Nevin Manimala

Pol Przegl Chir. 2026 Jan 27;98(2):13-18. doi: 10.5604/01.3001.0055.5916.

ABSTRACT

<b>Introduction:</b> Colorectal cancer (CRC) is the second most common cancer worldwide. Much attention has recently been paid to the epigenetic features of CRC. Homologous recombination repair (HRR) is a biochemical pathway that plays a crucial role in maintaining genome integrity through the repair of double-strand breaks (DBS). <i>RAD51</i> recombinase is widely considered a key enzyme in HRR. Genome-wide single nucleotide polymorphisms (SNPs) are a significant type of genetic variation.<b>Aim:</b> The aim of this study was to assess the association between the occurrence of individual genotypes/alleles of the <i>RAD51</i> 172G/T polymorphism (rs1801321) and the risk of CRC.<b>Materials and methods:</b> The material used for DNA isolation was peripheral blood from patients at the Department of General and Colorectal Surgery, Medical University of Lodz. The study recruited patients (n = 188) with histologically confirmed colorectal cancer. The control group consisted of undiagnosed individuals (n = 200), matched for age and gender, without a family history of cancer among first-degree relatives.<b>Results:</b> No statistically significant association was found between the frequency of the assessed alleles/genotypes and the presence of CRC. The analysis also showed that the 127G/T variant of the RAD51 gene was not statistically significantly associated with the development of colorectal cancer.<b>Discussion:</b> The 127G/T polymorphism of the <i>RAD51</i> gene appears to be an unpromising marker for colorectal cancer. However, new observations regarding the variant in the distal promoter may open up prospects for future research on molecular markers.<b>Conclusions:</b> The study results indicate no association between the <i>RAD51</i> 172G/T polymorphism and the risk of CRC. Therefore, there is a need for further research in the area of selected polymorphisms in CRC.

PMID:42178953 | DOI:10.5604/01.3001.0055.5916

Int J Rheum Dis. 2026 May;29(5):e70713. doi: 10.1111/1756-185x.70713.

ABSTRACT

INTRODUCTION: Systemic Lupus Erythematosus (SLE) presents a significant diagnostic challenge for clinicians due to its diverse clinical manifestations and overlap with other autoimmune conditions. Large Language Models (LLMs) are currently regarded as having the potential to assist clinicians in expediting decision-making. This study aimed to evaluate the performance of four LLMs in differentiating SLE from clinically mimicking conditions.

METHODS: A retrospective diagnostic accuracy study was conducted involving 100 patients at a rheumatology center: 50 patients with confirmed SLE and 50 non-SLE patients with conditions including rheumatoid arthritis, systemic sclerosis, axial spondyloarthritis, psoriatic arthritis, myositis, ANCA-associated vasculitis, mixed connective tissue disease, undifferentiated connective tissue disease, and fibromyalgia. Four LLMs were evaluated: Deepseek, ChatGPT 4.0, Claude Sonnet 4, and Gemini. The 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology (EULAR/ACR) classification criteria were applied. Diagnostic accuracy, positive predictive value (PPV), negative predictive value (NPV), and Area Under the Receiver Operating Characteristic Curve (AUC) were calculated. IBM SPSS Statistics version 25 was used for all analyses.

RESULTS: Gemini achieved the highest performance score, with an accuracy of 96% (95% CI: 91.2-100.0%), sensitivity of 94% (95% CI: 89.3-98.7%), specificity of 98% (95% CI: 93.1-100.0%), and an AUC of 0.960. ChatGPT 4.0 and Claude Sonnet 4 exhibited comparable accuracy. Deepseek recorded the lowest performance score.

CONCLUSION: Gemini demonstrated significant potential to assist clinicians in differentiating SLE from mimicking conditions. Nevertheless, prospective validation in real-world clinical settings is required before these tools can be reliably integrated into clinical practice.

PMID:42178941 | DOI:10.1111/1756-185x.70713

Pediatr Transplant. 2026 May;30(5):e70348. doi: 10.1111/petr.70348.

ABSTRACT

BACKGROUND: The quadratus lumborum (QL) and transversus abdominis plane (TAP) blocks reduce opioid consumption and pain scores in adult renal transplantation. However, their efficacy in pediatric renal transplantation remains unknown. This retrospective study investigates the effect of different regional anesthesia techniques on postoperative opioid consumption and recovery outcomes following pediatric renal transplantation.

METHODS: Retrospective review of pediatric patients undergoing renal transplantation at a single academic children’s hospital between January 2019 and September 2023. Patients received either an anterior QL block with contralateral RS block (QL/RS group), high-dose TAP block (hTAP group), low-dose TAP block (lTAP group), or no block (control group). The primary aim was to compare postoperative opioid consumption. The secondary outcomes were intraoperative opioid consumption, median operative time, time to extubation, and length of stay (LOS) in the intensive care unit (ICU) and hospital.

