Nevin Manimala

Nano Converg. 2026 Jul 7;13(1):32. doi: 10.1186/s40580-026-00562-0.

ABSTRACT

This study investigates the impact of high-energy proton irradiation (33 and 100 MeV) on the radiation response and statistical uniformity of the breakdown field of Hf_xZr_1-xO₂ based metal-insulator-metal capacitors. While macroscopic electrical characteristics-such as polarization hysteresis, dielectric constant, and leakage current-exhibit remarkable radiation stability across various crystalline phases, a distinct improvement is observed in the statistical distribution of the breakdown field (E_BD). Weibull distribution analysis reveals a consistent increase in the shape factor (β) following irradiation, indicating a “healing effect” that effectively narrows the variance of dielectric breakdown. This enhancement leads to a normalized yield improvement ranging from 3.0% to 14.8%. Our findings suggest that optimized high-energy proton treatment can effectively mitigate localized defects and suppress early-stage failures. These results provide a strategic pathway for enhancing the reliability and operational lifetime of high-k dielectrics in space-qualified and radiation-hardened electronics.

PMID:42412370 | DOI:10.1186/s40580-026-00562-0

J Endocrinol Invest. 2026 Jul 7. doi: 10.1007/s40618-026-02980-7. Online ahead of print.

ABSTRACT

INTRODUCTION: The C-reactive protein to albumin ratio (CAR), an integrative biomarker of inflammation and malnutrition, has shown prognostic value in various diseases, but its role in diabetic chronic kidney disease (CKD) remains inadequately defined. This study aimed to evaluate the independent association of CAR with progression of chronic kidney disease (CKD) and all-cause mortality.

DESIGN AND METHODS: We retrospectively retrieved 231 CKD patients with diabetes who had not received erythropoietin stimulants or iron therapy. The primary outcomes were mortality and progression of CKD (composite), specifically, progression to end-stage renal disease (ESRD) and initiation of renal replacement therapy (RRT), or a doubling of serum creatinine (SCr) levels in patients not receiving RRT. We used Kaplan-Meier survival curves and constructed multivariate Cox proportional hazards models adjusted for potential confounding factors, to estimate the association of CAR with progression of CKD and all-cause mortality; in addition, we employed restricted cubic spline analysis to explore nonlinear relationships. We used the SHAP machine learning algorithm to evaluate the predictive performance of CAR and to analyze the predictive increment of CAR for clinical outcomes. Subgroup analyses were conducted to assess the robustness of the results across different subgroups and modeling choices.

RESULTS: The analysis cohort included a total of 231 adults. Kaplan-Meier curves showed a progressive and significant increase in cumulative CKD progression and mortality across CAR quartiles. In the fully adjusted model of the Cox multivariate regression analysis, a 1-unit increase in CAR (log-transformed) was associated with a 59% increase in the risk of CKD progression (HR = 1.59, 95% CI 1.20-2.09; P = 0.001) and a 32% increase in the risk of mortality (HR = 1.32, 95% CI 1.03-1.68, P = 0.029); participants in the highest quartile had a significantly higher mortality risk compared to those in the lowest quartile (Q4 vs. Q1, HR = 3.8, 95% CI 1.24-11.67; P = 0.02). Restricted cubic spline analysis revealed a significant linear relationship (nonlinear P > 0.05). Subgroup analysis indicated that CAR was consistently associated with outcomes across different age, sex, and BMI groups, with no significant interactions observed, confirming the robustness of these results. In machine learning models, SHAP analysis identified CAR as a key predictor. Compared with the baseline risk model (UTP, eGFR), adding CAR improved predictive performance for CKD progression and mortality, with enhanced C-statistic, improved discriminatory index (IDI), and improved net reclassification index (NRI).

CONCLUSIONS: The CAR serves as a robust, independent predictor of CKD progression and all-cause mortality in patients with diabetic CKD. As a readily accessible biomarker, it holds significant potential to enhance risk stratification and identify candidates warranting intensified clinical management.

PMID:42412363 | DOI:10.1007/s40618-026-02980-7

Ann Med. 2026 Dec;58(1):2699553. doi: 10.1080/07853890.2026.2699553. Epub 2026 Jul 7.

ABSTRACT

METHODS: A hospital-based cross-sectional study was conducted among hypertensive outpatients at the University of Gondar Comprehensive and Specialized Hospital from January 30 to May 30, 2024. Participants were selected using simple random sampling. Alcohol use disorder was assessed using the Alcohol Use Disorders Identification Test (AUDIT) and medication adherence was evaluated over a three-month period. Bivariable and multivariable logistic regression analyses identifed factors associated with AUD and non-adherence to antihypertensive therapy. Statistical significance was set at p < 0.05.

