < 0.001), large lobar consolidation (OR = 8.53; 95% CI, 3.63∼20.02; p < 0.001), length of hospital stay (OR = 1.20; 95% CI, 1.08-1.33; p < 0.001), and duration of fever (OR = 1.20; 95% CI, 1.09-1.32; p < 0.001). Mechanical ventilation showed a trend toward increased risk but did not reach statistical significance (OR = 5.35; 95% CI, 0.74-38.56; p = 0.096). The nomogram demonstrated excellent discriminative ability, with an area under the curve of 0.90 (95% CI: 0.85-0.94). Calibration curves indicated good agreement between predicted and observed outcomes. Decision curve analysis showed a net clinical benefit within a clinically relevant threshold probability range of 0.10-0.70.

CONCLUSIONS: A nomogram incorporating five independent risk factors-wheezing, duration of fever, length of hospital stay, mechanical ventilation, and large lobar consolidation-was developed to predict BO risk in children with SAP.

PMID:42473815 | DOI:10.1155/carj/2606203

Span J Psychol. 2026 Jul 20;29:e27. doi: 10.1017/SJP.2026.10043.

ABSTRACT

Loneliness is a growing concern in contemporary societies, particularly in urban environments, where social dynamics are rapidly evolving. Existing measures may not fully capture the complexity of loneliness in the context of ongoing technological and social changes. This study introduces the Madrid Loneliness Questionnaire (MLQ), a new instrument designed to assess loneliness in adults within modern sociocultural contexts. A sample of 1,526 adults (77.1% women; 18-87 years) participated in the study. The sample was randomly divided for structural validation: one subsample underwent exploratory factor analysis (EFA, n = 623) and the other confirmatory factor analysis (CFA, n = 903). Measurement invariance across gender and age was examined using multigroup CFA. Convergent validity was assessed through correlations with self-esteem and perceived stress. Internal consistency was evaluated using Cronbach’s alpha and McDonald’s omega. EFA and CFA supported a three-factor structure with excellent fit indices (Comparative Fit Index = 0.998; Tucker-Lewis Index = 0.997; RMSEA = 0.019; SRMR = 0.05): Social Skills, Partner Relationships, and Emotional Isolation. Multigroup CFA confirmed scalar invariance across gender and age. Significant gender differences were found in Social Skills (higher in men) and Partner Relationships (higher in women). The oldest age group (>65 years) scored higher on Partner Relationships than younger groups. The MLQ and its subscales showed moderate to strong negative correlations with self-esteem (rho = -.36 to -.63) and positive correlations with perceived stress (rho = .25 to .49). The scale demonstrated excellent internal consistency (α = .93, ω = .92). The MLQ is a psychometrically sound instrument for assessing loneliness in adults, enabling tailored interventions by serving as a basis for public health policies.

PMID:42473808 | DOI:10.1017/SJP.2026.10043

J Basic Clin Physiol Pharmacol. 2026 Jul 21. doi: 10.1515/jbcpp-2026-0101. Online ahead of print.

ABSTRACT

OBJECTIVES: Conventional semen analysis often fails to detect hidden functional defects contributing to male infertility. Factors such as sperm DNA-integrity, oxidative stress, MMP, and acrosome integrity are critical for fertilization and early embryonic development. This study aimed to evaluate sperm function defects in normozoospermic infertile men and highlight limitations of routine semen parameters in infertility assessment.

METHODS: Semen samples underwent standard semen analysis. Sperm DNA damage was assessed using Acridine Orange staining, acrosome integrity by FITC-PSA staining, and ROS levels along with MMP were measured using flow cytometry. Appropriate statistical analyses were performed to compare infertile men and fertile controls and determine correlations among functional parameters.

RESULTS: Among clinically screened infertile patients, 23 % were normozoospermic according to WHO 2010 criteria. Sperm function parameters were evaluated in normozoospermic infertile men (n=45) and fertile controls (n=17). Infertile men exhibited significantly higher ROS levels and DNA damage (p<0.001), alongside reduced acrosome integrity and MMP (p<0.001) compared to controls. ROS showed a positive correlation with DNA damage and acrosome-reacted sperm, and a negative correlation with MMP.

CONCLUSIONS: Functional sperm defects may underlie infertility in a substantial proportion of normozoospermic men. Incorporating sperm function tests as second-line investigations may improve diagnosis and management of unexplained male infertility.

PMID:42473807 | DOI:10.1515/jbcpp-2026-0101

Scand J Surg. 2026 Jul 20:14574969261467712. doi: 10.1177/14574969261467712. Online ahead of print.

ABSTRACT

BACKGROUND: Anastomotic leakage after anterior resection for rectal cancer is associated with long-term morbidity, such as bowel dysfunction, but its impact on health-related quality of life remains insufficiently studied. The aim of this study was to evaluate the association between anastomotic leakage and health-related quality of life 3 years after surgery.

