Nevin Manimala

Brain Imaging Behav. 2026 Jul 23;20(4):112. doi: 10.1007/s11682-026-01181-3.

ABSTRACT

Growth-associated protein 43 (GAP-43), a synaptic protein involved in neuronal plasticity, has emerged as a potential biomarker for Alzheimer’s disease (AD) and mild cognitive impairment (MCI), with elevated levels linked to synaptic dysfunction. This dysfunction, in turn, has been associated with reduced cerebral glucose metabolism, which further exacerbates cognitive decline and accelerates disease progression. However, the link between CSF GAP-43 and cerebral glucose metabolism, measured by FDG-PET, remains less understood. This study aimed to investigate the relationship between CSF GAP-43 levels, cerebral glucose metabolism, and cognitive performance across different stages of cognitive impairment, specifically in individuals with AD (n = 83), MCI (n = 370), and cognitively normal (CN; n = 215). Cognitive function was assessed using the ADAS-Cog 13 scale, CSF GAP-43 levels were measured via ELISA, and cerebral glucose metabolism was analyzed with FDG-PET. The results showed that CSF GAP-43 levels were significantly elevated in the AD group compared to the CN and MCI groups (p < 0.001). In the MCI group, there was a modest but statistically significant negative association between CSF GAP-43 levels and cerebral glucose metabolism (β = -0.126, FDR p = 0.003), whereas this association was not significant in the CN (β = -0.031, FDR p = 0.612) or AD groups (β = 0.157, FDR p = 0.584). Mediation analysis, adjusted for age, sex, education, and APOE ε4 carrier status, showed that FDG-PET cerebral glucose metabolism partly and statistically mediated the association between CSF GAP-43 and cognitive performance only in the MCI group (β = 0.047, FDR-adjusted p = 0.009). These findings indicate that higher CSF GAP-43 was associated with lower cerebral glucose metabolism, which in turn was associated with worse cognitive performance in MCI. However, because of limitations, cross-sectional design, and modest magnitude of the effects, these results should be interpreted as statistical associations rather than evidence that CSF GAP-43 impairs glucose metabolism or cognition.

PMID:42489996 | DOI:10.1007/s11682-026-01181-3

Environ Sci Pollut Res Int. 2026 Jul 23. doi: 10.1007/s11356-026-37999-z. Online ahead of print.

ABSTRACT

The manufacturing process of normal concrete is highly responsible for producing carbon dioxide, resulting in a larger carbon footprint, thus leading to the need for alternative materials to be used in the construction industry. The current research focuses on analyzing the impact and effect of the addition of fly ash (FA) and rice husk ash (RHA) as partial substitution of ordinary Portland cement (OPC) in high-performance self-compacting concrete (SCC). The study evaluates the fresh properties (slump flow, L-box, and V-funnel), mechanical properties (compressive, split tensile, and flexural strength), and durability properties (water absorption, acid, sulfate, and saline water resistance). A Response Surface Methodology (RSM) based Box-Behnken design was employed to analyze the influence of OPC, FA, and RHA proportions and to optimize mix performance. According to the findings, the most efficient ternary combination (OPC 75%, FA 15%, and RHA 10%) obtained better performance with compressive strength of 52.6 MPa, split tensile strength of 4.7 MPa, and flexural strength of 6.1 MPa at 90 days. Additionally, from Life Cycle Assessment (LCA), there was a decrease in carbon dioxide emissions by 119.25 kg/m³, as well as reductions in energy, water use in comparison to control mix of SCC. The use of ternary blend with the optimized combination resulted in a cost reduction of 9.3%compared to the control mix. These results indicate the substantial possibilities of FA-RHA composite SCC in promoting sustainability and sustainable development, thus providing a solution to support circular economy approaches and minimize environmental impacts in contemporary construction projects.

PMID:42489975 | DOI:10.1007/s11356-026-37999-z

J Thromb Thrombolysis. 2026 Jul 23. doi: 10.1007/s11239-026-03361-w. Online ahead of print.

ABSTRACT

Severe sepsis-associated thrombocytopenia creates a difficult clinical trade-off between thrombosis prevention and bleeding risk, yet evidence to guide pharmacological prophylaxis when platelet counts are 30,000-50,000/µL remains limited. We conducted a target trial emulation using the MIMIC-IV database, classifying eligible adults with sepsis upon first intensive care unit admission based on whether a predominantly unfractionated heparin (UFH)-based prophylaxis strategy was administered within a 24-hour grace period after platelet counts initially entered this range. Among 938 eligible patients (189 prophylaxis strategy, 749 control strategy), venous thromboembolism (VTE) occurred in 14 and 86 patients, respectively. In the inverse probability-weighted Cox analysis, early administration of this UFH-based prophylaxis was associated with a lower 28-day VTE hazard (adjusted hazard ratio 0.51, 95% confidence interval 0.28-0.92; P = 0.025), though this association was attenuated in certain prespecified sensitivity analyses. Electronic health record-derived major bleeding occurred in 22 and 95 patients, respectively, and no statistically higher hazard was observed under the prophylactic strategy (adjusted hazard ratio 0.74, 95% confidence interval 0.46-1.20; P = 0.220). These findings suggest that early administration of a predominantly UFH-based prophylactic strategy may be associated with a lower VTE risk, without a statistically higher hazard of the electronic health record-derived major bleeding endpoint. Given the observational design, this efficacy signal remains hypothesis-generating rather than definitive and warrants prospective validation.

