Nevin Manimala

Ann Plast Surg. 2026 Jan 26. doi: 10.1097/SAP.0000000000004672. Online ahead of print.

ABSTRACT

BACKGROUND: Age-related physiological changes may influence surgical outcomes following breast reduction. This study investigates the association between patient age and postoperative complications using a large institutional cohort.

METHODS: We retrospectively reviewed 985 patients who underwent bilateral reduction mammaplasty between 2002 and 2024 by a single surgeon. Patients were stratified by age into 3 groups: <31, 31 to 50, and >50 years. Baseline demographics, comorbidities, surgical techniques, and complication rates were analyzed. Univariable and multivariable logistic regression was used to assess associations between age and minor and major complications, adjusting for diabetes, hypertension, smoking history, and prior radiation.

RESULTS: Our patient cohort’s mean age was 39.3 (13-76) years. A total of 276 (28.0%) had either a minor or major complication. The minor complications across the cohort (154) included seroma, skin necrosis, delayed wound healing, infection, nipple necrosis, hematoma, and fat necrosis. Major complications (122) included cases requiring readmission and/or reoperation. Patients in the 31- to 50-year age group were more likely to have a minor complication (17.9%) compared to those in the <31-year age group (13.1%) (P = 0.05). Patients aged 31 to 50 years (13.0%) and >50 years (18.7%) were more likely to develop major complications than those aged <31 years (6.56%) (P < 0.05 and P = 0.0001, respectively). The >50-year age group was more likely to be readmitted (7.4% vs 1.3%, P = 0.05) and reoperated (11.3% vs 5.3%, P < 0.05) compared to the <31-year age group. However, no statistically significant relationship was found with minor or major complication rates in senior groups with age ≥ 60 years. In adjusted models, age was not an independent predictor of minor or major complications; instead, diabetes (minor; odds ratio, 1.80; 95% confidence interval, 1.04-3.07; P = 0.03) and smoking (major; odds ratio, 2.16; 95% confidence interval, 1.12-3.98; P = 0.02) were associated with increased risk.

CONCLUSION: Older patients show higher unadjusted morbidity after reduction mammaplasty, but age itself is not an independent risk factor once comorbidities are considered. Preoperative counseling and optimization should prioritize diabetes, hypertension, and smoking over rigid age thresholds.

PMID:41587443 | DOI:10.1097/SAP.0000000000004672

AIDS. 2026 Jan 23. doi: 10.1097/QAD.0000000000004453. Online ahead of print.

ABSTRACT

OBJECTIVE: HIV has been shown to persist in cerebrospinal fluid (CSF) in persons on antiretroviral therapy (ART), which may be linked with inadequate ART exposure, potentially contributing to neurocognitive dysfunction. Our objective was to compare ART regimen inhibitory activity in CSF with participant outcomes.

METHODS: A5321 is a prospective study of HIV reservoirs among persons with HIV on long-term ART with documented suppressed viremia; 44 participants who underwent lumbar puncture were evaluated. CSF trough concentrations were determined and inhibitory quotients (IQs) calculated for each antiretroviral (ARV) in a participant’s regimen as the ratio of CSF concentration to literature values for in vitro HIV IC50or90. The geometric mean (GM) of CSF IQs of all drugs in each participant’s ART regimen was calculated (CSF ART-IQGM). Statistical analyses evaluated associations among ART-IQGM and CSF HIV DNA, biomarkers and global deficit score (GDS).

RESULTS: The median (Q1, Q3) CSF ART-IQGM was higher in those with undetectable vs detectable CSF HIV DNA: 0.9 (0.5, 1.6) vs 0.5 (0.3, 0.9), p = 0.027. Higher ART-IQGM was associated with lower GDS (i.e., better global cognitive function, Spearman: -0.30, p = 0.05). There was no association between CSF inflammatory biomarkers and ART-IQGM.

CONCLUSIONS: The CSF ART-IQGM is a novel approach to assess ART regimen activity. This metric was associated with lack of CSF HIV DNA detection and better GDS, which suggests ART regimen activity affects HIV persistence in CSF. This tool motivates further investigations of relationships between regimen activity and biomarkers of HIV persistence in CSF and in other anatomic HIV reservoirs.

PMID:41587440 | DOI:10.1097/QAD.0000000000004453

Ann Plast Surg. 2026 Jan 26. doi: 10.1097/SAP.0000000000004643. Online ahead of print.

ABSTRACT

BACKGROUND: The quantification of phantom limb pain (PLP) is challenging due to the heterogeneity of patient experiences. This study evaluated the use period prevalence questionnaires in assessing PLP in patients with lower limb osseointegrated implant (OI) prostheses.