METHODS: In this population-based prospective cohort study, patients who underwent anterior resection for rectal cancer in Sweden between 2015 and 2017 were identified through the Swedish Colorectal Cancer Registry. Health-related quality of life was assessed 3 years after surgery using the EORTC QLQ-C30 and QLQ-CR29 questionnaires. The primary outcome was the QLQ-C30 summary score. Targeted maximum likelihood estimation was applied to estimate the adjusted effect of anastomotic leakage on health-related quality of life.

RESULTS: Of 1778 eligible patients, 1178 (66.3%) responded, including 104 (8.8%) with anastomotic leakage. Patients with anastomotic leakage reported a lower mean QLQ-C30 summary score compared to those without anastomotic leakage (80 vs 86, p < 0.001). After adjustment for confounders, anastomotic leakage was associated with a 4-point difference in summary score (p < 0.01). Patients with anastomotic leakage also reported worse body image. Compared with patients without anastomotic leakage, those with anastomotic leakage and no stoma reported more perianal skin irritation, while those with a stoma more frequently reported stool leakage from the stoma bag.

CONCLUSIONS: Anastomotic leakage after anterior resection is associated with a small negative effect on overall health-related quality of life 3 years after surgery. Nevertheless, specific functional impairments-particularly related to body image, and stoma- or perianal symptoms-persist and warrant attention. These findings highlight the importance of patient counseling and long-term follow-up after anastomotic leakage.

PMID:42473772 | DOI:10.1177/14574969261467712

Anim Health Res Rev. 2026 Jul 20;27:e5. doi: 10.1017/S1466252326100127.

ABSTRACT

Antimicrobial resistance (AMR) is a global threat, and responsible antimicrobial use (AMU) in animals is crucial. However, AMR development is influenced by numerous factors. This scoping review aims to describe the association between AMR, AMU, and other risk factors in European livestock farms. Understanding the impact of different risk factors is essential for mitigating AMR. The results confirm that the AMR prevalence varies between livestock farms and that AMU affects this prevalence. At herd level, factors related to infection pressure and AMU have been predominantly studied and are often associated with AMR. Only a few other factors such as temperature and metals or disinfectants in the farm environment have been investigated. Overall, the associations between AMR and the studied farm level. Risk factors, including AMU, were variable and complex. The studies varied in their methodological approaches. Different AMR indicators were used, with phenotypic resistance in indicator Escherichia coli being most common, and resistome characterisation gaining interest in recent years. Some studies did not include AMU data or had insufficiently detailed data, while some calculated treatment incidences in different ways. Standardised measures for risk factors and outcome variables would facilitate comparisons between studies and meta-analyses. For deeper insights into resistance dynamics, resistome characterisation is preferable, whereas phenotypic characterisation of pathogenic bacteria is more appropriate for developing clinical guidelines, and resistance profiles in indicator bacteria are useful for monitoring. In conclusion, farm-level risk factors are complex and risk factor studies including AMU, using validated methods, sufficient sample sizes, and sound statistical analyses are still needed.

PMID:42473768 | DOI:10.1017/S1466252326100127

Biol Open. 2026 Jul 20:bio.062488. doi: 10.1242/bio.062488. Online ahead of print.

ABSTRACT

Repeated measures designs are a common experimental setup in biology, from ecology to biomedical sciences. Traditional statistical techniques for analyzing such data, such as repeated measures ANOVA (RMANOVA), have limitations that prevent them from being used to answer many questions relevant to measurements taken over time. Response feature analysis (RFA) techniques can provide an ideal means for answering those questions by analyzing data based on a creatively chosen summary function of the individual subject’s data. The process and rationale for the RFA is laid out in a step-by-step manner and is demonstrated on an example of behavioral data from a rodent spinal cord injury study. In the original analysis, a difference in average functional score was only found at one timepoint early in the study. Using RFA, we show that the female rats reached 90% of their peak recovery 15.3 days (95% CI 1.73, 28.86 days) earlier than the male rats. RFA enables answering the important question “do the two sexes differ in the speed at which they recovery functional ability?”, and, by way of demonstration, illustrates its flexibility in answering questions that traditional repeated measures analyses cannot.

PMID:42473766 | DOI:10.1242/bio.062488

Foot Ankle Int. 2026 Jul 20:10711007261446621. doi: 10.1177/10711007261446621. Online ahead of print.

ABSTRACT

BACKGROUND: Hallux valgus is a common and potentially debilitating foot deformity, and the modified Lapidus is a prominent corrective procedure in the United States. The clinical distinctions between the minimally invasive surgery (MIS) and the established open techniques for modified Lapidus have not yet been well-described, particularly in the context of patient-reported outcomes. This study aims to systematically compare patient-reported outcomes between the 2 surgical approaches.

METHODS: One hundred forty moderate to severe hallux valgus patients who received modified Lapidus (66 MIS, 74 open) were identified via retrospective review. Patient-Reported Outcomes Measurement Information System (PROMIS) scores were used to assess clinical outcomes preoperatively and at 1 year postoperatively. Hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA) were measured on radiographs. Meary angle, first-ray length, first-ray elevation, first-ray pronation, and sesamoid position were analyzed on weightbearing computed tomography (WBCT). Surgical complications were identified through chart review and radiographic assessments.

