Nevin Manimala

Nat Methods. 2026 Jul 24. doi: 10.1038/s41592-026-03155-1. Online ahead of print.

ABSTRACT

Highly multiplexed immunofluorescence imaging visualizes and quantifies protein levels at single-cell resolution in intact tissues at low cost and high scalability. Analysis of these data involves multiple steps with many method and parameter choices that must be adapted to the data and analytical objectives. There is an unmet need for a toolbox that offers flexible end-to-end coverage of the workflow. Here we present ‘spatialproteomics’, a Python package that addresses these challenges. Spatialproteomics enables the processing and analysis of large imaging data, including steps such as segmentation, image processing and cell-type classification, while synchronizing shared coordinates across data modalities. We demonstrate spatialproteomics on images of reactive lymph nodes and B cell non-Hodgkin lymphomas from 132 patients. We showcase an end-to-end analysis from raw images to statistical characterization of how cell type composition and spatial distribution vary across indolent and aggressive lymphomas. Furthermore, we show how spatialproteomics can process Gigapixel whole-slide images.

PMID:42498882 | DOI:10.1038/s41592-026-03155-1

Behav Res Methods. 2026 Jul 24;58(9):251. doi: 10.3758/s13428-026-03125-7.

ABSTRACT

Hierarchical models (HMs) are commonly used to jointly model response accuracies and response times (RTs). However, their relationship cannot be fully captured by the population-level correlation between ability and speed, as local dependencies may arise and threaten valid inferences about individuals and items. In this study, a mixture-based hierarchical model (Mix-HM) that allows respondents to switch between different pacing speeds and identifies positive and negative item-level dependencies is proposed. Two simulation studies were conducted: Simulation 1 examined parameter recovery effects, and Simulation 2 evaluated the effectiveness of Bayesian information-based criteria in model selection processes. The results showed that the Mix-HM achieved satisfactory parameter recovery effects, whereas the conventional HM yielded biased estimates when local dependencies were present. In addition, the model fit criteria were generally able to correctly identify the true model across most conditions. An empirical analysis conducted using large-scale assessment data further showed that the new model provided an improved degree of fit and more stable parameter estimates, while the conventional HM distorted the relationship between ability and speed. These findings highlight the importance of accounting for the heterogeneity of latent speed and local dependencies when incorporating RTs as collateral information.

PMID:42498879 | DOI:10.3758/s13428-026-03125-7

Obes Surg. 2026 Jul 25. doi: 10.1007/s11695-026-08800-4. Online ahead of print.

ABSTRACT

BACKGROUND: Laparoscopic Sleeve Gastrectomy (LSG) is the most frequently performed technique among bariatric surgical procedures; however, it may lead to aesthetic concerns due to visible port scars. The primary objective of this study is to compare the safety, efficacy, and cosmetic outcomes of the Modified Bikini Line Sleeve Gastrectomy (MBLSG) technique-which we have defined to address this drawback-with conventional LSG.

METHODS: Patients who underwent MBLSG and conventional LSG at the participating centers between 2020 and 2025 were retrospectively analyzed. A total of 1834 patients (Conventional LSG: 928; MBLSG: 906) were included in the study. The two groups were compared based on demographic data (age, sex, BMI, ASA score), operative time, complication rates (according to the Clavien-Dindo classification), postoperative pain scores (VAS), and weight loss percentages (%TWL, %EWL) at the 3rd, 6th, and 12th months.

RESULTS: Significant differences were observed between the groups in terms of age (35.8 ± 6.7 vs. 34.5 ± 6.8 years; p < 0.001) and sex distribution (p < 0.001, with a significantly higher proportion of female patients in the MBLSG group). However, no significant differences were found regarding mean body mass index (BMI), body weight, or ASA score distribution (p > 0.05). The operative time in the MBLSG group (26.9 ± 3.4 min) was longer than that in the conventional group (23.1 ± 3.2 min; p < 0.001). Regarding complication rates, the Grade I complication rate was significantly higher in the MBLSG group (27.0%) compared to the conventional group (25.1%), as was the Grade II complication rate (15.1% in MBLSG vs. 12.0% in conventional; p = 0.049). Analysis of weight loss percentages (at 3, 6, and 12 months) revealed no statistically significant difference between the groups (p > 0.05). The groups also exhibited similar results for early postoperative parameters such as pain levels (VAS) and time to mobilization. Conversely, when postoperative cosmetic scores were evaluated, the level of patient satisfaction was significantly higher in the MBLSG group than in the conventional LSG group.

