Nevin Manimala

Clin Oral Investig. 2026 May 22;30(6):242. doi: 10.1007/s00784-026-06916-6.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the impact of sagittal and vertical skeletal patterns as well as gender on temporomandibular joint (TMJ) morphology using Cone Beam Computed Tomography (CBCT).

METHODS: A cross-sectional analysis was conducted on CBCT scans of 126 adult patients (63 females, 63 males) aged 20 to 40 years, stratified into Class I, II and III sagittal classifications and further divided by vertical patterns: horizontal, normal and vertical. Measurements included condylar dimensions (length, height, and width) and glenoid fossa dimensions (depth and width). Left and right TMJs were assessed and average values were used due to the absence of significant side differences. A multiple linear regression model was used to examine the effects of sagittal and vertical patterns and Gender on the parameter. Gender was included as a covariate in all models. Both an interaction model (vertical × sagittal pattern) and a main-effects-only model were considered with interaction effects accounted for where present. Model selection was based on statistical significance and model fit criteria. Pairwise comparisons were conducted using Tukey’s Honest Significant Difference (HSD) test and estimated marginal means (EMMs) were calculated where applicable. Statistical significance was set at p < 0.05 with adjustments for multiple comparisons.

RESULTS: For Condyle Height, a significant difference was found between Class III and Class I within the vertical pattern (VP) subgroup (p = 0.011). In contrast, Gender significantly influenced Condyle Length (p = 0.009) and a significant difference was found between Class II and Class I (p = 0.01). Subgroup analysis revealed a significant difference between Class II and Class I in the VP group (p = 0.023). For Condyle Width, a significant interaction between VP and Class III was found (p = 0.029). Significant pairwise differences were observed between HP-Class II and VP-Class III (p = 0.023), NP-Class II and VP-Class III (p = 0.007), and HP-Class III and VP-Class III (p = 0.013). Within the NP subgroup, Class II differed significantly from Class I (p = 0.044). Analysis of Glenoid Fossa Width revealed a significant interaction between NP and Class III (p = 0.048). Multiple significant pairwise differences were identified, including NP-Class I versus HP-Class II (p = 0.002), NP-Class I versus NP-Class II (p = 0.004), and VP-Class II versus HP-Class III (p = 0.004). Regarding glenoid fossa depth, a significant interaction between VP and Class III was found (p = 0.037), but no pairwise subgroup differences reached statistical significance (all p > 0.05).

CONCLUSIONS: This study demonstrates that TMJ morphology is variably influenced by vertical and sagittal skeletal patterns and gender. Significant differences in condyle length and width as well as glenoid fossa width were primarily observed in individuals with vertical patterns and Class II or III skeletal relationships. Gender significantly affected condyle length. While glenoid fossa depth showed a high interaction between vertical pattern and sagittal skeletal relationships, no individual comparisons reached statistical significance. These findings underscore the nuanced interplay of sagittal and vertical skeletal patterns in shaping TMJ morphology.

PMID:42168666 | DOI:10.1007/s00784-026-06916-6

Neurol Sci. 2026 May 22;47(6):511. doi: 10.1007/s10072-026-09105-1.

ABSTRACT

BACKGROUND: Total cerebral small-vessel disease (cSVD) score is a well-established predictor of vascular risks. However, the specific type of recurrent stroke associated with cSVD scores remains unclear in hemorrhage-prone patients-those with cerebral microbleeds (CMBs) or prior intracerebral hemorrhage (ICH).

METHODS: This study was a post hoc analysis of 1,454 patients enrolled in a prospective, multicenter, randomized controlled trial. Patients were categorized by modified cSVD (m-cSVD) scores 1-3. One point was awarded for each of the following: white matter hyperintensities (WMH) above the median, ≥2 CMBs or 1 ICH, and ≥1 lacune. The primary outcome was any stroke; secondary outcomes were ischemic and hemorrhagic stroke; the tertiary outcome was major adverse cardiovascular events (MACE). Multivariable Cox regression analysis was used to investigate associations between m-cSVD scores and events.

