Nevin Manimala

Ir J Med Sci. 2026 Mar 3. doi: 10.1007/s11845-026-04284-4. Online ahead of print.

ABSTRACT

INTRODUCTION: Anatomy education forms a cornerstone of medical curricula, integrating theoretical knowledge with practical understanding. The flipped classroom model, an innovative and interactive pedagogical strategy, has gained increasing attention for promoting active learning, engagement, and long-term knowledge retention. This study aimed to evaluate the impact of the flipped classroom model on learning performance, student engagement, and perceptions of digital learning tools in anatomy education.

METHODS: A total of 194 second- and third-year medical students participated during the 2024-2025 academic year (94 second-year and 100 third-year students). Flipped classroom sessions focused on the cerebral hemispheres (second year) and the pelvis and perineum (third year). Preparatory materials were provided via Moodle at least 15 days before the sessions. Student performance was assessed through a 20-question formative quiz graded out of 10 marks and related items in the final committee examination. Post-session perceptions were gathered using a 14-item Likert-scale questionnaire. Statistical analyses were performed using the Mann-Whitney U and Wilcoxon Signed-Rank tests.

RESULTS: Average quiz scores were 8.4 for second-year and 8.3 for third-year students, while committee exam accuracy was 78% and 70.06%, respectively. Over 75% of students reported that the flipped classroom enhanced their understanding and engagement. Significant differences were observed between year groups in enjoyment (p = 0.004) and perceived support for independent learning (p = 0.004). More than 70% agreed that digital anatomy resources improved comprehension and confidence.

CONCLUSION: The flipped classroom model enhances engagement, independent learning, and comprehension in anatomy education. This digitally supported, student-centred approach promotes deeper cognitive involvement and supports the integration of hybrid learning models into future curricula.

PMID:41774341 | DOI:10.1007/s11845-026-04284-4

Environ Monit Assess. 2026 Mar 3;198(3):272. doi: 10.1007/s10661-026-15037-2.

ABSTRACT

This study assessed leachate and soil contamination at the Igbatoro dumpsite, Akure, Nigeria. Leachate samples were analyzed for heavy metals, BOD, and other physicochemical parameters. Soil samples were collected at depths of 0.5, 1.0, and 1.5 m to evaluate twenty-five (25) parameters, including pH, TDS, DO, COD, and heavy metals. Statistical analyses, including two-way ANOVA and correlation analysis, were performed. Leachate Pollution Index (LPI), revised LPI (r-LPI), Geo-accumulation Index (Igeo), Metal Pollution Index (MPI), Pollution Load Index (PLI), Degree of Contamination (Cdeg), and Potential Ecological Risk Factor (RI) were used to evaluate contamination levels of Igbatoro dumpsite. Results showed that Leachate pH ranged from 5.44 to 6.45 (mean 6.01), and metals like As and Cu exceeded the Federal Environmental Protection Agency (FEPA) limits. Strong negative correlations were observed between pH and most parameters, while temperature showed positive correlations with nitrate and Ni. An LPI of 13.65 and r-LPI of 40.39 exceeded pollution thresholds, indicating significant contamination. Soil analysis revealed elevated metal concentrations compared to the control, with Cd showing the highest Igeo value (-0.60). Location 6 recorded the highest MPI values for Cu and Cr, while most heavy metals fell within pollution classes, reflecting severe contamination. The potential ecological risk factor (RI) value of 174.70 indicates moderate ecological risk, with Cd posing a particularly high risk (Eir = 98.34). Overall, the study highlights considerable environmental and public health risks, underscoring the urgent need for remediation and adoption of sustainable waste management practices.

PMID:41774287 | DOI:10.1007/s10661-026-15037-2

Int Ophthalmol. 2026 Mar 3;46(1):142. doi: 10.1007/s10792-026-04021-x.