RESULTS: A total of 400 participants were included (response rate: 100%), with a mean age of 44.9 ± 12.5 years. The prevalence of AUD was 12.2%, comprising hazardous drinking (8.0%), harmful use (2.5%), and alcohol dependence (1.7%). Male sex (AOR = 3.60; 95% CI: 1.30-9.94), cigarette smoking (AOR = 8.56; 95% CI: 3.89-18.82), and comorbidities (AOR = 3.87; 95% CI: 1.75-8.56) were independently associated with AUD. Overall, 42.2% of participants were non-adherent to antihypertensive therapy. Alcohol dependence was associated with nearly fourfold higher odds of poor adherence compared with social drinking.

CONCLUSION: AUD is common among hypertensive patients and is significantly associated with poor adherence to antihypertensive therapy. Integrating alcohol use screening and intervention into routine hypertension care may improve medication adherence and treatment outcomes.

PMID:42411344 | DOI:10.1080/07853890.2026.2699553

Public Health Nutr. 2026 Jul 7:1-72. doi: 10.1017/S1368980026102985. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the impact of one-to-one peer support on mothers’ personal breastfeeding goals.

DESIGN: Scoping review guided by Arksey and O’Malley’s five-stage framework and reported in accordance with PRISMA-ScR guidelines. Qualitative data were analysed using descriptive content analysis. Quantitative data were analysed by identifying numerical trends and recurring patterns, and a concise overview of key descriptive findings was provided using frequency counts and proportions.

SETTING: Studies conducted across 10 countries globally, identified through systematic searches of seven electronic databases and screening of reference lists.

PARTICIPANTS: Thirty-eight studies were included: 20 quantitative, 7 qualitative, 6 mixed-methods, and three secondary analyses (drawing on two relevant primary sources). Participants were mothers who received one-to-one breastfeeding peer support, predominantly in community or home-based settings.

RESULTS: One primary outcome was assessed: The impact of one-to-one peer support on mothers’ personal breastfeeding goals. Two secondary outcomes were identified. The first examined the effect of one-to-one peer support on breastfeeding outcomes based on traditional measures of breastfeeding success. Of the included studies, 50% reported positive effects of one-to-one peer support on traditional measures of breastfeeding success, while 21% found no statistically significant differences. An additional secondary outcome reported in 34% of the included studies examined the impact of mother-centred breastfeeding peer support on maternal emotional well-being.

CONCLUSIONS: One-to-one peer support enhances the mothers’ ability to achieve their personal breastfeeding goals and positively influences emotional well-being. These findings underscore the need to integrate structured one-to-one peer support into maternal health services in Ireland and globally.

PMID:42411308 | DOI:10.1017/S1368980026102985

Womens Health (Lond). 2026 Jan-Dec;22:17455057261465645. doi: 10.1177/17455057261465645. Epub 2026 Jul 7.

ABSTRACT

BackgroundDespite increased recognition of autism in women and girls, their reproductive health remains underexplored. Understanding reproductive health burden and healthcare experiences is essential to identifying barriers and improving support for conditions that can impact quality of life.ObjectivesInvestigate reproductive health and healthcare experiences among autistic compared to non-autistic individuals assigned female at birth (AFAB).DesignWe conducted a cross-sectional online survey in the UK (April 2024-July 2025) among individuals AFAB aged 18-40 years recruited via convenience-sampling from autism networks, social media, and Prolific.MethodsIn total, 311 participants were included (165 self-reported autistic [M=31.1 years, SD=6.2], 146 non-autistic [M=30.6 years, SD=5.5]). The survey, developed with input from autistic people, covered reproductive health conditions, knowledge and management of reproductive health, and reproductive healthcare experiences. Group differences were analysed using logistic regressions, chi-squared and Wilcoxon rank-sum tests. Healthcare inequality (HIE) scores were calculated overall and for five subdomains as composite of negative reproductive healthcare experiences. Associations between autism and HIE were examined using logistic regression.ResultsAutistic participants reported more reproductive health conditions (44% vs. 28%) and symptoms (95% vs. 84%) than non-autistic participants. Age-adjusted regression models indicated higher odds for any condition (OR=1.96[1.21-3.17], p <.01) and any symptom (OR=3.23[1.44-7.25], p <.01) with OR for specific conditions/symptoms ranging from OR=1.09[0.57-2.09], p=.799 to OR=3.97[2.43-6.50], p <.001. Adjusting for other neurodivergence attenuated estimates; however, the overall associations for any symptom remained statistically significant (p <.05). Autistic participants were more likely to report irregular menstrual cycles, menstrual cycle-related mental health and sensory experiences changes and poorer reproductive health knowledge and management (all p <.001). HIE scores overall and across subcategories were higher among autistic individuals. Autism diagnosis was associated with higher overall HIE scores (OR=2.86[2.37-3.45], p <.001) and domain specific HIE scores (OR_range = 1.81[1.49-2.22]-5.31[3.56-8.13], p <.001).ConclusionAutistic individuals AFAB face increased reproductive health burden, greater difficulty managing their reproductive health, and significant healthcare inequities. Tailored education and individualized service adjustments are essential for equitable reproductive care in autistic individuals AFAB.

