Nevin Manimala

Dig Dis Sci. 2026 Jun 10. doi: 10.1007/s10620-026-10054-0. Online ahead of print.

ABSTRACT

BACKGROUND: Nowadays, Endoscopic Muscularis Dissection (EMD) and Endoscopic Cap External Snare Resection (ECESR) are utilized as effective techniques for removing small submucosal tumors. Herein, We aimed to clarify the efficacy and outcomes of ECESR vs EMD to determine the optimal minimally invasive approaches for managing small (≤ 12 mm) Gastric Submucosal Tumors (sGSMT) arising from the muscularis propria (MP) layer.

METHODS: This study retrospectively included data from patients who underwent ECESR or EMD to excise sGSMT of 12 mm or less. The propensity score matching (PSM) algorithm mitigated selection bias using age, gender, tumor size, location, and growth patterns for one-to-one matching. Finally, 96 patients were divided into ECESR (48) and EMD (48) groups. Clinicopathologic characteristics, procedural outcomes (procedure time, tumor resection time, and R0 resection), adverse events, length of hospital stay, and costs were compared between the two groups.

RESULTS: After PSM, the ECESR group experienced significantly shorter procedure time and tumor resection time (23 [21, 22] vs 47 [40-56] min; 5 [5, 6] vs 27 [26-30] min, P < 0.001). The ECESR group exhibited significantly shorter hospital stays (P < 0.001) and lower operation costs (P < 0.001) compared to the EMD group. Both groups achieved high rates of complete (R0) resection, with no statistically significant difference observed. Importantly, no recurrence or metastasis was observed in either group during follow-up. The incidence of adverse events, including perforation and postoperative complications, was comparable between groups, and no statistically significant differences were identified..

CONCLUSIONS: For sGSMT (≤ 12 mm), ECESR exhibits shorter procedure and tumor resection times, speedier recovery, lower operating costs, and shorter hospital stays compared to EMD.

PMID:42268359 | DOI:10.1007/s10620-026-10054-0

Appl Psychophysiol Biofeedback. 2026 Jun 10. doi: 10.1007/s10484-026-09792-8. Online ahead of print.

ABSTRACT

An investigation the effect of an Electromyography Respiratory Biofeedback (ERB) method on the anxiety level of male patients with incomplete cervuaical spinal cord injury (CSCI). 40 patients (men) were included in the study considering the inclusion criteria and randomly divided into two groups of 20 patients. The control group received 15 sessions of common respiratory physiotherapy (CRPT). In addition to 15 sessions of CRPT, the intervention group also received 15 sessions of ERB. Anxiety level was measured by the Zung questionnaire for both groups at three levels, before the beginning of the treatment, after the completion of the treatment and one month after the completion of the treatment sessions. The results were evaluated by SPSS software. The results of the repeated measure test showed that both CRPT and the addition of ERB can have statistically significant effects on the anxiety level of patients over time (p-value < 0.001). The emotional and physical subscales of the Zung questionnaire were also statistically significantly affected by the passage of time in both groups. The values related to the total score of the Zung questionnaire and its emotional and physical subscales, in the control group, increased again one month after the treatment sessions, while in the control group, these values continued to decrease. CRPT aimed at improving diaphragmatic breathing can reduce the anxiety level of patients with CSCI in the short term, and these positive effects may diminish over time. However, the addition of ERB appears to support the short-term maintenance of these therapeutic effects during the one-month follow-up.

PMID:42268352 | DOI:10.1007/s10484-026-09792-8

Genet Med. 2026 Jun 9:102627. doi: 10.1016/j.gim.2026.102627. Online ahead of print.

ABSTRACT

PURPOSE: To systematically evaluate the diagnostic yield of ES and GS for investigating suspected genetic disorders in critically ill neonates and infants.

