Nevin Manimala

Biomed Eng Comput Biol. 2026 May 4;17:11795972261438666. doi: 10.1177/11795972261438666. eCollection 2026.

ABSTRACT

In biomedical and engineering research, entropy metrics have become well-established tools for assessing the complexity of dynamic and physiological systems. This scoping review examines the relationship between information theory quantifiers (ITQs), bioelectrical signals, and time series, and the limited diagnostic value of these measures in functional dyspepsia (FD). Three main variables were defined in this study: entropy, health experiments, and FD. Eighty-five academic documents were analyzed using the PRISMA methodology, following 4 phases: (i) heuristic; (ii) classification and systematic review; (iii) hermeneutic analysis; and (iv) presentation of results. ITQs are currently applied in the study of neurodegenerative diseases, cardiological conditions, and, to a lesser extent, gastric disorders, thereby opening new avenues for diagnosis and comprehensive clinical management. The review of the documents shows that, despite the methodological robustness, statistical testing, classification approaches, and the breadth of entropy measures employed, significant challenges remain when integrating these techniques due to the intrinsic complexity and heterogeneity of bioelectrical signals in FD. Furthermore, knowledge gaps persist, particularly in digestive disorders such as FD, underscoring the need to deepen and diversify analytical methodologies.

PMID:42125732 | PMC:PMC13158506 | DOI:10.1177/11795972261438666

Front Psychol. 2026 Apr 24;17:1752831. doi: 10.3389/fpsyg.2026.1752831. eCollection 2026.

ABSTRACT

Vocal performance anxiety is a common psychological barrier among vocal students, severely impacts their skill development, stage performance, and overall wellbeing. This study aims to comprehensively evaluate the short-term and long-term effects of an integrated pedagogical model for anxiety management, constructed based on music psychology theories, through a mixed-methods study with a pre-test, post-test, and 3 month follow-up. We recruited 60 undergraduate vocal performance majors and randomly assigned them to an experimental group (receiving a 12-week “Awareness-Skill-Simulation-Reflection” four-stage integrated pedagogical intervention) and a control group (receiving traditional technical instruction). We collected data on students’ state anxiety in performance, vocal performance quality (expert blind ratings), psychological resilience, self-efficacy, and Heart Rate Variability (HRV) at three time points: pre-intervention (T1), post-intervention (T2), and 3 months post-intervention (T3). Additionally, reflective journals from the experimental group were subjected to qualitative analysis. Quantitative findings indicate: (1) Compared to the control group, the integrated intervention significantly reduced the experimental group’s vocal performance anxiety and enhanced their performance quality, psychological resilience, and HRV levels. These positive effects remained stable 3 months after the intervention concluded. (2) The intervention’s effectiveness was moderated by students’ initial trait anxiety levels, meaning the intervention was more potent for students with high trait anxiety. (3) Psychological resilience was identified as a potential statistical mediator of the relationship between the pedagogical intervention and the reduction in anxiety levels. Qualitative results revealed profound subjective experiences among students across four dimensions: “Shifting Mindsets,” “Enhanced Bodily Control,” “Reconstructing the Stage Experience,” and “Trust in Teacher-Student Relationship.” This study provides evidence for the effectiveness and durability of this integrated pedagogical model and explores its potential mechanisms, offering a scientific reference for modern vocal education reform.

PMID:42125720 | PMC:PMC13159198 | DOI:10.3389/fpsyg.2026.1752831

Front Oncol. 2026 Apr 27;16:1750773. doi: 10.3389/fonc.2026.1750773. eCollection 2026.

ABSTRACT

BACKGROUND: Distinguishing pulmonary cryptococcosis (PC) from lung adenocarcinoma (LAC) remains clinically challenging in practice. The purpose of this study was to investigate the utility of intranodular and perinodular radiomics features derived from non-contrast CT in differentiating PC from LAC.

MATERIALS AND METHODS: A total of 244 patients with PC and LAC from two centers were randomly divided into a training set and a testing set at a ratio of 7:3. Logistic regression analysis was used to establish the clinical model. Radiomics features were extracted from the lesions and lesion margins of 10 mm. Support vector machine (SVM) was used to construct the intranodular, perinodular, and combined radiomics models. The areas under the receiver operating characteristic curve (AUCs) and decision curve analysis (DCA) were employed to assess the diagnostic performance, while the DeLong test was applied for model comparisons.