PMID:42411262 | DOI:10.1177/17455057261465645

Stat Med. 2026 Jul;45(15-17):e70668. doi: 10.1002/sim.70668.

ABSTRACT

Accurately estimating treatment effects is crucial for designing optimal treatment plans in personalized medicine, especially in the presence of right-censored survival data. We propose a parameter transfer learning method for estimating treatment effects on right-censored survival data, which leverages multi-source auxiliary data to enhance the prediction accuracy and robustness of the target model. This method constructs multiple source models by extracting shared parameters from other datasets and uses a smoothed concordance index function specifically designed for right-censored survival data to estimate candidate model parameters. To enhance performance, a leave-one-out cross-validation criterion is applied to optimize model averaging weights. Theoretically, we have demonstrated that under mild conditions, the proposed method asymptotically achieves the highest smoothed concordance index when the target model is misspecified, and ensures model weight consistency when the target model is correctly specified. Simulation studies confirm the advantages of our proposed method in reducing bias and enhancing prediction accuracy, particularly with right-censored and heterogeneous data. Its application to the SUPPORT (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments) extension dataset, support2, further demonstrates its strong potential in personalized clinical decision-making.

PMID:42411252 | DOI:10.1002/sim.70668

Nucl Med Commun. 2026 Jul 7. doi: 10.1097/MNM.0000000000002203. Online ahead of print.

ABSTRACT

AIM/INTRODUCTION: Adenosine pharmacological stress is commonly used for the detection of ischemia by myocardial perfusion imaging (MPI) using radiotracers and gated single-photon emission computed tomography/computed tomography (SPECT/CT) imaging. Recently, a phenomenon, splenic switch-off (SSO), has been observed where reduced perfusion to the spleen occurs after adenosine, suggesting an adequate effect of adenosine on the heart. The aim of the study is to evaluate the SSO effect in adenosine stress 99mTc tetrofosmin MPI studies using semiquantitative analysis of SPECT/CT data.

MATERIALS AND METHODS: Seventeen adenosine MPI studies were selected. Each study included stress and rest, which were reoriented in short, horizontal, and vertical long axes. Also, data were reconstructed in the body transaxial, coronal, and sagittal planes. In the resulting images, the spleen was identified on the CT component, and regions of interest were drawn on the spleen, thoracic vertebra, and myocardium. The ratios spleen/vertebra (S/VAd and S/VRst) and myocardium/vertebra (M and M/t) were calculated. Statistical analysis was done using a paired t test.

RESULTS: Mean age was 60.35 years, with 9 males (53%). Mean S/VAd was 0.98 ± 0.38 and S/VRst 1.87 ± 0.87 (t = -3.707, P < 0.01). The mean M/VAd was 2.86 ± 1.65 and M/VRst 3.75 ± 2.41 (t = -1.323, P = 0.204).

CONCLUSION: Using the method outlined, especially the S/V ratio, evaluation of the SSO can be achieved from the acquired data, which shows promise as a marker for adequate effectiveness of adenosine stress in doubtful cases.

PMID:42411251 | DOI:10.1097/MNM.0000000000002203

Nucl Med Commun. 2026 Jul 7. doi: 10.1097/MNM.0000000000002205. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to explore the effects of different breath-holding times (20, 18 and 15 s) on PET/computed tomography (PET/CT) image quality and metabolic parameters of hypermetabolic lung nodules. We hope that our findings will elucidate the clinical feasibility of short-duration breath-hold PET imaging.

RESULTS: Compared to free-breathing PET group, all breath-hold groups showed significantly higher tumour-to-background ratio but lower signal-to-noise ratio (all P < 0.05). Importantly, the 18 s breath-hold group demonstrated overall image quality, fusion scores and contrast-to-noise ratio comparable to those of the 20-s group, without statistically significant differences (all P > 0.05). Moreover, the 18-s group exhibited a more favourable signal-to-noise ratio profile than the 15-s group. Metabolically, all breath-hold scans significantly increased maximum standardized uptake value (SUVmax) and mean SUV while reducing metabolic tumour volume and total lesion glycolysis relative to free-breathing (P < 0.05). Notably, there were no significant differences in key quantitative metrics, including maximum SUV, peak SUV, metabolic tumour volume and total lesion glycolysis, among the three breath-hold groups. The consistency of peak SUV across groups further supports its reliability as a robust parameter under reduced acquisition times.