METHODS: Relevant literature published before December 2024 was retrieved from PubMed, Embase and Web of Science. Eligible cohort studies and case series (≥4 patients) adopting ES/GS as primary diagnostic tools were included. Random-effects proportional meta-analysis, subgroup analysis and meta-regression were performed to synthesize overall diagnostic yield, compare different sequencing modalities, and explore the correlation between diagnostic yield and publication year. This study was registered on PROSPERO (CRD42025631436).

RESULTS: The meta-analysis included 26 ES cohorts (2,205 individuals) and 22 GS cohorts (2,101 individuals). The overall diagnostic yield was 39.4% for ES (95% CI, 32.8%-46.3%) and 39.4% for GS (95% CI, 34.7%-44.1%). Subgroup analyses revealed trends toward higher yields with trio-based sequencing compared to non-trio approaches and with rapid GS compared to rapid ES, although these differences were not statistically significant. The meta-regression did not find a significant change in diagnostic yield over time.

CONCLUSION: The results of this systematic review and meta-analysis indicate the substantial diagnostic utility of both ES and GS in critically ill neonates and infants, providing a molecular diagnosis in nearly two-fifths of cases. These findings support the use of next-generation sequencing to improve diagnostic outcomes in this vulnerable patient population.

PMID:42267533 | DOI:10.1016/j.gim.2026.102627

Anal Chem. 2026 Jun 10. doi: 10.1021/acs.analchem.6c02559. Online ahead of print.

ABSTRACT

Cupping therapy is a widely used therapeutic procedure in traditional Chinese medicine, yet its mechanism remains unclear. Some of the literature on the mechanism of cupping relates its beneficial effects to chemical detoxification. Currently, however, there is a lack of rapid, in-situ, and noninvasive analytical approaches for verifying this theory. Here, we developed a method to analyze compounds inside the cupping jar during cupping. After sampling and upconcentration with a thin-film solid-phase microextraction (TF-SPME) membrane during cupping, analytes on the membrane were released via thermal desorption (TD) and then entered a dielectric barrier discharge ionization (DBDI) source mass spectrometer for analysis. Pork skin was first used as surrogate, and we were able to detect five volatile organic compounds that had previously been reported in the literature on the skin surface. Under optimized conditions, the limits of detection (LOD) ranged from 0.003 to 0.063 μg/cm², and a good reproducibility (relative standard deviation ≤8.7%) was achieved. In subsequent cupping experiments on human volunteers, we employed statistical analysis methods to analyze changes in the levels of compounds emanating from the human skin surface before and after cupping, correlated these changes with the clearance of chemicals as described by the detoxification theory. Compared to most previous studies, the method in this work is more convenient, more rapid, noninvasive and can be performed directly on the skin surface.

PMID:42267511 | DOI:10.1021/acs.analchem.6c02559

Curr Opin Cardiol. 2026 Jun 4. doi: 10.1097/HCO.0000000000001320. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Right ventricular size and function are vital to risk stratification in pulmonary hypertension, valvular disease, and congenital heart disease, yet right ventricular assessment remains technically demanding and subject to interpreter variability. This review aims to synthesize the rapidly expanding evidence on the application of artificial intelligence to RV structural and functional assessment across echocardiography, cardiac magnetic resonance (CMR), and computed tomography.

RECENT FINDINGS: Artificial intelligence has demonstrated accuracy approaching interobserver variability for automated right ventricular segmentation and chamber quantification across imaging modalities. Functional applications include artificial intelligence derived fractional area change, tricuspid annular plane systolic excursion, free-wall strain, and ejection fraction estimation compared against CMR. Emerging applications address right ventricular-pulmonary artery coupling and hemodynamic phenotyping through afterload-aware, physiology-centered models.

SUMMARY: Current artificial intelligence tools can standardize and accelerate established right ventricular measurements, with the strongest performance in echocardiographic segmentation, annular tracking, and ejection fraction surrogates. Translation into clinical practice will require robust external validation across disease phenotypes, hybrid artificial intelligence workflows that loop in humans, and prospective studies that display measurable impact on clinical efficiency and patient outcomes.

