Nevin Manimala

Sci Rep. 2026 May 13. doi: 10.1038/s41598-026-51718-1. Online ahead of print.

ABSTRACT

Investigation of in utero, tissue-specific molecular pathways contributing to prenatal programming of childhood-onset asthma is needed to develop effective, targeted prevention strategies. We aimed to examine the relationship between predicted gene expression in placenta and childhood-onset asthma and to compare relationships between childhood- and adult-onset asthma. Asthma genome-wide association study published summary statistics were obtained from the UK Biobank and published placental gene expression quantitative trait loci were obtained from the Rhode Island Child Health Study. We used S-PrediXcan to evaluate and compare associations between placental predicted gene expression and childhood- and adult-onset asthma and to determine whether signals were placenta-specific. Among 8,038 tested placental predicted expression-asthma associations, we identified 56 (0.7%) genes only significantly associated with childhood-onset asthma, 12 (0.1%) genes only significantly associated with adult-onset asthma, and 18 (0.2%) shared genes. Predicted expression of several genes (ACTL9, AMN, C9orf38, C11orf30, CTSE, EFCAB13, EIF4E1B, FN1, GLS2, IL6, IVL, LZIC, MAN2A2, MEGT1, RACGAP1, SMAD6, SPATA5, TMEM25, VTI1B, WDR19) was not significantly associated with childhood- or adult-onset asthma in any non-placental tissue, suggesting that the associations may be placenta-specific. This study identified alterations in predicted expression of placental genes associated with transcriptional pathways critical to the development of asthma. We identified unique and shared pathways, particularly related to immune regulation, associated with childhood- and adult-onset. This expands our understanding of the fetal origins of asthma, highlights the placenta as an informative tissue in understanding asthma pathogenesis, and identifies target genes to prioritize for future functional studies.

PMID:42129325 | DOI:10.1038/s41598-026-51718-1

Sci Rep. 2026 May 13. doi: 10.1038/s41598-026-52632-2. Online ahead of print.

