Nevin Manimala

Circ Cardiovasc Imaging. 2026 May 14:e019402. doi: 10.1161/CIRCIMAGING.125.019402. Online ahead of print.

ABSTRACT

BACKGROUND: The 2016 American Society of Echocardiography (ASE) guidelines for left ventricular diastolic dysfunction (LVDD) classification resulted in a significant proportion of indeterminate classifications and grades. To address these limitations and incorporate new evidence, the ASE updated its recommendations in 2025. The impact of these revisions in community cohorts remains unclear.

METHODS: We studied 1953 Project Baseline Health Study participants who underwent comprehensive transthoracic echocardiography. LVDD was classified using the 2016 and 2025 ASE recommendations. For the 2025 recommendations, fixed and age-specific thresholds were evaluated separately. We compared LVDD prevalence, reclassification patterns, associations with cardiovascular risk factors, and prognostic value for major adverse cardiovascular events over a median follow-up of 4.3 years.

RESULTS: Median age was 50.6 years (Q1-Q3: 36.3-64.2); 56.3% were female, 35.3% had hypertension, and 14.2% had diabetes. The prevalence of LVDD was higher with the 2025 recommendations than with the 2016 algorithm: fixed criteria 308 (15.8%), age-specific criteria 220 (11.3%) versus ASE 2016 154 (8.0%). Among 119 (6.1%) participants classified as indeterminate by the 2016 algorithm, the 2025 recommendations reclassified 51.2% as no LVDD and 31.8% as Grade 2 LVDD. Participants reclassified as no LVDD had event-free survival that was not statistically different from those without LVDD (P=0.26), whereas those reclassified as Grade 2 had higher event rates (12.5% versus 3.8%; P=0.02). Major adverse cardiovascular events occurred in 98 (5.0%) participants over the follow-up period. LVDD by all classification approaches was independently associated with major adverse cardiovascular events after adjustment for baseline risk factors.

CONCLUSIONS: The 2025 ASE recommendations identified more participants with LVDD than the 2016 algorithm without indeterminate classification or grading. LVDD by the 2025 classification was significantly associated with major adverse cardiovascular events, supporting the clinical relevance of the revised framework.

PMID:42131912 | DOI:10.1161/CIRCIMAGING.125.019402

Stroke. 2026 May 14. doi: 10.1161/STROKEAHA.126.055924. Online ahead of print.

ABSTRACT

BACKGROUND: Vascular cognitive impairment and dementia is characterized by profound demyelination of white matter and the loss of myelin-producing oligodendrocytes. Clinical reports reveal negative correlations between plasma levels of adiponectin, the most abundant adipokine, and the severity of white matter lesions and cognitive impairments. Therefore, this study evaluated the effects of adiponectin and adipoRon, a small-molecule agonist of adiponectin receptors, on white matter integrity after chronic hypoperfusion-induced vascular cognitive impairment and dementia.

METHODS: Male C57BL/6 wild-type, adiponectin knockout, and wild-type microglia-depleted (PLX5622-treated) mice were subjected to asymmetrical common carotid artery stenosis to model vascular cognitive impairment and dementia. White matter integrity was measured by immunohistochemistry, transmission electron microscopy, electrophysiology, and ex vivo diffusion tensor imaging. Cognitive functions were evaluated by Morris water maze, Y maze, and passive avoidance tests. A model of lysophosphatidylcholine/LPC (lysolecithin)-mediated demyelination using ex vivo organotypic cerebellar slice cultures was used to assess white matter repair. Primary microglia and oligodendrocytes were prepared for in vitro studies. Statistical tests (t test or ANOVA) were based on the group numbers, types of variables, and data structure.

RESULTS: Adiponectin deficiency worsened white matter lesions and impaired axonal conduction compared with wild-type mice 42 days after asymmetrical common carotid artery stenosis. Conversely, adipoRon improved white matter integrity for the long term in both young and aged mice, consistent with their superior cognitive functions after asymmetrical common carotid artery stenosis. Adiponectin and adipoRon directly protected primary oligodendrocytes against oxygen/glucose deprivation, enhanced microglial engulfment of myelin debris, and promoted oligodendrogenic capacities of microglia in vitro. AdipoRon treatment enhanced microglial engulfment of damaged myelin after asymmetrical common carotid artery stenosis and boosted oligodendrocyte regeneration and white matter integrity in a microglia-dependent manner.