RESULTS: MIS and open Lapidus patients reported clinically meaningful improvements in PROMIS physical function, pain interference, pain intensity, and global physical health scores at 1 year postoperatively, along with modest changes in global mental health and depression scores. There were no statistically significant differences in PROMIS scores between groups (adjusted P > .05, 95% CIs excluding zero). Although both techniques reliably achieved excellent correction, there was greater correction of HVA (3.82°) and IMA (2.02°) in open Lapidus patients and greater correction of Meary angle (3.16°) in MIS patients (adjusted P < .05, 95% CIs excluding zero). Rates of nonunion, recurrence, infection, and hardware removal were not statistically significant between surgical cohorts.

CONCLUSION: With the numbers available, no statistically significant difference was detected between the MIS and open Lapidus groups across all collected PROMIS measures, implying that the foot and ankle surgeon can expect to see similar patient-reported outcomes at 1 year postoperatively using either approach.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.

PMID:42473753 | DOI:10.1177/10711007261446621

Pulm Med. 2026;2026(1):e4702786. doi: 10.1155/pm/4702786.

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the value of therapeutic bronchoscopy in malignant central airway obstruction (MCAO) patients secondary to non-small cell lung cancer (NSCLC), especially in those experiencing respiratory failure (RF).

METHODS: This retrospective cohort study was conducted on 101 cases of NSCLC-related MCAO patients who received therapeutic bronchoscopy from January 2018 to January 2025. Patients were classified into the RF group (n = 39) and the non-RF group (n = 62) based on the presence of RF (PaO₂/FiO₂ ≤ 300) resulting from MCAO.

RESULTS: Therapeutic bronchoscopy achieved technical success in 93.1% of 101 patients, with no significant differences in technical success (p = 0.521), complication rates (p = 0.147), and short-term or intermediate-term efficacy between RF and non-RF groups. Kaplan-Meier curves indicated a median survival of 16.98 months posttherapeutic bronchoscopy, with univariate analysis revealing statistically significant differences between the RF and non-RF groups (10.46 months vs. 18.62 months, log – rank χ² = 4.494, p = 0.034). Multivariate Cox survival regression indicated that ECOG PS of 3-4 points (HR = 3.437, 95% CI: 1.751-6.746, p < 0.001), serum lactate dehydrogenase (LDH) ≥ 250 U/L (HR = 2.538, 95% CI: 1.328-4.852, p = 0.005), and lack of systemic antitumor treatment (HR = 3.274, 95% CI: 1.481-7.235, p = 0.003) are risk factors affecting the 2-year survival of NSCLC-related MCAO patients. Notably, the presence of secondary RF, the location, and the degree of airway stenosis in patients before surgery were not associated with the prognosis (p > 0.05).

CONCLUSION: Therapeutic bronchoscopy is safe and effective in NSCLC patients with MCAO. This intervention should be performed promptly when airway narrowing causes RF. The ECOG PS, serum LDH level, and systemic antitumor treatment might be independent factors affecting the prognosis of MCAO patients.

PMID:42473740 | DOI:10.1155/pm/4702786

Laryngoscope. 2026 Jul 20. doi: 10.1002/lary.70748. Online ahead of print.

ABSTRACT

OBJECTIVE: Maxillomandibular advancement (MMA) is the most effective surgical treatment for obstructive sleep apnea (OSA) after tracheotomy. However, the influence of patient characteristics such as age and gender on MMA outcomes remains understudied. This meta-analysis evaluates MMA outcomes stratified by age and gender.

DATA SOURCES: A comprehensive literature search of CINAHL, Cochrane Library, PubMed, and Scopus was performed from inception through 2026. Studies reporting age- or gender-specific outcomes of MMA for adults with OSA were included.

REVIEW METHODS: Extracted data included cephalometric measurements, apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), SpO2 nadir (LSAT), surgical success, and cure rates. Meta-analysis was performed.

RESULTS: Thirty-six studies comprising 608 patients were included. MMA significantly improved AHI, ESS, and LSAT (p < 0.05), with no significant differences in improvement between males and females or across age groups. Mean maxillary/mandibular advancement was 9.7/11.7 mm in males and 9.2/10.6 mm in females. Surgical success and cure rates were comparable between genders (OR_success = 1.06 [95% CI 0.54-2.10]; OR_cure = 1.17 [95% CI 0.51-2.69]). Increasing age was associated with decreased surgical success and cure, although only the decline in odds of cure reached statistical significance (OR = 0.97 annually, p = 0.029).

CONCLUSION: Maxillomandibular advancement yields significant improvements in OSA outcomes regardless of age or gender. While outcomes are generally consistent across groups, clinicians should counsel older adults on the reduced likelihood of surgical cure.

LEVEL OF EVIDENCE: N/A.

PMID:42473733 | DOI:10.1002/lary.70748