Nevin Manimala

Spine Deform. 2026 May 21. doi: 10.1007/s43390-026-01433-8. Online ahead of print.

ABSTRACT

PURPOSE: While 3D radiographic parameters are increasingly used to assess adolescent idiopathic scoliosis (AIS), barriers to 3D imaging limit their routine use. 2D-to-3D prediction algorithms have been proposed as a substitute. This study sought to determine if a predicted 3D kyphosis, derived from 2D images, is a more robust predictor of FEV1 in patients with AIS than a traditional 2D analysis.

METHODS: A retrospective, cross-sectional review of 259 AIS patients with surgical-range thoracic curves (> 40°) was performed. We built two multivariate linear regression models to predict FEV1. Due to structural multicollinearity, the deformity measures were tested separately. Model A included Main Thoracic Cobb, BMI, and Age. Model B included Predicted 3D T5-T12 Kyphosis, BMI, and Age. The models were compared using the Akaike Information Criterion (AIC) and adjusted.

RESULTS: The cohort (87% female, mean age 15.7 ± 3.3 years) presented with severe deformities (mean Main Thoracic Cobb 68.4° ± 16.5°) and widespread restrictive impairment (71%). Multivariate Analysis revealed that Model A, (2D Main Thoracic Cobb) was statistically superior to Model B (Predicted 3D T5 – T12 Kyphosis) with a lower AIC (-292.5 vs. -265.9) and a higher adjusted R² (0.241 vs. 0.159). All factors were significant independent predictors.

CONCLUSION: The predicted 3D-based model was not superior, while a parsimonious 2D-based multivariate model including Main Thoracic Cobb, BMI, and Age explained a significantly larger proportion of the variance in FEV1. This specific 2D-to-3D prediction algorithm is an imperfect proxy and is not a valid substitute for true 3D imaging in predicting pulmonary risk.

PMID:42166107 | DOI:10.1007/s43390-026-01433-8

Updates Surg. 2026 May 21. doi: 10.1007/s13304-026-02675-x. Online ahead of print.

ABSTRACT

Laparoscopic sleeve gastrectomy (LSG) is currently the most commonly performed weight loss surgery. Omentopexy is believed to help reduce the risk of postoperative nausea and vomiting (PONV), bleeding, gastric leakage, and gastroesophageal reflux disease (GERD). In recent years, fibrin glue posterior fixation has emerged as an alternative method shown to reduce gastrointestinal symptoms after LSG surgery. However, the comparative evidence between these two fixed techniques is still limited. This study aims to compare the clinical efficacy of two gastric fixation methods, fibrin glue posterior fixation and Omentopexy, in LSG. This retrospective study included 649 patients who underwent LSG between 2022 and 2024, divided into two groups: fibrin glue posterior fixation (n = 331) and Omentopexy (n = 318). A 1:1 propensity score-matching (PSM) was performed to balance baseline characteristics between the groups. After matching, 480 patients were included (240 per group). There were no significant differences between the fibrin glue posterior fixation group and the Omentopexy group in operative time or intraoperative blood loss (P > 0.05). The incidence of PONV in the two groups was 6.6% (16/240) and 5.8% (14/240), respectively, with no statistically significant difference (P > 0.05). The incidence of postoperative bleeding was 0.8% (2/240), and there was no significant difference between the groups (P > 0.05). There was 1 case of gastric leakage (0.4%) in the fibrin glue posterior fixation group, and no gastric leakage was observed in the Omentopexy group, and the difference between the groups was not statistically significant (P > 0.05). Neither group experienced gastric torsion. The incidence of postoperative GERD was 5.8% (14/240) and 7.5% (18/240), respectively, with no statistically significant difference (P > 0.05). In addition, both groups of postoperative bleeding patients underwent reoperation, with a reoperation rate of 0.8% (2/240), and there was no significant difference between the groups (P > 0.05). This study demonstrates that there were no significant differences in short-term postoperative complications between fibrin glue posterior fixation and Omentopexy in LSG.