ABSTRACT

PURPOSE: Dry eye disease (DED) is a multifactorial ocular surface disorder characterized by tear film instability and chronic inflammation. Natural compounds with anti-inflammatory activity have therefore attracted increasing interest. Chelidonium majus (C. majus) latex contains bioactive alkaloids with proven anti-inflammatory properties; however, its potential role in DED has not yet been investigated.

METHODS: Forty-six Wistar rats were randomized into six groups: Control, DED, Loteprednol etabonate (LE), and three C. majus latex dilutions (1/1, 1/10, 1/100). DED was induced by twice-daily instillation of 0.2% benzalkonium chloride (BAC) for 14 days. Following induction, LE or C. majus latex was administered according to group allocation; controls received vehicle. Tear volume (phenol red thread test), fluorescein corneal staining score (CSS), and Cochet-Bonnet esthesiometry were measured on days 0, 14, 21, and 28. On day 29, corneal tissues were analyzed by ELISA for TNF-α, IL-1β, IFN-γ, NF-κB, MMP-2, MMP-9, TIMP-2, AQP1, and AQP5, and underwent histopathological evaluation (H&E). Latex composition was characterized using LC-QTOF-MS. Statistical analysis included ANOVA with post hoc Tukey testing; p < 0.05 was considered significant.

RESULTS: At week 2, the DED groups demonstrated reduced tear volume (2.13 ± 0.83 mm) and increased corneal staining scores (CSS) (4.63 ± 1.06). By week 4, tear secretion improved in the LE (4.38 ± 0.52 mm) and in the C. majus 1/1 (4.56 ± 0.56 mm), 1/10 (4.88 ± 0.52 mm), and 1/100 (4.56 ± 0.50 mm) groups, approaching values observed in the control group. CSS decreased markedly in the C. majus 1/10 (0.38 ± 0.52) and LE (1.13 ± 0.83) groups, whereas the DED group remained elevated (2.38 ± 0.52). Corneal sensitivity improved in the LE and C. majus 1/1 (3.44 ± 0.42 mm), 1/10 (3.75 ± 0.27 mm), and 1/100 (3.50 ± 0.46 mm) groups. Inflammatory cytokines and MMP-2/9 levels decreased significantly across treatment groups, with the most pronounced reductions observed in the C. majus 1/10 group. Histopathological analysis revealed better preservation of stromal architecture and reduced inflammatory infiltration in treated groups compared with the DED group.

CONCLUSIONS: Chelidonium majus latex demonstrated significant anti-inflammatory and tissue-protective effects in this experimental model, supporting further investigation as a potential adjunctive approach in inflammatory DED.

PMID:41774285 | DOI:10.1007/s10792-026-04021-x

J Cancer Res Clin Oncol. 2026 Mar 3;152(3):56. doi: 10.1007/s00432-026-06424-w.

ABSTRACT

PURPOSE: In recent decades, small renal masses (SRMs) have become common incidental findings in cross-sectional studies; however, a widely implemented approach for the characterization of SRMs is still lacking. Thus, in this study, we aimed to explore the diagnostic performance of existing algorithms and to propose – as a conceptual framework rather than a clinically verified tool – a new simple radiological scale for estimating the probability of malignancy in SRMs.

METHODS: Patients with indeterminate solid SRMs (N = 50), discovered using magnetic resonance imaging (MRI) between 2012 and 2023 were included. In 38 cases, the final diagnosis was based on histopathology, while in 12 cases it relied on regression or lack of progression during follow-up. Modified versions of the clear cell likelihood score (ccLS) were calculated, and its diagnostic performance was assessed. Moreover, we analyzed the newly created score, which consisted of selected MRI and clinical features. All of our modified scales used a Likert score for the likelihood of clear cell renal cell carcinoma (ccRCC).