CONCLUSION: The 18-s breath-hold protocol is a valid clinical alternative to the 20-s acquisition, offering comparable image quality and metabolic data while superior efficiency and patient tolerability, making it an ideal choice for routine practice.

PMID:42411244 | DOI:10.1097/MNM.0000000000002205

Curr Vasc Pharmacol. 2026 Jul 6. doi: 10.2174/0115701611415264260622061654. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite the large use of renin-angiotensin system inhibitors (RASI) in STSegment Elevation Myocardial Infarction (STEMI) patients, few data have been reported on the prognostic impact of chronic RASI at admission in patients suffering from STEMI, especially during the COVID-19 pandemic. Therefore, the current study investigated the prognostic impact of chronic RASI at admission in patients suffering from STEMI, including both SARS-CoV-2 positive and negative individuals, enrolled before and during the COVID-19 pandemic.

METHODS: We included STEMI patients who received primary percutaneous coronary intervention (PPCI) and were enrolled in the ISACS-STEMI COVID-19 registry. In the present sub-analysis, patients were allocated according to chronic RASI therapy at admission. The primary study endpoint was the occurrence of in-hospital mortality. Secondary endpoints were postprocedural TIMI 3 flow and mortality at 1 month.

RESULTS: The overall population was 15,693 patients, including 6,213 patients pretreated with RASI. Several differences in baseline characteristics were observed between the two groups. No difference was observed in the prevalence of SARS-CoV-2 infection. After correction for all baseline confounders, including procedural features, chronic pretreatment with RASI was independently associated with improved postprocedural TIMI 3 flow (OR [95% CI] = 1.14 [1.03-1.35], p = 0.042), lower in-hospital mortality (adjusted OR [95% CI] = 0.64 [0.54-0.75], p < 0.001), and lower 30-day mortality (adjusted OR [95% CI] = 0.62 [0.53-0.73], p < 0.001).

CONCLUSION: This is the largest study investigating the prognostic impact and benefits of chronic RASI pre-treatment in STEMI patients undergoing PPCI, including those treated during the COVID19 pandemic. We found that chronic RASI treatment at hospital admission was associated with significant improvement in reperfusion and reduction in mortality, without any negative effect in SARS-CoV-2 positive patients. Results should be interpreted considering the retrospective, nonrandomized nature of the study.

PMID:42411222 | DOI:10.2174/0115701611415264260622061654

Innate Immun. 2026 Jan-Dec;32:17534259261446053. doi: 10.1177/17534259261446053. Epub 2026 Jul 7.

ABSTRACT

BackgroundConsider this Carrion’s disease (CD) is a biphasic illness-comprising acute and chronic phases-endemic to Peru and caused by Bartonella bacilliformis, a bacterium transmitted by sandflies. Despite its clinical relevance, the mechanisms underlying innate immune activation in response to B. bacilliformis remain poorly understood. Toll-like receptors (TLRs) play a central role in recognizing conserved molecular patterns present in pathogens, thereby initiating innate immune responses. The present study aimed to describe the expression patterns of TLR2 and TLR4, along with cytokine secretion profiles, during peripheral blood mononuclear cells (PBMCs) exposure to B. bacilliformis.MethodsPeripheral blood mononuclear cells (PBMCs) from healthy donors were stimulated with heat-inactivated B. bacilliformis (ATCC 35685 strain), zymosan (TLR2 control), or E. coli LPS (TLR4 control). TLR2 and TLR4 gene expression was quantified by RT-qPCR at 0, 12, 24, 36, and 48 h. Cytokines were measured using a 17-plex panel. Analyses were descriptive, using non-parametric statistics.ResultsResults elicited measurable changes in the transcriptional expression of TLR2 and TLR4 during stimulation, with peak activation typically observed at 12 h, although in one case the maximal response was delayed to 24 h. These expression changes coincided with significant modulation of multiple cytokines, including pro-inflammatory mediators (TNF-α, IL-17, IL-12p70), Th1/Th2 cytokines (IFN-γ, IL-2, IL-5, IL-13), regulatory cytokines (IL-10), and growth factors (GM-CSF, IL-7).ConclusionsThis exploratory study describes the transcriptional expression patterns of TLR2 and TLR4 and the accompanying cytokine responses in PBMCs exposed to B. bacilliformis. These profiles expand current knowledge of the early innate immune signature elicited by this neglected pathogen and provide a foundation for future studies using receptor-specific functional assays. Importantly, these patterns likely reflect early innate immune response signatures rather than definitive evidence of functional receptor activation.

PMID:42411209 | DOI:10.1177/17534259261446053