PMID:42489962 | DOI:10.1007/s11239-026-03361-w

Brain Topogr. 2026 Jul 23;39(5):83. doi: 10.1007/s10548-026-01237-z.

ABSTRACT

Understanding how the brains structural architecture supports task-evoked functional activity is a fundamental goal of neuroscience. However, most predictive models rely on single-scale structural features, overlooking the brains intrinsically hierarchical organization. Here, we introduce the Collaborative Graph Attention Multi-Task Network (CoGA-MTN), a deep learning framework that integrates multi-scale structural features to jointly predict task-based functional connectivity (FC) and identify potential disease-related network alterations. CoGA-MTN employs a dual-branch graph attention network to extract complementary global statistical and local topological features from structural MRI, and a cross-modal task-coordinated learning mechanism that enables task-conditioned FC prediction alongside multi-disease classification. Validated on the Consortium for Neuropsychiatric Phenomics dataset (152 participants, three tasks, four diagnostic groups), CoGA-MTN outperforms single-scale baselines in task-conditioned FC prediction (PCC = 0.657 ± 0.02) and achieves macro F1 scores of 0.68-0.75 across three psychiatric disorders. Crucially, the model reconstructs a stable whole-brain connectivity architecture that is conserved across tasks, while simultaneously revealing diagnosis-related discrepancies that are consistent with established pathophysiological models. By modeling psychiatric conditions within a normative structure-function framework, this work provides a unified approach for characterizing the relationships between multi-scale brain structure, dynamic function, and psychopathology.

PMID:42489954 | DOI:10.1007/s10548-026-01237-z

Environ Monit Assess. 2026 Jul 23;198(8):867. doi: 10.1007/s10661-026-15716-0.

ABSTRACT

In the Delhi National Capital Region (NCR), post-monsoon or winter air pollution is a significant environmental stressor on nearby agricultural systems. The current study analyzed the possible effects of particulate matter (PM) and ozone (O₃) pollution on wheat and mustard yield losses during October-February coinciding with the post-monsoon cropping season, as well as the spatial characteristics of these pollutants throughout the agricultural airshed centered around Delhi. Pollution exceedance frequency, severe pollution episode analysis, PM_2.5/PM₁₀ ratios, O₃ exposure indices, spatial gradient analysis, principal component analysis (PCA) and cluster analysis, and crop stress risk assessment were used to analyze daily PM_2.5, PM₁₀, O₃, and NO₂ data (2022-2025) from Central Pollution Control Board monitoring stations situated within about 150 km of Delhi. The findings showed severe winter particulate pollution throughout the entire airshed, with frequent occurrences of severe PM_2.5 pollution at stations affected by transportation and peri-urban areas. Particulate pollution was found to be the primary cause of regional atmospheric variability using PCA and cluster analyses. The values of the Crop Stress Index (CSI) varied from 54.35 in Palwal to 122.89 in Bahadurgarh for winter crops of this airshed. Potential yield-loss risks for rabi wheat in Bahadurgarh, Rohat and Sonipat could be up to 15, 14.25 and 11.4% while that of mustard could be potentially reduced by 12, 11.4 and 10.54%, respectively. Overall, the study shows that wintertime air pollution in the Delhi NCR area is a regional-scale agro-environmental stressor that may have an impact on the growth, physiology, and productivity of wheat and mustard throughout the Delhi’s agricultural airshed.

PMID:42489950 | DOI:10.1007/s10661-026-15716-0

Clin Oral Investig. 2026 Jul 23;30(8):355. doi: 10.1007/s00784-026-07040-1.

ABSTRACT

OBJECTIVES: The NLRP3 inflammasome amplifies inflammation and may contribute to the destruction of tooth-supporting tissues in periodontitis. This study evaluated the expression of inflammasome markers (NLRP3, AIM2, IL-1β, TNF-α, CASP1, IL-10, TLR2, and TLR4) and the epigenetic patterns of NLRP3 and IL-1β in primary gingival fibroblasts from healthy individuals and patients with Grade C periodontitis (PerioC).