CONCLUSION: Despite a minimal extension in operative time and a slight increase in the risk of minor, medically manageable complications (specifically surgical site infections and ecchymosis), MBLSG is a safe, clinically effective, and feasible bariatric surgical approach for selected patients who prioritize cosmetic benefits and aesthetic satisfaction.

PMID:42498877 | DOI:10.1007/s11695-026-08800-4

Eur J Pediatr. 2026 Jul 25;185(8):607. doi: 10.1007/s00431-026-07274-x.

ABSTRACT

The aim of this study was to assess right ventricle (RV) systolic function in infants with severe bronchiolitis using tricuspid annular plane systolic excursion (TAPSE) and to explore its prognostic value. We hypothesized that lower TAPSE at pediatric intensive care unit (PICU) admission could be associated with prolonged length of stay (LOS) and duration of respiratory support. We conducted a prospective single-center observational pilot study in a tertiary general PICU during the 2022-2023 bronchiolitis season. All children < 12 months admitted to PICU for bronchiolitis were eligible. TAPSE was measured by transthoracic echocardiography at PICU admission. Patients were followed up until discharge. Forty-six patients were included, aged from 16 days to 9.5 months. TAPSE Z-score was within normal range (- 2 to + 2) in 36/46 (78%) patients and > + 2 in 10/46 (22%) patients. TAPSE Z-score was weakly associated with PICU LOS (Spearman ρ = – 0.38, p = 0.009) and moderately associated with the duration of respiratory support (Spearman ρ = – 0.45, p = 0.002). No significant association was found between other echocardiographic parameters and PICU LOS or duration of respiratory support. In post hoc exploratory multivariable analysis, TAPSE Z-score was independently associated with a duration of respiratory support < 3 days (OR = 2.29, 95% CI [1.25; 4.17], p = 0.007). Conclusion: TAPSE was within or above normal range in children with severe bronchiolitis, suggesting that RV systolic dysfunction is uncommon. Although its value may be associated with patients’ clinical course, the pathophysiological basis and the clinical relevance of this association warrants further investigations.Trial registration: NCT07209956, date of registration October 7, 2025, retrospectively registered.

PMID:42498874 | DOI:10.1007/s00431-026-07274-x

Environ Sci Pollut Res Int. 2026 Jul 25. doi: 10.1007/s11356-026-38088-x. Online ahead of print.

NO ABSTRACT

PMID:42498872 | DOI:10.1007/s11356-026-38088-x

Surg Endosc. 2026 Jul 24. doi: 10.1007/s00464-026-13082-z. Online ahead of print.

ABSTRACT

BACKGROUND: Artificial intelligence enables surgical robots to perform certain actions without surgeon control or semi-autonomously. Patient willingness to undergo surgery via an automated machine is a key barrier to adoption of emerging robotic technology. Further, semi-autonomous surgical robots raise numerous ethical concerns, yet little is known about patients’ perceptions of these issues. We assessed patients’ perceptions of ethical issues in semi-autonomous robot-assisted surgery (RAS) and how their perceptions would affect decision-making about undergoing semi-autonomous RAS.

METHODS: Adult patients who underwent surgery within the prior three years, with a non-autonomous robot or without any robot, were recruited via email. We conducted semi-structured teleconference interviews that included open- and closed-ended questions, to assess factors affecting patient decision-making and ethical concerns about semi-autonomous RAS, and demographics. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using thematic analysis.

