Nevin Manimala

Discov Nano. 2026 Jun 24;21(1):284. doi: 10.1186/s11671-026-04711-6.

ABSTRACT

The present study investigates transient nanofluid flow in a vertical porous channel with buoyancy effects and Navier slip at the walls, with particular emphasis on thermodynamic irreversibility, entropy generation, and mixed convection. The study formulates dimensionless, coupled nonlinear governing equations for velocity, temperature, and entropy generation. These equations are solved numerically using a finite-difference scheme (FDS) that is second-order accurate in space and first-order accurate in time, capturing both transient and steady-state behaviors. Parametric analyses are conducted for permeability (Darcy number), buoyancy (Grashof number), pressure gradient, Biot number, Prandtl number, Brinkman number, and distinct Navier slip coefficients at the heated and cooled walls. Increasing permeability and buoyancy accelerate the flow and enhance convective heat transfer, but intensify entropy generation near the walls where velocity and temperature gradients are highest. Stronger pressure forcing sharpens the centerline velocity and increases near-wall irreversibility. Higher Biot and Prandtl numbers reduce velocity and temperature levels across the channel, while potentially increasing entropy generation due to steeper thermal gradients. Increased viscous dissipation raises temperatures near the heated wall and amplifies entropy generation near both plates.

PMID:42340619 | DOI:10.1186/s11671-026-04711-6

Knee Surg Sports Traumatol Arthrosc. 2026 Jun 24. doi: 10.1002/ksa.70499. Online ahead of print.

ABSTRACT

PURPOSE: To compare clinical and functional outcomes after primary anterior cruciate ligament reconstruction (ACLR) using quadriceps tendon (QT) autografts versus bone-patellar tendon-bone (BPTB) and, separately, QT versus hamstring tendon (HT) autografts, to inform evidence-based graft selection.

METHODS: We performed a Cochrane-guided systematic review and meta-analysis. Searches of PubMed, Scopus, Cochrane Library, SPORTDiscus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science and major trial registries through November 2025 identified randomized controlled trials (RCTs) comparing QT with HT or BPTB in adults undergoing primary ACLR. Random-effects models (REML) were used to pool mean differences/standardized mean differences and risk ratios. Heterogeneity was quantified using I² and Q statistics. Sensitivity analyses (leave-one-out) and the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach were applied. When pooling was infeasible, a structured narrative synthesis was provided.

RESULTS: Fifteen RCTs (2014-2025) were included. Objective anterior stability (KT-1000) showed no significant difference between QT and HT at 12 or 24 months and no significant difference between QT and BPTB at 12 months. Patient-reported outcomes (International Knee Documentation Committee, Lysholm, Knee Injury and Osteoarthritis Outcome Score [KOOS], Tegner) were largely equivalent at 12-24 months. After resolving inconsistencies due to non-exchangeable constructs/comparators, a small 12-month KOOS signal favoured QT, while 24-month effects remained null. Graft failure rates were comparable for QT versus HT and QT versus BPTB. Donor-site morbidity was substantially lower with QT versus BPTB; QT versus HT showed no significant difference. Pivot-shift favoured QT, but not significantly; postoperative stiffness did not differ. Overall certainty was mostly moderate (downgrades for imprecision and occasional indirectness); donor-site morbidity versus BPTB reached high certainty.

CONCLUSION: Across randomized evidence up to 24 months, QT provides stability and patient-reported outcomes comparable to HT and BPTB, with clearly lower donor-site morbidity compared to BPTB and no excess failure compared to HT. QT is an evidence-supported alternative for primary ACLR; longer, adequately powered, construct-specific RCTs are needed for guideline-level certainty.

LEVEL OF EVIDENCE: Level I, systematic review of Level I randomized controlled studies.

PMID:42340609 | DOI:10.1002/ksa.70499

Infect Dis Ther. 2026 Jun 24. doi: 10.1007/s40121-026-01395-4. Online ahead of print.

ABSTRACT

INTRODUCTION: The 2025-2026 COVID-19 vaccine season introduced updated formulations targeting the LP.8.1 lineage. This interim analysis assessed absolute vaccine effectiveness (aVE) of mRNA-1283 and BNT162b2 on COVID-19 outcomes in adults aged ≥ 65 years.

