Nevin Manimala

Ann Afr Med. 2026 Jun 30. doi: 10.4103/aam.aam_12_26. Online ahead of print.

ABSTRACT

BACKGROUND: Lumbar facet joint pain is a common cause of chronic low back pain and contributes substantially to physical disability, reduced functional capacity, and socioeconomic burden. Radiofrequency ablation (RFA) and steroid injection therapy are widely used interventional procedures for managing facet-mediated pain, yet their comparative effectiveness in routine clinical practice remains an area of ongoing investigation.

AIM: To compare the clinical efficacy, functional outcomes, and duration of pain relief achieved with RFA versus steroid injection therapy in patients with lumbar facet joint pain.

MATERIALS AND METHODS: This prospective comparative study included 132 adult patients with lumbar facet joint pain diagnosed on clinical evaluation and confirmatory medial branch block. Patients were allocated into two groups: RFA group (n = 66) and steroid injection group (n = 66). Clinical outcomes were assessed using the Visual Analog Scale (VAS) for pain, Oswestry Disability Index (ODI) for function, and duration of pain relief over a 6-month follow-up period. Adverse events and the need for repeat interventions were also documented. Statistical analysis included paired and unpaired t-tests, Chi-square test, and repeated-measures analysis of variance, with P < 0.05 considered statistically significant.

RESULTS: Both groups demonstrated significant short-term improvement in VAS and ODI scores; however, the RFA group showed greater reduction in pain intensity and functional disability at 3 and 6 months. The proportion of patients achieving sustained pain relief and the mean duration of clinically meaningful benefit were higher in the RFA group than in the steroid injection group. Minor transient complications were observed in both groups, with no major adverse events or procedure-related neurological deficits.

CONCLUSION: RFA provides superior long-term pain relief and functional improvement compared with steroid injection therapy for lumbar facet joint pain. RFA may be considered a more durable and effective interventional option in patients with chronic facet-mediated lumbar pain.

PMID:42377934 | DOI:10.4103/aam.aam_12_26

Clin Nucl Med. 2026 Jun 29. doi: 10.1097/RLU.0000000000006564. Online ahead of print.

ABSTRACT

BACKGROUND: To compare HER2-targeted with ¹⁸F-FDG PET/CT for detecting axillary lymph node metastasis in patients with newly diagnosed HER2-positive or HER2-low breast cancer.

METHODS: In this prospective study, HER2-expressed breast cancer participants underwent both 18F-FDG and Al18F-NOTA-HER2-BCH PET/CT within 1 week. On the basis of IHC and/or FISH, participants were categorized as HER2-positive (n=25) or HER2-low (n=26). Histopathology or imaging follow-up served as reference standards. Statistical analyses utilized the paired McNemar test for diagnostic performance, and the Wilcoxon signed-rank and Mann-Whitney U tests for paired and unpaired comparisons of uptake parameters, respectively.

RESULTS: Between August 2024 and October 2025, 51 participants with breast cancer were enrolled. Among 40 participants with lymph node metastasis, Al18F-NOTA-HER2-BCH detected metastatic lymph nodes exclusively in one HER2-positive participant and more lesions than 18F-FDG in 11 cases. On a per-lesion analysis, Al18F-NOTA-HER2-BCH demonstrated significantly higher sensitivity, accuracy, and negative predictive value than 18F-FDG for detecting metastatic axillary lymph nodes in the HER2-positive cohort (94%, 94%, 93% vs. 79%, 85%, 84%, all P<0.001). This superiority was particularly pronounced for small lymph nodes (<5 mm), with a detection rate of 90% versus 62% for 18F-FDG (P<0.001). Al18F-NOTA-HER2-BCH PET/CT directly influenced nodal staging and subsequent treatment decisions in 4 of 25 (16.0%) HER2-positive participants. In the HER2-low cohort, however, the diagnostic performance of the 2 tracers did not differ significantly, although 18F-FDG PET/CT led to clinically relevant nodal upstaging in one case.

