Nevin Manimala

J Pediatr Soc North Am. 2026 Jul 8;17:100421. doi: 10.1016/j.jposna.2026.100421. eCollection 2026 Nov.

ABSTRACT

BACKGROUND: Posterior spinal fusion (PSF) is the standard surgical treatment for progressive adolescent idiopathic scoliosis (AIS). While return to sport after PSF has been described, return to school (RTS) remains poorly defined despite its educational and psychosocial importance. This study aimed to quantify RTS timelines, compare anticipated versus observed absences, and evaluate demographic, surgical, psychosocial, and socioeconomic predictors.

METHODS: Consecutively enrolled English-speaking AIS and juvenile idiopathic scoliosis (JIS) patients undergoing PSF at a single institution between 2022 and 2025 were prospectively studied. Preoperative surveys captured demographics, school type, anticipated RTS, and awareness of accommodations available through a patient’s school setting. Postoperative surveys documented actual RTS, attendance, and barriers. RTS was defined as the first day the patient resumed full-day, in-person school attendance. Partial day attendance, hybrid instruction, and virtual learning were not separately analyzed. The Pain Catastrophizing Scale assessed psychological status, and the Area Deprivation Index (ADI) measured socioeconomic context. Group comparisons used chi-square/Fisher’s exact tests and t-tests/Mann-Whitney U; regression identified predictors.

RESULTS: A total of 118 patients (84% female; mean age 14.5 ± 1.9 years) were included. Families anticipated 31.4 days of absence, while 71 postoperative respondents reported a mean absence of 46.8 ± 18.6 days (P = .022). Homeschool and private school students demonstrated numerically shorter RTS intervals than public school students (26.3, 32.8, and 43.1 days, respectively); however, these differences did not reach statistical significance (P = .160). Fusion length, sex, ADI, and race were not independent predictors of RTS.

CONCLUSIONS: AIS/JIS patients undergoing PSF returned to school at a mean of 6.7 weeks, approximately 2 weeks later than anticipated. Exploratory analyses suggested possible differences by school type and psychosocial factors, which should be investigated further in future, larger studies.

KEY CONCEPTS: (1)There may be an educational gap, as families tend to underestimate the time required for their child to return to school (RTS).(2)Surgical and demographic factors, including length of fusion, sex, Area Deprivation Index, and race, were not associated with time to RTS.

LEVEL OF EVIDENCE: II, Prospective cohort study.

PMID:42571470 | PMC:PMC13452329 | DOI:10.1016/j.jposna.2026.100421

JSAMS Plus. 2026 Jul 30;8:100153. doi: 10.1016/j.jsampl.2026.100153. eCollection 2026 Dec.

ABSTRACT

BACKGROUND: Heart failure (HF) significantly reduces functional capacity and quality of life in patients classified as New York Heart Association (NYHA) functional class II-III. While cardiopulmonary rehabilitation (CR) is beneficial, innovative strategies are required to improve accessibility and effectiveness for individuals unable to tolerate high hemodynamic loads.

AIMS: To compare the effects of conventional moderate-to-high intensity resistance training (CRT) versus low-load resistance training combined with blood flow restriction (BFRRT) on clinical, functional, and biochemical outcomes in HF patients.

METHODS AND ANALYSIS: This randomized, prospective, parallel-group clinical trial will include 52 patients (NYHA II-III) allocated into CRT (60-80% 1RM) or BFRRT (20-30% 1RM, calibrated at 50% arterial occlusion pressure) groups. The supervised intervention lasts 4 months, with an 8-month post-intervention follow-up. The primary outcome is the change in serum NT-proBNP levels. Secondary outcomes include quality of life, echocardiographic ventricular function, functional capacity, and clinical events. Advanced statistical models and exploratory machine learning analyses with k-fold cross-validation will be utilized for predictive modeling and exploring personalized medicine strategies.