RESULTS: The three radiomics models exhibited excellent diagnostic performance for identifying PC and LAC, with the combined radiomics model achieving the highest AUC value in both the training (AUC = 0.936, sensitivity = 0.838, specificity = 0.898, accuracy = 0.859) and testing sets (AUC = 0.922, sensitivity = 0.854, specificity = 0.808, accuracy = 0.892). In the testing set, the AUC of the combined radiomics model was significantly higher than that of the clinical model (p = 0.005), while no statistically significant difference was found when compared with the intranodular or the perinodular model (p > 0.05). The combined model outperformed the other three models according to the DCA in terms of net benefit.

CONCLUSION: A combined radiomics model integrating intranodular and perinodular features can effectively improve diagnostic accuracy in differentiating PC from LAC.

PMID:42125701 | PMC:PMC13158070 | DOI:10.3389/fonc.2026.1750773

Front Oncol. 2026 Apr 27;16:1813333. doi: 10.3389/fonc.2026.1813333. eCollection 2026.

ABSTRACT

CPX-351 for the treatment of acute myeloid leukemia (AML) has demonstrated better efficacy compared with standard chemotherapy regimens, with an excellent safety profile. We aimed to assess the determinants of response, relapse, and survival in patients treated with CPX-351 as the first-line therapy for AML. In this retrospective monocentric study, we analyzed 60 consecutive patients treated with CPX-351 for therapy-related AML or AML with myelodysplastic-related changes. We observed a 61% overall response rate, with 58% complete response. The presence of complex karyotype at diagnosis predicted lower response rates. Among patients who achieved complete response, the relapse rate was 50%, with a median relapse-free survival of 154 days. The median overall survival was 412 days. We found that the biological profile at diagnosis is associated with survival. Leukocytosis at diagnosis, complex karyotype, and mutations of IDH1 and SRSF2 were correlated with lower survival in the univariable analysis. In the multivariable analysis, leukocytosis and complex karyotype retained their statistical significance.

PMID:42125699 | PMC:PMC13158078 | DOI:10.3389/fonc.2026.1813333

Front Oncol. 2026 Apr 27;16:1780492. doi: 10.3389/fonc.2026.1780492. eCollection 2026.

ABSTRACT

BACKGROUND: Nutritional status and immune function are pivotal to the progression of cancer. The present study is designed to explore the associations between the prognostic nutritional index (PNI) score, hemoglobin-albumin-lymphocyte-platelet (HALP) score, and lymph node metastasis (LNM) in breast cancer patients.

METHODS: A total of 799 breast cancer patients were enrolled in this retrospective study, and their clinical data were collected. The PNI and HALP score were calculated for all patients. According to the status of LNM, the patients were divided into LNM-positive patients and LNM-negative cohort. The differences in PNI and HALP score between the two groups were compared, and statistical analysis was performed to clarify the relationship between these two scores and LNM.

RESULTS: 412 cases (51.6%) were confirmed with LNM, whereas the remaining 387 (48.4%) were LNM-free. The median levels of both HALP (37.9 (28.2, 46.8) vs. 42.0 (33.4, 54.6), p < 0.001) and PNI (51.2 (48.3, 53.8) vs. 52.6 (50.2, 55.3), p < 0.001) were notably lower in patients with LNM than in those without this condition. When LNM was designated as the endpoint for receiver operating characteristic (ROC) curve analysis of HALP and PNI levels, the optimal cutoff values were determined to be 39.95 for HALP and 52.45 for PNI. Logistic regression analysis showed that low PNI levels (odds ratio [OR]: 1.481, 95% confidence interval [CI]: 1.016-2.159, p = 0.041) was associated with LNM, but HALP not (p = 0.257).

CONCLUSIONS: Low PNI is a potential risk factor for LNM in breast cancer. Clinically, PNI can be used as a convenient warning tool for LNM in breast cancer, and attention should be paid to nutritional and immune intervention before and after surgery.

PMID:42125695 | PMC:PMC13158087 | DOI:10.3389/fonc.2026.1780492

Front Oncol. 2026 Apr 27;16:1479189. doi: 10.3389/fonc.2026.1479189. eCollection 2026.