PMID:42166091 | DOI:10.1007/s13304-026-02675-x

Mamm Genome. 2026 May 21;37(1):71. doi: 10.1007/s00335-026-10245-0.

ABSTRACT

Osteosarcopenia-the concurrent presence of osteoporosis and sarcopenia-affects approximately 18.5% of older adults globally, yet its shared genetic basis remains poorly understood. We applied genomic structural equation modeling (Genomic SEM) to integrate genome-wide association study (GWAS) summary statistics across five phenotypes spanning the pathophysiological spectrum of osteosarcopenia: appendicular lean mass (ALM), bone mineral density (BMD), handgrip strength (HGS), walking pace, and fracture. Fine-mapping, transcriptome-wide association study (TWAS), pathway enrichment, cell-type enrichment, and spatial transcriptomic mapping were performed to functionally annotate the identified loci. A single-factor model (CFI = 0.976) captured the shared genetic liability, with HGS and ALM loading most strongly. A two-factor sensitivity analysis confirmed partial separability of muscle and bone dimensions, though the single common factor was retained for integrated downstream annotation. We identified 58,696 genome-wide significant single-nucleotide polymorphisms (SNPs) condensed into 1078 independent lead variants, including 29 novel loci. Fine-mapping prioritized 317 high-confidence causal variants, encompassing key genes including BMP6, ACAN, IHH, LRP5, and SOX5. TWAS and MAGMA converged on IGF1R, FOXO3, and IRS1 as dual susceptibility genes. Pathway analysis revealed significant enrichment in endochondral ossification and growth hormone/insulin-like growth factor-1 signaling. Cell-type enrichment localized genetic risk to mesenchymal stem cells and skeletal muscle satellite cells, while spatial mapping identified cartilage primordium as the most enriched developmental context. This study systematically elucidates the shared genetic architecture of osteosarcopenia, highlighting developmental, endocrine, and stem cell-related pathways as core mediators. These findings provide a theoretical foundation for precision geroscience and the development of dual-target therapeutic strategies.

PMID:42166073 | DOI:10.1007/s00335-026-10245-0

Cogn Res Princ Implic. 2026 May 21. doi: 10.1186/s41235-026-00733-x. Online ahead of print.

ABSTRACT

This study used a between-subjects experimental design to examine how five spoiler conditions, including a complete scene without spoiler, a chaotic scene without spoiler, a video spoiler, a verbal spoiler, and a written spoiler, influenced viewers’ narrative engagement, heart rate synchrony measured by inter-subject correlation, and task performance while watching suspenseful film clips. Seventy-six university students were randomly assigned to one of the spoiler groups and viewed clips from the film Revenge. Narrative engagement was assessed using the Narrative Engagement Scale (NES), and ECG signals were recorded to derive heart rate time series for ISC-HR analyses. Key cue search task was indexed by a sticker-counting task during viewing. Results indicated that the video spoiler group showed the most consistent advantages, including higher narrative engagement, more frequent key cue search task, and the highest ISC-HR during the spoiler exposure phase. In contrast, the chaotic scene without spoiler group showed the weakest subjective engagement profile, with differences most evident in comprehension-related engagement and partially attentional focus. ISC-HR varied by spoiler modality primarily during the spoiler exposure phase, with the video spoiler group eliciting the highest synchrony, whereas ISC-HR during movie watching did not show clear group differences. Overall, these findings suggest that spoiler modality and narrative coherence shape viewers’ cognitive processing and cue monitoring during film viewing, and that ISC-HR can be used as a complementary physiological indicator to support the interpretation of immersion-related self-reports by indexing shared response dynamics among viewers.

PMID:42166072 | DOI:10.1186/s41235-026-00733-x

Environ Geochem Health. 2026 May 21;48(8):366. doi: 10.1007/s10653-026-03260-2.