IMPLICATIONS: The REHAB-WASHOUT HF trial aims to establish an effective, safe, and accessible therapeutic approach for HF rehabilitation, potentially enhancing clinical outcomes and guiding personalized prescriptive strategies in cardiovascular rehabilitation.

ETHICS AND REGISTRATION: Approved by the local institutional review board (No. 5.848.965; CAAE 64955022.9.1001.0029). Trial registration: RBR-5y8k7d7.

PMID:42571467 | PMC:PMC13452277 | DOI:10.1016/j.jsampl.2026.100153

Public Health Pract (Oxf). 2026 Jul 24;12:100832. doi: 10.1016/j.puhip.2026.100832. eCollection 2026 Dec.

ABSTRACT

OBJECTIVES: The COVID-19 pandemic was associated with increased maternal morbidity and mortality, with racially minoritized women having worse outcomes than other women in the United States. However, there is little understanding of pandemic-specific stressors that may contribute to disparate outcomes. Thus, this analysis provides descriptive statistics of COVID-19 pandemic related factors among a sample of women who recently gave birth in the United States that can inform future public health disaster preparedness.

STUDY DESIGN: Cross-sectional analysis of secondary data.

METHODS: Analysis of 2020-2021 Pregnancy Risk Assessment Monitoring System COVID-19 supplement data (weighted n = 453,231) identified five pandemic experience factors through factor analysis: family household stressors, housing instability, COVID prevention measures, COVID household exposure, and external exposure. Prevalence of each factor was estimated overall and by demographic factors.

RESULTS: Family household stressors affected 42.1% of women, including increased anxiety (48.5%) and job loss (29.9%). Housing instability impacted 11.3%, while 35.2% struggled accessing prevention supplies. Significant disparities emerged: Black and Hispanic women experienced highest family stress rates (48.5%, 48.0%); American Indian/Alaska Native women faced greatest housing instability (21.6%). Younger, unmarried women and those with lower education, Medicaid enrollment, or pre-existing vulnerabilities experienced disproportionate burdens.

CONCLUSIONS: Findings necessitate targeted emergency preparedness protocols prioritizing pregnant women’s social support infrastructure, including housing assistance programs, expanded childcare services, and guaranteed access to prevention resources. The pandemic exacerbated maternal health disparities, with marginalized communities bearing the greatest burden. Medicaid expansion and culturally-responsive interventions should be implemented to support vulnerable populations during public health crises.

PMID:42571459 | PMC:PMC13452337 | DOI:10.1016/j.puhip.2026.100832

Vet Anim Sci. 2026 Jul 29;34:100790. doi: 10.1016/j.vas.2026.100790. eCollection 2026 Dec.

ABSTRACT

Heat stress is an increasingly important constraint on cattle welfare, fertility, productivity, and developmental resilience. DNA methylation may mediate part of the molecular response to thermal exposure, but current studies differ widely in tissue type, exposure model, assay platform, and endpoint definition. This review systematically synthesizes evidence linking heat stress to DNA methylation changes in cattle and evaluates whether a quantitative meta-analysis of global methylation responses is currently feasible. A PRISMA-informed search was conducted for peer-reviewed bovine studies published between 2015 and early 2026. The PECO framework defined cattle or cattle-derived biological material as the population, heat stress or thermal challenge as the exposure, thermoneutral, cooled, or non-stressed conditions as comparators, and DNA methylation-related measures as outcomes. The predefined primary quantitative endpoint was global DNA methylation or hydroxymethylation reported as a continuous outcome. Locus-specific, promoter-level, DMC, DMR, and multi-omics studies were retained for structured qualitative synthesis. Global methylation studies often reported non-significant bulk changes, whereas sequencing-based and promoter-level studies revealed extensive tissue-specific and locus-specific methylation signatures involving oxidative stress, immune regulation, metabolism, endocrine signaling, and developmental programming. A formal pooled meta-analysis was not statistically defensible because fewer than three independent studies reported complete and comparable group-level data for the predefined global methylation endpoint. Heat stress in cattle appears to induce targeted, tissue-specific methylome remodeling rather than a consistent genome-wide shift in global methylation. Future studies should report extractable group-level methylation statistics, standardized heat-load metrics, tissue and cell-composition information, and phenotypic outcomes to enable robust meta-analysis. Beyond reporting standardization, future trial and cohort designs should prospectively incorporate paired global and locus-specific methylation endpoints to enable meta-analytic pooling within the next research cycle.