RESULTS: There was no difference in opioid consumption in milligram morphine equivalents per kilogram (MME/kg) on postoperative days (POD) 0 and 1 between each block group as compared to the no block group. The QL/RS group had the shortest time to extubation, with all patients extubated in the operating room (compared to 5.2 ± 21.2 h in the hTAP group, 2.4 ± 7.8 h in the lTAP group, and 10.9 ± 22.6 h in the no block group). There was no difference in ICU LOS. The QL/RS, hTAP, lTAP groups all had shorter overall hospital LOS (median days [95% CI]: 6.3 [5.6, 6.6], p = 0.01; 6.4 [5.6, 7.2], p = 0.02; 5.6 [4.4, 6.9], p = 0.01; respectively) as compared to the no block group (7.3 [6.6, 8.5] days).

CONCLUSION: Although there was no significant difference in postoperative opioid consumption between groups, the QL/RS block group was associated with the shortest time to extubation, with all patients extubated in the operating room. All block groups had reduced overall hospital LOS compared to the no block group. Both QL/RS and TAP blocks may offer benefits in perioperative recovery, warranting further prospective investigation to optimize regional anesthesia strategies for pediatric renal transplant recipients.

PMID:42178914 | DOI:10.1111/petr.70348

Laryngoscope. 2026 May 24. doi: 10.1002/lary.70634. Online ahead of print.

ABSTRACT

OBJECTIVE: This systematic review explores the natural history of residual and recurrent juvenile nasopharyngeal angiofibromas (JNAs) to inform clinical decision-making.

DATA SOURCES: PubMed, Embase, Scopus, and Web of Science.

REVIEW METHODS: A systematic literature review was conducted according to PRISMA guidelines across PubMed, Embase, Scopus, and Web of Science from inception to February 20, 2025 and was re-run on September 21, 2025. Studies included patients with advanced JNA and documented follow-up of residual or recurrent disease. Descriptive statistics, chi-squared analysis, and analysis of variance were used to evaluate treatment outcomes across different modalities including surgery, radiotherapy, gamma knife surgery, and medical therapies.

RESULTS: Twenty-one studies encompassing 131 male patients (mean age 16.3 years) were included. Residual or recurrent disease demonstrated complete involution in 41%, stable disease in 29%, and reduction in size in 25% of cases. Only 2% of patients had progressive disease. A statistically significant association was observed between treatment modality and outcome (p = 0.015), with radiotherapy, either alone, or as part of a multimodal approach, showing the highest rates of spontaneous involution.

CONCLUSION: Residual and recurrent JNAs often remain stable or regress without further intervention. Close surveillance with imaging is a safe and effective strategy for asymptomatic patients, minimizing the risks of additional treatment in a young patient population with disease near critical anatomical structures.

PMID:42178599 | DOI:10.1002/lary.70634

Virol J. 2026 May 24. doi: 10.1186/s12985-026-03201-6. Online ahead of print.

ABSTRACT

Viruses strongly depend on the host cell for efficient replication and influenza A virus (IAV) amongst others also lead to remarkable changes of the host cell metabolism. The restriction of virus replication through suppression of glucose metabolism has already been described. In addition to glycolysis and glutaminolysis, viral replication also relies on the tricarboxylic acid (TCA) cycle. So far, the metabolic key intermediate of the TCA cycle, oxaloacetate (OAA), is described to enhance glycolysis and respiration flux rates under metabolic stress conditions. However, the mode of action of the metabolic fuel intermediate OAA in direct relation to influenza viral growth under strong glycolysis inhibition remains unclear. As the TCA cycle acts as a central metabolic hub linking all major metabolic pathways, the effects of OAA under glycolysis inhibition were examined in greater detail in this study. We aimed to get a better understanding of metabolic host-virus interactions and to analyze the effects of metabolic fueling intermediates on IAV replication under glycolysis inhibition. We inhibited glycolysis and supplemented IAV infected cells with the metabolic fueling intermediate OAA. Inhibition of glycolysis led to a statistically significant reduction of viral titers while OAA addition reversed the antiviral effects such as reduced viral protein accumulation, viral titers, and vRNA expression. In line with previous studies, we showed that mannose, which is closely connected to glycolysis, circumvents the virus restricting effects of glycolysis inhibition. Moreover, we demonstrated that supplementation of mannose or OAA led to a roughly comparable replication recovery under strong inhibition of glycolysis. Furthermore, mass spectrometry-based metabolomics data revealed a strong accumulation of pyruvate in OAA supplemented samples. Finally, comparing OAA and pyruvate rescuing capacities of IAV growth under glycolysis inhibition tended to show similar activities for both metabolites arguing that OAA mediated IAV rescue is achieved through its conversion to pyruvate. Summarizing, our data indicate that the TCA cycle intermediate OAA has virus supporting effects as it reversed the antiviral effects of glycolysis inhibition.