CONCLUSIONS: Al18F-NOTA-HER2-BCH retains developmental potential for detecting axillary lymph node metastasis in HER2-positive breast cancer, complementing 18F-FDG.

PMID:42377932 | DOI:10.1097/RLU.0000000000006564

Food Sci Anim Resour. 2025 Jul;45(4):1129-1147. doi: 10.5851/kosfa.2024.e85. Epub 2025 Jul 1.

ABSTRACT

Wet brewer’s spent grain (WBSG), a major brewing industry byproduct, is generated in large quantities annually and used as feed ingredient for animal production. The low cost of this feed also has a positive impact on the economics of production. This work focused on the supplementation of WBSG in the feeding diet and its effects on the yield, nutritional quality, and sensory attributes of fresh cheese. The investigation was conducted on two cohorts of Holstein-breed cows. The first group was fed on pasture supplemented with hay, silage, and concentrate, while the second group received the same diet with the addition of WBSG. Statistical analysis was carried out using analysis of variance test to compare cheeses on a nutritional and sensory basis. The results obtained reveal that incorporating WBSG can enhance the nutritional quality of fresh cheese. It was observed that lower titratable acidity was associated with a higher yield in the WBSG cheese group (p<0.001). Additionally, cheese derived from cows fed on WBSG exhibited a lower ratio of Σn-6 to Σn-3 fatty acids (p<0.001), as well as a higher ratio of unsaturated to saturated fatty acids (p<0.05). The vitamin E analysis showed highly significant differences and predominant amounts for fresh cheese WBSG. Additionally, they exhibited superior sensory attributes such as darker color, grainy and softer texture, and a more pronounced odor. The utilization of WBSG use is promising for the breeding of dairy cattle and makes it possible to obtain a fresh cheese with attractive sensory quality.

PMID:42377876 | DOI:10.5851/kosfa.2024.e85

Ir J Med Sci. 2026 Jun 30. doi: 10.1007/s11845-026-04528-3. Online ahead of print.

ABSTRACT

AIM: This study was conducted to explore the effect of stress ball use on pain, sleep quality and physiologic parameters in critically ill patients.

METHODS: A prospective, two-arm randomized controlled trial was performed in the intensive care units (ICUs) of a training and research hospital in Turkey. Study participants were randomly assigned to either a control group or a stress ball group. The outcome measures were pain, sleep quality (RCSQ) and physiological parameters.

RESULTS: Thirty patients in each group completed the study. A statistically significant difference was found between the groups at 07:00 on ICU day 3 (T3), with lower pain intensity in the stress ball group (p < 0.05). The difference in RCSQ scores between the two groups was found to be statistically significant, with higher RCSQ scores observed in the stress ball group (p < 0.05). No significant differences were found between the groups heart rate across all measurements and respiration rate at any time point except 19:00-23:00 (T4), whereas diastolic blood pressure differed significantly at all measurements and systolic blood pressure showed significant group differences at 13:00-17:00 (T3) and 19:00-23:00 (T4) (p < 0.05).

CONCLUSION: The findings of this study indicated that the use of a stress ball was associated with improved sleep quality and significant reductions in pain intensity, systolic and diastolic blood pressure in critically ill patients.

PMID:42377870 | DOI:10.1007/s11845-026-04528-3

Ir J Med Sci. 2026 Jun 30. doi: 10.1007/s11845-026-04529-2. Online ahead of print.

ABSTRACT

BACKGROUND: Colorectal cancer is one of the most common malignancies worldwide and often develops from precancerous polyps. Early detection and differentiation of polyp types are essential for prevention and management.

AIM: This study evaluated long non-coding RNA (lncRNA) expression levels in hyperplastic polyps(HP), adenomatous polyps(A), and colon adenocarcinomas(CA) tissues to assess their diagnostic potential as tissue-based candidate biomarkers for distinguishing CA from A and HP tissues.