ABSTRACT

Many environmental pollutants are released during the dismantling of electronic waste (e-waste). Per- and polyfluoroalkyl substances (PFAS) and heavy metals are representative pollutants of persistent and hazardous contaminants that are known to pose threats to human health. In an e-waste dismantling area, 149 mothers with singleton births and their infants were recruited in 2021 to investigate associations between heavy metals and PFAS concentrations in postpartum breast milk and infant birth outcomes. The concentrations of six heavy metals and six PFAS compounds were measured in breast milk. The median concentration of chromium (Cr) in breast milk was 1.27 μg/L, whereas the median perfluorooctanoic acid (PFOA) concentration was 0.28 ng/mL. Birth weight and length were recorded and were subsequently used in stratified analyses via multiple regression models. Exploratory evidence suggests that higher log-transformed Cr (β = 0.371, 95% CI: 0.082-0.660) and PFOA (β = 0.163, 95% CI: 0.009-0.317) concentrations in breast milk were associated with greater birth length among female infants. These findings suggest that concentrations of Cr and PFOA in breast milk are associated with sex-specific infant growth patterns. Furthermore, quantile g-computation analyses did not identify any statistically significant mixture effects. However, the cross-sectional design and the sample size both limit the interpretation of these results. Therefore, the findings should be interpreted with caution. Larger longitudinal studies are needed to confirm these findings and to clarify their potential biological and health implications.

PMID:42166065 | DOI:10.1007/s10653-026-03260-2

J Orofac Orthop. 2026 May 21. doi: 10.1007/s00056-026-00644-y. Online ahead of print.

ABSTRACT

OBJECTIVE: Dental caries (DC), a biofilm-mediated permanent disease, affects approximately 50% of the global population. Diet is an important modifiable factor among many factors affecting DC. At present, the health benefits of foodborne microbe intake are widely recognized. We aimed to study the association of dietary active microbe intake with the occurrence of DC among American adults.

MATERIALS AND METHODS: Data of adults with complete clinical information were extracted from the National Health and Nutrition Examination Surveys (NHANES) 2015-2020. Occurrence of untreated DC was the primary outcome and DC experience was the secondary outcome. Dietary active microbe intake was divided into three groups: G1 (low), G2 (medium), and G3 (high). Logistics models were performed to test the association of dietary DC with untreated DC and DC experience. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Further subgroup analyses were performed to verify whether the association between them remained robust.

RESULTS: A total of 12,762 subjects were included; among them, 3458 (27.10%) had untreated DC. After adjusting all covariates, we observed subjects with G2 and G3 levels of dietary active microbe intake had lower occurrence of untreated DC (G2, OR = 0.81, 95%CI 0.69-0.94; G3, OR = 0.72, 95%CI 0.61-0.84). Subjects with G3 level of dietary active microbe intake were linked to a lower incidence of DC experience (OR = 0.72, 95%CI 0.55-0.94). Subgroup analysis suggested a robust association of dietary active microbe intake and untreated DC and DC experience.

CONCLUSION: Our study suggested the potential advantage of high levels of dietary active microbe intake for the prevention of DC in American adults.

PMID:42166043 | DOI:10.1007/s00056-026-00644-y

Eur Radiol. 2026 May 21. doi: 10.1007/s00330-026-12641-1. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the diagnostic accuracy of multiparametric breast MRI combining dynamic contrast-enhanced imaging with diffusion-weighted imaging (DWI) for differentiating benign from malignant non-mass enhancement (NME) breast lesions.

MATERIALS AND METHODS: This prospective diagnostic accuracy study recruited patients from seven tertiary centers with centralized imaging over a 20-month period. The index test was multiparametric MRI, including morphological assessment, kinetic curve analysis, and DWI with apparent diffusion coefficient (ADC) measurements. The reference standard was histopathological confirmation. Nine experienced radiologists from participating centers independently evaluated examinations while blinded to clinical history and outcomes.

INCLUSION CRITERIA: female patients aged ≥ 18 years with BI-RADS 3-5 NME lesions. Statistical analyses included ROC curve analysis, logistic regression, and inter-reader agreement (IRA) assessment.

