Nevin Manimala

Farm Hosp. 2026 Mar 24:S1130-6343(26)00030-9. doi: 10.1016/j.farma.2026.02.018. Online ahead of print.

ABSTRACT

BACKGROUND: Serum creatinine-based equations are commonly used to estimate glomerular filtration rate (eGFR) in critically ill patients, despite not having been specifically developed for this population. This study aimed to assess and compare the performance of three widely used serum creatinine-based equations in this setting.

METHODS: Observational retrospective study conducted in four intensive care units of a tertiary university hospital. The most commonly used serum creatinine-based equations, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD-4), and Cockcroft-Gault (CG) equations were compared to the creatinine clearance from 24-hour urine collection (CrCl_24h), used as the reference method. Bland and Altman plots, bias and precision were performed to contrast CrCl_24h values with estimated GFR. Bias and its 95% confidence interval were calculated as the mean difference between the eGFR estimated by each equation and the measured CrCl_24h. Precision was reported as one standard deviation of the bias.

RESULTS: A total of 261 patients were included. In patients with CrCl_24h between 0-129 mL/min, no significant differences were observed between equations. However, in patients with augmented renal clearance (15.7%), with a mean CrCl_24h of 180 mL/min, there was a statistically significant bias between the CKD-EPI equation (66.4 mL/min/1,73m²) and both the CG and MDRD-4 equations (24.8 mL/min/m² and 29.3 mL/min/1,73 m², respectively; p < 0.01).

CONCLUSIONS: This study highlights that the most commonly used equations to estimate glomerular filtration rate in critically ill patients have remarkable limitations compared to creatinine clearance from 24-hour urine collection. In critically ill patients with CrCl_24h between 0-129 mL/min, no significant differences were found between the CG, MDRD-4, and CKD-EPI equations. However, for patients with augmented renal clearance, the CG and MDRD-4 equations performed statistically better than the CKD-EPI equation.

PMID:41881746 | DOI:10.1016/j.farma.2026.02.018

Farm Hosp. 2026 Mar 24:S1130-6343(26)00029-2. doi: 10.1016/j.farma.2026.02.017. Online ahead of print.

ABSTRACT

OBJECTIVE: Pivotal study on perioperative toripalimab in resectable non-small-cell lung cancer showed population differences by histological subtype compared with other immunotherapy regimens, raising doubts about therapeutic positioning. The aim of this study was to interpret the methodological analysis by subgroups according to histological subtype of perioperative toripalimab in resectable non-small-cell lung cancer.

METHODS: Validated subgroup analysis applicability tool was used. This tool had two parts: preliminary questions to directly rule out analysis without relevant minimum conditions, and checklist. This checklist assessed statistical association, biological plausibility and consistency of subgroup results, and related these criteria to recommendations on applicability.

RESULTS: Preliminary question regarding differences in effect between subgroups p(i) < 0.1 was answered negatively, and checklist was not applied due to direct discard. Even if the checklist had been applied, statistical association criterion would have been rated ‘null’ due to absence of statistically significant differences. Biological plausibility would have been rated ‘probable’ due to non-squamous histology being a negative prognostic factor. Consistency would have been rated ‘null’ for absence of heterogeneity between subgroups in similar studies.

CONCLUSIONS: This methodological interpretation recommended against applying histology-based subgroup results for perioperative toripalimab in resectable non-small-cell lung cancer, avoiding ruling out the use of toripalimab in the non-squamous subgroup.

PMID:41881745 | DOI:10.1016/j.farma.2026.02.017

Sleep Health. 2026 Mar 24:S2352-7218(26)00022-7. doi: 10.1016/j.sleh.2026.02.011. Online ahead of print.

ABSTRACT

OBJECTIVES: To test the effectiveness of a mobile phone text message-based intervention to mitigate fatigue and improve indicators of sleep health in a nationally representative sample of emergency medical services clinician shift workers.

METHODS: We conducted a cluster-randomized trial of emergency medical services agencies in the United States. Agencies (clusters) were randomized to intervention or the attention control group. Individual emergency medical services clinician shift workers used a mobile app to complete monthly surveys for 6 months and answered text message queries 1 out of every 4 weeks. Intervention text messages promoted adoption of fatigue mitigation behaviors. All attention control group text messages focused on teamwork improvement.

RESULTS: In total, 108 emergency medical services agencies and 708 emergency medical services shift workers were enrolled. Participants responded to >77% of monthly surveys and text message queries. The proportion of emergency medical services shift workers reporting severe fatigue declined over the study period; however, differences by intervention and attention control group status were not statistically significant. The proportion of participants with a clinically meaningful reduction in daytime sleepiness at 6 months was greater in the intervention group vs. the attention control group (p = .04).