METHODS: Formalin-fixed paraffin-embedded colon tissue samples from 120 patients were analyzed, including 40 CA, 40 A, and 40 HP. Expression levels of CCAT1, CCAT2, HOTAIR, HOTTIP, GAS5, LNCP21, H19, and MALAT1 were quantified by qRT-PCR. Statistical analyses were performed using PRISM9.2.0. Diagnostic performance was evaluated by ROC analysis, including AUC, sensitivity, and specificity. Age- and sex-adjusted logistic regression models were performed.

RESULTS: Several lncRNAs were differentially expressed among CA, A, and HP groups. ROC analyses showed strong diagnostic performance for HOTAIR, CCAT2, and MALAT1, with AUC values of 0.896, 0.834, and 0.833, respectively. LNCP21, HOTTIP, H19, and CCAT1 also demonstrated significant discriminatory ability after multiple-testing correction. In age- and sex-adjusted logistic regression analyses, HOTAIR, LNCP21, H19, CCAT2, CCAT1, MALAT1, and HOTTIP remained independently associated with colorectal adenocarcinoma, whereas GAS5 showed limited discriminatory value. Exploratory pathway enrichment analysis suggested involvement of WNT/β-catenin/MYC, p53/ubiquitin-mediated, and inflammatory JAK-STAT/EGFR-related signaling pathways.

CONCLUSION: HOTAIR, CCAT2, MALAT1, LNCP21, HOTTIP, H19, and CCAT1 showed potential diagnostic value for distinguishing CA from A and HP, with HOTAIR, CCAT2, and MALAT1 exhibiting the strongest performance. Pathway enrichment findings provide exploratory biological context and require validation in larger prospective studies and functional analyses.

PMID:42377869 | DOI:10.1007/s11845-026-04529-2

Ir J Med Sci. 2026 Jun 30. doi: 10.1007/s11845-026-04519-4. Online ahead of print.

ABSTRACT

INTRODUCTION: Healthcare professionals work within an imperfect, multi-faceted system and cannot shoulder the burden of responsibility for unintentional patient harm. Patient safety governance aims to address the challenges of patient safety through monitoring systems and processes to provide assurance of patient safety and quality of care. The evidence suggests that healthcare staff demonstrate mixed views towards patient safety governance processes and varying attitudes towards hospital patient safety climates.

STUDY AIMS: This study aims to explore the insights of both healthcare staff and senior healthcare decision makers into patient safety governance and its associated patient safety processes. It aims to capture the attitudes of healthcare staff towards hospital patient safety climates. The researchers intend to identify the gaps in patient safety governance between praxis and theory, with the view of developing recommendations to address these gaps.

STUDY DESIGN: This research study is convergent parallel in design, with two study strands occurring simultaneously. It is set in four Irish teaching hospitals located in one regional area. A methodological pluralistic approach, using both qualitative and quantitative methods, will be applied to allow the researchers to adopt the most suitable methodology for data collection, analysis and data interpretation to fulfil the study aims. The study consists of three groups. Qualitative methods will apply to Groups 1 and 2, where consenting participants will be given a choice to engage with a focus group or semi-structured interview. The data collected through these methods will be analysed using the six phases of reflexive thematic analysis. Quantitative methods will apply to Group 3, where consenting participants will complete an electronic questionnaire. The quantitative data will be described in statistical terms using the Stata Now statistical package. Data integration will occur during the data interpretation phase, using a weaving approach in a narrative format where the qualitative and quantitative data findings will be compared thematically. The intention of this study is to broaden the corpus of academic understanding into healthcare staff’s insights of patient safety processes and their attitudes towards hospital patient safety climates comparatively to evidence-based best practice for patient safety governance. This study will be carried out using a methodological pluralistic approach, allowing the researchers to choose the most appropriate methods for data collection, analysis and interpretation. The researchers will then identify the current gaps in patient safety governance practice in a small group of Irish hospitals in one healthcare region. These gaps will then be assessed and explored with implementation plans developed to address the gaps, through decision makers and policy development within healthcare.