RESULTS: During a mean 1.9-year follow-up, the incidence rate per 100 person-years for ischemic stroke increased significantly with m-cSVD scores (1.9, 2.8, and 5.7, respectively). Compared to score 1, m-cSVD score 3 was associated with a higher risk of ischemic stroke (adjusted HR 2.72; 95% CI 1.03-7.18) and MACE (adjusted HR 2.34; 95% CI 1.08-5.10). While the incidence of hemorrhagic stroke showed a numerical increase (0.5, 0.8, and 1.5), this association did not reach statistical significance (unadjusted HR 3.05; 95% CI 0.66-14.14).

CONCLUSION: A high m-cSVD burden was independently associated with recurrent ischemic stroke, but not hemorrhagic stroke, in patients with high bleeding risk. High cSVD burden may reflects elevated ischemic risk, warranting careful consideration of ischemic stroke prevention even in patients with hemorrhagic potential.

PMID:42168664 | DOI:10.1007/s10072-026-09105-1

Sci Rep. 2026 May 21. doi: 10.1038/s41598-026-53110-5. Online ahead of print.

ABSTRACT

Machine Learning (ML) and Artificial Intelligence (AI) are important tools for modelling drying processes to reduce moisture and preserve food products. This study investigated the drying performance of an industrial infrared conveyor belt drying system on onion slices under different drying conditions. The effects of drying temperature, infrared intensity, and airflow rates were evaluated. The results demonstrated that increasing IR power and air temperature significantly reduced drying time by 44.23%. Effective moisture diffusivity increased from 0.238 × 10⁻¹⁰ to 0.457 × 10⁻¹⁰ m²/s, indicating enhanced internal moisture transport at elevated thermal inputs. The lowest Sect. (10.72 kWh/kg) was achieved at 600 W, 65 °C, and 0.3 m/s, while the highest (22.26 kWh/kg) occurred at low temperature and high airflow conditions. Thermal efficiency improved with increasing temperature and radiation intensity, reaching a maximum of 21.92%. However, the Artificial Neural Network model exhibited excellent predictive capability with a correlation coefficient (R) of 0.999, accurately estimating key drying parameters. Self-Organizing Map (SOM) analysis identified distinct operational clusters, revealing that higher air temperature and IR power reduced drying time and energy consumption, whereas increased airflow increased energy usage. Therefore, the study demonstrates that integrating AI and statistical tools provides a robust framework for optimizing industrial drying systems, enabling reduced energy consumption and improved process efficiency.

PMID:42168663 | DOI:10.1038/s41598-026-53110-5

Nat Neurosci. 2026 May 21. doi: 10.1038/s41593-026-02302-3. Online ahead of print.

ABSTRACT

Multiple sclerosis (MS) is a chronic neuroinflammatory disease in which demyelinating white matter lesions accumulate and expand, driving irreversible disability. Here we identify a distinct population of foamy GPNMB⁺ microglia/macrophages associated with lesion expansion in secondary progressive MS. Using integrated lipidomic, transcriptomic, proteomic, chemical proteomic and histological analyses of human postmortem MS lesions, we show that lesions containing foamy microglia/macrophages exhibit disrupted lipid metabolism, lysosomal stress and markers associated with heightened phagocytosis and antigen presentation without classical pro-inflammatory signatures. These lesions are enriched for oxylipins, bismonoacylglycerolphosphates and cholesterol esters, and are associated with increased B cell infiltration and IgG1. Monoacylglycerol lipase (MAGL), a lipid-metabolizing enzyme enriched in lesions with foamy microglia/macrophages, emerged as a potential therapeutic target. Inhibition of MAGL promoted lesion recovery and reduced microgliosis in a mouse model of demyelination. Finally, oxylipins in cerebrospinal fluid correlate with the proportion of foamy lesions, suggesting potential biomarkers for progression. Our findings implicate disturbed lipid metabolism in chronic MS pathology and suggest that foamy microglia/macrophages are an interesting cell type to target for progressive disease.