MATERIALS AND METHODS: Cells were exposed to Aggregatibacter actinomycetemcomitans Protein Extract (AaPE) (5 µg/ml) for 1.5 h. After the experimental period, total RNA and DNA were collected and extracted. Total RNA was isolated and gene expressions of TLR2, TLR4, NLRP3, CASP1, AIM2, IL-10, IL-1β and TNF-α were analyzed via qPCR. DNA methylation and hydroxymethylation patterns of the IL-1β and NLRP3 genes were evaluated. Statistical analyses were performed considering a significance level of 5%.

RESULTS: Fibroblasts from PerioC exhibited higher AIM2 levels before and after stimulation compared to healthy individuals (p < 0.05). Conversely, IL-10 expression was lower in PerioC before AaPE incubation (p < 0.05). NLRP3 expression increased post-stimulation in healthy cells but remained unchanged in PerioC. IL-1β expression was consistently lower in PerioC in both conditions. The NLRP3 gene showed reduced methylation after AaPE exposure only in healthy fibroblasts, resulting in lower methylation levels compared to PerioC (p < 0.05).

CONCLUSIONS: PerioC fibroblasts exhibited dysregulated inflammasome-related gene expression and a distinct epigenetic response to AaPE, suggesting altered local immune regulation at the transcriptional level.

CLINICAL RELEVANCE: Patients with severe and rapidly progressing periodontitis exhibit an altered inflammasome-related gene expression and epigenetic response to bacterial stimulation. The reduced transcriptional responsiveness of inflammatory mediators and distinct DNA methylation profile observed in PerioC cells may contribute to ineffective host defense and persistent periodontal tissue destruction.

PMID:42489943 | DOI:10.1007/s00784-026-07040-1

J Dev Orig Health Dis. 2026 Jul 23;17:e34. doi: 10.1017/S2040174426100658.

ABSTRACT

Public understanding of the Developmental Origins of Health and Disease (DOHaD) remains limited, hindering efforts to shift health behaviours and policy. Arts-based knowledge translation (ABKT) offers a promising approach to engage the public with complex health science. We evaluated the feasibility, acceptability, and impact of a multi-site exhibition co-developed by scientists, artists, and community members to convey DOHaD concepts. The Art of Creation Exhibition, shown in a mid-sized Canadian city in gallery and community settings, featured professional and community-created artworks and interactive activities. Using a parallel convergent mixed methods design, we collected and analysed observational notes, written reflections, analytics from QR codes linked to information about the artworks and DOHaD, and structured activity responses. Quantitative data were analysed using Firth-penalised logistic regression and descriptive statistics. Qualitative data underwent conventional content analysis. Findings were integrated narratively. The Exhibition was successfully installed at all sites, although space and security constraints in community settings required adaptation. 93% of observed individuals at the gallery site engaged with the exhibition, compared to 3%-17% at community sites. Gallery visitors engaged with more artworks for longer. Viewing over half of the artworks was associated with higher odds of endorsing Social Determinants of Health (SDoH) (OR = 6.63, 95% CI [1.22, 68.34]). Written and verbal feedback demonstrated increased awareness, emotional engagement, and interest in further learning. Despite some misinterpretation and low fidelity of interactive activities, the Exhibition was well received and evoked critical reflection. Using ABKT for DOHaD can enhance health literacy, foster dialogue about the SDoH, and support equitable health communication.

PMID:42489013 | DOI:10.1017/S2040174426100658

J Med Internet Res. 2026 Jul 22;28:e90289. doi: 10.2196/90289.

ABSTRACT

BACKGROUND: Chronic low back pain (CLBP) is a major global health challenge. While nonpharmacological therapies are recommended, patient compliance is often hindered by kinesiophobia. Virtual reality (VR) offers an immersive, distraction-based approach, but the comparative effectiveness of different VR modalities remains unclear.

OBJECTIVE: The aim of the study is to compare and rank the efficacy of different VR-based training modalities on pain intensity, disability, and kinesiophobia in patients with CLBP.

METHODS: Systematic searches were conducted in PubMed, Web of Science, Scopus, Embase, CINAHL, and the Cochrane Library from inception until June 2025. Randomized controlled trials (RCTs) assessing the effects of VR-based training on individuals with CLBP were selected. Primary outcomes were pain intensity, disability (Oswestry Disability Index), and kinesiophobia (Tampa Scale of Kinesiophobia). The Cochrane Risk of Bias 2 tool was used for quality assessment. Confidence in Network Meta-Analysis (CINeMA) framework was used to evaluate the credibility of cumulative evidence. A Bayesian network meta-analysis with standardized mean difference (SMD) as effect size was performed to synthesize evidence and rank interventions using surface under the cumulative ranking curve values. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework was adapted to evaluate the quality of evidence.