PMID:42571439 | PMC:PMC13452235 | DOI:10.1016/j.vas.2026.100790

EClinicalMedicine. 2026 Jul 31;98:104122. doi: 10.1016/j.eclinm.2026.104122. eCollection 2026 Aug.

ABSTRACT

Circulating tumor DNA (ctDNA) has emerged as a powerful prognostic biomarker in gastrointestinal (GI) oncology, with the strongest evidence in colorectal cancer. Postoperative ctDNA positivity identifies patients at high risk of recurrence, and serial clearance patterns further refine risk. However, prognostic validity has not consistently translated into treatment-selection utility. In stage II colon cancer, DYNAMIC supported chemotherapy de-escalation without compromising recurrence-free survival, whereas DYNAMIC-III showed that escalation in ctDNA-positive stage III disease did not improve outcomes. More recent randomized data from CIRCULATE suggest that ctDNA-positive patients with proficient mismatch repair and microsatellite-stable stage II colon cancer may benefit from adjuvant chemotherapy, although the intention-to-treat primary endpoint was not statistically significant. COBRA further highlights the vulnerability of low-risk populations to assay-dependent interpretation and unvalidated clearance endpoints. Outside colorectal cancer, ctDNA is strongly prognostic in gastro-esophageal, pancreatic, and biliary tract cancers, but evidence supporting ctDNA-directed treatment remains limited. Assay heterogeneity, variable tumor shedding, postoperative sampling timing, false-positive and false-negative results, and uncertain benefit from treating molecular recurrence before radiographic disease remain major barriers. Prospective trials must show that biomarker-guided interventions improve patient-important outcomes before ctDNA can serve as a stand-alone treatment mandate across GI cancers.

PMID:42571422 | PMC:PMC13452147 | DOI:10.1016/j.eclinm.2026.104122

Food Nutr Res. 2026 May 7;70. doi: 10.29219/fnr.v70.12024. eCollection 2026.

ABSTRACT

BACKGROUND: Though a healthy diet is the most effective solution for obesity, it is hindered by two main barriers: difficulty in accessing or preparing healthy meals and lack of portion control knowledge.

OBJECTIVE: This study compared two different medical nutrition therapies (home-delivered diet meal service [HDMS] combined with dietary counseling and dietary counseling solely) in terms of anthropometric measurements, biochemical parameters and eating behaviors in women with overweight or obesity who participated in a weight loss program.

DESIGN: A non-randomized, controlled, parallel-group intervention study was conducted with 60 women aged 25-45 years, having a Body Mass Index (BMI) of 25-35 kg/m², representing individuals with overweight and class I obesity. Participants were divided into two groups: an intervention group receiving HDMS combined with dietary counseling (n = 30) and a control group receiving dietary counseling solely (n = 30). Anthropometric measurements, bioelectrical impedance analysis (BIA), and dietary and physical activity records were monitored throughout the 8-week intervention, while comprehensive assessments including biochemical parameters (fasting blood glucose, homeostatic model assessment for insulin resistance (HOMA-IR), lipid profile), resting metabolic rate (RMR) (FITMATE), and eating behaviors assessed using the Three-Factor Eating Questionnaire (TFEQ) were conducted at baseline, week 4, and week 8.