CONCLUSIONS: Adiponectin strengthens white matter integrity in chronic hypoperfusion-induced vascular cognitive impairment and dementia, providing a novel therapeutic target. Adiponectin may exert dual mechanistic effects by enhancing oligodendrocyte survival and promoting a reparative microglial phenotype.

PMID:42131908 | DOI:10.1161/STROKEAHA.126.055924

Food Nutr Bull. 2026 May 14:3795721261450295. doi: 10.1177/03795721261450295. Online ahead of print.

ABSTRACT

BackgroundAnimal-source foods (ASFs) are critical for addressing child undernutrition, yet consumption remains low in Ethiopia. Prevailing evidence often aggregates ASFs, potentially obscuring the unique socioeconomic and demographic determinants of specific, nutrient-rich foods like dairy, eggs, and meat.ObjectiveThis secondary analysis aimed to compare the determinants of dairy, egg, and meat/poultry consumption among children aged 6 to 23 months in Harar City, Eastern Ethiopia, using existing cross-sectional data.MethodsThis secondary analysis utilized data from an institution-based cross-sectional study conducted among 542 mother-child pairs from July to August 2024. The original data were collected electronically via structured questionnaires. For this analysis, consumption of each ASF (dairy, eggs, meat/poultry) in the preceding 24 h was the primary outcome. Separate multivariable logistic regression models identified adjusted factors associated with each food type. The very low prevalence of meat/poultry consumption (4.5%) limits statistical power for detecting associations.ResultsConsumption prevalence was 28.6% for dairy, 15.0% for eggs, and 4.5% for meat/poultry. Household wealth exhibited a strong, positive gradient for all ASFs, most pronounced for eggs (richest vs poorest: Adjusted Odds Ratio [AOR] = 3.50, 95% Confidence Interval [CI]: 1.33-9.24). Maternal primary education was significantly associated with higher odds of dairy (AOR = 1.93, 95% CI: 1.17-3.19) and egg consumption (AOR = 2.52, 95% CI: 1.26-5.05) but not meat. Large family size (≥7 members) was a major constraint, reducing the odds of egg consumption by 70% (AOR = 0.30, 95% CI: 0.13-0.74).ConclusionsThe socioeconomic and demographic determinants of ASF consumption are not uniform but are distinctly patterned by food type. Nutrition-sensitive interventions must therefore be equally specific, combining economic strategies to improve affordability with targeted education-particularly for dairy and eggs-while addressing intrahousehold food allocation in larger families.

PMID:42131902 | DOI:10.1177/03795721261450295

J Microsc. 2026 May 14. doi: 10.1111/jmi.70105. Online ahead of print.

ABSTRACT

Spatial transcriptomics and in situ hybridisation techniques have become essential for contextualising single-cell RNA sequencing (scRNA-seq) data by mapping cell type- and state-specific mRNA expression within intact tissues. Beyond validating scRNA-seq predictions, these spatial methods provide critical insight into the localisation of specific cell types and their spatial relationships with neighbouring cells. However, current approaches rely on light microscopy (LM), which, despite advances, lacks the resolution needed to resolve detailed cell morphology or subcellular RNA localisation in situ. While correlative imaging methods can enhance spatial context, RNA detection remains limited by the optical constraints of LM. To overcome these challenges, we developed a three-dimensional RNA-based correlated light and electron microscopy (RCLEM) workflow. This method integrates RNA labelling with serial block-face scanning electron microscopy (SBF-SEM), allowing high-resolution 3D visualisation of RNA molecules within their ultrastructural environment. We optimised the RNA labelling protocol for thick, whole-mount tissues by fine-tuning detergent conditions to preserve ultrastructure while maintaining probe accessibility. This RCLEM approach offers several advantages over protein-based correlative methods, including robust detection with nucleotide probes and independence from antibody optimisation or fixation-sensitive epitopes. Applied to choroid plexus (ChP) and liver tissue, this workflow enabled precise 3D correlation between mRNA expression and EM features, supporting detailed morphological characterisation of rare scRNA-seq-defined cell subtypes. This protocol is broadly applicable to other complex tissues and provides a powerful platform for integrative, high-resolution spatial transcriptomic analyses that bridge gene expression with ultrastructure. LAY DESCRIPTION: To overcome the resolution limits of current spatial transcriptomics, we developed a 3D RNA-based correlated light and electron microscopy (RCLEM) workflow. By integrating RNA labelling with scanning electron microscopy, this method enables high-resolution 3D visualisation of mRNA within its ultrastructural environment in thick tissues. Validated in choroid plexus and liver, our antibody-independent RCLEM approach provides a broadly applicable platform bridging gene expression and precise cellular morphology for advanced spatial analyses.