RESULTS: Based on the results of our statistical analyses, we modified the ccLS by adding T1 SI ratio < 0.73, arterial to delayed ratio (ADER) > 0.99, and smoking as independent predictors of ccRCC. We created a new scale, the CAT score, which combined hyperintensity in the Corticomedullary phase, ADER > 0.99, and TI SI ratio < 0.73 (with 1 point being assigned to each of the above-mentioned MRI parameters). In our results, the best diagnostic accuracy was observed for a CAT score ≥ 2, with a sensitivity of 73.9% (51.6-89.8%), a specificity of 77.8% (57.7-91.4%), and an accuracy of 76.0% (61.8-86.9%). Univariate logistic regression analyses demonstrated that all scales created by our group were significant predictors of ccRCC. Importantly, they showed a better predictive ability than the standard ccLS score.

CONCLUSIONS: The CAT score appears to improve the prediction of ccRCC compared with both standard and modified versions of the ccLS and may serve as a potential aid in the routine assessment of indeterminate SRMs. Nonetheless, this study should be regarded as a preliminary, proof-of-concept analysis rather than a definitive model-development study. The main limitation of our study is its small, single-center cohort, which limits the statistical power and robustness of model development. Moreover, a substantial proportion of benign diagnoses based only on radiological follow-up rather than histopathology. Therefore, before clinical implementation, the CAT score requires prospective validation in larger, independent, multicenter cohorts.

PMID:41774259 | DOI:10.1007/s00432-026-06424-w

J Mol Model. 2026 Mar 3;32(4):89. doi: 10.1007/s00894-026-06670-2.

ABSTRACT

CONTEXT: Computer-aided design of polymers with specific properties often encounters excessive computational demands due to the vast number of potential chemical structures. Reducing the number of candidates is critical for efficient virtual screening. A promising approach to overcome this challenge is the use of the synthetic accessibility score (SAscore), originally proposed by Ertl and Schüffenhauer (2009). It relies on decomposing chemical structures into molecular fragments and leveraging statistical analyses of fragment frequencies from large chemical databases. The initial implementation of the SAscore algorithm was not suitable for polymers. In this study, we demonstrate that our previously developed polymer-adapted approach can be used to filter polymer structures. We analyzed the impact of using fragments obtained by decomposing chemical compounds from different databases on SAscore calculation results. We showed that, in most cases, the differences fall within the error range. However, structures containing fragments with limited database presence may exhibit notable SAscore fluctuations across fragment sources.

METHOD: The Ertl and Schüffenhauer SAscore algorithm was adapted to account for the specific structural features of polymeric structures. We implemented our algorithm in a program that decomposes large databases of chemical structures into fragments and calculates their frequency of occurrence. The decomposition of polymers into fragments considers the ambiguity of the smallest repeating unit (SRU) specification and the possibility of specifying a polymer structure with multiple SRUs. This ensures identical calculated SAscore values for polymers specified in different ways. For SAscore calculations, we used PubChem Compounds (115 million records as of August 2023) and Aurora Fine Chemicals (116 million records) as sources of molecular fragments. The resulting database of molecular fragments is publicly accessible. A test database of virtually generated polymers with calculated SAscore values (MCKintech, 2.2 million records) is also freely available.

PMID:41774247 | DOI:10.1007/s00894-026-06670-2

Arch Orthop Trauma Surg. 2026 Mar 3;146(1):92. doi: 10.1007/s00402-026-06255-x.

ABSTRACT

OBJECTIVE: The pararectus approach (PRA) offers good visualization of the entry point for posterior column screw insertion with an adequate screw length. However, conventional practice typically employs the lateral window (LW) of the pelvic approach. This study aimed to compare the radiographic trajectory of posterior column screws inserted via the PRA with that of screws inserted via the LW approach.

METHODS: We retrospectively analyzed 68 cases of posterior column screw placement during acetabular fracture surgery, beginning in March 2020, when metal-reformatted images could be generated from postoperative pelvic computed tomography (CT) scans. Group 1, consisting of 32 cases where screws were inserted through the second window of the PRA, was compared with Group 2, which included 36 cases using the LW in combination with various pelvic approaches. Demographic data (including body mass index [BMI] and presence of sacral dysplasia), the coronal angle of the posterior column screw in three-dimensional (3D) images, Sagittal Angle to Linea Terminalis (SALT), Sagittal Angle to Ischial Line (SAIL), and screw length (measured from 3D-CT metal-reformatted images) were analyzed.