RESULTS: In total, 25 RCTs with a total of 2610 participants were included in the analysis. For pain intensity, shooting games (SMD -4.40, 95% credible interval [CrI] -6.80 to -2.20) and VR-based equestrian training (SMD -2.00, 95% CrI -3.70 to -0.57) were significantly superior to all types of controls. Surface under the cumulative ranking curve indicated that shooting games had the highest probability (98%) of being the most effective intervention for pain relief. For disability, no intervention demonstrated statistically significant superiority. For kinesiophobia, shooting games (SMD -3.40, 95% CrI -5.60 to -1.10) significantly outperformed traditional exercise controls. The quality of evidence ranged from very low to moderate across outcomes.

CONCLUSIONS: This first network meta-analysis to compare and rank distinct VR modalities for CLBP offers several key innovations and contributions to the field. By moving beyond aggregate VR categorizations, we provide a granular, comparative ranking of specific, actionable VR interventions. Unlike previous reviews that treated VR as a homogeneous group or only compared it to sham, our network meta-analysis directly and indirectly compares 7 distinct VR modalities, revealing that not all VR is equally effective. Our findings suggest that shooting games have the potential to be the most effective VR therapy for relieving pain intensity and kinesiophobia, though evidence for disability remains limited. Unfortunately, due to heterogeneity and low-quality evidence, there is no evidence demonstrating significant improvement in specific outcomes for patients with CLBP. More RCTs are needed to provide robust clinical evidence.

PMID:42489003 | DOI:10.2196/90289

Med J Aust. 2026 Jul;224(7):e70236. doi: 10.5694/mja2.70236.

ABSTRACT

Indigenous children are seen as an intrinsic, systematic foundation of hope in Aboriginal conceptualisations of hope, yet are grossly overrepresented in Australian suicide statistics. Despite being a target of the Australian Government’s almost 20-year-long Closing the Gap campaign, the numbers are only getting worse. ‘It’s not depression, it’s despair’ are words that echo a sentiment so ghastly for parents of Indigenous children who only hope to bestow them with the gift of exactly that: hope. It is only sensible to counteract this with holistic, culturally empowered, strengths-based well-being programs to both develop Cultural strength while concurrently instilling a sense of Cultural pride and identity.

PMID:42488985 | DOI:10.5694/mja2.70236

JMIR Res Protoc. 2026 Jul 22;15:e92825. doi: 10.2196/92825.

ABSTRACT

BACKGROUND: Cardiovascular disease remains the leading global cause of mortality, driven by interrelated behavioral, biological, and psychosocial risk factors, despite the availability of effective prevention and treatment strategies. Persistent policy inertia, systemic fragmentation, and adverse social and commercial determinants have limited national responses. Addressing these gaps necessitates place-based, systems-oriented approaches that mobilize local assets, engage multisector stakeholders, and incorporate adaptive evaluation. The Springfield Healthy Hearts initiative exemplifies such an approach by positioning Greater Springfield as a “living laboratory” for coordinated cardiovascular health action through a comprehensive data framework, providing a replicable model for other communities.

OBJECTIVE: This protocol outlines the Springfield Healthy Hearts Data Framework, a multicomponent system for dynamically guiding, implementing, and evaluating coordinated action for heart health.

METHODS: The data framework was developed through a structured co-design process involving community members, expert researchers, health professionals, and representatives from local implementation partners. The framework comprises four integrated components: (1) Project evaluation, applying pragmatic frameworks to assess coordinated action projects; (2) Community evaluation, a repeated cross-sectional evaluation of Springfield residents, workers, and regular visitors to capture individual-level behavioral, biological, and psychosocial cardiovascular disease risk factors, as well as engagement with coordinated action projects; (3) City evaluation, ongoing monitoring of suburb- and city-level indicators across 4 domains (sociodemographic characteristics, built environment, food and commercial environment, and health services); and (4) Data synthesis, to utilize data across all levels to inform a continuous learning system. Project evaluations will use both quantitative and qualitative methods, including realist evaluation where appropriate. Community evaluation will be analyzed using descriptive statistics, mixed effects models, and subgroup analyses, with missing data addressed via multiple imputation. City-level data will be analyzed descriptively and dynamically to detect temporal trends and contextual changes.

RESULTS: Initial funding for the Springfield Healthy Hearts Data Framework was secured in June 2025. Co-design workshops were conducted between November 2025 and February 2026 (n=15 participants), informing the design and prioritization of framework components. Community evaluation data collection is scheduled to commence in September 2026 and conclude in August 2027. Data cleaning and preliminary analyses are anticipated in late 2027, with first results expected to be disseminated in early 2028.

CONCLUSIONS: The Springfield Healthy Hearts Data Framework is a replicable model for other communities aiming to implement city-wide, coordinated approaches to heart health action. Findings will be disseminated through peer-reviewed publications, community reports, interactive dashboards, and policy briefs.

PMID:42488978 | DOI:10.2196/92825