PMID:42377867 | DOI:10.1007/s11845-026-04519-4

Radiol Phys Technol. 2026 Jun 30. doi: 10.1007/s12194-026-01089-z. Online ahead of print.

ABSTRACT

Accurate estimation of entrance skin dose (ESD) is essential for radiation protection and protocol optimization. This study proposes a new analytical formulation for ESD estimation, the New Mathematical Model Equation for ESD (NMME_ESD), which explicitly integrates both technical and geometric beam-formation parameters, notably the ripple factor and anode angle. These parmeters are often neglected in conventional ESD models. A dataset comprising 3800 examinations acquired from four high-frequency X-ray generators was analyzed. NMME_ESD predictions were compared with experimental measurements, Monte Carlo simulations using PHITS, and the Davies and Edmonds models. The ripple factor and anode angle influence on ESD was evaluated using sensitivity analysis based on Friedman tests and Wilcoxon signed-rank post-hoc comparisons. NMME_ESD predictions showed strong agreement with both experimental measurements and PHITS simulations (with deviations of ≤ 8.6%, r = 0.996, p > 0.05). Compared with conventional formulations, the proposed model demonstrated comparable predictive performance to the Davies model while offering improved robustness under practical clinical conditions and reduced discrepancies compared with the Edmonds model (up to 59.6%, p < 0.01). Sensitivity analysis indicated statistically significant ESD variations associated with ripple factor and anode angle (p < 0.001). Furthermore, the NMME_ESD analytical model provided instantaneous dose estimates. The NMME_ESD model provides a reliable, non-invasive analytical approach for ESD estimation. Explicit inclusion of ripple factor and anode angle in the proposed formulation improves predictive dose estimation accuracy under realistic operating conditions, offering measurable practical benefit for routine clinical dosimetry.

PMID:42377865 | DOI:10.1007/s12194-026-01089-z

Food Sci Anim Resour. 2025 Sep;45(5):1308-1325. doi: 10.5851/kosfa.2024.e95. Epub 2025 Sep 1.

ABSTRACT

Bovine tuberculosis (BTB) is a zoonotic illness of significant public health concern. This research aims to investigate the prevalence of BTB and its risk factors in Upper Egypt governorates. A total of 600 cattle (200 from each of New Valley, Qena, and Aswan) were tested using a single intradermal cervical tuberculin test (SICTT), and the positive animals were slaughtered at the central abattoirs of each governorate. The tissues of the affected carcasses were inspected by Ziehl-Neelsen (ZN) staining and culturing, and confirmation of results was achieved through ELISA and PCR. The findings revealed that 2.3% of inspected animals tested positive by the SICTT. Qena recorded the highest rate of tuberculin-positive animals at 3.5%. BTB was found to be statistically associated with sex, body condition, age, breed, and yard density, and the thoracic organs and their lymph nodes were mostly affected. ZN staining identified only 85.7% of the isolates as acid-fast bacilli. ELISA results indicated that 78.6% of positive tuberculin animals were also positive for bovine-purified protein derivative antigen and 71.4% were positive for commercial polypeptide antigen. Furthermore, there was no significant correlation between the molecular identification of Mycobacterium bovis using tissue samples or isolates, and the PCR results confirmed the occurrence of Mycobacterium bovis DNA in 8 of each examined category. The findings underscore the crucial role of slaughterhouses in providing essential data for monitoring BTB epidemiology within specific regions. These insights are pivotal for forming strategies and implementing effective regulation and prevention measures.

PMID:42377843 | DOI:10.5851/kosfa.2024.e95

Food Sci Anim Resour. 2025 Sep;45(5):1326-1340. doi: 10.5851/kosfa.2024.e96. Epub 2025 Sep 1.

