Nevin Manimala

J Racial Ethn Health Disparities. 2026 Jun 1. doi: 10.1007/s40615-026-02952-w. Online ahead of print.

ABSTRACT

The term “Hispanic Paradox” refers to research findings that Hispanic immigrants often exhibit better health than more socioeconomically advantaged U.S.-born populations. However, much of this research attributes this epidemiological phenomenon to immigration selectivity and rarely examines (1) whether a Hispanic-specific health advantage persists within immigrant-only populations and (2) how any such advantage is structured by race and sex inequalities across highly heterogeneous immigrant groups. Using data from the IPUMS National Health Interview Survey (NHIS), 2006-2018 (N = 166,700), this study applies an intersectional approach to evaluate a Hispanic health effect in health-related functional limitations – a measure strongly linked to mortality and health care needs – across race-sex immigrant groups. Logistic regression and post-estimation results show that a health advantage associated with Hispanic identity appears only among female and male immigrants who identify as White, with no comparable benefit for other race-sex intersections. These findings indicate that a Hispanic health advantage among immigrants is not universal but shaped by structural inequality, underscoring the need for intersectionality-informed research that uncovers masked vulnerabilities across ethnoracially diverse immigrant populations.

PMID:42223888 | DOI:10.1007/s40615-026-02952-w

Ann Nucl Med. 2026 Jun 1. doi: 10.1007/s12149-026-02221-0. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the value of ¹⁸F-FDG PET/CT in assessing the local aggressiveness of desmoid-type fibromatosis (DF) and in predicting prognosis of DF.

METHODS: We retrospectively analyzed ¹⁸F-FDG PET/CT of DF lesions in participants. Clinical data and ¹⁸F-FDG PET/CT imaging features were collected and analyzed. The diagnostic performance of ¹⁸F-FDG PET/CT versus contrast-enhanced MRI (CE-MRI) for assessing peritumoral invasion was compared using reference of pathology. Lesions were followed up to record progressive disease (PD) and postoperative recurrence (POR), and event-free survival (EFS) was determined. Univariate and multivariate Cox regression analyses were performed to identify independent predictors of PD or POR.

RESULTS: Fifty-five lesions from 44 participants were included. ¹⁸F-FDG PET/CT showed higher accuracy and sensitivity than CE-MRI for assessing peritumoral invasion, with no statistically significant differences in paired comparisons. Notably, pathology in one case demonstrated tumor invasion of the lymph node capsules. Furthermore, DF lesions with PD or POR had significantly higher maximum standardized uptake value (SUV_max) and target-to-background ratio (TBR). SUV_max, TBR and irregular lesion morphology were identified as independent predictors of PD or POR. The AUC for SUV_max was 0.79 (95% CI: 0.64-0.95), with sensitivity, specificity, and overall accuracy of 78.6% (11/14), 82.9% (34/41), and 81.8% (45/55), respectively. Kaplan-Meier survival analysis revealed that SUV_max> 5.0 was associated with significantly shorter EFS (692.4 [427.5-957.3] days vs. 2419.9 [1989.5-2850.3] days).

CONCLUSION: ¹⁸F-FDG PET/CT showed numerically higher sensitivity and accuracy than CE-MRI for assessing peritumoral invasion of DF lesions, though with lower specificity. SUV_max, TBR, and lesion morphology were independent predictors of PD or POR.

PMID:42223872 | DOI:10.1007/s12149-026-02221-0

Ann Nucl Med. 2026 Jun 1. doi: 10.1007/s12149-026-02242-9. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the clinical utility of preoperative [¹⁸F]FDG PET/CT for CT-guided biopsy planning of large tumors, including predictors of PET/CT-informed target adjustment and malignant yield with FDG hotspot targeting in very large tumors.

METHODS: In this retrospective single-center study (January 2015-December 2025), we analyzed 82 patients who underwent pre-biopsy [¹⁸F]FDG PET/CT at our institution within 90 days. Target adjustment was retrospectively adjudicated as the presence of a spatial difference between the contrast-enhanced CT-based target and the PET/CT-informed target selected after considering intratumoral FDG uptake. ROC analysis was used to evaluate whether tumor size predicted target adjustment and to determine the optimal cutoff. Multivariable logistic regression included age, sex, tumor size, PET system (analog vs. digital), ΔSUV, lesion location (chest vs. other), and lymphoma (vs. other). In tumors ≥ 52 mm, malignant yield was compared between hotspot (highest uptake) and non-hotspot targeting.