ABSTRACT

PURPOSE: For surgical guidance applications, supine breast MRI tumor contrast should be non-inferior to prone MRI, currently considered the standard-of-care. However, comparing image contrast quantitatively between different MRI sequences and breast orientations presents a significant challenge. Herein, we present a method for quantitatively comparing regional tumor contrast in the prone and supine breast MRI orientations for the purpose of tumor localization, and we apply this framework to assess the performance of two investigational supine scans (i.e. independent and prone-to-supine, P2S) compared to diagnostic prone MRI.

METHODS: Patient tumors from two studies (NCT03573804, NCT03573661) were outlined slice-by-slice by a breast radiologist using Gd-enhanced, T1-weighted MRI. Image data were derived from subjects undergoing standard-of-care prone imaging (n = 78), independent supine imaging (n = 17), and P2S supine imaging (n = 61). Normalized tumor contrast was computed between the segmented tumor and neighboring normal tissue regions and compared for statistical differences amongst cohorts and non-inferiority to prone MRI.

RESULTS: The independent supine cohort possessed non-inferior tumor-to-fibroglandular contrast compared to prone (p = 0.002), while tumor-to-fibroglandular contrast from the P2S supine cohort was found inferior to the prone cohort. However, both investigational supine scans produced non-inferior tumor-to-adipose contrast when compared to prone MRI (p< 0.001 in both cases).

CONCLUSIONS: Regional contrast between tumor and surrounding fibroglandular tissue suffered at later timepoints observed in the P2S supine study, resulting in inferior tumor contrast. However, when contrast-enhanced supine breast MRI is acquired independently, ratiometric comparisons indicate that tumor contrast is non-inferior to prone MRI.

PMID:42125694 | PMC:PMC13158090 | DOI:10.3389/fonc.2026.1479189

Pulm Circ. 2026 May 11;16:e70314. doi: 10.1002/pul2.70314. eCollection 2026 Jun.

ABSTRACT

Red blood cell distribution width (RDW)-derived indicators have increasingly been recognized as biomarkers reflecting systemic inflammation and hematological disorders. However, the prognostic value of these indicators in critically ill patients with pulmonary hypertension (PH), especially the dynamic implications of their temporal changes, remains insufficiently elucidated. A total of 990 adult patients diagnosed with PH in the intensive care unit (ICU) based on ICD-9/10 codes were enrolled from the MIMIC-IV database. The association between baseline levels of three key indicators and the 1-year all-cause mortality risk was assessed using Cox proportional hazards models and restricted cubic spline (RCS) analysis, and the consistency of this association was assessed for external consistency in the eICU-CRD cohort (n = 298) and NWICU cohort (n = 182). In the subgroup of patients with ≥ 3 consecutive laboratory tests (n = 316), group-based multi-trajectory modeling (GBTM) was employed to identify the joint longitudinal trajectory patterns of these three indicators. The robustness of the prediction results was then evaluated using machine learning models as secondary exploratory analysis. In the MIMIC-IV cohort, higher baseline RAR (aHR = 1.17, 95% CI: 1.08-1.27) and RPR (aHR = 2.31, 95% CI: 1.38-3.86) were significantly associated with increased 1-year mortality risk, whereas higher HRR exerted a protective effect (aHR = 0.31, 95% CI: 0.17-0.58). Across the multiple cohorts, only RAR remained statistically significant in the multivariate model of the eICU-CRD cohort (p = 0.009); although RPR and HRR showed a consistent association, the results did not reach statistical significance. GBTM identified three distinct joint trajectory patterns. Compared with the reference group (Class 2), the high-risk trajectory group (Class 3, n = 35) exhibited a significantly elevated mortality risk (aHR = 2.48). In the exploratory analysis, the support vector machine (SVM) demonstrated moderate discriminative ability (AUC = 0.782). RDW-derived indicators are independently associated with the mortality risk in critically ill patients with ICD-code defined PH. Both their baseline levels and short-term change trajectories may reflect the severity of the underlying disease and systemic stress response. These findings suggest that RDW-derived indicators play an important role in risk phenotyping; however, prospective studies are warranted to confirm their clinical significance.

PMID:42125633 | PMC:PMC13158876 | DOI:10.1002/pul2.70314

AEM Educ Train. 2026 May 11;10:e70172. doi: 10.1002/aet2.70172. eCollection 2026 Jun.