ABSTRACT

This study focuses on the vessel normalization window of anlotinib to preliminarily explore the optimal intervention timing for combining anlotinib with whole brain radiotherapy (WBRT) in treating brain metastases from non-small cell lung cancer (NSCLC). We aimed to explore the feasibility of combining anlotinib with WBRT based on the hypothesized vascular normalization window, and to investigate potential associations with intracranial tumor control, iPFS, and quality of life in patients with NSCLC brain metastases. This study was designed as a prospective, non-randomized, single-center cohort study. From Feb 8, 2024, to Sep 30, 2025, a total of 38 patients with NSCLC brain metastases diagnosed by the Department of Oncology, the Fifth Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, were prospectively recruited. Anlotinib was used as the intervention measure in this study. According to whether the patients received anlotinib or not, they were divided into the experimental group (anlotinib combined with WBRT) and the control group (sole WBRT), with 19 patients in each group. In the experimental group, the vascular normalization time window of anlotinib, which is 5 to 7 days, was precisely utilized. The specific medication regimen was to start taking 8 mg of anlotinib 5 days before the initiation of WBRT and continue the medication until the end of WBRT. In contrast, the control group received only WBRT. The primary and secondary endpoint indicators of the patients in both groups were followed up regularly. The primary endpoint indicators included the intracranial objective response rate (iORR) and iPFS, while the secondary endpoint indicators included the intracranial disease control rate (iDCR), quality of life, and adverse reactions. The Kaplan-Meier method was used to draw the survival curve.Meanwhile, the clinical characteristics of the patients in both groups, such as gender, age, primary tumor site, T stage, N stage, and the number of brain metastases, were collected. Univariate analysis was used to screen out the prognostic factors that might affect iPFS. Then, the factors with statistical differences (P < 0.10) in the univariate analysis were taken as independent variables, and further Cox multivariate regression analysis was carried out to explore the independent prognostic factors affecting iPFS. The test standard P value was < 0.05. From Feb 8, 2024, to Sep 30, 2025, a total of 38 patients diagnosed with brain metastases from NSCLC by the Oncology Department of the Fifth Affiliated Hospital of Chengdu University of Traditional Chinese Medicine were prospectively recruited and included in the statistical analysis. The median follow-up time was 15.2 months (95% CI: 9.02-21.37). The results showed that the experimental group had better iORR (57.90% vs. 15.79%, P = 0.017) and iDCR (100% vs. 73.68%, P = 0.046) compared to the control group, with statistically differences. Compared with the control group, the experimental group showed a advantage in iPFS (6.7 months vs. 4.27 months, P = 0.038), and the median iPFS was extended by an additional 2.43 months. The results of subgroup analysis showed that the iPFS of patients with ≥ 3 brain metastases and patients with < 3 brain metastases were 6.3 months and 6.7 months, respectively, and there was no significant difference between the two groups (P = 0.723). The iPFS was longer in patients with less than 3 metastases than those with more than 3 metastases (11.73 months vs. 3.17 months, P = 0.035). After WBRT, the iPFS of NSCLC patients with brain metastases who received anti-tumor therapy was improved compared with those who did not receive anti-tumor therapy (8.67 months vs. 3.80 months, P = 0.040). In terms of quality of life, the experimental group showed better outcomes in functional status, symptom domains, and overall health compared to the control group over time. Regarding adverse reactions, the main ones included decreased appetite, fatigue, nausea and vomiting, hypertension, Myelosuppression, dizziness, headache, and abnormal liver function indicators. Grade ≥ 3 adverse reactions primarily included anemia, agranulocytosis, leukopenia, thrombocytopenia, cognitive impairment and abnormal liver function indicators, most of which were tolerable after symptomatic treatment. Univariate regression analysis of the overall population indicated that antitumor therapy after WBRT (P = 0.078) and the number of organ metastases (P = 0.038) were clinically relevant factors affecting iPFS. Further multivariate Cox regression analysis revealed that antitumor therapy after WBRT (P = 0.047) and the number of organ metastases (P = 0.028) were independent prognostic factors influencing iPFS. In this exploratory cohort, low-dose (8 mg) anlotinib administered 5-7 days prior to WBRT was associated with higher iORR, iDCR, and longer iPFS relative to WBRT alone in patients with NSCLC brain metastases. This combination regimen showed a manageable safety profile and trends toward improved quality of life. Subgroup analyses suggested that patients with < 3 organ metastases or those receiving post-WBRT antitumor therapy tended to have prolonged iPFS. Multivariate Cox regression identified post-WBRT antitumor therapy and number of organ metastases as potential independent prognostic factors for iPFS in this cohort. These findings are hypothesis-generating and require validation in larger randomized controlled trials.

PMID:42129320 | DOI:10.1038/s41598-026-52632-2

Sci Rep. 2026 May 13. doi: 10.1038/s41598-026-52297-x. Online ahead of print.

ABSTRACT

Nigeria faces a significant energy deficit (61.2% electricity access), hindering progress toward SDG 7 (Affordable and Clean Energy) and SDG 13 (Climate Action). Despite geothermal potential, comprehensive assessments of low-enthalpy resources (that is, subsurface temperatures below 100 ℃) in transitional geological environments (TGEs) – basement-sedimentary contact zones with mixed conductive-advective heat transfer – remain underexplored. This study uses high-resolution aeromagnetic data interpretation with statistical modeling to delineate geothermal potential within the Egbako-Share axis of North-Central, Nigeria. Spectral analysis adopting centroid depth technique from 40 overlapping blocks was employed to estimate Curie Point Depths (CPD), geothermal gradients (GTG), and heat flow (HF). Statistical modeling – including correlation analysis, multiple regression, PCA, and spatial autocorrelation (Moran’s I, Getis-Ord Gi*) – provided a robust framework for resource assessment and risk evaluation. The analysis revealed significant geothermal resources with CPD ranging from 26 to 46 km (mean: 38 ± 6 km), GTG of 13-23 °C/km (mean: 16 ± 2 °C/km), and HF values of 31-57 mW/m² (mean: 39 ± 6 mW/m²). Strong negative correlations between CPD and both GTG (r = -0.892, p < 0.001) and HF (r = -0.891, p < 0.001) were established, with the regression model explaining 79.5% of HF variance. PCA identified 12 high-potential geothermal zones for low-enthalpy development. Under a conceptual scenario assuming full development of all 12 zones, modelled capacity could range from approximately 15 to 25 MW, with scenario-based annual CO₂ emission reductions of 85,000-140,000 t/year (subject to confirmatory drilling and feasibility studies), supporting Nigeria’s SDG 7, SDG 13, and related development targets.