PMID:42178590 | DOI:10.1186/s12985-026-03201-6

BMC Psychol. 2026 May 25. doi: 10.1186/s40359-026-04836-4. Online ahead of print.

ABSTRACT

BACKGROUND: Workplace violence (WPV) represents a growing global health and occupational safety concern, with significant implications for employees’ well-being and job satisfaction as well as organizational performance. This study explores the prevalence of non-physical WPV, specifically perceived sexual harassment (PSH) and perceived gender discrimination (PGD), and examines their potential adverse outcomes such as job stress and intention to leave employment across the public and private sectors in Saudi Arabia.

METHODS: A cross-sectional online survey using non-probability purposive sampling was conducted from November 2023 to March 2025, involving 558 employees from 20 public and private sector organizations in Saudi Arabia. Descriptive statistics and multivariable generalized linear models with gamma regression were used for the analysis.

RESULTS: The mean PSH score was 18.5 (SD = 5.98) and the mean PGD score was 19.6 (SD = 7.97). The multivariable generalized linear models indicated that PGD was associated with higher PSH (adjusted rate ratio = 1.009, 95% CI [1.007, 1.012]) and that elevated job stress was associated with increased PSH (adjusted rate ratio = 1.005, 95% CI [1.002, 1.009]) and PGD (adjusted rate ratio = 1.015, 95% CI [1.010, 1.021]).

CONCLUSIONS: Non-physical forms of WPV, including PSH and PGD, are prevalent across workplace settings in Saudi Arabia and are associated with adverse psychological and occupational outcomes. The results underscore the necessity for organizational policies and psychologically informed workplace interventions to mitigate harassment and discrimination, enhance employee well-being, and foster safer workplace environments.

PMID:42178581 | DOI:10.1186/s40359-026-04836-4

Inj Epidemiol. 2026 May 24. doi: 10.1186/s40621-026-00690-5. Online ahead of print.

ABSTRACT

BACKGROUND: Mass public shootings represent a significant source of fatal and nonfatal injury in the United States. This study examines patterns of strain among individuals who carried out these events, with attention to the prevalence, co-occurrence, and cumulative burden of stressors.

METHODS: Data were drawn from a database of mass public shootings in the United States from 1999 to 2024, comprising 171 incidents and 175 perpetrators. Information was collected using a structured, multi-source approach including official records, secondary reports, and triangulated media sources. Eighteen dichotomous indicators of strain were coded. Descriptive statistics assessed prevalence and cumulative strain, and phi coefficients examined pairwise associations.

RESULTS: Perpetrators experienced multiple, overlapping forms of strain (mean = 4.78; SD = 2.78). Psychiatric concerns, job-related difficulties, and interpersonal stressors were most common. Strains frequently co-occurred, with strong associations among interpersonal and psychological factors and between structural stressors and ideological motivations. Most perpetrators experienced multiple concurrent stressors, indicating that these events rarely are preceded by a single, isolated grievance.

CONCLUSIONS: Mass public shootings may be better understood as the result of cumulative and co-occurring strains rather than isolated risk factors. Injury and violence prevention efforts may be strengthened by emphasizing patterns of stressors, early identification, and coordinated, systems-level responses, including threat assessment.

PMID:42178574 | DOI:10.1186/s40621-026-00690-5

BMC Nutr. 2026 May 25. doi: 10.1186/s40795-026-01371-8. Online ahead of print.

ABSTRACT

BACKGROUND: Vitamin D deficiency remains a major public health concern in the Middle East and North Africa despite abundant sunlight. The public’s understanding of vitamin D sources, risk factors, and preventive practices may influence recognition and prevention of deficiency, yet data from Palestine remain limited. This study assessed awareness and knowledge of vitamin D deficiency among Palestinian adults recruited online and examined whether knowledge differed according to sociodemographic characteristics and vitamin D-related experiences.

METHODS: An analytical online cross-sectional study was conducted among Palestinian adults using an adapted Arabic self-administered questionnaire distributed through social media between November and December 2025. The instrument assessed sociodemographic characteristics, vitamin D-related experiences, and knowledge across benefits, sources/determinants, and toxicity domains. Knowledge scores ranged from 0 to 14, and scores greater than 7 were classified as adequate knowledge, consistent with the source instrument. Descriptive statistics, bivariate analyses, and multivariable logistic regression were performed using SPSS version 25.