PMID:42168651 | DOI:10.1038/s41593-026-02302-3

Eur J Nucl Med Mol Imaging. 2026 May 22. doi: 10.1007/s00259-026-07886-3. Online ahead of print.

ABSTRACT

PURPOSE: The 2024 Alzheimer’s Association Workgroup research framework designates tau proteinopathy (T₂) as a key element for Alzheimer’s disease (AD) staging, but optimal staging approaches have yet to be determined. Here, we compared visual and quantitative tau-PET-based Braak staging as candidate strategies to implement T₂ biological staging in vivo.

METHODS: We included 140 participants from the TRIAD cohort who underwent [¹⁸F]MK6240 tau-PET. Quantitative Braak staging (qBraak) was derived from regional SUVR thresholds, whereas visual Braak staging (vBraak) was independently performed by three nuclear medicine physicians using an adapted interpretation algorithm. Inter-rater and inter-method agreement were assessed using Cohen’s and Fleiss’ κ statistics. Associations with clinical severity, cortical thickness, plasma pTau217, and cortical tau extent were examined. Diagnostic performance for identifying amyloid-positive cognitively impaired individuals was evaluated.

RESULTS: vBraak demonstrated substantial to nearly perfect inter-rater agreement (κ = 0.65-0.93). Agreement between vBraak and qBraak was moderate when stages were treated categorically (κ = 0.51), but substantial when their ordinal nature was considered (weighted κ up to 0.73). Both strategies showed comparable associations with clinical severity and neurodegeneration. vBraak was more sensitive to amyloid-β-positive cognitive impairment and identified intermediate-stage involvement at lower global tau extent. Visual-quantitative discordant cases were primarily attributable to off-target binding or spatially heterogeneous tau patterns.

CONCLUSION: Both vBraak and qBraak staging provide complementary and largely concordant approaches for operationalizing T₂ staging. Quantitative methods enable scalable, group-level analyses, whereas visual assessment remains essential for identifying atypical tau patterns and informing clinically relevant decision-making.

PMID:42168643 | DOI:10.1007/s00259-026-07886-3

Rheumatol Int. 2026 May 21;46(6):95. doi: 10.1007/s00296-026-06134-z.

ABSTRACT

Hypermobile Ehlers-Danlos Syndrome (hEDS) is associated with joint hyperflexibility, pain, and connective tissue frailty. Patients are at high risk for fracture due to poor proprioception. This study reports on the mental and physical health, pain, physical activity, and kinesiophobia in patients with hEDS, and explores bone mineral density and fracture risk. This single-center, cross-sectional prospective study was approved by the IRB (HHC-2022-0143). Patients with diagnosed hEDS were consented and completed demographic forms, activity levels, PROMIS-10 Global Health Assessments, and the Tampa Kinesiophobia Scale, prior to DXA (Dual-energy X-ray absorptiometry) scans. Descriptive and inferential statistics were conducted including correlations and univariate regression analyses. All patients were female and pre-menopausal with a mean age of 36 (range: 19-55). Patients maintained an overall adequate bone mineral density (Spine: 1.16 ± 0.12 g/cm³, Femur: 0.961 ± 0.09 g/cm³ ) though three patients were identified as osteopenic and 50% had fractured as an adult. The PROMIS-10 mental health T-score and pain were strongly negatively correlated (r_s = -0.87, p < 0.001) as were the PROMIS-10 physical function T-score and pain (r_s = -0.78, p < 0.001). Kinesiophobia was negatively correlated with low mental health (r_s = -0.56, p = 0.03) and with physical function T-scores (r_s = -0.75, p < 0.001). This study illustrates the association of mental health, physical function, chronic pain, and kinesiophobia in this unique patient population. Patients had higher fracture incidence without a significant reduction in bone mineral density. Future interventions could be directed at exploring disease-specific rehabilitation programs.