PMID:42129299 | DOI:10.1038/s41598-026-52297-x

Comp Immunol Microbiol Infect Dis. 2026 May 12;128:102479. doi: 10.1016/j.cimid.2026.102479. Online ahead of print.

ABSTRACT

Domestic dogs are frequently exposed to tick-borne pathogens such as Babesia vogeli, Hepatozoon canis, Anaplasma platys and Ehrlichia canis, which can cause a wide range of clinical manifestations, although little is known about the epidemiological and clinicopathological profiles of mono- and co-infections. This study aimed to characterize infection patterns and identify clinical and epidemiological factors associated with mono-infections, and co-infections with two or more pathogens in naturally infected dogs. We analyzed 181 dogs from a hospital population with suspected hemoparasitic infections, assessed hematocrit and platelet counts, and used statistical models (Chi-square, Fisher’s exact test, odds ratios, and multinomial logistic regression) to evaluate associations between infection types and clinical or epidemiological variables. This is the first comprehensive Brazilian study correlating infection type with clinical and epidemiological factors. Dogs with a history of tick infestation were 3.41 times more likely to be co-infected with two pathogens, and infections involving two (84.6%) or three or more pathogens (90.9%) were more frequent in dogs without the use of tick control medications. Male dogs and those presenting epistaxis, hyporexia or anorexia, dehydration, onychogryphosis, and ectoparasites were more likely to be co-infected with three or more pathogens. Thrombocytopenia was common in all groups, with dogs co-infected with three or more pathogens showing 16.3 times higher odds and dogs co-infected with two pathogens had increased odds of anemia (OR = 2.11). These results underscore the importance of tick control and comprehensive pathogen screening in endemic regions, especially in Brazil’s semi-arid northeast, to enhance diagnosis, management, and prevention strategies.

PMID:42127483 | DOI:10.1016/j.cimid.2026.102479

Semergen. 2026 May 13;52(5):102770. doi: 10.1016/j.semerg.2026.102770. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the association between healthcare resources and premature mortality from ischemic heart disease in the Spanish autonomous communities between 2018 and 2023.

METHODS: An observational ecological study was conducted using aggregated data by autonomous community and year. The dependent variable was premature mortality from ischemic heart disease (< 75 years, adjusted for age). Independent variables included primary care physician density and per capita healthcare expenditure. Descriptive statistics, Pearson correlations, and multiple lineal regression were applied.

RESULTS: The average premature mortality rate was 20.53/100,000 inhabitants (SD=4.59), being higher in men (34.21 vs. 7.66 in women) and in the Canary Islands, Asturias, and Andalusia. The rate remained stable over time (19.91-21.04/100,000). No significant associations were found between mortality and healthcare resources. However, healthcare expenditure correlated positively with the density of primary care physicians (r=0.307; P=.001).

CONCLUSIONS: Although the availability of healthcare resources did not explain the differences in premature mortality, this study highlights the persistent territorial and sex-based heterogeneity in Spain and the need for comprehensive strategies that combine investment, prevention, and the reduction of inequalities. The findings provide useful evidence for planning cardiovascular health policies at the regional level.

PMID:42127482 | DOI:10.1016/j.semerg.2026.102770

Breast. 2026 May 12;88:104797. doi: 10.1016/j.breast.2026.104797. Online ahead of print.

ABSTRACT

BACKGROUND: Women living with HIV (WLHIV) may present with distinct clinical and laboratory characteristics at the time of breast cancer diagnosis. While previous studies, including multi-country cohorts such as the ABC-DO study, have described baseline patient and tumor features, data on pre-treatment laboratory parameters in routine clinical settings remain limited. This study aimed to characterize baseline clinical and laboratory factors at diagnosis and assess differences by HIV status.

METHODS: We analyzed data from women newly diagnosed with breast cancer at three tertiary hospitals in Tanzania. HIV status was obtained from medical records or provider-initiated testing. Baseline clinical and laboratory variables measured before systemic cancer therapy were evaluated. Multivariable logistic regression was used to identify factors independently associated with HIV status.

RESULTS: Among 425 women with newly diagnosed breast cancer, 47 (11%) were living with HIV. Advanced disease at presentation was common across the cohort. Neutropenia (absolute neutrophil count <1.5 × 10⁹/L) was more frequent among WLHIV than among women without HIV (15% vs 3%) and remained independently associated with HIV status (adjusted odds ratio [aOR] 3.52, 95% confidence interval [CI] 1.26-9.79).