PMID:42131894 | DOI:10.1111/jmi.70105

Influenza Other Respir Viruses. 2026 May;20(5):e70224. doi: 10.1111/irv.70224.

ABSTRACT

INTRODUCTION: Respiratory syncytial virus (RSV) is one of the most common viruses infecting nearly all children worldwide within the first 2 years of life, requiring hospitalization for over 80% of cases in infants under the age of 1. The aim of this study was to evaluate the epidemiological impact of RSV infections on hospital admissions among patients aged less than 2 years in the Abruzzo region, Italy. In addition, the analysis on patients aged less than 1 year and the evaluation of direct costs related to RSV admissions were also performed.

METHODS: A retrospective observational study was performed in Abruzzo, a Southern Italian region. Data related to hospitalizations were extracted from the hospital discharge record (HDRs) of the Abruzzo region, considering all hospitalizations registered from 2018 to 2023. HDRs from patients younger than 2 years of age and diagnosed with RSV were extracted. Hospitalizations were stratified by calendar year and seasonal cycle. In addition, the analysis of costs generated by each admission was performed.

RESULTS: Totally, 1899 hospitalizations for RSV (98.43 admissions/1000 inhabitants aged under 2 years of age) were recorded in the Abruzzo region during the study period. The median length of stay of all the considered hospitalizations was 5 days (IQR 5-5). The year with the highest number of hospitalizations was 2023. The incident rate among patients under 2 years of age rose from 17.42 to 19.39 in 2023 in A2 over 1000 inhabitants. About costs, the total expenditure for hospitalizations strongly increased from €579,047.29 in 2018 to €1,060,018.94 in 2023.

CONCLUSIONS: This study highlights the heavy burden of RSV on hospital admissions among patients aged under 2 years in a region of Southern Italy. These results are in line with previously published research, leading to the necessity of the introduction of effective preventive measures.

PMID:42131892 | DOI:10.1111/irv.70224

Ecancermedicalscience. 2026 Mar 12;20:2090. doi: 10.3332/ecancer.2026.2090. eCollection 2026.

ABSTRACT

BACKGROUND: Multidisciplinary tumour board (MTB) plays an important role in cancer care by collaborating specialist from various disciplines to discuss diagnosis, treatment plan and patient management. Despite its importance, a systematic evaluations of tumour board in hospital registered under hospital-based cancer registries (HBCRs) is limited. This study aims to assess the characteristics, composition and functioning of tumour board in these hospital to identify gaps and challenges to improve the tumour board operations.

METHODS: The study was conducted from October 1st to 31st 2024 using cross sectional design among hospital under HBCR. A set of structured questionnaires was administered using Google Form, which consists of both qualitative and quantitative questionnaires. Descriptive statistics and chi-square test were used to analyze the quantitative data, while manual thematic analysis was carried out to analyze the qualitative responses.

RESULT: Of 229 hospitals, only 172 (75%) responded. Among them, 137 (79.7%) reported having a functional tumour board. Most of the tumour boards were established in tertiary care centres (45.3%) and medical colleges (43.6%). In-person meeting (73.7%) was the most common with 24.8% following a hybrid model. Only 5.1% of hospitals engaged in cross-hospital case discussions; 16.8% maintained electronic medical record notes; and 48.2% lacked any follow-up mechanisms to track tumour board recommendations and outcomes. Involvement of palliative care specialists and other supportive paramedical health professionals was low. In addition to that, thematic analysis also identified that there was inadequate documentation, inconsistent follow-up and limited tumour board participation.