METHODS: The study included patients who received single-stage lower limb OI prostheses at our institution. Period prevalence questionnaires included questions regarding frequency and duration of PLP prior to OI implantation and in the last year postoperatively. The frequency of PLP was assessed by asking participants how often they experienced PLP pain. The duration of each episode was evaluated by asking how long the PLP pain lasted. Nerve reconstruction procedures included targeted muscle reinnervation (TMR) or combined TMRpni.

RESULTS: A total of 11 patients completed the questionnaire (7 transtibial and 4 transfemoral). The median age was 52 years, and the median BMI was 29.7 kg/m2. Of the 11 patients, 8 underwent nerve reconstruction (72%): 5 with combined TMRpni and 2 with TMR. Six patients reported a reduction of PLP episodes (54%), whereas the remaining 5 patients experienced the same frequency of PLP. Statistical analysis revealed a significant reduction in PLP frequency from preop to postoperative time points (median, 4 vs 3; P = 0.016). For PLP duration, 5 patients reported shorter episodes (45.5%), 5 patients reported the same duration (45.5%), and 1 patient experienced a longer duration (9%). There was no significant difference in duration between preoperative and postoperative assessments. When examining the total scores, there was a significant reduction of PLP from preoperative to postoperative time points (median, 6 vs 5; P = 0.048).

CONCLUSIONS: We introduced a novel method to assess PLP using period prevalence instead of pain intensity. OI prostheses, with or without nerve reconstruction, significantly reduced PLP frequency and combined frequency-duration measures. Future work will validate the period prevalence survey against established PLP instruments.

PMID:41587428 | DOI:10.1097/SAP.0000000000004643

Ann Plast Surg. 2026 Jan 26. doi: 10.1097/SAP.0000000000004615. Online ahead of print.

ABSTRACT

INTRODUCTION: Positional plagiocephaly is characterized by cranial asymmetry and can be the result of prolonged uneven pressure on the developing skull. Extrauterine causes include extended time in the supine position, one-sided feeding, or insufficient tummy time. Beyond cosmetic concerns, it can affect visual, auditory, dentofacial, and speech development. Following the “Back-to-Sleep Campaign,” prevalence rose to 16% to 22.1% in 6-week-old infants (Iran J Child Neurol. 2022;16(2):85-92). Despite its extensive impact on development and finances, many caregivers and parents lack awareness, underscoring the need for improved education and prevention strategies.

METHODS: In this 2-arm, partially blinded randomized controlled trial (June 2022 to April 2025) at UMass Memorial Medical Center, we compared standard care to an educational intervention for plagiocephaly prevention. The primary outcome was cephalic index (CI), measured at 2, 4, and 6 months, with higher values indicating greater deformity. Secondary outcomes included parent-reported adherence to prevention strategies. Group comparisons used unpaired t tests and difference-in-difference models.

RESULTS: A total of 109 subjects were enrolled (intervention, 62; control, 47). The average CI differed significantly between groups at the 4-month mark (control, 89.84; intervention, 86.91; P = 0.05). Difference-in-difference analysis did not yield statistically significant results at any time point, but all intervention groups had a lower average CI. Survey data assessing parental adherence to plagiocephaly prevention behaviors showed a significant difference at 4 months (control, 15.87; intervention, 13.75; P = 0.03), with no significant differences at 2 or 6 months.

CONCLUSIONS: The intervention was associated with reduced cranial deformation, reaching statistical significance by 4 months. This correlated with better parental compliance, suggesting early education as an effective preventive strategy.

PMID:41587421 | DOI:10.1097/SAP.0000000000004615

J Phys Chem A. 2026 Jan 26. doi: 10.1021/acs.jpca.5c06933. Online ahead of print.

ABSTRACT

This study re-examines the bond cleavage mechanisms of fluoromethane cations (CH₃F⁺) in their low-lying electronic states (X²E, A²A₁, B²E) using a combination of threshold photoelectron photoion coincidence (TPEPICO) velocity map imaging and quantum chemical calculations. The C-H bond cleavage from the X²E state is confirmed to proceed via a statistical, thermodynamically controlled mechanism, as evidenced by a Boltzmann kinetic energy release distribution (KERD). In contrast, the C-F bond cleavage from the excited A²A₁ and B²E states exhibits nonstatistical dynamics. For the A²A₁ state, the dissociation is direct and rapid, characterized by a Gaussian-type KERD and a negative anisotropy parameter (β ≈ -0.5). Crucially, for the B²E state, our results contradict the previously proposed mechanism of internal conversion to the X²E state followed by statistical dissociation. Instead, we provide compelling evidence that CH₃F⁺(B²E) undergoes internal conversion to the A²A₁ state, which then dissociates directly. This revised pathway is supported by RRKM calculations, the near absence of CH₂F⁺ fragments, and the similarities in KERD and β parameters between the B²E and A²A₁ states.