RESULTS: Target adjustment was performed in 28/82 cases (34.1%). Interobserver agreement was 89% with Cohen’s κ = 0.74 (95% CI, 0.58-0.89). Tumor size predicted target adjustment (AUC 0.847; 95% CI 0.761-0.934), and the Youden-optimal cutoff was 52 mm (sensitivity 0.82, specificity 0.81). Target adjustment rates were 5/49 (10.2%) for < 52 mm and 23/33 (69.7%) for ≥ 52 mm (p < 0.001). In multivariable analysis, tumor size (per 10 mm) was independently associated with target adjustment (OR 2.33; 95% CI 1.56-3.50; p < 0.001), while female sex was inversely associated (OR 0.20; 95% CI 0.04-0.96; p = 0.045). Lymphoma showed a trend toward an inverse association that did not reach statistical significance (OR 0.11; 95% CI 0.01-1.11; p = 0.062). The multivariable model showed good discrimination (AUC 0.90; 95% CI 0.82-0.98; DeLong). Among tumors ≥ 52 mm, malignant pathology was obtained in 14/14 cases (100%) with hotspot targeting versus 5/9 (55.6%) with non-hotspot targeting (p = 0.014).

CONCLUSIONS: Preoperative [¹⁸F]FDG PET/CT supports CT-guided biopsy planning of large tumors by identifying cases likely to require target adjustment and was associated with higher malignant yield when the FDG hotspot was targeted in tumors ≥ 52 mm.

PMID:42223871 | DOI:10.1007/s12149-026-02242-9

MedScience. 2026 May 30. doi: 10.1007/s11684-026-1253-8. Online ahead of print.

NO ABSTRACT

PMID:42223858 | DOI:10.1007/s11684-026-1253-8

J Robot Surg. 2026 Jun 1;20(1):558. doi: 10.1007/s11701-026-03542-y.

ABSTRACT

INTRODUCTION: Imageless navigation is widely used in total hip arthroplasty (THA), yet evidence for procedures in the lateral decubitus position remains limited because pelvic orientation and registration differ from the supine position. This study evaluated the accuracy of imageless navigation for acetabular component positioning in lateral-position primary THA, using postoperative EOS-based 3D assessment as a postoperative reference method for agreement analysis.

METHODS: The study comprised in-vitro pretests and an in-vivo cohort. In vitro, a pelvic model was systematically rotated along all axes to assess effects on navigated cup inclination and anteversion. In vivo, 70 patients undergoing primary THA in lateral decubitus were included. Intraoperative imageless navigation values were compared with postoperative EOS-3D-measurements.

RESULTS: In vitro, z-axis (tilt) variations substantially altered both parameters. In vivo, inclination showed a small but statistically significant inter-method difference (mean 1.4°, p = 0.036, Cohen’s d = 0.26), whereas anteversion demonstrated a larger systematic underestimation by imageless navigation (mean -7.5°, p < 0.001, Cohen’s d = -0.78) with poor inter-method agreement (ICC = 0.168).

CONCLUSION: Imageless navigation demonstrated acceptable inclination agreement with postoperative EOS assessment, whereas anteversion showed a larger systematic deviation and poor inter-method agreement; sagittal pelvic tilt and positional frame-of-reference differences appear to be major contributing factors.

CLINICAL TRIAL REGISTRATION: The study was registered in the German Clinical Trials Register with the registration number DRKS00026749.

PMID:42223835 | DOI:10.1007/s11701-026-03542-y

J Robot Surg. 2026 Jun 1;20(1):559. doi: 10.1007/s11701-026-03530-2.

ABSTRACT

This study aimed to evaluate and compare perioperative outcomes of robotic versus laparoscopic cholecystectomy in patients with acute cholecystitis within an Acute Care Surgery setting. A retrospective cohort study was conducted including patients who underwent cholecystectomy for acute cholecystitis between January 1, 2023, and March 1, 2026. Patients were stratified by operative approach (robotic vs. laparoscopic). Baseline demographics, comorbidities, and postoperative outcomes were analyzed. Continuous variables were compared using Mann-Whitney U test, and categorical variables were assessed with Pearson χ². Statistical significance was defined as p < 0.05. A total of 322 patients were included, with 107 undergoing robotic and 215 laparoscopic cholecystectomies. Baseline characteristics were similar between groups. Median operative time did not differ significantly (78.0 [63.0-107.0] minutes robotic vs. 77.0 [60.0-95.0] minutes laparoscopic, p = 0.31). Conversion to open surgery occurred in one laparoscopic case (0.5%) and none in the robotic group. Length of hospital stay was comparable. Early postoperative complications were similar (10.3% robotic vs. 12.6% laparoscopic, p = 0.97), including comparable rates of severe (Clavien-Dindo III-IV) complications. Readmission and reintervention rates did not differ significantly. Two postoperative bile leaks occurred, one in each group. Subgroup analysis of gangrenous cholecystitis showed no significant differences in operative time, length of stay, or postoperative outcomes. Robotic cholecystectomy demonstrates comparable safety and efficacy to laparoscopic cholecystectomy for acute cholecystitis, including in severe cases, supporting its feasibility in acute care settings.

PMID:42223833 | DOI:10.1007/s11701-026-03530-2

Sports Med. 2026 Jun 1. doi: 10.1007/s40279-026-02461-0. Online ahead of print.