METHODS: This retrospective study used linked electronic health record and administrative claims data through January 31, 2026. Adults ≥ 65 years who received the mRNA-1283 or BNT162b2 2025-2026 COVID-19 vaccine were matched to unvaccinated individuals. Inverse probability of treatment weighting was applied to each vaccine’s matched cohorts to balance covariates. Each vaccine was evaluated independently against its own unvaccinated comparator group. aVE against COVID-19-related hospitalization and medically attended COVID-19 was estimated using Cox proportional hazards models; aVE = 100 × (1 – hazard ratio).

RESULTS: We identified 233,072 mRNA-1283 recipients and 422,610 BNT162b2 recipients ≥ 65 years. aVE (95% confidence interval [CI]) of mRNA-1283 against COVID-19-related hospitalization and medically attended COVID-19 was 59.3% (39.0%, 72.9%) and 42.0% (35.0%, 48.3%) among adults ≥ 65 years and 66.9% (45.9%, 79.8%) and 50.2% (42.1%, 57.2%) in ≥ 75 years, respectively. The aVE (95% CI) of BNT162b2 against COVID-19-related hospitalization and medically attended COVID-19 was 48.3% (32.4%, 60.5%) and 41.2% (36.2%, 45.8%) in ≥ 65 years and 45.9% (26.0%, 60.4%) and 44.0% (37.8%, 49.6%) in ≥ 75 years, respectively.

CONCLUSION: This study provides the first real-world evidence that mRNA-1283 was associated with protection against COVID-19-related hospitalization and medically attended COVID-19 among vulnerable older adults at highest risk of severe disease. These findings support mRNA-1283 as an important public health tool for reducing the continual burden of COVID-19 in this population.

PMID:42340584 | DOI:10.1007/s40121-026-01395-4

Head Neck Pathol. 2026 Jun 24;20(1):72. doi: 10.1007/s12105-026-01938-8.

ABSTRACT

PURPOSE: The aim of this study was to evaluate the immunohistochemical expression of CK13 and specific mutations in KRT13 and APC genes in cases of calcifying odontogenic cyst (COC), dentinogenic ghost cell tumor (DGCT), adenoid ameloblastoma (AA), and conventional ameloblastoma (CA).

MATERIALS AND METHODS: Twenty-nine cases (22 COC, 2 DGCT, 1 AA, and 4 CA) were collected from two diagnostic centers. Immunohistochemical analysis of CK13 expression and polymerase chain reaction (PCR)-based molecular investigation of specific mutations (APC E1080* and KRT13 M239V and Y281H) were performed.

RESULTS: CK13 expression in COC was observed in the suprabasal/superficial layers of the cystic epithelium in 14 cases-64%; ghost cells showed positivity in 12 cases-54%. DGCT cases were negative in the epithelial proliferation but positive in ghost cells. The AA case was negative. Three CA cases demonstrated positivity in suprabasal/central cells. None of the cases harbored the investigated mutations. However, the intronic polymorphism KRT13 c.735 + 10A > G (dbSNP rs7211235) was identified in 16 COC cases, one DGCT case, one AA case, and one CA case, whereas KRT13 c.735 + 6C > T (dbSNP rs181122697) was detected in one COC case. Additionally, one case harbored a previously unreported silent/synonymous mutation, KRT13 c.690G > A (p.E230E), of unknown significance.

CONCLUSIONS: CK13 expression in COC and CA suggests squamous differentiation of odontogenic epithelium. The detected KRT13 genetic variations are probably not associated with tumorigenic mechanisms in COC, DGCT, AA, and CA. The APC E1080* mutation was not identified in any of the entities included in the present study. Further studies are therefore required to more precisely define the genetic profile of these entities and, particularly, to clarify the potential biological relationship between dentinogenic ghost cell tumor and adenoid ameloblastoma.

PMID:42340570 | DOI:10.1007/s12105-026-01938-8

JMIR Med Inform. 2026 Jun 22. doi: 10.2196/82855. Online ahead of print.