PMID:41587419 | DOI:10.1021/acs.jpca.5c06933

Clin Exp Dent Res. 2026 Feb;12(1):e70278. doi: 10.1002/cre2.70278.

ABSTRACT

OBJECTIVES: The aim of this systematic review and meta-analysis was to evaluate the impact of open proximal contacts on peri-implant tissue changes, specifically marginal bone levels, probing pocket depth, and the incidence of peri-implant diseases.

METHODS: Electronic databases were searched to identify non-randomized observational studies comparing open and closed proximal contacts. Risk of bias was assessed using the Cochrane Collaboration’s tool and data were analyzed with a statistical software.

RESULTS: Out of 276 studies initially identified, five met the inclusion criteria, involving 4882 dental implants. Meta-analysis indicated that open proximal contacts were associated with greater, but not statistically significant, marginal bone changes (mean difference (MD) 0.07; 95% confidence interval (CI) -0.09 to 0.24; p = 0.38); probing pocket depths (MD 0.11; 95% CI -0.29 to 0.51; p = 0.59) and a higher incidence of peri-implantitis (relative risk (RR) 1.63; 95% CI 0.88-3.02; p = 0.12) compared to closed contacts. Open proximal contact was associated with a significant increase in incidence of peri-implant mucositis (RR 1.74; 95% CI 1.06-2.86; p = 0.03).

CONCLUSIONS: Open proximal contacts are associated with increased probing pocket depths and marginal bone changes and could be a risk indicator for peri-implant mucositis. Further research is needed to assess long-term effects and to develop preventive measures.

PMID:41587408 | DOI:10.1002/cre2.70278

ACS Nano. 2026 Jan 26. doi: 10.1021/acsnano.5c20466. Online ahead of print.

ABSTRACT

Multiplexed profiling of microRNAs (miRNAs) is central to refining diagnosis and prognosis, yet conventional fluorescence-based strategies remain vulnerable to environmental interference and signal crosstalk and rarely provide ground-truth validation of nanoprobe conformation. Here, we report pattern-verifiable heterowalkers (HW-TDONs) that integrate three DNAzyme walking modules confined on a triangular DNA origami nanosheet, each tethered to a size-distinct gold nanoparticle (10/15/20 nm) for the concurrent sensing of miRNA-10b, miRNA-21, and miRNA-155. Target recognition triggers autonomous DNAzyme walking that cleaves substrate strands, activating orthogonal fluorophores, and reconfiguring the origami pattern via AuNP detachment from predesignated sites. This dual-mode output quantitatively couples tricolored fluorescence with atomic force microscopy (AFM)─resolvable nanopattern statistics, thereby self-validating signal generation and mitigating false interpretations. This reliable and versatile platform enables combinatorial miRNA quantification in cell lysates and permits simultaneous imaging of multiple miRNAs in living cells, thereby supporting precise cell subtype discrimination. By coupling nanoscale conformational inspection to orthogonal optical readouts, HW-TDONs provide a programmable and scalable toolkit for facilitating multiplexed nucleic acid analysis and marker-associated pathological exploration with expansible potential for integrating patient-specific biomarkers in biomedical applications.

PMID:41587407 | DOI:10.1021/acsnano.5c20466

J Vet Med Educ. 2026 Jan 22:e20250107. doi: 10.3138/jvme-2025-0107. Online ahead of print.

ABSTRACT

Substantial expansion of enrollment in US veterinary medical educational programs is well underway. Meanwhile, important downward trends have been reported in high school and undergraduate student enrollments nationally, raising the critical question of potential concurrent downward trends in the size of the US veterinary medical applicant pool and the related applicant-to-seat ratio. This study was designed to analyze the total number of applicants to US colleges/schools of veterinary medicine longitudinally and to consider potential relationships to ongoing national undergraduate student enrollment trends. Historical data on the veterinary medical applicant pool and the number of first-year seats available were obtained from the American Association of Veterinary Medical Colleges. Undergraduate enrollment data, both historical and projected, were obtained from the US Department of Education, National Center for Education Statistics. Regression analyses revealed a negative relationship between these two variables, which is counterintuitive. Based on these findings, projections of the applicant pool were performed using the simple ratio of undergraduate student enrollment to veterinary medical applicants in recent years. These projections were combined with information currently available on the expansion of veterinary medical educational programs to consider potential trends in applicant-to-seat ratios. Results suggest an upcoming softening of the applicant-to-seat ratio. This information will be useful for veterinary medical enrollment management planning-including formulation of proactive and progressive recruitment strategies-going forward.