CONCLUSIONS: Mobile phone text message-based assessments followed by immediate intervention are engaging, scalable on a nationwide level, and effective for addressing some indicators of sleep health like daytime sleepiness. Interventions combining behavioral sleep recommendations with fatigue mitigation strategies could result in larger effects on sleep health and fatigue.

TRIAL REGISTRATION NUMBER: ClinicalTrials.gov ID# NCT04456764 registered on June 29, 2020. First enrollment/consent on December 8, 2020.

PMID:41881743 | DOI:10.1016/j.sleh.2026.02.011

Chin J Traumatol. 2026 Mar 21:S1008-1275(26)00062-3. doi: 10.1016/j.cjtee.2025.05.008. Online ahead of print.

ABSTRACT

PURPOSE: Traumatic brain injury (TBI) is a severe public health problem worldwide. Early post-traumatic seizures (EPTSs) are acute symptomatic events corresponding to the brain’s response to the physical effects of TBI. Although there are ongoing findings regarding the association between EPTS and TBI, the correlation between EPTS occurrence and the severity of TBI remains unknown. The lack of knowledge regarding such mechanisms can also explain ineffective management. This systematic review and meta-analysis aimed to determine whether EPTS became a predictor of severity in patients with TBI.

METHODS: We performed a meta-analysis between November 2023 – January 2024. The keywords of “Early Post Traumatic Seizure” and “Traumatic Brain Injury” were searched in the PubMed, PMC, Science Direct, Cochrane Library, and Taylor and Francis databases. Only studies published in English were included. If duplicate publications were identified, the study with the larger sample size was selected. The comparison of severe TBI with EPTS was assessed using a Z test.

RESULT: We included 588 TBI patients with EPTS and 1610 patients without EPTS, retrieved from 9 papers. We found that EPTS patients had a 1.170-fold and 0.840-fold increased risk of developing severe TBI in adults (risk ratio: 1.170, 95% confidence interval: 1.000 – 1.370) and pediatric patients (risk ratio: 0.840; 95% confidence interval: 0.380 – 1.840). The research identified no significant evidence of publication bias (p > 0.05) in EPTS data.

CONCLUSION: EPTS are associated with increased severity and may serve as an independent predictor in adult TBI patients; however, this association is not statistically supported in pediatric populations and warrants further investigation.

PMID:41881728 | DOI:10.1016/j.cjtee.2025.05.008

J Prosthet Dent. 2026 Mar 24:S0022-3913(26)00161-7. doi: 10.1016/j.prosdent.2026.02.042. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Cone beam computed tomography (CBCT) scans acquired with interocclusal separation improve stability and reduce motion artifacts but lack reliable occlusal contacts. Accurately reconstructing occlusion is critical for diagnosis, restorative planning, and implant workflows. While integrating intraoral scans (IOSs) can capture occlusion accurately, the validity of artificial intelligence (AI)-driven alignment algorithms for reconstructing occlusion in separated CBCT datasets has not been established.

PURPOSE: The purpose of this retrospective study was to validate an AI-based tool for reconstructing occlusion by aligning separated maxillary and mandibular CBCT segmentations using IOS-derived occlusal data, with IOS occlusion as the reference standard.

MATERIAL AND METHODS: Forty paired CBCT scans acquired with interocclusal separation and corresponding IOS datasets were uploaded into an AI-driven platform, which automatically segmented and registered the CBCT and IOS scans. The AI tool used IOS‑derived occlusal relationships to align the segmented CBCT models, generating 3 occluded models: IOS‑only, AI-fused CBCT‑IOS, and CBCT‑only. Occlusal contacts, occlusal intersections, occlusal contact surface area, and 3-dimensional (3D) occlusal surface deviations were analyzed. Statistical analyses were performed using the Friedman test, repeated-measures ANOVA, and the Mann-Whitney U test. Intra-operator reliability was assessed using weighted kappa (κ) (α=.05).

RESULTS: No significant differences were observed between IOS and AI-fused CBCT-IOS models for occlusal contacts or contact surface area (median=46, mean ±standard deviation=256 ±170 mm²) and (median=48, mean=255 ±166 mm²), respectively. AI-driven CBCT models showed significantly fewer contacts (median=22, mean ±standard deviation=184 ±163 mm²). Median surface deviation between IOS and fused models was 0 µm, whereas CBCT-only models showed deviations of 70 to 80 µm. Dentition status did not influence outcomes. Intra-operator reliability was excellent (κ=0.86).