RESULTS: Both groups showed significant reductions over time in body weight, BMI, waist circumference, hip circumference, body fat percentage, RMR, blood glucose, lipid parameters, and blood pressure values (P < 0.001). Although greater reductions were observed in the HDMS group, the differences between groups were not statistically significant (P > 0.05). When considering the group-time interaction, changes in waist circumference (P < 0.001), hip circumference (P < 0.05), RMR (P < 0.05), fasting blood glucose (P < 0.05), low-density lipoprotein (LDL), cholesterol (P < 0.05), and systolic blood pressure (P < 0.05) were found to be significant in the HDMS group. In addition, when examining eating behaviors, statistically significant changes were observed in the intervention group for both time effects and behavior outcomes. Uncontrolled eating and emotional eating behaviors decreased, while cognitive restraint increased (P < 0.001).

CONCLUSION: Both interventions improved anthropometric and metabolic parameters, with greater reductions observed in the HDMS group; however, the differences between groups were not statistically significant. HDMS may be considered a practical approach to support weight management.

PMID:42571413 | PMC:PMC13452270 | DOI:10.29219/fnr.v70.12024

J Trop Med. 2026 Aug 7;2026:3012361. doi: 10.1155/jotm/3012361. eCollection 2026.

ABSTRACT

BACKGROUND: Dengue has shifted from Dhaka-centric to nationwide in Bangladesh.

AIM: To quantify spatiotemporal patterns and identify high-risk clusters across all 64 districts from 2021 to 2025, and, extending previous reports with data from 2025, this study aims to observe an ongoing shift in per-capita risk hotspots.

METHODS: Retrospective ecological study of the Directorate General of Health Services (DGHS) aggregate yearly data on suspected and laboratory-confirmed dengue admissions (n = 637,626 cases). Incidence per 100,000 population was calculated using 2022 census projections with 1.12% annual growth. Global (Moran’s I) and local (Getis-Ord Gi∗) spatial autocorrelation and prospective space-time scan statistics (SaTScan) were applied.

RESULTS: National incidence: 76.4/100,000/year. 2025 rate-adjusted Moran’s I = 0.328 (p = 0.001). Raw-case hotspots: Greater Dhaka; population-adjusted hotspots: Jhalokathi, Barguna (coastal). High-rate space-time cluster (2024-2025): Dhaka, Manikganj (RR = 3.13, p = 0.001). Dhaka O/E = 4.31 (RR = 6.38). Two low-rate clusters (north, southeast).

CONCLUSION: Urban hyperendemicity, characterized by a high case volume, coupled with the emerging coastal per-capita risk, necessitates tailored interventions. Intensive vector control is essential in Dhaka, while early-warning surveillance should be implemented in coastal districts.

PMID:42571411 | PMC:PMC13451933 | DOI:10.1155/jotm/3012361

Arthroplast Today. 2026 Jul 30;40:102104. doi: 10.1016/j.artd.2026.102104. eCollection 2026 Aug.

ABSTRACT

BACKGROUND: Prosthetic joint infection (PJI) following total knee arthroplasty remains a serious complication. Although two-stage revision is considered the gold standard, predictors of failure remain unclear. This study aimed to identify factors associated with failure after two-stage revision for knee PJI using conventional statistics with exploratory machine-learning validation.

METHODS: A retrospective review was conducted on 154 patients who underwent two-stage revision for knee PJI between 2018 and 2022 at a high-volume arthroplasty center. All patients completed a minimum 24-month follow-up (mean 36.3 ± 20.3 months). Treatment success and failure were defined using MSIS Tier-1 criteria. Independent predictors of failure were identified using multivariate logistic regression and Random Forest classification model.