ABSTRACT

Xinjiang province is the main dairy production area of China, and Junggar Bactrian camel usually lived in the north part. Lipid is the main nutrient component of milk, and there is few reports about the differences in lipids between camel milk and cow milk in Xinjiang province. In this study, the analysis of lipids in Junggar Bactrian camel milk and cow milk in north part of Xinjiang province have been carried out by ultra-performance liquid chromatography quadrupole time of flight mass spectrometry. As a result, 669 kinds of lipids are identified in total, which are divided into 16 lipid classes. In the results of multivariate statistical analysis, camel milk and cow milk can be separated definitely when analyzed by principal component analysis, partial least squares discriminant analysis, and orthogonal partial least squares discriminant analysis, and revealed that lipids in camel milk is different from that in cow milk. Furthermore, 70 kinds of lipids are selected as differential lipids with the standards of fold change >2 or fold change <0.5, p<0.05, and variable importance in projection>1, which concludes 1 kinds of ceramides, 1 kinds of glycosphingolipids, 21 kinds of phosphatidylcholines, 10 kinds of phosphatidylethanolamines, 8 kinds of phosphatidylinositol, 8 kinds of phosphatidylserines, 11 kinds of sphingomyelins, and 10 kinds of triacylglycerides. In the present study, the lipid profiles of camel milk and cow milk from Xinjiang province of China are disclosed, and it can provide foundation for the utilization of lipids from milk, as well as provide a potential reference for the camel milk and dairy products adulteration.

PMID:42377842 | DOI:10.5851/kosfa.2024.e96

Sleep Breath. 2026 Jun 30;30(4):203. doi: 10.1007/s11325-026-03750-8.

ABSTRACT

BACKGROUND: Obstructive sleep apnea (OSA) has been increasingly associated with chronic kidney disease (CKD). NLRP3, a central component of the inflammasome, is involved in hypoxia- and inflammation-related pathways. We therefore investigated whether circulating NLRP3 was associated with prevalent CKD and incident CKD risk in patients with OSA.

METHODS: This single-center observational study included 648 OSA patients. Multivariable linear and logistic regression models were used to evaluate the associations of circulating NLRP3 with renal function indices and prevalent CKD. Cox proportional hazards models and Kaplan-Meier analysis were used to assess the relationship between baseline NLRP3 and incident CKD.

RESULTS: Compared with the non-CKD group, the CKD group showed a greater nocturnal hypoxic burden, including a higher apnea-hypopnea index (37.53 ± 18.80 vs. 29.74 ± 17.95 events/h) and higher T90 (18.37% [7.26-31.94] vs. 10.84% [4.12-21.63]) (all P < 0.01). Circulating NLRP3 was independently associated with lower estimated glomerular filtration rate (eGFR) (β = -4.18, 95% CI – 5.69 to – 2.67; P < 0.001) and higher logarithmically transformed urinary albumin-to-creatinine ratio [ln(UACR)] (β = 0.14, 95% CI 0.08 to 0.21; P < 0.001). In fully adjusted logistic models, each 1-standard deviation increase in NLRP3 was associated with higher odds of prevalent CKD (OR = 1.49, 95% CI 1.16-1.92; P = 0.002), and the highest quartile showed a greater likelihood of CKD than the lowest quartile (OR = 2.68, 95% CI 1.57-4.58; P < 0.001; P for trend < 0.001). In the prospective cohort, higher baseline NLRP3 remained associated with incident CKD after full adjustment (HR = 1.46, 95% CI 1.10-1.94; P = 0.009), and Kaplan-Meier analysis showed lower CKD-free survival in the high-NLRP3 group (log-rank P = 0.011).

CONCLUSIONS: In patients with OSA, elevated circulating NLRP3 was associated with prevalent CKD, and an increased risk of incident CKD during follow-up. These findings suggest that NLRP3 may serve as a potential inflammatory marker for renal risk stratification in OSA.

PMID:42377775 | DOI:10.1007/s11325-026-03750-8