CONCLUSIONS: The AI-driven fusion of IOS occlusal data with CBCT scans acquired with interocclusal separation accurately reconstructs occlusion, enabling reliable treatment planning without the need for CBCT acquisition in occlusion.

PMID:41881719 | DOI:10.1016/j.prosdent.2026.02.042

Trends Microbiol. 2026 Mar 24:S0966-842X(26)00042-9. doi: 10.1016/j.tim.2026.03.003. Online ahead of print.

ABSTRACT

This review constitutes an evolutionary journey that begins with the emergence of reverse transcriptase and other ancient catalytic folds that shape retroelements (Class I transposable elements) and ends with the appearance of retroviruses and their subsequent or simultaneous endogenization. This path comprises milestones such as the formation of prokaryotic retroelements, their appropriation by eukaryotes, which resulted in the occurrence of non-long terminal repeat (non-LTR) retroelements, the mosaic formation of LTR retroelements by utilizing components of non-LTR retroelements and DNA transposons, and the acquisition of new domains that led to the emergence of retroviruses. We present here a comprehensive recounting of all evolutionary events that took place from the formation of primordial enzymes to the origin of retroviruses and their endogenization.

PMID:41881695 | DOI:10.1016/j.tim.2026.03.003

Acad Radiol. 2026 Mar 24:S1076-6332(26)00170-4. doi: 10.1016/j.acra.2026.03.006. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: This study aims to compare the diagnostic performance of fibroblast activation protein inhibitor (FAPI) and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) in patients with cervical cancer.

METHODS: In this review, we performed a systematic search of studies published in PubMed, Web of Science, and Embase databases up to October 30, 2025. All included studies used radionuclide labeled FAPI and ¹⁸F-FDG to evaluate their performance in patients with cervical cancer.

RESULTS: In patient-based analysis (n=109), FAPI showed higher sensitivity than ¹⁸F-FDG (0.96 vs 0.77) and greater specificity (0.98 vs 0.86). Lesion-based analysis (n=203 lymph nodes) yielded similar sensitivity patterns (0.99 vs 0.72) but may inflate precision due to within-patient clustering. Semi-quantitative parameters (SUVmax) showed variable patterns across studies (FAPI SUVmax range: 15.1-18.3 for primary lesions; FDG SUVmax range: 13.96-17.1). Descriptive comparison suggests FAPI SUVmax was generally comparable to or higher than FDG values, though formal pooled statistical comparison was not performed due to substantial heterogeneity in PET platforms, tracer variants, and acquisition protocols.

CONCLUSION: Compared with ¹⁸F-FDG, FAPI PET/CT and PET/MR are suggested to be promising imaging modalities with favorable sensitivity for cervical cancer. However, these results should be interpreted cautiously due to heterogeneity among studies and potential verification bias. Larger prospective studies are needed to confirm it in the future.

PMID:41881693 | DOI:10.1016/j.acra.2026.03.006

Addict Biol. 2026 Apr;31(4):e70146. doi: 10.1111/adb.70146.

ABSTRACT

The present study aimed to investigate the expression of OIP5-AS1 in alcohol use disorder and to explore its potential clinical relevance. A total of 78 patients with alcohol use disorder and 36 healthy controls were enrolled in this study. Clinical data were collected for all participants. The expression levels of OIP5-AS1 were quantified using quantitative real-time polymerase chain reaction (RT-PCR). Receiver operating characteristic (ROC) analysis was subsequently performed to evaluate the diagnostic value of OIP5-AS1. StarBase-based bioinformatics analysis suggested that OIP5-AS1 may function within a miRNA-mediated regulatory network influencing SERPINA3 expression. OIP5-AS1 expression levels, as determined by RT-PCR, were markedly higher in patients with alcohol use disorder than in healthy controls (p < 0.001). Patients were stratified into high- and low-expression groups based on the median OIP5-AS1 level. Comparative analyses of baseline characteristics and clinical parameters showed that body mass index (BMI) was significantly lower in the high-expression group, and this inverse association between OIP5-AS1 expression and BMI remained statistically significant in subsequent logistic regression analyses. ROC analysis demonstrated that OIP5-AS1 had strong diagnostic performance, yielding an area under the curve of 0.9091 (p < 0.0001), with a sensitivity of 100% and a specificity of 75% at the defined cutoff. In conclusion, OIP5-AS1 expression was significantly increased in patients with alcohol use disorder and was inversely associated with BMI. In addition, OIP5-AS1 demonstrated good diagnostic performance in distinguishing patients with alcohol use disorder from healthy controls. These findings suggest that OIP5-AS1 may have potential clinical relevance in alcohol use disorder and merit further investigation.