RESULTS: Demographic data, including BMI and the presence of sacral dysplasia, were not significantly different between the two groups. The average coronal angle of the posterior column screw was 4.6° in Group 1 and 12.2° in Group 2, indicating a significant difference between both groups. For sagittal angles, SALT was 75.8° in Group 1 and 34.6° in Group 2, while SAIL was – 24.5° and – 4.1° in Groups 1 and 2, respectively, with both differences being statistically significant. The average screw length, measured by 3D-CT, was 73.2 mm and 93.7 mm in Groups 1 and 2, respectively, also demonstrating a significant difference between both groups.

CONCLUSION: Although the PRA allows good visualization of the posterior column screw entry point, it presents limitations in achieving optimal sagittal and coronal insertion angles due to the anatomical constraints of the abdomen and surrounding structures. In contrast, the LW approach demonstrated a screw trajectory that more closely aligns with the ideal anatomical corridor.

PMID:41774246 | DOI:10.1007/s00402-026-06255-x

J Mol Model. 2026 Mar 3;32(4):86. doi: 10.1007/s00894-026-06674-y.

ABSTRACT

CONTEXT: Coal slime water treatment and resource recovery are vital for the sustainable development of coal industry sustainability. Kaolinite, over 60% of clay minerals in coal slime water, is key for high-value flotation utilization. Phosphonic-acid collectors adsorb effectively on kaolinite via -PO(OH)₂ groups, but their structural diversity (phenyl/benzylphosphonic acids and esters) blurs structure-adsorption relationships. Existing studies focus on single collectors for specific minerals, lack a systematic screening/prediction database, and rarely combine first-principle calculations with three-dimensional quantitative structure-activity relationship (3D-QSAR) to explore multi-type collector mechanisms on kaolinite. This study combined density functional theory (DFT) with 3D-QSAR to study phosphonic-acid collector adsorption on kaolinite (001). Comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA) models were validated, with CoMSIA performing optimally (q² = 0.843, r² = 0.984). Diethyl (2-chlorobenzyl)phosphonate and (2-hydroxyphenyl)phosphonic acid in the test set showed prediction errors < 1%, confirming reliability. Two novel collectors (4-propylphenylphosphonic acid, 3-methyl-4-nitrophenylphosphonic acid) were designed, outperforming all database collectors, corroborating model validity and supporting high-efficiency collector development for kaolinite recovery.

METHODS: First-principle calculations via Cambridge Serial Total Energy Package (CASTEP) yielded the adsorption energies of 35 phenyl/benzylphosphonic acids/esters on kaolinite (001) to build a molecular structure-adsorption database. The dataset was split into 80% training and 20% test sets post molecular energy minimization. CoMFA/CoMSIA models were built via partial least squares (PLS) regression, evaluated by q², r², F-statistic and standard error of estimate (SEE); contour maps analyzed molecular field effects. New collectors were designed via CoMSIA and DFT-verified.

PMID:41774237 | DOI:10.1007/s00894-026-06674-y

Support Care Cancer. 2026 Mar 3;34(3):267. doi: 10.1007/s00520-026-10502-7.

ABSTRACT

PURPOSE: The aim of this scoping review was to explore the current knowledge on multimodal prehabilitation in digestive oncology, identifying the evidence, challenges, and future perspectives for research in this field.

METHODS: Research was realized by two independent reviewers in four databases following PRISMA-ScR guidelines. Data of included articles were extracted, and risk of bias analyzed.

RESULTS: Finally, 51 articles were included. Despite the heterogeneity of interventions, the totality of studies combined physical activity interventions with nutritional support following for five of them the European Society of Parenteral and Enteral Nutrition recommendations, with intervention lasting at least 4 weeks before surgery. Psychological support was inconsistently incorporated. Evidence suggests that prehabilitation improves functional capacities, with an average increase in 6-min walk test distance ranging from + 35 to + 70 m across randomized controlled trials, and concurrent improvements in body composition. However, the impact on perioperative outcomes and length of hospital stay was unclear.