RESULTS: A total of 351 female patients (mean age, 44.2 ± 11.1 years; 189 malignant, 162 benign lesions) were enrolled. Consensus-based multiparametric MRI achieved 98.4% (95% CI: 95.6-99.7) sensitivity, 86.4% (95% CI: 80.2-91.3) specificity, 89.4% (95% CI: 84.5-92.9) positive predictive value, 97.9% (95% CI: 94.0-99.6) negative predictive value (NPV), and 92.9% (95% CI: 89.6-95.3) accuracy (AUC = 0.94; 95% CI: 0.91-0.96). Individual reader performance averaged 97.1% sensitivity and 84.8% specificity. Five independent predictors were identified: Type III washout curves (OR = 26.84; p = 0.001), segmental distribution (OR = 9.12; p = 0.001), Type II plateau curves (OR = 6.58; p = 0.008), ADC values ≤ 1.3 × 10⁻³ mm²/s (OR = 6.24; p = 0.001), and regional distribution (OR = 5.34; p = 0.032). IRA was almost perfect (κ = 0.847; 95% CI: 0.801-0.893). High NPV was maintained across all BI-RADS categories (96.8-98.5%).

CONCLUSION: Multiparametric breast MRI demonstrates superior diagnostic accuracy for NME lesions with high NPV, supporting potential reduction of unnecessary biopsies while maintaining excellent sensitivity.

KEY POINTS: Question Can multiparametric MRI combining dynamic contrast-enhanced imaging with diffusion-weighted imaging improve diagnostic accuracy for non-mass enhancement breast lesions compared to individual imaging parameters? Findings Multiparametric MRI achieved 92.9% accuracy, 98.4% sensitivity, and 86.4% specificity with five independent malignancy predictors, significantly outperforming individual parameters, with almost perfect inter-reader agreement. Clinical relevance Multiparametric breast MRI demonstrates superior diagnostic performance for non-mass enhancement lesions, potentially reducing unnecessary biopsies while maintaining excellent sensitivity for malignancy detection.

PMID:42166016 | DOI:10.1007/s00330-026-12641-1

Eur Radiol. 2026 May 21. doi: 10.1007/s00330-026-12636-y. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare prenatal imaging-based subjective assessment of the ganglionic eminence (GE) on fetal MRI with three-dimensional volumetric analysis in patients with structural central nervous system anomalies.

MATERIALS AND METHODS: This retrospective study investigated 17 fetuses (undergoing 20 fetal MRIs, mean gestational age 26.3 weeks, SD 3.3, range 21.7-33.4 weeks) with enlarged GE based on subjective assessment of fetal neuroimaging experts and concurrent structural brain anomalies. Three-dimensional volumetry of super-resolution MRI was performed and compared to age-matched neurotypical controls (94 fetuses, 100 MRIs, mean age 27.2 weeks, SD 3.6, range 21.7-34.0 weeks).

RESULTS: Among 20 MR examinations, in only 5 cases (25%) GE hyperplasia was confirmed, while 12 (60%) were found to show normal GE volumes. In 3 (15%), GE volumes were smaller compared to controls. Most patients (80%) were found to have increased total brain volume, while only 30% had an increased intracranial volume-ventriculomegaly (75%) seemingly being the most common underlying cause. Brain parenchyma volume was enlarged in only 20%. No correlation was found between GE volumes and volumes of 10 other substructures of the fetal head in pathological cases.

CONCLUSION: The study suggests the unreliability of expert visual assessment of GE size, despite excellent examination conditions, emphasizing the need for three-dimensional volumetric GE measurements. Specifically in patients with structural brain anomalies, quantitative fetal neuroimaging serves as an emerging tool to identify abnormalities in GE size and complement current diagnostic techniques by objectifying subjective impressions.

KEY POINTS: Question To evaluate the reliability of expert visual assessment of ganglionic eminence size in fetal MRI compared to super-resolution brain volumetry. Findings Expert visual assessment and 2D fetal brain biometry were insufficient to provide correct volumetric quantification of the ganglionic eminence in the investigated patient collective. Clinical Relevance This study highlights the value of volumetric quantification of the ganglionic eminence in fetal MRI to provide an objective, reproducible and valid quantitative tool for assessment of the fetal brain, specifically in the presence of CNS anomalies.