PMID:41881680 | DOI:10.1111/adb.70146

Br J Nutr. 2026 Mar 26:1-37. doi: 10.1017/S0007114526106928. Online ahead of print.

ABSTRACT

Vitamin D has been associated with depression, potentially via anti-inflammatory mechanisms, yet data is scarce, particularly in adolescence. We investigated (1) whether lower vitamin D status is associated with greater depression severity and (2) whether this association is statistically moderated by inflammation in patients of a child and adolescent psychiatry department. At admission fasting morning venous blood was drawn. Serum vitamin D (25(OH)D) and C-reactive protein (CRP) were analyzed in all participants [n=465 (64.7%♀; 11.3-18.9 years)]. In a subsample [n=177], we additionally measured tumor necrosis factor-alpha, interferon-gamma and interleukin (IL)-1β, IL-6, IL-8, IL-10. Depression severity was assessed by the Beck Depression Inventory-II (BDI-II) [n=450], the Diagnostic System for Mental Disorders in Childhood and Adolescence via self-assessment (DISYPS Self) [n=441], and parent-assessment (DISYPS Proxy) [n=422]. Overall, 43.2% [n=201] were at risk for vitamin D deficiency (<30nmol/L), and 73.5%-83.2% -depending on assessment tool- showed at least mild depression. Linear regression revealed an inverse association between 25(OH)D and BDI-II in both crude and CRP-adjusted full-sample models. Logistic regressions showed a robust inverse association between 25(OH)D and DISYPS Proxy, but not for DISYPS Self. Although 25(OH)D was inversely correlated with some pro-inflammatory markers, neither their inclusion in regression models nor formal mediation analyses supported inflammation as a mediator of the vitamin D-depression association. Overall, our results suggest that vitamin D relates modestly to both depression and inflammation in adolescence. However, based on the measured parameters, we cannot confirm that anti-inflammatory effects are the link between vitamin D and depression.

PMID:41881679 | DOI:10.1017/S0007114526106928

J Cosmet Dermatol. 2026 Apr;25(4):e70820. doi: 10.1111/jocd.70820.

ABSTRACT

BACKGROUND: Melasma is a multifactorial disorder, and while treatments aimed at suppressing melanin production and removing excess melanin have demonstrated some efficacy, no definitive therapy has yet been established. Dermal aging is widely recognized as a contributing factor in melasma, and previous studies have demonstrated that the presence of senescent fibroblasts reduces the efficacy of melasma treatments. Therefore, treatment strategies focused on reactivating fibroblast activity are anticipated to be effective against melasma.

OBJECTIVE: The objective of this study is to investigate the safety and efficacy of the Thermal-Thread Technique, which utilizes high-intensity, high-frequency parallel ultrasound beams for the treatment of melasma among Asian subjects.

STUDY DESIGN/METHODS: Patients diagnosed with melasma, regardless of disease type, duration, or Fitzpatrick skin type, underwent a single treatment session covering the entire face utilizing a high-intensity, high-frequency parallel ultrasound beam with Thermal-Thread Technique. High-resolution skin images were captured using a skin analyzer before treatment and six months after the treatment. Two independent evaluators assessed these images using the modified Melasma Area and Severity Index (mMASI) scoring system to objectively evaluate treatment efficacy. Statistical analyses of the mMASI scores were performed using paired t-tests. All potential side effects were carefully monitored both during and after the procedure.

RESULTS: All patients (n = 20, female, mean age: 50.5 ± 5.7) completed the study. The distribution of Fitzpatrick skin types among participants was as follows: type II (n = 7), type III (n = 11), and type IV (n = 2). The mean mMASI score significantly decreased from 4.63 ± 1.66 at baseline to 1.69 ± 0.90 six months post-treatment (p = 1.53e-9; p < 0.001). No statistically significant difference was observed among FST groups (F(2,17) = 1.68, p = 0.216). No side effects were observed or reported during or after the treatment period.

CONCLUSION: The improvement in mMASI scores observed with the Thermal-Thread Technique, utilizing a high-intensity, high-frequency parallel ultrasound beam, demonstrates its potential as an effective treatment for melasma. Further research is necessary to evaluate its efficacy in more severe cases, extend the observational period, and investigate the potential benefits associated with multiple treatment sessions.

PMID:41881668 | DOI:10.1111/jocd.70820