RESULTS: Fifty patients participated. Most participants were female (62%), White (52%), and the mean age was 53. Most patients (56%) would undergo semi-autonomous RAS. However, willingness varied by which surgical process the robot would have control over. Many patients (46%) were highly willing to undergo semi-autonomous RAS when the robot has control over instruments. Four themes emerged about ethical concerns driving patients’ willingness to undergo semi-autonomous RAS: (1) desire for informed consent to express self-determination, (2) semi-autonomous RAS introduces new risks to procedures, (3) doctor-patient relationship and trust can facilitate patients’ willingness to undergo semi-autonomous RAS, and (4) semi-autonomous RAS comprises an important surgical innovation, conferring benefits.

CONCLUSION: Our findings suggest that most patients would be willing to undergo semi-autonomous RAS. Willingness was related to ethical considerations of informed consent, perceived risks, level of surgeon versus robot control over surgical processes, doctor-patient relationship, and perceived benefits. Addressing patients’ perceptions of semi-autonomous RAS may facilitate greater integration of surgical robots into clinical practice.

PMID:42498865 | DOI:10.1007/s00464-026-13082-z

Surg Endosc. 2026 Jul 24. doi: 10.1007/s00464-026-13167-9. Online ahead of print.

ABSTRACT

INTRODUCTION: This study evaluated whether a perioperative opioid-sparing multimodal pain regimen with intraoperative transversus abdominis plane (TAP) block reduces opioid use after laparoscopic paraesophageal hernia (PEH) repair while maintaining pain control.

METHODS: A retrospective chart review identified patients who underwent laparoscopic PEH repair at our institution from January 2010 to April 2025. Patients were grouped before and after implementation of a multimodal regimen with TAP block (July 2017). The regimen included scheduled acetaminophen and celecoxib. Outcomes included inpatient and follow-up pain scores (0-10), inpatient morphine milligram equivalents (MME), and opioid prescriptions at discharge or within 30 days. Statistical analysis included chi-squared, t tests, nonparametric tests, and multivariate analysis.

RESULTS: A total of 2539 patients were included (813 pre-regimen, 1726 post-regimen). Inpatient opioid use decreased from 86% to 67.6% (p < 0.001), and inpatient oral MME was significantly lower post-regimen (p < 0.001). Opioid prescriptions at discharge declined from 94.7% to 20.6% (p < 0.001). Median inpatient and follow-up pain scores were lower in the multimodal group (p < 0.0001 and p = 0.015). After adjusting for demographics, maximum inpatient pain score, and additional procedures at time of surgery, the post-regimen group remained associated with reduced inpatient opioid use (OR 0.36, p < 0.001). Median length of stay decreased from 2 to 1 day (p < 0.001). 30-day ED visits and readmissions were not significantly different (p = 0.116 and p = 0.404).

CONCLUSION: Implementation of a multimodal opioid-sparing regimen with intraoperative TAP block reduced inpatient and post-discharge opioid use after laparoscopic PEH repair, with lower pain scores and shorter hospital stays without increased ED visits or readmissions.

PMID:42498863 | DOI:10.1007/s00464-026-13167-9

J Neurol. 2026 Jul 24;273(8):491. doi: 10.1007/s00415-026-13999-4.

ABSTRACT

BACKGROUND: Few studies investigated factors that predict intensive language therapy (ILT) outcome. This study aimed to analyze multimodal neural factors that possibly underly ILT success.

METHODS: Lesion volume and DTI analyses were performed with 17 aphasic individuals, and complemented by fMRI analysis in 12 patients (due to drop-outs). Structural and functional data were collected at the beginning of a seven week ILT program and correlated with language changes, measured using the Aachen Aphasia Test. Additionally, all analyses were correlated with the patients’ initial aphasia severity.

RESULTS: Therapy success was associated with functional activity in right inferior and middle temporal gyri, bilateral superior frontal gyrus/ adjacent anterior cingulate cortex, and right occipital lobe (lingual gyrus, fusiform gyrus, lateral occipital cortex). Statistically uncorrected DTI analysis (p(uncorr) < .001) revealed a positive correlation between language improvement and structural integrity in the right temporal lobe and two left-hemisphere white matter clusters (frontal, parietal). Neither global nor language-specific lesion volume was correlated with therapy outcome. However, lesion volume in insula, putamen and white matter tracts was correlated with initial aphasia severity.