CONCLUSION: Although MTBs are established widely in most of the HBCR-affiliated hospitals, variation exist in structure, composition and functionality. Strengthening MTBs through standardised protocol, participation of diverse specialities, increased cross-hospital collaboration, virtual tumour boards and proper documentation practices through electronic data recording systems could enhance the decision making and cancer care outcomes.

PMID:42131886 | PMC:PMC13161587 | DOI:10.3332/ecancer.2026.2090

Ecancermedicalscience. 2026 Mar 12;20:2089. doi: 10.3332/ecancer.2026.2089. eCollection 2026.

ABSTRACT

BACKGROUND: Understanding symptom prevalence and palliative care needs is essential to advancing palliative care research in South America. This study aimed to assess these outcomes using the Palliative Outcome Scale (POS) and explore their relationship with the self-rated importance of spirituality.

METHODS: A cross-sectional study was conducted among adult persons with cancer receiving palliative care at an outpatient clinic in a Brazilian public hospital. Data were collected through structured interviews using the POS, which assesses physical and psychosocial symptoms, communication, practical concerns and information received. Spirituality was measured using a self-rated single-item question. Associations between symptom burden and spirituality were analysed using t-tests and logistic regression was used to examine the relationship between spirituality importance and inadequate pain control, adjusting for potential confounders. Statistical significance was set at p < 0.05.

RESULTS: Sixty-seven patients (mean age 60 ± 13.8 years; 68.6% female) participated. Pain (77.6%), nausea (27%), weakness/fatigue (20.9%) and psychological distress (19.4%) were the most prevalent symptoms. Most had metastatic cancer (62.7%), and 32.8% were undergoing chemotherapy. Patients rating spirituality as highly important had significantly lower pain scores (mean 1.4 ± 1.4 versus 2.6 ± 0.9, p = 0.006) and were over ten times less likely to report inadequate pain control (odds ratios = 10.74, 95% confidence intervals: 1.87-203.82, p = 0.028).

CONCLUSION: Our findings underscore the high prevalence of physical, psychological and social challenges among persons with cancer receiving palliative care. Symptom patterns aligned with global data, suggesting a universal burden. The strong association between spirituality and pain highlights the protective role of spiritual well-being in mitigating suffering, reinforcing the need to integrate spiritual care into palliative frameworks. These results offer valuable insights for guiding clinical practice, shaping international policy and informing future research to optimise care delivery and patient outcomes.

PMID:42131884 | PMC:PMC13161588 | DOI:10.3332/ecancer.2026.2089

Ecancermedicalscience. 2026 Mar 18;20:2095. doi: 10.3332/ecancer.2026.2095. eCollection 2026.

ABSTRACT

OBJECTIVE: To compare patient-reported outcomes of breast-conserving surgery (BCS) and breast reconstruction post-mastectomy (BRPM) at Mater Dei Hospital using the BREAST-Q™ questionnaire, with a focus on multiple quality-of-life domains including satisfaction with breasts, psychosocial well-being, physical well-being, sexual well-being, fatigue, cancer worry and impact on work.

METHODS: This retrospective audit analysed 46 patients treated between 2017 and 2020 at Mater Dei Hospital, Malta: 23 underwent BCS via wide local excision, and 23 underwent two-stage implant-based reconstruction following mastectomy. To reduce variability, only cases performed by a single breast surgeon were included, and age distributions were matched between groups. Patient-reported outcomes were assessed using the validated BREAST-Q™ version 1.0 questionnaire. Statistical comparisons between the BCS and BRPM groups were conducted using the Mann-Whitney U test.

RESULTS: BCS patients reported higher scores in physical well-being (70.0% versus 64.6%, p = 0.01) and slightly better sexual well-being (73.3% vs versus 66.7%, p = 0.83), while BRPM patients showed higher psychosocial well-being (74.0% vs versus 69.4%, p = 0.17). Satisfaction with breast outcomes appeared higher in the BCS group when expressed as a percentage of the maximum possible score (83.5% vs versus 63.3%, p = 0.43), though raw scores favoured BRPM. Cancer worry, fatigue and impact on work scores were similar between groups, with no statistically significant differences.