ABSTRACT

BACKGROUND: The growing need for and interest in geomatics in the medical sector, as well as the pandemic crisis, led us to create a France-wide geomatics project aimed at producing several atlases of all-cause mortality at the municipal and submunicipal district levels via uMap France, a free and open-source collaborative map-sharing platform. In 2020, we decided to circumvent the obstacle of accessing detailed COVID-19 data by adopting a mortality-based approach to map the consequences of the crisis.

OBJECTIVE: The aim of the uMap study was to provide a webmapping platform with original visualization and knowledge, as well as decision-making aids that complement existing information and are relevant to public and healthcare professionals. Our main hypotheses are as follows: 1- the medical sector could develop a private uMap platform dedicated to health; 2- interest in a municipal mortality atlas for France linked to the pandemic crisis will increase, even if it is produced after the pandemic; and 3- sharing the atlases with the uMap community will enhance their appeal and inspire the creation of similar atlases, owing to the new “experimental choropleth layer” recently developed by the uMap team.

METHODS: This approach focuses on three main parts-data management (data collection, cleansing and scheduling) and geomatic engineering-through a two-step geomatic action plan to create atlases of the first lockdown period in France, displayed on the uMap platform. A logarithmically transformed variable allows us to obtain an immediate statistical signal of excess mortality or submortality via the Traffic-Light Atlas.

RESULTS: The uMap Traffic-Light display provides instant statistical signals at a glance owing to the semantic interplay of colors. The atlas’s double legends make it easy to compare specific regions (northeast, northwest, southeast, and southwest) to all of France. The atlas revealed excess mortality in 42% of the municipalities (14,503) out of 34,833. Thirty-five percent are in the green class (close to average to twice the average), 5% are in the orange class (2-4 times the average), and 2% are in the red class (4-11 times higher than average).

CONCLUSIONS: We innovated, enriched, and reinforced the value of uMap for visual rendering by instantiating colored choropleth map atlases and double legends and showed its relevance to the healthcare sector. We focused on the Traffic-Light Atlas, which is the most relevant because of the instant message it conveys and its interpretability for all audiences. The uMap community can share our all-cause mortality atlases. A second version of the atlas encompassing four periods in 2020 and containing a minor error will be updated using either the “experimental choropleth layer” feature recently developed by the uMap team or, if this feature proves insufficient, the geomatic optimization process via the R-project.

CLINICALTRIAL: Not applicable.

PMID:42339616 | DOI:10.2196/82855

Cardiol Young. 2026 Jun 24:1-8. doi: 10.1017/S104795112611227X. Online ahead of print.

ABSTRACT

BACKGROUND: There has been a growing clinical application of ketamine for procedural sedation. This study aimed to determine its hemodynamic effects when utilized in patients in the pediatric cardiac intensive care unit.

METHODS: In this single-center, retrospective study, patients who were admitted to the pediatric cardiac intensive care unit and received a single dose of intravenous ketamine were studied. Patients were monitored utilizing high-fidelity physiologic data. Variables of interest for the study included: heart rate, arterial saturation, respiratory rate, mean arterial blood pressure, central venous pressure, and renal near infrared spectroscopy These variables of interest were obtained 30 min prior to the administration of ketamine, through 30 min after, serving as the comparison arm. Secondary aims included unexpected apnea, need for a fluid bolus, vasoactive bolus, or cardiopulmonary resuscitation.

RESULTS: A total of 45 administrations of intravenous ketamine were included. Average dose was 0.8 mg/kg per dose. Average age was 8.1 months. After administration of ketamine, there was a statistically significant increase in heart rate, arterial saturation, renal near infrared spectroscopy and central venous pressure and a statistically significant decrease in respiratory rate and mean arterial blood pressure. No cardiopulmonary resuscitation or bolus vasoactive was required after ketamine administration.

CONCLUSION: Intravenous ketamine dosed from 0.5 mg/kg to 1 mg/kg per dose in the pediatric cardiac intensive care unit appears safe and is associated with minimal hemodynamic change, apnea, or hemodynamic collapse. This represents the first data related to a single dose of ketamine’s effect captured with a 1-s temporal resolution.