PMID:41587406 | DOI:10.3138/jvme-2025-0107

J Vet Med Educ. 2026 Jan 21:e20250031. doi: 10.3138/jvme-2025-0031. Online ahead of print.

ABSTRACT

The COVID-19 pandemic accelerated the shift to online veterinary education, posing challenges for teaching practical skills. Although instructional videos have long supported medical and veterinary education, the impact of video storytelling (VST) using specific content-creation techniques for student engagement and achieving success for learning outcomes remains underexplored. Our research compared traditional lecturer-generated Brightspace videos (BSVs) with VST content to evaluate their effect on student experience and grades in a practical task. Students were assessed on their performance, and they used standardised questionnaires to evaluate their perceptions of the online material and the impact it had on practical skill acquisition. In both phases, students answered questionnaires using Likert scales. Responses were analysed using descriptive and inferential statistics. Comparison between groups for qualitative data were conducted using binomial or chi-square tests, with multiple comparisons controlled for using the Bonferroni correction method. For quantitative data, comparisons between groups were performed using the Mann-Whitney U test. In Phase 1 (2020), 106 final-year students were provided with BSV content ahead of a simulated assessment. All students in the year enrolled voluntarily in this observational study. However, 33/106 students (31.1%) did not view the content. No significant performance differences were observed between those who watched the videos and those who did not (p = 0.711). In Phase 2 (2023), 148 preclinical stage 3 students voluntarily participated in a randomised, blinded, controlled trial comparing BSV (75 students) with VST (73 students). The VST group reported significantly lower stress and anxiety levels (p = 0.002), felt better prepared for Directly Observed Practical Skill (DOPS) assessments (p < 0.001), and achieved higher practical assessment scores (p = 0.001). As online and blended learning continue to expand, veterinary programs should consider investing in high-quality VST to support student well-being, promote deeper learning, and more effectively prepare students for clinical practice.

PMID:41587399 | DOI:10.3138/jvme-2025-0031

Clin Exp Dent Res. 2026 Feb;12(1):e70297. doi: 10.1002/cre2.70297.

ABSTRACT

OBJECTIVES: Periodontitis is a common oral disease that affects populations globally, however, awareness of periodontal disease prevention remains limited. Since periodontal health knowledge may influence oral hygiene behaviors, which are essential for disease prevention and long-term maintenance, this study aimed to assess periodontal health-related knowledge and its association with oral hygiene practices among an adult cohort in Thailand using the validated Adult Periodontal Health Knowledge and Belief Questionnaire.

MATERIAL AND METHODS: A cross-sectional survey of Thai adults (≥ 18 years) was conducted from December 2023 to January 2024. The questionnaire captured demographics, oral hygiene practices (brushing and interdental cleaning), and periodontal health knowledge (ALPHA-K). Descriptive statistics, non-parametric tests, exploratory factor analysis, and multiple linear regression were used.

RESULTS: A total of 1770 participants completed the survey. The mean ALPHA-K score was 11.83 (2.88), which represents 59.2% of total score. While most recognized that plaque as the cause of gum disease, and smoking and diabetes as risk factors, misconceptions persisted (e.g., floss only removes food; tooth loss is inevitable with ageing; fluoride prevents gum disease). Higher periodontal health knowledge was associated with favorable flossing practices, brushing practices (longer brushing duration, extra-soft/soft bristles, manual toothbrush use) and higher education, higher income, and urban residence.

CONCLUSIONS: A significant knowledge deficit regarding periodontal health exists in this Thai cohort, particularly among rural residents, individuals with lower income, and those reporting inadequate brushing duration or preference for hard bristle brushes or electric toothbrushes in Thailand. Disseminating accurate information on periodontal health and disease is essential to enhance self-care practices and overall periodontal health outcomes.

PUBLIC HEALTH RELEVANCE: Thai adults, particularly those with lower education levels and living in rural areas, demonstrated considerable gaps in periodontal health knowledge. Addressing these gaps through tailored educational interventions is important for improving population-level periodontal health outcomes.

PMID:41587398 | DOI:10.1002/cre2.70297