CONCLUSION: Both BCS and BRPM yielded broadly comparable patient-reported outcomes across most domains. BRPM was associated with higher psychosocial well-being, while BCS patients experienced better physical and sexual well-being. The only statistically significant difference was found in physical well-being, favouring BCS. These findings underscore the importance of personalised counselling and shared decision-making to align surgical choices with patient values and expectations.

PMID:42131881 | PMC:PMC13161581 | DOI:10.3332/ecancer.2026.2095

Ecancermedicalscience. 2026 Mar 12;20:2093. doi: 10.3332/ecancer.2026.2093. eCollection 2026.

ABSTRACT

BACKGROUND: São Tomé and Príncipe, a small island developing state, relies heavily on medical evacuations for specialised cancer care. This country does not yet have a population-based cancer registry. Therefore, limited data exist on cancer epidemiology in this population.

OBJECTIVE: To characterise the profile of cancer among patients evacuated from São Tomé and Príncipe for medical treatment abroad.

METHODS: Descriptive study of medical evacuation records from the Ministry of Health’s Patient Evacuation Board (2019-2025). Descriptive statistics were reported for patient demographics, year of evacuation, primary diagnosis, referring speciality, number of evacuations per patient and if travelled with an escort.

RESULTS: Of 1,066 total evacuations, 413 (38.7%) were cancer-related. Cancer patients had a mean age of 48.3 ± 18.7 years with female predominance (58.6%). Breast cancer was most frequent (24.7%), followed by prostate (17.9%) and cervical cancer (9.4%). Most patients (76.9%) required single evacuation, with cancer patients more likely to have multiple evacuations.

CONCLUSION: Cancer represents a substantial burden among medical evacuees, with patterns suggesting opportunities for enhanced prevention and early detection programs. The high evacuation rate highlights critical gaps in local oncological capacity. Establishing a population-based cancer registry would enhance epidemiological data and inform public health strategies.

PMID:42131878 | PMC:PMC13161590 | DOI:10.3332/ecancer.2026.2093

J Saudi Heart Assoc. 2026 May 2;38(2):3. doi: 10.37616/2212-5043.1499. eCollection 2026.

ABSTRACT

OBJECTIVES: Accurate patient centring at the computed tomography (CT) scanner isocentre is essential for optimising radiation dose. This study aimed to quantify positioning errors, assess their relationship with radiation dose, and estimate the potential dose reduction achievable with optimal centring.

METHODS: This retrospective observational study included adult patients (≥18 years) who underwent electrocardiography (ECG)-gated cardiac CT angiography between January 2023 and July 2025 at a tertiary hospital. Scans were performed using Siemens SOMATOM Force dual-source CT systems. Vertical and lateral deviations from the scanner isocentre were calculated from scout images using integrated analytics within the institutional dose monitoring platform (Qaelum NV, Leuven, Belgium). Radiation dose indices, including the volume-weighted CT dose index (CTDI_vol) and dose length product (DLP), were extracted from DICOM dose reports. Statistical analyses comprised descriptive statistics, correlation analysis, multivariable regression, and simulation of potential dose reductions with ideal centring.

RESULTS: Data from 399 patients were evaluated. Significant off-centring (>10 mm) occurred in 83% of scans in the anteroposterior (AP) direction and 50% laterally. Severe AP off-centring (>30 mm) was present in 39% of cases. Off-centring showed no independent association with CTDI_vol or DLP after adjustment for body mass index (BMI), age, and sex. Male patients demonstrated significantly greater off-centring in both the AP (p = 0.048) and lateral (p = 0.037) directions, and BMI category was significantly associated with off-centring magnitude in the AP (p = 0.031) and lateral (p = 0.022) directions. Literature-based scenario modelling suggested that ideal centring could hypothetically reduce mean CTDI_vol by approximately 12%, with a similar reduction in DLP.

CONCLUSION: Patient off-centring was highly prevalent in cardiac CT examinations. No independent association between off-centring and radiation dose was observed when adjusting for BMI, age, and sex. Literature-based scenario modelling suggests that meaningful radiation dose reductions may be achievable with optimum centring, although this requires prospective confirmation.

PMID:42131871 | PMC:PMC13166806 | DOI:10.37616/2212-5043.1499