PMID:42168630 | DOI:10.1007/s00296-026-06134-z

Surg Endosc. 2026 May 21. doi: 10.1007/s00464-026-12921-3. Online ahead of print.

ABSTRACT

BACKGROUND: Although endoscopic submucosal dissection (ESD) is widely accepted for early gastric cancer (EGC), its role in managing undifferentiated-type EGC (UD-EGC) is still debated. This multicenter study aimed to compare the short- and long-term outcomes of ESD and surgery in patients with UD-EGC.

METHODS: We retrospectively analyzed patients with UD-EGC who underwent ESD or surgery at 11 tertiary centers in Taiwan between 2007 and 2025. Inclusion criteria included intramucosal tumors ≤ 20 mm without ulceration or lymphovascular invasion. Demographic, endoscopic, and pathological data were collected, and long-term outcomes were compared.

RESULTS: A total of 37 ESD and 42 surgery patients were analyzed. En bloc resection was achieved in all cases. R0 resection rates were 86% for ESD and 98% for surgery in unadjusted analysis (P = 0.06), while propensity score-weighted analysis showed significantly higher R0 resection in the surgery group (85.8% vs. 98.7%, P = 0.017). The ESD group demonstrated significantly shorter procedure times (84.6 vs. 285.7 min, P < 0.001) and hospital stays (6.8 vs. 17.6 days, P < 0.001). Complication rates were comparable between groups (11% for ESD vs. 14% for surgery, P = 0.74). In unadjusted analyses, the cumulative incidence of recurrence was higher in the ESD group than in the surgery group (P = 0.03), whereas overall survival (OS) was similar between groups (5-year OS: 93% for ESD vs. 90% for surgery; log-rank P = 0.12). After propensity score overlap weighting, the difference in recurrence between groups was attenuated and no longer statistically significant (P = 0.22).

CONCLUSIONS: Although ESD is less invasive with shorter procedure time and hospital stay, its lower R0 resection rate and higher recurrence risk require careful patient selection and close surveillance. Similar OS supports the potential role of ESD in selected UD-EGC patients, although further validation is needed.

PMID:42168610 | DOI:10.1007/s00464-026-12921-3

Sci Rep. 2026 May 21. doi: 10.1038/s41598-026-51501-2. Online ahead of print.

ABSTRACT

Cell type markers have been instrumental to physiological and molecular investigation of the human brain and remain essential for annotating cell type clusters in single-cell expression data and for target validation studies. However, expression of canonical markers in the target cell type (which we termed as the expression ‘fidelity’) as well as expression in unrelated cell types (which we termed as the ‘background expression’) across cortical regions remains poorly characterized. Here, leveraging nearly 500,000 high-quality single-nucleus and single-cell profiles from 19 studies, we quantified marker fidelity, revealing substantial regional variability. We developed a statistical framework that aggregates annotated barcodes into pseudo-bulk profiles, applied rigorous performance metrics, and identified markers with high fidelity, low background, and consistent expression across regions. This approach extended the canonical marker set for six major brain cell types and yielded superior subtype-specific markers. The resulting marker lists, and a user-friendly analysis interface, provide a valuable resource for cell type annotation and validation in neuroscience research.

PMID:42168596 | DOI:10.1038/s41598-026-51501-2

Prev Vet Med. 2026 May 17;254:106916. doi: 10.1016/j.prevetmed.2026.106916. Online ahead of print.

ABSTRACT

INTRODUCTION: This review evaluates the effectiveness of culling and birth control interventions for managing free-roaming dogs (FRD) and cats (FRC) worldwide across key outcome domains-population metrics, zoonotic disease indicators, shelter indicators, public metrics, animal welfare, ecological externalities, and cost-effectiveness-and identifies contextual conditions determining intervention effectiveness.