NO ABSTRACT

PMID:42223829 | DOI:10.1007/s40279-026-02461-0

J Robot Surg. 2026 Jun 1;20(1):566. doi: 10.1007/s11701-026-03524-0.

ABSTRACT

Robotic surgery is increasingly adopted across surgical specialties because of advantages in visualisation, dexterity, and ergonomics. However, data on its use in upper gastrointestinal (UGI) and hepatopancreatobiliary (HPB) surgery in Australia remain limited. This study characterises trends in robotic UGI and HPB surgery in Australia using data from the da Vinci System and Medicare Benefits Schedule (MBS) Item Reports website. Robotic procedure counts between 2013 and 2023 were obtained from Device Technologies Australia, local distributor of the da Vinci System by Intuitive Surgical in Australia. Corresponding MBS item numbers were used to determine UGI and HPB procedure volumes. Descriptive statistics, Poisson regression, and linear models were used to analyse trends over time. Robotic UGI and HPB surgery volume increased on average by 33% annually (95% CI 31%, 35%) over the study period, adjusted for surgery type. The proportion of MBS-claimed UGI and HPB procedures performed robotically increased on average by 0.16% (95% CI 0.12%, 0.20%) and 0.11% (95% CI 0.07%, 0.15%) per year, respectively. Cholecystectomy was the most common HPB procedure performed robotically but accounted for only 0.6% of MBS-claimed procedures. A considerable proportion of MBS-claimed left-sided pancreatectomies (34.4%) and pancreatoduodenectomies (18.1%) were performed robotically in 2023. Robotic bariatric procedures were the most commonly performed UGI procedure, although procedure counts plateaued after 2022. Robotic surgery for UGI and HPB procedures increased significantly over the study period. Notably, there has been a recent rise in the adoption of robotic approaches for complex non-bariatric procedures, particularly pancreatic surgery.

PMID:42223813 | DOI:10.1007/s11701-026-03524-0

Int Urol Nephrol. 2026 Jun 1. doi: 10.1007/s11255-026-05220-2. Online ahead of print.

ABSTRACT

PURPOSE: Behavioral therapy is the established first-line treatment for overactive bladder (OAB), followed by pharmacotherapy as the second-line intervention. Mirabegron, a β3-adrenoceptor agonist, has demonstrated comparable efficacy to antimuscarinics. This study aims to evaluate the real-world efficacy of behavioral therapy, both as a monotherapy and in combination with mirabegron, for male patients with OAB.

METHODS: This pooled analysis from three studies involved 280 adult male OAB patients assigned to behavioral therapy alone or combined with mirabegron (25 mg or 50 mg) for 12 weeks. The primary outcome was the change in the Overactive Bladder Symptom Score (OABSS) from baseline to week 12. Secondary outcomes included changes in the International Prostate Symptom Score (IPSS), Patient Perception of Bladder Condition (PPBC), Quality of Life (QOL) score, maximum flow rate (Qmax), and post-void residual (PVR) volume.

RESULTS: At week 12, all groups exhibited significant within-group improvements in total OABSS, with no statistically significant inter-group differences. Significant improvements were also observed in the IPSS, QOL, PPBC, urge urinary incontinence (UUI), and nocturia across all groups. Notably, behavioral therapy demonstrated substantial therapeutic potential for storage symptoms (IPSS storage sub-score), particularly regarding UUI and nocturia. No negative impacts on PVR or Qmax were observed across the three treatment arms at week 12.

CONCLUSION: In real-world clinical practice, both behavioral therapy and combination therapy with varied dosages of mirabegron effectively alleviate OAB symptoms in male patients without compromising voiding function. Beyond conventional pharmacotherapy, optimizing the role of behavioral therapy remains a fundamental component of comprehensive OAB management.

PMID:42223809 | DOI:10.1007/s11255-026-05220-2

Nat Prod Bioprospect. 2026 Jun 1;16(1):67. doi: 10.1007/s13659-026-00614-2.

ABSTRACT

Medicinal plants have long served as an important asset in the treatment of diseases. Recent developments in computer science have enabled the rise of specialized databases cataloging medicinal plant knowledge. However, a systematic comparison of available region-specific medicinal plant databases is lacking. This review summarizes globally available medicinal plant databases that focus on specific geographical regions, aiming to inspire and guide people from specialists to the general public toward fostering innovation and making informed decisions. Through a systematic search of literature and digital resources, 81 regional medicinal plant databases established or updated between 2013 and 2025 were identified. From this pool, 40 core platforms were subjected to detailed statistical characterization regarding their data categories and volume. Our analysis reveals a geographical concentration in Asia (48.1%), dominated by China and India, alongside a notable proliferation of universal databases with a global scope. These databases facilitate critical applications in drug discovery, quality control, biodiversity conservation, and policy-making. By identifying current research gaps and emphasizing the need for interdisciplinary standardization, this review serves as a strategic roadmap for bridging traditional wisdom with modern therapeutic innovation.

PMID:42223802 | DOI:10.1007/s13659-026-00614-2