PMID:42166015 | DOI:10.1007/s00330-026-12636-y

Arch Ital Urol Androl. 2026 May 20. doi: 10.4081/aiua.2026.14954. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this paper was to compare the intraoperative and postoperative outcomes of two similar groups of patients who underwent three-component penile prosthesis implantation under spinal versus local anaesthesia.

MATERIALS AND METHODS: We reviewed retrospectively the medical records of twenty consecutive patients who underwent three-component penile prosthesis implantation for erectile dysfunction under spinal anaesthesia (S-PPI) versus local anaesthesia (L-PPI) in the period between January 2023 and January 2025. As regards the assessment of the pain, the patient’s requests of sedation due to pain complaining during the induction of the anesthesia and the following surgical procedure were assessed. The Visual Analogue Scale (VAS) was also used for pain assessment six hours and one day after the surgical procedure. A modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) validated questionnaire was used to evaluate patient satisfaction after the prosthesis implantation. Perioperative and postoperative complications were also assessed.

RESULTS: There was no statistical difference in terms of age, BMI and etiology of erectile dysfunction among the two groups. As regards the assessment of the pain, a significantly higher request of sedation was assessed in the S-PPI group than in the L-PPI group of patients (10% versus 40%) due to discomfort during the local anaesthesia or the surgical procedure (p < 0.05). On the contrary, mean VAS scores of 6.0 and 6.5, 5.5 and 5 were reported by the S-PPI and L-PPI groups at 6 and 24 hours after surgery respectively, showing a similar degree of postoperative pain among the two groups of patients. The EDITS questionnaire scores showed no significant difference between the two groups in terms of patient satisfaction. As regards the complications, no significant difference was assessed between the two groups of patients.

CONCLUSIONS: Our preliminary outcomes showed that a threecomponent penile prosthesis implantation under local anesthesia can be successfully performed in terms of postoperative pain control, acceptable complication rates and remarkable satisfaction scores with respect to the same procedure under spinal anaesthesia. Concerning the perioperative pain control, a significantly higher request of sedation was reported in the L-PPI group of patients with respect to the S-PPI group due to discomfort during the induction of local anesthesia or the implant procedure. Basing on these aspects, we think that a three-component penile prosthesis implantation in local anaesthesia could be proposed in selected patients with comorbidities which contraindicated spinal or general anesthesia or in patients unwilling to undergo these types of anesthesia after a preoperative counselling regarding the pain control and the possible need of sedation.

PMID:42165155 | DOI:10.4081/aiua.2026.14954

Nucleic Acids Res. 2026 May 20;54(10):gkag485. doi: 10.1093/nar/gkag485.

ABSTRACT

Enhancer-promoter interactions (EPIs) play a central role in gene regulation, but experimental techniques such as Hi-C for mapping these interactions remain costly and labor-intensive. Computational methods have been developed to predict EPIs in silico from DNA sequence and chromatin information; however, there are major challenges with the generalizability and accuracy of predictions by existing methods across cell types and conditions unseen during model training. We developed and validated UniversalEPI, an attention-based deep ensemble model that predicts EPIs up to 2 Mb apart using only DNA sequence and chromatin accessibility (ATAC-seq) data. Unlike models that reconstruct full Hi-C contact maps, UniversalEPI focuses on biologically relevant, sparse chromatin interactions between accessible regulatory elements. It generalizes across both bulk and single-cell ATAC-seq-derived pseudo-bulk datasets, delivering state-of-the-art performance while using fewer input modalities than existing approaches. By modeling predictive uncertainty, UniversalEPI enables statistically robust differential analysis of chromatin interactions across conditions. We demonstrate its utility by tracking dynamic EPIs during human macrophage activation and identifying regulatory differences between cancer cell states in esophageal adenocarcinoma. By providing precalculated Hi-C predictions for 157 ENCODE datasets, UniversalEPI expands the scope and applicability of in silico 3D genome modeling for studying gene regulation in development and disease.

PMID:42165138 | DOI:10.1093/nar/gkag485