CONCLUSIONS: WLHIV more frequently presented with neutropenia and advanced disease at diagnosis. By identifying clinically relevant differences in hematologic status are detectable at presentation using routinely collected data, this study addresses a key gap in real-world evidence from sub-Saharan Africa. These findings provide clinically actionable insight into baseline patient status at entry into cancer care and may inform early clinical assessment and supportive care planning in resource-constrained settings.

PMID:42127480 | DOI:10.1016/j.breast.2026.104797

Clin Neurol Neurosurg. 2026 May 8;268:109465. doi: 10.1016/j.clineuro.2026.109465. Online ahead of print.

ABSTRACT

OBJECTIVE: Efgartigimod, a neonatal Fc receptor (FcRn) antagonist, has been shown to reduce pathogenic immunoglobulin G (IgG) autoantibodies, notably anti-acetylcholine receptor (AChR) antibodies, in myasthenia gravis (MG). While clinical trials have established its safety and efficacy, real-world evidence regarding its therapeutic effectiveness and steroid-sparing potential remains limited. This study aimed to evaluate the real-world efficacy and steroid-sparing benefits of efgartigimod in the clinical management of MG.

METHODS: Forty-one patients with generalized myasthenia gravis (gMG) were enrolled in this prospective study. Participants received efgartigimod treatment and were followed for 26 weeks. Clinical outcomes, primarily Myasthenia Gravis Activities of Daily Living (MG-ADL) scores and corticosteroid dosages, were systematically evaluated. Statistical analyses were performed using R version 4.5.0.

RESULTS: Patients were stratified into two cohorts based on treatment cycles: 22 received two cycles of efgartigimod, while 19 received a single cycle. Bulbar and respiratory symptoms improved within two weeks, whereas ocular and limb weakness required a more prolonged treatment duration to achieve clinical benefit. Myasthenia Gravis Activities of Daily Living (MG-ADL) scores demonstrated a significant decline, with a more rapid response observed in severe cases. By Week 26, the proportion of patients requiring more than 16 mg/d of methylprednisolone decreased from 63.4% at baseline to 14.6%. The two-cycle cohort exhibited a lower mean cumulative methylprednisolone dose (4861.50 mg vs. 5469.24 mg). No treatment-related adverse effects were observed.

CONCLUSION: Efgartigimod demonstrated variable clinical responses across different muscle groups, with early improvements in bulbar and respiratory function alongside significant steroid-sparing advantages. Given that baseline MG-ADL scores serve as a reliable predictor of the time to achieve minimal symptom expression (MSE), and considering that repeated treatment cycles further augment therapeutic efficacy, efgartigimod represents a promising steroid-sparing immunomodulatory strategy for the management of MG.

PMID:42127467 | DOI:10.1016/j.clineuro.2026.109465

J Plast Reconstr Aesthet Surg. 2026 Apr 18;117:226-234. doi: 10.1016/j.bjps.2026.04.011. Online ahead of print.

ABSTRACT

BACKGROUND: The deep inferior epigastric perforator (DIEP) flap is a reliable salvage option following complications of implant-based breast reconstruction (IBR). However, comparative data on indications and outcomes between radiated and non-radiated breasts remain limited.

METHODS: A ten-year retrospective cohort study was performed by including patients who underwent DIEP flap reconstruction following complicated IBR. Data were compared between radiated and non-radiated breasts using the Mann-Whitney U, Chi-square, and Fisher’s exact tests.

RESULTS: Among the 1684 patients who underwent IBR, 620 (36.8%) required implant removal or exchange, and 63 (3.7%) ultimately underwent DIEP flap reconstruction. In total, 89 breasts underwent DIEP reconstruction after complications of implant, among which 33 (37%) had received post-mastectomy radiation to the ipsilateral implant or tissue expander. Radiated breasts had higher rates of infection (25% vs. 7%, p = 0.02) and implant removal (34.4% vs. 7%, p = 0.002) rates prior to DIEP conversion. The median interval between mastectomy and DIEP reconstruction tended to be shorter in radiated breasts (28 vs. 39 months, p = 0.09). Capsular contracture was the most common indication for conversion (46.9% radiated vs. 29.8% non-radiated, p = 0.1). Flap survival was 100% in radiated breasts and 96.5% in non-radiated breasts (p = 0.53).