PMID:42267489 | DOI:10.1097/HCO.0000000000001320

Eur J Neurosci. 2026 Jun;63(11):e70580. doi: 10.1111/ejn.70580.

ABSTRACT

The aim of this study was to explore the associations between an aspect of self-regulation (SR), effortful control (EC) and cortical brain structure in 5-year-old children. Efficient EC is a predictor of many attributes and important outcomes in life, such as social-emotional functioning, finance, psychiatric and somatic health. The early brain correlates of EC are not widely studied, and a better understanding of them would aid in understanding how self-regulatory capacities emerge over development. Participants (N = 155) were a part of the FinnBrain Birth Cohort Study in Finland. T1-weighted brain magnetic resonance images were processed using FreeSurfer. The data were statistically analysed with a vertex-wise general linear model. At the age of 5 years, EC was assessed via parental report using The Children’s Behaviour Questionnaire. We found positive associations between EC and cortical volume in the left supramarginal region and in the right inferior temporal region. We also found positive associations between EC and surface area on the left hemisphere in the superior parietal region. We extended the previous literature by shedding light on early structural brain correlates of EC in a large sample of typically developing 5-year-olds. The main results differed significantly from previous findings in older children. The results were only present with questionnaire- and not task-based evaluation of EC. Both questionnaire and task-based evaluations are required to consider different aspects of EC and SR. In addition, longitudinal studies are needed to better understand the neural underpinnings of SR throughout development.

PMID:42267464 | DOI:10.1111/ejn.70580

Int J Aging Hum Dev. 2026 Jun 10:914150261456755. doi: 10.1177/00914150261456755. Online ahead of print.

ABSTRACT

Understanding the major purposes that individuals identify as central to their lives is fundamental to psychosocial health and life satisfaction. This study examined how major life purposes vary across six generational cohorts using categorical analysis. A sample of 364 participants was interviewed to assess their major life purposes. Results revealed statistically significant differences in life purpose distribution across generations, χ²(25) = 254.11, p < .001, Cramér’s V = .374. Family Responsibility emerged as the most prevalent overall purpose (37.4%), with particularly strong endorsement among Generation X (73.7%) and Baby Boomers (61.5%). The Silent Generation demonstrated the highest prioritization of Religious Obligations (57.1%), while younger generations (Alpha and Z) showed greater diversity in their life purposes, reflected in higher endorsement of “Mixed” categories (51.8% and 47.9%, respectively). These findings suggest important developmental and cohort-related differences in how individuals conceptualize meaning and purpose across the lifespan.

PMID:42267463 | DOI:10.1177/00914150261456755

Laryngoscope. 2026 Jun 10. doi: 10.1002/lary.70656. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the clinical efficacy and diagnostic precision of the Thomas Richard Vitton (TRV) chair compared to conventional maneuvers in uncomplicated Benign Paroxysmal Positional Vertigo (BPPV), identifying risk factors for recurrence and impact on quality of life.

METHODS: A prospective, randomized, open-label study was conducted. 102 patients were assigned to TRV chair or manual maneuvers. Clinical resolution, number of maneuvers, and recurrences were monitored over a 12-month follow-up. Quality of life was assessed via dizziness handicap inventory (DHI) and visual analog scale (VAS).

RESULTS: Eighty-nine patients completed follow-up (TRV = 44; manual = 45). No significant differences were found between groups in mean maneuvers for resolution (TRV: 2.25 ± 1.78; manual: 1.82 ± 1.23; p = 0.190). Both groups showed progressive reductions in DHI scores (TRV: 47.2 ± 25.1-10.6 ± 18.6; manual: 41.4 ± 22.2-11.6 ± 18.2; p < 0.001) and VAS scores (TRV: 5.3 ± 2.4-0.86 ± 1.4; manual: 4.3 ± 2.3-0.86 ± 1.4; p < 0.001), with no inter-group differences (p > 0.05). Notably, a trend toward faster resolution was observed in patients over 65 treated with the TRV chair. Advanced age and head trauma predicted increased maneuver requirements. Osteoporosis and prior BPPV episodes were associated with higher recurrence (p = 0.002). An inverse correlation was found between initial episode duration and time to first recurrence (ρ = -0.539, p = 0.005).