CONCLUSIONS: Implementing structured prehabilitation programs could be a key strategy to improve surgical outcomes in gastrointestinal cancers.

PMID:41774232 | DOI:10.1007/s00520-026-10502-7

Fish Physiol Biochem. 2026 Mar 3;52(2):38. doi: 10.1007/s10695-026-01664-6.

ABSTRACT

Microplastics (MPs) are one of the fastest-growing sources of pollution and have become a substantial risk to both the environment and human health. Hence, the present investigation was conducted to assess the potential toxic effects of Polyvinyl chloride (PVC) MPs (Treatment I- 3 µg/L and Treatment II- 30 µg/L) on D. rerio for 20 days. The PVC-MPs were characterised by SEM, XRD, DLS and FTIR analyses, and their presence was confirmed in the gastrointestinal tract of the fish. When compare to the control group, the studied locomotive, behavioural, blood (haematology) and tissue (gill, gut and brain) biomarkers (SOD, GST, GPx, LPO, AChE, histopathology) were altered significantly (P < 0.05) in the PVC-MPs treatment groups. Locomotive and behavioural responses declined. Among the blood biomarkers, RBC counts were increased significantly in the PVC-MPs treatments. Whereas, WBC counts were decreased. Tissue (gill, gut and brain) SOD and GPx activity was accelerated in the PVC-MPs treated fish. In contrast, the GST activity in the gill, gut, and brain tissues were declined. LPO levels in the gill of the PVC-MPs fish were increased. PVC-MPs inhibited AChE activity in the brain tissue of fish. No visible histological changes were noticed in the control group. Whereas, a series of histological anomalies were visualized in the gill, gut and brain tissues of the PVC-MPs. These biomarker-responses of fish reveals that PVC-MPs is potentially a toxic substance to non-target organisms. The studied locomotory, behavioural, haematological, antioxidants, AChE and histopathology are useful biomarkers to asses potential toxicity of plastic related materials on aquatic organisms.

PMID:41774229 | DOI:10.1007/s10695-026-01664-6

Cancer Causes Control. 2026 Mar 3;37(4):55. doi: 10.1007/s10552-026-02129-0.

ABSTRACT

PURPOSE: Anxiety before a first-time screening colonoscopy is a commonly reported patient-level barrier to completing colorectal cancer (CRC) screening. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of “For peace of mind. Get Screened,” a brief online mindfulness-based intervention (MBI) to reduce anxiety before a first-time screening colonoscopy.

METHODS: Participants (n = 100) were randomized (October 2023-July 2024) to usual care or the MBI (daily CRC screening infographics guided by the Protection Motivation Theory, mindfulness infographics, and brief mindfulness meditations based on Monitor and Acceptance Theory) starting five days before their scheduled colonoscopy. Anxiety was assessed using the State-Trait Anxiety Inventory-State Subscale (STAI-S) in the endoscopy suite’s waiting room.

RESULTS: Participant retention was 83% due to patient and health system issues. Participant satisfaction with the MBI was high (mean: 6.40 out of 7). The MBI group had an average STAI-S score 2.54 points lower than the usual care group, though this difference was not statistically significant (32.24 vs. 34.78; p = 0.21). However, among participants not lost to follow up (n = 83), the MBI group had significantly lower waiting room STAI-S scores compared to the usual care group (31.52 vs. 35.21; p = 0.02). Clinical outcomes did not differ between groups.

CONCLUSION: Feasibility of the MBI was partially limited due to logistical issues. Findings support MBI acceptability and suggest that a brief MBI has the potential to decrease anxiety prior to a first-time colonoscopy. A larger randomized controlled trial is needed to further examine the efficacy of this intervention.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT06233253.

PMID:41774215 | DOI:10.1007/s10552-026-02129-0