RESULTS: Most infections were late in onset (91.6%), and 68.2% were culture-positive. Difficult-to-treat (DTT) organisms were identified in 22.1% of cases and were associated with significantly worse postoperative WOMAC, KSS, and OKS outcomes (all P < .001). Multivariate analysis identified DTT organisms (odds ratio 0.035, P < .001) and shorter time from index surgery to infection (odds ratio 1.033, P = .016) as independent predictors of failure. The random Forest model demonstrated an overall accuracy of 84.2% and identified DTT organisms, pre-revision C-reactive protein levels, and time from index surgery as the most influential variables contributing to classification performance. Most failures occurred within 30 months of reimplantation.

CONCLUSIONS: DTT organisms and shorter time from index surgery to infection were independent predictors of failure following two-stage revision for knee PJI. Exploratory machine-learning analysis identified similar predictor patterns and supports the importance of microbiological factors in determining outcomes.

PMID:42571409 | PMC:PMC13452174 | DOI:10.1016/j.artd.2026.102104

J Oral Biol Craniofac Res. 2026 Sep-Oct;16(5):101509. doi: 10.1016/j.jobcr.2026.101509. Epub 2026 Jul 31.

ABSTRACT

BACKGROUND: Bilateral sagittal split osteotomy (BSSO) is widely used for mandibular advancement in patients with skeletal Class 2 malocclusion; however, long-term postoperative stability remains an important clinical concern.

PURPOSE: To evaluate long-term skeletal, dentoalveolar, and soft tissue stability following mandibular advancement with BSSO and rigid fixation.

METHODS: A retrospective cohort study was conducted in 32 patients undergoing mandibular advancement with BSSO and rigid fixation. Cephalometric measurements were obtained at four time points: preoperative, immediate postoperative, 12 months, and long-term follow-up (>3 years). Changes were analyzed using the Wilcoxon signed-rank test.

RESULTS: The mean mandibular advancement was 5.42 ± 1.71 mm. Immediately after surgery, significant skeletal correction was achieved, with increased SNB and decreased ANB (both p < 0.001), accompanied by significant improvements in occlusal and soft tissue profile measurements. Most skeletal and occlusal parameters remained stable during the first postoperative year and throughout long-term follow-up, with no statistically significant changes observed between one year and the final evaluation. Soft tissue remodeling continued during follow-up, whereas overall skeletal and dental stability was maintained.

CONCLUSION: Bilateral sagittal split osteotomy with rigid fixation effectively corrected skeletal Class 2 malocclusion and demonstrated favorable long-term skeletal, dental, and soft tissue stability.

PMID:42571381 | PMC:PMC13452201 | DOI:10.1016/j.jobcr.2026.101509

Plant Phenomics. 2026 Jun 19;8(3):100228. doi: 10.1016/j.plaphe.2026.100228. eCollection 2026 Sep.

ABSTRACT

Three dimensional (3D) instance segmentation is essential for precision characterization of tree architecture at the branch level, which supports both tree fruit crop breeding and the development of robotic systems for orchard management. Existing methods usually use sparse convolution-based operation, which requires a coordinate quantization preprocess to generate sparse tensors, risking the loss of geometric details for fine-grained downstream phenotyping tasks. To overcome this challenge, we developed the dynamic sparse point-voxel transformer (DSPVFormer) model for the efficient and accurate 3D instance segmentation of high-resolution point clouds for dormant apple trees. Our hybrid DSPVFormer architecture maximizes the use of raw point features by dynamically mapping and aggregating the raw point features into the sparse voxel embeddings, capturing strong geometric features that may be discarded during quantization. Evaluations demonstrate that DSPVFormer achieved statistically significant improvements over baseline models on most instance segmentation metrics, which are further translated into more accurate phenotyping evaluation including branch counting and pruning map generation. These advances directly benefit downstream applications in plant phenotyping and robotic pruning for tree crops such as apples. Meanwhile, experimental results on phenotyping tasks suggested that phenotyping-specific evaluation metrics should be prioritized over upstream computer vision performance metrics to realize the full potential of high-throughput phenotyping for real-world applications.

PMID:42571348 | PMC:PMC13452206 | DOI:10.1016/j.plaphe.2026.100228