CONCLUSION: For uncomplicated BPPV, mechanical rotational chairs offer comparable efficacy and quality-of-life improvement to manual maneuvers. While not statistically superior for the general population, the TRV chair is a valuable tool for patients with mobility constraints.

PMID:42267460 | DOI:10.1002/lary.70656

Occup Ther Int. 2026;2026(1):e3715445. doi: 10.1155/oti/3715445.

ABSTRACT

AIM: The aim of this study was to investigate the effects of sensory integration therapy on balance, functional independence, functional mobility, sensory processing, and cognitive function in children with cerebral palsy.

METHODS: Twenty-two children with cerebral palsy attending a rehabilitation center participated in the study. Participants were randomly assigned to the study group (two females, nine males; 7.3 ± 1.7 years) and the control group (four females, seven males; 8.3 ± 1.4 years). Sociodemographic data were collected using a structured questionnaire. Balance was assessed with the Pediatric Berg Balance Scale, functional mobility with the Timed Up and Go Test, functional independence with WeeFIM, sensory processing with the Sensory Profile, and cognitive function with Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA-Ch). Both groups received balance and coordination exercises (1 session/week, 45 minutes), while the study group additionally received individualized sensory integration therapy (1 session/week, 45 min) for 12 weeks.

RESULTS: Both groups showed improvement in all measured variables after the intervention. Although both groups demonstrated improvements in Berg Balance Scale and Timed Up and Go Test scores following the intervention, no statistically significant between-group differences were observed (p > 0.05). Significant differences (p < 0.05) were found between groups in WeeFIM, DOTCA-Ch, and specific subscales of the Sensory Profile (sensory seeking, emotional response, inattention, sensory sensitivity, and perceptual fine motor domains).

CONCLUSION: Consistent with the hypothesis, sensory integration therapy combined with balance and coordination exercises was associated with improvements in balance, functional mobility, independence, sensory processing, and cognitive function in children with cerebral palsy. However, these findings should be interpreted cautiously because formal group × time interaction analyses were not performed.

PMID:42267458 | DOI:10.1155/oti/3715445

Cancer Med. 2026 Jun;15(6):e72001. doi: 10.1002/cam4.72001.

ABSTRACT

PURPOSE: To investigate the concordance and correlation between programmed death-ligand 1 (PD-L1) expression in tumor tissue and circulating tumor cells (CTCs), explore the intrinsic link between epithelial-mesenchymal transition (EMT) and PD-L1 expression in CTCs, and examine the predictive value of FDG metabolic parameters, CTCs and their PD-L1 expression for early tumor response and long-term prognosis in patients with advanced non-small cell lung cancer (NSCLC) receiving immune checkpoint inhibitor (ICI) monotherapy or ICI combined with chemotherapy as first-line treatment.

METHODS: A total of 42 patients with advanced or metastatic NSCLC who received ICI monotherapy or combination chemotherapy as first-line treatment were enrolled as the study population. Pre-treatment peripheral blood CTCs and PD-L1 expression on CTCs were detected. Furthermore, F-18-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) tumor metabolic parameters, including maximum standardized uptake value (SUVmax), standard uptake value of lean body mass (SUL), metabolic tumor volume (MTV), total lesion glycolysis (TLG), whole-body metabolic tumor volume (WMTV), and whole-body total lesion glycolysis (WTLG) were collected and measured. Tumor early response was monitored using response evaluation criteria in solid tumors (RECIST criteria) at 8 weeks after ICI treatment, and the differences in CTC PD-L1 expression, FDG metabolic parameters, and clinical data between early respongders and non-responders were analyzed. Finally, the enrolled patients were followed up to evaluate progression-free survival/overall survival (PFS/OS) and its associated predictive factors. Bootstrap internal validation (1000 repeated samples) was used to evaluate the robustness of the above prognostic model.