ABSTRACT

BACKGROUND: The American Board of Emergency Medicine (ABEM) has recently introduced a new Certifying Exam, which incorporates assessment of performance in a simulated clinical environment. Simulation-based assessments allow for reproducible, controlled evaluations. The residency program has a responsibility to prepare residents for the Certifying Exam and to verify resident competency. We sought to determine the feasibility of a simulation-based assessment program encompassing three domains (resuscitation, procedural skills, and communication) with assessments against pre-determined Minimum Competency Scores (MCS) to provide evidence for program director attestations of competence.

METHODS: Eight stations were chosen based on ABEM’s Certifying Exam content, the Accreditation Council for Graduate Medical Education (ACGME) Milestones, and proposed Entrustable Professional Activities. Simulation-based case scenarios and assessment checklists were created with standard settings performed using the Mastery Angoff process. These stations were categorized into three different domains: resuscitation (Adult Medical, Pediatric Medical, Trauma, and Neonatal), procedural skills (Direct Laryngoscopy, Cricothyrotomy, and Central Venous Catheter Placement), and communication (Breaking Bad News). Results were summarized with descriptive statistics.

RESULTS: Thirty emergency medicine residents at an academic Midwestern residency program underwent assessments over one year. None of the residents achieved the MCS on all eight assessments. Residents achieved the MCS on an average of 4.24 stations. There was large performance variability, particularly for the Pediatric Medical (27%-100% items correct), Neonatal Resuscitation (30%-100%), and Breaking Bad News (31%-100%) scenarios. A greater percentage of residents met the MCS for procedural assessments.

CONCLUSIONS: This pilot study demonstrated the feasibility of a simulation-based assessment program designed to provide objective evidence of clinical competency. Assessment outcomes and associated feedback can be used by learners to guide the development of educational plans for performance improvement. Educators can use the resulting data to assess readiness for independent practice, prepare for the Certifying Exam, and identify content areas that may require additional program-wide education.

PMID:42125624 | PMC:PMC13159544 | DOI:10.1002/aet2.70172

Data Brief. 2026 Apr 7;66:112735. doi: 10.1016/j.dib.2026.112735. eCollection 2026 Jun.

ABSTRACT

This dataset provides full metabolomic data for root and stem samples of Sophora flavescens, a commonly used Chinese medicine. Metabolites were extracted separately from root and stem samples and subjected to high-resolution LC-MS in positive and negative modes. Raw spectral data were used for peak detection, alignment, normalization, and metabolite annotation using established metabolomic pipelines and public databases. Principal component analysis and partial least-squares discriminant analysis were used to obtain tissue-specific metabolic profiles. Differential metabolite analysis was conducted to determine the metabolites that were more enriched and depleted in roots and stems, and pathway enrichment analysis was performed to determine the metabolic pathways related to these metabolites. The dataset contains raw LC-MS files, processed feature tables, annotated metabolite lists, and statistical analysis results in a standard format. In these data, there are important materials for studying the tissue-specific metabolism different of S. flavescens, as well as for conducting research on the different distribution of medicine materials and studying biosynthesis routes and quality identification of medicinal plants. The same will be helpful for comparative metabolomics, integrative multi-omics, and natural products.

PMID:42125596 | PMC:PMC13158778 | DOI:10.1016/j.dib.2026.112735

Indian J Community Med. 2026 Mar-Apr;51(2):423-429. doi: 10.4103/ijcm.ijcm_173_25. Epub 2026 Mar 26.

ABSTRACT

Stigma associated with tuberculosis among the general population can lead to fear and encourage discrimination. It is an obstacle to the elimination of tuberculosis from India. The study aimed at estimating the gender-based prevalence of tuberculosis-associated stigma and its predictors in India. The study used unit level data on men and women from the nationally representative survey National Family Health Survey (NFHS 5), 2019-2021. Descriptive statistics and logistic regression analysis were done. It was found that tuberculosis-associated stigma is present in 22.9% of men and 15.6% of women. Among both men and women, tuberculosis-associated stigma was significantly higher among illiterate individuals (men: OR = 1.33; women: OR = 1.13), those belonging to higher wealth status (men: OR = 1.20; women: OR = 1.25), and those with comprehensive knowledge of the mode of transmission of this disease (men: OR = 1.24; women: OR = 1.32). In contrast, knowledge that tuberculosis is curable was associated with lower odds of stigma (men: OR = 0.59; women: OR = 0.83). It is recommended that health awareness activities on tuberculosis should emphasize comprehensive knowledge of disease transmission along with its curability.

PMID:42125591 | PMC:PMC13160205 | DOI:10.4103/ijcm.ijcm_173_25