RESULTS: A total of 756 respondents were included (mean age 27.5 ± 9.9 years; 79.1% female). The mean knowledge score was 10.21 ± 2.25, and 88.8% of participants were classified as having adequate knowledge. Correct responses were highest for skeletal benefits and the role of sun exposure in vitamin D production. Lower correct response rates were observed for items related to vitamin D toxicity, vegetarian-related risk, and the effect of darker skin pigmentation on deficiency risk. Higher mean knowledge scores were observed among males, single participants, participants without children, and those who had undergone vitamin D testing or had taken supplements. However, no independent predictors of adequate knowledge were identified in the adjusted logistic regression model.

CONCLUSIONS: Palestinian adults in this online non-probability sample demonstrated a generally high level of vitamin D knowledge, particularly regarding bone health and sun exposure. However, important gaps persisted in specific domains, especially toxicity and less commonly recognized risk factors. Because the sample was recruited online and was disproportionately female and highly educated, the findings should be interpreted as descriptive of this sampled group rather than representative of all Palestinian adults.

PMID:42178572 | DOI:10.1186/s40795-026-01371-8

Int J Ment Health Syst. 2026 May 24. doi: 10.1186/s13033-026-00713-0. Online ahead of print.

ABSTRACT

BACKGROUND: The practice of electroconvulsive therapy (ECT) is constrained by limited resources. Anticipating recurrent peaks in demand is therefore essential for optimizing resource planning within public healthcare systems. This study examined seasonal patterns of ECT utilization in France over an extended period.

METHOD: We analyzed data from the French national administrative and medical database. Seasonal patterns in monthly ECT utilization time series from 2017 to 2023 were investigated using robust statistical methods.

RESULTS: We observed a clear seasonal pattern with a 12-month periodicity in monthly ECT utilization, accounting for 16% of the variance in use, with a major peak in December and a mean relative amplitude of 13.1%. Seasonal variation was observed across sex, age and diagnostic subgroups, although it was less pronounced among patients aged 24 years or younger and those with schizophrenia. Across all subgroups, ECT activity consistently peaked at the onset of winter, between November and December.

CONCLUSION: These findings emphasize the need for ECT providers in France to anticipate recurrent winter peaks in activity. Proactive healthcare policies should ensure that medical staffing and equipements ressources are adjusted to accommodate predictable winter peaks in ECT demand.

PMID:42178564 | DOI:10.1186/s13033-026-00713-0

Popul Health Metr. 2026 May 25. doi: 10.1186/s12963-026-00487-0. Online ahead of print.

ABSTRACT

BACKGROUND: Gastric cancer has historically been driven by long‑standing Helicobacter pylori infection. The nationwide expansion of H. pylori eradication therapy beginning in 2013 created a unique opportunity to evaluate its population‑level impact on gastric cancer mortality. However, short‑term mortality trends following eradication are difficult to interpret because they reflect overlapping influences of ageing, cohort replacement, and cumulative infection history. This study aimed to provide a model‑based, population‑level assessment of the early impact of eradication during the first decade of nationwide implementation.

METHODS: We applied a two‑layer analytic framework consisting of a counterfactual analysis comparing observed mortality during 2013-2021 with expected mortality had eradication uptake remained at pre‑2013 levels, combined with a structured state‑transition (Markov) model with time‑dependent parameters. To estimate annual gastric cancer deaths prevented and the proportion of mortality reduction attributable to eradication, the model integrated age‑specific biological hazard, cumulative infection history, cohort‑specific H. pylori prevalence, and annual changes in eradication uptake.

RESULTS: Observed gastric cancer deaths declined from 48,632 in 2013 to 41,624 in 2021, whereas counterfactual gastric cancer deaths declined more modestly, from 49,779 to 49,453. The divergence between observed and counterfactual deaths steadily widened from 1,147 in 2013 to 7,829 in 2021. Model‑based estimates indicated that eradication prevented 6,461 gastric cancer deaths during 2013-2021, with annual deaths prevented increasing from 165 in 2015 to 1,604 in 2021, particularly among adults aged 60-79, who showed the most pronounced early benefit reflecting cumulative infection history and real-world uptake patterns.

CONCLUSIONS: The early population‑level impact of H. pylori eradication is consistent with a 16% reduction in gastric cancer deaths by 2021. These findings provide real‑world insight into how primary prevention can shape short‑term national cancer trends. This approach offers a quantitative framework to inform future prevention strategies in high‑prevalence settings seeking to evaluate early implementation effects.

PMID:42178557 | DOI:10.1186/s12963-026-00487-0