RESULTS: The percentage of PD-L1-positive cells in tumor tissue and CTC represents different immune characteristics of patients, and the correlation between these two percentages was not statistically significant (r = 0.041, p = 0.827). However, an intrinsic connection was identified between the EMT process and PD-L1 expression in CTCs, with PD-L1 expression in CTCs gradually increasing as the EMT process in CTCs changed. Furthermore, tumor proportion score (TPS) demonstrated a significant positive correlation with SUVmax (r = 0.684；p < 0.001) and SUL (r = 0.603；p < 0.01), with SUVmax and SUL increasing as TPS increased. Patients who exhibited an early response after 8 weeks of treatment had significantly higher SUVmax and SUL values, but lower mixed CTCs, than those in the non-response group (p < 0.05). The combination of SUVmax and PD-L1+ mixed CTCs yields a sensitivity of 81% and a specificity of 71% for predicting early response to ICI therapy in patients with NSCLC, but the combination did not result in a substantial enhancement in predictive efficacy. PD-L1+ mesenchymal CTCs (HR = 5.520, 95% CI 1.993-15.291) and WTLG (HR = 4.315, 95% CI 1.864-9.991) were identified as independent predictors of PFS, while PD-L1+ mesenchymal CTCs (HR = 2.880, 95% CI 1.124-7.381) were identified as independent predictors of OS. Bootstrap resampling analysis (B = 1000 iterations) revealed that PD-L1+ mesenchymal CTCs and WTLG achieve an apparent area under the ROC curve (AUC) of 0.822 for predicting PFS, with a bootstrap-corrected mean AUC of 0.821 (95% CI: 0.714-0.917). For OS prediction, PD-L1+ mesenchymal CTCs yielded an apparent AUC of 0.893 and a bootstrap-validated mean AUC of 0.88 (95% CI: 0.655-0.975). Furthermore, the combination of PD-L1+ mesenchymal CTCs and WTLG revealed that patients with WTLG < 1627.4 (g) and PD-L1+ mesenchymal CTCs < 1/5 mL exhibited prolonged PFS and OS (median PFS was 12.5 months; median OS was 18.5 months), while those with WTLG ≥ 1627.4 (g) and PD-L1+ mesenchymal CTCs ≥ 1/5 mL experienced the shortest PFS and OS (median PFS was 1.35 months; median OS was 3.0 months). Patients with PD-L1+ mesenchymal CTCs ≥ 1/5 mL or WTGL ≥ 1627.4 (g) exhibited a PFS and OS that fell between the two groups (median PFS was 6.0 months; median OS was 8.0 months). Stability analysis was conducted on the prognostic model after the combination of PD-L1+ mesenchymal CTCs and WTLG. Bootstrap resampling analysis (B = 1000 iterations) showed that the AUC value of the original ROC curve was 0.821, the mean AUC was 0.823 (95% CI: 0.716-0.914) when predicting PFS. For OS prediction, the AUC value of the original ROC curve was 0.875, the mean AUC was 0.874 (95% CI: 0.751-0.966).

CONCLUSION: EMT is associated with PD-L1 expression in CTCs, with CTCs exhibiting a mesenchymal phenotype tending to have higher PD-L1 expression. PD-L1+ mixed CTCs, SUVmax, and SUL were associated with early response to ICI-based treatment. Preliminarily, PD-L1+ mesenchymal CTCs, as an exploratory biomarker, were significantly associated with PFS and OS and may provide prognostic information complementary to conventional tissue-based PD-L1 assessment and FDG metabolic parameters. However, because PD-L1 expression in primary tumor tissue and CTCs was assessed using different detection methodologies, the observed discordance should be interpreted as potentially reflecting both biological heterogeneity and methodological variation. These findings require further validation in larger cohorts using harmonized detection platforms.

PMID:42267455 | DOI:10.1002/cam4.72001