CONCLUSIONS: Permanent implant-to-DIEP conversion occurred in 3.7% of patients. Radiated breasts were more likely to experience infection and implant removal before conversion. Although the time to DIEP tended to be shorter in radiated patients, this was not statistically significant. DIEP flap reconstruction provides high survival in both groups, confirming its reliability as a salvage option.

PMID:42127452 | DOI:10.1016/j.bjps.2026.04.011

Clin Nutr. 2026 Apr 9;62:106661. doi: 10.1016/j.clnu.2026.106661. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Although whole-body phase angle (PhA) is a recognized prognostic marker in cardiovascular surgery, the clinical significance of segmental PhA and the impact of fluid overload on its interpretation remain insufficiently elucidated. This study investigated the associations between segmental PhA, physical function, and long-term prognosis in patients undergoing cardiovascular surgery.

METHODS: This retrospective cohort study included consecutive patients who underwent elective cardiovascular surgery between October 2016 and March 2021 at Nagoya Heart Center, Japan. Preoperative whole-body, upper extremity, and lower extremity PhA were measured using bioelectrical impedance analysis. We analyzed correlations between PhA and physical functions. Additionally, the impact of fluid overload was assessed by stratifying patients based on an extracellular-to-total body water ratio (ECW/TBW) cut-off of 0.400. Long-term all-cause mortality was evaluated using multivariate Cox regression analyses adjusting for confounders including age, sex, cardiac and renal function.

RESULTS: A total of 859 patients were included in the present analysis (mean age = 68.4 ± 11.9 years, 67.6% male). Segmental PhA significantly correlated with muscle mass, grip strength, and knee extension strength. However, in patients with fluid overload (ECW/TBW ≥0.400), the associations between PhA and physical function were attenuated, and the correlation with age lost statistical significance. Regarding prognosis, low PhA values across all segments were independent predictors of long-term all-cause mortality, even after adjusting for confounders.

CONCLUSIONS: Segmental PhA is a robust predictor of long-term mortality in cardiovascular surgery patients. However, because fluid overload confounds the relationship between PhA and physical function, clinicians must account for fluid status when interpreting PhA as a marker of muscle quality..

PMID:42127431 | DOI:10.1016/j.clnu.2026.106661

Sleep. 2026 May 13:zsag130. doi: 10.1093/sleep/zsag130. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Sleep duration is a key component of overall sleep health, but prior population-level studies characterizing this have relied on brief self-report questions (often one item) or used different objective devices within the same study. We examined the normal variation of sleep duration in an adult population using a single consumer-grade wearable device with a unified algorithm.

METHODS: Retrospective cohort study conducted in the United States. Data were analyzed from 274,128 U.S.-based adults aged 20 to 69 who used a Samsung Galaxy Watch between February 2023 and April 2023; participants were included if they had ≥20 valid weekdays and ≥8 valid weekend days of data. Sleep duration was the primary outcome, defined as the longest continuous nighttime sleep period between 6:00 p.m. and 6:00 a.m. averaged over a three-month period. Sleep duration and weekday-weekend variability were examined across age groups and by sex using descriptive statistics and independent t-tests.

RESULTS: Overall, average sleep duration was 7.57 hours, with a 10th-90th percentile range of 6.5 to 8.9 hours. Sleep duration was shortest in the 40-49 year old group (7.54 hours) and longest in the 60-69 year old group (7.75 hours; p < .001). Overall, 23.0% of adults slept less than 7 hours, more commonly among those aged 40-49 (25.1%) and 50-59 (24.7%). Across all age groups, weekend sleep was longer than weekday sleep by an average of 28 minutes, with the largest gap in the 40-49 year old group (34 minutes), and the smallest in the 60-69 year old group (20 minutes). Women consistently slept longer than men (+18 minutes on average), and exhibited greater between-subject variability in total sleep duration (SD = 1.61 hours for women vs. 1.54 hours for men).

CONCLUSIONS: This study demonstrates considerable variability in objectively measured sleep duration across adulthood, spanning a broad range and differing by age groups and sex. These findings provide reference distributions that may inform clinical expectations and public health messaging regarding sleep duration.

PMID:42127423 | DOI:10.1093/sleep/zsag130