PMID:42339600 | DOI:10.1017/S104795112611227X

Phys Occup Ther Pediatr. 2026 Jun 24:1-24. doi: 10.1080/01942638.2026.2691064. Online ahead of print.

ABSTRACT

AIM: To examine the effects of Action Observation Therapy (AOT) and Mirror Therapy (MT) on occupational performance, occupational satisfaction, goal-oriented activities, bilateral hand skills, and upper extremity functions in children with unilateral cerebral palsy (CP).

METHOD: This randomized controlled trial included 24 children with unilateral CP (12 AOT, 12 MT) aged 6-12 years. Both groups received 18 sessions over 6 wk (3 days/week), consisting of 30 min of Bilateral Activity Training (BAT) combined with 30 min of AOT or MT. Outcomes were assessed using the Canadian Occupational Performance Measure, Goal Attainment Scale, Shriners Hospital Upper Extremity Evaluation, and ABILHAND questionnaire at baseline, post-intervention, and 1-month follow-up.

RESULTS: Both groups showed significant improvements in occupational performance, satisfaction, goal attainment, bilateral hand skills, and upper extremity function after treatment (all p < 0.001) and at follow-up (AOT: p = 0.02-0.09; MT: p = 0.02-0.05). Although some variation in effect size estimates was observed across outcomes, between-group differences were not statistically significant (all p > 0.05).

INTERPRETATION: AOT and MT, when combined with BAT, appear to be effective complementary interventions for improving upper extremity-related outcomes in children with unilateral CP.

TRIAL REGISTRATION: This study was registered as a Clinical Trial Number with the code NCT05951829.

PMID:42339598 | DOI:10.1080/01942638.2026.2691064

Int Endod J. 2026 Jun 24. doi: 10.1111/iej.70198. Online ahead of print.

ABSTRACT

BACKGROUND: Dental pulp inflammation triggers immune responses involving macrophages and dental pulp stem cells (DPSCs), which interact to regulate angiogenesis essential for tissue repair. M1 pro-inflammatory macrophages predominate early in pulpitis, and clarifying their angiogenic role is vital in identifying inflammatory regenerative mechanisms.

METHODOLOGY: THP-1 cells and peripheral blood monocyte (PBM)-derived macrophages were polarized to M1 or M2 phenotypes, characterized by qRT-PCR, ELISA, and angiogenesis arrays. A vasculature-on-a-chip comprising DPSCs, human umbilical vein endothelial cells (HUVECs) and THP-1-derived macrophages was imaged, and the vascular segments/sprouts were quantified using ImageJ. Density effects used 5 × 10⁴ versus 7.5 × 10⁴ M1 macrophages/device, with propidium iodide staining for cytotoxicity. IL-8 effects on DPSC VEGF secretion were assessed by ELISA (with/without Reparaxin 1 μM), Matrigel tube formation assays, and exogenous IL-8 (0.5 ng/mL). Transwell co-cultures underwent RNA sequencing and bioinformatics analysis, which identified candidate hub genes and signalling pathways; the results were validated by Western blotting (p-ERK, HIF-1α; ERK inhibitor SCH772984, 25 nM). Statistical testing was performed using ANOVA with Tukey’s post hoc test (p < 0.05).

RESULTS: M1 macrophages at low density (5 × 10⁴ cells/device) significantly enhanced vascularization in the vasculature-on-a-chip, increasing vascular segments (p < 0.0001) and free sprouts (p < 0.05-0.01) compared to M0 or no-macrophage controls, with effects comparable to M2. High-density M1 seeding (7.5 × 10⁴ cells/device) reduced sprouts (p < 0.0001 day 4, p < 0.01 day 5) due to increased cytotoxicity (p < 0.0001). Both THP-1- and PBM-derived M1-conditioned media (CM) showed significantly elevated IL-8 levels. M1 CM (THP-1/PBM) induced DPSC VEGF secretion, blocked by Reparaxin (p < 0.01-0.0001), confirming IL-8 mediation via CXCR1/2. Exogenous IL-8 (0.5 ng/mL) upregulated DPSC VEGF protein/mRNA (p < 0.05) and Matrigel tube formation (segments/junctions p < 0.05). M1-DPSC CM enhanced vascular meshes/segments on Matrigel (p < 0.05), reduced by Reparaxin. RNA-seq of M1 co-cultured DPSCs identified 17 angiogenic genes (logFC > 1.2), with HIF-1α as a hub gene and an enriched MAPK/ERK pathway. Western blot analysis confirmed MAPK/ERK-HIF-1α as a contributory pathway in IL-8-induced upregulation of VEGF in DPSCs.