METHODS: Following PRISMA, we conducted three separate systematic searches in PubMed, Web of Science, and Scopus (up to 16 October 2025) addressing culling, birth control, and modelling studies. Empirical evidence was synthesised using descriptive, stratified analyses. Modelling studies were synthesised to identify conditions associated with effectiveness.

RESULTS: Ninety-one empirical studies were included (33 culling; 58 birth control), alongside 18 modelling studies. Birth control interventions were more frequently classified as effective than culling, with statistically significant differences in effectiveness distributions between intervention types (p = 0.045). Culling effectiveness was context-dependent and largely confined to island systems, particularly for FRC, while FRD-targeted culling was rarely effective, especially for zoonotic disease indicators and public metrics. Birth control-particularly multi-component, long-term programmes-showed higher effectiveness across domains and in open mainland settings. Temporal analyses showed a decline in both the volume and reported effectiveness of culling studies since 2010, alongside increasing and geographically broader evidence for birth control. Modelling studies identified high population coverage, sustained implementation, and control of population inflow as key conditions for effectiveness.

CONCLUSIONS: Culling has limited, context-dependent effectiveness, whereas birth control within integrated strategies more consistently achieves sustained outcomes across domains. Effectiveness depends on coverage, duration, and addressing drivers of population inflow, including abandonment and uncontrolled breeding.

PMID:42166825 | DOI:10.1016/j.prevetmed.2026.106916

JMIR Res Protoc. 2026 May 21;15:e87165. doi: 10.2196/87165.

ABSTRACT

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are significant global health concerns, particularly prevalent in low- and middle-income countries (LMICs). In China, a significant number of international migrants from LMICs reside, many of whom are at high risk of HBV and HCV infection, while this group tends to engage in low HBV and HCV test use due to some adverse factors. Pay-it-forward (PIF) is a social innovation strategy that is based on the theories of upstream reciprocity and mutual aid. Previous studies have shown that the PIF strategy has proven effective in promoting sexually transmitted infections (STIs) testing in various populations.

OBJECTIVE: This study aims to evaluate the effectiveness of a PIF intervention in promoting HBV and HCV testing among international migrants from LMICs in China.

METHODS: A 2-arm cluster randomized controlled trial (RCT) will be conducted in Guangzhou, China. Participants will be recruited from a public hospital serving a large migrant community. A total of 100 eligible participants will be enrolled in blocks of 5 using a cluster randomization plan and randomly assigned to either the PIF intervention arm or the control arm in a 1:1 ratio. Participants in the intervention arm will watch a 2-minute video introducing the PIF concept and receive printed educational materials on HBV and HCV. Participants will then be offered free testing donated by previous participants, which they can accept or decline, and an opportunity to make a monetary donation to cover testing for a future participant. Control arm participants will receive standard medical services, with self-paid testing. The primary outcome is the proportion of participants tested for both HBV and HCV. Data will be collected through a self-administered questionnaire, and test information will be obtained from the hospital’s medical records without personally identifiable information. The survey data will be analyzed using generalized estimating equations to account for clustering effects.

RESULTS: This protocol was completed in August 2024, and implementation was conducted from September 2024 to February 2025. According to the baseline survey findings, 73.0% (73/100) of the 100 eligible participants recruited were male, 87.0% (87/100) were from African countries, and 85.0% (85/100) came to China for business purposes. About 40.0% (40/100) earned more than US $1100 per month, 62.0% (62/100) were married, and 6% (6/100) had both stable and casual sexual partners.

CONCLUSIONS: This study is innovative in targeting international migrants from LMICs in China and using the PIF strategy to promote HBV and HCV testing. The PIF intervention is expected to increase testing rates by addressing financial barriers and fostering community support. The findings will contribute to the understanding of HBV and HCV testing promotion among this understudied population, with potential implications for public health policy and practice.

PMID:42166794 | DOI:10.2196/87165