CONCLUSIONS: Our preliminary results suggest a predictive role of right temporal structures and functional activation in areas associated with healthy language processing. They also indicate a contribution of functional activation in brain areas associated with cognitive control and non-linguistic semantic processing. Further, lesion volume in both global and language-specific structures proved relevant for the initial severity of aphasia but not for recovery potential following ILT. Our results should be regarded as hypothesis-generating for future research.

PMID:42498848 | DOI:10.1007/s00415-026-13999-4

Eur Geriatr Med. 2026 Jul 24. doi: 10.1007/s41999-026-01565-0. Online ahead of print.

ABSTRACT

PURPOSE: Muscle health encompasses multiple components, including muscle mass, absolute strength, and muscle-specific strength (MSS). MSS, defined as strength relative to corresponding muscle mass, has emerged as a marker of muscle health, but its site-specific relevance to mobility remains unclear. Because these components are often examined separately, direct upper- and lower-limb comparisons are needed to clarify which indicators offer the most clinically relevant information on gait speed. We compared upper- and lower-limb muscle mass, absolute strength, and site-specific MSS in community-dwelling older adults.

METHODS: This cross-sectional analysis included 284 community-dwelling adults aged ≥ 65 years. Handgrip strength, knee extension strength, arm and leg muscle mass, and usual gait speed were measured. Upper-limb MSS was calculated as handgrip strength/arm muscle mass, and lower-limb MSS as knee extension strength/leg muscle mass. Age-, sex-, and body mass index-adjusted linear regression models examined associations with gait speed and compared model fit.

RESULTS: Mean age was 77.2 years; 77.1% were women. Arm and leg muscle mass were not associated with gait speed. Knee extension strength showed the strongest individual association (standardized β = 0.37, 95% confidence interval 0.23-0.51). Upper-limb MSS (β = 0.28, 0.15-0.40) and lower-limb MSS (β = 0.32, 0.21-0.44) were associated with gait speed. When entered simultaneously, upper-limb MSS (β = 0.18, 0.05-0.31) and lower-limb MSS (β = 0.27, 0.16-0.39) remained independently associated, and the combined MSS model showed the best fit.

CONCLUSION: Site-specific MSS, particularly when assessed in both upper and lower limbs, may provide complementary mobility-related information beyond limb muscle mass alone.

PMID:42498847 | DOI:10.1007/s41999-026-01565-0

Environ Monit Assess. 2026 Jul 25;198(8):875. doi: 10.1007/s10661-026-15701-7.

ABSTRACT

Afforestation of former agricultural land with silver birch (Betula pendula Roth) is increasingly promoted in Northern and Eastern Europe, yet its long-term effects on soil-plant heavy metal dynamics remain insufficiently understood. We assessed heavy metal accumulation in soil and woody biomass (stemwood and bark) 20 years after afforestation of former agricultural land at 11 plantations. Eleven elements (As, Cd, Co, Cr, Cu, Fe, Mn, Mo, Ni, Pb, and Zn) were initially determined, but subsequent analyses focused on five elements (Cr, Cu, Fe, Mn, and Zn) consistently detected above the limit of quantification. Metal allocation between stemwood and bark and the influence of soil physicochemical properties (pH, P, K, C_org, N_tot, bulk density and available water content) were analyzed. We also examined relationships between soil metal concentrations, tree growth, and the distribution of metals between stemwood formed at early-age (1-10 years) and late-age (11-23 years). Heavy metal accumulation was primarily governed by soil properties, with pH, P, and K showing important relationships with bioaccumulation patterns, while the role of C_org varied among elements and substrates. No statistically significant evidence was found that elevated soil metal concentrations inhibited tree growth. Within stems, metal concentrations varied with wood age, with higher levels observed in early-age wood. Overall, the findings highlight the importance of soil properties in shaping heavy metal dynamics in birch plantations and provide insight into long-term trace metal allocation in forest ecosystems established on former agricultural soils, supporting sustainable afforestation and the evaluation of woody biomass for potential bioenergy use.

PMID:42498846 | DOI:10.1007/s10661-026-15701-7