CONCLUSION: M1 macrophages promote angiogenesis via IL-8-induced DPSC VEGF secretion through CXCR1/2-MAPK/ERK-HIF-1α signalling density-dependently, suggesting that therapeutic modulation rather than total suppression of M1 activity could improve outcomes in vital pulp therapy.

PMID:42339579 | DOI:10.1111/iej.70198

Laryngoscope. 2026 Jun 24. doi: 10.1002/lary.70706. Online ahead of print.

ABSTRACT

OBJECTIVES: Petroclival and temporal bone meningiomas are rare neoplasms that mimic vestibular schwannomas in presentation. However, surgical approaches for their resection are often more complex, largely due to the necessity of resecting pathologic dura. Although several classification and staging systems for petroclival meningiomas have been proposed, they are rarely cited and none are reliably correlated with surgical outcomes. We present a descriptive framework and hypothesize that it is predictive of surgical outcomes.

METHODS: Medical records of patients seen at a tertiary referral center with a diagnosis of petroclival meningioma were reviewed. Patients were stratified into four tiers: tier 1, meningioma confined to internal auditory canal (IAC) only; tier 2, meningioma confined to cerebellopontine angle (CPA) only; tier 3, meningioma involving CPA and IAC; and tier 4, meningioma involving cavernous sinus, internal carotid artery or jugular bulb, or crossing midline. Tier 4 was subdivided into 4A (no carotid involvement) and 4B (carotid involvement). Outcomes of observation, radiation, and surgery were analyzed.

RESULTS: Of 64 qualified patients, tier 2 was most commonly encountered (41%); the remainder of patients were classified as tier 1, 3, and 4 (3%, 33%, 23%). Among patients indicated for resection, combined petrosal approach was utilized in 64% of cases. Simpson grade of resection, complication rate, and rate of residual/recurrent tumor were statistically significantly associated with tumor tier. Tier and postoperative House-Brackmann score showed no significant correlation.

CONCLUSION: The proposed framework demonstrates the potential clinical utility of an outcome-predictive staging system, helping to guide surgeon and patient expectations.

PMID:42339571 | DOI:10.1002/lary.70706

Int J Gynaecol Obstet. 2026 Jun 24. doi: 10.1002/ijgo.71189. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the association between gender-based violence (GBV) assessed in early pregnancy and adverse perinatal outcomes using relative and absolute effect measures in an urban low- and middle-income setting.

METHODS: We conducted a prospective cohort study including 3890 singleton pregnancies recruited from two public healthcare institutions in Mexico City between October 2020 and April 2023. GBV was assessed at first-trimester enrollment using a standardized screening procedure and analyzed as any reported violence versus none. The primary outcome was a composite of low birth weight, fetal growth restriction, or perinatal mortality. Associations were estimated using Poisson regression with robust variance to obtain adjusted risk ratios and risk differences. Secondary analyses examined fetal growth restriction, stillbirth, and neonatal mortality.

RESULTS: GBV was reported by 162 (4.16%) participants. After adjustment for sociodemographic factors, GBV was associated with higher risk of the composite adverse perinatal outcome (adjusted risk ratio [aRR] 1.23, 95% [confidence interval] CI: 1.06-1.44). The adjusted absolute risk difference was +0.099 (95% CI: 0.020-0.177), corresponding to approximately 99 additional adverse outcomes per 1000 births among women reporting GBV. GBV was not significantly associated with isolated fetal growth restriction but was associated with increased odds of stillbirth; no statistically significant association was observed with neonatal mortality.

CONCLUSION: In this urban cohort, GBV reported at first-trimester screening was associated with a clinically meaningful increase in adverse perinatal outcomes, largely driven by stillbirth.

PMID:42339561 | DOI:10.1002/ijgo.71189